Objectives: To report our experience of a patient in her 20s with multiple contiguous osteoporotic compression fractures.Summary of Literature Review: It is uncommon to develop multiple contiguous osteoporotic compression fractures at a young age. Materials and Methods: A 26-year-old woman was admitted with lower back pain. On radiologic examinations, compression fractures of L1, L2 and L5 were observed. Bone mineral density testing indicated severe osteoporosis. Secondary osteoporosis was suspected, and further examinations were performed. The patient was diagnosed with adrenocorticotropic hormone–independent Cushing’s syndrome.On abdominal computed tomography, a tumor suspected to be an adenoma was observed on the left adrenal gland. Tumor resection surgery was then performed. Results: Pathologic findings confirmed that the tumor was an adenoma. The lumbar fractures had healed at 3 months after the fracture. Conclusions If osteoporotic lumbar compression fracture occurs in a young patient, secondary osteoporosis should be suspected and the underlying cause must be found and treated.

Objectives: The purpose of this study was to assess the source and quality of information regarding cervical disc herniation available to patients on websites.Summary of Literature Review: Studies have shown that 92% of the Korean population regularly accesses and searches for medical information on websites. While a large amount of information exists on websites, there is a possibility that patients will be misled due to inaccurate information because there are no established criteria for qualitative evaluation. In addition, little research has been conducted on websites that provide information about cervical disc herniation. Materials and Methods: The search term ‘‘cervical disc herniation’’ was entered into the three most popular search engines in Korea (Naver, Daum, and Google). The first 50 websites displayed by each engine were selected for inclusion in this study and were categorized as academic, commercial, physician, non-physician, government organization, and unspecified. Information was assessed in terms of DISCERN, accuracy, and exhaustivity scores, and a total summary score was calculated for each website. Results: Among the theoretical total of 150 websites, 83 unique and relevant websites were identified. The distribution by source was as follows: non-physician, 34.9%; physician, 27.7%; commercial, 13.3%; unspecified, 10.8%; academic, 9.6%; and government, 3.6%. Academic and government websites obtained the highest total summary scores, with statistical significance when compared to other types (p=0.03). Conclusions Website information on cervical disc herniation is generally limited. Institutional improvement efforts are needed to foster an environment where patients can receive high-quality medical information, and physician groups should play a central role in this process.

OBJECTIVES: To evaluate the radiological outcomes of direct lateral lumbar interbody fusion (DLIF).SUMMARY OF LITERATURE REVIEW: DLIF, as a minimally invasive spinal surgical procedure, is useful for degenerative spinal diseases. However, few reports have evaluated the clinical and radiological outcomes of DLIF in Korea. MATERIALS AND METHODS: We analyzed 44 patients who underwent DLIF at our hospital from September 2015 to September 2017. Of these patients, 89 segments were included in this study. We measured preoperative and postoperative radiological values including the disc height, central canal area, height of the foramen, and segmental sagittal angle on magnetic resonance imaging. We also measured patients' visual analogue scale (VAS) and Oswestry Disability Index (ODI) scores as clinical parameters. RESULTS: Statistically significant improvements were found in the height of the left and right foramina (20.8% and 25.6%, respectively), the height of the intervertebral discs (86.0% and 84.3%, respectively), the cross-sectional area of the central nervous system (33.1%), lumbar lordosis, and the lumbar segmental angle (2.7° and 8.7°, respectively) after surgery. The VAS and ODI scores also showed significant improvements (65.7% and 67.7%, respectively) when compared with the preoperative level. CONCLUSIONS DLIF was found to be effective for the treatment of diseases such as foraminal stenosis, degenerative spondylolisthesis, and adjacent segment diseases through indirect neuro-decompression of the bilateral foramina and central vertebrae.

STUDY DESIGN: Retrospective study of prospectively-collected data.OBJECTIVES: To evaluate the radiological outcomes of direct lateral lumbar interbody fusion (DLIF).SUMMARY OF LITERATURE REVIEW: DLIF, as a minimally invasive spinal surgical procedure, is useful for degenerative spinal diseases. However, few reports have evaluated the clinical and radiological outcomes of DLIF in Korea.MATERIALS AND METHODS: We analyzed 44 patients who underwent DLIF at our hospital from September 2015 to September 2017. Of these patients, 89 segments were included in this study. We measured preoperative and postoperative radiological values including the disc height, central canal area, height of the foramen, and segmental sagittal angle on magnetic resonance imaging. We also measured patients' visual analogue scale (VAS) and Oswestry Disability Index (ODI) scores as clinical parameters.RESULTS: Statistically significant improvements were found in the height of the left and right foramina (20.8% and 25.6%, respectively), the height of the intervertebral discs (86.0% and 84.3%, respectively), the cross-sectional area of the central nervous system (33.1%), lumbar lordosis, and the lumbar segmental angle (2.7° and 8.7°, respectively) after surgery. The VAS and ODI scores also showed significant improvements (65.7% and 67.7%, respectively) when compared with the preoperative level.CONCLUSIONS: DLIF was found to be effective for the treatment of diseases such as foraminal stenosis, degenerative spondylolisthesis, and adjacent segment diseases through indirect neuro-decompression of the bilateral foramina and central vertebrae.
Animals ; Central Nervous System ; Constriction, Pathologic ; Humans ; Intervertebral Disc ; Korea ; Lordosis ; Magnetic Resonance Imaging ; Retrospective Studies ; Spinal Diseases ; Spinal Fusion ; Spinal Stenosis ; Spine ; Spondylolisthesis

PURPOSE: This study examined the effects of beraprost sodium on digital infrared thermal images in patients with peripheral arterial disease caused by type 2 diabetes mellitus. MATERIALS AND METHODS: Twenty-five diabetic patients with peripheral arterial disease were treated with beraprost sodium in a prospective, multicenter, cohort study from February 2013 to December 2014. Beraprost sodium (40 μg) was administered orally 3 times daily (120 μg/day) for 6 months. The visual analogue scale (VAS) and digital infrared thermal imaging (DITI) were performed to compare the blood flow improvement between before and after dosing. RESULTS: Among the 25 patients included in the evaluation, 22 patients completed the study. A significant increase in body temperature was observed in the front and left side, particularly in the plantar side in DITI compared to that before and after administration. An increase in body temperature was observed at the frontal part from 28.1℃±2.3℃ to 29.1℃±2.1℃ (p=0.021), at the left side from 27.8℃±2.4℃ to 28.6℃±1.9℃ (p=0.028), at the plantar part at 24.0℃±1.5℃, and at the plantar part at 27.1℃±2.4℃ (p < 0.01). The VAS decreased significantly from 5.4±1.3 to 2.7±2.0 after 6 months of treatment (p < 0.01). CONCLUSION: Beraprost sodium is a safe and easy-to use oral medication for diabetes peripheral arterial disease. It can be expected to increase the blood flow and decrease the lower extremity pain statistically after being taken for 6 months.
Body Temperature ; Cohort Studies ; Diabetes Mellitus, Type 2 ; Humans ; Lower Extremity ; Peripheral Arterial Disease* ; Prospective Studies ; Sodium*

PURPOSE: The purpose of this study is to present the effective design of N-plasty of the iliotibial band and surgical results of its use as a treatment for refractory external snapping hip. MATERIALS AND METHODS: We evaluated 17 patients (24 cases) with external snapping hip who underwent N-plasty between October 2013 and May 2016 and who were followed up for at least 12 months. All patients were male and the mean age was 20.8 years. The mean duration of symptoms prior to surgical intervention was 28.5 months with an average follow up of 24.5 months. Surgery was defined as being successful when patients could carry out their daily activities and exercise without a clicking sensation or pain 6 months after surgery until their last follow-up. Failure was defined when either a clicking sensation or pain was present. The visual analog scale (VAS) and modified Harris hip score (mHHS) were measured and compared preoperatively and at last follow-up. RESULTS: All patients had complete resolution of pain and snapping. The VAS decreased from 6.77 preoperatively to 0.09 postoperatively and mHHS improved from 69.5 to 97.8 after surgery. CONCLUSION: Modified designed N-plasty is considered to be an excellent treatment method facilitating operation reproducibility with maximum elongation effect of the iliotibial band.
Follow-Up Studies ; Hip* ; Humans ; Male ; Methods ; Sensation ; Visual Analog Scale

PURPOSE: The purpose of this study is to present the effective design of N-plasty of the iliotibial band and surgical results of its use as a treatment for refractory external snapping hip. MATERIALS AND METHODS: We evaluated 17 patients (24 cases) with external snapping hip who underwent N-plasty between October 2013 and May 2016 and who were followed up for at least 12 months. All patients were male and the mean age was 20.8 years. The mean duration of symptoms prior to surgical intervention was 28.5 months with an average follow up of 24.5 months. Surgery was defined as being successful when patients could carry out their daily activities and exercise without a clicking sensation or pain 6 months after surgery until their last follow-up. Failure was defined when either a clicking sensation or pain was present. The visual analog scale (VAS) and modified Harris hip score (mHHS) were measured and compared preoperatively and at last follow-up. RESULTS: All patients had complete resolution of pain and snapping. The VAS decreased from 6.77 preoperatively to 0.09 postoperatively and mHHS improved from 69.5 to 97.8 after surgery. CONCLUSION: Modified designed N-plasty is considered to be an excellent treatment method facilitating operation reproducibility with maximum elongation effect of the iliotibial band.
Follow-Up Studies ; Hip* ; Humans ; Male ; Methods ; Sensation ; Visual Analog Scale

Although the incidence of sciatic nerve palsy following total hip arthroplasty is low, this complication can cause devastating permanent nerve palsy. The authors experienced a case of sciatic nerve palsy caused by ruptured and contracted external rotator muscles following total hip arthroplasty in a patient suffering from osteonecrosis of the femoral head. We report this unusual case of sciatic nerve palsy with a review of the literature.
Arthroplasty ; Arthroplasty, Replacement, Hip* ; Head ; Humans ; Incidence ; Muscles* ; Osteonecrosis ; Paralysis ; Sciatic Neuropathy*

Internal impingement syndrome is characterized by the posterior shoulder pain when the arm is abducted and external rotated, and articular partial rotator cuff tear with posterosuperior labral fraying in throwing athletes. Osteochondral lesion of humeral head as an associated lesion is reported in some cases but, not considered to be a main origin of the symptoms. We found the similar features of osteochondral lesion on humeral head in three cases of internal impingement syndrome irrespective of conservative treatment for over three months and report good results obtained from arthroscopic debridement and microfracturing for these lesions with a review of the literatures.
Arm ; Athletes ; Cartilage Diseases ; Debridement ; Humans ; Humeral Head* ; Rotator Cuff ; Shoulder Pain ; Shoulder*

STUDY DESIGN: A case report. OBJECTIVES: Lumbar burst fracture was treated with operation, which delayed recollapse of L1 and led to conus medullaris syndrome. SUMMARY OF LITERATURE REVIEW: After operation, conus medullaris syndrome causing by delayed recollapse is not frequently reported. MATERIALS AND METHODS: A 56-year-old male was admitted with lower back pain caused by a fall. Radiologic findings showed L1 burst fracture with about 42% of height loss. There was no neurologic deficit. Posterior fusion was performed using instrumentation. Five weeks after the operation, the patient was admitted for urination and defecation difficulty. Radiologic findings showed that the L1 had recollapsed with about 38% of height loss. To resolve the problem, anterior surgery was performed. RESULTS: Two years after surgery, bladder and anal sphincter dysfunction wasn't recovered. CONCLUSIONS: Lumbar burst fracture should be follow up carefully until union of the fracture because burst fracture leads to delayed recollapse.
Anal Canal ; Defecation ; Humans ; Low Back Pain ; Male ; Middle Aged ; Neurologic Manifestations ; Spinal Cord Compression* ; Urinary Bladder ; Urination