Cases reported "Spinal Diseases"

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1/20. Intraspinal extradural cysts communicating with adjacent herniated disks: imaging characteristics and possible pathogenesis.

    We report two cases of intraspinal extradural cysts communicating with an adjacent herniated disk that we term "disk cysts." These cysts were well defined and homogeneous, and were present in the ventrolateral extradural space adjacent to a lumbar herniated disk. They had rim enhancement on contrast-enhanced MR images, and communication with a herniated disk was revealed by diskography.
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2/20. synovial cyst at the intervertebral foramina causing lumbar radiculopathy.

    OBJECTIVE: To determine the presence of intraforaminal synovial cysts resulting in nerve root compression. methods: A 26 year old man presenting with left leg pain was admitted. He had no motor, sensory, or reflex changes. magnetic resonance imaging (MRI) and MRI-myelography showed an intra and extra foraminal, extradural, cystic lesion at L4 vertebra on the left side. RESULTS: At surgery there was a cystic mass pressing on the nerve root, and no connection or communication with the dural structures could be found. CONCLUSION: Synovial cysts are uncommon extradural degenerative lesions. Intraspinal synovial cysts occur most often at the L4-5 level, but they have been reported in all areas of the spine except the intraforaminal region and the sacrum.
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3/20. Prevertebral abscess with extension into the hip joint.

    We present a case of a paravertebral abscess with extension into the hip joint. The presumed conduit of infection in this case is the iliopsoas bursa, which has been shown to provide direct communication between the retroperitoneal space and the hip joint in up to 15% of cadaveric specimens. The patient was treated with emergent open irrigation and debridement of the hip joint, as well as percutaneous drainage of the prevertebral abscess. The patient remains minimally symptomatic at the 2-year follow-up.
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4/20. Hemorrhagic synovial lumbar cyst: a case report and review of the literature.

    The authors report a case of an 81-year-old woman affected by a synovial cyst arising from the left facet joint of L3. The patient presented with severe pain and claudicatio spinalis. Diagnosis was based upon standard x-rays and MRI; the patient was operated on and the histology of the lesion confirmed the pre-operative diagnosis. On MRI images the lesion appeared as a roundish extradural mass arising from the left facet joint of L3, compressing the cauda equina posteriorly, and it appeared with an increased heterogeneous signal, consistent with a high quantity of fluid and hemosiderin within the cyst. A communication between the lesion and the joint space was evident on the MRI sagittal reconstruction. Grossly the cut surface of the mass had a cystic aspect, with some hemorrhagic areas between whitish myxoid tissue. Histologically the lesion was formed by fibrous connective tissue covered by synovium; focal inflammation and hemosiderin-laden macrophages were also present in some areas. At one year follow-up the patient is symptom-free.
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5/20. Spontaneous regression of an intraspinal disc cyst.

    We present a patient with a so-called disc cyst. Its location in the ventrolateral epidural space and its communication with the herniated disc are clearly shown. The disc cyst developed rapidly and regressed spontaneously. This observation, which has not been reported until now, appears to support focal degeneration with cyst formation as the pathogenesis.
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6/20. Enlarging vertebral body pneumatocysts in the cervical spine.

    An intravertebral pneumatocyst is a relatively rare condition, and its natural course and etiology are unclear. We report a case of intravertebral pneumatocysts in the C5 vertebra that gradually enlarged during a 16-month period as documented by follow-up CT. In addition, direct communication was observed between the gas in the intervertebral disk and another pneumatocyst in the C6 vertebral body, which suggests that the gas in the pneumatocyst had an association with the gas in the degenerated intervertebral disk.
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7/20. Studies of vertebral coronal cleft in rhizomelic chondrodysplasia punctata.

    dissection and serial section-reconstruction preparations from vertebrae with coronal cleft of a 2 5/12-year-old girl with rhizomelic chondrodysplasia punctata are described. The cartilage plate between the dorsal and ventral vertebral ossification centers, abnormal thickness of which is the explanation of the radiologic coronal cleft, shows differences in thickness, with dorsal and ventral midline extensions and with small foci of communication of the cancellous bone of the dorsal and ventral ossification centers of the vertebral body bilaterally. Although the process in coronal cleft is in some ways similar to that of radiologic "retarded epiphyseal closure," the explanation of the coronal clefts in rhizomelic chondrodysplasia punctata appears to be overproduction of cartilage in the zone between the dorsal and ventral vertebral body ossification centers, plus reduced removal of cartilage cells from this zone. No evidences of persistence of notochord cells were seen microscopically in sections of the coronal clefts.
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8/20. Osteogenic sarcoma of the sacral spine: an interdisciplinary team challenge.

    A child with osteogenic sarcoma of the sacral spine has complex nursing and interdisciplinary team needs. The course of one patient is discussed, both from the patient and family's perspective and that of her inter-disciplinary care team. The need for a coordinated, holistic approach to care that involves advance planning, continual reassessment of goals, and clear communication among the team members and consulting services is clearly demonstrated.
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9/20. Cervical epidural hematoma in children: a rare clinical entity. Case report and review of the literature.

    Pediatric spinal epidural hematoma is a very rare clinicopathological entity. In the vast majority of cases, spinal epidural hematomas have a nonspecific clinical presentation; this, along with their rapid progression, makes their early diagnosis and prompt surgical evacuation critical. magnetic resonance imaging is the neuroimaging modality of choice, whereas hemilaminectomy or laminectomy is the indicated surgical intervention. The outcome is good when hematoma evacuation is performed before the onset of complete sensorimotor paralysis. In this communication, the authors describe a 12-year-old girl with a traumatic acute cervical epidural hematoma. This lesion was successfully evacuated through a hemilaminectomy, and the patient had an excellent outcome. The pertinent literature is reviewed in terms of the incidence, origin, management, and prognosis of this rare and potentially disastrous clinical entity.
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10/20. Spinal meningeal cyst.

    A case of meningeal cyst of the spine in the thoraco-lumbar region is described. Although water-soluble myelography may disclose a filling defect and possibly reveal communication between the cyst and the subarachnoid space, computerized tomographic myelography more readily reveals communication between the cyst and the subarachnoid space. This finding allows accurate diagnosis of a spinal meningeal cyst and rules out other mass lesions. A classification comprising three categories is made: spinal extradural meningeal cysts without spinal nerve root fibers (Type I), spinal extradural meningeal cysts with spinal nerve root fibers (Type II) and spinal intradural meningeal cysts (Type III). Final characterization is based on operative inspection and histological examination.
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