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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This study was designed as a cross-sectional questionnaire-based survey of low back pain (LBP) in 13- to 16-year-old Danish school children. The cohort consisted of 671 boys and 718 girls in eighth and ninth grade in 46 municipal schools in three counties of Sealand. All the pupils filled in a questionnaire with LBP as the main topic and were at the same time examined by the school doctors. ⋯ This was positively correlated to female gender, BMI more than 25 kg/m(2), competitive sport for boys, poor physical fitness, daily smoking, heavy jobs in leisure time, increased use of the health system and reduced life quality. Stepwise logistic regression analysis indicates that female gender, daily smoking and heavy jobs are important associated factors for severe LBP in adolescents, with an observed probability of 46% if all factors are present. We don't know yet whether these factors are of any causal importance in the development of severe LBP.
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We present the case of a 44-year-old female patient, who sustained an odontoid fracture after a minor trauma (uncomplicated fall). The radiologic evaluation revealed a skeletal tumor of the second cervical vertebra together with a fracture line at the base of the odontoid process of the axis. The patient underwent surgery, the tumor was resected and the odontoid was stabilised using an autologous cortico-cancellous bone graft and a halo fixator. Histologic examination revealed benign fibrous histiocytoma, which is reported to be a very rare skeletal tumor.
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Case Reports
Myelopathy due to calcification of the cervical ligamenta flava: a report of two cases in West Indian patients.
Two cases of cervical myelopathy due to calcification of the ligamenta flava (CLF) are described for the first time in black patients from the French West Indies. A pre-operative CT scan differentiated the diagnosis from one of ossification of the ligamenta flava. Microanalysis on the operatively excised specimen in one patient revealed a mixture of calcium pyrophosphate dihydrate crystals and hydroxypatite crystals. Poor outcome in one patient contrasting with excellent recovery in the other one, who had undergone posterior decompressive laminectomy, emphasizes the importance of surgery in the management of CLF.
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Case Reports
Delayed focal neurological deficit secondary to a cervico-thoracic spinal cord epidural haematoma.
This is a report of an elderly woman who developed focal neurological deficit in association with a cervico-thoracic spinal epidural haematoma. Symptoms developed several days after the initial injury and subsequently resolved without surgical intervention. The unusual features of this presentation are discussed.
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The degree of calcification as well as the structural changes of the elastic fibres in the ligamentum flavum in patients with degenerative lumbar spinal stenosis were evaluated and the results were compared to those of patients without spinal stenosis. In 21 patients (13 male, 8 female) with lumbar spinal stenosis the ligamentum flavum was removed, histologically processed and stained. The calcification, the elastic/collagenous fibre ratio as well as the configuration of the fibres were evaluated with an image analyzing computer. ⋯ In the control group we only found minimal calcification in 3 of 20 segments (average 0.015%). No relevant fibrosis was found and the configuration of elastic fibres showed no pathologic changes. The results of this study illustrate the important role of histological changes of the ligamentum flavum for the aetiology of lumbar spinal stenosis.