Recurrent episode of meningitis in infants and children frequently constitute a frustrating and distressing, both in determination of course and treatment. The authors are reporting a infected case of congenital dermal sinus with dermoid cyst in the subarachnoid space of cauda equina and conus medullaris which was cured after complete removal of cyst and sinus tract.
Cauda Equina ; Child ; Conus Snail ; Dermoid Cyst ; Humans ; Infant ; Meningitis ; Spina Bifida Occulta* ; Subarachnoid Space

No abstract available.
Humerus*

We checked and analysed the clinical and radiological status of the upper extremities of 142 baseball player in childhood and adolescence. The results of this study were as follow:1. The oreder of frequency of pain locations in the upper extremities was elbow, shoulder, and then wrist joint. 2. There was colse relationship between elbow pain and career, but not in shoulder and wrist area. 3. The characteristics of shoulder or wrist pain were diffuse and vague nature, but elbow pain was located in medial aspect. 4. The cubitus valgus and limited elbow ROM in throwing side were found in pitchers or older careers. 5. All players showed cortiocotrabecular hypertrophy of humerus, and high incidence of medial epicondylar changes were noticed with career increased. 6. Main bony changes: Shoulder
Adolescent ; Baseball ; Elbow ; Epiphyses ; Growth Plate ; Humans ; Humerus ; Hypertrophy ; Incidence ; Joints ; Shoulder ; Upper Extremity ; Wrist ; Wrist Joint

We report a case of irreducible atlantaxial dislocation with spinal cord injury. The patient was a 36-year-old man who suffered from the sudden onset of shallow respiration and severe motor weakness after slip down. We have performed the one-stage operation, the transoral decompression, reduction and posterior interspinous wiring with bone fusion. Three weeks after surgery, the reduction state and posterior wiring procedure were failed, due to severe osteoporotic change. So, we have performed second operation, the transarticular facet screw fixation and occipito-cervical fixation with Steinmann pin, from which good postoperative stability and neurological improvements, were obtained.
Adult ; Decompression* ; Dislocations* ; Humans ; Osteoporosis ; Respiration ; Spinal Cord Injuries* ; Spinal Cord*

Study of 22 cases with the pseudospondylolisthesis established that it occurred more frequently in the older women, and far more frequently at the L4 level, as same results as reported by others. The slipping occurred as a result of degenerative disease of the articular process and facet joint, but it never exceeded 25% in this series. This study was performed to recognize the stability of the lumbosacral joint by the measurement of the anterior and posterior vertical heights(deformity) of the body of the L5 vertebra and lumbosacral angles in our cases. We also attempted to observe whether the facet angle changes at the involved level was meaningful or not. Result : lumbosacral angles in the our patients with pseudospondylolisthesis were increased greater than normal, so lumbar lordosis was less than normal. The body of the L5 vertebra was not as wedged anteroposteriorly as it normally was. The contour of the body of the L5 vertebra resembled rectangle shape. The pedicle-facet angles were increased at involved level, but this measurement was not correctly demonstrated on the plain roentgenograms. Conclusion : The stability of the lumbosacral joint in the patients with pseudospondylolisthesis was increased due to rectangle shape of the body of the L5 vertebra and less lumbar lordosis. The pedicle-facet angles at the involved level were increased, but not correct diagnostic values.
Animals ; Female ; Humans ; Joints ; Lordosis ; Spine ; Zygapophyseal Joint

The cavitron ultrasonic surgical aspirator(CUSA) has been used for the surgical removal of 26 cases of spinal intradural tumors. In 26 patients, total removal was possible in 77% and there was no neurological deterioration due to surgical removal using CUSA. 21 of 26 patients(84%) showed neurological improvement at long term follow-up examination. The cavitron ultrasonic surgical aspirator had advantages in the surgical removal of spinal intradural tumors, as follows:1) precise removal of tumor without excessive meahcnical manipulation of normal tissue;2) rapidity of action relative to the consistency of the tissue;3) direct visualization of the tissue being removed and good proprioceptive feedback for the surgeon;4) preservation of large vessel and very little bleeding;5) lack of thermal injury. The limitation of CUSA was obscuring of operation field by large and straight hand piece.
Feedback, Sensory ; Follow-Up Studies ; Hand ; Humans ; Ultrasonics*

The authors treated 32 patients with Ossification of the Posterior Longitudinal Ligament(OPLL). Seventeen of these patient had surgery during the past 1 year between 1987 and 1988. In this study we present a radiological and clinical analysis of these cases with a literature review. We also discuss a clinical system of grading, different types of radiological patterns, the indication of surgical treatment and the choice of operative methods. 1) The incidence of the cervical OPLL was about 5.4% in our annual study, which was based on the cervical CT and CTM. 2) The highest incidence was in patients 50-60 years of age and male: female ratio was about 3:1. 3) The highest incidence was in C5, C6 and C4 levels of cervical spine and two and three level involvement was prominent. 4) The pattern of OPLL was devided into a continuous type (21%), a multiple segmented type(48%), a mixed type(25%), a localized type(6%). 5) Absolute diameter did not always parallel the extent of spinal cord signs as did the percentage of spinal canal narrowing. 6) In cases of a clinical grading of more than III, surgery must be considered. In grade II, surgery is indicative if conservative management failed to improve the clinical symptoms. 7) For the evaluation of the cervical OPLL, the CT-Scan of CT metrizamide myelography was more useful method. 8) Cervical Corpectomy and fusion with or without bone cement were found to be advisable in Cases of cervical OPLL.
Female ; Humans ; Incidence ; Longitudinal Ligaments* ; Male ; Metrizamide ; Myelography ; Spinal Canal ; Spinal Cord ; Spine

No abstract available.
Abortion, Habitual* ; Female ; Immunization* ; Lymphocytes* ; Pregnancy

To obtain wider versatility and greater reach in microsurgical lumbar discectomy, modified procedure has been performed on 263 patients in 1979-1983. It consisted of a smaller midline incision, removal of lateral half of the spinous process, partial but sufficient microdrilling of the lamina, use of a modified slender Taylor retractor, flavotomy, preservation of epidural adipose-areolar tissue etc. Particularly a slender Taylor-Chung retractor offered yielding surgical opening and therefore secured free of pituitary forceps to every direction. The microsurgical results including 72 bisegmental and 8 trisegmental discectomies were compared with those of standard operations of same number performed by same surgeon in 1972-1979, for the good contrast. Mean blood loss per operation was 94 ml with the standard discectomy and 46 ml with microsurgery. Dural tear occured in 17 cases undergoing standard operation and in 3 undergoing microsugery. The mean time until return to duty was 8.6 weeks with standard, compared with 4.2 weeks. In the microsurgical group, 3 patients had postoperative discitis while 2 had in the standard. In this series, the results of microsurgery surpasses the standard in the convalescent phase. Major advantages of this modified microsurgical technique were its ability to secure the greater reach to remove disc material as much as possible and to preserve the integrity of normal tissue better.
Discitis ; Diskectomy* ; Humans ; Microsurgery ; Surgical Instruments

The mean values of the height, depth and lateral shifting of the spinous processes and the height of the intervertebral disc spaces of 100 patients were measured in the lumbar region. The application of microsurgical techniques in the operation for lumbar disc herniation clearly reduced the overall surgical trauma suffered by patient, but the spinous process might disturb the insertional course and multidirectional activities of the pituitary forceps due to a very small skin incision. The purpose of this study was to prove the relationships between intervertebral disc space and spinous process in the lumbar region. The results were as follows; 1) The height of the intervertebral disc space from L3-4 to L5-S1 intervertebral disc space was 12.63mm, 12.57mm and 11.71mm respectively. 2) The depth of the spinous process from L3 to L5 was 28.87mm, 27.87mm and 23.97mm respectively. 3) The lateral shifting of the spinous process from midline to the right side was 4.39mm, 4.35mm and 4.01mm at L3, L4 and L5 spinous process respectively and to the left side was 3.61mm, 3.70mm and 3.69mm at L3, L4 and L5 spinous process respectively. Conclusively, the lower part of the spinous process was overlapped above the intervertebral disc space at L3-4, L4-5 and L5-S1 intervertebral disc space. About 4mm of the lateral shifting of the spinous process was protruded to both right and left side in the insertional course(about 2-3cm) of the pituitary forceps. The spinous process might disturb the multidirectional activities and perpendicular insertion of the pituitary forceps. So, the removal of the spinous process to the midline was recommended to perform the complete removal of disc materials in microlumbar discectomy.
Diskectomy ; Humans ; Intervertebral Disc* ; Lumbosacral Region ; Skin ; Surgical Instruments