Osteochondroma of the L-5 vertebra: a rare cause of sciatic pain

1999 ◽  
Vol 91 (2) ◽  
pp. 219-222 ◽  
Author(s):  
Ettore Fiumara ◽  
Tommaso Scarabino ◽  
Giuseppe Guglielmi ◽  
Michele Bisceglia ◽  
Vincenzo D'Angelo
Keyword(s):  
Vertebral Column ◽  
Cartilaginous Tissue ◽  
Content Type ◽  
Articular Process ◽  
Multiple Osteochondromas ◽  
Solitary Osteochondroma ◽  
Ossification Process ◽  
Upper Thoracic ◽  
Ossification Centers ◽  
Fine Print

✓ Solitary or multiple osteochondromas, which are benign bone tumors that usually occur in the long bones, are rarely found in the vertebral column. When present in the spine, however, they have a predilection for the cervical or upper thoracic regions. The authors present the case of a solitary osteochondroma arising from the left L-5 articular process that contributed to sciatica; complete cure was achieved following its removal. It is possible to speculate that the cartilage of secondary ossification centers can be the origin of aberrant islands of cartilaginous tissue that cause the osteochondroma to form. The more rapid the ossification process of these centers, the greater the probability that aberrant cartilage will form. Therefore, the fact that osteochondromas are more frequently located in the higher segments of the vertebral column could be explained by the different durations of the ossification processes in these centers, which increase gradually below the cervical segments.

Hemangiopericytoma of the spinal canal

1978 ◽  
Vol 49 (6) ◽  
pp. 914-920 ◽  
Author(s):  
Darrell J. Harris ◽  
Victor L. Fornasier ◽  
Kenneth E. Livingston
Keyword(s):  
Endothelial Cells ◽  
Differential Diagnosis ◽  
High Risk ◽  
Spinal Canal ◽  
Vertebral Column ◽  
Soft Tissues ◽  
Surgical Removal ◽  
Vascular Neoplasm ◽  
Content Type ◽  
Fine Print

✓ Hemangiopericytoma is a vascular neoplasm consisting of capillaries outlined by an intact basement membrane that separates the endothelial cells of the capillaries from the spindle-shaped tumor cells in the extravascular area. These neoplasms are found in soft tissues but have rarely been shown to involve the spinal canal. This is a report of three such cases. Surgical removal of the tumor from the spinal canal was technically difficult. A high risk of recurrence has been reported but in these three cases adjunctive radiotherapy appeared to be of benefit in controlling the progression of the disease. These cases, added to the six cases in the literature, confirm the existence of hemangiopericytoma involving the vertebral column with extension into the spinal canal. This entity should be included in the differential diagnosis of lesions of the spinal canal. The risk of intraoperative hemorrhage should be anticipated.

X-ray-translucent retractors in spine surgery

1986 ◽  
Vol 64 (3) ◽  
pp. 520-521 ◽  
Author(s):  
Peter Knöringer
Keyword(s):  
Spine Surgery ◽  
Vertebral Column ◽  
Operating Time ◽  
Surgical Instruments ◽  
X Rays ◽  
Content Type ◽  
X Ray ◽  
Image Intensification ◽  
Fine Print

✓ With surgery of the vertebral column under image intensification, surgical instruments and conventional metal retractors often obscure important x-ray landmarks. Surgery is more difficult, operating time is longer, and exposure to x-rays is increased. The author has developed x-ray-translucent retractors for ventral and dorsal operations. Although for reasons of strength these retractors have somewhat more bulk than equivalent metal retractors, they are sufficiently stable and are compatible with spacial requirements. They can be sterilized and reused.

Anatomical location of T2–3 sympathetic trunk and Kuntz nerve determined by transthoracic endoscopy

2002 ◽  
Vol 96 (1) ◽  
pp. 68-72 ◽  
Author(s):  
Yeou-Chih Wang ◽  
Ming-Hsi Sun ◽  
Chi-Wen Lin ◽  
Yen-Ju Chen
Keyword(s):  
Sympathetic Trunk ◽  
Anatomical Location ◽  
Content Type ◽  
Medial Border ◽  
Thoracic Sympathectomy ◽  
Operative Findings ◽  
The Right ◽  
Upper Thoracic ◽  
Rib Head ◽  
Fine Print

Object. Bilateral subaxillary transthoracic endoscopic sympathectomy (TES) is a popular procedure of upper thoracic sympathectomy. The anatomical locations of the T-2 and T-3 sympathetic trunks, as viewed under the endoscope, are varied in the rib head areas. In this study, the authors investigated the more visible anatomical locations of the T-2 and T-3 sympathetic trunks, the so-called nerves of Kuntz, and intercostal rami by performing transthoracic endoscopy. Methods. Seventy patients with palmar hyperhidrosis undergoing bilateral TES (140 sides) via the anterior subaxillary approach were included in this study. The operative findings and video images of the T-2 and T-3 sympathetic trunks and ganglia were recorded and analyzed. The anatomical locations of the T-2 and T-3 sympathetic trunks along the horizontal axes of the rib heads were determined using a three-region system constructed by the authors. The area between the rib neck and the medial border of the rib head was equally divided into Region E (external half) and Region M (medial half). The area between the medial border of the rib head and the paravertebral ligament was defined as Region I. The incidence of the T-2 and T-3 sympathetic trunks found in Regions E, M, and I were 31.4 to 42.9%, 50 to 57.1%, and 7.1 to 11.4%, respectively, on the left side, and 24.3 to 34.3%, 57.1 to 65.7%, and 8.6 to 10%, respectively, on the right side. One right (1.4%) and six left (8.6%) Kuntz nerves originating from the T-3 sympathetic trunk were found in seven patients (10%). The intercostal ramus was found around the T-2 rib neck in 24 patients (34.3%), with 18 cases (25.7%) for each side. The intercostal ramus around the T-3 rib neck was found in 17 patients (24.3%): 12 (17.1%) on the right and nine (12.9%) on the left. Conclusions. These results indicate that approximately 90% of the T-2 or T-3 sympathetic trunks are located on the rib head. These findings may also be used to assist the surgeon in fluoroscopic guidance for locating the T-2 and T-3 sympathetic trunks during posterior percutaneous sympathectomy.

Tophaceous gout producing spinal cord compression

1983 ◽  
Vol 58 (4) ◽  
pp. 580-582 ◽  
Author(s):  
Barry J. Leaney ◽  
James M. Calvert
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Vertebral Column ◽  
Cord Compression ◽  
Tophaceous Gout ◽  
Content Type ◽  
Fine Print

✓ A case of thoracic paraplegia secondary to extradural tophaceous gout is presented. The ability of gout to compromise bone elements, periarticular tissues, and neural elements in the vertebral column is discussed.

Coaxial double-lumen methylmethacrylate reconstruction in the anterior cervical and upper thoracic spine after tumor resection

2000 ◽  
Vol 92 (2) ◽  
pp. 181-190 ◽  
Author(s):  
Daniel J. Miller ◽  
Frederick F. Lang ◽  
Garrett L. Walsh ◽  
Dima Abi-Said ◽  
David M. Wildrick ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Supine Position ◽  
Magnetic Resonance Images ◽  
Reconstruction Technique ◽  
Double Lumen ◽  
Primary Tumors ◽  
Content Type ◽  
Spinal Reconstruction ◽  
Upper Thoracic ◽  
Fine Print

Object. A unique method of anterior spinal reconstruction after decompressive surgery was used to prevent methylmethacrylate—dural contact in cancer patients who underwent corpectomy. The purpose of this study was to assess the efficacy and stability of polymethylmethacrylate (PMMA) anterior surgical constructs in conjunction with anterior cervical plate stabilization (ACPS) in these patients. Methods. Approximately 700 patients underwent spinal surgery at The University of Texas M. D. Anderson Cancer Center over a 4-year period. The authors conducted a retrospective outcome study for 29 of these patients who underwent anterior cervical or upper thoracic tumor resections while in the supine position. These patients were all treated using the coaxial, double-lumen, PMMA technique for anterior spinal reconstruction with subsequent ACPS. No postoperative external orthoses were used. Twenty-seven patients (93%) harbored metastatic spinal lesions and two (7%) harbored primary tumors. At 1 month postsurgery, significant improvement was seen in spinal axial pain (p < 0.001), radiculopathy (p < 0.00 1), gait (p = 0.008), and Frankel grade (p = 0.002). A total of nine patients (31%) underwent combined anterior—posterior 360° stabilization. Twenty-one patients (72%) experienced no complications. Complications related to instrumentation failure occurred in only two patients (7%). There were no cases in which the patients' status worsened, and there were no neurological complications or infections. The median Kaplan—Meier survival estimate for patients with spinal metastases was 9.5 months. At the end of the study, 13 patients (45%) had died and 16 (55%) were alive. Postoperative magnetic resonance images consistently demonstrated that the dura and PMMA in all patients remained separated. Conclusions. The anterior, coaxial, double-lumen, PMMA reconstruction technique provides a simple means of spinal cord protection in patients in the supine position while undergoing surgery and offers excellent results in cancer patients who have undergone cervical vertebrectomy.

Neurological and pathological effects of second lumbar spondylectomy and spinal column shortening in the dog

1975 ◽  
Vol 42 (1) ◽  
pp. 47-58 ◽  
Author(s):  
Daniel J. Yturraspe ◽  
William V. Lumb ◽  
Stuart Young ◽  
Harry A. Gorman
Keyword(s):  
Vertebral Column ◽  
Axonal Degeneration ◽  
Spinal Column ◽  
Lumbar Vertebra ◽  
Spinal Nerve ◽  
Spinal Nerve Roots ◽  
Loss Of Function ◽  
Nerve Roots ◽  
Content Type ◽  
Fine Print

✓ The second lumbar vertebra was surgically removed from 10 dogs, and the shortened vertebral column was stabilized by internal fixation with two types of plastic plates. Shortening of the spinal column was usually not associated with detectable loss of function or neurological deficit. Histological lesions, however, included widely disseminated axonal degeneration, gliosis, and atrophy of spinal nerve roots in the surgical area. The spinal cord adapted to shortening of the vertebral column by becoming intrinsically shorter, rather than by being displaced within the spinal canal.

Chronological changes of postsympathectomy compensatory hyperhidrosis and recurrent sweating in patients with palmar hyperhidrosis

2005 ◽  
Vol 2 (2) ◽  
pp. 151-154 ◽  
Author(s):  
Thomas S. M. Chiou
Keyword(s):  
Patient Satisfaction ◽  
Palmar Hyperhidrosis ◽  
Analog Scale ◽  
Compensatory Hyperhidrosis ◽  
Content Type ◽  
Thoracic Sympathectomy ◽  
The Mean ◽  
Upper Thoracic ◽  
Fine Print

Object. The author sought to investigate the temporal changes of postsympathectomy compensatory hyperhidrosis and recurrent sweating in patients with primary palmar hyperhidrosis. Methods. The author examined 91 consecutive patients for this prospective 6-year study. The patients were interviewed at least twice during a 6-month interval; the first follow up was conducted at a median of 1.7 years after surgery (range 2.5–60.5 months). Overall, 24 patients (26.4%) were followed for more than 2 years. Attention was focused on patient satisfaction and the incidence of compensatory hyperhidrosis and recurrent sweating. The overall mean patient satisfaction rate was 78%, with a median 80% improvement on a visual analog scale from 0% (poor) to 100% (excellent). Overall, 88 patients (96.7%) developed compensatory hyperhidrosis, with the mean initial occurrence at 8.2 weeks. The symptoms of compensatory hyperhidrosis progressively worsened to the maximum degree within another 2 weeks after onset (mean 10.3 ± 1.83 weeks). In 19 patients (21.6%), symptoms of compensatory hyperhidrosis improved spontaneously within 3 months after sympathectomy (mean 13.3 weeks). Postoperative compensatory hyperhidrosis occurred in 71.4% of patients within the 1st year. Recurrent sweating occurred in only 17.6% of patients. None of these patients required repeated operation. The earliest onset of recurrent sweating was noted at 2 weeks postoperatively by three patients, and the mean initial postoperative reccurrence was 32.7 weeks after surgery. Conclusions. Compensatory hyperhidrosis and recurrent sweating are normal thermoregulatory responses that occurred after upper thoracic sympathectomy. Compensatory hyperhidrosis was more prevalent and developed earlier than recurrent sweating. The severity of both compensatory hyperhidrosis and recurrent sweating symptoms remained stable 6 months after surgery.

Spontaneous subarachnoid hemorrhage associated with spinal cord tumor

1974 ◽  
Vol 40 (2) ◽  
pp. 252-254 ◽  
Author(s):  
John B. Runnels ◽  
John W. Hanbery
Keyword(s):  
Spinal Cord ◽  
Differential Diagnosis ◽  
Subarachnoid Hemorrhage ◽  
Rare Case ◽  
Spinal Cord Tumor ◽  
Content Type ◽  
Upper Thoracic ◽  
Spontaneous Subarachnoid Hemorrhage ◽  
Fine Print

✓ A rare case of spontaneous subarachnoid hemorrhage from an extramedullary upper thoracic astrocytoma is described. The differential diagnosis between cranial and spinal spontaneous subarachnoid hemorrhage is discussed.

Polymethylmethacrylate-augmented screw fixation for stabilization in metastatic spinal tumors

2002 ◽  
Vol 96 (1) ◽  
pp. 131-134 ◽  
Author(s):  
Jee Soo Jang ◽  
Sang Ho Lee ◽  
Chang Hun Rhee ◽  
Seung Hoon Lee
Keyword(s):  
Vertebral Column ◽  
Screw Fixation ◽  
Neurological Deficits ◽  
Spinal Tumors ◽  
Complete Relief ◽  
Content Type ◽  
Vertebral Bodies ◽  
The Mean ◽  
Fine Print

✓ Screw fixation augmented with polymethylmethacrylate (PMMA) or some other biocompatible bone cement has been used in patients with osteoporosis requiring spinal fusion. No clinical studies have been conducted on PMMA-augmented screw fixation for stabilization of the vertebral column in patients with metastatic spinal tumors. The purpose of this study was to determine whether screw fixation augmented with PMMA might be suitable in patients treated for multilevel metastatic spinal tumors. Ten patients with metastatic spinal tumors involving multiple vertebral levels underwent stabilization procedures in which PMMA was used to augment screw fixation after decompression of the spinal cord. Within 15 days, partial or complete relief from pain was obtained in all patients postoperatively. Two of four patients in whom neurological deficits caused them to be nonambulatory before surgery were able to ambulate postoperatively. Neither collapse of the injected vertebral bodies nor failure of the screw fixation was observed during the mean follow-up period of 6.7 months. Screw fixation augmented with PMMA may offer stronger stabilization and facilitate the instrumentation across short segments in the treatment of multilevel metastatic spinal tumors.

The use of clip-suture in thoracic sympathectomy

1994 ◽  
Vol 81 (3) ◽  
pp. 482 ◽  
Author(s):  
Robert A. Beatty
Keyword(s):  
Sympathetic Chain ◽  
Content Type ◽  
Thoracic Sympathectomy ◽  
Upper Thoracic ◽  
Fine Print

✓ A technique is described for using a clip-suture to expedite handling of the divided sympathetic chain in a deep, small upper-thoracic exposure. No late failures were experienced in 23 patients with hyperhydrosis surgically treated using this technique.

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