Correlation between pedicle size and the rate of pedicle screw misplacement in the treatment of thoracic fractures: Can we predict how difficult the task will be?

Study Design: A retrospective study.

Objective: To correlate the incidence of pedicle-screw (PS) misplacement with the dimensions of the pedicles in the treatment of thoracic spine fractures.

Summary Of Background Data: The technical challenge of internal fixation with PS in the thoracic spine has been well documented in the literature.

Lumbosacral epidural lipomatosis causing rapid onset cauda equina syndrome.

Spinal epidural lipomatosis (SEL) is a rare cause of cauda equina syndrome (CES), which must be diagnosed with MRI in conjunction with a high level of clinical suspicion. Most reported cases are associated with obesity, steroid use or are secondary to endocrinopathies, frequently present subacutely or chronically, and have been managed with both surgical decompression and non-operative measures. We describe an obese 55-year-old man with rapid onset CES secondary to idiopathic lumbosacral SEL which was managed successfully with surgical decompression.

Vertebral hemangioma: an important differential in the evaluation of locally aggressive spinal lesions.

Study Design: A case report and a discussion of recent published data.

Objective: To highlight the importance of vertebral hemangioma (VH) as a differential diagnosis in the evaluation of locally aggressive spinal lesions.

Summary Of Background Data: VH commonly occur as incidental findings, however, locally aggressive VH have been described.

Brown tumour of the spine in a renal transplant patient.

We report a 30-year-old male who had undergone a renal transplant and suffered with secondary hyperparathyroidism. He presented with back pain and minimal neurological deterioration, caused by a thoracic brown tumour. The imaging findings, surgical treatment of the spinal lesion and outcome are discussed.

'Ecstasy'-induced subarachnoid haemorrhage: an under-reported neurological complication?

In the face of escalating recreational use of 'Ecstasy' (3,4-methylenedioxymethamphetamine, MDMA), physicians need to be aware of its possible adverse effects. We report two young patients who suffered subarachnoid haemorrhage following ingestion of 'Ecstasy' tablets. Angiographic studies demonstrated features consistent with vasculitis in both cases.