Study design: Retrospective case series. Objectives: To assess the efficacy of posterior spinal shortening for paraparetic patients following vertebral collapse owing to osteoporosis, especially on instrumentation loosening. Setting: Department of orthopaedic surgery, Jichi Medical University Hospital and Omiya Medical Center in Japan. Methods:The clinical records and radiographs of 13 patients with paraparesis following vertebral collapse owing to osteoporosis treated with posterior spinal shortening were retrospectively reviewed to evaluate the usefulness of this method. Assessment of the clinical course was done by direct examination in all cases. Ambulatory ability was divided into four categories. Results: Upon final observation, nine cases were able to walk with a cane or crutch, one case remained in gait training, two cases remained unable to stand and one case with urinary incontinence improved in urinary function. In one case, paralysis deteriorated. Vertebral compression fracture of the end vertebrae that were fixed occurred in three cases complicated with rheumatoid arthritis. Conclusion: The posterior spinal shortening can be a choice for treating delayed paraparesis following vertebral collapse owing to osteoporosis.

Adult cases with isolated juvenile xanthogranuloma of the central nervous system are very rare. We report a case with dumbbell-type juvenile xanthogranuloma in the cervical spine. A 38-year-old man presented with moderate numbness of the right ring finger and right little finger and weakness of the right grip. Magnetic resonance imaging (MRI) showed an intra-spinal mass extending into the paravertebral area. The spinal cord was compressed by the lesion, which was isointense with the spinal cord on both T1- and T2-weighted imaging. Homogenous enhancement was observed after gadolinium administration. These findings favored a preoperative diagnosis of a rare tumor, rather than tumor of the nervous system. Complete surgical removal of the tumor was performed through hemilaminectomy combined with facetectomy between C7 and T1. Histological examination and immunohistochemical testing led to a diagnosis of juvenile xanthogranuloma. Two years after complete resection, MRI showed no recurrence. This appears to represent the first report of dumbbell-type juvenile xanthogranuloma in the cervical spine. Total removal of such lesions is recommended because of the high potential risk of tumor recurrence around the central nervous system.

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Only eight cases of intraosseous schwannoma of the mobile spine have been reported in the English literature. We report herein a rare case of intraosseous schwannoma mimicking benign osteoblastoma originating from the posterior column of the thoracic spine. A 60-yearold man presented with a history of back pain for several months. The patient subsequently developed gait disturbance and numbness on bilateral lower limbs. Preoperative computed tomography and magnetic resonance imaging showed a neoplastic lesion occupying the posterior column of the ninth thoracic vertebra. The most likely preoperative diagnosis was osteoblastoma. The patient underwent tumor excision and posterior fusion with instrumentation. No nerve involvement of the tumor was identified intraoperatively. Histological diagnosis was schwannoma. To the best of our knowledge, this represents the first report of intraosseous schwannoma originating from the posterior column of the mobile spine.