Young adult and giant cervical exostosis

Degenerative changes in the spine can result in the formation of osteophytes on the anterior surface of the cervical spine. Depending on their site, osteophytes can bring on clinical manifestations such as dysphagia, hoarseness, and stridor. We discuss an interesting case of a young adult patient who presented with dysphagia along with neck discomfort, and on investigation was found to be suffering from diffuse idiopathic skeletal hyperostosis. Here, we briefly portray the presenting features, radiographic findings, and management options

Surgical repair of pars defects in spondylolysis.

Direct repair of the pars interarticularis defect was carried out in 16 spondylolysis patients. There were 8 male and 8 female patients. The site of pars defects involved L5 in 10 cases and L4 in 6 cases. Chronic low back pain was the main symptom, only one patient presented with acute severe back pain. Pars defects were confirmed by oblique views of the lumbosacral spine. The height of the spinous process of the involved vertebra was measured and compared to the above adjacent vertebra. Radiographic fusion of the defects was confirmed by bridging of bone across the pars on oblique views. All the patients except one were treated conservatively prior to surgery. Clinical outcomes were assessed by pre- and post-operative pain, union of the pars defects, functional status and patient verbal rating scales. The mean follow-up was 36 months, the longest was 7 years. At 2 years follow-up, the overall satisfaction and improvement were reported in most of the patients. There was no functional failure. Hypoplasia of the neural arch was found in 3 patients. There were two non unions, both of them had maldevelopment of neural arches. One symptomatic non union needed resurgery for stabilization.

Cervical spondylosis: a review of 230 cases.

Between January 1981 and March 1991, 230 patients of cervical spondylosis were treated surgically. The choice of surgical approach was dependent on clinicoradiological presentation. Anterior discectomy was performed in 105 cases decompressive laminectomy in 119 cases and combined approach in 6 cases. In anterior discectomy group 89% showed improvement, 4% remained unchanged and 7% worsened. In decompressive laminectomy group 68% improved, 15% unchanged, 15% worsened and 1.6% died. In combined approach 66% showed improvement, 17% remained unchanged and 17% died. Anterior discectomy had less risk of overall complications than decompressive laminectomy.