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BackgroundPercutaneous vertebroplasty (PVP) is a common treatment for osteoporotic vertebral compression fracture (OVCF). Perioperative bleeding is usually rare, so there are few reports of shock. However, we developed shock after treating a case of OVCF of the 5th thoracic vertebra with PVP.Case presentationAn 80 years old female patient received PVP due to OVCF of the 5th thoracic vertebra. The operation was successfully completed and the patient returned to the ward safely after the operation. At 90 min after operation, she developed shock, which was induced by subcutaneous hemorrhage up to 1500 ml at the puncture site. Before using vascular embolization, transfusion and blood transfusion were used to maintain blood pressure, and local ice bag compression was used to reduce swelling and stop bleeding, which achieved successful hemostasis. She recovered and discharged after 15 days, with the hematoma having absorbed. There was no recurrence during the 17-month follow-up.ConclusionAlthough PVP is considered to be a safe and effective method to treat OVCF, the possible hemorrhagic shock still needs to arouse the vigilance of surgeons.

BackgroundTranexamic acid (TXA) has been used in posterior lumbar interbody fusion (PLIF) and reduces blood loss. However, it has not been reported whether it will continue to affect postoperative red blood cells (RBC), hemoglobin (HB), hematocrit (HCT), C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). The purpose of this study was to observed the above indicators at different time after PLIF with unit dose intravenous (iv) TXA.MethodsThe data of 44 patients treated by single-segment PLIF from 2020.11 to 2022.3 were retrospectively analyzed. Observation group was given a unit dose of ivTXA (1 g/100 mL) 15 min before skin incision after general anesthesia. Patients without TXA were recorded as control group. Main observation indicators include RBC, HB, HCT, CRP and ESR on the 1st, 4th, 7th and last tested day after surgery. Secondary observation indicators include postoperative activated partial thrombin time (APTT), prothrombin time (PT), thrombin time (TT), and fibrinogen (FIB); and operation time, intraoperative blood loss, postoperative drainage volume, incision healing, postoperative deep vein thrombosis and postoperative hospital stay.ResultsThe operation was successfully completed without related complications. At term of main observation indicators, RBC, HB and HCT remained relatively stable, while CRP and ESR fluctuated to some extent after PLIF. The RBC, HB and HCT in the observation group were higher than those in the control group with statistically significant (p 0.05). At term of secondary observation indicators, the intraoperative blood loss and postoperative drainage volume of the observation group were lower than those of the control group with statistically significant (p 0.05).ConclusionThe application of unit dose of ivTXA in PLIF can safely and effectively reduce blood loss. Meanwhile, it can also maintain higher RBC, HB, HCT levels without disturbing CRP and ESR levels after surgery.

BackgroundCholesterol granuloma (CG) is a particular type of granulation tissue reaction. It is a very rare benign lesion characterized by swelling growth due to a large number of cholesterol crystals and foreign body giant cells. There has been no report of a CG of the femur.Case presentationA 74-year-old woman suffered from pain and discomfort in the upper right knee for 10 years, which became aggravated for 10 days. She was diagnosed with CG of the right femur at our hospital and was treated with surgery. During the operation, a large amount of yellow-brown, oily, crystal structures was found. Postoperative pathology investigations confirmed the lesion as a CG. Postoperative follow-up was carried out for 15 months that confirmed the effect of treatment was satisfactory.ConclusionsCG of the femur is an extremely rare benign lesion. Surgical treatment can provide effective treatment results.

BackgroundDiastematomyelia is a rare congenital spinal cord malformation, classified as type I or type II, with over half of the cases considered type I. However, type I diastematomyelia with breast abnormality and clubfoot is extremely rare in clinical practice.Case presentationWe admitted an 18-year-old female patient with type I diastematomyelia with breast abnormalities and clubfoot. She was underwent surgical treatment. After the surgical removal of the pressure-causing bone spur, the weakness of the right lower limb was significantly relieved. During the 22-month follow-up, there was no complication and no recurrence.ConclusionSurgical removal of the pressure-causing bone spur can relieve symptoms in the lower limbs. However, further research is warranted to explore the breast abnormalities in patients with diastematomyelia.

BackgroundCervical nerve root cysts are rare and easily missed or misdiagnosed in clinical practice. Although conventional surgery is effective for cervical nerve root cysts, it is limited by the small surgical field of view and operating range, relatively difficult procedure, and incomplete cyst resection. Microscope-assisted magnification of the surgical field of vision reduces the difficulty and ensures complete cyst resection.Case presentationA 58-year-old male patient was diagnosed with a cervical nerve root sleeve cyst on the right C7 vertebra with neurological symptoms. Microscope-assisted surgery was used as treatment. The cyst was completely removed by the microscope-assisted surgery, with satisfactory patient recovery. The surgery did not produce complications, such as spinal cord neurovascular injury, and the patient's symptoms disappeared quickly after surgery. During the 2-year follow-up, there was no complication and no recurrence.ConclusionMicroscope-assisted surgery in treatment of the C7 nerve root cyst could achieve a complete resection.