Aneurysmal Bone Cysts of Spine: An Enigmatic Entity.

AIMS: The study was done to review the literature about the intriguing aspects of the aneurysmal bone cyst and to describe our experience with these cases. DESIGN: Retrospective. MATERIAL AND METHOD: We reviewed the records of all patients with primary spinal tumours whom we managed over last 8 years. We selected the patients with biopsy proven aneurysmal bone cyst (ABC) for our study. RESULTS: Four patients (two males and two females) were included. The age ranged from 15-18 years. Three of them had neurological deficits and one had only pain. All of them were operated and three required instrumentation for stabilization. Neurological deficits improved in all the cases. However we had to re- operate one of the cases for recurrence and that patient was administered adjuvant radiotherapy. CONCLUSIONS: ABC is not a tumour in real sense but due to destructive nature that are classified as tumours. The patients have an excellent outcome as the disease is benign and has very low recurrence rates if surgical excision is complete. Best treatment modality is complete excision. Aneurysmal bone cyst is one of the uncommon tumors of the spine, and many of its features continue to be unclear even today. There is ambiguity about the definition, etiopathogenesis, radiological characteristics, histopathology and treatment modalities. They are common in young age and etiology is not clear. The presentation is varied with pain being the common symptom and neurological deficit depends on extent of cord involvement. The best treatment is controversial although surgery is believed to be curative in the majority of cases. We here describe our experience with four such cases who had varied clinical presentation and outcome.

Spinal epidural abscess: Report on 27 cases.

BACKGROUND: Spinal epidural abscess, although an uncommon disease, often correlates with a high morbidity owing to significant delay in diagnosis. METHODS: In a prospective 5-year study, the clinical and magnetic resonance (MR) findings, treatment protocols, microbiology, and neurological outcomes were analyzed for 27 patients with spinal epidural abscess. RESULTS: Patients were typically middle-aged with underlying diabetes and presented with lumbar abscesses. Those undergoing surgical intervention >36 h after the onset of symptoms had poor neurological outcomes. CONCLUSION: Early recognition and timely evacuation of spinal abscesses minimized neurological morbidity and potential mortality.

Posterior fossa dermoid with Klippel-Feil syndrome in a child.

Intracranial dermoid tumors constitute a rare entity. Their association with Klippel-Feil anomaly is all the more rare. These lesions, if associated with dermal sinuses, receive attention when a patient presents with features of central nervous system infection. We describe a 5-year-old girl who presented with purulent discharge from an occipital dermal sinus with an infected posterior fossa dermoid associated with cerebellar abscesses and characteristic Klippel-Feil anomaly.