1/122. spinal cord compression caused by unusual location and extension of ossified ligamenta flava in a Caucasian male. A case report and literature review.STUDY DESIGN: A case report of a spinal cord compression caused by ossification of the ligamenta flava is presented together with a review of the literature. OBJECTIVE: To present the diagnosis of ossification of the ligamenta flava in a Caucasian man with a proximal thoracic myelopathy. SUMMARY OF BACKGROUND DATA: This case shows that the upper parts of the thoracic spine can be involved in ossification of the ligamenta flava, which never before has been reported in Caucasian individuals. Furthermore, it is advised that computed tomography scanning and magnetic resonance imaging be combined to provide an accurate diagnosis and proper preoperative evaluation of the bony changes, spinal cord, and compression of the spinal cord. methods: A patient with a thoracic spinal cord compression caused by ossification of the ligamenta flava was treated surgically and made a good clinical recovery. Imaging studies, surgical findings, and results of histopathologic investigations were analyzed to substantiate the diagnosis. RESULTS: The results of the surgical findings seemed to be in contrast with those of the imaging studies. This contrast was occasioned by the uncommon perioperative finding of a fusion of the completely ossified upper and lower parts of the involved adjacent ligamenta flava. Ossification of the ligamenta flava was diagnosed by histopathologic examination, which revealed endochondral ossification and lamellar bone formation without fragments of ligamenta flava. CONCLUSION: Although rarely reported in whites, ossification of the ligamenta flava should be considered in all patients presenting with a spinal cord compression, even at high thoracic levels. The prognosis after decompressive surgery can be good, especially if intramedullary hyperintensities are absent on preoperatively performed T2-weighted magnetic resonance images.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
2/122. Ossification of the cervical anterior longitudinal ligament contributing to dysphagia. Case report.The authors evaluated the clinical, radiological, and surgical management of ossification of the anterior longitudinal ligament (OALL) that contributed to dysphagia in a patient with simultaneous cervical ossification of the posterior longitudinal ligament (OPLL). A 57-year-old man presented with increasing dysphagia and moderate myelopathy. Imaging studies, including esophagoscopy, revealed marked esophageal compression due to OALL that extended between the C2-5 levels and significant C5-7 OPLL that compressed the distal cervical spinal cord. The use of rongeurs and a high-speed drill facilitated excision of the C2-5 OALL mass, and a routine anterior corpectomy with fusion was performed at the C5-7 level. Postoperatively, the patient's dysphagia and symptoms of myelopathy immediately resolved. The strut graft became fully fused 3 months postoperatively, as demonstrated on dynamic x-ray films, and the patient has remained asymptomatic 4 months postoperatively. patients with dysphagia and coexisting myelopathy benefit from simultaneous surgery for resection of OALL and OPLL masses.- - - - - - - - - - ranking = 0.125keywords = compression (Clic here for more details about this article) |
3/122. Heterotopic bone formation in association with pelvic fracture and urethral disruption.PURPOSE: The initial and secondary management of pelvic fracture associated with disruption of the membranous urethra is the subject of a wide literature containing varied and controversial viewpoints. We have noted the presence of heterotopic bone formation surrounding the area of urethral injury in patients undergoing delayed repair. We investigated the etiology, incidence and risk factors associated with such an injury, as well as potential means of prophylaxis. MATERIALS AND methods: We reviewed the current literature on heterotopic bone formation with similar traumatic injury. While instances of severe urethral disruption of this type are fortunately rare in children we describe prepubertal boys with such an injury complicated by heterotopic ossification. RESULTS: The incidence of heterotopic ossification reported in children and adolescents is 3 to 15%, which is less than 15 to 80% reported in adults. risk factors associated with traumatic heterotopic ossification include prolonged operating time, hematoma formation, degree of bony debris, devitalized muscle and concomitant infection. Prophylaxis with single low dose radiation or nonsteroidal anti-inflammatory drugs has been shown to be effective in the prevention of heterotopic ossification and may be beneficial in this patient population. CONCLUSIONS: Heterotopic bone formation associated with severe traumatic injury in the presence of devitalized tissue resulting in the pathological formation of new bone is rare. This complication is only associated with the most severe pelvic fractures. Prophylaxis in these most severe cases with low dose radiation or nonsteroidal anti-inflammatory drugs can prevent the formation of heterotopic bone.- - - - - - - - - - ranking = 0.92655019689174keywords = fracture (Clic here for more details about this article) |
4/122. Intraarticular heterotopic ossification in the knee following intramedullary nailing of the fractured femur using a retrograde method.The cases of a forty-five-year-old woman and a twenty-year-old man who developed severe intraarticular and periarticular heterotopic ossification around the knee following intramedullary nailing of a femur fracture using a retrograde technique. The association of musculoskeletal heterotopic ossification with closed head injuries seems well established and can occur in and around the knee following retrograde intramedullary nailing. This complication may occur more often than has been reported.- - - - - - - - - - ranking = 0.77212516407645keywords = fracture (Clic here for more details about this article) |
5/122. Severe heterotopic ossification after arthroscopic acromioplasty: a case report.Heterotopic ossification is a well-recognized complication of spinal cord injury, closed head injury, total hip arthroplasty, burns, and other trauma and has been observed in various tissues such as muscles, tendons, ligaments, and menisci. Complications of arthroscopic acromioplasty are relatively uncommon and include hematoma, traction neuropathy, infection, acromial fracture, reflex sympathetic dystrophy, and instrument breakage. However, little has been reported on heterotopic ossification of the shoulder, particularly after arthroscopic surgery. Recurrent rotator cuff impingement symptoms caused by small amounts of heterotopic ossification after arthroscopic acromioplasty have been described. We report a case of severe heterotopic ossification about the shoulder after arthroscopic acromioplasty.- - - - - - - - - - ranking = 0.15442503281529keywords = fracture (Clic here for more details about this article) |
6/122. Spontaneous fracture of an ossified stylohyoid ligament.The stylohyoid ligament extends from the styloid process to the hyoid bone. For an unknown reason it occasionally ossifies and forms a solid structure which can break because of trauma or even spontaneously. Symptoms of the fracture may mimic tumours, foreign bodies, infections or neuralgia. In our cases a spontaneous fracture of totally ossified stylohyoid ligaments presented as a painful neck swelling. The diagnosis was achieved by an ortopantomographic radiograph. In both cases the healing was spontaneous and complete.- - - - - - - - - - ranking = 0.92655019689174keywords = fracture (Clic here for more details about this article) |
7/122. Dysphagia in a patient with giant osteophytes: case presentation and review of the literature.A patient with increasing dysphagia due to external bone compression of the oesophagus is presented. Radiographic evaluation revealed the underlying condition to be a diffuse idiopathic skeletal hyperostosis with exuberant and bumpy change within the anterior longitudinal ligament.- - - - - - - - - - ranking = 0.125keywords = compression (Clic here for more details about this article) |
8/122. Ossification of the yellow ligament causing thoracic cord compression.Ossification of the yellow ligament (OYL) is not infrequent in the cervical and lumbar regions but is very rare in the thoracic spine, with no more than 40 cases reported in the literature. We describe a 50-year-old male with progressive paraparesis and sensory dysfunction, secondary to OYL at T10-T11, studied by computed tomography (CT) and magnetic resonance imaging (MRI). Decompressive laminectomy and removal of the ligament resulted in marked clinical improvement. patients with OYL may initially develop sensory dysfunction associated with leg weakness. This pathological entity can be well defined by CT and MRI, and surgery by decompressive laminectomy is advised for all cases. The OYL should be removed both posteriorly and laterally to the dural sac to obtain sufficient decompression of the spinal canal.- - - - - - - - - - ranking = 0.625keywords = compression (Clic here for more details about this article) |
9/122. scala vestibuli insertion in cochlear implantation: a valuable alternative for cases with obstructed scala tympani.Insertion of a sufficient number of electrodes is important for a successful use of cochlear implants. We investigated the results of scala vestibuli insertion for cochlear implantation in cases of obstructed scala tympani. In a series of 200 cochlear implantations, scala vestibuli insertion was successfully performed in 4 cases with obstruction of the scala tympani. Etiologies included a temporal bone fracture, severe otosclerosis and malformations of the cochlea. The maximum insertion depth obtained via the scala vestibuli was 30 mm. Postoperative results were comparable to patients in whom conventional scala tympani insertion was performed. No adverse effects related to the site of insertion were observed. scala vestibuli insertion offers a valuable alternative in cases of obstructed scala tympani that can be employed for a variety of etiologies.- - - - - - - - - - ranking = 0.15442503281529keywords = fracture (Clic here for more details about this article) |
10/122. Heterotopic ossification of the adductor longus muscle presenting as dyspareunia.dyspareunia after heterotopic ossification of the adductor longus is a rare complication. We describe a patient with symptomatic heterotopic ossification of the adductor muscle that developed years after sustaining a fracture of the inferior pubic ramus in association with an injury to the adductor longus muscle. The patient's pain was reduced and his dyspareunia resolved after excision of the adductor longus heterotopic ossification and subsequent physical therapy.- - - - - - - - - - ranking = 0.15442503281529keywords = fracture (Clic here for more details about this article) |
| | Next -> |