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Introduction: Ischemia/reperfusion cascade can cause severe tissue damage as documented in myocardial infarction, stroke, and peripheral occlusive vascular; however, Chin et al. first identified unexplained neurological deterioration after decompressive spinal surgery and attributed this to reperfusion injury of the spinal cord. As this appears as hyperintense signal changes in post-operative T2-weighted magnetic resonance image (MRI) sequences, it is termed as "white cord syndrome." Case Report: A 63-year-old man presented with cervical myelopathy due to an ossified posterior longitudinal ligament and ossified ligamentum flavum, having Nurick's Grade IV posted for surgery. The patient underwent posterior instrumented decompression from 2nd cervical to 5th dorsal spine. Postoperatively, he had neurological deterioration and was investigated and found to have extensive cervical cord edema on MRI. There was no implant malposition. Conclusion: WCS has to be ruled out in a case of unexplained neurological deterioration after decompressive spinal surgery, especially in the cervical and dorsal spine. The exact mechanism and treatment of WCS remain unexplained; spine surgeons should warn patients about WCS before surgery to prevent ethical and medicolegal issues.
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Introduction: Traumatic hip dislocations frequently result from road traffic accidents and are prevalent in developing nations. Untreated dislocations either due to ignorance or lack of proper treatment become more challenging to manage and have an increased likelihood of developing avascular necrosis (AVN). Over time, closed methods of reduction become impractical, and if the waiting period surpasses 3 months, open reduction likewise becomes unworkable. Anterior dislocations are less common than posterior dislocations, accounting for a frequency of 7-13% of all hip dislocations. Neglected anterior hip dislocations are extremely rare, and therefore, there is a paucity of information about the management of these dislocations and associated injuries. The available treatment options for these particular situations are total hip arthroplasty (THA), Girdlestone surgery, or hip arthrodesis. Case Report: We describe the case of a 49-year-old male who presented to our hospital with a neglected anterior dislocation of the hip. The patient disclosed a history of hip trauma 8 months ago, initially receiving conservative management. However, due to persistent pain and functional limitations, he sought further medical attention. A physical examination, radiographic evaluation, and computed tomography (CT) scan confirmed the diagnosis. The patient underwent THA using dual anterior and posterior approaches, followed by a comprehensive rehabilitation program. Conclusion: Anterior dislocation of the hip is a relatively rare condition, and its neglected presentation is even rarer. This case highlights the importance of prompt diagnosis and early intervention in neglected anterior hip dislocations to minimize complications and optimize patient outcomes.
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Introduction: Aneurysmal bone cysts (ABCs) are non-neoplastic expansile, vascular, osteolytic benign tumors in the long bone, spine, and sternum. The location in the pelvis is sparse. Case Report: A 12-year-old female presented with pain in her left pelvis for 6 months. On radiological examination, we found an expansile balloting lytic lesion involving almost the whole ilium and sparing the hip joint. There were multiple fluid levels seen on magnetic resonance imaging. The initial biopsy suggested ABC. Curettage and bone grafting were done along with electrocauterization and chemical cauterization. At 1-year follow-up, she is doing well without any complaints. Conclusion: This case report demonstrates a rare ABC of the ilium that was managed with curettage and bone grafting.