title: Surgical treatment of destructive calcific lesions of the cervical spine in scleroderma: case series and review of the literature.
abstract: METHODS
  An independent retrospective chart review combined with a review of current literature.
  
  
  OBJECTIVE
  To describe a series of destructive, calcific masses of the cervical spine causing pain, neurologic dysfunction, and instability in patients with scleroderma and detail the surgical interventions required. To review benign, calcific cervical spine lesions associated with scleroderma and collagen vascular disorders.
  
  
  BACKGROUND
  Little is know about the diagnosis and management of the destructive, calcific lesions of scleroderma in the cervical spine.
  
  
  METHODS
  The medical and radiographic records of 3 patients with scleroderma lesions in the cervical spine were reviewed. A computer-based literature search of Ovid and PubMed databases was used to compile a comprehensive review of the topic.
  
  
  RESULTS
  The perioperative and surgical management of 3 cases of scleroderma of the cervical spine are discussed in the context of a complete literature review on the topic. These complex lesions were found to require significant resources with regard to diagnosis and management.
  
  
  CONCLUSIONS
  Destructive, calcific masses in the cervical spine associated with scleroderma and an indication for surgical treatment are rare. Treatment is complex and not without significant risk to the patient.
authors.affiliation: Department of Orthopaedic Surgery, The University of Iowa, Iowa City, IA 52242, USA. joseph-smucker@uiowa.edu
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Smucker
authors.forename: John G
authors.initials: JG
authors.lastname: Heller
authors.forename: Henry H
authors.initials: HH
authors.lastname: Bohlman
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Whitesides
mesh_terms: D000368:Aged; D001707:Biopsy, Needle; D002114:Calcinosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D002574:Cervical Vertebrae; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D019637:Orthopedic Procedures / Q000009:adverse effects; D010146:Pain / Q000209:etiology; D011182:Postoperative Care; D011300:Preoperative Care; D012189:Retrospective Studies; D012594:Scleroderma, Localized / Q000150:complications*; D013122:Spinal Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D014057:Tomography, X-Ray Computed