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BACKGROUND/AIM: Synovial chondromatosis associated, intra-articular loose bodies are usually small in size. Giant intra-articular loose bodies are rare. CASE REPORT: We present the case of a patient with synovial chondromatosis associated giant intra-articular loose bodies located under the patella and the intercondylar fossa, treated successfully with combined arthroscopic and open excision. CONCLUSION: Giant intra-articular loose bodies should be considered when treating patients with synovial chondromatosis. Arthroscopy confirms the diagnosis, allows the thorough examination of the knee joint, and subsequent excision of small or medium size attached synovial nodules or intra-articular loose bodies. Arthrotomy may be needed to excise giant loose bodies.
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BACKGROUND: Detailed knowledge of cervical canal and transverse foramens' morphometry is critical for understanding the pathology of certain diseases and for proper preoperative planning. Lateral x-rays do not provide the necessary accuracy. A retrospective morphometric study of the cervical canal was performed at the authors' institution to measure mean dimensions of sagittal canal diameter (SCD), right and left transverse foramens' sagittal (SFD) and transverse (TFD) diameters and minimum distance between spinal canal and transverse foramens (dSC-TF) for each level of the cervical spine from C1-C7, using computerized tomographic scans, in 100 patients from the archives of the Emergency Room. RESULTS: Significant differences for SCD were detected between C1 and the other levels of the cervical spine for both male and female patients. For the transverse foramen, significant differences in sagittal diameters were detected at C3, C4, C5 levels. For transverse diameters, significant differences at C3 and C4 levels. A significant difference of the distance between the transverse spinal foramen and the cervical canal was measured between left and right side at the level of C3. This difference was equally observed to male and female subjects. CONCLUSION: CT scan can replace older conventional radiography techniques by providing more accurate measurements on anatomical elements of the cervical spine that could facilitate diagnosis and preoperative planning, thus avoiding possible trauma to the vertebral arteries during tissue dissection and instrument application.
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Hombre de 52 años que sufrió un accdente de tráfico mientras conducía una motocicleta. Las radiografías simples de pelvis tomadas a su ingreso evidenciaron una amplia diastasis de la sínfisis púbica, una fractura mediosagital del sacro y otra fractura de la apófisis transversa derecha de la quinta vértebra lumbar. Presentamos el tratamiento utilizado para abordar esta inusual lesión (AU)
A 52-year-old male sustained a road traffic accident riding a motorbike. At his admission, plain radiograph of the pelvis showed wide diastasis of the pubic symphysis, a midsagittal fracture of the sacrum and a fracture of the right transverse process of the fifth lumbar vertebra. We discuss the treatment of this rare injury (AU)
Subject(s)
Humans , Male , Middle Aged , Pelvic Bones , Pelvis , Pubic Symphysis Diastasis/diagnosis , Pubic Symphysis Diastasis/surgery , Pelvic Bones/injuries , Pelvic Bones/surgery , Pelvis/injuries , Pelvis , Sacrum/injuries , Sacrum , Accidents, Traffic/trends , Pubic Symphysis Diastasis/physiopathology , Pubic Symphysis DiastasisABSTRACT
Se considera que la osteosíntesis con placa de la columna cervical anterior es capaz de estabilizar los segmentos afectados, reduce al mismo tiempo la migración de los injertos e impide el colapso de éstos, que podrían provocar una pérdida de lordosis, así como callos viciosos, seudoartrosis y alteraciones neurológicas. Aunque se han publicado tasas de fusión elevadas en discectomías y artrodesis cervicales anteriores multinivel realizadas con placa, con índices que oscilan entre el 47 y el 100% dependiendo del número de niveles operados, no existen en la bibliografía científica estudios que comparen la eficacia del tratamiento con cajetín de titanio más aloinjerto con el tratamiento con autoinjerto en estos pacientes.En este estudio hemos analizado de forma retrospectiva 36 casos de discectomía y artrodesis cervical anterior operados con placa semirrígida a 3 niveles. Se intervino a todos los pacientes entre agosto de 2000 y junio de 2005. El grupo de estudio estaba compuesto por 19 hombres y 17 mujeres, con una media de edad de 51,6 años (rango: 3569). Los niveles operados fueron C4-C7 en 30 pacientes, C3-C6 en 5 y C5-T1 en un paciente. En 19 pacientes (52%) se utilizaron injertos autólogos tricorticales de cresta ilíaca y en 17 pacientes (47%) se optó por cajetines de PEEK (polietercetona) rellenos de aloinjerto.En todos los casos se utilizó un acceso anteromedial a la columna cervical. Se extirparon los discos intervertebrales. En todos los pacientes se fresaron los platillos vertebrales y se procedió a la distracción del segmento móvil en 2mm y al avellanado de los injertos a 2mm del borde anterior de la vértebra. El injerto autógeno tricortical utilizado se obtuvo de la cresta ilíaca por medio de una sierra oscilante de baja velocidad. Se utilizó aloinjerto fresco-congelado, virutas de hueso esponjoso envasadas al vacío y pasta de hueso. Se seleccionó una placa cervical de titanio con tornillos de bloqueo de ángulo variable...(AU)
Anterior cervical plate fixation is believed to stabilize the operative motion segments, decreasing graft migration and preventing graft collapse that could lead to loss of cervical lordosis, malunion or nonunion and neurologic compromise. Although reports have noted high fusion rates in plated multilevel anterior cervical discectomy and fusion (ACDF) that range from 47% to 100% and are dependent on the number of levels fused, the efficacy of the combination of a titanium cage with allograft in comparison with autograft in such patients has not been investigated.We retrospectively analyzed 36 cases of three-level ACDF with anterior semi rigid plating. All cases were performed between August 2000 to June 2005. There were 19 males and 17 females with an average age of 51.6 (range from 35 to 69). Operated levels were C4-C7 in 30 patients, C3-C6 in 5 and C5-T1 in one patient. Nineteen patients (52%) had autologous iliac crest tricortical grafts, 17 (47%) had PEEK cages placed filled with allografts.The technique was the same in all cases: a standard left anteromedial approach to the cervical spine. The intervertebral discs were removed. All patients had burring of the end plates, 2mm distraction and countersinking of the grafts by 2mm from the anterior vertebral border. The autologous bone graft was tricortical and was harvested from the iliac crest using a low speed oscillating saw. The allograft used was fresh frozen, vacuum sealed cancellous chips and putty. An anterior cervical titanium plate was selected with variable angle locked screws...(AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Diskectomy/methods , Cervical Vertebrae/surgery , Intervertebral Disc Displacement/surgery , Retrospective Studies , Arthrodesis/methods , Transplantation, Homologous/methods , Treatment OutcomeABSTRACT
Introducción. Las fracturas del axis son las más comunes del raquis cervical y ofrecen un interés especial por sus características anatómicas. Los principales problemas de estas fracturas vienen dados por la posible inestabilidad residual y el riesgo vital de los pacientes lesionados. Pueden dividirse en cuatro grupos, con la incidencia que se cita entre paréntesis: a) fracturas de la apófisis odontoides (49,4%); b) fracturas del arco vertebral (37,4%); c) fracturas del cuerpo vertebral (10,6%), y d) fracturas del macizo lateral (1,6%). Revisión de la bibliografía. En este artículo hemos revisado los conceptos más actuales del tratamiento de este tipo de lesiones. Conclusiones. Esixten una serie de aspectos que influyen en el pronóstico de estos factores: edad del paciente, tipo de fractura, desplazamiento inicial, tiempo hasta el tratamiento, intensidad de la tracción, consecución o no de la estabilidad y posibles lesiones asociadas
Introduction. Fractures of the axis are the most frequent fractures of the cervical spine and are of special interest due to their anatomical characteristics. The main concern is that the residual instability associated with these fractures is life threatening. Fractures of the axis can be classified into 4 groups: a) fractures of the dens or odontoid process (incidence 49.4%); b) fractures of the vertebral arch, (incidence 37.4%); c) fractures of the vertebral body, (incidence 10.6%) and d) fractures of the lateral masses, (incidence 1.6%). Literature review. In this article we review the current treatments for these fractures. Conclusions. There are a series of variables that affect prognosis: age of the patient, type of fracture, initial slippage, time to treatment, intensity of traction, achievement of stability and possible associated lesions
