RESUMEN
BACKGROUND: Osteochondromas are benign bony tumours, with only 1 to 4% being located in the spine. It occurs more frequently in the cervical spine, with C2 being the vertebra most affected. The neurological presentation is slow due to the growth characteristics of the tumour. Computed axial tomography is the reference method for diagnosis. Surgical management is indicated for patients with neurological impairment or pain. CLINICAL CASE: The first case presents a 21-year-old male with osteochondroma located in the spinous processes of L2, L3 and L4. The second case is a 20-year-old female with multiple osteochondromatosis with tumours at the right lateral mass of C1, with extension to C2 and tumours on the spinous processes of C5 and C7. Both patients presented with painful symptoms, which were resolved after surgical resection of the tumours. CONCLUSIONS: The rarity of these conditions, relevance of a clinical-radiographic diagnosis, and considerations required for surgical treatment are discussed here.
Asunto(s)
Vértebras Cervicales , Vértebras Lumbares , Osteocondroma/diagnóstico por imagen , Osteocondroma/cirugía , Neoplasias de la Columna Vertebral/diagnóstico por imagen , Exostosis Múltiple Hereditaria/complicaciones , Exostosis Múltiple Hereditaria/diagnóstico por imagen , Exostosis Múltiple Hereditaria/cirugía , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Dolor de la Región Lumbar/etiología , Vértebras Lumbares/diagnóstico por imagen , Vértebras Lumbares/cirugía , Imagen por Resonancia Magnética , Masculino , Dolor de Cuello/etiología , Osteocondroma/complicaciones , Parestesia/etiología , Neoplasias de la Columna Vertebral/complicaciones , Neoplasias de la Columna Vertebral/cirugía , Tomografía Computarizada por Rayos X , Adulto JovenRESUMEN
PURPOSE: To evaluate the results of 2 different techniques of endoscopic iliopsoas tendon release in the treatment of internal snapping hip syndrome. METHODS: Between January 2008 and January 2012, a consecutive series of patients with the diagnosis of internal snapping hip syndrome were treated with endoscopic release of the iliopsoas tendon. The patients were divided into 2 groups according to the surgical technique used. Group 1 was treated with endoscopic iliopsoas tendon release at the lesser trochanter, and group 2 was treated with iliopsoas release from the central compartment. Hip arthroscopy of both the central and peripheral compartments was performed in both groups by the lateral approach. Associated injuries were identified and treated arthroscopically. The postoperative physical therapy protocol was the same for both groups. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were evaluated preoperatively and at last follow-up at a minimum of 24 months. RESULTS: Twenty patients were included in the study: 6 in group 1 (4 male and 2 female patients; mean age, 35.6 years) and 14 in group 2 (5 male and 9 female patients; mean age, 32.7 years). Associated injuries were found and treated in 4 patients in group 1 and 10 patients in group 2. Every patient in both groups had an improvement in the WOMAC score. One patient in group 2 presented with recurrence of snapping that required surgical intervention. No complications were seen. CONCLUSIONS: Both central compartment release and release at the lesser trochanter produced favorable results, based on WOMAC scores, for the treatment of internal snapping hip syndrome. LEVEL OF EVIDENCE: Level IV, therapeutic case series.