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Background: The Bruns Garland syndrome (diabetic amyotrophy) it is a very rare condition, with few cases reported in the literature. Clinical diff erentiation of diabetic amyotrophy or cauda equine syndrome may be difficult. The issue of misdiagnosis has been discussed as a reason for poor outcome after lumbar spine surgery. We report a case of diabetic amyotrophy that mimics a cauda equina syndrome. Case description: A 59 years old man diabetic patient that suddenly begins with weakness of lower extremities and loss of sphincters control. The patient was seen in the emergency room, the anteroposterior and lateral radiographs of the lumbosacral spine evidenced spondylolisthesis L5-S1 level II of Meyerding. However, the MRI show no vertebral canal compression, nerve root compression or disc extrusion. Electrodiagnostic study revealed diabetic amyotrophy (Bruns Garland syndrome). The patient rapidly improves with treatment based in antineuritics, diabetes control, physical therapy and rehabilitation. Four months after the diagnosis he recover his muscle strength, has no alterations in the march, no loss of balance, his sensitive is preserved and has no pain. Conclusion: Electrodiagnostic and radiologic studies should be used in every diabetic patient presenting with leg pain and/or weakness to diff erentiate diabetic neuropathy from cauda equina syndrome. Treatment of both diseases may be needed for relief of the patient's pain. [ABSTRACT FROM AUTHOR]

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Background and Objective: One of the most important outcomes regarding social reintegration after a traumatic spinal cord injury is social reinsertion; despite its huge impact, very few studies in Mexico have measured community reintegration in these patients. The objective of this study was to analyse the working situation of patients with traumatic spinal cord injury at a hospital centre in Mexico., Material and Methods: Cross-sectional descriptive study. Working patients, aged 19-55 years, diagnosed with traumatic spinal cord injury at a hospital centre in Mexico were included; a telephone survey was performed., Results: Eighteen patients were included (15 men, 3 women), with a mean age of 38 years (± 10.3). The most common levels of injury were cervical and thoracic; the most common Asia Impairment Scale grades were A and E; 17 patients were included at a rehabilitation programme at discharge; the average Spinal Cord Independence Measure score was 65.22 (± 35.11). Five patients were hired after the injury in a mean period of 7 months (± 2.9). The main factors associated with occupational reintegration were young age, lower injury levels, an adequate rehabilitation programme, high Spinal Cord Independence Measure scale score, and being married or cohabiting., Conclusion: This study shows the low return to work rate after a traumatic spinal cord injury, as well as the main factorsa affecting it; highlighting the importance of an adeaquate rehabilitation program with a multidisciplinary approach., (Copyright © 2020 Sociedad Española de Rehabilitación y Medicina Física. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: Hemangiomas are the most common primary tumors of the spine. Mainly asymptomatic Incidental finding when performing an imaging study. The incidence reported at autopsies is 11% in the spine, multifocal lesions are present in 25 to 30% of cases., Clinical Case: Vertebral cervical hemangioma with benign and stable characteristics that underwent surgical treatment, observing aggressive post-surgical behavior two months later., Conclusion: The approach to vertebral pathology is algorithmic and protocolized, it is necessary to determine the treatment based on the overall understanding of the disease and according to the clinical practice guidelines.

Background: The Bruns Garland syndrome (diabetic amyotrophy) it is a very rare condition, with few cases reported in the literature. Clinical differentiation of diabetic amyotrophy or cauda equine syndrome may be difficult. The issue of misdiagnosis has been discussed as a reason for poor outcome after lumbar spine surgery. We report a case of diabetic amyotrophy that mimics a cauda equina syndrome., Case Description: A 59 years old man diabetic patient that suddenly begins with weakness of lower extremities and loss of sphincters control. The patient was seen in the emergency room, the anteroposterior and lateral radiographs of the lumbosacral spine evidenced spondylolisthesis L5-S1 level II of Meyerding. However, the MRI show no vertebral canal compression, nerve root compression or disc extrusion. Electrodiagnostic study revealed diabetic amyotrophy (Bruns Garland syndrome). The patient rapidly improves with treatment based in antineuritics, diabetes control, physical therapy and rehabilitation. Four months after the diagnosis he recover his muscle strength, has no alterations in the march, no loss of balance, his sensitive is preserved and has no pain., Conclusion: Electrodiagnostic and radiologic studies should be used in every diabetic patient presenting with leg pain and/or weakness to differentiate diabetic neuropathy from cauda equina syndrome. Treatment of both diseases may be needed for relief of the patients pain.

The term «vertebral destruction syndrome» comprises pathologies causing structural changes in the spine, mainly in the vertebral body, producing mechanical deformity and neurological involvement. The pathologies found in this definition may be infectious, metabolic or tumoral. Vertebral osteomyelitis is a disease that occurs mainly in adults > 50 years; we speak of spondylodiscitis when the condition affects the disc and vertebral body. The most important organism in vertebral osteomyelitis is Staphylococcus aureus, seen in over 50% of cases. Tumors of the spine can start from local or adjacent spinal injuries or distant ones, and spread through the blood or lymphatic system. Metastases account for about 97% of all tumors of the spine. Primary tumors that most commonly spread to the spine are lung, prostate, breast and kidney. Metabolic bone diseases are a group of disorders that occur as a result of changes in the calcium metabolism. The spine contains large amounts of metabolically active cancellous bone, which must withstand axial loads during stance. Osteoporosis is a metabolic disease that most commonly affects the spine; it is characterized by low bone mass. The diagnosis of these entities is important for the treatment and prognosis of the patient. The term «vertebral destruction syndrome» proposes a notarized scheme aimed at improving the patients prognosis and his/her prompt treatment.