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
-
Case Reports
CT-guided percutaneous translaminar approach for blood patching: case report and technical note.
In this article the authors describe a novel technique for performing epidural blood patch (EBP) by percutaneous CT-guided translaminar approach in challenging cases where interlaminar approach is not possible. A 24-year-old woman with medical history of multiple spinal surgeries and instrumentations for the treatment of scoliosis, presented 3 months post-operatively with acute and severe orthostatic headaches that began 1 week after surgery. Neurological examination was normal. ⋯ Computed tomography (CT) myelography revealed CSF leakage in the level of T3 vertebra. EBP was attempted using fluoroscopic and then CT guidance; however, despite multiple attempts, the epidural space could not be accessed through the interlaminar route due to extensive instrumentation of the spine and profound structural bony abnormalities. EBP was performed successfully via a CT-guided translaminar approach using an Ostycut trephine needle (Angiomed(®)/Bard, Karlsruhe), without complications.
-
This prospective magnetic resonance imaging (MRI) study in chronic low-back pain (CLBP) patients evaluated the natural course of degenerative lumbar spine changes in relation to Modic 1 type changes (M1) within 1 year. ⋯ Endplate deformation, decreasing disc height and change of disc signal intensity appear essential features of accelerated degenerative process associated with M1.
-
The Cobb technique is the universally accepted method for measuring the severity of spinal deformities. Traditionally, Cobb angles have been measured using protractor and pencil on hardcopy radiographic films. The new generation of mobile 'smartphones' make accurate angle measurement possible using an integrated accelerometer, providing a potentially useful clinical tool for assessing Cobb angles. The purpose of this study was to compare Cobb angle measurements performed using a smartphone and traditional protractor in a series of 20 adolescent idiopathic scoliosis patients. ⋯ We conclude that the iPhone is an equivalent Cobb measurement tool to the manual protractor, and measurement times are about 15% less. The widespread availability of inclinometer-equipped mobile phones and the ability to store measurements in later versions of the angle measurement software may make these new technologies attractive for clinical measurement applications.
-
Perineural cysts are believed to be asymptomatic; however, they rarely cause symptoms related to nerve root compression. Cervical symptomatic perineural cysts are in fact exceedingly rare. There are no reported cervical perineural cysts in the literature that present like cubital tunnel syndrome. ⋯ We reported the first cervical perineural cyst as presenting like cubital tunnel syndrome patient in the literature. The visualization of perineural cyst may need extra magnetic resonance imaging (MRI) sections in order to view the nerve root through the neural foramen or extraforaminal area. These lesions are benign, and the appropriate treatment is curative.