scholarly journals Successful treatment of continuous ossification of the posterior longitudinal ligament in the lumbar spine using percutaneous transforaminal endoscopic spinal decompression: a case report

2021 ◽  
Vol 49 (4) ◽  
pp. 030006052110047
Author(s):  
Yuexin Tong ◽  
Zhangheng Huang ◽  
Zhiyi Fan ◽  
Chengliang Zhao ◽  
Youxin Song
Keyword(s):  
Case Report ◽  
Lumbar Spine ◽  
Vertebral Body ◽  
Posterior Longitudinal Ligament ◽  
Neurological Function ◽  
Posterolateral Approach ◽  
Lower Back ◽  
Scale Scores ◽  
History Of ◽  
Lumbar Spinal

Ossification of the posterior longitudinal ligament (OPLL) of the lumbar spine is rare relative to that of the cervical spine but is often associated with more severe symptoms. Continuous lumbar OPLL is extremely rare. We herein describe a 48-year-old Chinese woman with lumbar spinal stenosis caused by continuous OPLL. She presented with a 5-year history of lower back pain and intermittent claudication. We performed percutaneous transforaminal endoscopic decompression by the posterolateral approach to achieve adequate decompression of the spinal canal up to the lower 1/3 level (0.9 cm) of the L1 vertebral body and down to the upper 1/2 level (1.3 cm) of the L2 vertebral body. After surgery, the patient’s neurological function substantially improved, and her visual analog scale scores for the lower back and both lower extremities and her Oswestry disability index were significantly lower than those in the preoperative period. During the 12-month clinical follow-up period, the patient’s neurological function was fully restored, and she regained her ability to walk normally. No surgery-related complications were observed. This case report describes a novel surgical approach that may be an effective treatment alternative for continuous lumbar OPLL.

Polyarticular Septic Arthritis with Bilateral Psoas Abscesses following Acupuncture

2009 ◽  
Vol 27 (2) ◽  
pp. 81-82 ◽  
Author(s):  
Michihiro Ogasawara ◽  
Keisuke Oda ◽  
Ken Yamaji ◽  
Yoshinari Takasaki
Keyword(s):  
Staphylococcus Aureus ◽  
Case Report ◽  
Septic Arthritis ◽  
Acupuncture Treatment ◽  
Psoas Abscess ◽  
Clinical History ◽  
Chronic Lower Back Pain ◽  
Lower Back ◽  
History Of ◽  
Long Course

We report a case of polyarticular septic arthritis with bilateral psoas abscesses. A 50-year-old woman was admitted with fever, multiple joint swelling and pain. She had a clinical history of acupuncture therapy for treatment of her chronic lower back pain two days before the appearance of her symptoms. Methicillin-sensitive Staphylococcus aureus was isolated from blood culture, knee joint fluids and psoas abscess. After a long course of antibiotics for 70 days together with drainage of the abscess, the condition completely resolved. The acupuncture is the probable cause of the infection, and this case report reveals the importance of asking about a clinical history of acupuncture treatment and of making repeated bacterial examinations in undiagnosed polyarthritis patients.

scholarly journals Spinal Kinematics of Adolescent Male Rowers with Back Pain in Comparison with Matched Controls During Ergometer Rowing

2015 ◽  
Vol 31 (6) ◽  
pp. 459-468 ◽  
Author(s):  
Leo Ng ◽  
Amity Campbell ◽  
Angus Burnett ◽  
Anne Smith ◽  
Peter O’Sullivan
Keyword(s):  
Back Pain ◽  
Lumbar Spine ◽  
Tracking System ◽  
Adolescent Male ◽  
Lower Lumbar Spine ◽  
Spinal Kinematics ◽  
Ergometer Rowing ◽  
History Of ◽  
Lumbar Spinal ◽  
Lower Lumbar

There is a high prevalence of low back pain (LBP) in adolescent male rowers. In this study, regional lumbar spinal kinematics and self-reported LBP intensity were compared between 10 adolescent rowers with moderate levels of LBP relating to rowing with 10 reporting no history of LBP during a 15-minute ergometer trial using an electromagnetic tracking system. Adolescent male rowers with LBP reported increasing pain intensity during ergometer rowing. No significant differences were detected in mean upper or lower lumbar angles between rowers with and without LBP. However, compared with rowers without pain, rowers with pain: (1) had relatively less excursion of the upper lumbar spine into extension over the drive phase, (2) had relatively less excursion of the lower lumbar spine into extension over time, (3) had greater variability in upper and lower lumbar angles over the 15-minute ergometer trial, (4) positioned their upper lumbar spine closer to end range flexion for a greater proportion of the drive phase, and (5) showed increased time in sustained flexion loading in the upper lumbar spine. Differences in regional lumbar kinematics exist between adolescent male rowers with and without LBP, which may have injury implication and intervention strategies.

scholarly journals MIS Fusion of the SI Joint: Does Prior Lumbar Spinal Fusion Affect Patient Outcomes?

2013 ◽  
Vol 7 (1) ◽  
pp. 163-168 ◽  
Author(s):  
Leonard Rudolf
Keyword(s):  
Lumbar Spine ◽  
Spinal Fusion ◽  
Spine Fusion ◽  
Lumbar Spinal Fusion ◽  
Lumbar Spine Fusion ◽  
Spine Pathology ◽  
History Of ◽  
Lumbar Spinal ◽  
Si Joint

Background: Sacroiliac (SI) joint pain is a challenging condition to manage as it can mimic discogenic or radicular low back pain, and present as low back, hip, groin and/or buttock pain. Patients may present with a combination of lumbar spine and SI joint symptoms, further complicating the diagnosis and treatment algorithm [1-3]. SI joint pain after lumbar spinal fusion has been reported in the literature. Both clinical and biomechanical studies show the SI joint to be susceptible to increased motion and stress at the articular surface with up to 40-75% of patients developing significant SI joint degeneration after 5 years. In a recent case series study of 50 patients who underwent minimally invasive SI joint arthrodesis, 50% had undergone previous lumbar spinal fusion and 18% had symptomatic lumbar spine pathology treated conservatively [4]. The purpose of this study is to determine if history of previous lumbar fusion or lumbar pathology affects patient outcomes after MIS SI joint fusion surgery. Methods: We report on 40 patients with 24 month follow up treated with MIS SI joint fusion using a series of triangular porous plasma coated titanium implants (iFuse, SI-Bone, Inc. San Jose, CA). Outcomes using a numerical rating scale (NRS) for pain were obtained at 3-, 6-, 12- and 24 month follow up intervals. Additionally, patient satisfaction was collected at the latest follow up interval. Patients were separated into 3 cohorts: 1) underwent prior lumbar spine fusion (PF), 2) no history of previous lumbar spine fusion (NF), 3) no history of previous lumbar spine fusion with symptomatic lumbar spine pathology treated conservatively (LP). A repeated measures analysis of variance (rANOVA) was used to determine if the change in NRS pain scores differed across timepoints and subgroups. A decrease in NRS by 2 points was deemed clinically significant [5]. Results: Mean age was 54 (±13) years and varied slightly but not statistically between groups. All subgroups experienced a clinically and statistically significant reduction in pain at all time points (mean change >2 points, p<0.001). There was a statistically significant effect of cohort (p=0.045), with the NF cohort (no prior lumbar spinal fusion) having a somewhat greater decrease in pain (by approximately 1 point) compared to the other 2 groups (PF and LP).Patient reported satisfaction by cohort was: 89% (NF), 92% (PF) and 63% (LP).Overall satisfaction rate was 87%. Discussion and Conclusion: Patients with SI joint pain, regardless of prior lumbar spine fusion history, show significant improvement in pain after minimally invasive SI joint fusion. The presence of symptomatic lumbar spine pathology potentially confounds the treatment affect, as patients may not be able to discriminate between symptoms arising from the SI joint and the lumbar spine. These patients expressed a lower satisfaction with surgery. Patients without other confounding lumbar spine pathology and who have not undergone previous spine surgery tend to be younger and experience a greater reduction in pain.

scholarly journals Atraumatic Bilateral Lumbar Pedicle Fractures in a Patient with Back Pain and History of Long- Term Bisphosphonate Therapy: A Case Report

2020 ◽  
pp. 97-102
Author(s):  
Alec L. Meleger
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Case Report ◽  
Lumbar Spine ◽  
Conservative Management ◽  
Chronic Low Back Pain ◽  
Bisphosphonate Therapy ◽  
Low Back ◽  
History Of ◽  
Lumbar Pedicle

of atypical femoral fractures is a known complication of chronic bisphosphonate therapy; however, the finding of atraumatic lumbar pedicle fractures without a prior history of spinal surgery or contralateral spondylolysis is rare. While a few cases of osteoporotic pedicle fractures associated with adjacent vertebral compression fractures have been reported, only a single case of isolated atraumatic bilateral pedicle fractures has been published in a patient who had been on chronic risedronate therapy of 10-year duration. Case Report: The present case report illustrates a 63-year-old man who developed isolated atraumatic bilateral lumbar pedicle fractures after 3 years and 5 months on alendronate treatment. The patient’s past medical history had been significant for osteoporosis with a lumbar spine T-score of -2.7. At the time of initial diagnosis, a comprehensive work-up for secondary causes of osteoporosis proved to be negative; this was followed by initiation of bisphosphonate treatment with 70 mg of alendronate once per week. Ten months after starting bisphosphonate therapy, he underwent magnetic resonance imaging (MRI) of the lumbar spine for low back pain that had not responded to conservative management, with imaging not revealing any evidence of pedicle fractures or pedicle stress reaction. He was again seen in the spine clinic, for atraumatic exacerbation of his chronic low back pain with concurrent right lower extremity radiation, 6 months after stopping bisphosphonate therapy. Since the patient failed to respond to conservative management over the ensuing 6 months, a repeat MRI was obtained, which showed new acute/subacute bilateral L5 pedicle fractures. Conclusion: An isolated atraumatic lumbar pedicle fracture may be an additional type of atypical fracture associated with chronic bisphosphonate therapy in an osteoporotic patient. Key words: Chronic low back pain, bisphosphonate, alendronate, pedicle fracture Pain Medicine

scholarly journals SMARCE1 mutations in pediatric clear cell meningioma: case report

2015 ◽  
Vol 16 (3) ◽  
pp. 296-300 ◽  
Author(s):  
Linton T. Evans ◽  
Jack Van Hoff ◽  
William F. Hickey ◽  
Miriam J. Smith ◽  
D. Gareth Evans ◽  
...  
Keyword(s):  
Case Report ◽  
Lumbar Spine ◽  
Family History ◽  
Literature Review ◽  
Chromatin Remodeling ◽  
Clear Cell ◽  
Clear Cell Meningioma ◽  
Chromatin Remodeling Complex ◽  
History Of ◽  
Inactivating Mutation

Clear cell meningioma (CCM) is an uncommon variant of meningioma. The authors describe a case of a pediatric CCM localized to the lumbar spine. After resection, sequencing revealed an inactivating mutation in the SWI/SNF chromatin remodeling complex subunit SMARCE1, with loss of the second allele in the tumor. The authors present a literature review of this mutation that is associated with CCM and a family history of spine tumors.

scholarly journals Evolutive particularities in Diffuse Idiopathic Skeletal Hyperostosis associated with Spinal Stenosis – case report

2016 ◽  
Vol 22 (1) ◽  
pp. 30-36
Author(s):  
Andreea Lupu ◽  
Sandica Albina ◽  
Ramona Balta ◽  
Alina Lupsa ◽  
Madalina Iliescu
Keyword(s):  
Case Report ◽  
Lumbar Spine ◽  
Spinal Stenosis ◽  
Thoracic Spine ◽  
Diffuse Idiopathic Skeletal Hyperostosis ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Spine Pathology ◽  
Spinal Ligaments ◽  
Lumbar Spinal

Abstract Diffuse idiopathic skeletal hyperostosis is a non-inflammatory disease, that affects mostly males and the principal manifestations are calcification and ossification of spinal ligaments, calcification of the tendons and ligaments in the vertebral body insertion. Clinical manifestations of the disease are mainly in the thoracic spine, but it may involve also the cervical and the lumbar spine. Extraspinal involvements are frequently present at patients with diffuse idiopathic skeletal hyperostosis. Spinal stenosis is associated with this disease. The present case is of a 56 years old man, initially diagnosed with Ankyloses spondylitis, who was under a treatment with Sulfasalazin for approximately 7 years, afterwards the diagnosis was infirmed and he was diagnosed with “Diffuse idiopathic skeletal hyperostosis”. The patient has multiple extra spinal manifestations of the disease (shoulders, elbows, hips, knees), cervical and lumbar spinal stenosis with clinical manifestations and imagistic confirmation, and also treated in neurosurgical service for several times, for the lumbar spine pathology. Particularities of this case are related with the delay of a correct diagnosis which means that the anterior treatments, both medical and surgical are under the questions.

scholarly journals Topping Phenomenon with Recurrent Spinal Stenosis and Epidural Fibrosis Prevented with Oxidized Cellulose – a Case Report

2018 ◽  
Vol 61 (2) ◽  
pp. 69-73 ◽  
Author(s):  
Radek Hart
Keyword(s):  
Case Report ◽  
Lumbar Spine ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Oxidized Cellulose ◽  
Epidural Fibrosis ◽  
Nerve Roots ◽  
Failed Back Syndrome ◽  
Dural Sac ◽  
Lumbar Spinal

Lumbar spinal stenosis is a condition where the neural structures are compressed in the narrowed spinal canal and often situated only within a single specific segment of the spine, most frequently in the lumbar spine. A case report demonstrates a surgical solution of lumbar spinal stenosis with using oxidized cellulose as a prevention of post-operative adhesions and failed back syndrome. A female patient (68) with a significant pain of the lumbar spine lasting for a number of months due to advanced spondylosis, failing to respond to conservative treatment underwent instrumented, posterolateral fusion of affected segments. The patient re-arrived with pain due to spinal stenosis in another segments after 4 and then after 3 years. We repeatedly performed spinal fusion of the affected segments and applied an antiadhesive gel to the dural sac and the decompressed nerve roots to prevent the development of post-operative adhesions and the “failed back syndrome”. Last surgical solution included mobilisation of the simultaneously constricted dural sac through laminectomy. This time we covered the sac using a haemostat made of oxidized cellulose (Traumacel FAM). After this treatment, the patient was again without significant difficulties.

scholarly journals Spinal Epidural Haemangioma Associated with Extensive Gastrointestinal Haemangiomas

2005 ◽  
Vol 11 (2) ◽  
pp. 161-166 ◽  
Author(s):  
L. T. E. Cheng ◽  
W. E. H. Lim
Keyword(s):  
Back Pain ◽  
Lumbar Spine ◽  
Chronic Lower Back Pain ◽  
Cavernous Haemangioma ◽  
Open Biopsy ◽  
Lower Back ◽  
Paravertebral Muscles ◽  
History Of ◽  
Spinal Epidural ◽  
Spine Mri

A case of spinal epidural cavernous haemangioma associated with gastrointestinal haemangiomas is discussed. The patient was a young Chinese female presenting with chronic lower back pain. She had a history of extensive gastric and small bowel haemangiomas. Lumbar spine MRI showed a heterogeneously enhancing epidural mass infiltrating the paravertebral muscles. Open biopsy confirmed an epidural cavernous haemangioma. To our knowledge, an association between spinal epidural cavernous haemangiomas and gastrointestinal haemangiomas has not been reported.

scholarly journals Nevus Lipomatosus Cutaneous Superficialis with a Histopathological Appearance Resembling Sclerotic Fibroma: A Rare Case Report

2021 ◽  
Vol 9 (C) ◽  
pp. 246-249
Author(s):  
Rizka Ramadhani Ruray ◽  
Khairuddin Djawad ◽  
Airin Nurdin
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Histopathological Examination ◽  
Fat Cells ◽  
Morphological Abnormalities ◽  
Lower Back ◽  
Spray Method ◽  
Rare Case Report ◽  
Paraffin Block ◽  
History Of

Background: Nevus lipomatosus cutaneous superficialis (NLCS) of Hoffmann–Zurhelle is a benign idiopathic hamartoma. There are two types of NLCS, multiple and solitary. They are found in the abdomen, lower back, buttocks, hips, upper posterior thighs, and pelvis. The diagnosis can be evaluated with a typical histopathological of mature fat cells in the dermis, with 10%–50% of the dermis. Case Report: We reported a case of NLCS with clinical papules and multiple nodules on the buttocks since the age of 6 years with a history of lipoma removal. The dermoscopic examination was conducted to confirm the diagnosis. The histopathological examination showed a dominant sclerotic fibroma with two sessions of biopsy and a few mature fats on the dermis after deeper cuts paraffin block. Cryotherapy with an open spray method is treatment of choice in this patient. Discussion: The appearance of the dermis in NLCS can be normal or an increase in collagen. Interestingly, collagen has sclerosis partially and resembles sclerotic fibroma never been reported. NLCS increases the amount of collagen; however, collagen as sclerosis remains obscure. The features of NLCS histopathological with other morphological abnormalities in the dermis have been reported, such as NLCS with perifollicular fibroma (PF) features. The sclerotic fibroma features are other morphological abnormalities in NLCS, as reported in the PF.

scholarly journals Giant renal leiomyoma: a case report and brief review of the literature

2013 ◽  
Vol 3 (5) ◽  
pp. 58 ◽  
Author(s):  
Matei Andreoiu ◽  
Darrel Drachenberg ◽  
Ross MacMahon
Keyword(s):  
Case Report ◽  
Renal Cell ◽  
Abdominal Mass ◽  
Histochemical Staining ◽  
Flank Pain ◽  
Review Of The Literature ◽  
Lower Back ◽  
History Of

We report on a very large renal leiomyoma in a man presentingwith a 1-year history of lower back and flank pain and a rapidlygrowing abdominal mass. Since a cystic renal cell carcinomacould not be ruled out, a postembolization right radical nephrectomywas performed. Diagnosis was confirmed by pathologic andhistologic analysis. Renal leiomyomas are very rare benign tumoursthat are nearly indistinguishable from leiomyosarcoma or renalcell carcinoma preoperatively. This case represents the secondlargest such entity reported and demonstrates the limited abilityof accurate diagnostic determination preoperatively, with pathologicexamination and immune-histochemical staining postnephrectomyrepresenting the only definitive means of diagnosis. A briefreview of the literature and an outline of typical clinical and pathologicfeatures of renal leiomyomas are also presented.

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