No abstract available.
Decompression* ; Neurologic Manifestations*

The treatment of fractures of the dens is controversial and the major controversy has centered on type II fracture of Anderson and D'Alonzo classification because of its high incidence of nonunion when they were treated by external immobilization like halo apparatus. The posterior arthrodesis of atlas and axis which has been recommended by many authors results in the limitation of rotation of neck. In an attempt to promote bone union and to eliminate functional impairment, the authors have treated 7 consecutive cases of type II dens fracture by direct screw fixation with one or two screws. Minimum follow up period was 15 months(Av. 20mos.). Ages were varied between 23 to 68 years. Amounts of displacement on arrival were more than 4mm in all. Ambulation was started from the day after operation with the external support. Bone union was observed in 6 cases within 3 months without limitation of rotation. One nonunion with losening of screw and one transient dysphagia were observed. The authors believe that the procedure has the advantages in bone union and neck motion, but it requires surgeon's experience and the modification of implant for secure fixation.
Arthrodesis ; Classification ; Deglutition Disorders ; Follow-Up Studies ; Immobilization ; Incidence ; Neck ; Walking

No abstract available.
Spinal Cord Injuries* ; Spinal Cord*

No abstract available.
Spine* ; Spondylitis, Ankylosing*

No abstract available.
Ankle Fractures* ; Ankle*

There are many kinds of instrumentation systems for posterior operation in the treatment of scoliosis. Cotrel-Dubousset (C-D) system is most widly used for its excellent correction potential and stability. However there were some problems in C-D hook system such as hook dislodgement and correction loss. So, in order to reduce these problems we use transpedicular screw system and compare the results between two systems. We studied 44 cases of scoliosis ( hook 19 cases, screw 25 cases) who were operated with C-D instrumentation from February 1988 to August 1995. The average follow-up period was 54 months in hook group and 23 months in screw group. 1. Operation time was 241 minutes in hook group and 223 minutes in screw group. Average amount of transfusion was 5.0 pints in hook group and 4.6 pints in screw group. 2. Involved segments of main curvature were 7.0 in hook group and 6.6 in screw group. 3. Scoliotic curve was changed from 49degrees to 13degrees (73%) in hook group and from 47degrees to 12degrees (74%) in screw group. Loss of correction during follow up period was 7degrees in hook group and 3 in screw group. 4. Thoracic kyphosis was changed from 24degrees to 26degrees in hook group and from 27degrees to 30degrees in screw group. Lumbar lordosis was changed from 26degrees to 29degrees in hook group and from 26degrees to 31degrees in screw group. 5. Correction rate of rotation of apex vertebrae by Pedriolle method was 43% (from 20degrees to 12degrees) in hook group and 50% (from 22degrees to 11degrees) in screw group. 6. Complications were two cases of hook dislodgement, one delayed deep infection and four cases of progression of curvature in hook group and one case of malinsertion of screw and two cases of progression of curvature in screw group. In conclusion, these results suggested that screw system is more effective than hook system on rotational correction of apex vertebra and prevention of loss of correction.
Animals ; Follow-Up Studies ; Kyphosis ; Lordosis ; Scoliosis* ; Spine

Although several kinds of instrumentation systems are available for the transpedicular screw fixation in the treatment of spondylolisthesis, the clinical results and the difference between them remdins unclear. In order to study the feasibility of Zielke instrumentation system for that purpose, the author analysed the clinical results of 73 patients with mild or moderate degree of spondylolisthesis who were instrumented with the systems and followed up 25 months in average(Min. 12Ms). The results between the groups with different rod thickness in the system, 3.2mm(20 patients), 4mm(33 patients) and 5mm(20 patients), were compared to study the most appropriate thickness. Reduction of the deformity were done by aid of temporarilly applied Harrington system in 3.2mm group. Inlayed reduction potential coming from the jointing mechanism was utilized in the cases with less than 30% of slippage in 4 and 5mm group. Percentage of slippage was changed from 20% preoperatively, to 4% postoperatively and 6% at the end of follow up. The methods of fusion after reduction and fixation were anterior in 25 and posterolateral in 48. Bony fusion was achieved in all but one with pathological spondylolisthesis. Rod failures were observed in two of 3.2mm and one of 4mm group, and loosening of the joint were developed in three of 5mm group. Clinically, 93% of the patient showed excellent and good results at the end of follow up. From the results, we concluded that the instrumentation is a efficient method of treatment with several advantages in the reduction capacity and the stability of fixation. However, this system has several points in its mechanics that needs to be improved.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Joints ; Mechanics ; Methods ; Spondylolisthesis

To study the relationship between the bone mineral density measured by DEXA and QCT methods and to study the factors influencing on the value, bone mineral density in 208 patients with low back pain were measured by the two methods and compared statistically. Ages were varied between 17 to 79(Av. 46.7) years and male and female were 86 and 122. The results of this are as follows; 1. The values of DEXA and QCT showed statistically significant relationship(γ=0.58) as a whole. And bone mineral density in L2, L3 and L4 showed no difference in both groups. 2. Bone loss by aging(per year) in male and female was 0.99% and 1.06% by DEXA, 0,99% and 1.41% by QCT. 3. Body height and weight showed no significant influence of the value in two methods. 4. In body mass index over 27.5, the value measured by QCT was influenced to be diminished while that of DEXA was not influenced. 5. The value by QCT was influenced to be diminished by the increase of age especially over 50 years old in both sex. While the value by DEXA was influenced to be lowered than expected in female over 50 years old. It is concluded that the methods of measurement of bone mineral density have their limitation depend on the age, sex and mass index.
Body Height ; Body Mass Index ; Bone Density ; Female ; Humans ; Low Back Pain ; Male ; Spine

Authors retrospectively analyzed the CT findings of cystic tumors of the mediastinum in surgically confirmed13 cases at Seoul National University Hospital during the recent 3 years from August 1980 to August 1983. Theresults are as follows: 1. Among 13 cases, bronchogenic cyst and cystic teratoma were 4 cases respectively,pericardial cyst were 2 cases, and thymic cyst and cystic hygroma was 1 case respectively. 2. CT No. of 4bronchogenic cysts was in the range of 12-112 HU, 3 cases among them had thick-walled capsules. CT No. of 4 cysticteratomas was in the range of
Bronchogenic Cyst ; Capsules ; Diagnosis, Differential ; Lymphangioma, Cystic ; Mediastinal Cyst ; Mediastinum ; Retrospective Studies ; Seoul ; Teratoma

Menkes disease is an X-linked recessively inherited neurodegenerative disorder of copper metabolism leading to death in early childhood. This disease is characterized by low serum, liver and brain Cu levels, whereas the Cu content in nearly all other organs is increased. The main clinical features are irregular kinky hair, characteristic face, progresssive degeneration of the central nervous system, bone changes, arterial rupture and thrombosis, and instability of temperature. We have experienced a case of Menkes disease in a eight months old male patient, who manifested by seizure, developmental delay, hypotonia, characteristic hair and face along with low levels of serum copper and ceruloplasmin. We report the characteristic findings of cranial MRI and MR angiography in this Menke's patient. In cranial MRI, he showed progressive brain atrophy with subdural hemorrhage and effusion. MR angiography revealed tortuosity of vessels clearly obviating necessity of more invasive conventional arteriography in diagnosis of this disease. This study suggested that cranial MRI and especially MR angiography might be helpful in making early diagnosis of this disease.
Angiography ; Atrophy ; Brain ; Central Nervous System ; Ceruloplasmin ; Copper ; Diagnosis ; Early Diagnosis ; Hair ; Hematoma, Subdural ; Humans ; Liver ; Magnetic Resonance Imaging ; Male ; Menkes Kinky Hair Syndrome ; Metabolism ; Muscle Hypotonia ; Neurodegenerative Diseases ; Rupture ; Seizures ; Thrombosis