BackgroundTumoral calcinosis is rarely located in spine. A 55-year-old Japanese woman with cervical tumoral calcinosis is presented, along with a review of the literature relating to tumoral calcinosis in the spine. We discussed the etiology, diagnosis, and management of this condition.Case presentationWe report a case of a patient with cervical tumoral calcinosis with end-stage renal disease. A computed tomography scan showed a lobulated, calcified mass around the right facet joint at the fourth-fifth cervical spine and calcifications were also observed in the right intervertebral foramens at fourth-fifth cervical spine and fifth-sixth cervical spine levels and the anterior wall of the spinal canal. By performing a cervical decompression and stabilization, the patient recovered from her neurological symptoms.ConclusionsAlthough tumoral calcinosis is rarely located in the spine, it should be considered in the differential diagnosis of spinal lesions. If a calcified mass causes acute neurological symptoms, resection of the mass is still the most important treatment.

ObjectiveWorkplace violence in hospitals is recently becoming a major global concern in many countries. However, in Myanmar, we have felt that patients and their families have rarely made unreasonable complaints in hospitals, and then, the purpose of this study is to report the current state of workplace violence in hospitals in Myanmar. Participants are 196 physicians (108 males and 88 females) in hospitals in Myanmar.ResultsA descriptive survey was conducted in regard to verbal abuse and physical violence from patients or the people concerned. At the results of this study, the percentages of physicians who have encountered verbal abuse and those who have encountered physical violence are markedly low (8.7 and 1.0%, respectively). The present study is the first to report the frequencies of verbal abuse and physical violence against physicians in a least developed country, and the results of the present study are important in terms of discussing workplace violence in hospitals.

BackgroundSeveral studies showed instantaneous axis of rotation (IAR) in the intact spine. However, there has been no report on the trajectory of the IAR of a damaged spine or that of a fixed spine with instrumentation. It is the aim of this study to investigate the trajectory of the IAR of the lumbar spine using the vertebra of deer.MethodsFunctional spinal units (L5–6) from five deer were evaluated with six-axis material testing machine. As specimen models, we prepared a normal model, a damaged model, and a pedicle screw (PS) model. We measured the IAR during bending in the coronal and sagittal planes and axial rotation. In the bending test, four directions were measured: anterior, posterior, right, and left. In the rotation test, two directions were measured: right and left.ResultsThe IAR of the normal model during bending moved in the bending direction. The IAR of the damaged model during bending moved in the bending direction, but the magnitude of displacement was bigger compared to that of the normal model. In the PS model, the IAR during bending test hardly moved. During rotation test, the IAR of the normal model and PS model located in the spinal canal, but the IAR of the damaged model located in the posterior part of the vertebral body.ConclusionsIn this study, the IAR of damaged model was scattering and that of PS model was concentrating. This suggests that higher mechanical load applied to the dura tube and nerve roots in the damaged model and less mechanical load applied to that in the PS model.

Study Design: Cross-sectional study.Purpose: To report the prevalence and relationship of developmental cervical and lumbar spinal stenosis (DCSS and DLSS) with the bone parameters of the skull and extremities.Overview of Literature: DCSS and DLSS are found occasionally in daily practice. DCSS and DLSS can cause compressive myelopathy, radiculopathy, and cauda equina syndrome; however, data on their prevalence and correlation with skull and skeletal extremity profiles is scarce.Methods: A cross-sectional measurement study of 293 whole-body dried-bone samples was conducted. We measured the anteroposterior (AP) and transverse diameter of the fourth to sixth cervical vertebrae (C4–C6) and third to fifth lumbar vertebrae (L3–L5). Stenosis of the cervical spine and lumbar spine was defined as an AP diameter of <12 mm and <13 mm, respectively. We also measured the skull circumference, the AP and transverse diameters of the foramen magnum, the inner and outer inter distances between the left and right orbital bones, the humerus length, and the femoral length. Kruskal-Wallis and post hoc analyses were used in the statistical analyses.Results: The age was 22–93 years. DCSS was found in 59 (20.1%) and DLSS in 28 (9.6%). Twelve samples had both DCSS and DLSS (development spinal stenosis, DSS). When compared to the “no spinal stenosis sample,” DSS (−), DCSS and DSS had a significantly smaller skull circumference, the transverse diameter of the foramen magnum, and inner and outer distance between the orbital bone (<i>p</i><0.05). There was no significant difference in humeral length, femoral length, or AP diameter of the foramen magnum.Conclusions: DCSS was correlated with a small skull, a small transverse diameter of the foramen magnum, and a small orbital bone. A small skull was strongly associated with a small cervical canal. DLSS, on the other hand, was unrelated to either a small cervical canal or a small skull.

BackgroundIn regard to the fixation using a pedicle screw (PS) and rod system, the mechanism from the onset of the clear zone up to the development of loosening of the pedicle screw is not completely clarified. The purpose of this study is to determine the cause of the pedicle screw loosening by performing a biomechanical study with three-dimensional movie analysis.MethodsTen PS fixation model of the lumbar spines (L3–4) of boar cadavers were used. The rotational angles of the L3 and L4 vertebral body and the screw at the time of applying a ±5 Nm load in the left anterior and right posterior flexion directions respectively were calculated based on those at the time of applying no load. The absolute value of the difference in the rotational angles between each vertebral body with left anterior flexion and right posterior flexion and the inserted screws was defined as rotational micromovement.ResultsIn both the left anterior and right posterior flexion directions, there were significant differences (p < 0.05) in the rotational angles between the screw and the vertebral body for both the L3 and L4 vertebral bodies.ConclusionOur biomechanical results showed that rotational micromovement occurred between the PS and the vertebral body, and repeated rotational micromovement might cause loosening of the screw or pullout of PS fixation.