J. Ahn, M. Park, S. Kim, S. Chung, Do Sung Lee, K. Park
{"title":"Radiologic Changes of Operated and Adjacent Segments after Anterior Cervical Microforaminotomy","authors":"J. Ahn, M. Park, S. Kim, S. Chung, Do Sung Lee, K. Park","doi":"10.14245/kjs.2016.13.3.134","DOIUrl":"https://doi.org/10.14245/kjs.2016.13.3.134","url":null,"abstract":"Objective Anterior cervical microforaminotomy (ACMF) is a motion-preserving surgical procedure. The purpose of this study is to assess radiologic changes of operated and adjacent segments after ACMF. Methods We retrospectively reviewed 52 patients who underwent ACMF between 1998 and 2008. From X-ray film-based changes, disc height and sagittal range of motion (ROM) of operated and adjacent segments were compared at preoperative and last follow-up periods. Radiological degeneration of both segments was analyzed as well. Results The mean follow-up period was 48.2 months. There were 78 operated, 52 upper adjacent, and 38 lower adjacent segments. There were statistically significant differences in the ROM and disc height of operated segment between preoperative and last follow-up periods. However, there were no statistically significant differences in the ROM and disc height of adjacent segment between both periods. Radiological degenerative changes of operated segments were observed in 30%. That of adjacent segments was observed in 11 and 11% at upper and lower segments, respectively. Conclusion After mean 4-year follow-up periods, there were degenerative changes of operated segments. However, ACMF preserved motion and prevented degenerative changes of adjacent segments.","PeriodicalId":17867,"journal":{"name":"Korean Journal of Spine","volume":"18 1","pages":"134 - 138"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86452225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A 20-Year-Old Retained Surgical Gauze Mimicking a Spinal Tumor: A Case Report","authors":"Sungjoon Lee, Bomi Kim, Jung Soo Kim, B. Choi","doi":"10.14245/kjs.2016.13.3.160","DOIUrl":"https://doi.org/10.14245/kjs.2016.13.3.160","url":null,"abstract":"A 79-year-old man visited our clinic complaining of lower back and left leg radiating pain that began 1 month prior to his presentation. He underwent surgery for lumbar disc herniation 20 years ago at another hospital. Magnetic resonance imaging revealed left-sided foraminal stenosis at L4-5. In addition, a paraspinal mass occupying the L4 spinous process and left lamina was observed. We subsequently performed an L4-5 decompression and fusion. During the operation, retained surgical gauze with granulation tissue was found. The term gossypiboma is used to define a mass lesion consisting of retained surgical gauzes and an adjacent foreign body reaction. Gossypibomas are uncommon in the paraspinal area and are mostly asymptomatic in chronic cases. Because there are no specific clinical or radiological signs, they can be confused with other tumorous conditions. Gossypibomas should be included in the differential diagnosis of paraspinal soft-tissue masses detected in patients with a history of prior spinal surgery.","PeriodicalId":17867,"journal":{"name":"Korean Journal of Spine","volume":"81 1","pages":"160 - 163"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86150479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Postlaminectomy Bilateral Lumbar Intraspinal Synovial Cysts","authors":"S. Cho, J. H. Lee, C. Chough","doi":"10.14245/kjs.2016.13.3.157","DOIUrl":"https://doi.org/10.14245/kjs.2016.13.3.157","url":null,"abstract":"Lumbar intraspinal synovial cysts are included in the difference diagnosis of lumbar radiculopathy. Developing imaging modalities has result in increased reporting about these lesions. However, the case of bilateral new lumbar intraspinal synovial cysts after laminectomy has been rarely reported. We report of a rare case with bilateral lumbar intraspinal synovial cysts after laminectomy, requiring surgical excision.","PeriodicalId":17867,"journal":{"name":"Korean Journal of Spine","volume":"2 1","pages":"157 - 159"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85528394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Korean Journal of SpinePub Date : 2016-06-01Epub Date: 2016-06-30DOI: 10.14245/kjs.2016.13.2.67
Won Young Kim, Jin Bum Kim, Taek Kyun Nam, Young Baeg Kim, Seung Won Park
{"title":"Cervical Myelopathy Caused by Intracranial Dural Arteriovenous Fistula.","authors":"Won Young Kim, Jin Bum Kim, Taek Kyun Nam, Young Baeg Kim, Seung Won Park","doi":"10.14245/kjs.2016.13.2.67","DOIUrl":"https://doi.org/10.14245/kjs.2016.13.2.67","url":null,"abstract":"<p><p>Intracranial dural arteriovenous fistula (dAVF) usually results in various problems in the brain. But it can be presented as a myelopathy, which may make early diagnosis and management to be difficult. We recently experienced a case of cervical myelopathy caused by intracranial dAVF. A 60-year-old man presented with a 3-year history of gait disturbance due to a progressive weakness of both legs. Neurological examination revealed spastic paraparesis (grade IV) and Babinski sign on both sides. Magnetic resonance imaging showed serpentine vascular signal voids at C2-T1 on T2-weighted image with increased signal intensity and swelling of spinal cord at C1-C4. We performed a brain computed tomography angiography and found intracranial dAVF with multiple arteriovenous shunts. Venous drainages were noted at tentorial veins and cervical perimedullary veins. After Onyx embolization, the patient showed gradual improvement in motor power and gait disturbance. The venous drainage pattern is a well-known prognostic factor of dAVF. In our case, the intracranial dAVF drained to spinal perimedullary vein, which seemed to result in the ischemic myelopathy. Although it is rare condition, it sometimes can cause serious complications. Therefore, we should keep in mind the possibility of intracranial dAVF when a patient presents myelopathy. </p>","PeriodicalId":17867,"journal":{"name":"Korean Journal of Spine","volume":"13 2","pages":"67-70"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f9/50/kjs-13-67.PMC4949170.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34587531","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 : 2016-06-01Epub Date: 2016-06-30DOI: 10.14245/kjs.2016.13.2.80
Jae-Sang Oh, Jae-Won Doh, Jai-Joon Shim, Kyeong-Seok Lee
{"title":"Leading a Patient of Ankylosing Spondylitis to Death by Iatrogenic Spinal Fracture.","authors":"Jae-Sang Oh, Jae-Won Doh, Jai-Joon Shim, Kyeong-Seok Lee","doi":"10.14245/kjs.2016.13.2.80","DOIUrl":"https://doi.org/10.14245/kjs.2016.13.2.80","url":null,"abstract":"<p><p>Fractures in ankylosing spondylitis (AS) are often difficult to identify and treat. If combined with osteoporosis, the spine becomes weaker and vulnerable to minor trauma. An 83-year-old woman with a history of chronic AS and severe osteoporosis developed paraparesis and voiding difficulty for 4 days prior. She had been placed in the lateral decubitus position in a bedridden state in a convalescent hospital due to the progressive paraparesis. The laboratory findings showed CO2 retention in the arterial blood gas analysis. After the patient was transferred to the computed tomography (CT) room, a CT was taken in the supine position. Approximately half an hour later, the resident in our neurosurgical department checked on her, and the neurological examination showed a complete paraplegic state. She was treated conservatively and finally expired 20 days later. </p>","PeriodicalId":17867,"journal":{"name":"Korean Journal of Spine","volume":"13 2","pages":"80-2"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8d/1d/kjs-13-80.PMC4949174.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34746747","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 : 2016-06-01Epub Date: 2016-06-30DOI: 10.14245/kjs.2016.13.2.71
Seung-Kook Kim, Sun-Ho Lee, Eun-Sang Kim, Whan Eoh
{"title":"Diffuse Large B-Cell Lymphoma Mimicking Schwannoma of Lumbar Spine.","authors":"Seung-Kook Kim, Sun-Ho Lee, Eun-Sang Kim, Whan Eoh","doi":"10.14245/kjs.2016.13.2.71","DOIUrl":"https://doi.org/10.14245/kjs.2016.13.2.71","url":null,"abstract":"<p><p>A rare case of solitary diffuse large B-cell lymphoma arising from the lumbar spinal nerve root is reported. A 37-year-old man presented with a 3-month history of progressive numbness and paraparesis in both legs. The initial diagnosis was benign primary intradural extramedullary tumor including schwannoma and meningioma. Histopathological examination revealed diffuse large B-cell lymphoma. While a well-defined T1 isointense mass is common in primary spinal schwannoma, the present case was atypical and had a yellowish neural component. The pathogenesis and radiological findings of spinal diffuse large B-cell lymphoma are discussed and related literature is reviewed. </p>","PeriodicalId":17867,"journal":{"name":"Korean Journal of Spine","volume":"13 2","pages":"71-3"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/97/db/kjs-13-71.PMC4949171.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34746744","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 : 2016-06-01Epub Date: 2016-06-30DOI: 10.14245/kjs.2016.13.2.77
Kyung-Ho Jeong, Hyun-Woo Lee, Young-Min Kwon
{"title":"Spontaneous Anterior Thoracic Spinal Cord Herniation through Dura Defect: A Case Report.","authors":"Kyung-Ho Jeong, Hyun-Woo Lee, Young-Min Kwon","doi":"10.14245/kjs.2016.13.2.77","DOIUrl":"https://doi.org/10.14245/kjs.2016.13.2.77","url":null,"abstract":"<p><p>Thoracic spinal cord herniation is a rare disease cause of progressive myelopathy. Magnetic resonance image is a useful tool to diagnose preoperatively. Operation is a treatment of option. Sixty-six-year-old female visited Dong-A University Medical Center for progressive gait disturbance with falling tendency to right side. She had radiating pain and tingling sense on both leg. Sense of touch and temperature was decreased below T6 level. Both hip and knee motor power were grade IV. Magnetic resonance imaging scan showed anterior displacement of the spinal cord at T4-T5 vertebral level. Under the diagnosis of thoracic spinal cord herniation with dura defect, operation was performed for the patient with intraoperative neuromonitoring. Laminectomy at T4 and T5 level was done, and intradural exploration of the spinal cord revealed dura defect about 25mm×8mm in size. Spinal cord was released under microscope and dura defect was repaired with Lyoplant. The patient's symptom improved after the surgical procedure, but touch and temperature sense under T6 level had unchanged. </p>","PeriodicalId":17867,"journal":{"name":"Korean Journal of Spine","volume":"13 2","pages":"77-9"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/63/dc/kjs-13-77.PMC4949173.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34746746","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 : 2016-06-01Epub Date: 2016-06-30DOI: 10.14245/kjs.2016.13.2.53
Jun Gue Lee, Hyeun Sung Kim, Chang Il Ju, Seok Won Kim
{"title":"Clinical Features of Herniated Disc at Cervicothoracic Junction Level Treated by Anterior Approach.","authors":"Jun Gue Lee, Hyeun Sung Kim, Chang Il Ju, Seok Won Kim","doi":"10.14245/kjs.2016.13.2.53","DOIUrl":"https://doi.org/10.14245/kjs.2016.13.2.53","url":null,"abstract":"<p><strong>Objective: </strong>The anterior approach for C7-T1 disc herniation may be challenging because of obstruction by the manubrium and the narrow operative field. This study aimed to investigate the clinical and neurological outcomes of anterior approach for C7-T1 disc herniation.</p><p><strong>Methods: </strong>We retrospectively evaluated 13 patients who underwent the anterior approach for C7-T1 disc herniation by a single surgeon within a period of 11 years (2003-2014). The minimum follow-up duration was 6 months. We describe the clinical presentation, radiographic findings, neurological outcome, and related complications.</p><p><strong>Results: </strong>Of 372 patients with single-level anterior discectomy and fusion or artificial disc replacement for cervical disc herniation, 13 (3.5%) had C7-T1 disc herniation. The main clinical presentation was unilateral motor weakness in intrinsic hand muscles (11 patients), along with numbness, pain, and tingling sensation that radiate down the arm to the little finger. Most of the patients improved after surgery via the anterior approach. Ten patients underwent successful anterior discectomy and fusion by the standard supramanubrial Smith-Robinson approach, but 2 needed additional manubriotomy and sternotomy. In 1 patient, we performed surgery at a wrong level because the correct level was difficult to identify intraoperatively. Two patients had transient vocal dysfunction, but none had major complications related to injuries of the great vessels such as the thoracic duct or esophagus.</p><p><strong>Conclusion: </strong>For patients who require direct anterior decompression for C7-T1 disc herniation, the anterior approach is relatively feasible. However, care should be taken to overcome physical constraints by the manubrium and slope.</p>","PeriodicalId":17867,"journal":{"name":"Korean Journal of Spine","volume":"13 2","pages":"53-6"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.14245/kjs.2016.13.2.53","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34587528","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 : 2016-06-01Epub Date: 2016-06-30DOI: 10.14245/kjs.2016.13.2.41
Woong Bae Park, Jae Taek Hong, Sang Won Lee, Jae Hoon Sung, Seung Ho Yang, Il Sub Kim
{"title":"Clinical and Radiological Comparison between Ipsilateral and Contralateral Side Canal Decompression Using an Unilateral Laminotomy Approach.","authors":"Woong Bae Park, Jae Taek Hong, Sang Won Lee, Jae Hoon Sung, Seung Ho Yang, Il Sub Kim","doi":"10.14245/kjs.2016.13.2.41","DOIUrl":"https://doi.org/10.14245/kjs.2016.13.2.41","url":null,"abstract":"<p><strong>Objective: </strong>To compare the clinical and radiological outcome of both sides using the unilateral approach.</p><p><strong>Methods: </strong>Unilateral laminotomy was performed to achieve bilateral decompression. Thirty-nine patients who underwent this procedure were analyzed prospectively using the Oswestry Disability Index (ODI), the visual analog scale (VAS) pain score to evaluate symptoms in both legs, and the radiological morphometric index to calculate the anteriorposterior diameter and midcanal width. The incidence of complications from this approach was then evaluated.</p><p><strong>Results: </strong>The mean follow-up time was 12.2 months. The mean ODI was 48.4 preoperatively and 14.2 postoperatively. The mean dural sac widening of the ipsilateral side (187.0%) was significantly larger (p<0.01) than that of the the contralateral side (145.6%). The VAS improvement ratio ([preoperative VAS score-postoperative VAS score]/[preoperative VAS score]×100) for the pain in each leg was 75.4%(ipsilateral side) and 73.7%(contralateral side). While the VAS improvement ratio for pain in each side was significantly reduced, the difference in the VAS ratio between sides was statistically insignificant (p=0.64). There were 2 cases (5.1%) of dural tearing during the procedure, 1 case (2.6%) of transient paresthesia of nerve roots, and 2 cases (5.1%) of transient paresthesia of the contralateral nerve root. The transient paresthesias of nerve roots never lasted more than 2 weeks.</p><p><strong>Conclusion: </strong>This technique allows for significant decompression of the contralateral canal and excellent clinical outcomes without troublesome complications. Although ipsilateral the dural sac widening was significantly larger than contralateral side, the difference in the clinical outcome between sides was statistically insignificant.</p>","PeriodicalId":17867,"journal":{"name":"Korean Journal of Spine","volume":"13 2","pages":"41-6"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4e/95/kjs-13-41.PMC4949165.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34587526","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}
{"title":"Effect of Using Local Intrawound Vancomycin Powder in Addition to Intravenous Antibiotics in Posterior Lumbar Surgery: Midterm Result in a Single-Center Study.","authors":"Gun-Ill Lee, Koang Hum Bak, Hyoung-Joon Chun, Kyu-Sun Choi","doi":"10.14245/kjs.2016.13.2.47","DOIUrl":"https://doi.org/10.14245/kjs.2016.13.2.47","url":null,"abstract":"<p><strong>Objective: </strong>We conducted this study to report the efficacy of local application of vancomycin powder in the setting of surgical site infection (SSI) of posterior lumbar surgical procedures and to figure out risk factors of SSIs.</p><p><strong>Methods: </strong>From February 2013 to December 2013, SSI rates following 275 posterior lumbar surgeries of which intrawound vancomycin powder was used in combination with intravenous antibiotics (Vanco group) were assessed. Compared with 296 posterior lumbar procedures with intravenous antibiotic only group from February 2012 to December 2012 (non-Vanco group), various infection rates were assessed. Univariate and multivariate analysis to figure out risk factors of infection among Vanco group were done.</p><p><strong>Results: </strong>Statistically significant reduction of SSI in Vanco group (5.5%) from non-Vanco group (10.5%) was confirmed (p=0.028). Mean follow-up period was 8 months. Rate of acute staphylococcal SSIs reduced statistically significantly to 4% compared to 7.4% of non-Vanco group (p=0.041). Deep staphylococcal infection decreased to 2 compared to 8 and deep methicillin-resistant Staphylococcus aureus infection also decreased to 1 compared to 5 in non-Vanco group. No systemic complication was observed. Statistically significant risk factors associated with SSI were diabetes mellitus, history of cardiovascular disease, length of hospital stay, number of instrumented level and history of previous surgery.</p><p><strong>Conclusion: </strong>In this series of 571 patients, intrawound vancomycin powder usage resulted in significant decrease in SSI rates in our posterior lumbar surgical procedures. Patients at high risk of infection are highly recommended as a candidate for this technique.</p>","PeriodicalId":17867,"journal":{"name":"Korean Journal of Spine","volume":"13 2","pages":"47-52"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.14245/kjs.2016.13.2.47","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34587527","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}