Teratoma is very rarely developed in the third ventricle. We report a case of third ventricular mature teraroma in 12 year old boy with headache and precocious puberty. In TlWl and Gd-DTPA enhanced TlWl, the mass in the third ventricle showed mixed signal intensities with signal void and partial contrast enhancement. The tumor was confirmed as a mature teratoma including teeth and fatty tissue.
Adipose Tissue ; Child ; Gadolinium DTPA ; Headache ; Humans ; Magnetic Resonance Imaging* ; Male ; Puberty, Precocious ; Teratoma* ; Third Ventricle* ; Tooth

STUDY DESIGN: The authors retrospectively analysed the difference of clinical natures in contained vs. ruptured HIVD. OBJECTIVE: To compare contained HIVD with ruptured HIVD in respect of clinical symptoms, signs and the result after surgery. SUMMARY OF LITERATURE REVIEW: In contained disc herniation, the disc material remains beneath tile intact outer annulus. But, once disc material penetrates through the limit of posterior annulus, it is a ruptured herniation or disc extrusion/sequestration. There is few report concerning the clinical characteristics related to type of herniation. MATERIALS AND METHODS: Forty-six patients, treated by open discectomy from March 1990 to December 1994, were followed up for minimum two years. The clinical symptoms and signs including SLR, motor deficit, sensory deficit, change of DTR, and severity of radiating pain were periodically followed up on the predesigned protocol. Result: Twenty patients had contained disc and remaining 26 had ruptured disc. The mean age of contained disc was 31.4 years and that of ruptured disc was 43.3 years. In preoperative examination, 18/26 cases of patients with ruptured discs, developed pain in less than 3 months, compared with 7/20 cases of does with contained ones. Motor deficit was positive in 25/26 cases (96.2%) of ruptured discs and 12/20 cases (60%) of contained ones. 23/26 cases (80.8%) of patients with ruptured discs, had sensory deficit compared with 12/20 cases (60%) of those with contained ones. There was no significant difference in SLR and DTR change between ruptured and contained disc. CONCLUSIONS: Factors such as age, motor and sensory deficits and duration of symptoms had correlation with the type of herniation, but SLR and DTR change showed no statistical difference in this study. Clinical outcome showed no significant difference between two groups, but in ruptured group, the results were getting worse with the time goes. On the basis of this study, we concluded that the clinical symptoms and signs were different between the two groups, but surgical results showed no statistical difference.
Diskectomy ; Humans ; Retrospective Studies

STUDY DESIGN: Surgically treated thirty-five Denis type B thoracolumbar and lumbar burst fractures were assessed to compare the differences of fracture patterns by the level of fracture. OBJECTIVE: To know the major surgical indications according to the level of fracture. SUMMARY OF BACKGROUND DATA: General operative indications of thoracolumbar and lumbar burst fractures were collapse of anterior body height more than 40-50%, kyphotic deformity more than 30 degrees, canal encroachment more than 50% and neurologic deficit. But we could not apply the same surgical indications to the whole thoraco]embar and lumbar burst fractures because their fracture patterns are different. METHODS: We compared the collapse of anterior body height, collapse of posterior body height, Cobb angle, wedge angle, canal encroachment and incidence of posterior injury according to the level of fracture. RESULTS: The higher the level of fracture, the more the collapse of anterior body height, Cobb angle, wedge angle and incidence of posterior injury But the lower the level of fracture, the more the canal encroachment. CONCLUSIONS: These results mean that the primary surgical indications for thoracolumbar junction are collapse of anterior body height, possibility of posterior injury and increased kyphosis, while for the lower lumbar fractures, amount of canal encroachment is an important factor to make decision for surgery.
Body Height ; Congenital Abnormalities ; Incidence ; Kyphosis ; Neurologic Manifestations

Complete decompression is very important for the surgical treatment of the spinal stenosis. But it may produce the segmental instability or spondylolisthesis as postoperative complications. So rigid internal fixation is mandatory to reduce this problem. Authors treated 16 cases of spinal stenosis by complete decompression and pedicale screw fixation and posterolateral fusion, analyzed 11 cases which were followed more than 9 months. The results were as follows: 1. Among the 11 cases, the mean age was 49 years old and there were 5 males and 6 females. 2. The most common cause was degenerative type, 7 cases. The most frequent level of involvement was L4–L5, 10 cases and two level involvement was 3 cases. 3. Among the 11 cases, 6 cases were excellent and 4 cases were good, and 1 case was fair, in Hanley's criteria. 4. In spondylolisthetic stenosis, the average percentage of slippage was changed from 22% pre-operatively to 2.7% postoperatively and 3.8% after 9 months follow up. 5. The complications were relatively few(1 case of hematoma and 3 cases of pain on the bone graft donor site).
Constriction, Pathologic ; Decompression ; Female ; Follow-Up Studies ; Hematoma ; Humans ; Male ; Pedicle Screws ; Postoperative Complications ; Spinal Stenosis ; Spondylolisthesis ; Tissue Donors ; Transplants

Unilateral absence of the articular process at a lumbar vertebra is a rare anomaly. The etiology of the congenital absence of articular process is not precisely determined yet, but it was explained as some of the possible embryologic bases. Absence of the articular process at the level of L5-Sl have been reported a few, but anomaly above L4 is rare. We are reporting a case of absence of articular process at the level of the 4th lumbar vertebra.
Spine

In the developed countries in Europe and the United States, The spinal tuberculosis is of no serious problem due to the developed anti-tuberculotic agents and the advanced operative techniques. However, in Korea poor economic and other conditions prevent many patienta from getting proper treatments for spinal tuberculosis. We analysed 45 cases of spinal tuberculosis who were treated at our department during three years from June, 1972 to June, 1975 by operative treatment and being compared with these results that obtained conservative treatment. The results were obtained as follows; 1. There was most common in below 9 years old (28.9%) and common age incidence was below 35 years old (68.8), The sexual incidence was 22 in male and 23 in female. 2. Lower thoracic and upper lumbar were mostly involved, i.e thoracic (52.2%), lumbar (32.7%), thoraco-lumbar in orders. 3. Two affected vertebra was most common in 33 cases, number of affected vertebra averaged 2.5. 4. In laboratory finding, E.S.R. that was 50–60 mm/hr. in average of then admission wss shifted as normal range of 10–20 mm/hr. after cure of 5–6 months. 5. In 28 cases of operative treatment, anterior spinal fusion was done in 19 cases (67.9%), posterior spinal fusion in 8 cases(28.6%), one case(3.5%) was treated by thoracotransversectomy. 6. In consequence of pathologic exaraination and A.F.B. stain, the case of tuberculotic constitution was 18 in tissue pathology, and that of positive reaetion was 9 in direct smear for A.F.B. 7. The case that tuberculosis was limited at spine and was not found in other organs was 27, it got from 60% of the whole. 8. Average kyphotic angle of the thoracic region after operation was 4.3°, in 6 months was reduction of 1.8°, that of lumbar region after operation was 1.2°, in 6 months was reduction after operation was reduction of 0.7°, as change of radiologic kyphosis. 9. As a result of being cured during 18 months by operative or conservative methods, not a case is found in activity.
Constitution and Bylaws ; Developed Countries ; Europe ; Female ; Humans ; Incidence ; Korea ; Kyphosis ; Lumbosacral Region ; Male ; Pathology ; Reference Values ; Spinal Fusion ; Spine ; Tuberculosis ; Tuberculosis, Spinal ; United States

No abstract available.
Autografts*

Spinal instrumentation using pedicle screws offers several advantages such as 1) achievement of rigid fixation through the pedicles which is the strongest structure of spine, 2) nearly anatomic reduction by direct force on the deformed sites of fracture and 3) preservation of mobile segments by short segment fixation. The authors analysed 14 cases of unstable thoracolumbar and lumbar fracture treated by pedicle screw fixation from May 1988 to June 1989. Mean follow up was 14 months(8M.-20M.) and following results were obtained. 1. Most of the cases were male(13 cases) and their age ranged from 26 to 55 with an average of 36. 2. According to Denis classification, there were 7 cases of burst fracture, 5 cases of fracture-dislocation, 1 case of seat belt injury and unclassified one case. 3. After operation, the height of anterior column was reduced from 61% to 86%, posterior column, from 134% to 105%, local kyphosis, from 17.4% degrees to 3.4 degrees and anterior translation, from 6mm to 1.2mm. 4. In comparision of preoperative and postoperative moter index between fracture-dislocation and burst fracture, the former changed from 3.2 to 21.8 and the latter, from 40.2 to 48.6. 5. Significant neurologic recoveries were observed in all cases except one complete paraplegia. 6. There was no significant complication and minimal loss of correction was noted.
Classification ; Follow-Up Studies ; Kyphosis ; Paraplegia ; Pedicle Screws ; Seat Belts ; Spine

At present the newer computerized tomography scanners provide a means for direct measurement of the size of normal and abnormal body structures from monitor. In orthopedics and rheumatology, CT is very important and useful means to make correct diagnosis and treatment modalities. In spite of its increasing importance in orthopedic field, reports about accuracy of CT are not common. We reviewed several reports that described about anatomical measurement using CT or similar experiments to our study. But there are few statements that have directly compared CT and caliper measurements in spine or other bones. So, authors performed experiments with 36 vertebrae of 8 pig spines to know the difference of CT measurement from actual measurement. The results were as follow: 1. In CT, bony portions including diameter of body and both pedicles were overestimated about 5% than actual ones. 2. In CT, AP and lateral diameters of spinal canal were 6~7% smaller than actual measurement and canal area, estimated by the products of AP and lateral diameter of spinal canal, is about 13% smaller than actual size. 3. It is the result of cortical overestimation around canal that spinal canal area was estimated less than actual size. 4. Main cause of this differences was partial volume effect that developed during CT scanning. In conclusion, CT scanner is the useful means and gives many useful informations to diagnose the spinal disease, but the physicians must understand mechanical, physical and mathematical limitations of CT and discrepancy of measurement data.
Diagnosis ; Orthopedics ; Rheumatology ; Spinal Canal ; Spinal Diseases ; Spine ; Tomography, X-Ray Computed

Most patients who have spondylolysis dont's need surgical treatment. However, for the patients who have no response to conservative treatment, surgical treatment may be indicated. In 1970, Buck reported the operative technique that the used two screws between the pars defect and lamina followed by bone graft. In patients who have spondyloysis, pain in the back seems to be due to instability and irritation of nerve root by the abnormal motion of the loose neural arch and granulation tissue. For period of 7 years from May, 1984 to March, 1991, twelve patients with spondyloysis who had no response to conservative treatment were treated with Buck's operation and were analyzed. Following results were obtained: 1. The age of the patients was 24 years in average ranging from 14 to 40 years. 2. The level of the lesion was L5 in 10 cases, L4 in 2 cases. 3. Preoperative clinical feature included low back pain in 12 cases, refered pain in 2 cases. 4. Clinical sympotoms were improved in 83%, and the follow up result of the operation: excellent 16.7%, good 66.6% and poor 16.7%.
Follow-Up Studies ; Granulation Tissue ; Humans ; Low Back Pain ; Spondylolysis ; Transplants