No abstract available.

No abstract available.
Esophageal Fistula* ; Tuberculosis, Spinal*

No abstract available.

No abstract available.
Animals ; Lordosis* ; Spine*

No abstract available.
Fractures, Spontaneous* ; Spine* ; Spondylitis*

An automated percutaneous lumbar discectomy(APLD) have been apphed for contained lumbar disc herniation. But suggested that more exclusion criteria than disc containment was needed to improve success rate. The purposes of this study are to evaluate cIinical outcome of more than 4 years follow up of APLD, to analysis the cause of failure for longer follow up period, and to define prognostic factor of APLD. The l04 patients with contained lumbar disc herniation were treated with APLD from March 1990 to November 1992 in National Medical Center. The surgical candidates were contained focal disc herniation in MRI, sciatica than back pain, failure to conservative management at least 6 weeks and clinical and radiological correlation. And patient were excluded from this data if they had history of previous lumbar surgery and compensation claims. Among them 74 cases were followed up for over 4 years (Mean: 5.3 years). The results were accessed by questionnaire using telephone or OPD follow up. The overall success rate was 84% on 3 months follow up, but 68.9% on more than 4 years follow up by four subjective criterias (Onik, 1987). Causes of decreasing success rate were reoperation, recurrence without specific cause or after sprain and heavy work. 76% of failed cases occurred within 1 year and 40% of them underwent open discectomy. The patient sex, treated level, duration of symptom were not influenced on success rate, but age was factor related to success rate. In this study we can assess the effectiveness of APLD within 3 months in most cases and then change treatment option according to patients status, and it seems that we need more exclusion criteria than disc containment in MRI and refined patient selection in order to decrease the failures.
Back Pain ; Compensation and Redress ; Containment of Biohazards ; Diskectomy* ; Follow-Up Studies* ; Humans ; Magnetic Resonance Imaging ; Patient Selection ; Surveys and Questionnaires ; Recurrence ; Reoperation ; Sciatica ; Sprains and Strains ; Telephone

The transpedicular screw fixation is known to be capable of providing more secure correctional, force and rigid fixation to the spine. But it is often accompanied by various complications, including stress shield effects, loosening in osteoporotic spine, pseudoarthrosis, hardware problems and long-term change in motion behaviors at the adjacent motion segment and etc. The purpose of this study is to compare the flexible and rigid rods system in terms of complications and problems for various degenerative lumbar diseases. From September 1991 to November 1994, 41 patients were operated with the flexible rods system (group A) and 39 patients with the rigid rods system (group B). They were followed up for more than 4 years. The flexible rods system was composed of 41 cases of Wiltse system and the rigid rods system was composed of 29 cases of Diapason, 8 cases of TSRH and 2 cases of CD instrument. The resuits of the study were as follows: 1. By standard Cobb lateral measurement, 7 cases in group A and 10 cases in group B showed significant loss of sagittal angle (>4), post-operatively. 2. Hardware failure was noted in 7 cases in group A and 10 cases in group B. In group A, rod bending was seen in 4 cases, rod breakage in 2 and screw loosening in one. In group B, screw loosening was observed in 5 and screw-rod locking mechanism failure in 5 cases. 3. In spondylolisthesis patients, 10 cases in group A and 14 in group B, there was no statistically significant differences between the two groups in the reduction rate immediately after surgery and loss of reduction at the last follow up. 4. Clinical results were good to excellent in 85.4% of patients in group A and 82.1% of group B. No statistically significant differences between the two groups were found, 5. No statistically significant differences between the two groups were found with respect to degenerative changes at the adjacent motion segment to the fused level and pseudoarthrosis.
Follow-Up Studies ; Humans ; Pseudarthrosis ; Spine* ; Spondylolisthesis

One of the commonest and most serious problems of the injured hand is flexion contractures of the fingers. Such deformities not only functionally impair the digit, but also reduce or restrict the functional capability of the entire hand. We reviewed 150 digits of 73 patients with flexion contractures of the fingers which had been treated at National Medical Center from Jan. 1976 to Dec. 1985. The results were as follows: 1. The duration of flexion contractures which were scattered from 4 months to 17 years and average duration of contracture was 20.6 months. 2. The methods of treatment were Z-plasty, adhesiolysis, capsulotomy, excision of both collateral ligaments, stripping of extensor mechanism and volar plate and release of flexor tendon sheath according to injury mechanism and duration of contracture. 3. The postoperative results showed up 32 (21.3%) excellent, 78 (52%) good, 24 (16%) fair and 16 (10.7%) poor. 4. The postoperative results of burned injury which showed up-8 excellent, 11 good out of 20 cases they are supposed to have satisfactory results. 5. Crushing injury which had intraarticular fracture or comminution show up unsatisfactory results. 6. It seems obvious that the early active motion of interphalangeal joint is important to improve joint function. 7. The arc of motion was retained in a more functional position postoperatively than preoperatively.
Burns ; Clinical Study ; Collateral Ligaments ; Congenital Abnormalities ; Contracture ; Fingers ; Hand ; Humans ; Intra-Articular Fractures ; Joints ; Tendons

The flexor tendon injuries of the finger are very difficult to treat satisfactorily. Early treatment is desirable, but not always posaible. In addition, joint stiffness and limitation in gliding of the tendon caused by adhesion, make the problem more complex. From 1978 until 1988, 13 patients (14 eases) underwent operations for free tendon graft, and 10 patients (13 eases) for staged tendon graft at the Department of Orthopaedic Surgery, National Medieal Center. They have been followed up for clinical study, and the result was summarized as follows:1. Old flexor tendon injuries were common in the teen and twenties, especially in male. 2. They occurred in the index (10 Cases, 37.0%) and middle (8 cases, 29.6%) fingers most commony, especially zone II (62.9%). 3. The result was evalusted according to the method designed by Strickland and Glovac. In 19 out of 27 cases, satisfactory result (excellent and good) was yielded. 4. In cause, deep laceration by sharp object was better in the result than crushing injury. 5. The interval between the injury and the operation ranged from 1 month through 11 years, averaging 16 months, and is supposed to have little relation to the result. 6. The preoperative state is supposed to have much relation to postoperative result, judging from 100% of satisfactory result in Grade I compared with 40% in Grade V according to Boyes preoperative classification. 7. Little difference is seen in the result between free tendon graft and staged tendon graft. And 5 cases complicated by adhesion, rupture of grafted tendon and wound infection yielded poor result.
Adolescent ; Classification ; Clinical Study ; Fingers ; Hand ; Humans ; Joints ; Lacerations ; Male ; Methods ; Rupture ; Tendon Injuries ; Tendons ; Transplants ; Wound Infection

Cysts of the meniscus are rare lesion of the knee. They may present as a local tumor or mimic signs of an internal derangement of the knee. So it is difficult to diagnose and apt to overlook in physical examination. Also they almost always have combined pathology of the involved meniscus, such as, meniscal tear or discoid meniscus. The pathologic basis of the meniscal cyst is controversial, but rece 2. Most of the patients had tear of the involved meniscus, but the patients with discoid meniscus did not have gross tears or previous trauma history. nt works suggest the etiology is infiltration of joint fluid through micro and macro tears in the meniscus. In the past, complete excision of the meniscus as well as cyst was thought to be the treatment of choice to prevent recurrences. But nowadays, the trend is changed as preserving the involved meniscus, when no tear of the meniscus is found to prevent enevitable degenerative changes after total meniscectomy. We experienced 6 cases of meniscal cyst during recent 2 years and obtained following results. 1. Precise joint line evaluation is much more important in the diagnosis of the meniscal cyst before making special study. 2. Most of the patients had tears of the involved meniscus, but the patients with discoid meniscus did not have gross tears or previous trauma history. 3. When the cyst is located anteriorly in the joint line, it is prominent in flexed position of the knee; and when located posteriorly, prominent in extended position of the knee. 4. Excision of the cyst and reattachment of the meniscus were thought to be good method when the cyst was located in the parameinscal area without gross tear of the involved meniscus.
Diagnosis ; Humans ; Joints ; Knee ; Methods ; Pathology ; Physical Examination ; Recurrence ; Tears