L4-L5 traumatic spondylolisthesis has been rarely reported in the literature. At lumbar spine level traumatic dislocation lesion realizes "traumatic spondylolisthesis or traumatic bilateral lumbar facet locked syndrome". The aim of the present paper is to report this rare lesion and discuss its mechanism and management. A case report is followed by Literature review made on Medline and scholar google database from 2000 to 2015. The case report concerned a 33-year-old man, who refused to wear a seat belt, injured his lumbar spine following a motor vehicle accident. L4-L5 spondylolisthesis occurred after the vehicle rolled over several times. Sixteen months after the accident the patient had a favorable outcome. Literature review on Medline and scholar google database from 2000 to 2015 was carried out and five cases of traumatic spondylolisthesis were found. The Sex ratio was 3/2. Surgical treatment consisted of posterolateral interbody fusion. Traumatic lumbar spine spondylolisthesis is rare. When it occurs, it is always associated with vertebral lumbar fracture. L4-L5 traumatic spondylolisthesis was caused by a high-energy mechanism and improper use of seat belt.
Anterior cervical spine surgery for traumatic or degenerative disease is a well-established procedure. However, complications such as pharyngoesophageal perforation can occur. In this study, we report a series of 6 pharyngoesophageal perforations after surgery. Based on the literature review, we analyzed pathogenesis, diagnosis and discussed therapeutic strategies. Three cases occurred after surgeries of traumatic cervical spine whereas the remaining were after surgeries for degenerative cervical myelopathy. The mean duration of surgery was 210 minutes. The symptoms, appearing 48 hours after surgery, were commonly hyperthermia, dysphagia, sore throat and swelling of the incision site. The diagnostic was confirmed after contrast-enhanced esophagography. The treatment strategies consisted of insertion of nasogastric feeding tube, oral intake restriction, intravenous antibiotics administration, wound drainage. Reoperation was necessary in 4 cases with removal of the hardware in three of them. One death occurred by pulmonary embolism in a tetraplegic patient. The occurrence of pharyngoesophageal perforation after cervical spine surgery can be disastrous. It can be avoided by increasing surgeon awareness during the surgical procedure. Early detection, immediate and multidisciplinary therapy are recommended to achieve the best outcomes.
Nine cases of intramedullar histoplasmosis have been published in the literature. In six cases, spinal cord compression was associated with brain localization or with contex of disseminated histoplasmosis. The authors are reporting here the third isolated spinal cord compression in immunocompetent 42-year-old African-rabbits breeder, a woman. This case was successfully managed with surgical removal of the lesion associated to itraconazole during 8 months. Intramedullar lesion because of the Histoplasma capsulatum was necrosis granulomatous localized at spinal conus. In conclusion, according to literature data the most frequent spinal cord compression caused by histoplasmosis capsulatum. General risk factors include residence in endemic areas as well as immunosuppression. Endemic areas include Africa, Australia, parts of Eastern Asia, and America (Mississippi, Missouri, and Ohio River valleys). Initial localization was cutaneous. Two histopathological forms reported are abscess and necrotizing granuloma. Management is mainly based on antifungus like itraconazole. Surgery is only necessary for the etiology diagnosis.
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