No abstract available.
Intervertebral Disc* ; Retrospective Studies*

Five adult cases of post-laminectomy swan-neck deformity are reported. The factors causing the deformity, prophylactic measures, and treatment of the deformity are discussed. It is strongly adviced to the neurosurgeons and orthopedic surgeons that they should be aware of this unwanted complication of the multi-level cervical laminectomies, and that they should provide every preventive measures before post-laminectomy swan neck deformity develops. Anterior interbody fusion spanning the entire unstable segments is preferably recommended together with application of pre-fusion traction.
Adult ; Congenital Abnormalities ; Humans ; Laminectomy ; Neck ; Neurosurgeons ; Orthopedics ; Surgeons ; Traction

OBJECTIVES: In order to standardize the CRP, ESR and WBC count after three types of spinal surgery and get clinical usefulness from these laboratory dadas after spinal surgery and clincal usefulness of laboratory datas. MATERIAL AND METHODS: Three groups of patients(microdisectomy, anterior and posterior fusion) were chosen for the study. CRP, ESR and WBC levels were prospectively determined before surgery and at days 1-5, 10, 14,21 and 42 after surgery. RESULTS: In all patients, preoperative normal CRP level(<10mg/L) increased, reaching peak levels on the second day after anterior fusion(84.6mg/L), and at the third day after microdiscectomy(54.5mg/L) and posterolateral intercorporal fusion(152.2mg/L), with normalization in 5-10 days. Preoperative normal ESR level increased to peak level on the forth day after microdiscectomy(33.0mm/hr), and increased double peak levels after anterior(postoperative days 2&5) and posterolateral intercorporal fusion(postoperative days 3&5). ESR followed by a slow and irregular decrease, and at 42 days after surgery often remained elevated. WBC increased to variable peak level within normal limit in all patients. CONCLUSIONS: The rapid decline in CRP will probably be interrupted by a second rise or persisting elevation if infection occurs. CRP is presumably a better test than ESR for early detection of postoperative infection.
Blood Sedimentation* ; C-Reactive Protein* ; Erythrocytes* ; Humans ; Prospective Studies

1. Evaluation of the Neural Injury For evaluation of neural injury from the thoracolumbar spine fracture, we should know the type and extent of injury. In case of the complete Spinal Cord Injury( SCI - Frankel classification A), they will not only lose the spinal cord function permanently distal to the injury site, but also show the probability 0~9% from Frankel A to D or E. But in case of the incomplete SCI, they will show sacral sparing and some kind of function will be recovered. The anticipation of recovery from the SCI depend on the results of neurologic examination after the spinal shock. If they have motor sparing, 86% of patients show the recovery of motor function during the first 6 month. The factor that influence to neurologic recovery are the initial kyphosis angle and canal compromising pattern, and do not influenced by treatmet methods. 2. The Factor of the Neural Injury Recovery 1) Conservative treatment in acute stage The inital pathophysiology of SCI is the mechanical injury, but secondary injury will be occur by impairment of blood supply and biochemical alteration, formation of free radial, release of glutamic acid, calcium influx, lipid peroxidation. Immediate methylprednisolone could minimize the spinal cord inury during the first 8 hours, and other GM-1 ganglioside, naloxone, TRH, spinal cord cooling, hyperbaric theraphy will be helpful. 2) Surgical treatment The factor influence the recovery of SCI (1) time interval injury to operation, (2)decompression of neural element, (3) reduction of fractured fragment. 3) Management of the Residual chronic stage Most common cause of death in SCI is urinary complication. We always should consider the improvement bladder function in SCI and the maintenance of low bladder pressure and feel free a bladder symptom.
Calcium ; Cause of Death ; Classification ; Glutamic Acid ; Humans ; Kyphosis ; Lipid Peroxidation ; Methylprednisolone ; Naloxone ; Neurologic Examination ; Shock ; Spinal Cord ; Spine* ; Urinary Bladder

STUDY DESIGN: A rectrospective study of microscopic lumbar decompressions was performed elderly patients suffering from multiple level of lumbar stenosis. OBJECTIVES: The Purpose of this study were to assess the outcome of this procedure performed only microscopic decompression on multiple lesions in 5 years follow up and to identify the clinical features of the elderly patients with multiple stenosis. SUMMARY OF BACKGROUND DATA: There was a common to perform fusion and instrumentation in spinal stenosis surgery, because of extensive decompression and instability. However the introduction of microscope in spine operation can minimize lesions and the incidence of spinal fusion. MATERIALS AND METHODS: Twenty-one patients were identified as having had a microscopic decompression without arthrodesis, for degenerative lumbar spinal stenosis over 60 years. The follow up period was more than 5 years. The clinical results was evaluated by Low-Back Outcome scale. RESULTS: Ten cases were above good results in two levels involved 14 cases, 4 cases above good results in three levels involved 6 cases, one case above good results in four levels. In the cases of affected duration, 4 of 5 cases in less than 1 year, 8 of 12 cases in 1 to 5 years, 3 of 4 cases in more than 5 years were above good results by the criteria. We had calculated the average score (54.8) and concluded that the long-term outcome of decompressive surgery in the elderly is good. CONCLUSION: Selective microscopic decompression is one of the effective method for the elderly patients or patients with osteoporosis in addition to multiple stenotic lesions. And preoprative root block is also useful for selective microscopic decompression.
Aged ; Arthrodesis ; Constriction, Pathologic ; Decompression* ; Follow-Up Studies* ; Humans ; Incidence ; Osteoporosis ; Spinal Fusion ; Spinal Stenosis* ; Spine

PURPOSE: A retrospective study on the usefulness of selective spinal nerve root block among lumbar herniated intervertebral disc (HIVD), spinal stenosis and postoperative syndrome over 10 years. MATERIAL AND METHOD: From a total 1195 patients, whose symptoms were not improved by conservative treatment, 505 treated by selective nerve root block were divided into 3 groups; 150 (29.7%) with HIVD, 313 (62.0%) with spinal stenosis and 42 with postoperative syndrome, and were followed up from Oct. 1992 to Dec 2001. The degree of pain and activity were evaluated by a visual analogue scale method at the out-patient department or through telephone interviews. RESULTS: The end-results of selective spinal nerve root block, with more than 50% reduction in pain occurred in 380 (75.3%) of the 505 patients. The effectiveness was greater in young patients with HIVD than elderly patients with spinal stenosis. After discharge, 160 patients (31.7%) needed no other treatment: 14 (31.0%) with an extrusion type HIVD and 17 (20.0%) with spondylolisthesis. The only 98 patients (19.4%) needed a surgical procedure after selective spinal nerve root block. CONCLUSION: Selective spinal nerve root block in patients with lower back and radiating pain is a valuable conservative treatment to quickly improved symptoms and avoid surgical procedures and the continuous administration of drugs.
Aged ; Humans ; Intervertebral Disc ; Interviews as Topic ; Outpatients ; Retrospective Studies ; Spinal Nerve Roots* ; Spinal Nerves* ; Spinal Stenosis ; Spondylolisthesis

No abstract available.
Animals ; Neurons* ; Rats*

PURPOSE: The purpose of this study was to evaluate the overall rate and risk factors for the development of an incisional hernia and a parastomal hernia after colorectal surgery. METHODS: The study cohort consisted of 795 consecutive patients who underwent open colorectal surgery between 2005 and 2007 by a single surgeon. A retrospective analysis of prospectively collected data was performed. RESULTS: The overall incidence of incisional hernias was 2% (14/690). This study revealed that the cumulative incidences of incisional hernia were 1% at 12 months and 3% after 36 months. Eighty-six percent of all incisional hernias developed within 3 years after a colectomy. The overall rate of parastomal hernias in patients with a stoma was 6.7% (7/105). The incidence of parastomal hernias was significantly higher in the colostomy group than in the ileostomy group (11.9% vs. 0%; P = 0.007). Obesity, abdominal aortic aneurysm, American Society of Anesthesiologists score, serum albumin level, emergency surgery and postoperative ileus did not influence the incidence of incisional or parastomal hernias. However, the multivariate analysis revealed that female gender and wound infection were significant risk factors for the development of incisional hernias female: P = 0.009, wound infection: P = 0.041). There were no significant factors related to the development of parastomal hernias. CONCLUSION: Our results indicate that most incisional hernias develop within 3 years after a colectomy. Female gender and wound infection were risk factors for the development of an incisional hernia after colorectal surgery. In contrast, no significant factors were found to be associated with the development of a parastomal hernia.
Aortic Aneurysm ; Cohort Studies ; Colectomy ; Colorectal Surgery ; Colostomy ; Emergencies ; Female ; Hernia ; Hernia, Ventral ; Humans ; Ileostomy ; Ileus ; Incidence ; Multivariate Analysis ; Obesity, Abdominal ; Prospective Studies ; Retrospective Studies ; Risk Factors ; Serum Albumin ; Surgical Stomas ; Wound Infection

No abstract available.
Adenoma, Pleomorphic ; Palate

Purpose: Previous studies have reported that presarcopenia negatively affects rectal cancer treatment. However, most studies have analyzed patients including majority of open surgery, and the association between presarcopenia and clinical outcomes after laparoscopic rectal cancer surgery remains unclear. This study aimed to evaluate the impact of presarcopenia on the clinical and oncological outcomes after laparoscopic rectal cancer surgery. Methods: Three hundred and one patients undergoing laparoscopic rectal cancer surgery between December 2009 and May 2016 were enrolled. Body composition was assessed using computed tomography by measuring the muscle and fat areas at the third lumbar (L3) vertebra. The L3 skeletal muscle area was used to calculate the skeletal muscle index and evaluate presarcopenia. Results: Presarcopenia was more common in older ( ≥ 70 years, P = 0.008) or female patients (P = 0.045). Patients with presarcopenia had decreased skeletal muscle area (P < 0.001), lower hemoglobin level (P = 0.034), longer time to first flatus (P < 0.001), and more frequent surgical site infection (P = 0.001). However, survival rates were not significantly different between those with and without presarcopenia. Conclusion Computed tomography-assessed presarcopenia was associated with delayed functional recovery and increased surgical site infection, although it was not revealed as a prognostic factor for oncological outcomes.