OBJECTIVE: We report an outcome of surgical treatment of the elderly patients with spinal stenosis, managed by a bilateral narrowed spinal canal widening technique through unilateral approach. METHODS: The operations were performed in 16 patients who diagnosed with spinal stenosis. All individuals had been presented with low-back pain, neurogenic claudication or radiculopathy and unresponsive to conservative treatment over six months. We perfomed hemi-laminectomy at the appropriate levels on the most symptomatic side preserving the facet joint. And the ligamentum flavum, as well as the cortical bone on the ventral surface of the contralateral laminae were removed. The spinous process was left as possible as we can, and the contralateral side of the spinal canal was decompressed completely. RESULTS: The mean age of the patients was 71 years. The mean operation time was 73 minutes. Despite of old age, the patients were able to walk in three days after the surgery. The significant pain scale improvement(7.73 to 2.68) and widening of the spinal canal diameter(7.60+/-1.75 to 17.77+/-1.47mm) were noted after the operation. No patient was presented spinal instability on their follow-up period over 24 months. CONCLUSION: The bilateral canal widening technique through the unilateral approach, minimizes the damage to the inter-spinous ligament and the inter-spinous muscle, and saves the operation time because it is not necessary to use the instruments which prevent spinal instability, despite spinal canal was sufficiently enlarged.
Aged* ; Follow-Up Studies ; Humans ; Ligaments ; Ligamentum Flavum ; Radiculopathy ; Spinal Canal ; Spinal Stenosis* ; Zygapophyseal Joint

Metronidazole is commonly used for brain abscess but is not well known for its neurotoxic complications. Metronidazole-induced encephalopathy (MIEP) is toxic encephalopathy associated with the use of metronidazole. We experienced a case of brain abscess which developed reversible severe MIEP during treatment period. Although MIEP occurs in typical locations, it is not easy to differentiate from other conditions such as cerebral infarction, demyelinating diseases and metabolic diseases. Neurosurgeons should be aware that severe MIEP can occur during the use of metronidazole though it is not common.
Brain ; Brain Abscess ; Cerebral Infarction ; Demyelinating Diseases ; Humans ; Metabolic Diseases ; Metronidazole ; Neurotoxicity Syndromes

Endovascular aneurysm repair is a minimally invasive, durable and effective alternative to open surgery for treatment of abdominal aortic aneurysms (AAA). However, in patients who do not have an adequate sealing zone, open surgical repair is required, which may increase mortality and morbidity. An alternative treatment in patients with challenging anatomy is the so-called "chimney graft" technique. Here, we describe a case using the chimney graft technique for treatment of juxtarenal type I endoleak followed by a previous conventional stent graft insertion to the AAA with good results.
Aneurysm ; Angioplasty ; Aortic Aneurysm, Abdominal* ; Blood Vessel Prosthesis ; Endoleak* ; Humans ; Mortality ; Transplants

PURPOSE: This study was to determine the prevalence of herniated intervertebral disc (HIVD) among Korean 19-year-old male in a large national sample and to compare the prevalence across geographic regions based on the data of conscription. MATERIALS AND METHODS: We analyzed the conscription data of 615508 cases who were 19-year-old male, given an examination for conscription at nationwide Korean Military Manpower Administration from January 2008 to December 2009. Prevalence was determined by dividing the number of cases by the number of persons enrolled for 2 years. The analyses included of a cross-tabulations and nonparametric chi-square to compare the prevalence according to geographic region, disc severity, and conscription year. RESULTS: The prevalence of HIVD among 19-year-old male was 0.47%. Seoul had the highest prevalence of HIVD (total HIVD was 0.60%, and severe HIVD was 0.44%). The prevalence of HIVD was lower in Jeollabuk-do and Jeollanam-do (total HIVD was 0.25-0.27%, and severe HIVD was 0.16-0.17%). Annual prevalence of HIVD was slightly decreased in 2009, but geographic distribution annually was not different. CONCLUSION: In Korean 19-year-old male, the national prevalence of adolescent HIVD was 0.60%, but different geographic distribution was observed. It is quite possible that secondary contributing factor(s) interfere with the different geographic prevalence of HIVD.
Adult ; Cross-Sectional Studies ; Geography ; Humans ; Intervertebral Disc Displacement/*epidemiology ; Male ; Prevalence ; Republic of Korea/epidemiology

In recent years, the interest in minimally invasive surgery has grown, and the same trend is observed in vascular surgery and interventional radiology, leading to what is called endovascular surgery. Since the first use of a stent-graft for the endovascular exclusion of an abdominal aortic aneurysm (AAA), endovascular aneurysm repair (EVAR) has greatly expanded, and more than 50,000 devices have been implanted until now. The endovascular graft can be implanted from a remote access site in the groin with a less anesthetic requirement. The endovascular graft is advanced over guidewires up the femoral and iliac arteries. Once in position, the graft is deployed immediately distal from the renal arteries. The aorta is not clamped and the blood loss is less than with open surgery. EVAR for AAA offers an important new alternative to open surgical procedure. The mortality rates after EVAR are reported between 0~5%. Long-term follow-up reports are not available, but mid-term follow-up of EVAR reveals an incidence of re-intervention between 10~20% and a rate of late rupture of between 0.5~1.5% per year. The problems of endoleaks and graft failure continue to be the challenges that require technological innovations. Based on the currently available evidence, EVAR is an appropriate treatment for selected patients, especially those at high risk for open surgical repair.
Aneurysm* ; Aorta ; Aortic Aneurysm, Abdominal ; Endoleak ; Groin ; Humans ; Iliac Artery ; Incidence ; Inventions ; Mortality ; Radiology, Interventional ; Renal Artery ; Rupture ; Stents ; Surgical Procedures, Minimally Invasive ; Transplants

Endovascular repair of abdominal aortic aneurysm is associated with low morbidity and mortality rates when compared to open surgery, and this can be used in patients who are at a high risk for open surgical repair. Also, secondary intervention is an important for achieving intermediate and long term success of endovascular repair of abdominal aortic aneurysm as this can resolve complications. We report here on endovascular stent-graft placement and a secondary interventional procedure in the abdominal aortic aneurysm of a patient who had a previously inserted iliac stent.
Aortic Aneurysm ; Aortic Aneurysm, Abdominal* ; Humans ; Iliac Artery ; Mortality ; Stents*

The purpose of the study was to assess the role of two types screws(bicortical screws with 3.5mm diameter and monocortical screws with 4.5mm diameter) in anterior cervical spinal fusion. Seventy patients surgically treated on the same surgeon was retrospectively reviewed. All patients were managed as the same technique(modified Smith-Robinson technique) and the same non-locking plate system(Top plate system), but the bicortical screws were used in 40 patients(Group 1) and the monocorical screws in 30 patients(Group 2). The overall fusion rate during the 3 months follow up at least was to be satisfied on the both groups. The complication from the Group 2 was never seen but Group 1 was observed in 5 patients; one as slip of grafted bone, 2 as screw loosening, 1 as psychologic intolerance and 1 as CSF leakage. The monocortical screw was considered to be superior than bicortical screw and was related to the screw diameter.
Follow-Up Studies ; Humans ; Retrospective Studies ; Spinal Fusion ; Transplants

No abstract available.
Glycoproteins* ; Oligodendroglia* ; Rubella virus* ; Rubella*

No abstract available.
Stroke ; Subclavian Artery