No abstract available.
Spondylosis*

2268 cases of low back pain were analysed at the low back pain clinic, Department of Neurosurgery, Yongdong Severance Hospital Yonsei University College of Medicine from January to July 1986. 1) About 85.4% were in between 20's and 50's of age groups. 30's(25.7%) and 40's(24.7%) were common. Teenagers were about 5.9%. Male to female ratio was 1 : 1.1. 2) By occupations housewives were most common(40.5%), office workers 26.4% light workers 13.2%, and students 12.7% in order. But drivers(2.4%) and heavy workers(1.9%) were relatively rare. 3) About 30.7% of all patients had some history of trauma. Among them lifting was most common in 45.8%, exercise 17.8%, and traffic accident 10.8%. 4) About 37.8%(860 cases) had had various treatments before they came to our clinic. Among them, 63.6% had visited to other hospitals. 98 cases had had lumbar disc surgery at other hospitals. Among 860 cases physical therapies were 33.8%, acupunctures 22.8%, herb medications 13.4%, moxibustions 12.5%, chiropractics 5.5%, and religious methods 1.4%. 5) Diagnostic work up were done in 85%. Plain spine X-rays were taken in 97.8%, spine CT scan 53.7%, and myelography(Iopainidol) 7.6%. 6) Etiology of the low back pain were herniated lumbar disc 44.8%, mechanical low back pain syndromes 26.4%, degenerative spondylosis 22.1%, traumas 2.8%, spinal cord tumors 1.3%, failed back surgery syndromes 1.1%, spondylolysis 0.9%, spondylolisthesis 0.3% and infections 0.3%. 7) About 15.8% of all patients were admitted. Surgical treatments were done in 12.1%(275 cases), among them chemonucleolysis with chymopapain(Discase) were 6.6%(151 cases), lumbar discectomy 5.5%(122 cases) and posterior lumbar interbody fusion 2 cases. 8) In the past history 98 cases(4.3%) had had lumbar disc surgery at the other hospitals. Among them, 8 cases were reoperated.
Accidents, Traffic ; Adolescent ; Diskectomy ; Female ; Humans ; Intervertebral Disc Chemolysis ; Lifting ; Low Back Pain* ; Male ; Neurosurgery ; Occupations ; Spinal Cord Neoplasms ; Spine ; Spondylolisthesis ; Spondylolysis ; Spondylosis ; Tomography, X-Ray Computed

The aim of the spine fusion is to obtain the stability of the spine. Spinal fusion have been used for the treatment of tuberculosis and arrest of the progress of spinal deformity such as scoliosis. Nowadays the spine fusion is used often in conditions which present the instability; spondylosis, spondylolisthesis and the unstable postlaminectomy spine. Unilateral posterolateral fusion plus hemiposterior fusion were done only in the cases who had wide hemilaminectomy, while in rest of cases bilateral posterolateral fusion was indicated in this series. Fifty-two cases, treated with posterolateral lumber fusion during the period from June 1980 to Dec. 1985, were analysed clinically and radiologically and the following results were obtained. l. Among the 52 cases, 25 cases(48.1%) were male; and 27 cases(51.9%) were female; The youngest was 16 years of age and the oldest one was 63 years of age. Average age of the patient was 39.6 years. 2. Fifteen patients had spinal stenosis, 14 cases of spondylolisthesis, 11 cases of H.N.P., 6 cases of spondylolysis, 4 cases of tuberculous spondylitis and 2 cases of fracture-dislocation of lumbar spine. 3. As a method immobilization after operation, postoperatively hips spica cast was applied in 4 cases for 12 weeks, Norton-Brown back brace in 9 cases following 6 weeks of posloperative hip spica cast immobilization and Norton-Brown brace 39 cases following 2 weeks of postoperative bed rest. 4. In 41 cases bilateral posterolateral fusion was done, and in 11 cases unilateral posterolateral fusion plus hemiposterior fusion were done. The bony union was established within 4 months after bilateral posterolateral fusion in 37 cases and after unilateral posterolateral fusion in 9 cases. In 2 cases complete union was obtained within 6 months after fusion. 5. The union rate was 92.7% in bilateral posterolateral fusion and 90.9% in unilateral posterolateral fusion. There was no significant differences of the union rate between bilateral and unilateral fusion groups. Therefore, the unilateral posterolateral fusion is a suitable method in the treatment of mild spinal instability regardless of its causes. The procedure has benefits, such as short operation time, less blood loss, and less surgical burden to the patient.
Arthrodesis ; Bed Rest ; Braces ; Clinical Study ; Congenital Abnormalities ; Female ; Hip ; Humans ; Immobilization ; Male ; Methods ; Scoliosis ; Spinal Fusion ; Spinal Stenosis ; Spine ; Spondylitis ; Spondylolisthesis ; Spondylolysis ; Spondylosis ; Tuberculosis

STUDY DESIGN: A prospective radiographic study of cervical spine with congenital monosegment fusion. PURPOSE: To evaluate the effect of cervical synostosis on adjacent segments and the vertebral morphology. OVERVIEW OF LITERATURE: There are numerous clinical studies of adjacent segment disease (ASD) after monosegment surgical fusion. However, there was no report on ASD in the cervical spine with congenital monosegment synostosis. METHODS: Radiograms of 52 patients, aged 5 to 90 years, with congenital monosegment synostosis (CMS) between C2 and C6, who complained of neck/shoulder discomfort or pain were studied. 51 were normally aligned and one was kyphotically aligned. RESULTS: Spondylosis was not found in the patients below 35 years of age. Only 12 out of 24 patients with normally aligned C2-3 synostosis had spondylosis in 19 more caudal segments, and only one at C3-4. A patient with kyphotic C2-3 had spondylolysis at C3-4. In 8 patients with C3-4 synostosis, spondylosis was found in only 9 caudal segments (4 at C4-5, 4 at C5-6, and 1 at C6-7). The caudate C4-5 disc was the most liable to degenerate in comparison with other caudate segments. Caudal corporal flaring and inwaisting of the synostotic vertebra were the features that were the most evident. In 2 of 9 C4-5 and 7 out of 10 C5-6 synostosis patients, spondylosis was found at the two adjacent cephalad and caudate segments, respectively. Only corporal inwaisting without flaring was found. In all cases, spondylosis was confined to the adjacent segments. More advanced spondylosis was found in the immediate caudal segment than the cephalad one. CONCLUSIONS: It is concluded that spondylosis at the mobile segments in a synostotic spine is thought to be a fusion-related pathology rather than solely age-related disc degeneration. Those data suggested that CMS definitely precipitated the disc degeneration in the adjacent segments.
Humans ; Intervertebral Disc Degeneration ; Pathology ; Prospective Studies ; Spine* ; Spondylolysis ; Spondylosis ; Synostosis*

OBJECTIVE: The authors performed a retrospective study to assess the clinical and radiological outcome in symptomatic lumbar spondylolysis patients who underwent a direct pars repair surgery using two different surgical methods; pedicle screw with universal hook system (PSUH) and direct pars screw fixation (DPSF), and compared the results between two different treated groups. METHODS: Forty-seven consecutive patients (PSUH; 23, DPSF; 15) with symptomatic lumbar spondylolysis who underwent a direct pars repair surgery were included. The average follow-up period was 37 months in the PSUH group, and 28 months in the DPSF group. The clinical outcome was measured using visual analogue pain scale (VAS) and Oswestry disability index (ODI). The length of operation time, the amount of blood loss, the duration of hospital stay, surgical complications, and fusion status were also assessed. RESULTS: When compared to the DPSF group, the average preoperative VAS and ODI score of the PSUH group were less decreased at the last follow-up; (the PSUH group; back VAS : 4.9 vs. 3.0, leg VAS : 6.8 vs. 2.2, ODI : 50.6% vs. 24.6%, the DPSF group; back VAS : 5.7 vs. 1.1, leg VAS : 6.1 vs. 1.2, ODI : 57.4% vs. 18.2%). The average operation time was 174.9 minutes in the PSUH group, and 141.7 minutes in the DPSF group. The average blood loss during operation was 468.8 cc in the PSUH group, and 298.8 cc in the DPSF group. The average hospital stay after operation was 8.9 days in the PSUH group, and 7 days in the DPSF group. In the PSUH group, there was one case of a screw misplacement requiring revision surgery. In the DPSF group, one patient suffered from transient leg pain. The successful bone fusion rate was 78.3% in the PSUH group, and 93.3% in the DPSF group. CONCLUSION: The present study suggests that the technique using direct pars screw would be more effective than the method using pedicle screw with lamina hook system, in terms of decreased operation time, amount of blood loss, hospital stay, and increased fusion success rate, as well as better clinical outcome.
Collodion ; Follow-Up Studies ; Humans ; Leg ; Length of Stay ; Pain Measurement ; Retrospective Studies ; Spondylolysis ; Spondylosis

Humans ; Spondylosis ; diagnosis ; therapy

STUDY DESIGN: Descriptive cross-sectional study. PURPOSE: To determine the prevalence of lumbar spondylolysis and spondylolisthesis in a general adult population unrelated to lower back pain as evaluated by multidetector computed tomography. OVERVIEW OF LITERATURE: There is a significant paucity of information related to the prevalence of spondylolysis and spondylolisthesis and its degenerative changes in a general adult population unrelated to lower back pain in developing countries. METHODS: A retrospective study was conducted on abdominopelvic computed tomography (CT) scans performed between January 1st 2015 and December 31st 2015 for various clinical indications. Patients with lower back pain, with a history of trauma or road traffic accident, or referred from orthopedic or neurosurgery departments were excluded to avoid any bias. CT scans were reviewed in axial, sagittal, and coronal planes using bone window settings for evaluating spondylolysis and spondylolisthesis. RESULTS: Of 4,348 patients recruited, spondylolysis and spondylolisthesis were identified in 266 (6.1%) and 142 (3.3%) patients, respectively. Age was significantly higher in both spondylolysis and spondylolisthesis patients than in those without spondylolysis and spondylolisthesis (47.19±15.45 vs. 42.5±15.96, p<0.001 and 53.01±15.31 vs. 42.44±15.88, p<0.001, respectively). Gender was significantly associated with spondylolisthesis (p=0.029) but not spondylolysis. Of patients who were >60 years old, both spondylolysis (p=0.018) and spondylolisthesis (p=0.025) were significantly more prevalent in females. CONCLUSIONS: The prevalence of pars interarticularis fracture observed higher with gradual increase in the prevalence with advancing age. In particular, preponderance was significantly higher among older females.
Accidents, Traffic ; Adult* ; Bias (Epidemiology) ; Cross-Sectional Studies ; Developing Countries* ; Female ; Humans ; Low Back Pain ; Multidetector Computed Tomography* ; Neurosurgery ; Orthopedics ; Prevalence ; Retrospective Studies ; Spine ; Spondylolisthesis* ; Spondylolysis ; Spondylosis ; Tomography, X-Ray Computed

Of the 68 cervical spondyltic patients showing symptoms of radiculomyelopathy, assessments were made on 29 patients who underwent neural decompressive surgery with cervical laminectomy through posterior approach for the results of surgery. Analyses were also made on the anterior-posterior diameters of cervical canal on the plain film of cervical spine. The mean values of anterior-posterior diameters measured on the levels of cervical C3-7 were 16.5+/-1.83 mm in the normal adult and 7.3+/-1.08 mm in the cervical spondylotic patients with radiculomyelopathy, which is far narrower than that of the normal. In cervical spondylotic patients, the anterior-posterior diameters of directly upper and lower parts of the lesions were 11.9+/-1.20 mm and 12.1+/-1.61 mm respectively, also much narrower mean values than those of the normal control group. The results of the 29 patients who received cervical laminectomy by posterior approach were much improved for 51.7% and improved for 44.8%.
Adult ; Humans ; Laminectomy ; Spine ; Spondylosis*

Cervial spondylosis is one of the most common orthopedic diseases. But in recent years, onset age of cervical spondylosis becomes more and more younger, which not only cause serious physical and psychological pain on the patients, but also cause a series of social problems. The occurrence of youth cervical spondylosis caused by cervical bad learning work posture for a long time, but psychological factors cannot be igored. The disease belongs to the early stage of cervical spondylosis in fact, which results from power imbalance of neck muscle. Clinical symptom is given priority to with neck shoulder pain and discomfort, often show the cervical physiological curvature change on imaging and cervical instability. Prevention and treatment of youth cervical spondylosis should mainly focus on prevention. Comprehensive treatment should be provided as soon as possible after the clinical diagnosis of the disease in order to prevent the illness even worse. Conservative treatment is often applied, and the neck rehabilitation training cannot be ignored at the same time. It's necessary to further study about the pathogenesis of cervical spondylosis, which will help to enhance the understanding of the disease and better to guide the treatment. The review aims to make a conclusion about advancement in cervical spondylosis in youths in aspects of etiology, pathogenesis, clinical characteristics and treatment.
Humans ; Spondylosis ; diagnosis ; etiology ; therapy

Twenty seven patients of symptomatically unstable spondylosis or spondylolisthesis, that failed respond to conservative treatment, were treated with a simplified unilateral posterior lumbar interbody fusion in which the disc was removed and replaced by two bone dowels and chip bones. The symptomatic spinal canal was decompressed by removing lamina and/or unroofing the intervertebral foramen, unilaterally or bilaterally, removing disc, and decorticate partially the adjacent vertebral bodies in semicirculr fashion unilaterally. The exposed intervertebral tunnel was packed with chip bones and two biocortical bone dowels serially, and reinforced by small bone screw. The clinical status and stability were verified by clinical examination and motion roentgenographic films during follow up period, which ranged from 8 to 20 months. Symptomatic improvement was observed in 23 cases (85%) and solid fusion was confirmed by stress view and computed tomography at 3 or 6 months after operation in 24 cases (89%). The complication rate was 41%(11 cases) in which all but one cases of nerve injury were resolved within 3 months while reoperation was needed in 3 cases.
Bone Screws ; Follow-Up Studies ; Humans ; Reoperation ; Spinal Canal ; Spondylolisthesis ; Spondylosis