Intraosseous Lipoma: 18 Years of Experience at a Single Institution

BACKGROUND: Intraosseous lipoma is a very rare lesion that constitutes no more than 0.1% of all bone tumors. We analyzed 21 cases of intraosseous lipoma at a single institution for clinical and radiographic characteristics. METHODS: A retrospective study was performed on 21 pathologically confirmed intraosseous lipomas treated in our hospital from 2000 to 2017. Simple X-ray and magnetic resonance imaging findings and medical records were reviewed. Patients' age, sex, and clinical symptoms were investigated. From the radiographic images, the site of the lesion, calcification, bony expansion, and stage of the lesion were evaluated. Correlations between the degree of involution and clinical symptoms were analyzed. RESULTS: The mean age of patients was 50 years (range, 20 to 67 years), and there were 13 males and eight females. The mean lesion size was 6.1 cm (range, 2.5 to 13.6 cm). The most common anatomical site of the lesion was the femur (seven cases), and three cases occurred in flat bones such as the ilium and scapula. Visual analogue scale score for pain was 3 to 6 in 15 patients. There were no complaints of functional limitation. There was no correlation between the degree of degeneration and clinical symptoms (p = 1.000). Curettage was performed as a surgical treatment in 20 patients, and bone graft was performed using a bone chip. Excision was performed in one patient. Pain was resolved in seven of 11 patients with a complaint of preoperative pain; intermittent pain remained in four cases. There was no local recurrence or malignant change during the follow-up. CONCLUSIONS: There was no correlation between the degree of degeneration and clinical symptoms. Pain was the most common clinical symptom, but it was rarely accompanied by functional limitation. However, it is important to distinguish it from other pain-inducing disorders. The incidence of intraosseous lipomas is low, and detection based on various imaging findings can be difficult. Clear understanding of the radiographic findings and symptoms of intraosseous lipoma is helpful for diagnosis and differentiation.

The Effectiveness of Ultrasound-Guided Selective Nerve Root Block for the Treatment of Radicular Pain in the Lower Cervical Spine: An Assessment of Sustainability and Side Effects / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to evaluate the sustainability and adverse effects of ultrasound-guided selective nerve root block in patients who complained of radiculopathy due to lower cervical disc herniation. MATERIALS AND METHODS: Between February 2014 and February 2016, 39 out of 60 patients who visited Department of Orthopedic Surgery, Kosin University Gospel Hospital with a chief complaint of radiculopathy due to lower cervical disc herniation were treated with an ultrasound-guided selective nerve root block. To evaluate the efficacy and sustainability of this treatment, the degree of pain relief and functional improvement were evaluated before and 3 months after the procedure. Patients were categorized into two groups: The soft disc group and the hard disc group. The safety of the procedure was evaluated by examining the side effects occurring immediately after the procedure and the following day. RESULTS: Visual analogue scale and Neck Disability Index were improved from 6.00 to 3.02 and from 15.82 to 6.15, respectively (p < 0.05). There were 2 cases of headache and 2 cases of dizziness; however, they were resolved within 1 hour after the procedure. In 32 patients (82.1%), there was improvement in pain, which persisted for more than 3 months in 24 patients. Contrastinly, 7 patients (17.9%) showed no improvement and 6 patients (15.4%) experienced recurrence of pain or symptoms within 1 month after the procedure. In the soft disc group, there was a reduction in pain, from a score of 5.88 before the procedure to 2.64 twelve weeks after the procedure (p < 0.01). In the hard disc group, there was also a reduction in, from a score of 6.09 before the procedure to 3.22 at postoperative 12 weeks (p < 0.01). There was no significant difference between the two groups. CONCLUSION: In patients with cervical disc herniation, an ultrasound-guided selective nerve root block appears to be an effective treatment option for outpatients due to its low risk of serious complications.