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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Spinal stenosis at the C2-3 segment is a rare occurrence, and when it occurs myelopathy infrequently results. Furthermore, only a handful of cases involving congenital abnormalities of the posterior arch of the axis have been described resulting in cervical myelopathy many of which described simultaneous congenital abnormalities at adjacent levels and none of which identified ossification of the posterior longitudinal ligament (OPLL) at the same level. We report a case of a previously undescribed combination of abnormalities at the C2-3 segment resulting in clinical myelopathy. ⋯ Deficiencies in the posterior arch of the axis are rare and have not previously been reported in conjunction with OPLL. Advanced imaging is helpful to define the abnormality and site of compression. In the setting of a progressive neurological dysfunction, surgical decompression and stabilization is a reasonable intervention and can be associated with neurological and symptomatic improvement.
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Facet tropism is defined as asymmetry between left and right facet joints and is postulated as a possible cause of disc herniation. In the present study, the authors used a 3-T MRI to investigate the association between facet tropism and lumbar disc herniation at a particular motion segment. They also examined whether the disc herniated towards the side of the more coronally oriented facet joint. ⋯ The findings of the study suggest that facet tropism is associated with lumbar disc herniation at the L5-S1 motion segment but not at the L4-L5 level.
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To compare volume-occupying rate of cervical spinal canal between patients with cervical spondylotic myelopathy (CSM) and normal subjects, and to investigate its significance in cervical spine disease. ⋯ Volume-occupying rate of cervical spinal canal is an objective reflection of compression on cervical spine and spinal cord, and it is associated with cervical spinal cord function. These suggest that it may play a significant role in predicting the development of CSM.
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Case Reports
Congenital costo-vertebral fibrous band and congenital kyphoscoliosis: a previously unreported combination.
Congenital kyphoscoliosis (CKS) results from abnormal vertebral chondrification. Congenital fibrous bands occur in several locations with variable impact on vertebral development. ⋯ We also describe the therapeutic approach, consisting of surgical excision of the fibrous band and postoperative fulltime bracing, with a 7-year follow-up. We recommend a high index of suspicion in any unusual presentation of CKS and insist on case by case management in such cases.
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Case Reports
Two-stage multilevel en bloc spondylectomy with resection and replacement of the aorta.
We report a case of multilevel spondylectomy in which resection and replacement of the adjacent aorta were done. Although spondylectomy is nowadays an established technique, no report on a combined aortic resection and replacement has been reported so far. ⋯ En bloc spondylectomy in combination with aortic resection is feasible and might expand the possibility of producing tumor-free margins in special situations.