No abstract available.
Longitudinal Ligaments*

No abstract available.

No abstract available.
Fatigue* ; Sciatica*

No abstract available.
Electrocardiography, Ambulatory*

Vertebroplasty was introduced in 1987 for painful cervical hemangioma. Since then, there has been an explosion of interest in this remarkable procedure, which can be useful for the majority of vertebral fractures throughout the spinal column. This procedure is indicated for painful vertebral compression fracture(VCF) due to osteoporosis or malignancy, and for painful hemangiomas. Vertebroplasty is the injection of bone cement, generally polymethylmethacrylate (PMMA), into a vertebral body (VB). Kyphoplasty is the placement of balloons into the VB, followed by an inflation/deflation sequence to create a cavity prior to the PMMA injection. These procedures are most often performed in a percutaneous fashion under local anesthesia. Although these methods are minimally invasive procedure, numerous complications can occur. The common complications include bleeding at the puncture site, PMMA leakage, local infection, and adjacent vertebral body fracture. A grave complication, which is rarely reported, is pulmonary embolism by PMMA leakage. These procedures can reduce pain in about 90% of patients with osteoporotic VCFs. Additionally, improvements in mobility and in activities of daily living occur. The success rate is slightly less in patients with metastatic VCFs than osteoporotic VCFs. Much evidence favors the use of these procedures for pain associated with the aforementioned disorders. The risk/benefit ratio appears to be favorable in carefully selected patients. This article summarizes the indications, techniques, complications and outcomes for the vertebroplasty and kyphoplasty.
Activities of Daily Living ; Anesthesia, Local ; Explosions ; Hemangioma ; Hemorrhage ; Humans ; Kyphoplasty ; Osteoporosis ; Polymethyl Methacrylate ; Pulmonary Embolism ; Punctures ; Spine ; Vertebroplasty

No abstract available.
Spondylolisthesis*

No abstract available.

Acute subdural hematoma (ASDH), chronic subdural hematoma (CSDH) and subdural hygroma (SDG) occur in the subdural space, usually after trauma. We tried to find a certain relationship among these three traumatic subdural lesions in 436 consecutive patients. We included all subdural lesions regardless of whether they were main or not. We evaluated the distribution, age incidence and interval from injury to diagnosis of these lesions, and the frequency of new subdural lesions in each lesion. ASDH constituted 68.6%, SDG 15.8%, and CSDH 15.6%, Age incidence of CSDH was similar to that of SDG, but differed from that of ASDH. Mean interval from injury to diagnosis was 0.4 days in ASDH, 13.4 days in SDG, and 51.6 days in CSDH. Focal brain injuries accompanied in 37.5% of ASDH, 5.8% of SDG, and no CSDH. In ASDH, 2 recurrent ASDHs, 17 SDGs and 9 CSDHs occurred. In SDG, 3 postoperative ASDHs and 8 CSDHs occurred. In CSDH, 2 postoperative ASDHs, 2 SDGs and 1 CSDH occurred. These results suggest that the origin of CSDH is not only ASDH, but also SDG in upto a half of cases. SDG is produced as an epiphenomenon by separation of the dural border cell layer when the potential subdural space is sufficient. A half of CSDHs may originate from ASDHs. ASDH may occur in CSDH by either a repeated trauma or surgery. Such transformation or development of new lesions is a function of a premorbid condition and the dynamics between the absorption capacity and expansile force of the lesion.
Adolescent ; Adult ; Age Factors ; Aged ; Brain Injuries/complications/pathology ; Child ; Female ; Glasgow Coma Scale ; Hematoma, Subdural/etiology/*pathology/therapy ; Human ; Male ; Middle Age ; Subdural Space/*pathology ; Tomography Scanners, X-Ray Computed

The following is our report a series of 220 patients who visited the neurosurgical out-patient department from January 1994 to June 1994 complaining of low back pain. We investigated how they were treated and what was the outcome on December 1995. Three certified neurosurgeons had managed these patients. Although the patients were not significantly different in terms of age, sex, and the duration of pain, the diagnostic methods(p<0.005), impression(p<0.01), and the methods of treatment(p<0.01) differred from doctor to doctor. The rates of admission and operation were 11.8% and 7.3%, respectively, and found to be consistent among doctors. We conducted telephonic interviews of 123 patients during December 1995 with the following outcome : improved in 69.1%, unchanged in 22.0%, and aggravated in 4.1%, together with six(4.9%) deaths. The cause of death was cancer in four cases, respiratory failure in one, and unknown in one. Sixteen patients underwent surgery in this hospital, while the other 12 patients were operated on in other hospitals. The outcome was favorable when 1) the patients were female, 2) the age was 21-40 years old, 3) presence of sciatica, 4) the duration was 1 week to 3 months, 5) the diagnostic impression was herniated lumbar disc, 6) drugs were not prescribed, and finally 7) managed by senior doctor. However, these differences were statistically not significant(p>0.1). Although low back pain is a very common complaint, there was enormous ambiguity with respect to its diagnosis and management. Neverthless, the outcomes were not significantly different. Despite the above, we still feel that low back pains should be more systematically classified and precisely dignosed. Also the therapeutic efficacies of different modalities of treatment should be critically reviewed.
Cause of Death ; Diagnosis ; Female ; Humans ; Low Back Pain* ; Outpatients* ; Respiratory Insufficiency ; Sciatica

The purpose of this study was to determine the factors which were responsible for delaying early diagnosis and optimal management of rheumatoid arthritis (RA) in Korea. We interviewed 109 outpatients diagnosed as RA being treated by rheumatologists, and we eventually analyzed 98 patients' data. The median length of time from symptom onset to the first visit to a medical doctor, to diagnosis, and visiting a rheumatologist were 8 weeks, 23 weeks, and 42 months respectively. The subspecialist with whom the patients consulted with for the longest time before visiting a rheumatologist were an orthopaedic surgeon for 51 patients, a Chinese herbal doctor for 19 patients, and a pharmacist for 16 patients. For early diagnosis and optimal management of RA in Korea, we believe that it is necessary to reduce the use of unconventional medical services such as Chinese herbal medicine and nonprescribed medication, and to emphasize rheumatologic and rehabilitative care in the early stage.
Adult ; Alternative Medicine/utilization ; Arthritis, Rheumatoid/therapy* ; Arthritis, Rheumatoid/rehabilitation ; Female ; Health Services/utilization* ; Human ; Korea ; Male ; Middle Age ; Rheumatology/methods