Clinical and Imaging Features of Longus Colli Calcific Tendinitis: An Analysis of Ten Cases.

BACKGROUND: Longus colli calcific tendinitis (LCCT) exhibits characteristic clinical features; thus, misidentification can be avoided once it is learned. There is a lack of reports on this disease. In this study, we analyzed the imaging and clinical features of LCCT in 10 patients. METHODS: We retrospectively reviewed the radiolographic findings, laboratory data and clinical features of 10 patients diagnosed with LCCT between January 2015 and June 2017. All patients were treated with medical treatment consisting of intravenous methylprednisolone 125 mg twice and oral nonsteroidal anti-inflammatory drug administration. RESULTS: On clinical findings, all 10 patients complained of severe posterior neck pain and cervical motion limitation. Odynophagia was present in nine patients. The mean time from symptom onset to hospital visit was 2.9 days. The mean time to symptom relief was 4.6 days. Of the 10 patients, three patients were admitted through the emergency room. There were five patients in the medical records who were transferred from another hospital. On the laboratory data, the mean value of C-reactive protein and erythrocyte sedimentation rate were 2.08 mg/dL (reference range, < 0.30 mg/dL) and 36.9 mm/hr (reference range, < 20 mm/hr), respectively. Leukocytosis was found in only two patients and fever was not present all patients. On radiographic findings, calcification was present on computed tomography images of all patients. The calcification was located at the lower part of the C1 arch, except for one case where calcification occurred in the anterolateral aspect of the C4-5 disc space. The mean value of the retropharyngeal space was 7.2 mm. CONCLUSIONS: LCCT, a rare disease, has characteristic radiographic findings and clinical features. Understanding such characteristics of this disease can prevent unnecessary testing and misdiagnosis.

Analysis of spinopelvic parameters in lumbar degenerative kyphosis: correlation with spinal stenosis and spondylolisthesis.

STUDY DESIGN: Retrospective study. OBJECTIVE: To define the relationship between pelvic parameters and lumbar spinal disorders including spinal stenosis, spondylolisthesis, and lumbar degenerative kyphosis (LDK). SUMMARY OF BACKGROUND DATA: Although numerous studies have investigated the relationship between various lumbar spinal disorders and spinal parameters previously, none has reported on the relationship with LDK. METHODS: The present study analyzed 211 patients (163 females and 48 males) with spinal stenosis (n = 57), degenerative spondylolisthesis (n = 78), spondylolytic spondylolisthesis (n = 34), and LDK (n = 42). Lateral standing radiograph of the whole spine was analyzed with a dedicated software allowing calculation of the following parameters: pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), lumbar lordosis (LL), thoracic kyphosis (TK), and sagittal vertical axis. RESULTS: Significant differences in the pelvic parameter were observed between the groups. The mean PI in males (49.6°) was less than that in females (57.3°) (P < 0.05). PI was found to be proportional to SS, PT, and LL (P < 0.001). PT was inversely proportional to TK and LL (P < 0.001). Analysis revealed the values of SS, LL, and TK to be significantly higher and those of PT and the PT/PI ratio to be significantly lower in LDK than in the other groups. Values of PI, SS, and LL, but not PT, were significantly higher in subjects of LDK with Takemitsu type 1 than in those with type 2. PI was shown to possess statistically significant correlation to SS, PT, LL, and PT/PI ratio but not to TK or sagittal vertical axis. CONCLUSION: PI has a direct influence on the variable lumbar curvature in LDK. PI and SS may be complementary factors in determining the subtype of LDK, as PT appears to be relatively constant between the different subtypes of LDK.

Stage 4 compressive-extension injury of the cervical spine: a theoretical stage?

STUDY DESIGN: Case reports of stage 4 compressive-extension injury (CES-4). OBJECTIVE: To present CES-4, which has been known as a theoretical stage. SUMMARY OF BACKGROUND DATA: Compressive-extension stage 3 and 4 lesion has been considered as theoretical stages between the mild and advanced lesions of the compressive-extension phylogeny. METHODS: Clinical and radiologic details are presented documenting the CES-4 injury. RESULTS: The authors have encountered 2 cases of CES-4 injury and in this study report the radiographic findings and describe the surgical treatment of the cases. CONCLUSION: CES-4 is not a theoretical stage.