Benign Osteoblastoma Located in the Parietal Bone

Benign osteoblastoma is an uncommon primary bone tumor, extremely rare in calvarium. We present a case of a 25-year-old female with an osteoblastoma of parietal bone which was totally resected. The authors discussed the clinical presentation, radiographic finding, differential diagnosis and management of the benign calvarial osteoblastoma with a review of the literature.

Clinical Outcome of Minimally Invasive Tubular Retractor Assisted Microscopic Discectomy in Far Lateral Lumbar Disc Herniation

OBJECTIVE: The purpose of this study is to analyze the clinical outcomes of the minimally invasive approach for the surgical treatment of far lateral lumbar disc herniation. METHODS: Between January 2007 and May 2009, 19 patients who underwent minimally invasive, tubular retractor-assisted microscopic discectomy were retrospectively reviewed. The patients included 11 men and eight women with a mean age of 58 years. The mean symptom duration before surgery was 6.5 months, and the mean follow up time was 20.5 months. Clinical outcomes were assessed according to neurologic status, bleeding volume, surgical time, length of hospital stay, visual analogue scale (VAS) and the modified MacNab's criteria. RESULTS: The most frequent lesion was at the L4-L5 level (53%), and the mean bleeding volume was 59.3ml. The mean surgical time and length of hospital stay were 91.1 minutes and 6.4 days, respectively. The mean VAS for radicular pain was improved from 8.37 +/- 1.11 before surgery to 1.37 +/- 1.33 (P<0.05) at discharge and 0.68 +/- 0.89 one year after surgery. The mean VAS for back pain was decreased from 4.6 3 +/- 0.99 before surgery to 2.00 +/- 1.23 (P<0.05) at discharge and 0.42 +/- 0.61 one year after surgery. The success rates were 100% according to the modified MacNab's criteria, and there were no postoperative complications or recurrences. CONCLUSIONS: The minimally invasive, tubular retractor-assisted microscopic discectomy method is a safe and effective procedure and may be an alternative for treating far lateral lumbar disc herniations.

Intradural Bone Cement Leakage Following Percutaneous Vertebroplasty

Bone cement extravasation is a frequent occurrence after percutaneous vertebroplasty(PVP) using polymethylmetacrylate(PMMA) for the treatment of osteoporotic vertebral compression fracture. Fortunately, major neurological complication is rare in spite of potential occurrence. The authors reported a case of in a 67-year-old woman whom a intradural cement leakage provoked left leg weakness with hypesthesia and paresthesia below the area of the left L1 dermatome. Emergency laminectomy with removal of intradural bone cement for decompression was performed. After operation, her pain resolved, but left leg weakness was persistent. PVP using PMMA are now being used wide spreadly for osteoporotic vertebral compression fracture as minimally invasive and safe procedure, but the potential risks of major complication exist always. We experienced a rare case of intradural bone cement leakage after PVP using PMMA,