No abstract available.
Cystadenocarcinoma, Mucinous* ; Humans* ; Mucins*

The vertebral pedicle is an important structure used as an implant site for spinal instrumentation surgery. Since precise anatomical knowledge of lumbar pedicles in vivo is essential for risk - free surgery, we analyzed Korean vertebrae with radiologic imaging techniques. The authors analayzed 500 pedicles from L1 to L5 vertebrae with computerized tomograms (CT) and simple radiograms taken from patient free of vertebral abnormality. Five morphometric parameters: transverse pedicle width, transverse pedicle angle, sagittal pedicle width, sagittal pedicle angle depth to anterior cortex were measured. The transverse diameter and angle of pedicle increased gradually from L1 to L5, while the sagittal diameter and angle decreased from L1 to L5. The depth to anterior cortex from posterior elements was longer along the pedicle axis than along axis parallel to midline.
Axis, Cervical Vertebra ; Humans ; Lumbar Vertebrae* ; Spine

A patient is presented with a cervical spinal cord transection which occurred after a motor vehicle accident in which the air bag deployed and the seat belt was not in use. The patient had complete quadriplegia below the C5 level and his imaging study showed cervical cord transection at the level of the C5/6 disc space with C5, C6 vertebral bodies and laminar fractures. He underwent a C5 laminectomy and a C4-7 posterior fusion with lateral mass screw fixation. Previous reports have described central cord syndromes occurring in hyperextension injuries, but in adults, acute spinal cord transections have only developed after fracture-dislocations of the spine. A case involving a post-traumatic spinal cord transection without any evidence of radiologic facet dislocations is reported. Also, we propose a combined hyperflexion-hyperextension mechanism to explain this type of injury.
Accidents, Traffic ; Adult ; Cervical Vertebrae/*injuries/radiography/surgery ; Fracture Fixation, Internal ; Humans ; Laminectomy ; Male ; Spinal Cord Injuries/etiology/*radiography/surgery ; Tomography, X-Ray Computed

Congenital intraspinal epidermoid tumors, while rare, do occur ; that they are related to spinal puncture is less well understood. This article describes the case of a 10 year-old boy with intraspinal epidermoid tumor, who five years previously had undergone lumbar puncture. A striking clinical features of this case is pain in the lower extremity. In this report, we review the literature and discuss the probable developmental mechanism of such tumor.
Child ; Humans ; Lower Extremity ; Male ; Spinal Puncture* ; Strikes, Employee

OBJECTIVE: Total intervertebral disc replacement is designed to preserve motion and avoid limitations of fusion after removing local pathology. The authors report the results of a signle-center study to determine functional and radi- ologic outcomes associated with cervical total disc replacement versus those of cervical fusion. METHODS: We retrospectively reviewed the charts and radiographs of patients who underwent a total intervertebral disc replacement(TDR) or a single-level anterior cervical fusion(ACDF) between January 1, 2004, and September 31, 2007. Clinical symptom was assessed using the Visual Analog Scale(VAS) of the neck and of the arm pain. Range of motion was determined by radiologic assessment of flexion-extension radiographs. Data were collected before surgery and at 6 weeks, 3, 6, 12, and 24 months after surgery. RESULT: A total of 125 patients were identified with 63 having TDR(43 males and 20 females) and 62 having fusion(42 males and 20 females). The average age was 49.1 years(TDR) and 51.7 years(ACDF)(p=0.229). The mean neck pain VAS before surgery was 6.52(TDR) and 6.61(ACDF)(p=0.732). At 2-year follow-up, the average neck pain VAS for the TDR group was 1.59 and ACDF 1.85(p=0.168). The mean arm pain VAS before surgery was 6.37(TDR) and 6.60(ACDF)(p=0.335). At 2 years: 1.41(TDR) and 1.65(ACDF)(P = 0.148). More motion(an average of 9.00 degrees at 24 months) was retained after surgery in the TDR group than the fusion group at the treatment level. There was no significant diffe- rence in motion at adjacent levels. CONCLUSION: Total disc replacement maintained physiological segmental motion at the 2-year follow-up. The finding that there was no statistically significant difference between the groups in motion at adjacent levels must be verified on further studies.
Arm ; Biomechanics ; Follow-Up Studies ; Humans ; Intervertebral Disc ; Male ; Neck ; Neck Pain ; Range of Motion, Articular ; Retrospective Studies ; Total Disc Replacement

It has long been thought that in individuals with congenitally narrower spinal canals, the risk of spinal cord injury might be increased. The purpose of the present study was to quantitatively assess spinal cord pressures in cadaveric human cervical spines with narrow and wide canals, and with normal and degenerative columns. Twelve human cadaveric cervical spine preparations were evaluated on the basis of their level of degeneration and canal size. A drop mass assembly was constructed with different combinations of masses to produce 24 possible drop combinations for each spine preparation. These resulted in input energies from 100 to 1000 'gram-centimeters'. Cadaver cervical spine was instrumented with a collagen encased artificial spinal cord and seven sensor transducer arrays recorded pressures on the cord during the impact event. The results indicated that depending on the extent and and level of degeneration, degenerated spinal columns produced distinctly different patterns of cord pressure. Normal spinal columns produced consistent patterns of high pressures under the impact site, but this decreased caudally and cranially. In specimens with narrow spinal canals, cord pressures under the impact site were significantly higher than in specimens with wide canals. For the higher drop energies(800 and 1000 'g-cm') the disparity between narrow and wide canal specimens increased. This implies that for the same inpt drop energy, the propensity for spinal cord injury is higher for narrower spinal canals than for those which are wider.
Cadaver ; Collagen ; Humans ; Spinal Canal ; Spinal Cord Injuries ; Spinal Cord* ; Spine ; Transducers

Osteochondromas make up about 30% to 40% of benign bone tumors. Most are solitary lesions but some are multiple, usually with autosomal dominant inheritance. From 1% to 4% of osteochondromas occur in the spine, where they can cause a variety of signs and symptoms, including those of spinal cord compression. Isolated osteochondromas are usually of little significance. However, if they are located near neural structures, they may cause irritation due to mechanical compression. In patients with hereditary multiple exostoses who present with neck or back pain, and particularly in those who have neurologic symptoms in the upper or lower extremities, a diagnosis of intracanalicular osteochondroma should be presumed until proven otherwise. Computerized tomography(CT) and MRI are the imaging procedures of choice. Prompt surgical excision affords the best prognosis for these patients who have spinal cord compression secondary to intracanalicular osteochondroma.
Back Pain ; Diagnosis ; Exostoses* ; Exostoses, Multiple Hereditary ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Neck ; Neurologic Manifestations ; Osteochondroma* ; Prognosis ; Spinal Cord Compression ; Spine ; Wills

The occurrence of cerebellopontine angle(CPA) medulloblastoma is a rare phenomenon. This article describes the case of a 30-year-old man who presented with headache, nystagmus and cerebellar dysfunction of one month's duration. The tumor arose from the left flocculus or adjacent cerebellar hemishere and projected into the cerebellopontine angle. We review the literature and discuss the clinical characteristics and pathogenesis of CPA medulloblastoma.
Adult ; Cerebellar Diseases ; Cerebellopontine Angle* ; Headache ; Humans ; Medulloblastoma*

We describe a case of brain abscess which developed in a 64-year-old man after hepatic artery chemoem-bolization(HACE) for hepatocellular carcinoma(HCC).On his first admission, percutaneous liver biopsy led to a diagnosis of type-C liver cirrhosis, he readmitted 5 years later and HCC was diagnosed. The patient underwent two HACE procedures, with a two-month interval. Three month later, he was readmitted to hospital with headache and brief loss of consciousness; brain magnetic resonance imaging(MRI) revealed a brain abscess. Stereotactic aspiration was performed and antibiotics sensitive to the klebsiella pneumonia bacteria cultured in the abscess were administrated intraveously. One month later, the abscess size became smaller and the patient was discharged. This report reviews the literature and discusses the pathogenesis of brain abscess after intra-arterial embolization.
Abscess ; Anti-Bacterial Agents ; Bacteria ; Biopsy ; Brain Abscess* ; Brain* ; Carcinoma, Hepatocellular* ; Diagnosis ; Headache ; Hepatic Artery* ; Humans ; Klebsiella ; Liver ; Liver Cirrhosis ; Middle Aged ; Pneumonia ; Unconsciousness

Neuroendocrine tumors are heterogeneous and potentially aggressive, and they must be distinguished from classic carcinoid tumors as the tumors share histologic features with their counterparts that occur in the lung, such as oat cell and intermediate cell carcinomas. Histopathologically, the oat cell neuroendocrine carcinoma displays itself in sheets, cord and rib-bons of small hyperchromatic, undifferentiated cells with very scanty cytoplasm. The intermediate cell is slightly larger than the oat cell and has more abundant cytoplasm. The authors report a case of a 52-year old patient with neuroendocrine carcinoma that occurred at the anterior cranial fossa extending into the nasal cavity. The patient presented with recurrent meningitis and seizure. Histological examination of the nasal biopsy tumor specimen confirmed neuroendocrine carcinoma, afterwhich the patient treated with a 4300 rad radiation therapy. Magnetic resonance imaging taken 2 years later showed an enlargement of the tumor mass at the anterior cranial fossa, and the patient was operated for removal of the intracranial tumor. The nasal cavity defect was reconstructed using rotation galeal flap technique.
Avena ; Biopsy ; Carcinoid Tumor ; Carcinoma, Neuroendocrine* ; Cranial Fossa, Anterior* ; Cytoplasm ; Humans ; Lung ; Magnetic Resonance Imaging ; Meningitis ; Middle Aged ; Nasal Cavity ; Neuroendocrine Tumors ; Seizures