No abstract available.
Lipomatosis*

The pathological lesion in spinal injury is usually more severe in the central gray matter and spreads centrifugally to surrounding white matter. Opiate antagonists, naloxone, by blocking the pathophysiologic effect of endorphins, should increase both mean arterial pressure and spinal cord blood flow and limit neurologic injury. Naloxone produce increase of lateral column blood flow and ameliorate the central gray matter ischemia. We have investigated the effects of naloxone on histopathological change in cats subjected to thoracic cord contusion. The histopathological evaluation of the injured spinal cords in naloxone-treated cats had less tissue damage than would be observed in time-matched standards. The acute histopathology in saline-treated cats had lesions typical of what we would expect in untreated cats, but the chronic histopathology had slightly better than typical that.
Animals ; Arterial Pressure ; Cats ; Contusions ; Endorphins ; Ischemia ; Naloxone* ; Spinal Cord Injuries* ; Spinal Cord* ; Spinal Injuries

No abstract available.
Meningioma* ; Paragonimiasis*

OBJECTIVE: Anterior wedge compression fractures and burst fractures have different clinical features, treatment methods and risks of neurologic deficits. The aim of this study was to evaluate the radiological differences and postoperative risk due to cement leakage after vertebroplasty. METHODS: From January 2007 to December 2008, we retrospectively analyzed the radiological features of 43 patients. We divided the patients into three groups by the degree of the displaced bony fragments into the spinal canal. The change of the compression ratio, the kyphotic angle, the presence of cement leakage and the occurrence of major complications were investigated. RESULTS: The immediately postoperative improvement of the compression ratio was significantly better in the anterior wedge compression fracture group than that in the burst compression group (p-value: 0.022). Cement leakage was more common in the burst fracture group even though this was not statistically significant (p-value: 0.114), but cement leakage into spinal canal did not occur. There was no major complication, including embolism and additional neurologic deficit, after vertebroplasty in all the patients. CONCLUSION: Vertebroplasty was the more effective method for treating an anterior wedge fracture than a burst fracture, and especially for achieving an improved compression ratio. Even though the risk of cement leakage may be higher for a burst fracture, vertebroplasty may be also carefully applied to burst fracture patients with no neurologic deficits at admission.
Embolism ; Fractures, Compression ; Humans ; Neurologic Manifestations ; Retrospective Studies ; Spinal Canal ; Spinal Cord Compression ; Vertebroplasty

A case of endodermal sinus tumor in the pineal region of a 12-year-old boy is presented. Preponderance of this tumor occurs in the boys, usually in their second decade. The tumor is characterized by perivascular structure(Schiller-Duval body) which simulate endodermal diverticula of yolk sac origin. His serum alpha-fetoprotein levels was abnormally high(over 400ng/ml) He was treated with operation and irradiation of 4500rad to the whole brain and spinal axis. But he died 6 month later after operation. The authors report a case of endodermal sinus tumor arising from pineal gland and briefly review literature.
alpha-Fetoproteins ; Axis, Cervical Vertebra ; Brain ; Child ; Diverticulum ; Endoderm* ; Endodermal Sinus Tumor* ; Humans ; Male ; Pineal Gland ; Yolk Sac

OBJECTIVE: Unilateral percutaneous vertebroplasty is a widely accepted treatment for osteoporotic vertebral compression fractures (VCFs). However, bone cement may fail to fill both hemivertebra from the single needle. We assessed the radiographic and clinical outcome of hemivertebroplasty (HVP) and evaluated the factors that affect subsequent VCFs after HVP. METHODS: Fifty two patients who underwent HVP were reviewed. VCFs were identified based on clinical and radiological findings. The patients were grouped into two groups: 1) no subsequent VCFs, 2) subsequent VCFs. We evaluated the association between age, sex, body mass index (BMI) and bone mineral density (BMD) and subsequent VCFs. We also assessed the impact of location, type and grade of fracture, endplate fracture, burst fracture, bone cement volume on subsequent VCFs. We analyzed the compression ratio, wedge angle, kyphotic angle, and visual analogue scale (VAS) score in both groups. RESULTS: There were no significant differences in age, gender, BMI, and BMD between two groups. No significant difference was also found in pre-existing VCF, location, type and grading of fracture, endplate fracture, burst fracture, amount of bone cement, and radiological findings such as compression ratio, wedge angle, and kyphotic angle between two groups. The final mean VAS scores of patients with or without subsequent VCFs were 3.11 and 4.02, respectively. CONCLUSION: No major risk factors for the subsequent VCFs after HVP were found. However, we identified adjacent fractures, refractures, and remote fractures after HVP in chronological order. Therefore, long-term follow-up is necessary to evaluate the effectiveness of HVP to osteoporotic VCFs.
Body Mass Index ; Bone Density ; Follow-Up Studies ; Fractures, Bone ; Fractures, Compression ; Humans ; Needles ; Osteoporotic Fractures ; Risk Factors ; Vertebroplasty

The authors report our recent experience with 4 cases of syringomyelia that had developed secondary to tuberculous meningitis. Three cases of syringomyelia were treated by syringoperitoneal shunt and 1 case, by syringosubarachnoid shunt. Postoperatively, upper and lower extremity pain that had persisted in all the patients was relieved in all the patients, but improvement in limb sensation was noted in only 1 case. Improvement in limb motor power was noted in 3 cases. The clinical presentation, surgical consideration, and pathogenesis of syringomyelia is discussed together with a review of the literature.
Extremities ; Humans ; Lower Extremity ; Sensation ; Syringomyelia* ; Tuberculosis, Meningeal*

Tuberculosis is still remains an important cause of morbidity and mortality throughout the world. Calvarial tuberculosis is a rare entity and when the primary lesion is in the calvarium without any detectable pulmonary lesion, it is even exeedingly rare. The authors present a case of a 60-year-old female patient presenting with headache and an area of painful protrusion in the left parietal scalp. Plain skull radiographs, computerized tomography(CT) scan and magnetic resonance(MR) image of the brain revealed an osteolytic lesion in the left parietal bone with an outward growth of the outer table. Chest radiograph was normal. At operation, the osteolytic lesion of the skull and the abnormal soft tissue were removed completely. Histopathological report on the surgical specimen confirmed the tuberculosis of the calvarium.
Brain ; Female ; Headache ; Humans ; Middle Aged ; Mortality ; Parietal Bone ; Rabeprazole ; Radiography, Thoracic ; Scalp ; Skull ; Tuberculosis*

OBJECTIVE: The goal of study is the evaluation of clinicofunctional outcomes and fusion success rates of unilateral posterior lumbar interbody fusion(PLIF) using cages. METHODS: The authors conducted retrospective study of 81 patients who underwent unilateral PLIF using cages. The outpatient notes, standard hospital charts, and pre-and postoperative imaging studies were analyzed. In this study pre-and postoperative back pain, radiating pain, fusion success rates, pseudoarthrosis, clinicofunctional outcome, and complications were evaluated. Follow-up duration ranged from 3 to 8 years. RESULTS: Eighty-one patients underwent unilateral PLIF using 98 cages(TFC:37, CH cage:25, Novus cage 36). Two-level fusion was performed in 17 patients. There were 48 men(59%) and 33 women(41%). Seventh decade was most common(47%). The most common site of PLIF was at L4-5 space(69.4%) and left side(58%) was prevalent. Fusion was successful in 91 out of 98 levels(92.8%) and pseudoarthrosis was observed in five patients(7 level, 7%). The clinicofunctional results by Prolo scale were as follows:good(score 8-10):80.3%, moderate(score 6-7):14.8%, poor(score 5 or less 5):4.9%. Device migration was observed in six cases:5(20%) of 25 CH cages and 1(2.8%) of 36 Novus cages. CONCLUSION: Unilateral PLIF using cage is one of method to decrease the rates of iatrogenic complications in patient of unilateral symptomatic spinal instability while preserving normal anatomic structures with good fusion success rates and clinicofunctional results after surgery.
Back Pain ; Follow-Up Studies ; Humans ; Outpatients ; Pseudarthrosis ; Retrospective Studies

Traumatic spinal subdural hematoma associated with intracranial subdural hematoma is a rare condition. Herein, we report the case of a 62-year-old man with lower back pain, radiating pain, and numbness in both lower extremities, without motor weakness, for 2 weeks. Lumbar magnetic resonance imaging (MRI) revealed high signal intensity on T1-weighted image (WI), and low signal intensity on T2-WI from L2 to L5. Two weeks after conservative management, follow-up lumbar MRI did not show the hematoma and his symptoms were relieved and there was no neurological deficit; therefore, he was discharged. However, subsequently, intracranial subdural hematoma increased and upper extremity motor weakness appeared. This was treated surgically. If there is no neurological deficit, conservative treatment may be a good option. Follow-up evaluation for asymptomatic cranial subdural hematoma is necessary.
Follow-Up Studies ; Hematoma ; Hematoma, Subdural ; Hematoma, Subdural, Intracranial* ; Hematoma, Subdural, Spinal* ; Humans ; Hypesthesia ; Low Back Pain ; Lower Extremity ; Magnetic Resonance Imaging ; Middle Aged ; Spinal Cord Injuries ; Upper Extremity