No abstract available.

Klippel-Feil syndrome is characterized by congenital fusion of cervical vertebrae with a wide range of associated anomaly. The authors present a 50-year-old Klippel-Feil syndrome patient with a minor trauma followed progressive quadriparesis. He had typical radiologic findings of type II Klippel-Feil syndrome and presented progressive myelopathy due to cord compression at foramen magnum level with cervical instability. The patient underwent craniocervical decompression and fusion. The authors reviewed the pertinent literatures and discussed this rare syndrome.
Cervical Vertebrae ; Decompression ; Female ; Foramen Magnum ; Humans ; Klippel-Feil Syndrome* ; Middle Aged ; Quadriplegia* ; Spinal Cord Diseases

Intraparenchymal epidermoid cyst is extermely rare. The authors treated a case of intraparenchymal, temporal lobe epidermoid cyst in 21-year old male who had presented with a generalized seizure attack and headache without any neurological deficits. The diagnosis was based on the characteristics of CT scan and MR imaging. The cyst was totally removed via transtemporal approach. Postoperative course was uneventful. The authors report this rare case with a review of the literature.
Diagnosis ; Epidermal Cyst* ; Headache ; Humans ; Magnetic Resonance Imaging ; Male ; Seizures ; Temporal Lobe ; Tomography, X-Ray Computed ; Young Adult

C5 palsy is a common complication after cervical decompressive surgery, which have 0 to 30% complication rate. A 61-year-old female patient with cervical spondylotic myelopathy showed bilateral C5 palsy following circumferential decompression and fusion. Unexpectedly, bilateral C5 palsy was noted in different time points on postoperative day 2 and 8, respectively. Steroid injection and physical therapy were performed, and her motor function is recovering. Surgeons should make an effort to prevent possible C5 palsy when performing cervical decompression surgery.
Decompression* ; Female ; Humans ; Middle Aged ; Paralysis* ; Spinal Cord Diseases*

OBJECTIVE: The authors report the successful use of a recently described technique of posterior fixation of the C1 lateral mass and the C2 pedicle with polyaxial screws and rods. METHODS: After posterior exposure of the C1-C2 complex, the polyaxial screws were inserted into the lateral mass of C1 and the pedicle of C2 with the guidance of anatomic landmarks and fluoroscopy. Then, the pedicle screws of each side were linked with a rod. Because the C1-C2 pedicle screw fixation was sufficiently rigid, an additional posterior wiring or structural bone graft is unnecessary. RESULTS: The early clinical and radiologic follow-up data indicated solid fusion of C1 and C2 vertebrae with no observed neural or vascular damage related to this technique. CONCLUSION: The posterior fixation of the C1-C2 complex using polyaxial screws and rods seems to be a reliable technique and an efficient alternative to the more commonly accepted procedures.
Anatomic Landmarks ; Axis, Cervical Vertebra* ; Fluoroscopy ; Follow-Up Studies ; Spine ; Transplants

To investigate relationship between intracranial aneurysm and systemic hypertension, 190 consecutive cases of intracranial aneurysm which were treated surgically were analized in regard to the incidence of ypertension and to the effect of hypertension on their outcome. The incidence of hypertension in cases with aneurysm was higher than in general population. Multiple aneurysm patients had significantly higher incidence of hypertension than single aneurysm patients did. The amount of subarachnoid clot on postictal CT scan and neurological status on admission were not statistically different between hypertensive and normotensive group. Frequency of rebleeding was significantly higher in hypertensive group than in normotensive group. The incidence of cerebral vasospasm or hydrocephalus was statistically not significant between hypertensive group and normotensive group. The clinical outcome was similar between two groups.
Aneurysm ; Humans ; Hydrocephalus ; Hypertension* ; Incidence ; Intracranial Aneurysm* ; Tomography, X-Ray Computed ; Vasospasm, Intracranial

The clinical significance of cystic fluid motion in syringomyelia is uncertain. Because of its sensitivity to fluid motion, MR imaging was used to investigate fluid dynamics in syringomyelia by various tecniques. SPAMM (Spatial Modulation of Magnetization) MRI is one of these techniques which shows the fluid motion of syrinx in syringomyelia. After taking preimaging pulse sequence, the MR images show periodic bands due to the magnetic modulation. Motion between the time of banding and image formation is directly demonstrated as a corresponding displacement of the bands. The authors evaluated 7 patients of syringomyelia due to various causes with SPAMM MRI technique and compared preoperative SPAMM MRI findings and clinical results, postoperative size of syrinx. Among 4 patients of syringomyelia with Arnold-Chiari malformation, 3 patients showed band shift representing fluid motion of syrinx on SPAMM MRI. Clinical results of these patients were good and the size of postoperative syrinx decreased. Three patients of posttraumatic or postmeningitic syringomyelia who did not show band shift on SPAMM MRI had poor clinical courses and the sizes of postoperative syrinx remained unchanged. These results indicate that SPAMM MRI may be useful in dete rmining the type of treatment and predicting clinical results in syringomyelia.
Arnold-Chiari Malformation ; Humans ; Hydrodynamics ; Magnetic Resonance Imaging* ; Prognosis* ; Syringomyelia*

PURPOSE: We have experienced 23 patients who had underwent cervical disc replacement with Mobi-C disc prosthesis and analyzed their radiological results to evaluate its efficacy. PATIENTS AND METHODS: This study was performed on 23 patients with degenerative cervical disc disease who underwent CDR with Mobi-C disc prosthesis from March 2006 to June 2006. RESULTS: The age of the study population ranged from 31 to 62 years with mean of 43 years, and 16 male and 7 female cases. Regarding axial pain, the average preoperative VAS score was 6.47 +/- 1.4, while at final follow-up it was 1.4 +/- 0.7 (p < 0.001). The preoperatively VAS score for radiculopathy was 6.7 +/- 0.7 compared with an average score of 0 +/- 0 at the final follow-up (p < 0.001). At postoperative 6th month, Odom's criteria were excellent, good, or fair for all 23 patients (100%). 7 patients (30.4%) were classified as excellent, 15 patients (65.2%) as good, and 1 patients (4.4%) as fair. Prolo economic and functional rating scale was average 8.9 +/- 0.7 at postoperative 6th month. ROM in C2-7, ROM of FSU, and ROM in upper adjacent level were well preserved after CDR. CONSLUSION: This report would be the first document about the CDR with Mobi-C disc prosthesis in the treatment of degenerative cervical disc disease. CDR with Mobi-C disc prosthesis provided a favorable clinical and radiological outcome in this study. However, Long-term follow-up studies are required to prove its efficacy and ability to prevent adjacent segment disease.
Adult ; Cervical Vertebrae/physiopathology/*surgery ; Diskectomy/adverse effects/instrumentation/*methods ; Female ; Humans ; Joint Prosthesis/adverse effects ; Male ; Middle Aged ; Postoperative Complications/prevention & control ; Range of Motion, Articular ; Time Factors ; Treatment Outcome

PURPOSE: We performed 65 cases of posterior fusion surgery for cervical and/or high thoracic lesions using a polyaxial screw-rod system. PATIENTS AND METHODS: A total of 486 screws were implanted in 65 patients. RESULTS: Fixation of the screws was carried out over an average of 2.9 spinal segments. Upon evaluation by postoperative CT scans, twelve (2.5%) screws had suboptimal trajectories but two of these revealed radiculopathy in one patient and required screw repositioning. No vascular sequelae resulted. There has been no segmental motion in any of the cases to date. As for other complications, there was one case of dural tearing and two cases of lateral mass fractures. There were no infections or other wound healing problems or hardware failures. No patients had neurological deterioration after surgery. There were statistically significant improvements in the mean Neck Disability Index (NDI) scores and Visual Analogue Scale (VAS) scores in the preoperative and late postoperative follow-up evaluations. Although further studies are required to establish the long-term results of fusion rates and clinical outcomes. CONCLUSION: We cautiously suggest that the posterior polyaxial screw-rod system can be safely used as a primary or additional fusion method in this risky region. The successful and safe use of this method is dependent on a precise preoperative surgical plan and tactics for ensuring safe screw fixation.
Adult ; Aged ; Aged, 80 and over ; *Bone Screws ; Cervical Vertebrae/radiography/*surgery ; Female ; Humans ; Male ; Middle Aged ; Recovery of Function ; Reproducibility of Results ; Spinal Diseases/physiopathology/*surgery ; Spinal Fusion/instrumentation/*methods ; Thoracic Vertebrae/radiography/surgery ; Time Factors ; Tomography, X-Ray Computed ; Treatment Outcome

The purpose of this study was to evaluate the clinical feasibility, benefits, and limitations of CT fluoroscopy (CTF) -guided percutaneous vertebroplasty (PVP). PVP under the guidance of CTF without additional guidance by conventional C-arm fluoroscopy was performed in a total of 29 vertebral bodies in 21 patients with vertebral compression fractures. While monitoring sectional CTF images, the needle was advanced from the skin to the target vertebra. Contrast media and polymethylmethacrylate (PMMA) were injected into the target vertebra with careful monitoring of their distribution. After the procedure, an evaluation was conducted to determine whether extraosseous leakage of PMMA occurred and whether sufficient filling of PMMA had been achieved. Needle placement into the target vertebra was easily achieved with both the transpedicular and posterolateral approaches. Injection of PMMA and venous leakage of contrast media were carefully monitored in all patients, and early detection of PMMA leaking was achieved in 5 patients. Extraosseous leakage that had not been detected during the procedure was not found upon postoperative evaluation. Pain scales were significantly decreased after the procedure, and no obvious complications occurred following the procedure CTF-guided PVP without the combined use of C- arm fluoroscopy was feasible and showed definite benefits. We believe that, in spite of some limitations, CTF-guided PVP provides an alternative technique appropriate in certain situations.
Tomography, X-Ray Computed ; Spine/radiography/*surgery ; Spinal Fractures/*surgery ; Radiation Dosage ; Polymethyl Methacrylate ; Osteoporosis/*complications ; Orthopedic Procedures/*methods ; Middle Aged ; Male ; Humans ; Fluoroscopy ; Female ; Aged, 80 and over ; Aged