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BackgroundTumor-induced osteomalacia (TIO) is a rare disorder, which is commonly found in craniofacial locations and in the extremities. To the best of our knowledge, only 16 cases have been described in the spine, and this is the first report to describe a case of patient with TIO in the thoracic spine combined with a mesenchymal hamartoma which had confused the therapeutic strategies to date.Case descriptionWe report the case of a 60-year-old patient with hypophosphatemia and presented with limb weakness. Treating with phosphate did not correct the hypophosphatemia and an 111In pentetreotide scintigraphy (octreotide scan) revealed an increased uptake at the right forearm. The tumor was resected totally, and the histopathology revealed a mesenchymal hamartoma, but we noticed that hypophosphatemia was not corrected after the tumor resection. Then a whole-body magnetic resonance imaging (WB-MRI) was performed and the results revealed tumorous tissues at the right T1 vertebral pedicle. The tumor was removed with an en bloc method, and the pathology showed phosphaturic mesenchymal tumor. Follow-up at 1 year after surgery revealed no recurrence, and the serum phosphorus level of the patient was normal.ConclusionsTumor-induced osteomalacia is exceedingly rare with only 16 cases in spine published in the literature. It is difficult to find and leads to years of suffering debilitating complications. In this regard, the WB-MRI is a better method to locate the real tumor. Treating with phosphate can only relieve symptoms, and a complete surgical removal remains the gold standard treatment.Electronic supplementary materialThe online version of this article (doi:10.1186/s12957-015-0589-3) contains supplementary material, which is available to authorized users.

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Our study compared the incidence and radiological and clinical characteristics of C5 palsy in those two groups. The incidence of C5 palsy combined with posterior decompression and fusion are also discussed in relation to the findings. █ MATERIAl and METhODSThe data of 133 patients suffering cervical spondylosis operated by laminectomy and hardware fusion at the authors' institutions from 2007 to 2009 were reviewed. The average clinical postoperative follow-up period was 6 months (range: 3 to 12 months). One hundred and thirty three of the 133 patients who had complete sets of clinical and radiographic data were screened. 89 patients were male and 44 were female. The █ INTRODUCTIONLaminectomy and posterior internal fixation is a common treatment method for cervical spondylosis. However, C5 palsy can be a significant postoperative complication (3-5, 8-10,12,13,16,17). Patients develop of sensation disorder and/or persistent pain around the shoulder region which is dominated by C5. Moreover, there is muscle weakness, or only motor motion weakness in the C5 sector (15,17). A traction bed (Figure 1) or a plaster bed (Figure 2) are two common body positions used during this operation. These two different methods may be associated with the incidence of C5 palsy after surgery. AIM:To compare both the clinical characteristics and incidence of postoperative cervical nerve root palsy in cervical spondylosis patients treated by posterior total laminectomy, decompression and instrumentation with two different common body positions, traction bed and plaster bed. MATERIAl and METhODS:One hundred and thirty-three patients, with a mean age of 49.5 years suffering from multilevel cervical spondylosis and treated by laminectomy from 2007 to 2009, were reviewed. RESUlTS:Overall 30 of 133 (22.56%) patients had C5 palsy, of which 14 (19.44%) out of 72 patients were in the plaster bed group, while 16 of 61 (26.23%) patients were in the traction bed group. The difference was statistically significant (P <0.05). CONClUSION:The cervical curvature index (CCI) reflected both the change of cervical height and the change of the overall cervical curvature. CCI was related with the incidence of C5 nerve root palsy postoperatively. The patients in the traction bed group had a higher nerve root palsy rate and change in cervical alignment because of over traction.

It is valuable of using of PET-CT to diagnose OOs of the cervical vertebra. Subsequently, it is a good way that helps us in efficient removal of the OOs completely.