The European Interbalkan Medical Center (Greek: Ιατρικό Διαβαλκανικό Κέντρο, Iatriko Diavalkaniko Kentro), is a major private general hospital located and based in Thessaloniki, Greece, on the road to the airport, opposite of the commercial center of Apollonia (Florida) and close to Mediterranean Cosmos. It was founded by businessman Giorgos Apostolopoulos in 2000. It offers a wide variety of medical and surgical treatments, and has 383 beds.
BACKGROUND Achondroplasia is an autosomal dominant skeletal dysplasia and the most common genetic cause of dwarfism, characterized by shortened pedicles, thickened laminae, and reduced interpedicular distances that lead to congenital narrowing of the spinal canal. These anatomical abnormalities frequently result in lumbar spinal stenosis (LSS) requiring surgical management. Surgical treatment typically involves decompression of neural elements, with or without fusion, to restore canal patency and prevent postoperative deformity. However, adjusting the surgical approach to the unique anatomical constraints of achondroplasia remains critical for optimizing clinical outcomes. CASE REPORT We present a rare case of a 55-year-old woman with achondroplasia who presented with a 5-year history of progressively worsening low back pain, bilateral foot drop, and neurogenic claudication after walking short distances. Magnetic resonance imaging (MRI) demonstrated critical lumbar spinal stenosis at L2-L3, L3-L4, and L4-L5. She underwent multilevel laminectomy under general anesthesia with intraoperative fluoroscopic guidance and high magnification. Postoperatively, she was mobilized within 3 hours and discharged the same day without complications. At 4-week follow-up, the muscle strength of the anterior tibialis and quadriceps had improved to 4/5 on the MRC scale, patellar reflexes were normalized, and lower-limb sensation showed marked recovery. CONCLUSIONS This case highlights the importance of intraoperative precision and an appropriate surgical approach in managing lumbar spinal stenosis associated with achondroplasia. Decision-making, detailed preoperative planning with assessment of imaginary findings, intraoperative use of microsurgical techniques, and postoperative care are important in minimizing complications and optimizing clinical outcomes.
Introduction:The best tissue sample is still very important for the diagnosis of mesothorax lymphadenopathy. In the past 20 years endobronchial ultrasound (EBUS) has been used efficiently in most cases of primary lung cancer disease or metastatic disease. Several new type of needles have been created such 19G, 18G and hybrid biopsies with cryoprobes. Rapid on-site evaluation (ROSE) is used as an additional initial diagnostic tool. Confocal microscopy is a method of rapid on-site evaluation. Patients and Methods:One hundred patients with mesothorax lymphadenopathy were biopsied with ebus and two groups were created one with rapid on-site evaluation with confocal microscopy and one by an operator with microscopic evaluation with sample preparation on cytoglasses. Our main objective was to assess parameters such as time, false negative results between the two techniques and technical issues such as the accessibility and evaluation between the two techniques. Safety was also evaluated. Results:Rapid on-site evaluation is more cost efficient with a cytologist on site, however; with a higher rate of false negative results. Accessibility with the Cellvizio® catheter was less possible in a few cases due to rigid angles within the airways especially for small lymphnodes ≤ 1.5 cm (L4L mainly). Discussion:Confocal is a safe and time-efficient technique for mesothorax lymphadenopathy. A high level of training is required for pulmonary physicians in order to assess the novel imaging technique. Definitely different parts of the lymphnode have to reached and evaluated in order to have a proper initial evaluation.
