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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Case report. ⋯ In rare case, intradural tumor coexists with cervical disc herniation. When suspicious findings were noticed, or clinical symptoms cannot be fully explained, contrast MR imaging is helpful in differential diagnosis. Microscopic transdural discectomy is safe, and could be used as an optional procedure for cervical disc herniation in some cases.
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Ankylosing spondylitis (AS) can result in severe cervico-thoracic kyphotic deformity (CTKD). Few studies have addressed the relationship between cervico-thoracic osteotomies in AS and health-related quality of life scores. The aim of this study is to evaluate the impact of cervico-thoracic osteotomy (CTO) on improving quality of life for patients with fixed CTKD. ⋯ Cervical osteotomy for the management of fixed flexion deformity of cervical spine in ankylosing spondylitis is a safe procedure and can result in restoration of horizontal gaze and sagittal balance with significant improvement of the patient's health-related quality of life. These slides can be retrieved under Electronic Supplementary Material.
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High thoracotomy allows access to the anterior cervicothoracic and upper thoracic vertebrae; however, traditional techniques transect shoulder girdle muscles, leading to postoperative shoulder dysfunction. Muscle-sparing techniques diminish this concern, but often sacrifice the quality of exposure. We describe a novel muscle-sparing, high thoracotomy approach for the treatment of ventral cervicothoracic and upper thoracic spine lesions. ⋯ The described muscle-sparing, high thoracotomy approach provides excellent exposure of the ventral cervicothoracic and upper thoracic spine without the morbidity associated with the transection of shoulder girdle muscle bellies. This technique is particularly useful in patients with primary malignant bone tumors requiring en bloc excision and metastatic tumors with large soft tissue components.
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Case Reports
Spinal dural arteriovenous fistula (SDAVF) variant with dual perimedullary and epidural drainage.
A spinal dural arteriovenous fistula (SDAVF) is an abnormal connection between a radiculomeningeal artery and a radiculomedullary vein (RMV) characteristically draining into the perimedullary venous system. We present an observation of SDAVF draining simultaneously into the perimedullary and epidural venous systems. ⋯ Dual drainage of the right L1 SDAVF into the perimedullary and epidural venous systems allowed to locate the site of the arteriovenous shunt at the point of transdural passage of the RMV, a narrowed segment also known to represent an anti-reflux mechanism. The potential role played by the topographical relationship between the shunt and the anti-reflux mechanism of the RMV in the formation and clinical expression of SDAVFs is discussed.