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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The influence of the anterior rib cage on the stability of the human thoracic spine is not completely known. One of the most common surgical interventions on the anterior rib cage is the longitudinal median sternotomy and its fixation by wire cerclage. Therefore, the purpose of this in vitro study was to examine, if wire cerclage can restore the stability of the human thoracic spine after longitudinal median sternotomy. ⋯ In this in vitro study, the longitudinal median sternotomy resulted in a destabilization of the thoracic spine and relative motion of the sternal cut faces, which could be rectified by fixation with wire cerclage. However, the stability of the intact condition could not be reached. Nevertheless, a fixation of the sternum should be considered clinically to avoid instability of the spine and sternal pseudarthrosis.
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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.
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We report a rare case with multiple intradural-extramedullary spinal ependymomas with different histological features. ⋯ Surgical resections and subsequent radiotherapy and chemotherapy for cases with multiple intradural-extramedullary ependymomas can result in a good postoperative course.
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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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Lumbar spinal stenosis is most often a degenerate condition observed in the older population. We describe the case of a lady with typical claudicant symptoms with an unusual cause of stenosis identified at the time of her decompressive surgery. On review of the literature this is only the second case of osteochondral loose body as a cause for lumbar spinal stenosis and thus remains a rare phenomenon.