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Discal cysts--intraspinal cysts communicating with an adjacent intervertebral disc--are an uncommon cause of lumbar radiculopathy. We report a case of discal cyst of the lumbar spine. The cyst contents were bloody and clotted rapidly; no disc materials were seen. Communication between the cyst and the intervertebral disc was detected. Histopathology of the cyst wall revealed fibrous connective tissue without synovial lining cells. We hypothesise that the discal cyst was formed by haemorrhage of the epidural venous plexus caused by separation of the peridural membrane by mechanical force transmitted by an annulus fibrosis fissure. The minute segmental motion caused by the affected disc may have stimulated continuous bleeding.

BackgroundSeveral authors reported encouraging results of total hip arthroplasty (THA) for Crowe IV hips performed using shortening osteotomy. However, few papers have documanted the results of THA for Crowe IV hips without shortening osteotomy. The aim of the present study was to assess the long term-results of cemented THAs for Crowe group IV hips performed without subtrochanteric shortening osteotomy.MethodsWe have assessed the long term results of 27 cemented total hip arthroplasty (THA) performed without subtrochanteric osteotomy for Crowe group IV hip. All THAs were performed via transtrochanteric approach.ResultsAfter a mean follow-up of 10.6 (6 to 17.9) years, 25 hips (92.6%) had survived without revision surgery and survivorship analysis gave a survival rate of 96.3% at 10 years with any revision surgery as the end point. Although mean limb lengthening was 3.2 (1.0 to 5.1) cm, no hips developed nerve palsy. Complications occurred in four hips, necessitating revision surgery in two. Among the four complications, three involved the greater trochanter, two of which occurred in cases where braided cables had been used to reattach the greater trochanter.ConclusionsAlthough we encountered four complications, including three trochanteric problems, our findings suggest that THA without subtrochanteric shortening osteotomy can provide satisfactory long-term results in patients with Crowe IV hip.

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We present the first known adult case of solitary myofibroma of bone, which affected a lumbar vertebra in a 33-year-old male. Radiography identified a purely lytic lesion with a sclerotic rim in the right pedicle of L1. CT showed an expansile lytic lesion with a sclerotic rim. MRI of the lesion revealed an isointense signal on T1-weighted images, an inhomogeneously hyperintense signal on T2-weighted images, and marked enhancement with gadolinium. Pathological study showed a mixed picture of nodular proliferation of spindle-shaped myoid cells and hemangiopericytomatous proliferation of short spindle/small round cells. The tumor cells were immunoreactive for smooth muscle actin and immunonegative for desmin. This case of solitary myofibroma of bone is exceptionally rare because of its occurrence in an adult older than 20 years of age and its location at an extra-craniofacial site.