RESUMO
We present a rare case of a male child in middle childhood who presented to the emergency department with neck pain, neck deformity, low-grade fever, breathing difficulty and swallowing difficulty. The patient had a significant history of weight loss and loss of appetite. On examination, neurological deficits were observed, including mildly increased tone in bilateral lower limbs, reduced power in both lower limbs, exaggerated knee and ankle jerks, and upgoing plantar reflexes. Radiographs and MRI revealed a kyphotic deformity with apex at the T1 vertebra, lytic lesions in seven contiguous vertebrae and a large prevertebral abscess extending from C2 to T5. The patient underwent a posterior-only surgical approach with decompression, abscess drainage and stabilisation, resulting in successful cord decompression and correction of the kyphotic deformity. At 18 months follow-up, the patient is doing well with improvement to normal neurology and full return of a child to normal activities.
Assuntos
Vértebras Cervicais , Tuberculose da Coluna Vertebral , Humanos , Masculino , Tuberculose da Coluna Vertebral/complicações , Tuberculose da Coluna Vertebral/cirurgia , Tuberculose da Coluna Vertebral/diagnóstico , Tuberculose da Coluna Vertebral/diagnóstico por imagem , Vértebras Cervicais/diagnóstico por imagem , Imageamento por Ressonância Magnética , Descompressão Cirúrgica/métodos , Criança , Cifose/cirurgia , Cifose/diagnóstico por imagem , Vértebras Torácicas/diagnóstico por imagem , Vértebras Torácicas/cirurgiaRESUMO
Femoral tunnel preparation during the anterior cruciate ligament reconstruction is a technically demanding step. The anteromedial (AM) portal technique necessitates knee hyperflexion during the femoral tunnel reaming. In a hyperflexed knee, the arthroscopic visualization of the laser markings on the femoral tunnel reamer becomes obscured. Thus, the calculation of the depth of the femoral tunnel becomes difficult. Our technique helps in femoral tunneling reliably without the need for arthroscopic visualization using the AM portal as a reference point to calculate the depth while drilling. This technique can be performed without the need for a second assistant to hold the arthroscope. Furthermore, this technique does not require any specific instruments, and there is no obligation for an additional incision.