No abstract available.
Sturge-Weber Syndrome*

Pelvic fistulas may result from obstetric complications, inflammatory bowel disease, pelvic malignancy, pelvic radiation therapy, pelvic surgery, or other traumatic causes, and their symptoms may be distressing. In our experience, various types of pelvic fistulas are identified after pelvic disease or pelvic surgery. Because of its close proximity, the majority of such fistulas occur in the pelvic cavity and include the vesicovaginal, vesicouterine, vesicoenteric, ureterovaginal, ureteroenteric and enterovaginal type. The purpose of this article is to illustrate the spectrum of imaging features of pelvic fistulas.
Bladder Fistula/diagnosis/etiology ; Female ; Fistula/*diagnosis/*etiology ; Human ; Intestinal Fistula/diagnosis/etiology ; *Pelvis ; Ureteral Diseases/diagnosis/etiology ; Urinary Fistula/diagnosis/etiology ; Uterine Diseases/diagnosis/etiology ; Vaginal Fistula/diagnosis/etiology

PURPOSE: To evaluate CT features of metastatic ureteral tumors. MATERIALS AND METHODS: CT findings in 16 patients with ureteral metastases were evaluated retrospectively ;there were eight cases of bilateral ureteral involvement. Primary tumors metastatic to the ureter were advanced gastric cancer (n=13), breast cancer (n=l), colon cancer (n=l), or adenocarcinoma of unknown primary (n=l). We analysed CT findings with regard to the site of ureteral obstruction, configuration of obstructed sites of ureter, presence or absence of periureteral soft tissue density, and status in other organs. RESULTS: Among 24 ureters involved, ureteral wail thickening was noted in 15, periureteral soft tissue density in 13. Small nodular enhancing lesions less than lcm, within the retroperitoneal space around the involved ureters were noted in seven patients, and four of them were multiple lesions. CONCLUSION: Among various primary tumors, gastric cancer was the most common cause of ureteral metastasis. The common CT findings of ureteral metastases were thickening of ureteral wall, periureteral soft tissue density, and small periureteral enhancing nodular lesions. The constellation of these CT findings may be helpful in making the diagnosis of ureteral metastases.
Adenocarcinoma ; Breast Neoplasms ; Colonic Neoplasms ; Diagnosis ; Humans ; Neoplasm Metastasis* ; Retroperitoneal Space ; Retrospective Studies ; Stomach Neoplasms ; Ureter* ; Ureteral Obstruction

Background: Studies have reported on the usefulness of whole spine magnetic resonance imaging (MRI) in evaluating specific diseases such as spinal tuberculosis, spinal trauma, spondyloarthropathies, and multiple myeloma. In studies concerning degenerative spinal disease, sample sizes were small and some did not provide information on how symptomatic coexisting lesions were treated. We evaluated the types and prevalence of coexisting spine lesions found on whole spine T2 sagittal screening performed at the time of routine cervical and lumbar spine MRI and evaluated the efficacy of such screening in degenerative diseases of the cervical and lumbar spine. Methods: We reviewed 1,757 and 2,266 consecutive cases where whole spine T2 sagittal screening had been performed with routine cervical and lumbar spine MRI, respectively, in patients with cervical and lumbar spinal degenerative diseases. Coexisting spine lesions were documented and statistical analysis was performed to investigate significant differences according to sex, age, and initial diagnosis. Electronic medical records were reviewed to determine whether additional interventions were necessary following such findings. Results: We reviewed 1,252 and 1,689 consecutive cases of routine cervical and lumbar spine MRI respectively, with whole spine T2 sagittal screening. Of the 1,252, 419 (33.5%) patients with cervical spinal degenerative disease had coexisting lesions in the thoracolumbar spine.Patients with ligament ossification disease of the cervical spine showed a higher prevalence of coexisting spine lesions. Sixty of the 419 (14.3%) patients with coexisting spine lesions warranted additional intervention or surgical treatment. Four hundred and eighty-one of 1,689 (28.5%) patients with lumbar degenerative disease had coexisting spine lesions in the cervicothoracic spine. Forty-eight of the 481 (10.0%) patients with coexisting spine lesions warranted additional intervention. In both patient groups, older patients showed a significantly higher prevalence of coexisting spine lesions than younger patients. Conclusion Considering the minimal extra time and cost in performing whole spine screening, its application to routine spine MRI can be considered in evaluating cervical and lumbar spinal degenerative diseases.

Background: Studies have reported on the usefulness of whole spine magnetic resonance imaging (MRI) in evaluating specific diseases such as spinal tuberculosis, spinal trauma, spondyloarthropathies, and multiple myeloma. In studies concerning degenerative spinal disease, sample sizes were small and some did not provide information on how symptomatic coexisting lesions were treated. We evaluated the types and prevalence of coexisting spine lesions found on whole spine T2 sagittal screening performed at the time of routine cervical and lumbar spine MRI and evaluated the efficacy of such screening in degenerative diseases of the cervical and lumbar spine. Methods: We reviewed 1,757 and 2,266 consecutive cases where whole spine T2 sagittal screening had been performed with routine cervical and lumbar spine MRI, respectively, in patients with cervical and lumbar spinal degenerative diseases. Coexisting spine lesions were documented and statistical analysis was performed to investigate significant differences according to sex, age, and initial diagnosis. Electronic medical records were reviewed to determine whether additional interventions were necessary following such findings. Results: We reviewed 1,252 and 1,689 consecutive cases of routine cervical and lumbar spine MRI respectively, with whole spine T2 sagittal screening. Of the 1,252, 419 (33.5%) patients with cervical spinal degenerative disease had coexisting lesions in the thoracolumbar spine.Patients with ligament ossification disease of the cervical spine showed a higher prevalence of coexisting spine lesions. Sixty of the 419 (14.3%) patients with coexisting spine lesions warranted additional intervention or surgical treatment. Four hundred and eighty-one of 1,689 (28.5%) patients with lumbar degenerative disease had coexisting spine lesions in the cervicothoracic spine. Forty-eight of the 481 (10.0%) patients with coexisting spine lesions warranted additional intervention. In both patient groups, older patients showed a significantly higher prevalence of coexisting spine lesions than younger patients. Conclusion Considering the minimal extra time and cost in performing whole spine screening, its application to routine spine MRI can be considered in evaluating cervical and lumbar spinal degenerative diseases.

Osteoporotic vertebral fracture is a disease condition with high morbidity and mortality, whose prevalence rises with mean increase in the life span. Conventional treatments for an osteoporotic vertebral fracture include bed rest, pain medication and brace implementation, but if the patient's pain is severe, cement augmentation procedures, including vertebroplasty and kyphoplasty, are performed. Vertebroplasty and kyphoplasty are relatively easy procedures that have been reported to be effective in controlling acute pain. But, the risk of complication and additional adjacent segment fracture and their superiority over conventional treatment remain debatable. Therefore, the authors have summarized the procedures, complications, and clinical evidence of vertebroplasty and kyphoplasty in this review.
Acute Pain ; Bed Rest ; Braces ; Kyphoplasty* ; Mortality ; Prevalence ; Vertebroplasty*

STUDY DESIGN: Retrospective study. OBJECTIVES: To evaluate how the timing of pedicle screw fixation (early or late) in pyogenic spondylitis relates to the period of hospitalization, duration of intravenous antibiotic use, and recurrence of infection and to confirm the efficacy of early pedicle screw fixation for pyogenic spondylitis. SUMMARY OF LITERATURE REVIEW: Intravenous antibiotics and surgery including debridement and fixation are used as a treatment option for pyogenic spondylitis. MATERIALS AND METHODS: We retrospectively reviewed 31 patients who underwent posterior decompression and pedicle screw fixation with intravenous antibiotic treatment for pyogenic spondylitis from November 2005 to February 2015. We divided the study group into an early fixation group, whose instrumentation was inserted no later than 15 days after antibiotic therapy, and a late fixation group for cases who underwent the procedure 15 days or more after antibiotic therapy. We compared the period of hospitalization and intravenous antibiotic treatment, the rate and period of the prescription of oral antibiotics, and the rate of recurrence or reoperation. RESULTS: The period of hospitalization and intravenous antibiotic treatment of the early fixation group (55 and 43.4 days) were significantly shorter than those of the late fixation group (85 and 67.1 days). The rate and period of the prescription of oral antibiotics were not significantly different between the two groups. There was no case of recurrence or reoperation in either group. CONCLUSIONS: Early fixation using pedicle screws for pyogenic spondylitis reduces the period of hospitalization and intravenous antibiotic treatment compared to late fixation.
Anti-Bacterial Agents ; Debridement ; Decompression ; Hospitalization* ; Humans ; Pedicle Screws* ; Prescriptions ; Recurrence ; Reoperation ; Retrospective Studies ; Spondylitis*

STUDY DESIGN: Literature review. OBJECTIVES: To present updated information on the conservative treatment of osteoporotic spinal fractures (OSFs). SUMMARY OF LITERATURE REVIEW: The treatments of osteoporotic spinal fractures are bed rest, pain medication, bracing, exercise and rehabilitation, and osteoporosis medication. However, there is disagreement about the outcomes of these treatments. MATERIALS AND METHODS: Review of the relevant literature. RESULTS: In the case of osteoporotic spinal fractures, analgesic administration, bracing, physical therapy, and exercise should be conducted. In order to prevent secondary fractures, bisphosphonates, selective estrogen receptor modulators, strontium ranelate, or parathyroid hormone, which has proven efficacy with respect to the prevention of secondary fractures, should be prescribed. CONCLUSIONS: We should actively prevent the occurrence of secondary fractures with fracture healing by implementing a proven effective treatment for osteoporotic spinal fractures.
Bed Rest ; Braces ; Diphosphonates ; Fracture Healing ; Osteoporosis ; Parathyroid Hormone ; Rehabilitation ; Selective Estrogen Receptor Modulators ; Spinal Fractures* ; Strontium

The consequences of osteoporotic vertebral compression fractures are pain, progressive vertebral collapse with resultant kyphosis, and systemic manifestations. Minimally invasive stabilization procedures such as vertebroplasty and balloon kyphoplasty have been introduced to treat for refractory pain due to these fractures. Vertebroplasty and kyphoplasty are new alternatives for the treatment of osteoporotic vertebral compression fractures. Both methods stabilize the fractured vertebra with polymethylmethacrylate cement to relieve pain and allow immediate mobilization. Kyphoplasty is an extension of vertebroplasty that uses an inflatable bone tamp to restore the vertebral body height while creating a cavity to be filled with bone cement. A large proportion of subjects had some pain relief both in vertebroplasty and kyphoplasty. Vertebral height restoration was possible using kyphoplasty and for a subset of patients using vertebroplasty. Cement leaks occurred in both groups but, the incidence of cement leakage in kyphoplasty is lower than that of the vertebroplasty. Vertebroplasty and kyphoplasty are safe and effective procedures. Good short-term results have been reported following both vertebroplasty and kyphoplasty for the painful osteoporotic vertebral fractures. Severe complications result from bone cement leakage into the spinal canal or the vascular system have been reported but the incidence was very rare. Both vertebroplasty and kyphoplasty offer therapeutic benefit significantly reducing pain and improving mobility in patients with vertebral fracture without significant differences between groups in term of quality. While early results are promising, more research is needed to better understand the log-term effects of both procedures on the human spine.
Body Height ; Fractures, Compression ; Humans ; Incidence ; Kyphoplasty ; Kyphosis ; Pain, Intractable ; Polymethyl Methacrylate ; Spinal Canal ; Spine ; Vertebroplasty

The incidence of spinal fusion surgery has increased due to an increase in the incidence of degenerative spinal disease or trauma. Moreover, the development of various kinds of implants and bone graft substitutes has also increased. The animal models of spinal fusion are useful methods in evaluating the effectiveness of the newly developed spinal implants or bone graft substitutes. The most widely used animal models of spinal fusion are posterolateral fusion model, posterior fusion model, and anterior interbody fusion model. Mice, rats, rabbits, dogs, pigs, goats, sheep, and primates are frequently used in animal models of spinal fusion. Small animals are implanted with a bone graft substitute without internal fixation; however middle- or large-sized animals are implanted with a bone graft substitute using pedicle screws or cages. Small animals are easy to handle due to their size, but have different anatomical or biomechanical reactions with the human body. Middle- or large-sized animals have characteristics like the human body, but they are difficult to handle or there is an ethical problem. The fusion status is evaluated by manual palpation, mechanical testing using Instron, and radiologic techniques such as computed tomography, micro-computed tomography or undecalcified histology. The fusion rate and duration required for successful fusion differ according to the species and anatomical site. We have identified and reviewed several typical animal models of spinal fusion.
Animals* ; Dogs ; Goats ; Human Body ; Incidence ; Mice ; Models, Animal* ; Orthopedics* ; Palpation ; Pedicle Screws ; Primates ; Rabbits ; Rats ; Sheep ; Spinal Diseases ; Spinal Fusion* ; Swine ; Transplants