The authors performed 19 cases of percutaneous automated discectomy using Nucleotome between Feb, 1988 and Jan, 1993. The mean age was 33 years ranging from 20 to 56 years. Eleven of the patients were men and eight were women. One level nucleotomy was done in 14 cases, two level in 4 cases and three level in 1 cases. Overall success rate was 63%. No intraoperative and postoperative complications occurred except transient back pain in 3 cases.
Back Pain ; Diskectomy* ; Female ; Humans ; Male ; Postoperative Complications

We must once consider spondylitis, if the patient complains of severe back pain and back muscle spasm following a more or less improvement after disk surgery. The etiology of these postoperative complications is not well understood in suspected cases of spondylitis, but the most likely causes reveals to be low grade infection, aseptic necrosis and pyogenic infection etc. Conservative treatment with complete bed rest and antibiotics led to satisfactory results in major cases, but there is no improvement in spite of application strong antibiotics and muscle relaxant in some cases. In later cases, we got the good results with immediate pain relieve and reducing hospital day by anterior interbody fusion. So we report 4 cases of aseptic spondylitis with review of literature.
Anti-Bacterial Agents ; Back Muscles ; Back Pain ; Bed Rest ; Humans ; Necrosis ; Postoperative Complications ; Spasm ; Spondylitis*

Acupuncture is a popular technique used worldwide, particularly for clinical pain management. Diverse methods of acupuncture with several types of needle have recently been introduced; however, medical evidence of the treatment and safety of many of these techniques has not been established. In addition, severe, life-threatening acupuncture-related complications have been reported even though the treatment is considered to be safe. We report a case of a post-dural puncture headache that occurred following acupuncture for the treatment of lower back pain, with a literature review. Pain physicians should consider that acupuncture can cause far more serious side effects than those previously known.
Acupuncture ; Low Back Pain ; Needles ; Pain Management ; Post-Dural Puncture Headache* ; Postoperative Complications

Spondyloepiphyseal dysplasia (SED) tarda is an inherited skeletal arthropathy. Because SED tarda involves the joints and resemble the clinical findings of chronic arthropathies, this disease is frequently misdiagnosed as juvenile idiopathic arthritis (JIA). We report here on three patients (father and his two daughters) in one family with SED tarda. All patients had back pain and polyarthralgia. Their radiographs revealed typical changes for SED tarda including platyspondyly and dysplastic bone changes. This rare disease has major clinical importance in that it is similar with JIA or rheumatoid arthritis.
Adult ; Arthralgia/complications ; Back Pain/complications ; Female ; Humans ; Male ; Osteochondrodysplasias/complications/*diagnostic imaging/pathology/therapy ; *Pedigree ; Republic of Korea ; Young Adult

STUDY DESIGN: The efficacy of the operative techniques, possible benefits as well as pitfalls and limitations of the techniques are discussed. Potential drawbacks are also detected. PURPOSE: This study aims to report indications, techniques, and our experience with the use of the Sextant and PathFinder percutaneous transpedicular screw fixation systems. OVERVIEW OF LITERATURE: Percutaneous pedicle screw insertion is a novel technique. Successful percutaneous placement of pedicle screws requires surgical skill and experience because of lack of anatomic surface landmarks. Fluoroscopy-guided percutaneous placement of pedicle screws is effective. Many systems are now available. METHODS: We conducted a prospective operative and postoperative analysis of 40 patients with absolute indication for thoracic or lumbar instability between January 2009 and June 2013. All procedures were performed with the Sextant (group A) and PathFinder (group B) systems under fluoroscopic guidance. Operative techniques are discussed and the results compared. RESULTS: Percutaneous transpedicular screw fixation minimizes the morbidity associated with open techniques without compromising the quality of fixation. A total of 190 screws were inserted. There was no additional morbidity. Postoperative computed tomography images and plain X-rays were analyzed. Reduction of visual analog scale scores of back pain was evident. CONCLUSIONS: Fluoroscopy-guided percutaneous pedicular screws are feasible and can be safely done. Current systems allow multi-segmental fixation with significantly less difficulties. The described techniques have acceptable intra- and postoperative complication rates, and overall sufficient pain control with early mobilization of patients.
Back Pain ; Early Ambulation ; Humans ; Postoperative Complications ; Prospective Studies ; Visual Analog Scale

STUDY DESIGN: We retrospectively assessed the results of percutaneous balloon kyphoplasty (KP) by clinical and radiological methods. PURPOSE: To evaluate the outcome of KP as a treatment for osteoporotic burst fractures. OVERVIEW OF LITERATURE: Many surgeons are concerned about the possibility of neurological complications after percutaneous kyphoplasty for osteoporotic burst fractures, secondary to intra-canal cement leakage. METHODS: We performed KP as a treatment for osteoporotic burst fractures. We studied 12 patients/13 vertebrae. The two control groups consisted of patients who only underwent conservative treatment and those who underwent posterior instrumentation and fusion. We measured each preoperative/postoperative vertebral kyphotic deformity angle (KDA) using simple lateral spine images and checked for leakage of cement, as well. The preoperative/postoperative visual analog scale (VAS) scores for back pain, degree of daily activity, and postoperative complications were evaluated. RESULTS: The mean improvement in KDA after KP was 9.7+/-2.2degrees. The mean preoperative and postoperative VAS scores for back pain were 8.3+/-0.4 and 3.1+/-0.17, respectively. Regarding the control group, the mean postoperative VAS score for the conservative group and the posterior surgery group decreased by 4.5+/-0.17 and 3.2+/-0.19, respectively. There was no statistically significant difference between the KP and posterior surgery groups (p=0.125). However, there was a statistically significant difference between the KP and conservative treatment groups (p=0.012). CONCLUSIONS: KP is safe and useful for treating osteoporotic burst fractures.
Back Pain ; Congenital Abnormalities ; Humans ; Kyphoplasty ; Postoperative Complications ; Retrospective Studies ; Spine

OBJECTIVES: To examine the outcome after operative resectoscopic resection of submucosal myomas in symptomatic women. METHODS: Forty eight symptomatic women with submucosal myomas underwent operative resectoscopy for resection of the submucosal myomas. A few months after the myomectomy, I compared postoperaive status of the patients to preoperative status of the patients. RESULTS: No operative or postoperative complications occurred and all patients were discharged within 4 days. The follow-up period was 11.12+/-6.44 months(mean+/-SD). The age of the patients was 37.69+/-9.22 years(mean+/-SD) at the time of the operation. Twelve women out of 16 conceived(pregnancy rate of 75%)and all of them subsequently delivered at term. Thirty two women(menorrhagia of 28 and backache of 4) had been rid of their chief complaints that they had suffered from preoperatively. CONCLUSION: The results of this study indicate that operative resectoscopy achieved a pregnancy rate 75%. These results suggest that operative resectoscopy is an effective procedure to resect submucosal myomas in infertile symptomatic women.
Back Pain ; Female ; Follow-Up Studies ; Humans ; Infertility ; Menorrhagia ; Myoma* ; Postoperative Complications ; Pregnancy Rate ; Prognosis*

STUDY DESIGN: A retrospective study. OBJECTIVES: To analyze and compare the clinical results of different surgical methods for spinal stenosis, without lumbar instability, in patients over 70 years-old. SUMMARY OF LITERATURE REVIEW: Much controversy exists as to the best operative method for spinal stenosis. MATERIALS AND METHODS: Thirty eight patients that had undergone surgical treatment for spinal stenosis, without lumbar spinal instability, with a mean age of 75.1 years(70 to 91 years) and follow up period was 44 months(24 to 52 months), were retrospectively reviewed. The patients were divided into two groups: * Group A (n=23): posterior decompression alone * Group B (n=15): posterior decompression and posterolateral fusion Clinical outcome and satisfaction were assessed using Bohlman's measurements, on a 10 point pain rating scale, and the clinical outcomes were further analyzed according to the co-morbidity and postoperative complications. RESULTS: Clinically excellent and good outcomes were achieved in 86.9 and 80.0% in groups A and B, respectively. The 10-points pain scale for low back pain showed improvements in both groups. The co-morbidity did not influence the clinical outcome in either group. There were no serious postoperative complications in either group. CONCLUSIONS: Posterior decompression alone was an effective surgical method, and was found to be equivalent to posterior decompression and posterolateral fusion in patients over 70 years-old with degenerative lumbar spinal stenosis and without lumbar spinal instability.
Aged* ; Decompression ; Follow-Up Studies ; Humans ; Low Back Pain ; Postoperative Complications ; Retrospective Studies ; Spinal Stenosis*

BACKGROUND: Several reports have indicated that there are fewer postoperative complications after using a smaller spinal needle in young patients. However, no comparative report has been issued on the incidences of postoperative complications after using differently sized spinal needles for spinal anesthesia in elderly patients. Here, we compared a 22 G Quincke needle with a 25 G Quincke needle in elderly patients and investigated postoperative complications. METHODS: Fifty patients, aged over 60 years presented for an elective urological operation. Patients were randomized into two groups to receive spinal anesthetics using a 22 G Quincke needle (group L) or a 25 G Quincke needle (group S). The incidences of postdural puncture headache (PDPH), backaches, and the outcomes of spinal anesthesia were compared between the two groups. RESULTS: Two patients in group L and one in group S developed PDPH postoperatively with no significant statistical difference between the two groups. Four patients suffered backache in group L and two in group S again without significance. But the number of puncture attempts was significantly higher in group S. CONCLUSION: In conclusion, postoperative complications were similar for both groups. However, spinal anesthesia was performed more easily when using a larger spinal needle. Therefore, we recommend that a larger spinal needle be used when difficult spinal anesthesia is anticipated in elderly patients.
Aged* ; Anesthesia, Spinal* ; Anesthetics ; Back Pain ; Humans ; Incidence ; Needles* ; Post-Dural Puncture Headache ; Postoperative Complications* ; Punctures

Degenerative scoliosis is one of the important reasons of low back pain in middle-aged and elderly. The surgical treatment has been gradually paid more attention to in recent years. Pain and the quality of life are the key points of the surgical treatment. In addition to neurogenic compression,clinical symptoms and health-related quality of life are also closely related to the three-dimensional deformity of spine. Researchers try to employ different classifications of degenerative scoliosis to guide personalizedly surgical treatment. In the future,osteoporosis and complications may be the research highlights in the surgical treatment of degenerative scoliosis.
Aged ; Humans ; Low Back Pain ; etiology ; Middle Aged ; Osteoporosis ; etiology ; Quality of Life ; Scoliosis ; complications ; surgery ; Spine