Ganglión intraneural del nervio ciático poplíteo externo. Una posible causa de pie caído / Intraneural ganglion cyst of the external popliteal sciatic nerve: A possible cause of foot drop

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Vertebral destruction due to abdominal aortic aneurysm.

INTRODUCTION: Low back pain is a common cause of medical consultation, and usually supposes a non-malignant prognostic. PRESENTATION OF CASE: We report an atypical appearance of low back pain associated to shock and pulsatile abdominal mass that made us diagnose an abdominal aortic aneurysm as reason of vertebral lysis and pain. DISCUSION: Surgical repair of contained AAA should be directed to secondary re-rupture prevention, with an approximate survival near to 100% at selected patients for elective surgery. Consequently, orthopedic surgery for back spine stabilization has to be elective in those cases when vertebral destruction is above 30% and clinic is directly related to spine instability. CONCLUSION: We should consider AAA as other cause of low back pain and routinely examine the abdomen and seek complementary imaging proves when risk factors for AAA are present.

Caracterización de células madre de núcleo pulposo de disco intervertebral cervical y comparación con células de médula ósea de los mismos pacientes / Characterization of stem cells from nucleus pulposus of cervical intervertebral disc and compared with bone marrow cells from the same patients

Objetivo: Evaluar la presencia de células mesenquimales en el núcleo pulposo de disco intervertebral cervical y caracterizarlas comparativamente con las obtenidas de médula ósea de los mismos sujetos. Pacientes y metodología: Hemos realizado un estudio descriptivo con 14 pacientes que precisaron cirugía de artrodesis cervical. Se analizó la presencia de células mesenquimales (CSM) en el núcleo pulposo (NP) del disco, comparándolas cualitativamente con las de médula ósea (MO) de los mismos pacientes. Se aislaron y expandieron CSM, tanto de NP como de MO. Se realizaron los estudios de diferenciación multilineal in vitro de las células mesenquimales de ambas fuentes, hacia osteoblasto y adipocito, y caracterización inmunofenotípica por citometría de flujo. Resultados: Las células de ambos orígenes se diferencian in vitro hacia ambos tipos celulares, si bien la diferenciación adipocítica de las células procedentes del disco fue menor que las procedentes de MO. Tampoco se han demostrado diferencias en los marcadores inmunofenotípicos. Las células de ambas fuentes poseen los marcadores inmunofenotípicos característicos de las células mesenquimales. Conclusión: El NP de disco vertebral cervical degenerado contiene células troncales mesenquimales. Estas células son similares a las células de MO, con la excepción de su capacidad disminuida de diferenciación adipogénica (AU)

Objective: To evaluate the presence of mesenchymal cells in the nucleus pulposus (NP) of cervical discs and characterize them in comparison ot those obtained from the bone marrow of the same subjects. Patients and methods: We have performed a descriptive study with 14 patients requiring cervical fusion surgery. The presence of mesenchymal stem cells (MSCs) were analyzed in the NP from the disk and compared qualitatively with the bone marrow (BM) of the same patients. MSC were isolated and expanded for both NP and MO. We performed in vitro differentiation studies of mesenchymal cells from both sources, into osteogenic and adipogenic lines, and flow cytometric immunophenotyping. Results: We got differentiation towards both cell types, although adipocyte differentiation of disc-derived cells was decreased compared to those from BM. There were no differences in immunophenotypic markers. Cells from both sources have immunophenotypic markers characteristic of mesenchymal cells. Conclusion: The NP of degenerated cervical disc contains mesenchymal stem cells. These cells are quite similar to BM cells, with the exception of a diminished adipogenic differentiation capacity (AU)

Fracture of the body of hamate associated with a fracture of the base of fourth metacarpal: A case report and review of literature of the last 20 years.

INTRODUCTION: Fractures of the carpal bones are often difficult to diagnose and treat due to the complex bone architecture of this region. Hamate fractures, particularly body fractures, are extremely uncommon. PRESENTATION OF CASE: We present a case of a coronal fracture of the hamate associated with a fracture of the base of the fourth metacarpal, which was treated by open reduction and internal fixation. DISCUSSION: Some of hamate body fractures are associated with other injuries like metacarpal fractures. Its diagnosis is difficult and requires a high clinical suspicion and a proper radiological examination. This fracture is a very rare lesion that can raise questions about their most adequate diagnostic and therapeutic approaches. CONCLUSION: After reviewing the literature, we conclude that there is a high rate of delay in the diagnosis of these lesions, probably due to their rarity and to the lack of radiological studies specifically targeting this region. Despite this, surgical treatment in its different modalities has been shown to have the best clinical and functional results.

Lesión del nervio ciático poplíteo externo, asociado a lesiones del ligamento cruzado anterior y del ángulo posterolateral de la rodilla / External popliteal sciatic nerve damage associated with anterior cruciate ligament injuries and posterolateral angle of the knee

Las lesiones vasculonerviosas asociadas a lesiones de los ligamentos de la rodilla sin luxación de la misma son infrecuentes. Se presenta el caso de un joven deportista, que tras traumatismo deportivo sufre rotura completa del ligamento cruzado anterior y ligamento lateral externo. Se le asoció parálisis completa del nervio ciático poplíteo externo. El paciente precisó reparación quirúrgica en dos tiempos, con estabilización de la rodilla mediante la reconstrucción y reparación ligamentosa, con muy buenos resultados funcionales y cirugía de las secuelas de la lesión nerviosa posteriormente. A pesar de la inusual asociación de lesiones nerviosas a este tipo de traumatismos, debemos saber identificarlas precozmente para precisar los tiempos terapéuticos de manera adecuada (AU)

Associated neurovascular injuries to injured knee ligaments without dislocation are uncommon. We report the case of a young athlete who after a sports injury, suffered complete rupture of the anterior cruciate and the lateral collateral ligament. He had an associated paralysis of the peroneal nerve. The patient required two-stage surgery for stabilisation, with ligament repair and reconstruction of the knee and surgery of the sequelae of the nerve injury, with very good functional results. Despite the unusual association of nerve damage in this type of trauma, we need to identify this nerve damage early in order to establish optimal treatment (AU)