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One-Step Ventro-Posterior Fusion via Transpedicular Approach for L1 Burst Fracture by Use of Expandable Cage.

Korean Journal of Spine.2009;6(3):231-234.

Accepted methods of treatment of lumbar burst fractures include conservative therapy, posterior reduction and instrumentation, and anterior decompression and instrumentation. Surgery aims at the correction of the kyphotic deformity and at the decompression of the spinal cord thereby reducing pain and allowing early patient mobilization. Posterior-only procedures usually rely on ligamentotaxis or manual tamping of bone fragments for decompression of the spinal canal. Transpedicular corpectomy allow for circumferential surgery through a single posterior approach. The authors use an expandable cage to restore the normal spinal curvature and to prevent the kyphotic deformity.
Congenital Abnormalities ; Decompression ; Humans ; Spinal Canal ; Spinal Cord ; Spinal Curvatures

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Delayed Spinal Cord Injury Following Low Voltage Electrical Accident.

Chung Jae LEE ; Sung Han OH ; Jong Kook RHIM ; Jae Sub NOH ; Bong Sub CHUNG

Korean Journal of Spine.2009;6(3):228-230.

Although the prediction of a delayed spinal cord injury after a low voltage electrical accident is difficult, we present a young paraplegic man who had delayed spinal cord injury after a low voltage electrical accident while working. Because the passage of an electric current is variable, the tissues far distant from the point of entry may be damaged, including the spinal cord. Low voltage itself is not a safe.
Paraplegia ; Spinal Cord ; Spinal Cord Injuries

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Carpal Tunnel Syndrome Diagnosed by Carpal Tunnel Pressure Measurement.

Seong Yeol AHN ; Yeong Seob CHUNG ; Sang Hyung LEE ; Yeong Je SON ; Hee Jin YANG

Korean Journal of Spine.2009;6(3):225-227.

Carpal tunnel syndrome(CTS), the most common compressive neuropathy, is usually diagnosed by clinical features and nerve conduction test(NCS). However, NCS might show no abnormal finding. Ultrasonography(USG), known as helpful adjunctive in diagnosis of CTS, also might show false negative finding. A 33-year-old woman presented with complaints of pain and numbness in median nerve area on her right hand for 4 years. Despite typical clinical features of CTS, neither NCS nor USG showed abnormal finding. Because of persistent symptom, without significant improvement on conservative management, endoscopic carpal tunnel release(ECTR) was performed with carpal tunnel pressure(CTP) measurement. The measured CTP was 27.9mmHg before ECRT, which was reduced to 5.9mmHg after operation. The pain and numbness subsided after operation. Our case showed the usefulness of CTP measurement in diagnosis of CTS. The measurement of CTP might be an important diagnosis modality for some patients having CTS, especially in cases without definitive findings in NCS and USG.
Adult ; Carpal Tunnel Syndrome ; Cytidine Triphosphate ; Electromyography ; Female ; Hand ; Humans ; Hypesthesia ; Median Nerve ; Neural Conduction

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Combined en Bloc Spondylectomy and Chest Wall Resection for Malignant Tumors Invading Spinal Column and Chest Wall.

Tae Hoon ROH ; Keung Nyun KIM ; Do Heum YOON ; Yoon HA ; Seong YI

Korean Journal of Spine.2009;6(3):221-224.

We performed combined spondylectomy for 2 patients of malignant tumors invading spinal column and chest wall. For one patient with Pancoast tumor, anterolateral thoracotomy, apical lobectomy, chest wall resection, and hemispondylectomy were performed. For another patient with solitary metastatic tumor from nasopharyngeal cancer, posterolateral thoracotomy, chest wall resection, and total en bloc spondylectomy were performed with anterior and posterior instrumentation. The tumor including invaded chest wall and spinal column werewas removed completely in both patients. No local recurrence was found at 18 months follow-up evaluation in both patients.
Follow-Up Studies ; Humans ; Nasopharyngeal Neoplasms ; Pancoast Syndrome ; Recurrence ; Spine ; Thoracic Wall ; Thoracotomy ; Thorax

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Symptomatic Spinal Epidural Lipomatosis Induced by Repeated Epidural Steroid Injections.

Ho Sang KIM ; In Ho HAN ; Jung Hwan LEE ; Byung Kwan CHOI

Korean Journal of Spine.2009;6(3):218-220.

We present a very rare case of symptomatic spinal epidural lipomatosis(SEL) induced by repeated epidural steroid injections. A 59-year-old woman presented with severe neurogenic claudication and bilateral radiating leg pain aggravated for 1 year. She had undergone epidural triamcinolone injections 19 times for 3 years in a local clinic for chronic low back pain. At first, there had been no symptoms of lumbar stenosis such as leg pain or claudication. During the period of injections, radiating leg pain and claudication appeared newly and were gradually aggravated. Hormonal study and physical examination confirmed iatrogenic Cushing's syndrome. Magnetic resonance imaging(MRI) revealed extensive epidural fat deposition compressing cauda equnina from L3 to S1. Therefore, we concluded that multiple epidural steroid injections caused iatrogenic Cushing's syndrome and SEL. We performed debulking of epidural fat and bilateral neural decompression via left unilateral partial hemilaminectomy at L3-4-5-S1 in order to preserve stability considering preexisting multiple compression fractures. After operation, the patient's neurogenic claudication and radiating pain were completely disappeared.
Constriction, Pathologic ; Cushing Syndrome ; Decompression ; Female ; Fractures, Compression ; Humans ; Leg ; Lipomatosis ; Low Back Pain ; Magnetic Resonance Spectroscopy ; Middle Aged ; Physical Examination ; Triamcinolone

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Giant Invasive Intraosseous Schwannoma in Lumbar Spine.

Seong Cheol PARK ; Heon YOO ; Sang Hoon SHIN ; Seung Hoon LEE

Korean Journal of Spine.2009;6(3):214-217.

A rare case of giant invasive intraosseous schwannoma in lumbar vertebra with no neurologic deficit is reported. This tumor had vertebral body, left paravertebral tissue and lamina invasion and thus classified as type V giant invasive schwannoma according to Sridhar's classification of benign nerve sheath tumor. Because intraosseous portion was significantly larger than extraosseous portion, this tumor was mentioned as intraosseous schwannoma. Tumor was successfully resected using corpectomy, mesh cage insertion and posterior fixation. Pathological diagnosis was benign schwannoma.
Neurilemmoma ; Neurologic Manifestations ; Spine

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Intradural Mature Teratoma in the Lumbar Spine found in Adult.

Se Jin JEONG ; Jin Young YOUM ; Seung Won CHOI ; Seon Hwan KIM

Korean Journal of Spine.2009;6(3):211-213.

Intradural spinal teratoma is a very rare entity, more prevalent in childhood, and may be associated with dysraphic defects. Moreover, mature teratoma in adult is extremely rare. The authors report on a 56-year-old man with right leg motor weakness and numbness and sensation of incomplete voiding. The lumbar radiograph showed spina bifida in L4, L5, and S1. Magnetic resonance image(MRI) showed a 6.4-cm intradural cystic mass on the L2 and L3 levels of the spinal canal and tethering of the spinal cord. We performed a total laminectomy at L2, L3, and partial laminectomy at L4 and removed the mass completely. Histopathologic diagnosis was mature teratoma. The patient's complaints were improved after the surgery.
Adult ; Humans ; Hypesthesia ; Laminectomy ; Leg ; Magnetic Resonance Spectroscopy ; Middle Aged ; Sensation ; Spinal Canal ; Spinal Cord ; Spinal Dysraphism ; Spine ; Teratoma

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Delayed Neurological Deficit in a Patient with a Compression Fracture of the Thoracic Spine: Coexistence of Ankylosing Spondylitis and Diffuse Idiopathic Skeletal Hyperostosis.

Jong Rak JUNG ; Sang Won YOON ; Jae Kyun JUN ; Sung Bae PARK

Korean Journal of Spine.2009;6(3):207-210.

Ankylosing spondylitis(AS) and diffuse idiopathic skeletal hyperostosis(DISH) increase the risk of spinal fracture after minor trauma in an ankylosed spine. There are few reports on a spinal fracture in people with both conditions. A 67-year-old man visited our emergency room with moderate back pain developed after slipping. No neurological deficit was noted. On physical examination, direct tenderness was noted in the back at the level of the thoracolumbar(TL) junction. Radiological evaluations showed the compression fracture of ankylosed spine and the coexistence of AS and DISH. Vertebroplasty was performed in fractured spine due to persistent back pain. Several weeks later, neurological deficits were developed. Finally, decompressive laminectomy and posterior screw fixations were performed. After operation, neurological deficits were fully recovered and patient was discharged. Patient who had a fracture of an ankylosed spine in association with coexisting AS and DISH could be considered the early surgical treatment.
Aged ; Back Pain ; Emergencies ; Fractures, Compression ; Humans ; Hyperostosis, Diffuse Idiopathic Skeletal ; Laminectomy ; Physical Examination ; Spinal Fractures ; Spine ; Spondylitis, Ankylosing ; Vertebroplasty

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Surgery for Recurrent Lumbar Disc Herniation During Pregnancy: A Case Report.

Jae Meen LEE ; In Ho HAN ; Soo Hyeon MOON ; Byung Kwan CHOI

Korean Journal of Spine.2011;8(4):304-306. doi:10.14245/kjs.2011.8.4.304

A few cases of lumbar disc herniation (LDH) that have been treated by surgery during pregnancy have been reported in the literature. However, symptomatic recurrent LDH during pregnancy has been rarely reported. A 32-year-old parous woman presented with lumbago and severe right leg pain at 20 weeks' gestation. Eleven years prior to admission, she had undergone an open discectomy for right-sided LDH at the L4-5 level. Magnetic resonance imaging (MRI) showed a recurrent disc herniation that affected the nerve root at the right L4-5 level. The radiating pain did not respond to conservative treat-ment. Revision surgery was performed under general anesthesia and in the left lateral position to avoid fetal stress and aortocaval compression, and the ruptured disc particle was completely removed. Postoperatively, the radiating pain was completely relieved. She delivered a full-term healthy girl (birth weight, 3.39 kg) at 40 weeks' gestation by normal vaginal delivery. We report the rare case of a 32-year-old parous woman with recurrent LDH that was successfully treated by revision surgery. In recurrent LDH patients with incapacitating pain who do not respond to opioid injections, surgical treat-ment could lead to a satisfactory outcome maintaining pregnancy.
Adult ; Anesthesia, General ; Diskectomy ; Female ; Humans ; Leg ; Low Back Pain ; Magnetic Resonance Imaging ; Pregnancy ; Recurrence

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Propriospinal Myoclonus Induced by a Herniated Lumbar Intervertebral Disc at a Young Age: A Case Report.

Kwan Su SONG ; Jae Gon MOON ; Chang Hyun KIM ; Ho Kook LEE

Korean Journal of Spine.2011;8(4):300-303. doi:10.14245/kjs.2011.8.4.300

The cause of propriospinal myoclonus (PSM) is idiopathic. Cervical trauma, ischemic myelopathy secondary to a spinal dural arteriovenous fistula, syringomyelia, Lyme neuroborreliosis, human immunodeficiency virus central nervous system infection, and cervical disc herniation can be the cause of PSM, but lumbar herniated intervertebral disc (HIVD) induced PSM has not been reported. We describe a patient who presented with PSM induced by HIVD and was treated with an epidural steroid injection using a transforaminal approach.
Central Nervous System Infections ; Central Nervous System Vascular Malformations ; HIV ; Humans ; Injections, Epidural ; Intervertebral Disc ; Lyme Neuroborreliosis ; Myoclonus ; Spinal Cord Ischemia ; Syringomyelia

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