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

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

Eighty-four patients whose cervical lesions not associated with any trauma or tumor were operated for anterior cervical interbody fusion. The patients were separated into two groups, one group operated with a cervical plate and the other group, without the cervical plate. The mean follow-up duration in anterior cervical interbody fusion with cervical plate cases was 16 months(from 6 months to 30 months), without cervical plate 35 months(from 6 months to 84 months). Retrospective analysis of the two groups were done in order to compare the incidence of postoperative complications, clinical outcome, and radiological changes. The most notable postoperative complications of the group operated without the cervical plate were migration of the bone graft(3.3%) and angulation(3.3%), whereas of the group operated with the cervical plate were screw loosening(4.2%) and infection of the operative wound(4.2%). Comparative analysis of the postoperative clinical outcome and changes in radiological measurement of the intervertebral heights and angles showed no statistically significant difference between the two groups. The results of this study suggest that whether or not the cervical plate should be used for anterior cervical interbody fusions requires a decision made carefully and meticulously by the operator, so that the possibility of any postoperative complications can be minimized.
Follow-Up Studies* ; Humans ; Incidence ; Postoperative Complications ; Retrospective Studies

OBJECTIVE: The purpose of this study was to determine the optimal volume of injected cement and its distribution when used to treat vertebral compression fractures, and to identify factors related to subsequent vertebral fractures. METHODS: A retrospective analysis of newly developing vertebral fractures after percutaneous vertebroplasty was done. The inclusion criteria were that the fracture was a single first onset fracture with exclusion of pathologic fractures. Forty-three patients were included in the study with a minimum follow up period of six months. Patients were dichotomized for the analysis by volume of cement, initial vertebral height loss, bone marrow density, and endplate-to-endplate cement augmentation. RESULTS: None of the four study variables was found to be significantly associated with the occurrence of a subsequent vertebral compression fracture. In particular, and injected cement volume of more or less that 3.5 cc was not associated with occurrence (p = 0.2523). No relation was observed between initial vertebral height loss and bone marrow density (p = 0.1652, 0.2064). Furthermore, endplate-to-endplate cement augmentation was also not found to be significantly associated with a subsequent fracture (p = 0.2860) by Fisher's exact test. CONCLUSION: Neither volume of cement, initial vertebral height loss, bone marrow density, or endplate-to-endplate cement augmentation was found to be significantly related to the occurrence of a subsequent vertebral compression fracture. Our findings suggest that as much cement as possible without causing leakage should be used.
Bone Marrow ; Follow-Up Studies ; Fractures, Compression ; Fractures, Spontaneous ; Humans ; Retrospective Studies ; Vertebroplasty

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

OBJECTIVE: The aim of this study is to analyze the clinical symptoms, radiological changes, interval from first operation to symptom recurrence and to propose the proper treatment method for re-operated patients following chronic subdural hematoma surgery. METHODS: Between January 1992 and April 2003, 18 of 138patients of chronic subdural hematoma repeatedly underwent surgical treatment. The symptoms, mental status by Bender grade, radiological hematoma size and midline shifting, interval from symptom onset to diagnosis, surgical method and prognosis by Glasgow outcome scale(GOS) between the first attack and the recurrence were compared. RESULTS: The symptoms at the time of recurrence were nearly the same as with the first attack, but two patients(2/18, 11.1%) showed a more declined mentality. In addition, the recurred hematoma sizes were the same or large than those previously found. Many patients were recurred within two weeks(13/18, 72.2%). Most patients were operated on using the previous burr hole, with the exception of one patient who recurred at a different site. All patients had a good prognosis more than GOS 4(GOS 4: 4 , GOS 5: 12), but two died due to extracranial complication and infection. CONCLUSION: These results suggest that the early diagnosis and treatment are important, mostly recurred same symptoms within two weeks. Re-operation using the previous burr hole site is a good method.
Diagnosis ; Early Diagnosis ; Hematoma ; Hematoma, Subdural, Chronic* ; Humans ; Prognosis ; Recurrence ; Retrospective Studies*

Repeated surgery of the lumbar spine after lumbar discectomy was not uncommon. Total 817 cases of lumbar disorders were carried out surgical intervention in author's clinic from Jan. 1993. to May 1997. Among them, 82 cases were reoperated cases after lumbar disc surgery. The causes, methods and outcome of reoperation were reviewed. The most common causes of reoperation was epidural adhesion, and the most frequent method of reoperation was the interbody fusion with adhesiotomy. Epidural fibrosis was the major problem and must be studied forward for preventing reoperaion.
Diskectomy ; Fibrosis ; Reoperation* ; Spine