Although a rare entity, intraspinal extradural cyst can cause severe deficit via neural compression. After reviewing available literature, the authors report a rare case of cord compression by intraspinal extradural cystic mass that developed after an osteoporotic vertebral compression fracture. An 80-year-old female patient had undergone vertebroplasty for osteoporotic vertebral compression fracture of T12, subsequent to a minor fall. However, the patient complained about sustained pain and progressive weakness of lower extremities even after the procedure. Follow-up magnetic resonance imaging revealed an intraspinal extradural cystic lesion compressing the spinal cord, and the patient had to undergo a surgical intervention via the posterior approach. Symptoms were relieved postoperatively, with no recurrence during the 1-year follow-up.

STUDY DESIGN: A case report. OBJECTIVES: To report a case of simultaneous pulmonary and renal embolisms after balloon kyphoplasty and review relevant literature. SUMMARY OF LITERATURE REVIEW: Pulmonary or renal embolism caused by cement leakage during balloon kyphoplasty is a rare complication but can be fatal. MATERIALS AND METHODS: An 84-year-old female patient was treated with balloon kyphoplasty for an osteoporotic compression fracture. Pulmonary and renal embolisms were detected after the procedure and the patient was treated conservatively. RESULTS: After conservative treatment, embolism-related symptoms were not found during the follow-up period. CONCLUSIONS: We encountered a case of simultaneous pulmonary and renal cement embolisms which occurred during kyphoplasty. This is a very rare but potentially serious complication. However, the patient had no long-term sequelae after conservative treatment.
Aged, 80 and over ; Embolism* ; Female ; Follow-Up Studies ; Fractures, Compression ; Humans ; Kyphoplasty* ; Pulmonary Embolism ; Spine

Angioleiomyomas are relatively uncommon benign tumors originating from smooth cells of a blood vessel. Although curative by surgical excision, they are rarely diagnosed definitely before surgery. We report on a case of calcified angioleiomyoma occurring on the sole, which was treated by surgical excision without recurrence and a review of literature is presented.
Angiomyoma* ; Blood Vessels ; Foot ; Recurrence

Pregnancy- and lactation associated osteoporosis is a rare condition. However, it may cause fragility fracture with severe pain. A 29-year-old woman had first delivery without any complications and she was breast-feeding her baby. In a postpartum one month, she had a severe back pain and it has gotten worse. She was diagnosed with multiple recent compression fractures in thoracic spines and treated with brace immobilization and bisphosphonate therapy. We report this rare case of pregnancy- and lactation associated osteoporosis with multiple vertebral compression fractures.
Adult ; Back Pain ; Braces ; Female ; Fractures, Compression ; Humans ; Immobilization ; Lactation ; Osteoporosis ; Postpartum Period ; Pregnancy ; Spine

A short femoral stem (type 1 cementless stem) is being increasingly used to perform total hip arthroplasty; however, various types of intra- or postoperative periprosthetic fractures have been reported in recent times. A 66-year-old woman with a history of bilateral total hip arthroplasties using a type 1B femoral stem was admitted 2 months post-operation for a Vancouver type C periprosthetic fracture. She underwent open reduction and internal fixation; however, we observed recurrent non-union and plate breakage at the same site. In this case report, we discuss the factors associated with treatment failure in patients with a Vancouver type C periprosthetic fracture following type 1 femoral stem im-plantation.

Purpose: To evaluate the timing of the improvement in surgical skills of the direct anterior approach for hip arthroplasty through an analysis of the clinical features and learning curve in 58 cases. Materials and Methods: From November 2016 to November 2018, 58 patients, who were divided into an early half and late half, and underwent hip arthroplasty by the direct anterior approach, were enrolled in this retrospective study. The operation time and complications (fracture, lateral femoral cutaneous nerve injury, heterotopic ossification, infection, and dislocation) were assessed using a chi-square test, paired t-test, and cumulative sum (CUSUM) test. Results: The mean operation times in total hip arthroplasty (26 cases) and bipolar hemi-arthroplasty were 132.1 minutes and 79.7 minutes, respectively, demonstrating a significant difference between the two groups. CUSUM analysis based on the results revealed breakthrough points of the operation time, decreasing to less than the mean operation time because of the 16th case in total hip arthroplasty and 14th case in bipolar hemiarthroplasty. Complications were encountered in the early phase and late phase: five cases of fractures in the early phase, no case in the late phase; eight and two cases of lateral femoral cutaneous nerve injury, respectively; three and two cases of heterotopic ossification, respectively; and one case of dislocation, one case of infection and three cases of others in the early phase. The CUSUM chart for the fracture rate during operation in the early phase revealed the following: five cases fracture (17.2%) in the early phase and no case in the late phase (0%). This highlights the learning curve and the need for monitoring the inadequacy of operation based on the complications. Conclusion Hip arthroplasty performed by the direct anterior approach based on an anatomical understanding makes it difficult to observe the surgical field and requires a learning curve of at least 30 cases.

Intramedullary osteosclerosis is an uncommon benign condition characterized by endosteal new bone formation in long tubular bone of lower extremity and treatment as well as etiology is unknown. Due to the rarity of this disease, and because there is no specific clinical finding except leg pain, it is difficult to differentiate this entity from other causes presenting similar symptoms. We report on a case of intramedullary osteosclerosis mistaken for radiculopathy from lumbar disease with a review of the literature.
Leg* ; Lower Extremity ; Osteogenesis ; Osteosclerosis* ; Radiculopathy

Purpose: Total hip arthroplasty (THA) is performed using various approaches, including posterior, lateral, and direct anterior approaches.The most beneficial method is controversial. Each approach has its advantages and disadvantages. This study compared patient satisfaction after bilateral THA using the direct anterior and lateral approaches on the same patient, considering the advantages and disadvantages of each approach. Materials and Methods: This study examined 30 patients who underwent bilateral THA: two with femoral neck fractures, 18 with osteonecrosis of the femoral head, six with borderline dysplasia-induced hip osteoarthritis, and four with degenerative hip osteoarthritis.Without distinguishing between the left and right sides, THA was performed randomly using the direct anterior approach on one side and the lateral approach on the other. The results of THA were compared using different approaches on the same patient, and patient satisfaction was evaluated. Results: Surgery using the direct anterior approach for THA showed favorable results in terms of the initial postoperative pain compared to surgery using the lateral approach. On the other hand, there was no significant difference observed after one month post-surgery. Among the participants, three preferred the direct anterior approach; four preferred the lateral approach, and 23 reported no preference. Conclusion In THA, the direct anterior approach may offer advantages in terms of initial postoperative pain and rehabilitation compared to the lateral approach. Nevertheless, the pain and joint function one month after surgery were similar between the two approaches.Therefore, the choice of approach should be determined by the surgeon's preference or experience, as both methods appear rational.

Purpose: Total hip arthroplasty (THA) is performed using various approaches, including posterior, lateral, and direct anterior approaches.The most beneficial method is controversial. Each approach has its advantages and disadvantages. This study compared patient satisfaction after bilateral THA using the direct anterior and lateral approaches on the same patient, considering the advantages and disadvantages of each approach. Materials and Methods: This study examined 30 patients who underwent bilateral THA: two with femoral neck fractures, 18 with osteonecrosis of the femoral head, six with borderline dysplasia-induced hip osteoarthritis, and four with degenerative hip osteoarthritis.Without distinguishing between the left and right sides, THA was performed randomly using the direct anterior approach on one side and the lateral approach on the other. The results of THA were compared using different approaches on the same patient, and patient satisfaction was evaluated. Results: Surgery using the direct anterior approach for THA showed favorable results in terms of the initial postoperative pain compared to surgery using the lateral approach. On the other hand, there was no significant difference observed after one month post-surgery. Among the participants, three preferred the direct anterior approach; four preferred the lateral approach, and 23 reported no preference. Conclusion In THA, the direct anterior approach may offer advantages in terms of initial postoperative pain and rehabilitation compared to the lateral approach. Nevertheless, the pain and joint function one month after surgery were similar between the two approaches.Therefore, the choice of approach should be determined by the surgeon's preference or experience, as both methods appear rational.

Purpose: Total hip arthroplasty (THA) is performed using various approaches, including posterior, lateral, and direct anterior approaches.The most beneficial method is controversial. Each approach has its advantages and disadvantages. This study compared patient satisfaction after bilateral THA using the direct anterior and lateral approaches on the same patient, considering the advantages and disadvantages of each approach. Materials and Methods: This study examined 30 patients who underwent bilateral THA: two with femoral neck fractures, 18 with osteonecrosis of the femoral head, six with borderline dysplasia-induced hip osteoarthritis, and four with degenerative hip osteoarthritis.Without distinguishing between the left and right sides, THA was performed randomly using the direct anterior approach on one side and the lateral approach on the other. The results of THA were compared using different approaches on the same patient, and patient satisfaction was evaluated. Results: Surgery using the direct anterior approach for THA showed favorable results in terms of the initial postoperative pain compared to surgery using the lateral approach. On the other hand, there was no significant difference observed after one month post-surgery. Among the participants, three preferred the direct anterior approach; four preferred the lateral approach, and 23 reported no preference. Conclusion In THA, the direct anterior approach may offer advantages in terms of initial postoperative pain and rehabilitation compared to the lateral approach. Nevertheless, the pain and joint function one month after surgery were similar between the two approaches.Therefore, the choice of approach should be determined by the surgeon's preference or experience, as both methods appear rational.