Cases reported "Back Pain"

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1/56. Childhood leukemia presenting with back pain and vertebral compression fractures.

    Vertebral body collapse and back pain are an unusual presentation for childhood leukemia. This report is intended to promote greater awareness that acute lymphocytic leukemia can cause significant back pain in children without other systemic symptoms. We describe four cases in which patients with acute lymphocytic leukemia presented with back pain and vertebral compression fractures. All of the patients were initially misdiagnosed. No patient had neurologic compromise, despite extensive vertebral body collapse. The back pain was relieved after chemotherapy.
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2/56. Stress fracture of the hip and pubic rami after fusion to the sacrum in an adult with scoliosis: a case report.

    Correction of adult scoliosis frequently involves long segmental fusions, but controversy still exists whether these fusions should include the sacrum. It has been suggested that forces associated with activities of daily living transfer the stresses to the remaining levels of the spine and to the pelvis. The case described here was a 43-year-old woman with scoliosis and chronic back pain refractory to non-surgical modalities. Radiographically, the patient had a 110 degree lumbar curve. An anterior and posterior fusion with Luque-Galveston instrumentation was performed. Six months postoperatively the patient returned with a 2-week history of right hip pain with no history of trauma. There was radiographic evidence of a displaced femoral neck fracture and pubic rami fractures. The femoral neck fracture was treated with a total hip replacement. Further surgeries were required to correct a lumbar pseudoarthrosis and hardware failure. We believe that this case provides evidence that fusion into the lumbosacral junction may distribute forces through the pelvic bones and hip resulting in stress and potential hardware complications, especially in patients at risk due to osteopenic conditions.
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3/56. osteoporosis and men. Don't forget the blokes.

    BACKGROUND: There is a clear analogy between osteoporosis and hypertension. After all, the fractures associated with osteoporosis can be as disastrous as a cardiovascular event associated with hypertension and both fractures and cardiovascular events, can be greatly reduced by modern treatment. However, osteoporosis is still relatively underdiagnosed, especially in men where it may not be considered an important aspect of men's health. OBJECTIVE: This case study may trigger readers to look for osteoporosis in men at risk and to use the available medications and interventions to preserve bone and avoid falls in such men, thus reducing fractures and associated disability and pain. DISCUSSION: The risk factors for osteoporosis and fracture are known and easily identified and measurement of bone mineral density quantifies bone loss and fracture risk. There are well established strategies to protect bone, to prevent fractures and to maintain comfort. osteoporosis is already a major public health problem in australia and will become more important as the proportion of old and the 'old old' increase over the next two decades. osteoporosis is recognised as an important component of the health of older women and should not be forgotten in older men.
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4/56. Glomangiopericytoma causing oncogenic osteomalacia. A case report with immunohistochemical analysis.

    A 47-year-old woman suffered from gait disturbance due to back pain and muscle weakness. Laboratory data showed serum hypophosphatemia, elevated alkaline phosphatase, and a normal level of ionized calcium. Radiological examinations revealed multiple pathologic fractures in the ribs and pubic rami. She had had no episode of familial or any other notable disorder, and so she was initially treated with medication for adult-onset osteomalacia. However, 19 years later (when she was 66 years old), she noticed a soft-tissue tumor in her buttock. The tumor was excised. The histological features were those of glomangiopericytoma characterized by both glomus tumor-like and hemangiopericytoma-like structures. After removal of the tumor, her symptoms disappeared immediately. Laboratory data normalized 8 months later. To our knowledge, this is the first report of oncogenic osteomalacia caused by glomangiopericytoma.
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5/56. Postpartal sacral fracture without osteoporosis.

    Stress fractures of the sacrum during pregnancy or the postpartum seem uncommon. We report a new case of nontrauma-related postpartal sacral fracture. Only four similar cases have been reported to date. The patient was 36 years of age and her fracture was diagnosed four weeks after her first delivery. vitamin d levels were low, but there was no osteomalacia. Other standard laboratory tests were normal, as were absorptiometry measurements at the lumbar spine and femur. Rheumatologists should consider sacral fracture in pregnant or nursing patients with buttock pain. magnetic resonance imaging is the diagnostic investigation of choice.
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6/56. Intraspinal metallosis causing delayed neurologic symptoms after spinal instrumentation surgery.

    STUDY DESIGN: Two cases of intraspinal metallosis causing delayed neurologic symptoms secondary to spinal instrumentation surgery are reported. OBJECTIVE: To present an unusual delayed neurologic complication after spinal instrumentation surgery. SUMMARY OF BACKGROUND DATA: Metal-related complications caused by orthopedic implants have long been a concern in the field of arthroplasty or internal fixation of fractures, but no such complications have been reported for spinal instrumentation. methods: Retrospective case report of two patients with degenerative scoliosis who presented with delayed neurologic symptoms months to years after uneventful, but without secondary degenerative changes or dislodgement of the implants. RESULTS: In both reported cases, a granulation-tissue mass characterized by marked metallosis had been formed in the spinal canal adjacent to a loosened laminar hook. CONCLUSIONS: Intraspinal metallosis should be kept in mind as a rare cause of delayed neurologic symptoms after spinal instrumentation surgery. With the metal implants in place, myelography was the sole informative examination for diagnosis.
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7/56. Root and spinal cord compression from methylmethacrylate vertebroplasty.

    STUDY DESIGN: Case report and literature review. OBJECTIVES: Clinicians use methylmethacrylate vertebroplasty to treat vertebral hemangiomas, metastases, and osteoporotic fractures. Cement may leak out of the vertebral body and compress the adjacent spinal cord and nerve roots. We review a case of nerve-root and cord compression from methylmethacrylate extrusion during vertebroplasty. SUMMARY OF BACKGROUND DATA: A 50-year-old female presented with disabling thoracic back pain. A metastasis to T1 was discovered, with collapse of the vertebral body but without cord compression. methylmethacrylate vertebroplasty was performed. After injection, portable computed tomography (CT) showed a leakage of methylmethacrylate into the C8 and T1 foramina and spinal canal. radiculopathy and myelopathy developed. Surgical decompression using the anterior approach was necessary. methods: Case report. RESULTS: Early surgical intervention decompressed the neural elements and relieved the neurological deficits. CONCLUSIONS: Neurologic complications of methylmethacrylate vertebroplasty necessitate active involvement of spine surgeons in patient evaluation and management.
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8/56. Vertebral compression and eosinophilia in a child with acute lymphatic leukemia.

    A 10-year-old girl, presenting with fever, eosinophilia, and back pain, was diagnosed with pre-B CD10-positive acute lymphoblastic leukemia. eosinophilia resolved rapidly during remission induction treatment, but diffuse spinal osteopenia with multiple compression fractures became manifest after 4 weeks. During subsequent treatment the spine remineralized slowly, and after 26 months vertebral bone regeneration was apparent. eosinophilia and osteopenia are separately known as early manifestations of acute lymphoblastic leukemia, but their simultaneous occurrence is particularly interesting. A late bone marrow relapse was not accompanied by bone changes or eosinophilia.
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9/56. Nonsecretory multiple myeloma.

    Nonsecretory multiple myeloma (NSMM) is a rare variant of the classic form of multiple myeloma (MM) and accounts for 1% to 5% of all cases of MM. The clinical presentation and radiographic findings of NSMM and MM are the same. The diagnosis of MM requires the detection of a monoclonal gammopathy in the serum or urine. In NSMM, however, no such gammopathy can be demonstrated, making the diagnosis more difficult. We describe a 43-year-old African American woman who initially had back pain and pathologic vertebral compression fractures that were thought to be due to osteoporosis. Five months later, hypercalcemia developed and NSMM was diagnosed. No monoclonal gammopathy was found in the serum or urine, but skeletal survey showed diffuse osteolytic lesions, and bone marrow biopsy revealed marked plasmacytosis. The immunohistochemical techniques and chromosomal analysis methods that are currently available are discussed.
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10/56. Severe erosion of lumbar vertebral body because of abdominal aortic false aneurysm: report of two cases.

    STUDY DESIGN: Two cases of lumbar vertebral erosion resulting from abdominal aortic false aneurysm are reported. OBJECTIVE: To present an uncommon complication of aortic endoprosthesis causing spinal pathology. SUMMARY OF BACKGROUND DATA: Vertebral body pathologies usually are associated with fracture, osteoporotic collapse, tumor, spondylitis, or spondylodiscitis. Aortic abdominal aneurysm rarely has been reported as causing lytic lesions of the spine. methods: A retrospective case analysis was performed for two patients with an aorta bifurcation prosthesis and lytic lesions of the spine. False aneurysms were detected at the proximal junction of the prostheses. A biopsy of the affected vertebrae showed no infection or malignancy. Surgery was performed in both cases, and the prostheses were successfully revised. In one case, an anteroposterior spinal fusion was performed because of severe anterior bone loss. RESULTS: The back pain of both patients resolved completely after surgery. In one of the patients, an embolectomy in the right leg failed, and a below-the-knee amputation had to be performed. CONCLUSIONS: In patients with endovascular prostheses, false aneurysm should be considered when lytic lesions of vertebral bodies are differentially diagnosed because these patients can present with only spinal symptoms.
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ranking = 0.2
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