Korean Journal of SpinePub Date : 2015-09-01Epub Date: 2015-09-30DOI: 10.14245/kjs.2015.12.3.139
Jin Hyuk Bang, Keun-Tae Cho
{"title":"Rapidly Progressive Gas-containing Lumbar Spinal Epidural Abscess.","authors":"Jin Hyuk Bang, Keun-Tae Cho","doi":"10.14245/kjs.2015.12.3.139","DOIUrl":"https://doi.org/10.14245/kjs.2015.12.3.139","url":null,"abstract":"<p><p>Gas-containing (emphysematous) infections of the abdomen, pelvis, and extremities are well-known disease entities, which can potentially be life-threatening. They require aggressive medical and often surgical treatment. In the neurosurgical field, some cases of gas-containing brain abscess and subdural empyema have been reported. Sometimes they progress rapidly and even can cause fatal outcome. However, gas-containing spinal epidural abscess has been rarely reported and clinical course is unknown. We report on a case of rapidly progressive gas-containing lumbar spinal epidural abscess due to Enterococcus faecalis in a 72-year-old male patient with diabetes mellitus. </p>","PeriodicalId":17867,"journal":{"name":"Korean Journal of Spine","volume":"12 3","pages":"139-42"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/12/fc/kjs-12-139.PMC4623168.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34127164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Korean Journal of SpinePub Date : 2015-09-01Epub Date: 2015-09-30DOI: 10.14245/kjs.2015.12.3.225
Jin Bum Kim, Seung Won Park, Young Seok Lee, Taek Kyun Nam, Yong Sook Park, Young Baeg Kim
{"title":"Two Cases of Klippel-Feil Syndrome with Cervical Myelopathy Successfully Treated by Simple Decompression without Fixation.","authors":"Jin Bum Kim, Seung Won Park, Young Seok Lee, Taek Kyun Nam, Yong Sook Park, Young Baeg Kim","doi":"10.14245/kjs.2015.12.3.225","DOIUrl":"https://doi.org/10.14245/kjs.2015.12.3.225","url":null,"abstract":"<p><p>Klippel-Feil syndrome (KFS) is a congenital developmental disorder of cervical spine, showing short neck with restricted neck motion, low hairline, and high thoracic cage due to multilevel cervical fusion. Radiculopathy or myelopathy can be accompanied. There were 2 patients who were diagnosed as KFS with exhibited radiological and physical characteristics. Both patients had stenosis and cord compression at C1 level due to anterior displacement of C1 posterior arch secondary to kyphotic deformity of upper cervical spine, which has been usually indicative to craniocervical fixation. One patient was referred due to quadriparesis detected after surgery for aortic arch aneurysmal dilatation. The other patient was referred to us due to paraparesis and radiating pain in all extremities developed during gynecological examinations. Decompressive C1 laminectomy was done for one patient and additional suboccipital craniectomy for the other. No craniocervical fixation was done because there was no spinal instability. Motor power improved immediately after the operation in both patients. Motor functions and spinal stability were well preserved in both patients for 2 years. In KFS patients with myelopathy at the C1 level without C1-2 instability, a favorable outcome could be achieved by a simple decompression without spinal fixation. </p>","PeriodicalId":17867,"journal":{"name":"Korean Journal of Spine","volume":"12 3","pages":"225-9"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/60/ef/kjs-12-225.PMC4623191.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34194002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Korean Journal of SpinePub Date : 2015-09-01Epub Date: 2015-09-30DOI: 10.14245/kjs.2015.12.3.165
Chungnam Lee, Woo Jin Choe, Nara Kim
{"title":"Epithelioid Sarcoma in the Cervical Spine: A Case Report.","authors":"Chungnam Lee, Woo Jin Choe, Nara Kim","doi":"10.14245/kjs.2015.12.3.165","DOIUrl":"https://doi.org/10.14245/kjs.2015.12.3.165","url":null,"abstract":"<p><p>Epithelioid sarcoma is a rare and highly malignant soft tissue neoplasm that most commonly occurs in the long bones. This uncommon tumor has a poor clinical outcome, and the modality of its treatment has not yet been fully established. The authors report an extremely rare presentation of epithelioid sarcoma in the cervical spine, along with its clinical progression, imaging, and pathology. The patient underwent three surgical procedures and adjuvant radiochemical management. He survived for 25 months with a good general condition and adapted well to his social activity. Systemic metastasis was not found, but the patient died of respiratory failure due to direct tracheal invasion of the tumor. </p>","PeriodicalId":17867,"journal":{"name":"Korean Journal of Spine","volume":"12 3","pages":"165-8"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ca/b3/kjs-12-165.PMC4623175.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34296528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Korean Journal of SpinePub Date : 2015-09-01Epub Date: 2015-09-30DOI: 10.14245/kjs.2015.12.3.200
Hyeong-Seok Jeon, Keung-Nyun Kim
{"title":"Delayed Bilateral C5 Palsy following Circumferential Decompression and Fusion in Patient with Cervical Spondylotic Myelopathy.","authors":"Hyeong-Seok Jeon, Keung-Nyun Kim","doi":"10.14245/kjs.2015.12.3.200","DOIUrl":"https://doi.org/10.14245/kjs.2015.12.3.200","url":null,"abstract":"<p><p>C5 palsy is a common complication after cervical decompressive surgery, which have 0 to 30% complication rate. A 61-year-old female patient with cervical spondylotic myelopathy showed bilateral C5 palsy following circumferential decompression and fusion. Unexpectedly, bilateral C5 palsy was noted in different time points on postoperative day 2 and 8, respectively. Steroid injection and physical therapy were performed, and her motor function is recovering. Surgeons should make an effort to prevent possible C5 palsy when performing cervical decompression surgery. </p>","PeriodicalId":17867,"journal":{"name":"Korean Journal of Spine","volume":"12 3","pages":"200-3"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e4/66/kjs-12-200.PMC4623184.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34297570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Korean Journal of SpinePub Date : 2015-09-01Epub Date: 2015-09-30DOI: 10.14245/kjs.2015.12.3.173
Hyun-Ho Lee, Sung-Choon Park, Young Kim, Young-Soo Ha
{"title":"Spontaneous Spinal Epidural Hematoma on the Ventral Portion of Whole Spinal Canal: A Case Report.","authors":"Hyun-Ho Lee, Sung-Choon Park, Young Kim, Young-Soo Ha","doi":"10.14245/kjs.2015.12.3.173","DOIUrl":"https://doi.org/10.14245/kjs.2015.12.3.173","url":null,"abstract":"<p><p>Spontaneous spinal epidural hematoma is an uncommon but disabling disease. This paper reports a case of spontaneous spinal epidural hematoma and treatment by surgical management. A 32-year-old male presented with a 30-minute history of sudden headache, back pain, chest pain, and progressive quadriplegia. Whole-spinal sagittal magnetic resonance imaging (MRI) revealed spinal epidural hematoma on the ventral portion of the spinal canal. Total laminectomy from T5 to T7 was performed, and hematoma located at the ventral portion of the spinal cord was evacuated. Epidural drainages were inserted in the upper and lower epidural spaces. The patient improved sufficiently to ambulate, and paresthesia was fully recovered. Spontaneous spinal epidural hematoma should be considered when patients present symptoms of spinal cord compression after sudden back pain or chest pain. To prevent permanent neurologic deficits, early and correct diagnosis with timely surgical management is necessary. </p>","PeriodicalId":17867,"journal":{"name":"Korean Journal of Spine","volume":"12 3","pages":"173-6"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/43/38/kjs-12-173.PMC4623177.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34296530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Korean Journal of SpinePub Date : 2015-09-01Epub Date: 2015-09-30DOI: 10.14245/kjs.2015.12.3.181
Woong-Beom Kim, Young-Seop Park, Jong-Hwa Park, Seung-Jae Hyun
{"title":"Posterior Spinal Reconstruction with Pedicle Screws, Multiple Iliac Screws and Wisconsin Spinal Wires in a Patient with Neurofibromatosis Scoliosis: A Case Report.","authors":"Woong-Beom Kim, Young-Seop Park, Jong-Hwa Park, Seung-Jae Hyun","doi":"10.14245/kjs.2015.12.3.181","DOIUrl":"https://doi.org/10.14245/kjs.2015.12.3.181","url":null,"abstract":"<p><p>A 54-year-old female with neurofibromatosis type 1 presented with progressing truncal shift owing to spinal deformity. On plain radiograph, the Cobb angle was 54 degree in coronal plane. Radiological examinations showed severe dystrophic change with dysplastic pedicles, bony scalloping, neural foraminal widening from dural ectasia. The patient underwent deformity correction and reconstruction surgery from the T9 to the pelvis using multiple iliac screws and Wisconsin interspinous segmental instrumentation by wiring due to maximize fixation points. The postoperative course was uneventful. One-year follow-up radiographs showed a successful curve correction with solid fusion. We report a case of pedicle dysplasia and dystrophic change treated by posterior segmental spinal instrumentation and fusion with help of multiple iliac screws and modified Wisconsin interspinous segmental wiring. </p>","PeriodicalId":17867,"journal":{"name":"Korean Journal of Spine","volume":"12 3","pages":"181-4"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c5/1f/kjs-12-181.PMC4623179.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34296532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Korean Journal of SpinePub Date : 2015-09-01Epub Date: 2015-09-30DOI: 10.14245/kjs.2015.12.3.130
Su Yong Choi, Sang Gu Lee, Woo Kyung Kim, Seong Son, Tae Seok Jeong
{"title":"The Actual Level of Symptomatic Soft Disc Herniation in Patients with Cervical Disc Herniation.","authors":"Su Yong Choi, Sang Gu Lee, Woo Kyung Kim, Seong Son, Tae Seok Jeong","doi":"10.14245/kjs.2015.12.3.130","DOIUrl":"https://doi.org/10.14245/kjs.2015.12.3.130","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to predict the relationship between the symptomatic disc herniation level and the osteophyte level or decreased disc height in patients with cervical disc herniation.</p><p><strong>Methods: </strong>Between January 2011 and December 2012, 69 patients with an osteophyte of the cervical spine underwent surgery at a single center due to soft cervical disc herniation. Data including soft disc herniation level, osteophyte level in the posterior vertebral margin, Cobb's angle, and symptom duration were retrospectively assessed. The patients were divided into three groups according to the relationship between the degenerative change level and the level of reported symptoms.</p><p><strong>Results: </strong>Among the 69 patients, 48 (69.6%) showed a match between osteophyte level and soft disc herniation level. Disc herniation occurred at the adjacent segment to degenerative osteophyte level in 12 patients (17.4%) and at both the adjacent and the osteophyte level in nine (13.0%). There was no significant difference in Cobb's angle or duration among the three groups. Osteophyte type was not significant. The mean disc height of the prominent degenerative change level group was lower than the adjacent segment level, but this was not significant.</p><p><strong>Conclusion: </strong>Soft cervical disc herniation usually occurs at the level an osteophyte forms. However, it may also occur at segments adjacent to that of the osteophyte level. Therefore, in patients with cervical disc herniation, although a prominent osteophyte alone may appear on plain radiography, we must suspect the presence of soft disc herniation at other levels.</p>","PeriodicalId":17867,"journal":{"name":"Korean Journal of Spine","volume":"12 3","pages":"130-4"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/89/9a/kjs-12-130.PMC4623166.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34127162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Korean Journal of SpinePub Date : 2015-09-01Epub Date: 2015-09-30DOI: 10.14245/kjs.2015.12.3.143
Pius Kim, Seok Won Kim, Chang Il Ju, Hyeun Sung Kim
{"title":"Lumbar Disc Herniation Combined with Posterior Apophyseal Ring Separation in a Young Child: A Case Report.","authors":"Pius Kim, Seok Won Kim, Chang Il Ju, Hyeun Sung Kim","doi":"10.14245/kjs.2015.12.3.143","DOIUrl":"https://doi.org/10.14245/kjs.2015.12.3.143","url":null,"abstract":"<p><p>Lumbar disc herniation in children aged 10 years or less is extremely uncommon and posterior apophyseal ring separation is not a common injury that usually occurs in adolescents or young adults after a sports-related microtraumatism. The authors report an unique case of 10-year-old boy who presented with low back pain and radiating pain on both legs. The boy received conservative treatment, which included anti-inflammatory medication, muscle relaxants, and physical therapy, but symptoms were not improved. Computed tomography and magnetic resonance imaging revealed a huge central disc herniation combined with posterior apophyseal ring separation. Microscopic lumbar discectomy with the removal of apophyseal ring separation was performed due to the intractable pain. At six months after surgery, the child was symptom free. </p>","PeriodicalId":17867,"journal":{"name":"Korean Journal of Spine","volume":"12 3","pages":"143-5"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.14245/kjs.2015.12.3.143","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34127165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Korean Journal of SpinePub Date : 2015-09-01Epub Date: 2015-09-30DOI: 10.14245/kjs.2015.12.3.177
Hyun-Jun Cho, Jang-Bo Lee, Junseok W Hur, Sung-Won Jin, Tai-Hyoung Cho, Jung-Yul Park
{"title":"A Rare Case of Malignant Lymphoma Occurred at Spinal Epidural Space: A Case Report.","authors":"Hyun-Jun Cho, Jang-Bo Lee, Junseok W Hur, Sung-Won Jin, Tai-Hyoung Cho, Jung-Yul Park","doi":"10.14245/kjs.2015.12.3.177","DOIUrl":"https://doi.org/10.14245/kjs.2015.12.3.177","url":null,"abstract":"<p><p>The sacral spinal epidural space is an uncommon site for primary malignant lymphomas, presenting with symptoms associated with cauda equina compression. Especially, lumbo-sacral epidural lymphoma has been reported to be very rare. We present a rare case of 29-year-old male with sacral spinal epidural malignant lymphoma. The patient complained of tingling sensation in his buttocks that was radiating to his calf. The neurological examination was normal. Magnetic resonance imaging (MRI) with contrast showed a well-defined extradural mass lesion at the mid L5 to mid S2 level. The lesion was iso- to hypointense on T1 and T2 weighted images and showed homogenous enhancement and a focal enhancement in the L5 vertebral body on post-contrast images. The patient underwent a L5-S2 laminectomy and subtotal excision of the lesion. Intra-operatively, the lesion was extradural and not densely adherent to the dura; the lesion was friable, not firm, fleshy, brownish and hypervascular. The histologic diagnosis was grade 2 non-Hodgkin's follicular lymphoma. Even though the primary spinal epidural non-Hodgkin's lymphoma is a very rare disease, clinicians should take it into consideration in the differential diagnosis of patients with spinal epidural tumor. </p>","PeriodicalId":17867,"journal":{"name":"Korean Journal of Spine","volume":"12 3","pages":"177-80"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f7/1a/kjs-12-177.PMC4623178.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34296531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Korean Journal of SpinePub Date : 2015-09-01Epub Date: 2015-09-30DOI: 10.14245/kjs.2015.12.3.221
You-Sub Kim, Jung-Kil Lee, Ki-Young Choi, Jae-Won Jang
{"title":"Spinal Burkitt's Lymphoma Mimicking Dumbbell Shape Neurogenic Tumor: A Case Report and Review of the Literature.","authors":"You-Sub Kim, Jung-Kil Lee, Ki-Young Choi, Jae-Won Jang","doi":"10.14245/kjs.2015.12.3.221","DOIUrl":"https://doi.org/10.14245/kjs.2015.12.3.221","url":null,"abstract":"<p><p>Non-Hodgkin's lymphoma (NHL), a disease which may involve the spine, is frequently associated with advanced disease. Radiculopathy caused by spinal root compression as the initial presentation in patients with NHL is very rare and thought to occur in less than 5% of cases. A 69-year-old woman complained of a history of low back pain with right sciatica for 1 month prior to admission. Computed tomography and magnetic resonance imaging of the lumbar spine showed a dumbbell-shape epidural mass lesion extending from L2 to L3, which was suggestive of a neurogenic tumor. After paraspinal approach and L2 lower half partial hemilaminectomy, total excision of the tumor was achieved, followed by rapid improvement of back pain and radiating pain. The lesion was confirmed to be Burkitt's lymphoma by histopathological examination. We then checked whole-body PET-CT, which showed multifocal malignant lesions in the intestine, liver, bone and left supraclavicular lymph node. Although a rare situation, Burkitt's lymphoma should be considered in the differential diagnosis for patients presenting with back and lumbar radicular pain without a prior history of malignancy. Burkitt's lymphoma could be the cause of dumbbell-shape spinal tumor. </p>","PeriodicalId":17867,"journal":{"name":"Korean Journal of Spine","volume":"12 3","pages":"221-4"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f4/7c/kjs-12-221.PMC4623190.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34194001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}