Asunto(s)
Calcinosis/diagnóstico , Calcinosis/etiología , Canal Medular/patología , Talasemia beta/complicaciones , Adulto , Calcinosis/cirugía , Hematopoyesis Extramedular , Humanos , Imagen por Resonancia Magnética , Cintigrafía , Canal Medular/diagnóstico por imagen , Compresión de la Médula Espinal/diagnóstico , Compresión de la Médula Espinal/etiología , Compresión de la Médula Espinal/cirugía , Tomografía Computarizada por Rayos XAsunto(s)
Hematoma Espinal Epidural/diagnóstico , Anciano , Anciano de 80 o más Años , Enfermedad Crónica , Diagnóstico Diferencial , Femenino , Hematoma Espinal Epidural/etiología , Hematoma Espinal Epidural/cirugía , Humanos , Laminectomía , Imagen por Resonancia Magnética , Masculino , Resultado del TratamientoRESUMEN
Atlantoaxial rotatory dislocation (AARD) is a rare complication in adults usually leading to pain, spinal cord injury, or death. Clinical and radiological diagnosis is difficult and often delayed. We report a rare case of posttraumatic AARD in a neurological intact 27-year-old male in which initial radiographic evaluation was negative. A computed tomography (CT) scan was promptly done because the patient showed a severe torticollis. Therefore, early diagnosis, immobilisation, and surgical fusion and arthrodesis were performed. After surgery, cervical pain and torticollis were resolved and the patient remained neurologically intact with a CT scan documentation of fusion at the 3-year followup.
RESUMEN
We present here a rare case of heterotopic ossification in interspinous/interlaminar Coflex device. The classical surgical indications for these implants are degenerative canal stenosis, discogenic low back pain, disk herniations, facet syndrome, and instability. However, fractures of spinous processes are a potential risk after interspinous/interlaminar devices' implantation. Recently, heterotopic ossification, a well-known complication of hip and knee arthroplasty, has been reported after cervical and lumbar prosthesis. We performed undercutting and implantation of the dynamic interspinous/interlaminar device to treat an adult male patient with L4-L5 stenosis. The patient underwent 45-day imaging and clinical followup, and we observed both a neurological and imaging improvement. A CT bone scan, performed 3 years after surgery for recurrence of neurogenic claudication, showed a new stenosis due to an abnormal ossification all over the device. To our knowledge, this is the first reported case of heterotopic ossification in an interspinous/interlaminar dynamic device. Accordingly, we aim to suggest it as a new complication of interspinous/interlaminar devices.