Cervical spondylosis is known to be one of the most common disorders involving bony and neural structures of cervical region and shows variety of clinical menifestation, namely radiculopathy, myelopathy, or both. Also, the outcome of the treatment of this disorder, whether surgical or nonsurgical, shows wide variations according to handful reports from different institutions. The purpose of this report is to assess the patients treated by our department for their spondylogenic symptoms. The results of treatments from 102 patients with cervical spondylotic radiculopathy and/or myelopathy were clinically assessed. Among them, thirty eight patients were undelwent operation and followed up for at least six to twelve month period. Remaining sixty four patients were treated conservatively for three weeks to three months. The results are as follows: 1) Among 102 patients, the most common type was combined myeloradiculopathy(57.8%). 2) Mean age was 52 tears with range between 31 to 74 years. Male to female ratio was about three to one. 3) Multiple level involvement was 52% and C5-6 was the most commonly involved level by single lesions. 4) Mean AP diameter of cervical canal of the spondylotic patients, as compared with the control group, was significantly narrowed(p<0.01). 5) Overall outcome by conservative treatment showed 65.3% improvement and 86.8% improvement by operative treatment. 6) Among various clinical factors studied(age, severity, duration of symptoms, multiple level involvement, methods of operation), only the degree of severity revealed statistically significant effect on outcome of both conservative and operative group. 7) There were three cases of mild transient neurological complications and one case of technical complication(graft extrusion).
Female ; Hand ; Humans ; Male ; Radiculopathy ; Spinal Cord Diseases ; Spondylosis

Spinal trauma produced from motor vehicle accidents, diving accidents, or falls occur at high rates of loading. This study was undertaken to reproduce clinically relevant cervical spine injuries under controlled conditions. Six isolated head-T2 human cadaveric preparations were tested using an electrohydraulic piston actuator at loading rates from 295 to 813 cm/sec. The Hybrid III head-neck was tested similarly at rates from 401 to 683 cm/sec. The input forces for specimen tests were of higher magnitude and shorter duration than the distally measured forces. In contrast, the Hybrid III head-neck revealed similar magnitude and duration force traces from input to output. The specimen preparations were analyzed kinematically at 1200 frame/sec with 20 to 30 retroreflective targets fixed to each level of the cervical spine. With this technique it is possible to temporally follow cervical damage as a function of applied forces. Wedge, burst, and anterior compression fractures were documented using CT and cryosectioning techniques. This pathology can be evaluated quantitatively using the target analysis. For example, a burst fracture occurred suddenly and 2.5 msec, whereas wedge fractures were progressive and took 4 to 5 msec to occur.
Cadaver* ; Cryoultramicrotomy ; Diving ; Fractures, Compression ; Humans* ; Motor Vehicles ; Pathology ; Spine

Aneurysmal bone cyst is an uncommon spinal tumor of vascular origin and represents less than 1% primary bone tumors. A case of 15-year-old girl who presented with low back pain and severe left leg pain. The lesion was expansile in nature involving anterior and posterior bony elements of the spine. It also showed expanision into the intraspinal canal and paraspinal soft tissue. Surgical treatment consisted of tumor excision and pedicle screw fixation via extracavitary approach. Postoperative course was uneventful and her symptoms and signs were improved. Extracavitary approach, as applied to our case, seemed to be an ideal surgical method in such cases because of its nature and extent of involvement.
Adolescent ; Aneurysm* ; Bone Cysts* ; Female ; Humans ; Leg ; Low Back Pain ; Spine

No abstract available.
Sepsis* ; Yersinia*

Two cases of vertex epidural hematomas are described to illustrate their unique diagnostic and treatment problems. Due to its specific location, a correct diagnosis of the intracranial hematoma was delayed in the first case. Quantitative analysis of the hematoma volume was performed in the second case. We would like to emphasize the usefulness of the magnetic resonance imaging and quantitative analysis of vertex epidural hematoma in choosing treatment options in such patients.
Adult ; Case Report ; Hematoma, Epidural/*diagnosis/surgery ; Human ; Magnetic Resonance Imaging ; Male

A case of AVM(Arteriovenous Malformation) harboring a large venous aneurysm is presented. The AVM was located in right temporo-parietal area. The pathology revealed a AVM and large venous aneurysm which was attached to nidus and drained into petrosal sinus. The authors reviewed the pathology of AVM and venous aneurysm.
Aneurysm* ; Arteriovenous Malformations* ; Pathology

OBJECTIVES: The craniopharyngioma is a benign tumor located at least in part in the suprasellar cistern. However, the symptoms and signs from this tumor may be determined not only by the location of the tumor but also by its size and the age of the patient. The objective of our study is to analyze retrospectively the clinical manifestations of craniopharyngiomas with regards to tumor characteristics in children and adults. MATERIALS AND METHODS: Twenty-three patients(16 adults, 7 children) treated for craniopharyngioma between 1990 and 1999 were studied to demonstrate the relationship of tumor size, growth pattern, and its invasiveness with clinical symptoms. As part of the assessment, 16 adults(M:F=8:8, mean age:43.7 years) and 7 children(M:F=5:2, mean age:10.1 years) underwent magnetic resonance(MR) imaging and computerized tomography(CT) scanning with a three-dimensional volume acquisition sequence. RESULTS: The three major cardinal signs were defined to increased intracranial pressure, endocrine dysfunction, and visual problems. The tumor size in child group was larger than that in adult group. Also, visual problems, symptoms of increased intracranial pressure and hydrocephalus were more frequently observed in child group. However, endocrine dysfunction and neuropsychological symptoms related with hypothalamic connections to the thalamus, pituitary, frontal lobe, and other cortical areas were more frequent in adult group. Conclusions: In our series, the tumor size and invasiveness of craniopharyngioma revealed to be relevent with initial symptoms of increased intracranial pressure and visual symptoms which were more frequent in child group. As for the growth pattern, we did not find major difference between adults and children.
Adult* ; Child* ; Craniopharyngioma* ; Frontal Lobe ; Humans ; Hydrocephalus ; Intracranial Pressure ; Retrospective Studies ; Thalamus

Chordoma is a relatively rare primary osseous tumor arising from the remnants of the primitive notochord and located along the axial skeleton. It is characterized by is slow growth, hight frequency to invade and destroy bone by direct extension, local recurrence after surgical excision and distant metastasis. It accounts for 1 to 4% of all malignant bone tumors. Approximately 50% of chordomas arise in the sacrococcygeal region, 35% at the clivus, and 15% in the vertebral column above the sacrum. The tumor tends to predominate in males, with roughly a 2 : 1 male-female ratio, and occurs predominantly in the fifth through seventh decades of life. Pain is the most common symptom in the chordomas of the spine, and symptoms of constipation, urinary frequency, or nerve root compression may appear before patients present to their physician. Many patients, therefore, are misdiagnosed as having degenerative disc disease, coccygodynia, or hemorrhoids. A firm, fixed presacral mass can usually be palpated on rectal examination. Surgical extirpation of the tumor is the only curative procedure and the indicated surgical procedure for sacrococcygeal chordoma is a high sacral amputation, maintaining a cuff of normal tissue over the tumor. Radiation therapy seems to be effective with adjuvant or palliative aims. We report a case of large sacral chordoma detected in a 60-year-old female in the course of a clinical examination, which was successfully treated by high sacral resection by a posterior approach and repair of the sacral bone defect with bone cement.
Amputation ; Chordoma* ; Constipation ; Cranial Fossa, Posterior ; Female ; Hemorrhoids ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis ; Notochord ; Radiculopathy ; Recurrence ; Sacrococcygeal Region ; Sacrum ; Skeleton ; Spine

Spinal angiolipomas are distinct but rare benign lesions composed of mature lipocytes admixed with abnormal blood vessels that vary from capillary to sinusoid or from venular to arterial in size. They account of 0.14% to 1.2% of all spinal axial tumors, 2% to 3% of extradural spinal tumors, and 16% to 35% of spinal lipomas. The tumors are mostly extradural and have a predilection site in the midthoracic region. The symptoms are usually due to cord compression. Magnetic resornance imaging is the diagnostic choice and surgery is universally successful in relieving the symptoms. The authors report a case of spinal angiolipoma in a 35-year-old female which was successfully treated by operation. A review of the literature on this lesion is also presented.
Adipocytes ; Adult ; Angiolipoma* ; Blood Vessels ; Capillaries ; Female ; Humans ; Lipoma ; Spinal Cord

OBJECTIVE: The purpose of this study is to review retrospectively 28 patients with re-operation due to complications related to instrumentation from thoracic and lumbar spinal fusion surgery. METHODS: A total of 285 patients underwent spinal fusion surgery with instrumentation between 1996 and 2000. Of these, 11 men and 17 women(mean age 46 years, range 21 to 69 years) presented with complications related to instrumentation. Previous surgery was preformed for vertebral column instability secondary to fracture(4), spondylolisthesis(12), failed back surgery syndrome(7), osteomyelitis(1), herniated nuclus pulposus(4). All patients underwent repeated spinal surgery including removal of instrument, new instrument fixation, or I & D. The mean follow-up period after second operation was 19 months. RESULTS: The complications related instrumentation system include six interbody fusion system retropulsion, eight screw loosenings, five screw fractures, three screw malpositions, three osteomyelitis, and one donor site infection. After repeated surgery, eight became asymptomatic and did not require further treatment, but eleven showed persistent low back pain without neurological deficits and the remaining nine continued to have nerve root deficits. CONCLUSION: In conclusion, spinal fusion surgery with instrumentation offers an immediate postoperative stability of the thoracic and lumbar spine and enhances early fusion. However, it may be associated with few, but significant, complications which may permanantly. The proper selection of patients and meticulous surgical technique for surgery are probably the most important factors associated good outcomes and prevention of complications.
Follow-Up Studies ; Humans ; Low Back Pain ; Male ; Osteomyelitis ; Retrospective Studies ; Spinal Fusion* ; Spine ; Spondylolisthesis ; Tissue Donors