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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Case Reports
Ten year follow-up of Jarcho-Levin syndrome with thoracic insufficiency treated by VEPTR and MCGR VEPTR hybrid.
Jarcho-Levin syndrome patients commonly suffer from repeated respiratory infections and become ventilator dependent due to an insufficient thoracic volume. Multiple congenital vertebral anomalies are associated with this genetic disorder and results in stunted spine growth. The purpose of this case report is to present the results of a hybrid vertical expandable prosthetic titanium rib (VEPTR) and magnetically controlled growing rod (MCGR) construct for the management of a patient with Jarcho-Levin syndrome. ⋯ A hybrid construct is necessary for managing Jarcho-Levin syndrome as the VEPTR deals with the thoracic cage deformity while the MCGR deals with the spine deformity.
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Anterior approach to the upper thoracic spine is difficult. It is important for spine surgeons to know the indication and the effect of anterior decompression for upper thoracic lesions and also to recognize the complications which are related to the approach with sternotomy. We present two patients for whom we took the sternum-splitting anterior approach for thoracic ossification of the posterior longitudinal ligament (OPLL) following posterior decompression and fusion surgery; the clinical course and surgical outcome are discussed, with particular reference to complication avoidance and also we review the previous literature. ⋯ Both a safe surgical approach and preventive measures to alleviate postoperative complications are mandatory in difficult cases with thoracic OPLL.
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Case Reports
Atlantoaxial dislocation and os odontoideum in two identical twins: perspectives on etiology.
There are two theories about the origin of os odontoideum: traumatic or congenital. However, most studies favor the hypothesis of traumatic theory. To emphasize the congenital theory, we report a pair of identical twins both with atlantoaxial dislocation and os odontoideum, which is believed to be a congenital defect. ⋯ Although a great number of cases with os odontoideum have been reported to be traumatic, there are some cases believed to be congenital.
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Lumbar spinal canal stenosis (LSCS) is associated with fibrosis, decreased elastin-to-collagen ratio, and hypertrophy of the ligamentum flavum (LF). Diabetes mellitus (DM) is known to cause metabolic disturbances within the extracellular matrix in multiple tissues. These alterations may play a major role in the severity of clinical symptoms of LSCS affecting diabetic patients. We aimed to examine the hypothesis that DM may contribute to the LF changes seen in patients with LSCS. ⋯ The present study points to a significant contribution of DM to the loss of elastin fibers that occurs in the LF of patients with LSCS.
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Review Case Reports
The etiology of congenital scoliosis: genetic vs. environmental-a report of three monozygotic twin cases.
To describe the presence of congenital scoliosis in a genetically identical population as it relates to the possible genetic vs. environmental etiologic factors. ⋯ The variable presentation of congenital scoliosis in a genetically unique population serves as testament to the complexity associated with its development, likely involving both environmental factors and a genetic predisposition.