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
Intraosseous pseudomeningocele of the mobile spine: a case report and review of the literature.
Pseudomeningoceles most commonly occur due to prior trauma or surgery and are often located in the posterior paraspinous tissues. Here, we report a case of an intraosseous pseudomeningocele that mimicked an intra-osseous T2 hyperintense lesion in the L1 vertebral body. ⋯ This case illustrates a rare case of an intra-osseous pseudomeningocele and highlights the importance of CT myelogram for diagnosis.
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The anterior elements of the spine, particularly the odontoid processes, are a rare location for osteoblastomas. Pseudomalignant osteoblastomas are themselves rare histologic types and are also extremely rare in this location. Most osteoblastomas are Enneking stage 2 lesions; less frequently, they can be more aggressive with extra-capsular extension (Enneking stage 3). En bloc resection is recommended for aggressive lesions, but the literature is less clear regarding the approach to stage 2 tumors, particularly those with pseudomalignant histologic features. ⋯ This unique case of odontoid osteoblastoma illustrates that malignant behavior may not be predicted only by the presence of pseudomalignant features on histology.
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Review Case Reports
Recurrent primary osseous hemangiopericytoma in the thoracic spine: a case report and literature review.
Primary osseous hemangiopericytoma (HPC) of the spine is exceedingly rare. HPC has malignant potential and has the capacity for metastasis and local recurrence. We herein present the first case of recurrent primary osseous HPC in the thoracic spine that was successfully treated by total spondylectomy at three vertebral levels and spinal reconstruction. ⋯ Total spondylectomy and spinal reconstruction with instrumentation might be useful for performing the safe and adequate excision of recurrent HPC of the spine. However, patients should be closely monitored to detect local recurrence and the malignant degeneration of the tumor after surgery.
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Review Case Reports
Extensive spinal extradural ganglioneuroma of the lumbar spine: mimicking lymphoma.
Ganglioneuromas are rare, benign, well-differentiated tumors arising from neural crest cells that commonly occur in the posterior mediastinum, retroperitoneum, cervical spine, and adrenal gland. We report an unusual case of an extensive spinal extradural ganglioneuroma, circumferentially and longitudinally affecting the extradural space of the lumbar spine and continuously invading bilateral psoas muscles. ⋯ This is the first known reported case in the literature of a spinal extradural ganglioneuroma with circumferentially and longitudinally extensive involvement of the extradural space and a large psoas mass.
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Review Case Reports
Surgical management of cauda syndrome in third trimester of pregnancy focusing on spinal anesthesia and right lateral positioning during surgery as possible practices.
This article presents a surgical solution of a lumbar disc hernia of a pregnant woman focusing on the use of right lateral positioning, spinal anesthesia which has not previously been utilized in third trimester and discusses positioning options, and possible anesthesia methods with the surgical procedure options. ⋯ So far examples are given for almost every possible patient position in the third trimester except the right lateral one. All the previously presented positionings (prone, left lateral) were equally effective regarding the outcome with none being better than another. For left-sided lumbar pathologies performed in the third trimester the right lateral position might be an alternative option for easier access. Based on the literature an epidural and general anesthesia can be applied successfully in the third trimester. Spinal anesthesia might be another anesthesia consideration.