The authors experienced two cases of cervical epidural AVM resembling that of tumor. It is the purpose of this report to point out by means of two cases the problem involved in establishing the diagnosis. To our knowledge, our two cases of cervical epidural AVM is the first report in Korea.
Diagnosis ; Korea

Recently, transsphenoidal approach is regarded as the principal method for the resection of pituitary tumor. The sublabial transseptal transsphenoidal hypophysectomy is a classical one, but it has certain limitations and postoperative problems. So various modifications of transsphenoidal hypophysectomy have been proposed. The columellar flap is one of such modified approaches.
Hypophysectomy ; Pituitary Neoplasms

No abstract available.
Intra-Articular Fractures* ; Tibia*

OBJECTIVE: The sacroiliac joint complex is often related with functionally incapacitating pain in old aged people. The purpose of this study is to delineate the investigation strategies and to determine the long-term effect of radiofrequency (RF) neurotomies for pain arising from sacroiliac joint dysfunction(SIJD) METHODS: Sixteen patients were diagnosed as having chronic pain from SIJD by comparative controlled blocks on L5 dorsal rami, sacroiliac joints and deep interosseous ligaments. After confirming the positive response (more than 50% of pain relief), sensory stimulation was applied to detect the `pathological' branches. Subsequently, RF neurotomies were performed on the selected nerve branches. Surgical outcome was graded as successful, moderate improvement, and failure after a 6month follow-up period. RESULTS: Stimulation intensity was 0.45V to elicit pain response in the L5 dorsal rami and lateral sacral branches. The number of RF-lesioned nerve branches was 6per patient. The average number of lesions for each branch was 1.3. Most commonly selected branches were L5 dorsal ramus (88%) and S2-upper division (88%). Ten patients (63%) reported a successful outcome according to the outcome criteria after 6months of follow-up, and five patients (31%) reported complete relief (100%). Five patients (31%) showed moderate improvements. One patient reported failure. CONCLUSION: RF neurotomy of lateral sacral branches is an excellent treatment modality for the pain due to SIJD, provided that comparative controlled block shows a positive response.
Chronic Pain ; Follow-Up Studies ; Humans ; Ligaments ; Sacroiliac Joint*

No abstract available.

Transpedicular screw instrumentation allows good fixation to the unstable spine after wide laminectomy procedure. The authors experienced 30 cases of transpedicular screw instrumentation in lumbar spine surgery, which had been operated from November, 1989 and had follow up at least for 6 months. We evaluated and reviewed the advantages and problems of transpedicular screw instrumentation through our experiences and literatures.
Follow-Up Studies* ; Laminectomy ; Spinal Stenosis* ; Spine ; Spondylolisthesis*

The authors reviewed computed tomography(CT) findings of spondylolylisthesis which composed of 20 cases of spondylolytic type and 20 cases of degenerative type. In most cases of spondylolisthesis, characteristic changes were seen at the corresponding pars interarticularis defects in spondylolytic type, and apophysial joints in degenerative type, each other.
Joints ; Spine* ; Spondylolisthesis*

Chronic low back pain (CLBP) has become more prominent with globally increasing life expectancy. Its cause is more attributable to degenerative changes than to traumatic lesions. Although the diagnosis of CLBP is recently on higher demand, lack of clinical features and non-informative imaging findings in patients with CLBP are challenging to clinicians to establish the diagnosis. Therefore, understanding of the new concept of pathogenesis, elimination of prejudice, and evidence-based diagnostic steps are required to resolve the question of pain source. Analysis of pain distribution patterns and careful history taking can be utilized as an initial guide to divide CLBP into somatic and radicular pain. Zygapophyseal joint pain and sacroiliac joint pain representing somatic pain can be further investigated using medial branch and sacroiliac joint blocks. However, comparative blocks are essential to decreased false positive rate. Infiltration of a small volume of local anesthetics can increase the specificity of the procedures. Discogenic pain stemming from internal disk derangement can be confirmed by pressure-controlled discography. Automated discography is recommended to provide the constant rate of dye injection with obviating the fluctuation of intradiscal pressure. Evidencebased concept and diagnostic procedures can provide more accurate and efficient methods to establish the diagnosis of CLBP.
Anesthetics, Local ; Diagnosis ; Evidence-Based Medicine ; Humans ; Life Expectancy ; Low Back Pain* ; Nerve Block ; Nociceptive Pain ; Prejudice ; Sacroiliac Joint ; Sensitivity and Specificity ; Zygapophyseal Joint

No abstract available.
Breast Neoplasms* ; Breast* ; Humans ; Soil*

Primary chondrosarcoma of the extraskeletal soft tissue is extremely rare. Extraskeletal chondrosarcoma was first described as entity in 1953 by Stout and Verner, who were able to collect a series of seven cases. Because of the rarity of this lesion in extremities, neither the clinical course nor the preferred method of treatment has been clearly established. Authors report a case of extraskeletal chondrosarcoma which occurred on the right forearm of a thirty-nine-year-old man. The lesion was completely excised with free resection margins. There was no recurrence or metastasis for four years follow up.
Chondrosarcoma ; Extremities ; Follow-Up Studies ; Forearm ; Methods ; Neoplasm Metastasis ; Recurrence