Achondroplasia is abnormal intracartilagenous ossification that's caused by a genetic point mutation. Thoracic myelopathy in achondroplasia that is due to thoracolumbar kyphosis and spinal stenosis is a rare finding. There is no report available on this topic in Korea. We report here a case of achondroplasia with thoracic myelopathy due to thoracolumbar kyphosis and spinal stenosis, and we include a brief review of literature.
Achondroplasia* ; Korea ; Kyphosis* ; Point Mutation ; Spinal Cord Diseases* ; Spinal Stenosis*

Ganglion cyst and synovial cyst are rarely found in the lumbar spinal canal. Synovial cysts usually arise from degenerative apophyseal joints, and ganglion cysts arise from articular facet joints. We present here two cases: one ganglion cyst that arose from the posterior longitudinal ligament at the L2-3 intervertebral space level, and a synovial cyst that also arose from the posterior longitudinal ligament at the level of the L4 body. Both patients progressively developed low back pain with radiating pain. The lesions were detected by magnetic resonance imaging in both cases. The dural sac was displaced by the cysts in both cases. Relief of symptoms was achieved by decompressive laminectomy and excision of the ganglion cyst, and excision of the synovial cyst and PLIF at L3-4. Because these lesions have not been reported on before, we report here on 2 cases with synovial and ganglion cyst from the posterior longitudinal ligament at lumbar spinal level.
Ganglion Cysts* ; Humans ; Joints ; Laminectomy ; Longitudinal Ligaments* ; Low Back Pain ; Magnetic Resonance Imaging ; Spinal Canal ; Synovial Cyst* ; Zygapophyseal Joint

The Cauda Equina syndrome after spine surgery is a relatively uncommon condition, but it is a serious complication that needs emergency treatment. A 35-year-old woman was transferred to our hospital and she presented with decreased perianal sensation and rectal tone after percutaneous endoscopic discectomy. Magnetic resonance image showed that the dura sac was compressed by herniated disc material at L5-S1. After performing emergency open discectomy for the cauda eguina syndrome, the patient's neurologic symptoms were completely resolved at 12 months follow-up. There has been no previous report on Cauda Equina syndrome after percutaneous endoscopic discectomy, and so we report here on one case.
Adult ; Cauda Equina* ; Diskectomy* ; Emergencies ; Emergency Treatment ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Displacement ; Neurologic Manifestations ; Polyradiculopathy* ; Sensation ; Spine

STUDY DESIGN: This is a retrospective study. OBJECTIVE: We analyzed the clinical and radiographic results of surgical treatment for patients with tuberculous spondylitis. MATERIAL AND METHODS: Our study included 18 active tuberculous spondylitis patients (12 males and 6 females) who underwent anterior curettage, strut bone grafting and posterior instrumentation. Their average age was 50.1 years (age range: 24-76 years). The mean follow-up was 43 months. Vertebral bodies from T5 to L5 were involved. The anterior column support was iliac autograft in 10 patients and titanium mesh in 4. All the patients had transpedicular instrumentation with an additional hook in 3 and anterior instrumentation in 1. Except for one paraplegic patient, all the others were able to ambulate wearing TLSO. The mean duration of Anti-Tbc medication was 13.3 months (range: 12 to 18 months). The clinical and radiographic results were analyzed, and they included the segmental kyphotic angle and the complications of instrumentation on the involved vertebrae. RESULT: The subjective satisfaction was greater than good except for 2 patients. These 2 patients' satisfaction was fair due to incomplete neurologic recovery and persistent BG-donor site pain. The three paraplegic patients fully recovered postoperatively. The mean correction of the segmental kyphosis was 13 degrees. The mean correction loss was 0.7 degrees at the final follow-up. Pedicle screws were inserted in the involved vertebrae for 10 patients (n = 30). There was no loosening of instrumentation nor spread or recurrence of infection. One case was complicated by pneumonia. CONCLUSION: For the surgical treatment of active tuberculous spondylitis, anterior column support with strut grafting and posterior instrumentation is mandatory in the destabilized spine after anterior debridement or the correction of kyphosis.
Autografts ; Bone Transplantation ; Curettage ; Debridement* ; Follow-Up Studies ; Humans ; Kyphosis ; Male ; Pneumonia ; Recurrence ; Retrospective Studies ; Spine ; Spondylitis* ; Titanium ; Transplants*

STUDY DESIGN: The comparison was based on the radiographc and clinically differences of 96 vertebroplasty cases. PURPOSE: This study evaluated the clinical and radiological results of performing percutaneous vertebroplasty for acute or subacute osteoporotic vertebral compression fracture (group A) and for posttraumatic vertebral collapse (Kummell's disease) (group B). SUMMARY OF LITERATURE REVIEW: Percutaneous vertebroplasty is a minimal invasive procedure for the treatment of a painful collapsed vertebral body MATERIALS AND METHODS: We experienced 67 cases of group A and 29 cases of group B, and we followed these patients for 2 years or more. We evaluated the clinical results by using the serial visual analogue scale (VAS) and the radiological results were evaluated by measuring the restoration of the anterior vertebral height and the change of the kyphotic angle. We also compared both groups for their bone mineral density (BMD) and new fracture rate. RESULTS: Statistically significant pain relief was obtained by both groups in the perioperative period. The average VAS change was 6.5 (from 8.7 preoperatively to 2.2 postoperatively) in group A, and 7.1 (from 9.1 preoperatively to 2.0 postoperatively) in group B on a 10 point pain scale. The anterior vertebral height increased an average of 4.9mm (16.5%), (from 16.8mm preoperatively to 21.7 mm postoperatively) in group A, and 6.5 mm (21%) (from 12.8 mm preoperatively to 19.3 mm postoperatively) in group B on the perioperative period. But the height was minimally decreased more that it was measured at the immediate postoperative period: 18.7 mm in group A, and 16.2 mm in group B on the last follow up. The kyphotic angle was restored an average of 5.2 degrees (from 32.4 degrees preoperatively to 27.2 degrees postoperatively) in group A, and 4.9 degrees (from 39.5 degrees preoperatively to 34.6 degrees postoperatively) in group B on the perioperative period. But the angle was increased more than that measured preoperatively: about 1.7 degree in group A and group B on the last follow up. There's no significant difference in the BMD between the groups. New fracture developed in 17.9% (12) of group A, and 20.7% (6) of group B. We did this procedure for 15 cases of new fracture, and then the VAS change was an average 5.0 immediately after the operation. CONCLUSIONS: Percutaneous vertebroplasty was an effective treatment method for both groups and there were no statistically significant differences in the clinical and radiological results. Care must be taken due to the relatively high rate of new fracture and this can be resolved by repeat vertebroplasty
Bone Density ; Follow-Up Studies ; Fractures, Compression* ; Humans ; Osteoporosis ; Perioperative Period ; Postoperative Period ; Vertebroplasty*

STUDY DESIGN: This is a retrospective study. OBJECTIVES: We wanted to compare the early course of APLD with the long term follow-up after APLD and also the long term follow up after APLD with the short term follow-up after nucleoplasty. SUMMARY OF LITERATURE REVIEW: We evaluated the postoperative clinical course of both APLD and nucleoplasty. The evaluation of the postoperative clinical course was performed by using the Oswestry Disability Index (ODI). MATERIALS AND METHODS: We studied 59 patients who underwent APLD and nucleoplasty from 1989 to 2004. We defined the 26 cases with less than 5 years follow up as the early course follow-up after APLD, the 20 cases with over 5 years follow up as the long term after APLD, and 13 cases with less than 5 years follow up as the short term follow up after nucleoplasty. We then compared three groups. We inspected the condition of the discs on MRI and the level of the operated disc. RESULTS: The most common type of disc was a protruded disc (69.4%). Its ODI was lower than that of the extruded type. 5 cases out of the total group underwent open discectomy after APLD. In our study, the extruded type patients underwent a worse clinical course than protruded type patients. The patients who under went procedures at two affected disc levels had higher ODI scores compared to patients who underwent procedures at one level. The ODI score of the early course follow-up after APLD was 12.4%, the ODI of the long term follow up was 6.9% and that of the short term follow-up after nucleoplasty was 4.6%. CONCLUSIONS: On the long term follow-up, the patients who underwent APLD had significant improvement for any of the clinical parameters, as compared with their preoperative status. The patients who underwent nucleoplasty had a better prognosis than those patient who underwent APLD with less than 5 years follow up.
Diskectomy* ; Follow-Up Studies* ; Humans ; Magnetic Resonance Imaging ; Prognosis ; Retrospective Studies

Intervertebral disc degeneration is main cause of various spinal degenerative conditions, and results in a significant socio-economic burden and morbidity to those affected. Intervertebral disc degeneration is a multifactorial process that has no known curative method. Hence, various factors that cause intervertebral disc degeneration, especially biochemical ones, were discussed in this study.
Intervertebral Disc Degeneration* ; Intervertebral Disc* ; Regeneration*

Congenital absence of a lumbar pedicle is an uncommon anomaly, and most cases are asymptomatic and discovered incidentally. A 72-year-old man presented with lower back pain that radiated to his bilateral lower extremities. Physical examination revealed no neurological deficits. Plain radiographs of the lumbar spine revealed absence of the left L4 pedicle, along with hypertrophy and sclerosis of the contralateral pedicle. Magnetic resonance imaging showed stenosis of the L3-4 neural canal. Computed tomography revealed absence of the left L4 pedicle associated with hypertrophy and sclerosis of the right L4 pedicle and facet joint. The symptoms of the patient were resolved after posterior decompression without fusion. Here, we report one case of congenital absence of an L4 pedicle detected in a spinal stenosis patient who need to undergo a decompressive surgery for the spinal stenosis caused by contralateral facet hypertrophy.
Aged ; Constriction, Pathologic ; Decompression ; Humans ; Hypertrophy ; Low Back Pain ; Lower Extremity ; Magnetic Resonance Imaging ; Neural Tube ; Physical Examination ; Sclerosis ; Spinal Stenosis* ; Spine ; Zygapophyseal Joint

May-Thurner syndrome, compression of the left common iliac vein by the right common iliac artery, or intimal hypertrophy of the vein resulting from chronic pulsatile force of the right common iliac artery, may results in deep vein thrombosis on the left lower extremity. A patient presented to our facility with deep vein thrombosis caused by May-Thurner syndrome, and showed post-operative fever, pain, and tenderness over the left leg, showing severe lumbar disc herniation with acute cauda equina syndrome. This syndrome should be considered as one of the causes of deep vein thrombosis in the left lower extremity.
Cauda Equina* ; Fever ; Humans ; Hypertrophy ; Iliac Artery ; Iliac Vein ; Leg ; Lower Extremity ; May-Thurner Syndrome* ; Polyradiculopathy* ; Veins ; Venous Thrombosis*

Epidural abscess is a rare disease that can cause severe neurological complications or death if it is not recognized and treated early. Authors report a case of panspinal epidural abscess, which is diagnosed by MRI and treated with surgical drainage and antibiotics.
Anti-Bacterial Agents ; Drainage ; Epidural Abscess* ; Magnetic Resonance Imaging ; Rare Diseases