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Kunow A, Freyer Martins Pereira J, Chenot JF. Extravertebral low back pain: a scoping review. BMC Musculoskelet Disord 2024; 25:363. [PMID: 38714994 PMCID: PMC11075250 DOI: 10.1186/s12891-024-07435-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 04/11/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Low back pain (LBP) is one of the most common reasons for consultation in general practice. Currently, LBP is categorised into specific and non-specific causes. However, extravertebral causes, such as abdominal aortic aneurysm or pancreatitis, are not being considered. METHODS A systematic literature search was performed across MEDLINE, Embase, and the Cochrane library, complemented by a handsearch. Studies conducted between 1 January 2001 and 31 December 2020, where LBP was the main symptom, were included. RESULTS The literature search identified 6040 studies, from which duplicates were removed, leaving 4105 studies for title and abstract screening. Subsequently, 265 publications were selected for inclusion, with an additional 197 publications identified through the handsearch. The majority of the studies were case reports and case series, predominantly originating from specialised care settings. A clear distinction between vertebral or rare causes of LBP was not always possible. A range of diseases were identified as potential extravertebral causes of LBP, encompassing gynaecological, urological, vascular, systemic, and gastrointestinal diseases. Notably, guidelines exhibited inconsistencies in addressing extravertebral causes. DISCUSSION Prior to this review, there has been no systematic investigation into extravertebral causes of LBP. Although these causes are rare, the absence of robust and reliable epidemiological data hinders a comprehensive understanding, as well as the lack of standardised protocols, which contributes to a lack of accurate description of indicative symptoms. While there are certain disease-specific characteristics, such as non-mechanical or cyclical LBP, and atypical accompanying symptoms like fever, abdominal pain, or leg swelling, that may suggest extravertebral causes, it is important to recognise that these features are not universally present in every patient. CONCLUSION The differential diagnosis of extravertebral LBP is extensive with relatively low prevalence rates dependent on the clinical setting. Clinicians should maintain a high index of suspicion for extravertebral aetiologies, especially in patients presenting with atypical accompanying symptoms.
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Affiliation(s)
- Anna Kunow
- Department of General Practice, University Medicine Greifswald, 17475, Fleischmannstraße, Greifswald, Germany.
| | | | - Jean-François Chenot
- Department of General Practice, University Medicine Greifswald, 17475, Fleischmannstraße, Greifswald, Germany
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Nasir IT, Shoab SS, Bani-Hani MG. Conservative Treatment of Ruptured Abdominal Aortic Aneurysm. Vasc Specialist Int 2023; 39:32. [PMID: 37905386 PMCID: PMC10616691 DOI: 10.5758/vsi.230073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/19/2023] [Accepted: 10/01/2023] [Indexed: 11/02/2023] Open
Abstract
Although nonsurgical management of ruptured abdominal aortic aneurysm (rAAA) is still used among a significant number of patients, survival after conservative treatment is extremely rare. We report a case of an 86-year-old female who presented with an rAAA that was confirmed clinically and radiologically via computed tomography angiography. Although the patient was not deemed a candidate for surgery owing to significant comorbidities and poor baseline function, she survived the episode with no surgical intervention. Given the growing aging and frail population, it is vital to explore this further, with the aim of improving both mortality and advanced care planning in the nonsurgical management of rAAA.
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Affiliation(s)
- Imama Taiba Nasir
- Department of Vascular Surgery, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom
| | - Sulaiman Syed Shoab
- Department of Vascular Surgery, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom
| | - Mohamed Ghaleb Bani-Hani
- Department of Vascular Surgery, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom
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Hariri O, Al Laham O, Mohammad A. Chronic contained ruptured abdominal aortic aneurysm with a rare presentation of lower limb neuropathic claudication: a report of two cases. Ann Med Surg (Lond) 2023; 85:4121-4125. [PMID: 37554875 PMCID: PMC10406037 DOI: 10.1097/ms9.0000000000000970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 06/10/2023] [Indexed: 08/10/2023] Open
Abstract
UNLABELLED A vertebral body erosion that takes place due to a chronic contained rupture of an abdominal aortic aneurysm is an especially rare vascular pathology that comprises less than 5% of all causes of vertebral body erosion. Chronic contained rupture of an abdominal aortic aneurysms are primarily observed in hemodynamically stable patients whose chief complaint is lower limb neuropathic pain. This entity is extremely misleading and this results in delayed management of those patients increasing the morbidity and mortality rates. CASE PRESENTATION We present the two cases of 62-year-old and 65-year-old males. Preoperative radiology for each patient showed an infrarenal aortic aneurysm with a retroperitoneal hematoma in contact with the lumbar vertebral bodies and psoas muscle. The draped aorta sign was evident in both cases. CLINICAL DISCUSSION A curative surgical intervention was accomplished for both patients, respectively. This was achieved through the removal of the existing hematomas that were compressing the vertebrae in addition to the complete isolation and resection of the respective abdominal aortic aneurysms along with thorough reconstruction of the aortoiliac spindles with patent synthetic grafts to ensure the patency of the preexisting vascular axis. CONCLUSION A contained rupture of an abdominal aortic aneurysm is a rare occurring vascular pathology that manifests with nonspecific symptoms, such as femoral neuropathy and lower back pain proportionate to the degree of the level of erosion of the affected lumbar vertebrae. This will increase the possibility of misdiagnosis and delays in treatment. Such a life-threatening vascular emergency should be timely detected and treated to avoid its complications and patient mortality.
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Affiliation(s)
- Omar Hariri
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic
| | - Omar Al Laham
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic
| | - Ammar Mohammad
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic
- Department of Vascular and Endovascular Surgery, Al Assad University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic
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Pesce A, Armocida D, Petrella G, Guerrini F, Pompucci A. Vertebral body erosion by a chronic contained rupture of thoraco-abdominal aortic aneurysm: systematic review and spine surgical recommendations. World Neurosurg 2021; 158:e75-e86. [PMID: 34737100 DOI: 10.1016/j.wneu.2021.10.116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Vertebral body erosion (VBE) is commonly caused by neoplastic, inflammatory or infectious diseases: it can be rarely associated with aortic wall disorders, such as contained rupture of aortic aneurysm (CCR-AA). CCR-AA is a rare event consisting of less than 5% of all reported cases. This condition is easily undiagnosed, differential diagnosis may be challenging, and there is no consensus or recommendation that dictates guidance on management of spinal surgical treatment. MATERIAL AND METHODS We performed a systematic review of literature of all cases of VBE secondary to CCR-AA to identify clinical, radiological, and surgical outcome characteristics with the aim of providing a basis for future research studies. RESULTS The search returned a total of 80 patients. All reported cases have a history of hypertension. In almost all cases the AA size reported was very high (mean diameter of 7.056 cm). The treatment of this condition involves various reported treatment strategies: a totally conservative approach, treatment of the aortic aneurysm through a minimally invasive endovascular procedure, or through open surgery and combined approach. Despite the wide variability in therapeutic strategy, the rate of good outcomes was 80%, relatively high. CONCLUSIONS ''Back pain'' and pain along the vertebral column are such frequent complaints that unusual etiologies or serious and life threatening complications may be overlooked. In addition to the common traumatic and degenerative causes of back pain, AA must also be considered. A combined approach between vascular and spine surgery could be achieved without any increased risk.
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Affiliation(s)
| | - Daniele Armocida
- Santa Maria Goretti Hospital, Latina (LT), Italy; Human Neurosciences Department Neurosurgery Division "Sapienza" University.
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van der Sluis N, Tielliu IFJ, Zeebregts CJ, Krievins D, van Schaik PM. Endovascular Repair of Contained Abdominal Aortic Aneurysm Rupture Using a Bilateral D-Shaped Stent System. Vasc Endovascular Surg 2017; 51:139-140. [PMID: 28114868 DOI: 10.1177/1538574416689428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To report the first case of the treatment of a contained aortic aneurysm rupture using a bilateral D-shaped endovascular stent graft system.
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Affiliation(s)
- Nanouk van der Sluis
- 1 Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Ignace F J Tielliu
- 1 Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Clark J Zeebregts
- 1 Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Dainis Krievins
- 2 Department of Vascular surgery, Pauls Stradins University Hospital, University of Latvia, Riga, Latvia
| | - Paul M van Schaik
- 1 Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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Lombardi AF, Cardoso FN, da Rocha Fernandes A. Extensive Erosion of Vertebral Bodies Due to a Chronic Contained Ruptured Abdominal Aortic Aneurysm. J Radiol Case Rep 2016; 10:27-34. [PMID: 27200153 DOI: 10.3941/jrcr.v10i1.2274] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This report describes a case of chronically ruptured abdominal aortic aneurysm contained within the lumbar vertebral bodies that presented with dull abdominal pain. Sudden, massive hemorrhage is an uncommon, yet well-known complication of an untreated abdominal aortic aneurysm. In addition, misleading clinical and radiological findings present difficult diagnostic challenges in such cases. This report emphasizes the findings obtained with multidetector computed tomography and delineates the differentiation of this condition from similar pathologies.
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Affiliation(s)
- Alecio Fernando Lombardi
- Department of Radiology, Sao Paulo hospital, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Fabiano Nassar Cardoso
- Department of Radiology, Sao Paulo hospital, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Artur da Rocha Fernandes
- Department of Radiology, Sao Paulo hospital, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
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Chronic Rupture of Abdominal Aortic Aneurysm with Vertebral Erosion: An Uncommon but Important Cause of Back Pain. Ann Vasc Surg 2014; 28:1931.e1-4. [DOI: 10.1016/j.avsg.2014.07.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Revised: 06/28/2014] [Accepted: 07/01/2014] [Indexed: 11/22/2022]
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8
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Massive vertebral destruction associated with chronic rupture of infrarenal aortic aneurysm: case report and systematic review of the literature in the English language. Spine (Phila Pa 1976) 2012; 37:E1665-71. [PMID: 22990367 DOI: 10.1097/brs.0b013e318273dc66] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Case report and review of literature. OBJECTIVE To highlight the specific features of a rare, life-threatening, clinical picture. SUMMARY OF BACKGROUND DATA Vertebral erosion (VE) is rarely associated with contained rupture of an abdominal aortic aneurysm. The involvement of radicular nerves can mimic a discus hernia syndrome; eventually vertebral erosion induces isolated lower back pain. These features often lead to a delayed or wrong diagnosis of a life-threatening condition. Forty-two complete similar case reports have been published in the English literature since 1962. The most prevalent symptoms are low back pain and neurological signs due to compression of radicular nerves. METHODS A 73-year-old man presented to Vascular Surgery department complaining of continuous pain in the lumbar region during the previous 6 months. The duplex examination revealed a huge infrarenal aortic aneurysm with an undefined posterior wall. Spiral CT and MR scan confirmed the aneurysm and a scalloping of the second and third lumbar vertebral bodies. RESULTS A double-team intervention, vascular and orthopedic, consisted in aneurysm graft replacement; vertebral bodies excision and anterior and posterior spinal stabilization. Postoperatively the patient experienced reversible respiratory and renal failure and was discharged home in good health after 30 days. CONCLUSION The presence of aortic abdominal aneurysm is always to be considered in the evaluation of an elderly patient complaining lower back pain or lower limb neuropathy of recent onset, especially in the presence of a degenerative process of the spine.
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Chronic contained abdominal aortic aneurysm rupture after suprarenal fixation fatigue fracture. Ann Vasc Surg 2012; 26:1011.e7-1011.e10. [PMID: 22944573 DOI: 10.1016/j.avsg.2012.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Revised: 01/25/2012] [Accepted: 03/08/2012] [Indexed: 11/22/2022]
Abstract
Chronic contained rupture (CCR) of an abdominal aortic aneurysm is a rare condition, and differential diagnosis might be difficult. We present a clinical case of a hemodynamically stable octogenarian who presented with intermittent pain in the left lower abdomen. The patient had a history of diverticulitis, and 6 years ago, he had undergone endovascular abdominal aortic aneurysm repair (EVAR) with a Talent bifurcated prosthesis. Additionally, 20 days before his admission to our hospital, he had undergone a secondary iliac limb extension for treatment of post-EVAR rupture. On admission, abdominal plain radiography identified suprarenal fixation fracture as a possible reason for CCR, but computed tomographic angiography failed to confirm any endoleak or "active" bleeding and rupture. The patient received medication treatment for possible diverticulitis and was kept under close monitoring for suspected failure of recently performed secondary endovascular procedure and CCR. A day later, the abdominal pain symptoms worsened, and a new computed tomographic angiography confirmed the suspected CCR. The patient was treated successfully by "open" repair using a Y prosthesis. To our knowledge, this is the first reported case of post-EVAR CCR due to suprarenal fixation fatigue fracture. Lifelong post-EVAR follow-up with high level of both clinical and imaging diagnostic accuracy is essential for the early recognition and proper treatment of EVAR pitfalls.
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Chronic rupture of abdominal aortic aneurysm. Ann Vasc Surg 2011; 25:981.e1-5. [PMID: 21620664 DOI: 10.1016/j.avsg.2011.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2010] [Accepted: 01/17/2011] [Indexed: 11/23/2022]
Abstract
Although the mortality rate after abdominal aortic aneurysm rupture approximates 90% despite the urgent management, a few cases of chronic rupture and delayed repair have been reported in the world literature; anatomic and hemodynamic reasons occasionally allow for the fortunate course of these patients. We report in this article the case of 76-year-old man with a ruptured abdominal aortic aneurysm who was transferred to our facility 4 weeks after his initial hospitalization in a district institution and who finally had a successful open repair.
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Tsubota H, Nakamura T. Chronic contained rupture of an abdominal aortic aneurysm manifesting as lower extremity neuropathy. J Vasc Surg 2011; 55:548. [PMID: 21458206 DOI: 10.1016/j.jvs.2010.12.061] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2010] [Revised: 12/17/2010] [Accepted: 12/17/2010] [Indexed: 11/16/2022]
Affiliation(s)
- Hideki Tsubota
- Department of Cardiovascular Surgery, Uji Tokushukai Hospital, Kyoto, Japan.
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12
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Apter S, Rimon U, Konen E, Erlich Z, Guranda L, Amitai M, Portnoy O, Gayer G, Hertz M. Sealed rupture of abdominal aortic aneurysms: CT features in 6 patients and a review of the literature. ACTA ACUST UNITED AC 2008; 35:99-105. [DOI: 10.1007/s00261-008-9488-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2008] [Accepted: 11/12/2008] [Indexed: 11/30/2022]
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Davidović LB, Marković MD, Jakovljević NS, Cvetković D, Kuzmanović IB, Marković DM. Unusual forms of ruptured abdominal aortic aneurysms. Vascular 2008; 16:17-24. [PMID: 18258158 DOI: 10.2310/6670.2007.00042] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Over 95% of abdominal aortic aneurysms (AAAs) rupture into the retroperitoneal space. Rare types of AAA ruptures comprise ruptures into the inferior vena cava with aortocaval fistula formation (ACF), ruptures into the duodenum with formation of a primary aortoduodenal fistula (ADF), and chronic contained ruptures (CCRs). This article presents a study of 41 cases with unusual forms of ruptured AAA of a series of 506 patients with AAA rupture treated within a 14-year period. There were 11 cases of CCR, 5 cases with ADF, and 25 cases with ACF. The correct preoperative diagnosis was established in 6 (of 11) cases of CCR, in 2 (of 5) cases of primary ADF, and in 13 (of 25) cases of ACF. AAA replacement was performed in 8 cases using a tube graft, whereas a bifurcated graft was used in 31 patients because of the distant extent of the atherosclerotic/aneurysmatic lesions engaging iliac arteries. Two patients had an axillobifemoral bypass. The overall 30-day mortality rate was 19% (8 of 41), with subgroup mortality rates of 0 (CCR), 60% (ADF), and 20% (ACF). Diagnosis and treatment are simplest in cases of CCR and the most complicated in cases of ADF.
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Affiliation(s)
- Lazar B Davidović
- Clinic for Vascular Surgery, Institute for Cardiovascular Diseases, Clinical Center of Serbia, Belgrade, Serbia.
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Gandini R, Chiocchi M, Maresca L, Pipitone V, Messina M, Simonetti G. Chronic contained rupture of an abdominal aortic aneurysm: from diagnosis to endovascular resolution. Cardiovasc Intervent Radiol 2007; 31 Suppl 2:S62-6. [PMID: 17710469 DOI: 10.1007/s00270-007-9154-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2007] [Revised: 05/03/2007] [Accepted: 07/25/2007] [Indexed: 10/22/2022]
Abstract
A male patient, 69 years old, presented with fever, leucocytosis, and persistent low back pain; he also had an abdominal aortic aneurysm (AAA), as previously diagnosed by Doppler UltraSound (US), and was admitted to our hospital. On multislice computed tomography (msCT), a large abdominal mass having no definite border and involving the aorta and both of the psoas muscles was seen. This mass involved the forth-lumbar vertebra with lysis, thus simulating AAA rupture into a paraspinal collection; it was initially considered a paraspinal abscess. After magnetic resonance imaging examination and culture of the fluid aspirated from the mass, no infective organisms were found; therefore, a diagnosis of chronically contained AAA rupture was made, and an aortic endoprosthesis was subsequently implanted. The patient was discharged with decreased lumbar pain. At 12-month follow-up, no evidence of leakage was observed. To our knowledge, this is the first case of endoprosthesis implantation in a patient, who was a poor candidate for surgical intervention due to renal failure, leucocytosis and high fever, having a chronically contained AAA ruptured simulating spodylodiscitis abscess. Appropriate diagnosis and therapy resolved potentially crippling pathology and avoided surgical graft-related complications .
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Affiliation(s)
- Roberto Gandini
- Department of Diagnostic and Molecular Imaging, Interventional Radiology, Nuclear Medicine and Radiation Therapy, University of Rome Tor Vergata, 81 Oxford Street, Rome 00133, Italy
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Padua L, Caliandro P, Bertolini C, Calistri A, Aprile I, Pazzaglia C, Tonali P. Post traumatic femoral mononeuropathy. J Neurol 2006; 253:655-6. [PMID: 16767543 DOI: 10.1007/s00415-006-0972-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2004] [Revised: 03/31/2005] [Accepted: 05/06/2005] [Indexed: 10/24/2022]
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Aneurisma de aorta abdominal roto e hiperostosis esquelética idiopática difusa. ANGIOLOGIA 2006. [DOI: 10.1016/s0003-3170(06)74977-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Al-Koteesh J, Masannat Y, James NVM, Sharaf U. Chronic contained rupture of abdominal aortic aneurysm presenting with longstanding back pain. Scott Med J 2005; 50:122-3. [PMID: 16163999 DOI: 10.1177/003693300505000310] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Abdominal aortic aneurysm (AAA) is one of the important differential diagnoses of back pain which is often missed. Chronic contained rupture is a rare event that can cause diagnostic difficulties, presenting in different ways such as back pain, neuropathy or groin mass. We are presenting a case of 46-year-old man who presented with history of recurrent low back pain radiating to his left leg, associated with sensory deficit in the left thigh. His complaint proved to be resulting from chronic contained AAA leak.
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Affiliation(s)
- J Al-Koteesh
- Prince Philip Hospital, Llanelli, SA14 8QF Wales.
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Jones VA, Stubblefield MD. The role of knee immobilizers in cancer patients with femoral neuropathy. Arch Phys Med Rehabil 2004; 85:303-7. [PMID: 14966718 DOI: 10.1016/s0003-9993(03)00470-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To determine the utility of knee immobilizers for cancer patients with femoral neuropathy. DESIGN Retrospective case series with chart reviews and telephone interviews. SETTING Teaching hospital, inpatient setting, and 1-year follow-up as outpatients. PARTICIPANTS Five cancer patients with femoral neuropathy (4 men, 1 woman; age range, 51-76 y). Inclusion criteria were (1) diagnosis of femoral neuropathy, (2) receipt of knee immobilizer as an inpatient, and (3) ability to discuss opinions about knee orthotics at 1-year follow-up. INTERVENTION Knee immobilizer. Main outcome measures Number of falls with and without knee immobilizer, ambulatory distance with and without immobilizer, subjective rating of activity level, and feeling of stability with and without immobilizer. RESULTS Patients reported that the knee immobilizer reduced their number of falls by up to 10-fold, increased ambulatory distance between 105 and 420 ft (31.5 and 126 m), improved their feeling of stability, and increased overall activity levels. CONCLUSIONS Patients can benefit from knee immobilizers during their rehabilitation efforts: risk of falls decreased, ambulation distance increased, and relative peace of mind was achieved with the orthotic's use.
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Affiliation(s)
- Valerie A Jones
- New Yoek Presbyterian Hospital, Weill Medical College of Cornell University, New York, NY, USA
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