Pseudoaneurysm of Lumbar Artery following a Vertebral Biopsy: A Case Report

A 74-year-old man developed a severe low back pain and a fever. In the initial examinations, a collapse of the L5 anterosuperior vertebral body and narrowing of the L4/5 disc space were identified on radiographs, and the laboratory data showed inflammatory results. A computed tomography (CT) and a magnetic resonance imaging showed collapse of L5. A needle biopsy was performed to make a diagnosis; however, an abdominal pain and a hypotension appeared after the biopsy. An abdominal CT showed a hematoma in the retroperitoneal space, and an angiography revealed a left fourth lumbar artery pseudoaneurysm. The pseudoaneurysm was treated with transcatheter placement of microcoils. Although haemorrhagic complications following needle biopsy are very rare, patients with large amounts of vertebral destruction may have unusual anatomical positions of the lumber artery. Therefore, surgeons should be aware of the possibility of lumbar artery injury during a needle biopsy and take care of prebiopsy plans

Pneumocephalus Associated with Cerebrospinal Fluid Fistula as a Complication of Spinal Surgery: A Case Report

Pneumocephalus is a well-known condition following head trauma, but is rare as an injury or as a result of surgery of the spine. We present a 76-year-old patient with a rare case of pneumocephalus associated with a cerebrospinal fluid fistula as a complication of surgical treatment for cervical myelopathy. Although cerebrospinal fluid leakage was noted and the injured dura was carefully sutured at operation, tension pneumocephalus occurred. The resultant pneumocephalus was diagnosed based on neurogenic symptoms including sudden convulsion, head radiograph, and computed tomography scan. The benign course of the pneumocephalus postdiagnosis did not require secondary operation

Anterosuperior Dislocation of the Shoulder Joint in an Older Patient with Parkinson's Disease

An 83-year-old woman, subsequently diagnosed with Parkinson's disease, fell onher right shoulder. Radiographs showed the humeral head dislocated anterosuperiorly.The supraspinatus tendon was massively disrupted and judged irreparable. Thesubscapularis tendon was repaired, however re-dislocation of the humeral head wasconfirmed after the surgery but further treatment was rejected as she was almost painfree and had a low activity level. The patient was followed up for one year after surgeryand her shoulder became almost pain-free, but range of motion with active elevationwas limited. In such cases a goal of absence or reduction of pain rather than real repairmight be considered appropriate