Acta ortopédica mexicana
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Acta ortopédica mexicana · Jul 2009
Case Reports[Paraplegia due to adhesive arachnoiditis. A case report].
Various conditions of the spinal column occur at the lumbar level and new therapeutic surgical techniques have been applied to reduce the length of hospital stay, contribute to a quick return of patients to their activities of daily living, and reduce the postoperative limitations. However, a silent complication, adhesive arachnoiditis, has been reported with a frequency of 6-16% in cases undergoing lumbar surgery or with a history of revision surgery, and thus a second complication may occur, paraplegia, since the common symptom of arachnoiditis is persistent low back pain. The case of a 40-year-old patient is presented herein, who underwent lumbar spine surgery for herniated discs, and developed adhesive arachnoiditis involving the cauda equina, which was diagnosed with MRI. ⋯ The remaining reports of paraplegia have been in patients with spinal infection, such as HIV-TB, mycosis, brucellosis or meningeal hemorrhage. It is not easy for patients to understand the very likely irreversible neurologic lesion of his complication. However, it is important for the spine surgeon to bear in mind the occurrence and frequency of adhesive arachnoiditis which could lead to irreversible neurologic deficit in patients undergoing lumbar spine surgery.
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Bone tumors of the pelvic area a challenge for the orthopedist surgeon. The pelvic ring has no true barriers to contain the growth of neoplasias and thus by the time patients present to us, their lesion is already quite large. ⋯ The most important aspect of the surgery of bone tumors of the pelvis is achieving clear surgical margins. This surgery has high complication and morbidity rates.