Quiste óseo aneurismático en sacro / Aneurysmal bone cyst of the sacrum

El quiste óseo aneurismático es un tumor óseo primariobenigno poco frecuente. Suele presentarse en jóvenes yafecta a la columna vertebral en el 10% de los casos. Selocaliza con más frecuencia en la columna cervical y torácicaque a nivel lumbar o sacro. Las complicaciones neurológicasson variables y suelen precisar resección quirúrgicadel tumor. El TAC y la resonancia magnética son lasmejores pruebas diagnósticas presentando cavidades tabicadascon niveles líquidos en su interior. La recurrenciatras el tratamiento quirúrgico es de 10-59%.Se presenta el caso clínico de un varón joven con unquiste óseo aneurismático en sacro. Se trató mediante unacombinación de embolización arterial selectiva preoperatoriay resección quirúrgica con injerto óseo.A los 4 años de seguimiento clínico y radiológico, el pacientese encuentra libre de enfermedad y no presentacomplicaciones neurológicas.Revisamos las opciones de tratamiento y los resultadosclínicos y radiológicos a largo plazo de esta lesión

Aneurysmal bone cyst is an uncommon benign primitivebone tumor generally observed in young subjects, in a spinallocalization in 10% of the cases. There are more frequent inthe cervical and thoracic spine than lumbar or sacral localization.Neurological complications of variable severity arefrecuent and can be improved by surgical removal of the tumor.CT scan and MRI are the best exams and shows bonywalls and liquid-levels. High recurrence rates have been reportedafter surgical treatment from 10-59%.We report the clinical case of a young male with ananeurysmal bone cyst of the sacrum. The patient was treatedby a combination of preoperative adjuvant selective arterialembolization and surgical curettage followed bybone grafting.Clinical and radiographic follow-up for 4 years was uneventfuland the patient is still free of recurrence or anycomplaints.The surgical options and long-term clinical and radiographicsurveillance of aneurismal bone cyst are presentand discused

Tratamiento del quiste óseo simple en la población infantil / Treatment of simple bone cyst in children

Objetivo. Comparar los resultados del tratamiento del quiste óseo simple mediante aspiración e infiltración con corticoides frente al curetaje y relleno con injerto. Analizar la existencia de factores pronósticos que se relacionen con la respuesta al tratamiento. Material y método. Estudio retrospectivo de 29 niños con diagnóstico clínico-radiológico y/o anatomopatológico de quiste óseo simple que hayan sido tratados mediante alguno de los dos métodos. Se han comparado los resultados en función de la clasificación de Neer modificada. Resultados. La frecuencia de curaciones (completas o incompletas) fue del 85 por ciento para los tratados mediante curetaje e injerto y del 88 por ciento para los tratados mediante infiltración con corticoides. No se han encontrado diferencias significativas entre los dos grupos de tratamiento. La respuesta al tratamiento no se relacionó en nuestra serie con ninguno de los posibles factores pronósticos estudiados: edad, localización, actividad, tamaño y aspecto radiológico. No se observaron complicaciones entre los niños tratados con infiltraciones. Conclusiones. El tratamiento con infiltración con corticoides debe ser considerado de elección en el quiste óseo simple, por su menor morbilidad y coste (AU)

Flatfoot and calcaneal deformity secondary to osteomyelitis after neonatal heel puncture.

Deformity of the calcaneus was observed in three patients who developed osteomyelitis after neonatal heel puncture for newborn blood studies. Septic involvement of the calcaneal apophysis may produce an abnormal and early closure of this growth plate. Progressive deformity of the calcaneus, despite appropriate treatment, develops into an asymptomatic flatfoot. A strictly aseptic technique is mandatory for neonatal puncture of the heel to avoid this unusual complication. An infectious cause of flatfoot is proposed in this report.

[Back pain in children]. / Dolor de espalda en la infancia.

OBJECTIVE: The incidence of back pain in children in our country is unknown. Several causes can produce this symptom, but it is necessary to rule out pathologies that require specific treatments. The goal of this work was to study the incidence and the etiology of back pain in children in our country. PATIENTS AND METHODS: We present a prospective study done in our Orthopedic Department during a period of 7 months. Twenty-two patients were referred with back pain of at least two months duration. The incidence was 2.9% compared to the total number of patients. The average age ranged from 7 to 17 years. RESULTS: A careful history and a radiological examination diagnosed 50% (11 cases) of the causes of backache in the present study. An idiopathic etiology was the most frequent cause and represented 9 patients (41%). In the remaining 12 cases (59%) pathological causes that required special treatment were identified including 2 cases of Scheuermann disease, 4 cases of painful scoliosis, 3 spondylolysis with spondylolisthesis, 2 cases of discitis, 1 benign neoplasm and 1 psychogenic cause. CONCLUSIONS: We recommend conservative management with the use of medication for relief of pain and physical therapy in the idiopathic cases. In the remaining cases, the specific treatment of the disease can improve the back pain.

[Malignant lumbosciatic syndrome. Report of 21 cases with vertebral metastases]. / Síndrome lumbociático maligno. A propósito de veintiún casos de metástasis vertebrales.

We describe twenty one cases of tumoral metastasis on the vertebral column simulating initially discal herniation. All of them presented sciatica as a primary clinical manifestation of the malignant tumor. We describe here the differential diagnosis with other pathologies and the different outcome, like the poor response to regular treatment, alteration of the normal status, and alteration of the laboratory data. The radiologic findings and the laboratory abnormalities found in the emergency analysis should induce us to do more complete studies of the patient aimed to identify an underlying tumoral pathology.