Our preliminary findings indicate that DTI may show abnormalities in the spinal cord before the development of T2 hyperintensity on conventional sequences in patients with CSM.

Figure 1. Twenty-six years old female patient having postsurgical kyphosis after three previous operations. The preoperative and postoperative radiographs showed the correction of coronal and sagittal deformity after posterior vertebral column resection.Figure 2. Nine-year-old girl having previous in situ fusion and some kind of rib distraction device. PVCR was performed and the coronal and sagittal plane deformities were corrected. Spine www.spinejournal.com E343 DEFORMITY Posterior Vertebral Column Resection • Hamzaoglu et al

The aim of this retrospective study was to investigate the diagnostic yield and accuracy of stereotactic biopsy in patients harboring brain mass. Stereotactic biopsy was performed in 130 patients between 1995 and 2000 in an educational and research hospital in Turkey. The results of histological analysis were compared to the resected specimens in 23 patients. The lesions were lobar in 62% of cases and deep-seated in 38% of cases. During the biopsy procedures, the pathologist was in the operating theatre and a very small fragment was used for cytological examination. No frozen section was used in any of the cases. Samples were diagnostic in 122 cases. The overall diagnostic yield of the procedure was 94%. A definitive histological diagnosis was not made in eight patients. The histological diagnoses of the two procedures were identical (complete agreement) in 16 cases. In three cases, the histological diagnoses between the two procedures were slightly different without impact on patient care (minor disagreement). The diagnosis of the stereotactic biopsy was completely changed after craniotomy in four cases (major disagreement). The accuracy of the histological diagnosis was 83%. There was only one major complication, which involved intracerebral hemorrhage. Despite the limited number of patients who underwent resection, our data suggest that stereotactic biopsy of brain masses is a safe and accurate technique that can obtain adequate tissue for histological diagnosis, thus providing the best avaible treatment for patients. Cytological evaluation of the streotactic biopsy also is a highly effective tool for obtaining sufficient material during the procedure in many cases.

Posterior vertebral column resection is an effective technique providing a successful correction of stiff complex congenital deformities. However, it is a technically demanding procedure, with possible risks for major complications.

This study showed an overall 16.3% radiological PCE and 1.4% symptomatic PCE incidence when CAFPS were used due to severe osteoporosis. The symptomatic PCE risk was significant when CAFPS were > 7 levels; > 14 fenestrated screws; and > 20-25 cc cement volume is used and this may cause PAP increase and right ventricular dilatation.

IntroductionHydatid disease is more common in young people who have had contact with dogs, wolves or cats [9,12]. In a large percentage of cases, echinococcus granulosus usually involves the liver and lungs.Hydatid disease of the bone is found in 1% of all cases, with the spine being involved in 45% of bone infestations. Disease usually spreads to the spine by direct extension from pulmonary, abdominal or pelvic infestation, and most commonly affects the dorsal region [2,9,11,12,20]. Primary spinal extradural hydatid cyst is extremely rare.A rare case of primary lumbar extradural hydatid cyst, which causes cauda equina compression, is reported and clinical presentation, diagnosis and surgical treatment are discussed. Case reportAn 8-year-old boy from Eastern Anatolia, who had not suffered from any other disease till then, presented with back pain, progressive weakness, numbness in both legs and difficulty in walking; all symptoms having appeared 7 months earlier.Physical examination showed no abnormality. Neurological examination revealed perianal hypoesthesia and paraparesis prominent on the right and distal muscle groups. There was loss of patella and Achilles reflexes, as well as urinary and anal incontinence.Abdominal ultrasonography scans and magnetic resonance (MR) images of the cranium and cervical region were normal. MRI of the lumbar region showed an intracanalicular cystic lesion with a regular contour and extradural location, with dimensions of 4.9 cm craniocaudally and 2.5 cm axially. There was cerebrospinal fluid-(CSF-) like signal intensity on T1-and T2-weighted images. The lesion had excessively compressed the dural sac and caudal roots and had expanded to the L3 and L4 neural foramina without any bone involvement (Fig. 1). Initially, the lesion was considered to be a hydatid cyst, but serological tests (specific ELISA/Western blot) proved negative.The case was explored with L2, L3, L4 laminectomy. The lesion was removed totally, with a fibrous pseudocapsule that tightly adhered to the dural sac and bone, and the cavity was irrigated with hypertonic saline. Histopathological examination revealed a hydatid cyst.Albendazole treatment was applied in the early postoperative stage. Paraparesis was improved almost completely in later controls extending over 3 years, and postoperative MRI scans showed that the hydatid cyst had been totally removed (Fig. 2). Anal incontinence was improved, while urinary incontinence persisted, but in a decreasing manner.Abstract Spinal hydatid cyst is a rare but serious condition. An 8-yearold boy presented with back pain, progressive weakness and numbness in both legs. Magnetic resonance imaging (MRI) of the lumbar region showed a cystic lesion with regular contour located in extradural space. There was cerebrospinal fluid-(CSF-) like signal intensity on T1-and T2-weighted images. The lesion had excessively compressed the dural sac and caudal roots, and expanded to the L3 and L4 neural foramina. The case was explored with L2, L3, L4 laminectomy and the hydatid cyst was r...

The routine use of magnetic resonance imaging (MRI) in adolescent idiopathic scoliosis remains controversial, and current indications for MRI in idiopathic scoliosis vary from study to study. The purpose of this study was to demonstrate the prevalence of neural axis malformations and the clinical relevance of routine MRI studies in the evaluation of patients with adolescent idiopathic scoliosis undergoing surgical intervention without any neurological findings. A total of 249 patients with a diagnosis of idiopathic scoliosis were treated surgically between the years 2002 and 2007. A routine whole spine MRI analysis was performed in all patients. On the preoperative clinical examination, all patients were neurologically intact. There were 20 (8%) patients (3 males and 17 females) who had neural axis abnormalities on MRI.

The outcome obtained in this series has shown that transfrontal transforaminal total removal of colloid cysts through a stereotactically guided cylindrical retractor is a safe procedure.