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Hemophilic pseudotumor of the first lumbar vertebra.

Nachimuthu G, Arockiaraj J, Krishnan V, Sundararaj GD - Indian J Orthop (2014)

Bottom Line: Excision of pseudotumor was successfully carried out with additional spinal stabilization.At 2 years followup, there was no recurrence and the patient was well stabilized with a satisfactory functional status.Surgical excision gives satisfactory outcome in such cases.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Christian Medical College, Vellore, Tamil Nadu, India.

ABSTRACT
Hemophilic pseudotumor involving the spine is extremely uncommon and presents a challenging problem. Preoperative planning, angiography, intra and perioperative monitoring with factor VIII cover and postoperative care for hemophilic pseudotumor is vital. Recognition of the artery of Adamkiewicz in the thoracolumbar junction helps to avoid intraoperative neurological injury. We report the case of a 26-year-old male patient with hemophilia A, who presented with a massive pseudotumor involving the first lumbar vertebra and the left iliopsoas. Preoperative angiography revealed the artery of Adamkiewicz arising from the left first lumbar segmental artery. Excision of pseudotumor was successfully carried out with additional spinal stabilization. At 2 years followup, there was no recurrence and the patient was well stabilized with a satisfactory functional status. Surgical excision gives satisfactory outcome in such cases.

No MeSH data available.


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(a-b) At 2 years followup computed tomography scan (sagittal and axial views) revealing sclerosis of the vertebral body wall
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Figure 8: (a-b) At 2 years followup computed tomography scan (sagittal and axial views) revealing sclerosis of the vertebral body wall

Mentions: At 1 year and subsequently at 2 years followup, patient was doing well both clinically and functionally without any residual pain, discomfort or disability. He had returned back to his employment. Plain radiographs showed spinal stabilization in situ with no vertebral body collapse or progression of deformity [Figure 6a and b]. MRI revealed small residual tumor at L1 vertebral body, which was comparable to the preoperative picture [Figure 7a and b]. Followup computerised tomogram showed sclerosis of L1 body [Figure 8a and b].


Hemophilic pseudotumor of the first lumbar vertebra.

Nachimuthu G, Arockiaraj J, Krishnan V, Sundararaj GD - Indian J Orthop (2014)

(a-b) At 2 years followup computed tomography scan (sagittal and axial views) revealing sclerosis of the vertebral body wall
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4232833&req=5

Figure 8: (a-b) At 2 years followup computed tomography scan (sagittal and axial views) revealing sclerosis of the vertebral body wall
Mentions: At 1 year and subsequently at 2 years followup, patient was doing well both clinically and functionally without any residual pain, discomfort or disability. He had returned back to his employment. Plain radiographs showed spinal stabilization in situ with no vertebral body collapse or progression of deformity [Figure 6a and b]. MRI revealed small residual tumor at L1 vertebral body, which was comparable to the preoperative picture [Figure 7a and b]. Followup computerised tomogram showed sclerosis of L1 body [Figure 8a and b].

Bottom Line: Excision of pseudotumor was successfully carried out with additional spinal stabilization.At 2 years followup, there was no recurrence and the patient was well stabilized with a satisfactory functional status.Surgical excision gives satisfactory outcome in such cases.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Christian Medical College, Vellore, Tamil Nadu, India.

ABSTRACT
Hemophilic pseudotumor involving the spine is extremely uncommon and presents a challenging problem. Preoperative planning, angiography, intra and perioperative monitoring with factor VIII cover and postoperative care for hemophilic pseudotumor is vital. Recognition of the artery of Adamkiewicz in the thoracolumbar junction helps to avoid intraoperative neurological injury. We report the case of a 26-year-old male patient with hemophilia A, who presented with a massive pseudotumor involving the first lumbar vertebra and the left iliopsoas. Preoperative angiography revealed the artery of Adamkiewicz arising from the left first lumbar segmental artery. Excision of pseudotumor was successfully carried out with additional spinal stabilization. At 2 years followup, there was no recurrence and the patient was well stabilized with a satisfactory functional status. Surgical excision gives satisfactory outcome in such cases.

No MeSH data available.


Related in: MedlinePlus