Posterior epidural migration of a sequestrated intervertebral lumbar disc is rare with only five cases ever reported in the literature so far. The objective of this paper is to report our experience of such a extremely rare case with a review the literature

no abstract available

PURPOSE: To evaluate the biomechanical results according to various anterior spinal fixation methodology in the treatment of thoracolumbar spine fracture. MATERIALS AND METHODS: The comparative analysis of fixation method was evaluated by three dimensional finite element model using the 1 mm reconstruction image of CT. Authors evaluated the flexion, extension, lateral bending, torsional stresses with 12 fixation methods for the compression and burst fracture. RESULTS: In biomechanical analysis, stiffness of body-fixation device was more stable in two-rod system in compression fracture and was stable in one-rod, two-rod system in burst fracture, but two-rod system was showed over-increase of stiffness. CONCLUSION: Authors recommend the usage of two-rod system in anterior fixation only and anterior one-rod system in anterior-posterior fixation.
Fractures, Compression ; Methods ; Spine*

Background/Aims: We conducted a nationwide population-based study to investigate incidence rates of colorectal and biliary cancers according to accompanying primary sclerosing cholangitis in Korean ulcerative colitis patients. Methods: We used the Health Insurance Review and Assessment claim database from January 2007 to April 2020. Standardized incidence ratios of colorectal and biliary cancers in ulcerative colitis patients were calculated. Results: Among 35,189 newly diagnosed ulcerative colitis patients, 1,224 patients were diagnosed with primary sclerosing cholangitis. During the study period, 122 and 52 patients were diagnosed with colorectal and biliary cancers, respectively. Incidences of colorectal cancer were not higher in ulcerative colitis patients than those in the general population (standardized incidence ratios, 0.83; 95% confidence interval, 0.69–0.99), regardless of accompanied primary sclerosing cholangitis (standardized incidence ratio, 0.73; 95% confidence interval, 0.24–1.71). While incidences of biliary cancer were not higher in ulcerative colitis patients than those in the general population (standardized incidence ratio, 1.14; 95% confidence interval, 0.80–1.58), these were much higher with accompanied primary sclerosing cholangitis (standardized incidence ratio, 10.07; 95% confidence interval, 5.75–16.36). Cumulative incidences of colorectal and biliary cancers increased in patients who were diagnosed with ulcerative colitis at an older age. Conclusions In Korean ulcerative colitis patients, colorectal cancer incidences were not higher than those in the general population regardless of accompanied primary sclerosing cholangitis. However, biliary cancer incidences were much higher in ulcerative colitis patients with primary sclerosing cholangitis than in those without, or in the general population.

Epidural abscess is a rare disease that can cause severe neurological complications or death if it is not recognized and treated early. Authors report a case of panspinal epidural abscess, which is diagnosed by MRI and treated with surgical drainage and antibiotics.
Anti-Bacterial Agents ; Drainage ; Epidural Abscess* ; Magnetic Resonance Imaging ; Rare Diseases

STUDY DESIGN: A retrospective review was carried out on 23 patients with rigid fixed kyphosis who underwent surgical correction for their deformity. PURPOSE: To report the results of surgical correction of fixed kyphosis according to the surgical approaches or methods. OVERVIEW OF LITERATURE: Surgical correction of fixed kyphosis is more dangerous than the correction of any other spinal deformity because of the high incidence of paraplegia. METHODS: There were 12 cases of acute angular kyphosis (6 congenital, 6 healed tuberculosis) and 11 cases of round kyphosis (10 ankylosing spondylitis, 1 Scheuermann's kyphosis). Patients were excluded if their kyphosis was due to active tuberculosis, fractures, or degenerative lumbar changes. Operative procedures consisted of anterior, posterior and combined approaches with or without total vertebrectomy. Anterior procedure only was performed in 2 cases, while posterior procedure only was performed in 8 cases. Combined procedures were used in 13 cases, including 4 total vertebrectomies. RESULTS: The average kyphotic angle was 71.8degrees preoperatively, 31.0degrees postoperatively, and the average final angle was 39.2degrees. Thus, the correction rate was 57% and the correction loss rate was 12%. In acute angular kyphosis, correction rate of an anterior procedure only was 71%, correction rate of the combined procedures without total vertebrectomy was 49% and correction rate of the combined procedures with total vertebrectomy was 60%. In round kyphosis, correction rate of posterior procedure only was 65% and correction rate of combined procedures was 59%. The clinical results according to the Kirkaldy-Willis scale demonstrated 17 excellent outcomes, 5 good outcomes and one poor outcome. CONCLUSIONS: Our data indicates that the combined approach and especially the total vertebrectomy showed the safety and the greatest correction rate if acute angular kyphosis was greater than 60 degrees.
Congenital Abnormalities ; Humans ; Incidence ; Kyphosis* ; Paraplegia ; Retrospective Studies ; Spondylitis, Ankylosing ; Surgical Procedures, Operative ; Tuberculosis

The isolated idiopathic finger flexor tenosynovitis is a rare condition, related to diversed etiologies. The traditional treatment of flexor tenosynovitis includes medications and injection of steroids. If the conservative treatment is not effective, surgical management is usually recommended. And alcohol installations have been rarely performed. We are reporting an extremely rare case of a 56-year-old man who had chronic idiopathic isolated finger flexor tenosynovitis which was treated through alcohol injections. The patient had not yet been treated despite of medication and serial injections of steroid. We performed 1 mL of 50% ethanol injection for the initial treatment and the second injection was done in the same way 10 months later due to the improvements of the patient's clinical symptoms and images of the follow-up ultrasonography. As a result, the authors suggest alcohol installation as an alternative non-surgical treatment for flexor tenosynovitis when other conservative managements are not effective enough.
Alcohols ; Ethanol ; Fingers ; Follow-Up Studies ; Humans ; Steroids ; Tenosynovitis

Differentiating between intestinal tuberculosis (ITB) and Crohn’s disease (CD) remains a challenge for gastroenterologists. In Asia, where the prevalence of tuberculosis is relatively high and the incidence of CD is rapidly increasing, this issue is crucial. Here we report a case that was initially misdiagnosed as CD, subsequently showed no response to empirical first-line anti-tuberculosis medication, and was finally diagnosed with multidrug-resistant ITB. This case reminds physicians that multidrug-resistant ITB may complicate distinguishing between ITB and CD

Differentiating between intestinal tuberculosis (ITB) and Crohn’s disease (CD) remains a challenge for gastroenterologists. In Asia, where the prevalence of tuberculosis is relatively high and the incidence of CD is rapidly increasing, this issue is crucial. Here we report a case that was initially misdiagnosed as CD, subsequently showed no response to empirical first-line anti-tuberculosis medication, and was finally diagnosed with multidrug-resistant ITB. This case reminds physicians that multidrug-resistant ITB may complicate distinguishing between ITB and CD