[An adolescent man with pain at night in his lower right leg]

A 22-year-old man is referred to the orthopaedic surgeon. He has pain, mostly at night, in his proximal right tibia that greatly reduces with NSAIDs. The CT scan shows a focal lucent zone, called a nidus, in the tibia cortex, surrounded by reactive, sclerotic bone. This is typical for an osteoid osteoma, a benign bone tumour.

A concise follow-up of a previous report: posterior reduction and anterior lumbar interbody fusion in symptomatic low-grade adult isthmic spondylolisthesis

We report the updated results for a previously evaluated surgical treatment for adult low-grade isthmic spondylolisthesis. In 12 patients a decompressive laminectomy was performed followed by a circumferential fusion using posterior pedicle screw instrumented reduction and staged anterior cage-assisted interbody fusion. Average time to follow-up was 5.6 (range 4.9-6.6) years. The average Oswestry Disability Index at last follow-up was 14 compared to 13 at 2.1-year follow-up. The average VAS score for back pain at last follow-up was 2.3 compared to 2.8 at 2.1-year follow-up. Ten patients had resumed their pre-symptom work status. This study demonstrates maintenance of the good clinical and radiological 2.1-year outcome after 5.6-year follow-up with no deterioration of back-pain scores.

Asymptomatic Massive Dural Ectasia Associated with Neurofibromatosis Type 1 Threatening Spinal Column Support

We report the case of a girl with a dystrophic neurofibromatosis lumbar scoliosis with asymptomatic progression and spread of dystrophic characteristics over 18 years. Resorption of almost the entire anterior column of L1-L4 had occurred despite a previous posterior instrumentation and fusion. A vascularized fibula bone graft wrapped in titanium mesh was used as an anterior structural graft. With close follow-up, the need for this type of salvage surgery might have been averted. Further follow-up showed no graft resorption and unchanged sagittal alignment after 3 years.