No abstract available.
Antibody Formation* ; Immunoglobulin A* ; T-Lymphocytes*

OBJECTIVE: The purpose of this study was to determine the effect of bone cement augmentation of pedicular screwing in severe osteoporotic spondylolisthetic patients. METHODS: Twenty patients with spondylolisthesis (8 : spondylolytic spondylolisthesis 12 : degenerative spondylolisthesis) who had undergone pedicular screwing and interbody fusion for osteoporotic lumbar spine (T-score on bone mineral density<-3.0) from 2002 to 2005 were reviewed. Mean age was 62.3 years with 3 male and 17 female patients. Average follow-up period was 14 months. Average T-score on bone mineral density (BMD) was -3.62. After decompression of neural elements, about 6cc of polymethylmethacrylate (PMMA) was injected into the each vertebral body through transpedicular route. All patients underwent one level interbody fusion and pedicular screw fixation. Clinical outcome was assessed using Oswestry Disability Index (ODI) on the last clinical follow-up. In addition, a modified MacNab's grading criteria was used to objectively assess patient's outcome postoperatively. Radiographic analysis of sagittal contour was assessed preoperatively, immediately postoperatively, and at final follow-up including fusion rate. RESULTS: Eighteen of 20 patients were graded as excellent or good according to the modified MacNab's criteria. An significant improvement of ODI was achieved in both groups. Mean sagittal angle at the preoperative state, postoperative state and at the last follow-up state was 11.0 degrees, 20.1 degrees and 18.3 degrees, respectively, with mean sagittal angle correction gain 7.3 degrees. Firm fusion was achieved in all patients. There were one compression fracture above the fused segment after 6 months follow-up and one case of seroma. But, there were no postoperative complications related to bone cement leakage and pedicular screwings such as screw pullout or screw cut-up. CONCLUSION: Bone cement augmentation of pedicular screwing can be an effective procedure for osteoporotic lumbar spine in spondylolisthetic patients.
Bone Density ; Decompression ; Female ; Follow-Up Studies ; Fractures, Compression ; Humans ; Male ; Polymethyl Methacrylate ; Postoperative Complications ; Seroma ; Spine ; Spondylolisthesis

Osseous bridging between lumbar transverse processes is an uncommon condition that may cause low back pain. In most cases, its etiology is alleged to be trauma to the back and only rarely has a congenital origin been indicated. Furthermore, most reported cases involved adults, the majority of whom were middle-aged. Here, the authors describe the case of the youngest girl reported to date with congenital transverse process bridging. As far as the authors' knowledge, there has been no report of congenital bridging of transverse processes in children or adolescents in Korea.
Adolescent ; Adult ; Child ; Humans ; Korea ; Low Back Pain

Brown-Sequard syndrome is usually observed in patients with compressive myelopathy due to trauma, cord tumors, and degenerative spinal diseases. Brown-Sequard syndrome resulting from spinal cord infarction is rare. We report the case of a 46-year-old man who presented abruptly with left hemiparesis and diminished pain and temperature sensations on his right side below the C6 dermatome. Cervical spine magnetic resonance imaging revealed abnormally high signal intensity in the left lateral parenchyma of the spinal cord at the level of C4 and C6 on T2 weighted images. After excluding other possible causes, a clinical diagnosis of Brown-Sequard syndrome of probable vascular onset was made, associated with spinal cord infarction. The patient was managed conservatively with intravenous fluids and corticosteroids. However, his condition remained mostly unchanged after six months. Here, we present a rare case of spinal cord infarction causing acute Brown-Sequard syndrome, with a review of the literature.
Adrenal Cortex Hormones ; Brown-Sequard Syndrome ; Humans ; Infarction ; Magnetic Resonance Imaging ; Middle Aged ; Paresis ; Sensation ; Spinal Cord ; Spinal Cord Compression ; Spinal Diseases ; Spine

OBJECTIVE: The purpose of this study was to evaluate the surgical technique and outcome of mini-open posterior lumbar interbody fusion (PLIF) under circumferential releasing technique. METHODS: Fourty patients who underwent mini-open PLIF using the percutaneous screw fixation system for Meyerding Grade II spondylolisthesis or more were retrospectively studied. After complete circumferential release, the slipped vertebrae would tend to obtain spontaneous reduction, and with compressive force by percutaneous screw fixation, additional reduction could be achieved. The radiological measurements including slippage reduction, disc height, restoration of lumbar lordotic angle and focal segmental angle were analyzed. The clinical outcome was assessed using the visual analog scale (VAS) and low back outcome score (LBOS), and procedure related complications were also analyzed. RESULTS: Slippage percentage was improved from 38.0+/-12.6% to 9.3+/-7.8% and lumbar lordotic angle was changed from 43.0+/-13.8degrees to 48.2+/-10.3degrees. Focal segmental angle improved from 10.1+/-8.5degrees to 15.9+/-6.0degrees. The mean LBOS and mean pain score were also improved significantly. Complications included one case of medial penetration of pedicle border and two cases of transient radiculopathy. However, there were no signs of neurological aggravation or fusion failure during the follow-up period. CONCLUSION: Mini-open PLIF using the percutaneous screw fixation following complete circumferential release can be safe and effective treatment for even moderate to severe grade spondylolisthesis.
Follow-Up Studies ; Humans ; Radiculopathy ; Retrospective Studies ; Spine ; Spondylolisthesis* ; Visual Analog Scale

Ligamentum flavum hematoma (LFH) is a very rare condition of dural compression; most are observed in the mobile cervical and lumbar spine regions. A 67-year-old man who had a long level interbody fusion at L3-S1 four years ago presented with symptoms suggestive of dural compression. Magnetic resonance imaging showed a posterior semicircular mass located at the adjacent L2-L3 level. After decompression of the spinal canal and removal of the mass lesion, pathological examination of the surgical specimen revealed a hematoma within the ligamentum. The patient fully recovered to normal status after surgery. Here, we report our experience with a LFH in the adjacent segment after a long level fusion procedure and discuss the possible associated mechanisms.
Aged ; Decompression ; Hematoma ; Humans ; Ligamentum Flavum ; Magnetic Resonance Imaging ; Spinal Canal ; Spine

Pseudoaneurysm arising from the superficial temporal artery (STA) is a rare and potentially critical cause of palpable mass. Most pseudoaneurysms form as a result of blunt trauma and present as painless, pulsatile mass that may be associated with pathologic finding and enlarged size. We report a rare case of pseudoaneurysm arising from STA caused by blunt injury and diagnosed by 3-dimensional computed tomography (CT) angiography.
Aneurysm, False ; Angiography ; Temporal Arteries ; Wounds, Nonpenetrating

Discal cyst is a very rare lesion that can result in refractory low back pain and leg radiating pain. Because they are so uncommon, their exact origin and pathophysiology are still unknown. A 31-year-old man visited our institute due to low back pain and severe left leg radiating pain. Magnetic resonance images (MRI) revealed spherically shaped extradural cystic lesion at L2-L3 level. Computed tomography (CT) discography demonstrated obvious communication between the intervertebral disc and the cyst. The patient underwent posterior decompression and excision of cyst. The symptoms were remarkably improved immediately after surgery.
Adult ; Decompression ; Humans ; Intervertebral Disc ; Leg ; Low Back Pain

Postdural puncture headache (PDPH) is probably the most common complication of spinal anesthesia. The incidence of spinal headache is believed to be related to age, sex, pregnancy, size of the dural puncture needle, direction of the needle bevel, and the angle at which the needle penetrates the dura. This study were done to see the relation of sex, age, needle size (23 gauge, 25 gauge & 27 gauge needle) & bevel direction (parallel, perpendicular insertion to the longutudinal dural fiber) on the incidence, duration, severity, and location. The following results were observed: 1) The overall incidence of headache was 7.9% (49 cases). 2) The size of the needle was statistically significant assouation of PDPH. 3) Headache occured in highest frequency in patients in the second and third decades. 4) The frequency of PDPH was inversely associated with age. 5) The onset of headache was 1-2 days (68%) and duration of headache was 4-5 days (82%) in postanesthetic day. 6) The severity of headache was mild and moderate in 90% cases.
Anesthesia, Spinal ; Headache ; Humans ; Incidence ; Needles* ; Post-Dural Puncture Headache* ; Pregnancy ; Punctures

Low back pain is common during pregnancy. However, the prevalence of symtomatic lumbar disc herniation is rare, and cauda equina syndrome due to disc herniation during pregnancy is even rarer. We report a rare case of lumbar disc herniation causing cauda equina syndrome during third trimester of pregnancy which successfully treated by endoscopic discectomy. This case shows that endoscopic discectomy can be the treatment option for the lumbar disc herniation during pregnancy.
Cauda Equina* ; Diskectomy* ; Female ; Humans ; Low Back Pain ; Polyradiculopathy* ; Pregnancy ; Pregnancy Trimester, Third* ; Pregnancy* ; Prevalence