No abstract available.
Longitudinal Ligaments*

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.
Fatigue* ; Sciatica*

No abstract available.
Electrocardiography, Ambulatory*

No abstract available.

No abstract available.
Spondylolisthesis*

No abstract available.

BACKGROUND & OBJECTIVES: After introduction of MRI with excellent capability of diagnosis In intracerebral hemorrhage (ICH), old ICH is more readily detected in patients with ischemic stroke. However, very few studies have addressed the identification of clinical significance of mixed stroke. The aims of the study are to elucidate the incidence and the location of the coexisting ICH in non-embolic ischemic stroke. Also we tried to seek the difference of the vascular risk factors between ischemic strokes combined with and without ICH. MEHTODS: Having 222 patients with non-embolic ischemic stroke as subjects, we reviewed the clinical data and MRIs of them retrospectively. We have defined mixed stroke as ischemic stroke combined with MR evidence of coexisting old ICH. The diagnosis of old ICH was made on the basis of the following findings; T2 weighted image showing a low signal intensity lesion with or without a hyperintesity area within it, and Tl weighted image revealing a low intensity lesion in the corresponding area. The frequency of vascular risk factors in the patients with mixed stroke was compared to that of those with pure ischemic stroke. RESULTS: MRI examinations showed old coexisting ICH in 10.4% (23) of 222 non-embolic ischemic stroke patients. Of 23 patients, nineteen patients had old ICH associated with multiple lacunar infarction and others were cortical infarction. The anatomic distribution of the hemorrhage was as follows; basal ganglia and internal capsule 19(78.3%), thalamus 3(13.1%), corona radiata 1 (4.3%), cerebellum 1 (4.3%). Analyzing the vascular risk factors, no significant difference was noted between lacunar infarctions and mixed stroke. CONCLUSION: The results of the study support that lacunar infarction and hypertensive ICH are bases on similar vascular pathophysiology. Therefore, old intracerebral hemorrhage may have a similar significance as a risk factor like previous ischemic stroke and inadvertent anti-thrombotic therapy might be avoided in certain stroke subtypes, which must be defined in future study.
Basal Ganglia ; Cerebellum ; Cerebral Hemorrhage ; Diagnosis ; Hemorrhage ; Humans ; Incidence ; Infarction ; Internal Capsule ; Magnetic Resonance Imaging ; Retrospective Studies ; Risk Factors ; Stroke* ; Stroke, Lacunar ; Thalamus

We present a retrospective study on the results of posterior instrumentation with various devices after thoracolumbar spinal injuries. From Jaunary 1985 to December 1990, we operated 61 patients in Soonchunhyang University Chonan Hospital. Fourty-six patients were followed at least three months(three to 40 months). Rod system was used in 21 patients and pedicle screw system was used in 27 patients. In two patients, both systems were used. We divided them into two group ; Group A for the patients operated with rod system and Group B for the patients operated with pedicluar screw system. We analysed and compared the results of these two groups. There were no significant differences in the age, sex, causes of injury, levels and types of injury, and the incidence of cord injury. The final wedge deformity was less severe in Group B than A(P<0.02). However, the final angular deformity did not significantly differ in two groups. The mean hospital stay of Group B was shorter than that of Group A, but the difference was not statistically significant. Although there was no statistical significance, the final wedge deformity was severe in patients who were older than 40 years of age, who follwed up for more than 300 days, and who had cord injury. The final wedge deformity and angular deformity were severe in patients whose preoperative deformity was great(P<0.05 and P<0.02, respectively). The angular deformity was also severe Group A, in patients who had cord injury, who followed up for more than 300 days, and who were younger than 40 years of age, but these differences lack the statistical significance. Although the rate of complication in Group B(40.7%) was higher than Group A(28.6%), this diference was not significant. The most common complication was rod displacement in Group A and screw fracute in Group B. Pedicle screw system was superior to the rod system in this study. Improving the instruments and accumulating clinical experiences, pedicle screw system will be an effective method for thracolumbar stabilization.
Chungcheongnam-do ; Congenital Abnormalities ; Humans ; Incidence ; Length of Stay ; Retrospective Studies ; Spinal Injuries

The authors present the case of sciatica due to bicortical sacral screw impingement on the lumbosacral plexus across the anterior sacrum. The placement of sacral screw across the anterior sacral cortex carries significant inherent risks to neurovascular and visceral structures. However, the clinical reports of lumbosacral plexus involvement by the misplaced screw are not well documented in the literature. This is an unique case of sciatica due to sacral screw impingement on the lumbosacral plexus after motor vehicle accident(MVA), and confirmed by CT scan and intraoperative electrical stimulation. We reviewed sacral anatomy and preventive measures for avoiding complication of this type are discussed.
Electric Stimulation ; Lumbosacral Plexus* ; Motor Vehicles ; Sacrum ; Sciatica* ; Tomography, X-Ray Computed