No abstract available.
Longitudinal Ligaments*

No abstract available.
Fatigue* ; Sciatica*

No abstract available.

Vertebroplasty was introduced in 1987 for painful cervical hemangioma. Since then, there has been an explosion of interest in this remarkable procedure, which can be useful for the majority of vertebral fractures throughout the spinal column. This procedure is indicated for painful vertebral compression fracture(VCF) due to osteoporosis or malignancy, and for painful hemangiomas. Vertebroplasty is the injection of bone cement, generally polymethylmethacrylate (PMMA), into a vertebral body (VB). Kyphoplasty is the placement of balloons into the VB, followed by an inflation/deflation sequence to create a cavity prior to the PMMA injection. These procedures are most often performed in a percutaneous fashion under local anesthesia. Although these methods are minimally invasive procedure, numerous complications can occur. The common complications include bleeding at the puncture site, PMMA leakage, local infection, and adjacent vertebral body fracture. A grave complication, which is rarely reported, is pulmonary embolism by PMMA leakage. These procedures can reduce pain in about 90% of patients with osteoporotic VCFs. Additionally, improvements in mobility and in activities of daily living occur. The success rate is slightly less in patients with metastatic VCFs than osteoporotic VCFs. Much evidence favors the use of these procedures for pain associated with the aforementioned disorders. The risk/benefit ratio appears to be favorable in carefully selected patients. This article summarizes the indications, techniques, complications and outcomes for the vertebroplasty and kyphoplasty.
Activities of Daily Living ; Anesthesia, Local ; Explosions ; Hemangioma ; Hemorrhage ; Humans ; Kyphoplasty ; Osteoporosis ; Polymethyl Methacrylate ; Pulmonary Embolism ; Punctures ; Spine ; Vertebroplasty

Low back pain is one of the most common symptoms in medical practice. Differential diagnosis of back pain is complicated, however. Self-reported pain intensity and disability may affect on the decision for diagnosis or therapy. Exaggerated symptoms may cause unnecessary investigations or even surgical interventions. Self-reported pain intensity and disability are not in proportion to the objective physical findings. We investigated the relationship between self-reported pain intensity or disability and sleep disturbance or fatigue. The study was conducted as a survey using a questionnaire from November 1997 to March 1998. The survey included consecutive 368 patients who visited the neurosurgical out-patient department complaining of low back pain. Pain intensity was measured by visual analog scale, and disability was assessed by Waddell's chronic disability index. By multiple regression analysis, self-reported pain intensity corresponded best with the sleep disturbance. Age and fatigue were also related to the pain intensity. There was no good agreement between pain intensity and region or duration of the pain, appetite or indigestion. Disability corresponded best with the sleep disturbance. Fatigue, appetite, and indigestion were also related to the disability. There was no good relationship between disability and region or duration of the pain, or age. Self-reported pain intensity and disability are related to the psychological distress represented as sleep disturbance, fatigue, poor appetite or indigestion. Inquiring about sleep or fatigue is important to understand the underlying psychological condition, which may exaggerate pain intensity and disability.
Appetite ; Back Pain ; Diagnosis ; Diagnosis, Differential ; Dyspepsia ; Fatigue* ; Humans ; Low Back Pain ; Outpatients ; Surveys and Questionnaires ; Spine ; Visual Analog Scale

Tables and figures are very useful tools to support the author's point or opinion. It should be made according to instructions for the authors of the given Journal. The Journal of Korean Neurosurgical Society requires simple and clear English titles and explanations for the tables, figures and photos, which should be attached at the end of the manuscript. The author examined correctness of the tables and figures in the Jormnal of Korean Neurosurgical Society Volume 26. In 1997, 240 articles published in the Journal of Korean Neurosurgical Society. All 240 articles used at least one table or a figure. Tables were used in 157 articels, of which 107 articles(68.2%) have at least one incorrect table. Blanks in the field(26.2%), omitting the column headings(25.2%), and incorrect footnotes(19.6%) were common errors in the tables. Figures were used in 208 articles, of which 31 articles(14.9%) have at least one incorrect figure. Identifiable name or hospital number(35.5%), wrong numbering(29.0%), and duplication of tables and figures (19.4%) were common errors in the figures. It is important for the contributors to keep the instruction. To improve the quality of the journal, proper education for the manuscript and meticulous review of an article are necessary. It may be useful to illustrate an example of a table in the instruction of the Jormnal of Korean Neurosurgical Society.
Education

The Journal of Korean Neurosurgical Society is the unique official journal of Korean Neurosurgical Society. However, it is not yet indexed in the Index Medicus or Medline. The author investigated the accuracy of the references in the Jourmnal of Korean Neurosurgical Society Volume 26 and frequency of citation. In 1997, 240 articles published in the Journal of Korean Neurosurgical Society. The average number of references and frequency of citation were evaluated. Accuracy of the references was examined according to the instructions for the contributors which was revised at 1995. The references were described correctly in 104 articles(43.3%). In 136 articles(56.7%), there was at least one descriptive error. The most common error was an incorrect abbreviation of the journals, which was found in 87 articles (36.3%). Incorrect description of the books or chapters in a book was found in 62 articles(25.8%). Describing more than three authors was found in 31 articles(12.9%). There were some other faults, such as an incorrect author's name, omitting an article in the references, wrong order, or different description of the pages. The average number of references were 27.1 in total. The average number of Korean references were 1.3, and that of the Journal of Korean Neurosurgical Society was 0.93. It shared only 3.43% of all references. Only 108 articles (45.0%) cited at least one Korean reference. The number of articles citing the Journal of Korean Neurosurgical Society was 97(40.4%). It is an honor to publish an article in the official journal of his own academic society. However, submitting an articles which do not follow the instructions and publishing an inadequate article without proper correction would pull down the quality and the value of the journal. It is important to teach the way how to prepare an article. Meticulous review of an article is essential to improve the quality of the journal. It is also necessary to monitor the reviewer's missing.
MEDLINE

Although the prevalence of infectious disorders has been decreased, tuberculous infections are still common in this country. Therefore epidemiological data for the correct diagnosis of some spinal infections and proper selection of susceptible antibiotics are necessary. We presented a series of 40 patients with primary spinal infection dated from January 1990 to December 1994. Tuberculosis was the most common infection constituting 85% of this series, while pyogenic infection constituted only 10%, and primary discitis shared 5%. In a half of the tuberculous spondylitis, there were histories of previous tuberculosis except the vertebrae. We could identify the pathogenic organisms in only 47.5% o the cases(in 4 of 6 pyogenic infection and 15 of 34 tuberculous infection). Since it is difficult to differentiate the pyogenic and tuberculous infections by clinical or radiological features alone, some pyogenic infections might have been regarded as tuberculous, although the pyogenic spinal infections are rare. Nevertheless the tuberculous spinal infection outnumbered pyogenic ones in this country, which is similar to the patterns of other third-world countries. Therefore, correct identification of the microbial agent is important not only for the proper treatment but also to evaluate the patients of primary spinal infections in this country.
Anti-Bacterial Agents ; Developing Countries ; Diagnosis ; Discitis ; Epidemiology ; Humans ; Prevalence ; Spine ; Spondylitis ; Tuberculosis

Development of new surgical devices and approaches for management of injuries to the cervical spine has offered various methods of treatment available. Making it is not easy in choosing the most suitable method of treatment. We present our experience and results of 90 operations performed during the past eight-year-period(1986-1993) including 10 halo-vest applications. The timing of operation was within 7 days posttrauma in 34.2%, 8-14 days in 27.4%, 15-28 days in 1.0%, and over 28 days in 27.4%. In 18 cases of upper(C1-3) cervical spine injuries, 23 operations were performed, all approached from the posterior. In 5 cases of lower(C4-7) cervical spine injuries, 67 operations were performed, the anterior approach used in 33 patients and the posterior approach in 18 patients. Halo-vest was applied in 6 patients with upper cervical spine injuries and in 4 patients with lower cervical spine injuries. The halo-vest was inadequate in maintaining the stability of the injured spine in 5 out of 0 cases. The complication rate was 23.3% in postrior approaches and 32.4% in anterior approaches. Overall, 27 complications(0%) occurred in 90 operations, and the reoperation rate was 16.4%(85 operations for 73 patients, except for the halo-vest applications). Internal fixation with a variety of devices has become a popular procedure for ervical spine injuries. Despite the popular and wide usage of such devices, the occurrence of complications and the need to reoperate has rendered the procedure to be applied with much caution regarding its technical aspects and possible problems it may pose. In our study, the rate of reoperation and complications following such procedures were quite high. We conclude that in choosing the most proper surgical approach for ervical spine injuries with minimal occurrence of any complications, a stringent criteria should be adhered to rather then easily select the more fashionable, new of fancy devices over the traditional techniques.
Humans ; Reoperation ; Spine*

It is never easy to assess the rate of disability from spinal injuries objectively. One reason is that the pain is an unmeasurable subjective symptom, and the other is that the disability is usually not confirmed by or correlated with radiological or laboratory examinations. The disability is an essentially subjective inconvenience or limitation, which is hard to measure objectively. However, compensation or reparation requires a scale to measure this unmeasurable disability, even with a universal validity and equity. There are several guidelines or criteria for a quantitative assessment of the disability. They differ from each other and have their own advantages and disadvantages. This difference may cause confusion or inequity. To improve the validity and equity, we propose a new design for the disability evaluation in patients with spinal injuries. We reviewed the Korean law for compensation in industrial accidents, McBride's disability table, the guideline proposed by American Medical Association, and a impairment rating table. Disabilities resulting from spinal injuries were classified into three types, i.e., morphologic sequelae(deformity), functional sequelae(dysfunction), and others. Only objective findings were considered as criteria for rating the disability. Disability resulting from deformity were rated from 0 to 20% by the degree of compression. Dysfunction can be rated by the number of lost motion segment from 10 to 60%. Disability from other compensable spinal pain were rated by objective physical findings or neurologic deficit from 0 to 25%. By eliminating the subjective or intentional complaints, this design can be a useful method minimizing the differences from the multiple examiners.
Accidents, Occupational ; American Medical Association ; Compensation and Redress ; Congenital Abnormalities ; Disability Evaluation ; Humans ; Jurisprudence ; Neurologic Manifestations ; Spinal Injuries*