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
A case report of atypical long segmental thoracic hypertrophic pachymeningitis with ossification of ligamentum flavum and literature review.
Thoracic spinal stenosis caused by ossification of ligamentum flavum (OLF) is frequently seen, but long segmental thoracic spinal cord compressed by consequent thickened ligament posteriorly was rarely reported. ⋯ HP is a rare condition characterized as thickening and enhancement of the dura mater on contrast-enhanced MRI and chronic inflammatory hyperplasia changes on biopsy. A case of atypical HP complicated with OLF is described. Chondrocytes infiltration in histological examination indicates the potential of ossification in HP.
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Review Case Reports
Migratory low velocity intradural lumbosacral spinal bullet causing cauda equina syndrome: report of a case and review of literature.
Migration of the bullet within the spinal subarachnoid space has long been recognized as unusual complication of spinal gunshot injury. ⋯ Caudal migration of the bullet within the lumbosacral subarachnoid space results in cauda equina syndrome. Surgical retrieval of the bullet ensures the early recovery of neurological symptoms. Prone patient positioning can influence bullet location. Intraoperative fluoroscopy prior to skin incision is essential in addition to preoperative imaging to locate the bullet and thus avoid incorrect lower level laminectomy. Trapping the bullet after durotomy using suction and dissector in reverse Trendelenburg position is a useful aid in bullet removal.
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Case Reports
Long-term survival case of malignant glomus tumor mimicking "dumbbell-shaped" neurogenic tumor.
We report a very rare case of long-term survival case of malignant glomus tumor (MGT) without widespread metastasis. ⋯ This is the first case report of MGT which lesions at two time points were confirmed to have common histological features and which confirmed the long-term survival over a 40-year period.
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To use imaging, histology and electrophysiological assessment to compare the Wiltse approach to pedicle fixation with the conventional posterior open approach for thoracolumbar fractures. ⋯ The Wiltse approach showed a lower incidence of multifidus atrophy and denervation, and less fatty infiltration. It is an effective and minimally invasive approach for thoracolumbar fractures.
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Case Reports
Giant cell tumor of the thoracic spine completely removed by total spondylectomy after neoadjuvant denosumab therapy.
Denosumab, a novel monoclonal antibody that targets the receptor activator of nuclear factor-κB (RANK) ligand (RANKL), has recently been used to treat patients with giant cell tumor of bone (GCTB). However, few reports have described the clinical results of denosumab therapy for spinal GCTB and evaluated treatment efficacy with respect to the entirety of the resected vertebra after denosumab therapy. ⋯ These findings support that GCTB stromal cells survived around the newly formed woven bone after long-term denosumab treatment and total surgical resection of such primary spinal lesions as the gold-standard treatment, even following administration of denosumab. Surgeons should note that prolonged adjuvant denosumab therapy may increase the difficulty of performing a posterior-approach total en bloc spondylectomy.