scholarly journals Espondilodiscite Brucélica: Casuística dos Últimos 25 Anos

2014 ◽  
Vol 27 (2) ◽  
pp. 204 ◽  
Author(s):  
Ana Lebre ◽  
Jorge Velez ◽  
Diana Seixas ◽  
Eduardo Rabadão ◽  
Joaquim Oliveira ◽  
...  
Keyword(s):  
Average Duration ◽  
Signs And Symptoms ◽  
Neurological Deficits ◽  
Imaging Method ◽  
Low Back ◽  
Positive Serology ◽  
Abscess Drainage ◽  
Duration Of Symptoms ◽  
Spinal Magnetic Resonance Imaging ◽  
Appropriate Therapy

<strong>Introduction:</strong> Brucellosis is an endemic zoonosis in Portugal. Brucellar spondylodiscitis is one of the most frequent focal manifestations which may cause severe sequelae despite appropriate therapy.<br /><strong>Material and Methods:</strong> Retrospective study of patients with diagnosis of brucellar spondylodiscitis admitted to the Infectious Diseases Department of Centro Hospitalar e Universitário de Coimbra, over a 25-year period (1988-2012).<br /><strong>Results:</strong> We identified 54 patients, 55.6% male, mean age of 54.8 years. In 81.5% an epidemiological context was identified, mostly contact with sheep and goats. The duration of symptoms prior to diagnosis was 5.5 months. The most common signs and symptoms were pain (98.1%), fever (46.3%) and neurological deficits (25.9%). Spinal magnetic resonance imaging was the most used imaging method (77.8%) showing abscesses in 29.6% of patients. Lumbar location predominated (77.7%). Diagnosis was attained in 47 patients (87.0%): positive blood cultures (3 patients), positive serology (32 patients) or by both methods (12 patients). Combined regimens of doxycycline and rifampicin (64.8%), or streptomycin (24.1%) were most used, for an average duration of 4.4 months. A patient was referred for surgery for abscess drainage. Evolution was mostly favorable (92.6%), no deaths occurring.<br /><strong>Discussion:</strong> Research of the epidemiologic context turned out to be a major key leading to the diagnosis. Treatment of osteoarticular brucellosis is still controversial.<br /><strong>Conclusions:</strong> Brucellar spondylodiscitis should be considered in the differential diagnosis of patients with low back pain, even in the absence of fever, particularly in regions where the disease is endemic. Antibiotic regimen, its’ duration and the need for surgery should be individualized to achieve a better prognosis. Cases have declined over the years, a fact related to better control of animal endemic.

scholarly journals A Rare Cause of Postpartum Low Back Pain: Pregnancy- and Lactation-Associated Osteoporosis

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Rabia Terzi ◽  
Hasan Terzi ◽  
Tülay Özer ◽  
Ahmet Kale
Keyword(s):  
Risk Factors ◽  
Low Back Pain ◽  
Back Pain ◽  
Fragility Fractures ◽  
Low Back ◽  
Rare Form ◽  
Current Case ◽  
Pregnancy And Lactation ◽  
Significant Disability ◽  
Appropriate Therapy

Pregnancy- and lactation-associated osteoporosis (PLO) is a rare form of osteoporosis. It results in severe low back pain in the last trimester of pregnancy and in the postpartum period, decreases in height, and fragility fractures, particularly in the vertebra. The current case report presents a 32-year-old patient who presented with back and low back pain that began in the last trimester of the pregnancy and worsened at two months postpartum and who was diagnosed with pregnancy- and lactation-associated osteoporosis after exclusion of other causes; the findings are discussed in view of the current literature. PLO is a rare clinical condition causing significant disability. PLO must be kept in mind in the differential diagnosis in patients presenting with low back pain during or after pregnancy. The patients must be evaluated for the risk factors of PLO, and an appropriate therapy must be initiated.

scholarly journals Rapidly Progressive Spontaneous Spinal Epidural Abscess

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Abdurrahman Aycan ◽  
Ozgür Yusuf Aktas ◽  
Feyza Karagoz Guzey ◽  
Azmi Tufan ◽  
Cihan Isler ◽  
...  
Keyword(s):  
Epidural Abscess ◽  
Delayed Diagnosis ◽  
Clinical Findings ◽  
Neurological Deficits ◽  
Spinal Epidural Abscess ◽  
Low Back ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Paraspinal Abscess ◽  
Spinal Epidural

Spinal epidural abscess (SEA) is a rare disease which is often rapidly progressive. Delayed diagnosis of SEA may lead to serious complications and the clinical findings of SEA are generally nonspecific. Paraspinal abscess should be considered in the presence of local low back tenderness, redness, and pain with fever, particularly in children. In case of delayed diagnosis and treatment, SEA may spread to the epidural space and may cause neurological deficits. Magnetic resonance imaging (MRI) remains the method of choice in the diagnosis of SEA. Treatment of SEA often consists of both medical and surgical therapy including drainage with percutaneous entry, corpectomy, and instrumentation.

scholarly journals Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 8: Lumbar fusion for disc herniation and radiculopathy

2014 ◽  
Vol 21 (1) ◽  
pp. 48-53 ◽  
Author(s):  
Jeffrey C. Wang ◽  
Andrew T. Dailey ◽  
Praveen V. Mummaneni ◽  
Zoher Ghogawala ◽  
Daniel K. Resnick ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Lumbar Fusion ◽  
Signs And Symptoms ◽  
Herniated Disc ◽  
Spinal Instability ◽  
Low Back ◽  
Low Level ◽  
Disc Herniations

Patients suffering from a lumbar herniated disc will typically present with signs and symptoms consistent with radiculopathy. They may also have low-back pain, however, and the source of this pain is less certain, as it may be from the degenerative process that led to the herniation. The surgical alternative of choice remains a lumbar discectomy, but fusions have been performed for both primary and recurrent disc herniations. In the original guidelines, the inclusion of a fusion for routine discectomies was not recommended. This recommendation continues to be supported by more recent evidence. Based on low-level evidence, the incorporation of a lumbar fusion may be considered an option when a herniation is associated with evidence of spinal instability, chronic low-back pain, and/or severe degenerative changes, or if the patient participates in heavy manual labor. For recurrent disc herniations, there is low-level evidence to support the inclusion of lumbar fusion for patients with evidence of instability or chronic low-back pain.

A Modified Delphi Survey on the Signs and Symptoms of Low Back Pain: Indicators for an Interventional Management Approach

Pain Practice ◽  
2013 ◽  
Vol 15 (1) ◽  
pp. 12-21 ◽  
Author(s):  
José Cid ◽  
José L. De La Calle ◽  
Esther López ◽  
Cristina Del Pozo ◽  
Alfredo Perucho ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Signs And Symptoms ◽  
Delphi Survey ◽  
Management Approach ◽  
Low Back ◽  
Modified Delphi ◽  
Interventional Management

scholarly journals Cervical neuromyelitis optica with thoracic ependymoma

2021 ◽  
Vol 12 ◽  
pp. 396
Author(s):  
Yeow Leng Tan ◽  
Minghe Moses Koh
Keyword(s):  
Neuromyelitis Optica ◽  
Spinal Cord Tumor ◽  
Neurological Deficits ◽  
High Signal ◽  
Positive Serology ◽  
Limb Weakness ◽  
Intramedullary Spinal Cord ◽  
Critical Studies ◽  
Spinal Ependymoma ◽  
Abnormal Visual

Background: The occurrence of cervical neuromyelitis optica (NMO) in a patient with a thoracic ependymoma is uncommon. Here, we present a patient with a spinal ependymoma who developed the new onset of NMO 2 months later. Case Description: A 66-year-old male presented with right lower limb weakness. The magnetic resonance (MR) revealed an intramedullary spinal cord tumor at the T2-T4 level. It was surgically excised and proved pathologically to be an ependymoma. 2 months later, the patient presented with an acute partial quadriparesis and a high signal intensity cord lesion at the C2-C3 level attributed to seropositive NMO (i.e. additional diagnostic studies confirmed this diagnosis). Conclusion: Patients with intramedullary thoracic ependymomas may also develop NMO resulting in recurrent/ new neurological deficits. Critical studies utilized to diagnose NMO include brain and spine MRs showing unique intramedullary brain/cord lesions, aquaporin-4 positive serology, and classical abnormal visual studies. If the diagnosis of NMO is established, multiple additional medical therapies are warranted.

scholarly journals Commonest modes of presentation of bone and soft tissue tumors at sarcoma services of A Tertiary Care Hospital of KPK.

2020 ◽  
Vol 27 (12) ◽  
pp. 2744-2748
Author(s):  
Muhammad Ibrahim ◽  
Zeeshan Khan ◽  
Muhammad Saeed ◽  
Israr Ahmad ◽  
Salik Kashif ◽  
...  
Keyword(s):  
Health Care Professionals ◽  
Tertiary Care ◽  
Sampling Technique ◽  
Signs And Symptoms ◽  
Soft Tissue Tumors ◽  
Care Hospital ◽  
Duration Of Symptoms ◽  
Mode Of Presentation ◽  
Number Of Patients ◽  
Delays In Diagnosis

Objectives: The aim of this study is to assess the commonest mode of presentation at our sarcoma unit and the duration from onset of symptoms till presentation. Study Design: Retrospectively study. Setting: Sarcoma Unit of Hayatabad Medical Complex, Peshawar. Period: June 2016 to December 2019. Material & Methods: Two hundred and eighty two patients were included in this study of which 172 patients were male and 110 were female. Sample size was calculated through non-probability consecutive sampling technique. Results: Average age of patients presenting to us was 30.2years (±18.5) ranging from 3years to 83years. Highest numbers of patients fell into the age group category of 11-20years i.e. 94 (33.33%). The average duration of symptoms among our patients was 19.6 months (±26.09) ranging from 0.1months (3 days) to 168 months (14years). Highest number of patients fell into the 7months-12months category i.e. 86 patients (30.5%). The commonest mode of presentation among our patients was painful lump i.e. 128(45.3%) while patients presenting with painless lump were 57(20.2%) and those presenting with only pain were 28(9.9%). Conclusion: The study concluded that there is a need of greater awareness amount general population and health care professionals regarding red flag signs and symptoms in order to avoid the delays in diagnosis which may leads to poor prognosis.

scholarly journals An Intramuscular Epidermal Cyst of Erector Spinae Muscles: A Case Report

2020 ◽  
pp. 1-3
Author(s):  
Seung Won Park ◽  
Jong Han Gill ◽  
Myeong Jin Ko ◽  
Seong Hyun Wui ◽  
Seung Won Park
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Subcutaneous Tissue ◽  
Erector Spinae ◽  
Epidermal Cyst ◽  
Low Back ◽  
Palpable Mass ◽  
Spinal Magnetic Resonance Imaging ◽  
Local Tenderness ◽  
The Right

An intramuscular epidermal cyst without subcutaneous involvement is extremely rare. The patient presented with low back pain. Spinal magnetic resonance imaging indicated spindle-shaped mass in the right erector spinae muscles located at L3 to L5 level without any connection with subcutaneous tissue. The patient underwent operation for removal of intramuscular cystic lesion. The tumor was totally removed and pathologically confirmed with epidermal cyst. Unlike typical epidermal cyst, the patient had a characteristic clinical manifestation of mild low back pain without palpable mass and local tenderness.

scholarly journals Tubular approach to minimally invasive microdiscectomy for pediatric lumbar disc herniation

2018 ◽  
Vol 21 (5) ◽  
pp. 449-455 ◽  
Author(s):  
Julio D. Montejo ◽  
Joaquin Q. Camara-Quintana ◽  
Daniel Duran ◽  
Jeannine M. Rockefeller ◽  
Sierra B. Conine ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Pediatric Patients ◽  
Lumbar Disc ◽  
Low Back ◽  
Duration Of Symptoms ◽  
Patient Reported ◽  
The Mean

OBJECTIVELumbar disc herniation (LDH) in the pediatric population is rare and exhibits unique characteristics compared with adult LDH. There are limited data regarding the safety and efficacy of minimally invasive surgery (MIS) using tubular retractors in pediatric patients with LDH. Here, the outcomes of MIS tubular microdiscectomy for the treatment of pediatric LDH are evaluated.METHODSTwelve consecutive pediatric patients with LDH were treated with MIS tubular microdiscectomy at the authors’ institution between July 2011 and October 2015. Data were gathered from retrospective chart review and from mail or electronic questionnaires. The Macnab criteria and the Oswestry Disability Index (ODI) were used for outcome measurements.RESULTSThe mean age at surgery was 17 ± 1.6 years (range 13–19 years). Seven patients were female (58%). Prior to surgical intervention, 100% of patients underwent conservative treatment, and 50% had epidural steroid injections. Preoperative low-back and leg pain, positive straight leg raise, and myotomal leg weakness were noted in 100%, 83%, and 67% of patients, respectively. The median duration of symptoms prior to surgery was 9 months (range 1–36 months). The LDH level was L5–S1 in 75% of patients and L4–5 in 25%. The mean ± SD operative time was 90 ± 21 minutes, the estimated blood loss was ≤ 25 ml in 92% of patients (maximum 50 ml), and no intraoperative or postoperative complications were noted at 30 days. The median hospital length of stay was 1 day (range 0–3 days). The median follow-up duration was 2.2 years (range 0–5.8 years). One patient experienced reherniation at 18 months after the initial operation and required a second same-level MIS tubular microdiscectomy to achieve resolution of symptoms. Of the 11 patients seen for follow-up, 10 patients (91%) reported excellent or good satisfaction according to the Macnab criteria at the last follow-up. Only 1 patient reported a fair level of satisfaction by using the same criteria. Seven patients completed an ODI evaluation at the last follow-up. For these 7 patients, the mean ODI low-back pain score was 19.7% (SEM 2.8%).CONCLUSIONSTo the authors’ knowledge, this is the longest outcomes study and the largest series of pediatric patients with LDH who were treated with MIS microdiscectomy using tubular retractors. These data suggest that MIS tubular microdiscectomy is safe and efficacious for pediatric LDH. Larger prospective cohort studies with longer follow-up are needed to better evaluate the long-term efficacy of MIS tubular microdiscectomy versus other open and MIS techniques for the treatment of pediatric LDH.

EOSINOPHILIC GRANULOMA OF THE CERVICAL SPINE IN CHILDREN

PEDIATRICS ◽  
1970 ◽  
Vol 45 (5) ◽  
pp. 746-752
Author(s):  
Robin I. Davidson ◽  
John Shillito
Keyword(s):  
Cervical Spine ◽  
Pyramidal Tract ◽  
Eosinophilic Granuloma ◽  
Cervical Vertebra ◽  
Signs And Symptoms ◽  
Neurological Deficits ◽  
Restricted Range ◽  
Cervical Pain ◽  
Range Of Movement

Eosinophilic granuloma of the cervical spine is recorded in six children, two of whom had neurological deficits. A flaccid monoparesis occurred in one child with a C5 arch lesion. Pyramidal tract signs were present in a patient with a defect at the atlanto-occipital joint. Cervical pain, restricted range of movement, torticollis, and tenderness were other presenting signs and symptoms and occurred in all except one patient. A lytic defect in the arch or centrum of a cervical vertebra was associated with this presentation. Treatment following biopsy consisted of immobilization and radiotherapy in a range of 450 to 750 rads. Cure was effected in all instances.

CMV Colitis Mimicking Recurrent Inflammatory Bowel Disease: Report of Three Cases

2007 ◽  
Vol 73 (1) ◽  
pp. 58-61 ◽  
Author(s):  
Dorna Rezania ◽  
Abderrhman Ouban ◽  
Jorge Marcet ◽  
Scott Kelley ◽  
Domenico Coppola
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Cytomegalovirus Infection ◽  
Correct Diagnosis ◽  
Signs And Symptoms ◽  
Cytomegalovirus Colitis ◽  
Pathologic Features ◽  
Appropriate Therapy ◽  
Inflammatory Bowel ◽  
Cmv Colitis

The association between cytomegalovirus infection and inflammatory bowel disease challenges both the clinician and the pathologist to establish the correct diagnosis and to prescribe the most appropriate form of therapy. To understand this association the authors report three patients who presented with signs and symptoms mimicking reactivated inflammatory bowel disease who responded poorly to aggressive treatment of inflammatory bowel disease. Microscopic examination, in all three cases revealed numerous nuclear and cytoplasmic viral inclusions, as demonstrated by cytomegalovirus immunohistochemistry, as well as histologic findings consistent with inflammatory bowel disease (ulcerative colitis and/or Crohn's disease). Because the clinical pathologic features of cytomegalovirus colitis and inflammatory bowel disease often overlap, and because of the possible coexistence of cytomegalovirus colitis with idiopathic colitis, the possibility of cytomegalovirus infection should be always considered, so that the most appropriate therapy can be instituted for these patients.

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