OBJECTIVE: Lumbar lordotic curve on L4 to S1 level is important in maintaining spinal sagittal alignment. Although there has been no definite report in lordotic value, loss of lumbar lordotic curve may lead to pathologic change especially in degenerative lumbar disease. This study examines the changes of lumbar lordotic curve after posterior lumbar interbody fusion with wedge shape cage. METHODS: We studied 45patients who had undergone posterior lumbar interbody fusion with wedge shape cage and screw fixation due to degenerative lumbar disease. Preoperative and postoperative lateral radiographs were taken and one independent observer measured the change of lordotic curve and height of intervertebral space where cages were placed. Segmental lordotic curve angle was measured by Cobb method. Height of intervertebral space was measured by averaging the sum of anterior, posterior, and midpoint interbody distance. Clinical outcome was assessed on Prolo scale at 1month of postoperative period. RESULTS: Nineteen paired wedge shape cages were placed on L4-5 level and 6 paired same cages were inserted on L5-S1 level. Among them, 18patients showed increased segmental lordotic curve angle. Mean increased segmental lordotic curve angle after placing the wedge shape cages was 1.96? Mean increased disc height was 3.21mm. No cases showed retropulsion of cage. The clinical success rate on Prolo's scale was 92.0%. CONCLUSION: Posterior lumbar interbody fusion with wedge shape cage provides increased lordotic curve, increased height of intervertebral space, and satisfactory clinical outcome in a short-term period.
Postoperative Period

No abstract available.
Pain, Postoperative*

No abstract available.
Pain, Postoperative*

Although posterior lumbar interbody fusion (PLIF) is a widely accepted procedure, perioperative and postoperative complications are still encountered. In particular, cage migration can result in severe sequelae, and revision surgery is technically demanded. Here, we report a rare case of repeated migration of a fusion cage after PLIF. To the best of our knowledge, no report has been previously issued on repeated migration of a fusion cage after PLIF. The authors discuss the radiological and clinical findings of this unusual complication with a review of the literature.
Postoperative Complications

No abstract available.
Postoperative Complications*

No abstract available.
Endorphins* ; Pain, Postoperative* ; Plasma*

The mandibular contour determines the shape of the lower part of the face and thus influences the appearance of the face. A patient with a large, squarish, or broad face who desires a small, round, or slender face can undergo mandibular contouring surgery to reduce the width of the lower face. The successful correction of a prominent mandibular angle by conventional angle ostectomy has been reported. But, in the majority of patients with a widened facial appearance, both the mandibular angle and part of the mandibular body anterior to it are protuberant laterally, so both must be resected. The purpose of this study is to introduce a new method of performing mandibular contouring surgery, more effectively and easily, and to reduce postoperative complication and evaluate its results. We treated 6 patients who has prominent mandibular angle using multiple step osteotomy with angle-splitting ostectomy. The advantages of this new method are as following. (1) easily performable (2) effective mandibular contouring surgery by reducing the width of lower face (3) producing a natural relief of the mandibular angle (4) low risk of soft tissue damage and complications (5) shortening of the operation time. etc.
Humans ; Osteotomy ; Postoperative Complications

No abstract available.
Postoperative Nausea and Vomiting*

Among the postoperative complications of ptosis surgery, lagophthalmos and lid lag have been significant and untolerable problems. In this study, progressive change of lagophthalmos and lid lag following external levator resection was examined in 109 eyes of 74 patients from November 1988 through March 1996. Lagophthalmos and lid lag were measured at postoperative 1 month, 3 to 9 months and 12 to 18 months. The relations of lagophthalmos and lid lag according to preoperative MRD, levator function, resection amount of the levator muscle were analyzed. Lagophthalmos measured average 1.11mm and lid lag revealed average 4. 73mm at postoperative 11 to 84 months (mean 22.2 months). At the postoperative 1 year, lagophthalmos and lid lag were significantly decreased and decreasing amount measured 1.17mm and 0.90mm, respectively. Seventy eyes showed lagophthalmos less than 1mm at mean 13 months postoperatively. The postoperative change of lagophthalmos and lid lag had relation to the preoperative levator function.
Humans ; Postoperative Complications

Dissociated vertical deviation(DVD) is a clinical entity consisting of an up ward and extorsional drift of a nonfixating eye. This can occur spontaneously or during occlusion of that eye. The cosmetic importance of surgical management of manifest DVD has been agreed upon, but a number of different operative approaches have been cited in the literature. The surgical treatments for DVD are large recession of the superior rectus(10-16mm), resection of the inferior rect-us as much as 8mm, posterior fixation suture of the superior rectus and posterior fixation suture combined with the superior rectus recession. However, in comparing the long-term effect of recession of the superior rectus muscle, reces-sion of the superior rectus muscle combined with posterior fixation, with that of posterior fixation of the superior rectus muscle without recession, Duncan and von Noorden concluded that the best results are obtained by conventional recession of the superior rectus muscle(4 to 5mm) combined with posterior fixation of 12-15mm behind the muscle insertion. 8 eyes of 7 patients received 4mm recession of the superior rectus muscle combined with 12-15mm posterior fixation suture for the treatment of DVD. All patients were followed for postoperative period of 4 weeks to 20 months. The results were as follows: 1. The amount of preoperative DVD has ranged from 20 delta to 38 delta. 2. The amount of postoperative DVD has ranged from 0 delta to 10 delta, and the effect of that surgery has ranged from 10 delta to 33 delta, average 23 delta. 3. After operation 7 of 8 eyes were aligned, within the good to excellent categories (0-10 delta).
Humans ; Postoperative Period ; Sutures*