[Temporal meningocele and anophtalmia: about a case]. / Meningocèle temporale et anophtalmie: à propos d´un cas.

We here report the case of a 12-month old infant with congenital polymalformation including right temporal meningocele and homolateral eyeball aplasia. Brain CT scan confirmed this malformation with bone defect in the right temporal lobe, meningeal hernia containing cerebrospinal fluid and absence of the right eyeball. Surgery was performed to treat meningocele. Patient's outcome was favorable. The purpose of this study was to highlight the rarity of this disease on the basis of a literature review.

Spontaneous atlantoaxial pyogenic arthritis surgically managed.

PURPOSE: Septic cervical facet joints arthritis is a rare pathology, usually revealed by fever and neck pain. As symptoms may be indolent, a high index of suspicion needs to be maintained. Magnetic resonance imaging (MRI) is effective for early diagnostic, looking for local spread and guiding potential preoperative planning. We present a case exhibiting an uncommon pathology with possible significant morbidity if misdiagnosed. METHODS: A 75-year-old woman presented with fever, neck stiffness and torticollis accompanied with altered level of consciousness. RESULTS: The diagnosis was established by computed tomography and MRI, identifying atlantoaxial facet joint destruction with para spinal muscles and epidural abscesses. A surgical treatment consisting in posterior decompression of the spinal canal and atlantoaxial pars articularis fixation known as Harms technique, associated with a targeted antibiotic therapy, succeeded in obtaining favorable clinical course. CONCLUSION: Atlantoaxial septic arthritis is an under reported and severe infection. Early use of MRI should avoid delayed diagnosis and would guide the practitioner in choosing an appropriate therapy. Early surgical treatment for uncontrolled sepsis is also a critical element of the prognosis.

Circumferential management of unstable thoracolumbar fractures using an anterior expandable cage, as an alternative to an iliac crest graft, combined with a posterior screw fixation: results of a series of 85 patients.

OBJECT: The optimal management of unstable thoracolumbar fractures remains unclear. The objective of the present study was to evaluate the results of using an expandable prosthetic vertebral body cage (EPVBC) in the management of unstable thoracolumbar fractures. METHODS: Eighty-five patients with unstable T7-L4 thoracolumbar fractures underwent implantation of an EPVBC via an anterior approach combined with posterior fixation. Long-term functional outcomes, including visual analog scale and Oswestry disability index scores, were evaluated. RESULTS: In a mean follow-up period of 16 months, anterior fixation led to a significant increase in vertebral body height, with an average gain of 19%. However, the vertebral regional kyphosis angle was not significantly increased by anterior fixation alone. No significant difference was found between early postoperative, 3-month, and 1-year postoperative regional kyphosis angle and vertebral body height. Postoperative impaction of the prosthetic cage in adjacent endplates was observed in 35% of the cases, without worsening at last follow-up. Complete fusion was observed at 1 year postoperatively and no cases of infections or revisions were observed in relation to the anterior approach. CONCLUSIONS: The use of EPVBCs for unstable thoracolumbar fractures is safe and effective in providing long-term vertebral body height restoration and kyphosis correction, with a moderate surgical and sepsis risk. Anterior cage implantation is an alternative to iliac bone graft fusion and is a viable option in association with a posterior approach, in a single operation without additional risks.