Although anterior cervical plates are thought to be good tools, their clinical results have not been compared with those of anterior cervical fusion without a plating system in the domestic scientific literature. As there are some advantages as well as shortcomings in these two surgical methods, it is imperative to know which one might be better in terms of the postoperative complications and management. Therefore, the authors reviewed 80patients undergoing anterior cervical fusion during the period of January 1992 to May 1994. Top plate placement was made in 25 and simple fusion without a plating system was applied in 55. The average follow-up period was 9.6 months. In the patients undergoing simple cervical fusion, thirty-two patients(58%) needed rigid braces such as halo braces and Minerva casts for 3 months postoperatively. Thirteen patients(24%) showed graft complications including graft extrusion, whereas patients undergoing plate placement needed only semi-rigid Philadelphia braces for 4 to 8 weeks pos toperatively. Two patients(8%) showed graft setting and screw breakage without any indication of reoperation. However there appeared no difference in the immediate postoperative course of clinical symptoms and the fusion rate(95 vs 96%) at the final follow-up day between the simple fusion and the plate placement patients. The authors conclude that a plating system in anterior cervical fusion may be safe in spite of more extensive operations, and is more likely to offer postoperative stability in the cervical spine and early ambulation and rehabiliation without rigid braces.
Braces ; Early Ambulation ; Follow-Up Studies ; Humans ; Postoperative Complications ; Reoperation ; Spine ; Transplants

Although anterior cervical plates are thought to be good tools, their clinical results have not been compared with those of anterior cervical fusion without a plating system in the domestic scientific literature. As there are some advantages as well as shortcomings in these two surgical methods, it is imperative to know which one might be better in terms of the postoperative complications and management. Therefore, the authors reviewed 80patients undergoing anterior cervical fusion during the period of January 1992 to May 1994. Top plate placement was made in 25 and simple fusion without a plating system was applied in 55. The average follow-up period was 9.6 months. In the patients undergoing simple cervical fusion, thirty-two patients(58%) needed rigid braces such as halo braces and Minerva casts for 3 months postoperatively. Thirteen patients(24%) showed graft complications including graft extrusion, whereas patients undergoing plate placement needed only semi-rigid Philadelphia braces for 4 to 8 weeks pos toperatively. Two patients(8%) showed graft setting and screw breakage without any indication of reoperation. However there appeared no difference in the immediate postoperative course of clinical symptoms and the fusion rate(95 vs 96%) at the final follow-up day between the simple fusion and the plate placement patients. The authors conclude that a plating system in anterior cervical fusion may be safe in spite of more extensive operations, and is more likely to offer postoperative stability in the cervical spine and early ambulation and rehabiliation without rigid braces.
Braces ; Early Ambulation ; Follow-Up Studies ; Humans ; Postoperative Complications ; Reoperation ; Spine ; Transplants

OBJECTIVE: To elucidate etiological factors of heterotopic ossification (HO) by evaluating retrospectively if HO is a unique finding following cervical total disc replacement (CTDR) or a finding observable following an anterior cervical interbody fusion (ACIF). METHODS: The authors had selected 87 patients who underwent anterior cervical surgery (TDR or ACIF), and could be followed up more than 24 months. A cervical TDR was performed using a Bryan disc or a ProDisc-C and an ACIF using a stand-alone cage or fibular allograft with a plate and screws system. The presence of HO was determined by observing plain radiography at the last follow up. The relation between HO occurrence and specific preoperative radio-logical findings (osteophyte and calcification of posterior longitudinal ligament (PLL)) at the index level was investigated. RESULTS: Cervical TDR was performed in 40 patients (43 levels) and ACIF in 47 patients (54 levels). At the final radiographs, HO was demonstrated at 27 levels (TDR-Bryan; 8/18, TDR-Prodisc-C; 12/25, ACIF-cage alone; 7/29, and ACIF-plate screw; 0/25). Mean ROM at the last follow-up of each TDR subgroup were 7.8+/-4.7degrees in Bryan, 3.89+/-1.77degrees in Prodisc-C, and it did not correlated with the incidence of HO. Fusion status of ACIF groups was observed as 2 case of grade 1, 6 of grade 2, and 21 of grade 3 in cage alone subgroup, and no case of grade 1, 4 of grade 2, and 21 of grade 3 in plate screw subgroup. Fusion status in ACIF-cage alone subgroup was significantly related to the HO incidence. The preoperative osteophyte at the operated level observed in 27 levels, and HO was demonstrated in 12 levels (TDR-Bryan; 3/5, TDR-Prodisc-C; 2/3, ACIF-cage alone; 7/11, and ACIF-plate screw; 0/8). Preoperative PLL calcification at the operated level was observed 22 levels, and HO was defined at 14 levels (TDR-Bryan; 5/5, TDR-Prodisc-C; 4/5, ACIF-cage alone; 5/7, and ACIF-plate screw; 0/5). The evidence of preoperative osteophyte and PLL calcification showed statistically significant relations to the occurrence of HO. CONCLUSION: HO was observed in both TDR and ACIF groups. HO was more frequently occurred in TDR group regardless of prosthesis type. In ACIF group, only cage alone subgroup showed HO, with relation to fusion status. Preoperative calcification of longitudinal ligaments and osteophyte were strongly related to the occurrence of HO.
Cinnarizine ; Follow-Up Studies ; Humans ; Incidence ; Longitudinal Ligaments ; Ossification of Posterior Longitudinal Ligament ; Ossification, Heterotopic ; Osteophyte ; Prostheses and Implants ; Retrospective Studies ; Total Disc Replacement ; Transplantation, Homologous

OBJECTIVE: To investigate the sagittal sacropelvic morphology and balance of the patients with SIJ pain following lumbar fusion. METHODS: Among 452 patients who underwent posterior lumbar interbody fusion between June 2009 and January 2013, patients with postoperative SIJ pain, being responded to SIJ block were enrolled. For a control group, patients matched for sex, age group, the number of fused level and fusion to sacrum were randomly selected. Patients were assessed radiologic parameters including lumbar lordosis, pelvic incidence (PI), pelvic tilt (PT) and sacral slope (SS). To evaluate the sagittal sacropelvic morphology and balance, the ratio of PT/PI, SS/PI and PT/SS were analyzed. RESULTS: A total of 28 patients with SIJ pain and 56 patients without SIJ pain were assessed. Postoperatively, SIJ pain group showed significantly greater PT (p=0.02) than non-SIJ pain group. Postoperatively, PT/PI and SS/PI in SIJ pain group was significantly greater and smaller than those in non-SIJ pain group respectively (p=0.03, 0.02, respectively) except for PT/SS (p=0.05). SIJ pain group did not show significant postoperative changes of PT/PI and SS/PI (p=0.09 and 0.08, respectively) while non-SIJ pain group showed significantly decrease of PT/PI (p=0.00) and increase of SS/PI (p=0.00). CONCLUSION: This study presents different sagittal sacropelvic morphology and balance between the patients with/without SIJ pain following lumbar fusion surgery. The patients with SIJ pain showed retroversed pelvis and vertical sacrum while the patients without SIJ pain have similar morphologic features with asymptomatic populations in the literature.
Animals ; Humans ; Incidence ; Lordosis ; Pelvis ; Sacroiliac Joint* ; Sacrum

It is well documented that dorsal root entry zone(DREZ) lesions were good method to control intractable chronic deafferentation pain of spinal origin which was not controlled with various medical and surgical treatment. Experience with radiofrequency lesions of dorsal root entry zone in 3 of patients with post herpetic pain and 1 of patient with post amputation pain are reported. The follow-up period ranging from 3-20 months and all patients obtained satisfactory pain relief.
Amputation ; Causalgia ; Follow-Up Studies ; Humans ; Pain, Intractable* ; Phantom Limb ; Spinal Nerve Roots*

The finding of a traumatic subdural hygroma(SDHy) raises the question of whether to remove it surgically or not, because the management is still controversial. There has been noting but CT scan and clinical findings for neurosurgeons to decide surgical management, and most of neurosurgeons are still dependent upon their own experiences to decide the way of management for SDHy. In the present study, the authors investigated the changes of cerebral blood flow in 10 patients with SDHy by SPECT, and their relationships with the clinical findings and the results of 6-months postinjury. This study indicates that hypoperfusion of the frontal cortex, examined within a week postinjury, is a good indication for surgical management, and improvement of hypoperfusion at the follow-up SPECT, 1 month later, can predict better prognosis particularly in the cases of young age without associated brain injuries.
Brain Injuries ; Follow-Up Studies ; Humans ; Prognosis ; Subdural Effusion* ; Tomography, Emission-Computed, Single-Photon ; Tomography, X-Ray Computed

Twenty-two surgical cases of myelopathy due to narrow thoracic spinal canal associated with degenerative changes of the posterior spinal elements have ever been reported in the literature since Govoni presented the first cases in 1971. Authors have experienced five surgical cases and added them to the above twenty-two cases. And clinical analysis was made with twenty-one cases, which had proper data to be analysed and included our own five cases. Thirteen patients were male and the average age was around fifty-five years. Most of the lesions were found in the lower thoracic spines and involved single segment in each patient. The symptoms were so various and non-specific that pertinent treatments were delayed and the disease had been misdiagnosed in most of the patients. Intrathecal enhanced spine CT might be most accurate diagnostic tool. Surgical decompression may proceed good results, even when symptoms have been presented for years.
Constriction, Pathologic* ; Decompression, Surgical ; Humans ; Hypertrophy* ; Male ; Prognosis ; Spinal Canal* ; Spinal Cord Diseases ; Spine

PURPOSE: Laparoscopic management of intestinal obstruction is hypothetically attractive, However little is known about this procedure in our country. With new advances in diagnostic and therapeutic tools such as laparoscopic procedures, the management of intestinal obstruction has become feasible. METHODS: In order to analyze the clinical results of laparoscopic adhesiolysis, a retrospective review of a consecutive series of 20 cases of intestinal obstruction unresponsive to medical management was done between 1997 and 2000. RESULTS: The mean surgical time for the laparoscopic procedure was 75 min and two cases were converted to open surgery due to dense adhesion and intestinal strangulation. The characterization of adhesion type included 10 cases with simple fibrotic band, 4 cases with multiple fibrotic band and 5 cases with dense adhesion. Additionally, the most common site for adhesion was the small intestine and colon (12 cases). The mean diet start time was 2.3 days, mean hospital stay was 4.7 days and totally mean analgesic use was 1.6 times. CONCLUSION: Laparoscopic management of adhesive bowel obstruction is feasible and safe in experienced hands. The laparoscopic procedure also is an excellent diagnostic modality in case of obstruction, and the majority of these cases can be simultaneously managed laparoscopically. A laparoscopic approach is recommend as a first choice of treatment for selective cases of intestinal adhesion.
Adhesives ; Colon ; Diet ; Hand ; Intestinal Obstruction ; Intestine, Small ; Length of Stay ; Operative Time ; Retrospective Studies

No abstract available.
Glomerulonephritis, IGA* ; Immunoglobulin A* ; Korea*

14 supratentorial and 6 infratentorial arachnoid cysts, diagnosed and treated at Kangnam St Mary's Hospital from 1983 to 1988, are reported. The most common presenting symptoms in children were craniomegaly, delayed development, increased ICP and neurological focal signs. Neuroradiological examination included plain skull X-ray, brain CT and metrizamide CT or isotope study. Therapeutic criteria according to the clinical and radiological findings were reviewed. The results were as follows; 1) The patient below age of 2 yrs who's brain had a potent ability of growth should be operated in any cases for reducing mass effect. 2) In sylvian lesion, Type II and III according to the classification of Galassi were well treated with C-P snunt. 3) In infratentorial lesion, all patients had hydrocephalus and the patient who had communicated with subarachnoid space in metrizamide CT were well treated with V-P shunt and who not communicated with subarachnoid space was well treated with Y-shunt. 4) We had good results by fenestration above the age of 3 yrs and by C-P shunt under the age of 2 yrs in supratentorial lesion.
Arachnoid Cysts* ; Brain ; Child* ; Classification ; Humans ; Hydrocephalus ; Metrizamide ; Skull ; Subarachnoid Space