BackgroundSagittal spinopelvic alignment changes associated with degenerative facet joint arthritis have been assessed in a few studies. It has been documented that patients with facet joint degeneration have higher pelvic incidence, but the relationship between facet joint degeneration and other sagittal spinopelvic alignment parameters is still disputed. Our purpose was to evaluate the correlation between the features of sagittal spinopelvic alignment and facet joint degeneration.MethodsImaging data of 140 individuals were retrospectively analysed. Lumbar lordosis, pelvic tilt (PT), pelvic incidence (PI), sacral slope, and height of the lumbar intervertebral disc were measured on lumbar X-ray plates. Grades of facet joint degeneration were evaluated from the L2 to S1 on CT scans. Spearman’s rank correlation coefficient and Student’s t-test were used for statistical analyses, and a P-value <0.05 was considered statistically significant.ResultsPI was positively associated with degeneration of the facet joint at lower lumbar levels (p < 0.001 r = 0.50 at L5/S1 and P = 0.002 r = 0.25 at L4/5). A significant increase of PT was found in the severe degeneration group compared with the mild degeneration group: 22.0° vs 15.7°, P = 0.034 at L2/3;21.4°vs 15.1°, P = 0.006 at L3/4; 21.0° vs 13.5°, P = 0.000 at L4/5; 20.8° vs 12.1°, P = 0.000 at L5/S1.ConclusionOur results indicate that a high PI is a predisposing factor for facet joint degeneration at the lower lumbar spine, and that severe facet joint degeneration may accompany with greater PT at lumbar spine.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-016-1193-6) contains supplementary material, which is available to authorized users.

Abstract. Synovial osteochondromatosis is a rare condition in which multiple cartilaginous nodules proliferate within the synovial membranes of joints, tendon sheaths or bursae. In general, a complete synovectomy is an effective method to treat this disease. Commonly involved joints are the knee, glenohumeral joint, elbow, hip and ankle, although any articulation may be affected. However, synovial osteochondromatosis occurs rarely in the wrist, and there have been a lack of reports of this occurrence in the literature. The current study presents a case of synovial osteochondromatosis in a 33-year-old man, who was admitted in 2014 with the symptom of swelling of the left wrist joint for 2 years. The swelling had become increasingly painful over the previous 2 months. Physical examination revealed local tenderness and a soft pliable mass, with no involvement of the skin and with moderate pain. X-ray, computed tomography and magnetic resonance imaging of the left wrist revealed a lump at the volar radial side of the left wrist joint without any bone erosion. The lesion was subsequently excised. Histological examination resulted in a diagnosis of osteochondromatosis, which was not considered prior to the surgery. The present case was reported with the aim of analyzing the clinical, imaging characteristic and therapeutic modalities of synovial osteochondromatosis of the wrist. While there was no evidence of recurrence for the subsequent 4 months of post-operative follow-up in the present case, the long-term efficacy of surgical excision requires extended observation.

Abstract. Neurothekeoma is a rare myxoma of the peripheral nerve sheath. The current report presents a case of a giant neurothekeoma with a partially-formed capsule, scapula erosion and unclear biological behavior, which originated in the intermuscular space between the left trapezius muscle and scapula. The patient was initially misdiagnosed with a fibromatosis using computed tomography and magnetic resonance image scanning. Diagnosis of the neoplasm was confirmed by pathological and immunohistochemical examination, revealing a neurothekeoma with unclear biological behavior. The patient underwent a wide and complete local resection. Using a comprehensive postoperative follow-up strategy, it was determined that the patient recovered well. The tumor was ~17x16x10 cm in size and was in contact with the scapula. The purpose of the present study was to describe a rare giant neurothekeoma and review the diagnostic techniques utilized to reach a definitive diagnosis. Histopathological and immunohistochemical analyses were recommended for the diagnosis of neurothekeoma. There have been no previous reports regarding neurothekeomas exhibiting malignant transformation. Early and complete surgical resection is considered to be an effective method of treating this type of neurothekeoma.

Rationale:Chordoma is a relatively rare tumor that accounts for 1% to 4% of all malignant bone tumors, with an annual incidence of <0.1 per 100,000 people. Although chordoma is aligned with the axis of the spine and most commonly develops in the sacrum, to the best of our knowledge, giant sacrococcygeal chordoma is extremely rare.Patient concerns:A 61-year-old Chinese man presented with a massive dorsal sacral mass. The patient's primary complaint was that, during the last two months, the mass had been increasing in size and his right lower extremity was uncomfortable while he was sitting, although the discomfort was relieved when he was standing.Diagnoses:Based on the imaging findings, we suspected that the sacrococcygeal mass was a chordoma, and a postoperative pathological examination confirmed the diagnosis of a sacral chordoma.Intervention:The patient underwent extensive open surgery to achieve complete resection of the sacrococcygeal mass. An occlusion balloon catheter was used in the abdominal aorta to minimize intraoperative bleeding and maintain a clear surgical field.Outcomes:The patient was discharged without complications at 27 days after surgery. The 3-month follow-up revealed that the patient had recovered well, the discomfort in his right lower extremity while standing had completely resolved and that there was no evidence of recurrence.Lessons:The development of chordoma is not associated with clear symptoms, although early diagnosis and treatment are needed to prevent invasion of the nearby tissues and organs. Therefore, we believe that surgical treatment of sacral chordoma is effective, although care must be taken to completely remove all residual tumor tissue and reduce the risk of recurrence. Besides, This report adds to our limited understanding of the rare giant sacrococcygeal chordoma.