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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There is a paucity of literature describing Guillain-Barré syndrome (GBS) in the elective orthopedic patient. We aim to report one such case following spine surgery. ⋯ Neurologic symptoms of this autoimmune condition may also mimic the clinical picture of an elective spine patient, thus confounding diagnosis. If imaging cannot explain exam findings or new neurologic symptoms post-operatively, rare disease processes should be considered in the differential diagnosis.
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Although imaging has a major role in evaluation and management of thoracolumbar spinal trauma by spine surgeons, the exact role of computed tomography (CT) and magnetic resonance imaging (MRI) in addition to radiographs for fracture classification and surgical decision-making is unclear. ⋯ For accurate classification, radiographs alone were insufficient except for C-type injuries. CT is mandatory for accurately classifying thoracolumbar fractures. Though MRI did confer a modest gain in sensitivity in B2 injuries, the study does not support the need for routine MRI in patients for classification, assessing instability or need for surgery.
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Tui-na is a very important component of Chinese medicine. It is a well-respected treatment modality known to be helpful and safe for a wide range of conditions. ⋯ At present, it is extensively used for relieving pain and stiffness associated with ankylosing spondylitis in China, even though there is a lack of evidence to support its validation and feasibility. The patient in this case was treated by tui-na massage at acute flare-up of ankylosing spondylitis and ended up with catastrophic results.
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Traumatic C2-3 dislocation has been often described in the antero-posterior plane but is extremely rare in the lateral plane. Such dislocations have been described in thoraco-lumbar and C1-2. The need to study the imaging in multiple planes has been highlighted to plan proper realignment. ⋯ The saddle shape of the sub-axial cervical spine prevents such lateral dislocations. It is imperative to study the radiology in multiple planes to assess the 'multiplanar dislocation'. Correction is possible with proper planning and manipulation of facets and bodies using the available instrumentation. Though not obtained in this case, a preoperative MRI and a CT angiogram are important in surgery planning.
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Typical hemangioma of cauda equina with relative clear margin has been described in some case reports, but atypical hemangioma with invasion, infiltration, and augmentation of all nerve roots in the cauda equina area has never been reported. In this paper, we reported a rare case with invasive hemangioma in cauda equina, and analyzed its radiological appearance and treatment. ⋯ Surgery may be the first management modality for hemangiomas with severe or progressive neurologic deficits, and radiotherapy may be an alternative therapy to treat hemangiomas according to accurate histopathologic diagnosis.