STUDY DESIGN: A retrospective analysis of 166 patients was undertaken to observe radiologically the changes of adjacent segments at follow-up more than three years after lumbar fusion. OBJECTIVES: The purpose of this study is to analyse the changes of adjacent segments and to correlate these changes to the length of using level and to the degree of deviation from physiologic lumbar lordosis. The authors also correlate these radiologic changes to the clinical symptoms. MATERIALS AND METHODS: In simple x-ray, authors observed traction spur, disc space narrowing, endplate sclerosis and vacuum phenomenon of adjacent segments. Authors used Gelb's criteria in segmental lordosis angle(SLA) and Katz's classification in clinical results. RESULTS: The average age was 49.6 years old and the average follow-up period was 57.2 months(4 years and 9.2 months). We observed radiologically the traction spurs in 35 cases(21.1%), end-plate sclerosis in 32 cases(19.3%), disc space narrowing in 33 cases(19.9%) and the vacuum phenomenon in 10 cases(6.0%). The numbers of fusion segments and the degree of unphysiologic segmental lordosis angle in fusion segments were related with the frequency and degree of changes of adjacent segments(P<0.05). The clinical results showed satisfaction in 142 cases(85.5%), unsatisfaction in 24 cases(14.5%) and low back pain in 24 cases(14.5%), leg pain in 11 cases(6.6%) and extension of fusion level in 4 cases(2.4%). In low back pain patients more than two kinds of radiological changes were frequently observed than the patients without low back pain(P<0.05). CONCLUSIONS: The radiological changes of adjacent segments were more frequently observed in long fusion and in fusion with unphysiologic lumbar lordosis angle. And these changes are frequently associated with low back pain. Thus long fusion and fusion with unphysiologic lumbar lordosis angle should be avoided if possible.
Animals ; Classification ; Follow-Up Studies* ; Humans ; Leg ; Lordosis ; Low Back Pain ; Retrospective Studies ; Sclerosis ; Spinal Fusion* ; Traction ; Vacuum

PURPOSE: To analyze the complications and improvement of neurologic injury after operative treatment in the fracture-dislocations of thoracic and lumbar spine in long-term follow-up. MATERIALS AND METHODS: A retrospective review of 39 patients, who were operated on for fracture-dislocations in thoracic and lumbar spine from May 1982 to May 1995 was conducted. We evaluated the result with Denis classification for type of fracture-dislocations and with Frankel classification for the neurologic injury. Average levels of fusion were 4.56 segments, ranging from 2 to 7 segments. RESULTS: According to the Frankel classification, the most common neurologic status at initial presentation was grade A in 28 cases (71.8%) and cases with complete paraplegia showed no improvement in long-term follow-up at all. Six other cases with incomplete paraplegia showed average neurologic improvement of 1.5 grade. Ischial sore was most common (13 cases) complication. CONCLUSIONS: Fracture-dislocations showed a higher incidence of neurologic injury than other spine fractures. Complete paraplegia was most common with no neurologic improvement in longterm follow-up. Incomplete paraplegia showed neurologic improvement. The cases of complete paraplegia had more complications than cases of incomplete paraplegia. The authors think that the postoperative care of complete paraplegia is important.
Classification ; Follow-Up Studies ; Humans ; Incidence ; Paraplegia ; Postoperative Care ; Retrospective Studies ; Spine*

Operative reduction is not essential for mild to moderate spondylolisthesis, but some authors agree that reduction of spondylolisthesis is beneficial for widening of intervertebral canal and consequently for decompression of neural tissue even though the degree of slippage is grade I or II. In our institute, we sometimes reduced the slippage for these reasons. But at follow up study we would find redisplacement and the degree of it seemed to be associated with the kind of instruments. So we analyzed redisplacement rate according to the kind of instruments in 59 cases of spondylolisthesis that were followed more than one year. The conclusions were as follow; 1. There was no significant correlation between reduction and redisplacement rate with pathologic type, lesion site, age,iscectomy and clinical result at least in grade I or II spondylolisthesis (P>0.05). 2. The pedicle screw system was more useful in reduction and its maintenance than the Luque ring system (P<0.001). 3. Redisplacement was occurred mainly within 2 months after operation, 4. The cause of redisplacement after reduction seems to be associated with mechanical insecurity before consolidation of the grafted bone takes place.
Decompression ; Follow-Up Studies ; Spondylolisthesis* ; Transplants

Posterior epidural migration of a sequestrated intervertebral lumbar disc is rare with only five cases ever reported in the literature so far. The objective of this paper is to report our experience of such a extremely rare case with a review the literature

No abstract available.
Carcinoma, Hepatocellular* ; Spleen*

BACKGROUND: The study aimed to determine the type of capsular insertion and the extent of capsular elongation in anterior shoulder instability by quantitatively evaluating their computed tomography arthrographic (CTA) findings, and to investigate the correlation of these parameters with surgical outcomes. METHODS: We retrospectively reviewed 71 patients who underwent CTA and arthroscopic capsulolabral reconstruction for anterior shoulder instability between April 2004 and August 2008. The control group comprised 72 patients diagnosed as isolated type II superior labrum anterior to posterior (SLAP) lesion during the period. Among the 143 patients, 71 were examined with follow-up CTA at an average 13.8 months after surgery. It was measured the capsular length and cross-sectional area at two distinct capsular regions: the 4 and 5 o'clock position of the capsule. RESULTS: With regards to the incidence of the type of anterior capsular insertion, type I was more common in the control group, whereas type III more common than in the instability group. Anterior capsular length and cross-sectional area were significantly greater in the instability group than in the control group. Among patients of the instability group, the number of dislocations and the presence of anterior labroligamentous periosteal sleeve avulsion lesion were significantly associated with anterior capsular redundancy. Postoperatively, recurrence was found in 3 patients (4.2%) and their postoperative capsular length and cross-sectional area were greater than those of patients without recurrence. CONCLUSIONS: Capsular insertion type and capsular redundancy derived through CTA may serve as important parameters for the management of anterior shoulder instability.
Arthrography* ; Dislocations ; Follow-Up Studies ; Humans ; Incidence ; Joint Instability ; Recurrence ; Retrospective Studies ; Shoulder*

Subclinical thyroid disease is defined biochemically by an abnormal thyrotropin (TSH) level and normal serum-free thyroxine level. The prevalence of this condition varies according to the reference range for TSH and geographic or demographic factors. Recently, several studies, including our community-based cohort studies, have reported on the incidence of subclinical thyroid disease in Korea. Using these studies, we reviewed the prevalence and risk factors of subclinical thyroid disease, focusing on subclinical hypothyroidism.
Cohort Studies ; Demography ; Hypothyroidism ; Incidence ; Korea ; Prevalence* ; Reference Values ; Risk Factors* ; Thyroid Diseases* ; Thyroid Gland* ; Thyrotropin ; Thyroxine

Purpose: We report a case of permanent corneal opacity caused by unilateral chemical burns after exposure to a low-dose (0.12%) chlorhexidine antiseptic solution during a dental procedure.Case summary: A 33-year-old woman presented to our clinic with conjunctival injection, ocular irritation, and blurred vision in her right eye; all symptoms had been present for 2 weeks. These symptoms began several hours after a dental procedure, in which 0.12% chlorhexidine antiseptic solution had been splashed into the right eye. Initial examination revealed that the patient’s best-corrected visual acuity (BCVA) was 20/200 in the right eye. Slit lamp examination and anterior segment optical coherence tomography revealed substantial corneal edema and stromal infiltration on the nasal side. The patient’s BCVA improved to 20/20 in the right eye after 3 months of treatment with topical corticosteroid. However, the stromal opacity was permanent and the corneal endothelial cell count was substantially reduced to approximately 550 cells/mm2. Conclusions Low-dose (0.12%) chlorhexidine on the ocular surface may cause irreversible corneal opacity and chemical burn-induced endothelial cell damage.

Langerhans cell histiocytosis (LCH) is a rare condition that usually occurs in children and commonly affects the skeletal system. It is extremely rare in adults, especially in the clavicles. In this report, we describe a pathologically confirmed case of LCH in the clavicle of a 50-year-old male. We report various radiological findings, such as plain radiography, CT, MR, and PET-CT, along with a review of the literature.

Langerhans cell histiocytosis (LCH) is a rare condition that usually occurs in children and commonly affects the skeletal system. It is extremely rare in adults, especially in the clavicles. In this report, we describe a pathologically confirmed case of LCH in the clavicle of a 50-year-old male. We report various radiological findings, such as plain radiography, CT, MR, and PET-CT, along with a review of the literature.