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
Spinal Rosai-Dorfman disease: case report and literature review.
Sinus histiocytosis with massive lymphadenopathy or Rosai-Dorfman disease (RDD) is a rare benign disease of dubious etiology that arises predominantly in lymph nodes with generalized fever and malaise. Isolated intraspinal involvement has its unique characteristics. The purpose of this study is to present the largest series of cases in the spinal Rosai-Dorfman disease literature to increase familiarity with its clinicopathologic features, diagnosis, and treatment of RDD from spine. ⋯ RDD with spinal involvement is uncommon and it is challengeable in making a certain diagnosis. Histopathologic characteristics and immunohistochemical findings are considered as the key points for the diagnosis of this disease. The optimal treatment remains controversial, and more efforts should be focused on the investigation of etiology and adjuvant therapy for relapsing cases or subresected lesions.
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Review Case Reports
Aneurysmal bone cyst of the spine treated by concentrated bone marrow: clinical cases and review of the literature.
ABC is a benign lesion with unpredictable behavior. Its treatment is challenging, especially in poorly accessible surgical areas, such as spine and pelvis. Currently, the first-line treatment of ABC is repeated selective arterial embolization (SAE) until healing. Other options have been used with variable success rates. We propose an alternative treatment for spine aneurysmal bone cyst (sABC) based on the injection of concentrated autologous bone marrow. ⋯ Although SAE can still be considered the first line in the treatment of ABC in the axial skeleton, new promising therapeutic procedures involving the use of mesenchymal stem cells are developing.
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Deformities of the cervical spine are uncommon in the coronal plane. In this report, a unique case of a 31-year-old male with a fixed, 30° left coronal deformity due to heterotopic ossification 3 years status post poly-trauma was treated with an asymmetric C7 pedicle subtraction osteotomy (PSO). ⋯ In this one patient, an asymmetric C7 PSO was performed safely. While it was effective in addressing a fixed cervical coronal imbalance, its efficacy and safety profile should be confirmed in larger cohorts.
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Review Case Reports
Accidental or linked: separated odontoid process fused to the enlarged anterior arch of the atlas associated with atlantoaxial subluxation in a Kashin-Beck disease patient.
KBD is an endemic disease affecting the epiphyseal growth plate and articular cartilage of multiple joints, resulting in extremities' deformation and skeletal dysplasia. More attention has been paid to the visible deformed extremities instead of inconspicuous spinal condition. There is a lack of reports concerning the spinal radiological features, especially for the atlantoaxial joint. The aim of this paper is to report a case of a Kashin-Beck disease (KBD) patient diagnosed with atlantoaxial subluxation, concomitant with separated odontoid process fused to the enlarged anterior arch of the atlas. ⋯ The anomaly of atlantoaxial joint might occur in KBD patients. Larger numbers of KBD candidates with earlier symptoms are recommended for radiological examinations of atlantoaxial joint, especially for the adolescents. Spinal surgeons are suggested to involve the research of the spinal anatomy and variation for the prevention and earlier therapy for KBD patients.
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The objective of this study was to analyze the interobserver reliability and intraobserver reproducibility of the new AOSpine thoracolumbar spine injury classification system in young Chinese orthopedic surgeons with different levels of experience in spinal trauma. Previous reports suggest that the new AOSpine thoracolumbar spine injury classification system demonstrates acceptable interobserver reliability and intraobserver reproducibility. However, there are few studies in Asia, especially in China. ⋯ This study suggests that the new AO spine injury classification system may be applied in day-to-day clinical practice in China following extensive training of healthcare providers. Further prospective studies in different healthcare providers and clinical settings are essential for validation of this classification system and to assess its utility.