European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Review Case Reports
Atypical teratoid rhabdoid tumour of the spine: report of a case and literature review.
Atypical teratoid rhabdoid tumour (ATRT) is a rare and highly aggressive malignant neoplasm of the central nervous system (CNS), which occurs predominantly in children less than 2 years of age. There are less than 50 cases described in adult. We report a case of primary spinal ATRT in a 65-year-old male who presented to us with cauda equina syndrome. To the best of our knowledge, our patient is the (1) second oldest patient to be diagnosed with ATRT and only the third case of adult spinal ATRT report in the literature; (2) first reported case of CNS ATRT occurring in a patient with non-rhabdoid renal cancer; (3) first adult patient of ATRT to present with cauda equina syndrome.
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Literature studies showed a very wide range of pedicle screw loosening rates after thoracolumbar stabilization, ranging from less than 1 to 15 % in non-osteoporotic patients treated with rigid systems and even higher in osteoporotic subjects or patients treated with dynamic systems. Firstly, this paper aims to investigate how much this complication is affecting the success rate of pedicle screw fixation, in both non-osteoporotic and osteoporotic patients, and to discuss the biomechanical reasons which may be related to the variability of the rates found in the literature. The secondary aim was to summarize and discuss the published definitions and conventions about screw loosening from a clinical and radiological point of view. ⋯ Reported loosening rates primarily depended on the protocol used for the clinical examination during follow-up and on the conventions used for the radiological assessment. Aiming to a better comparability of published data, we recommend the authors of clinical studies to describe which criteria were used to assess a loosened screw, as well as the protocol of the clinical follow-up examination. Low-dose CT should be used for the assessment of screw loosening whenever possible.
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Review Case Reports
Idiopathic hypertrophic spinal pachymeningitis: a case report and review of literature.
To report an unusual case of idiopathic hypertrophic spinal pachymeningitis (IHSP) with a review of relevant literature and to discuss the etiology, clinical features, imaging, treatment and prognosis of IHSP. ⋯ IHSP is a rare disease characterized by inflammatory hypertrophy of the dura mater without identifiable cause and featured clinical progress of radiculalgia to myelopathy. It is a diagnosis of exclusion. In our view, surgical decompression with postoperative steroid therapy may be optimal. Furthermore,we speculated that increased levels of protein and cell count in cerebrospinal fluid (CSF) might be positively related to the disease progression. High inflammatory signs or CSF protein and cell levels before surgery or postoperative residual lesions are possible reasons of poor prognosis in patients with IHSP.
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Systematic review. ⋯ The grading system based on 2 mm increments seems to be the most widely accepted method for determining pedicle screw placement accuracy. All grading systems were based on imaging alone without taking into account the direction of the breach or patient's symptoms.
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Review Case Reports
Solitary sacral osteochondroma without neurological symptoms: a case report and review of the literature.
To report a case of solitary sacral osteochondroma without neurological symptoms and describe the en bloc excision of the tumour, as well as review the literature on osteochondroma involving the sacrum. ⋯ This is the 9th case of solitary osteochondroma of the sacrum to be reported, the first to be reported without any neurological symptoms, and third case reported for which en bloc excision was performed.