No abstract available.
Longitudinal Ligaments*

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.
Fatigue* ; Sciatica*

No abstract available.

No abstract available.
Spondylolisthesis*

No abstract available.

Two hundreds and four consecutive patients who sustained proven spontaneous subarachnoid hemorrhage with conservative treatment were studied retrospectively. The reasons for conservative treatment were poor condition for surgery, difficulties in surgery and operation refusal. Comparative study was done in proven 47 cases of aneurysmal SAH, 27 cases of SAH with negative angiography and 130 cases of SAH without angiography about age, aneurysm site & size, neurologic grade mortality & morbidity, etc. Death had occurred in 2 weeks after attack predominantly. Rebleeding was most common cause of mortality(64%, 68/107). Survivals had good quality of life(73%, 19/26).
Aneurysm ; Angiography ; Disulfiram ; Follow-Up Studies* ; Humans ; Mortality ; Retrospective Studies ; Subarachnoid Hemorrhage

It is never easy to assess the rate of disability from spinal injuries objectively. One reason is that the pain is an unmeasurable subjective symptom, and the other is that the disability is usually not confirmed by or correlated with radiological or laboratory examinations. The disability is an essentially subjective inconvenience or limitation, which is hard to measure objectively. However, compensation or reparation requires a scale to measure this unmeasurable disability, even with a universal validity and equity. There are several guidelines or criteria for a quantitative assessment of the disability. They differ from each other and have their own advantages and disadvantages. This difference may cause confusion or inequity. To improve the validity and equity, we propose a new design for the disability evaluation in patients with spinal injuries. We reviewed the Korean law for compensation in industrial accidents, McBride's disability table, the guideline proposed by American Medical Association, and a impairment rating table. Disabilities resulting from spinal injuries were classified into three types, i.e., morphologic sequelae(deformity), functional sequelae(dysfunction), and others. Only objective findings were considered as criteria for rating the disability. Disability resulting from deformity were rated from 0 to 20% by the degree of compression. Dysfunction can be rated by the number of lost motion segment from 10 to 60%. Disability from other compensable spinal pain were rated by objective physical findings or neurologic deficit from 0 to 25%. By eliminating the subjective or intentional complaints, this design can be a useful method minimizing the differences from the multiple examiners.
Accidents, Occupational ; American Medical Association ; Compensation and Redress ; Congenital Abnormalities ; Disability Evaluation ; Humans ; Jurisprudence ; Neurologic Manifestations ; Spinal Injuries*

Development of new surgical devices and approaches for management of injuries to the cervical spine has offered various methods of treatment available. Making it is not easy in choosing the most suitable method of treatment. We present our experience and results of 90 operations performed during the past eight-year-period(1986-1993) including 10 halo-vest applications. The timing of operation was within 7 days posttrauma in 34.2%, 8-14 days in 27.4%, 15-28 days in 1.0%, and over 28 days in 27.4%. In 18 cases of upper(C1-3) cervical spine injuries, 23 operations were performed, all approached from the posterior. In 5 cases of lower(C4-7) cervical spine injuries, 67 operations were performed, the anterior approach used in 33 patients and the posterior approach in 18 patients. Halo-vest was applied in 6 patients with upper cervical spine injuries and in 4 patients with lower cervical spine injuries. The halo-vest was inadequate in maintaining the stability of the injured spine in 5 out of 0 cases. The complication rate was 23.3% in postrior approaches and 32.4% in anterior approaches. Overall, 27 complications(0%) occurred in 90 operations, and the reoperation rate was 16.4%(85 operations for 73 patients, except for the halo-vest applications). Internal fixation with a variety of devices has become a popular procedure for ervical spine injuries. Despite the popular and wide usage of such devices, the occurrence of complications and the need to reoperate has rendered the procedure to be applied with much caution regarding its technical aspects and possible problems it may pose. In our study, the rate of reoperation and complications following such procedures were quite high. We conclude that in choosing the most proper surgical approach for ervical spine injuries with minimal occurrence of any complications, a stringent criteria should be adhered to rather then easily select the more fashionable, new of fancy devices over the traditional techniques.
Humans ; Reoperation ; Spine*