• Title/Summary/Keyword: Anterior approach

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An Evaluation of the Quality of Sleep Before and After Surgical Treatment of Patients with Cervical Disc Herniation

  • Ogden, Mustafa;Akgul, Mehmet Huseyin;Yuksel, Ulas;Bakar, Bulent;Kamasak, Kagan;Ozveren, Mehmet Faik
    • Journal of Korean Neurosurgical Society
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    • v.61 no.5
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    • pp.600-607
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    • 2018
  • Objective : It has been reported in recent studies that 50-80% of patients with cervical disc hernia have concomitant sleep disorders. The aim of this study was to evaluate the quality of sleep before and after surgical treatment in patients with cervical disc hernia and to assess the effects on treatment. Methods : The study included 32 patients performed discectomy and fusion with an intervertebral cage through the right anterior cervical approach. Oswestry Disability Index (ODI), Visual Analog Scale (VAS) and Pittsburgh Sleep Quality Index (PSQI) were applied to all patients preoperatively and at one month postoperatively. Results : The postoperative PSQI total points and all the PSQI subscale points, the ODI and VAS scores were significantly reduced compared to the preoperative values. A positive correlation was determined between the preoperative ODI points and the PSQI total points and sleep duration, sleep latency and daytime functional loss subscale points. A positive correlation was also found between preoperative ODI points and VAS points. A positive correlation was determined between the preoperative VAS points and and the PSQI total points and sleep duration, and sleep latency subscale points. A negative correlation was determined between the postoperative ODI and the daytime functional loss subscale points. Conclusion : The results of the study showed that in patients with cervical disc hernia, sleep quality and daytime functionality were negatively affected by severity of pain that limited daily activities. Bringing the pain under control with surgical treatment was observed to increase sleep quality. It can be concluded that when planning treatment for these patients, it should be taken into consideration that there could be a sleep disorder in addition to the complaints and symptoms such as pain, hypoestesia and loss of strength.

Modified facelift incision in parotidectomy (이하선 적출에서의 변형적 안면 거상 절개법)

  • Kim, Min-Sik;Sun, Dong-Il;Ro, Woo-Young;Cho, Seung-Ho
    • Korean Journal of Bronchoesophagology
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    • v.5 no.2
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    • pp.138-142
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    • 1999
  • Background and objectives : During the last century, various incisions for parotidectomy has introduced and among them, the modified Blair incision has been the one most commonly used. The modified facelift incision, in another hand, has only been introduced and applied recently for better aesthetic results, but also has been criticized for its potentially limited anterior exposure. The purpose of this study is to compare the modified facelift incision with the modified Blair incision in its indications, results and complications. Materials and methods : All parotidectomies done at Kang-nam St. Mary's Hospital for benign parotid masses from Jan. 1995 to Aug. 1998 were reviewed. They were then divided into 2 groups according to their surgical approach, and the parameters included age, gender, complications length of follow-ups, the aesthetic results and the pt's satisfaction. Results : There were no significant differences in the incidence of complications in both groups and the aesthetic results and patient's satisfaction were greater in the modified facelift group. Conclusion : The modified facelift incision provides improved aesthetic results in patients with benign parotid masses without the disadvantage of limited exposure and complications.

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Intracardiac Foreign Body by Penetrating Cardiac Injury (관통성 손상에 의한 심장내 이물 - 수술 치험 1례 -)

  • 정진용
    • Journal of Chest Surgery
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    • v.23 no.5
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    • pp.929-935
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    • 1990
  • Violence in our society, combined with improving transport system, resulted in increased numbers of patients with cardiac wounds reaching the hospital alive. Most patients with penetrating cardiac injury, rather than blunt injury, present with a syndrome of either hemorrhagic shock or cardiac tamponade. And they should be operated upon as soon as possible. Often the atrioventricular valves and other important cardiac structures are also damaged by the penetrating instruments or missile. Both intracardiac communications and atrioventricular fistulas may result in significant left-to-right shunts accompanied by congestive heart failure, necessitating surgical correction. Usually, retained cardiac foreign bodies, which are almost always bullets or fragments of missiles, may lie within a cardiac chamber or in the myocardium. Emboli of bullets or other missiles from distant sites to the right side of the heart are numerous enough to require attention. Recently we experienced a case with intracardiac foreign body due to penetrating cardiac injury. A 19 year-old man was admitted to our hospital due to penetrating anterior chest wound by iron segment. The roentgenogram of the chest revealed a radio-opaque metallic shadow in left lower chest around the cardiac apex, mild blunting of left costophrenic space, but no cardiomegaly. During operation the foreign body was noted to be present in the cardiac chamber by the portable C-arm fluoroscopy. But during the manipulation it moved into left inferior pulmonary vein from left ventricle by way of left atrium. So we could manage to remove it from left inferior pulmonary vein by direct approach to the vein. It was iron segment, sized 0.lcm x0.6cmx0.5cm, with sharp margins. The patient had an uneventful postoperative recovery except for chylopericardium and was discharged.

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Conservative management of dislocated temporomandibular joints: A case report (턱관절 탈구의 보존적 치료법에 대한 증례보고)

  • Park, Jo-Eun;Kim, Hye-Kyoung;Choi, Hee-Hoon;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.38 no.4
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    • pp.319-324
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    • 2013
  • Dislocation of the temporomandibular joint (TMJ) occurs when the mandibular condylar head is displaced completely out of the glenoid fossa and cannot be reduced by the patient. The occurrence of bilateral anterior dislocation is the most common. Dislocations can be classified into three types in terms of duration and frequency of dislocation, i.e., acute, chronic and recurrent. There are various treatment modalities for dislocation from conservative try to surgical intervention. The selection for the appropriate modality mainly depends on the types of dislocation as previously stated. The authors report three cases of dislocation with different treatment modalities according to the duration of dislocation. In particular, we tried prosthetic approach instead of surgical intervention in the patient with chronic dislocation.

Ankle Arthrodesis using Cannulated Screws & Hybrid Type Rigid External Fixation in Diabetic Charcot Neuroarthropathy (유관 나사 및 Hybrid형 외고정술을 이용한 당뇨병성 샤르코 족관절 신경관절병증의 관절 유합술)

  • Han, Kyeung-Jin;Roh, Hyong-Rae;Han, Seung-Hwan
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.2
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    • pp.140-145
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    • 2010
  • Purpose: The diabetic charcot neuroarthropathy of ankle is an infrequent site (around 5%), but is definitely the location that, because of the instability and progressive deformity it involves, cause ulceration in a high percentage of patients, and this can then become a reason for amputation. However, the treatment of this disastrous disease is still challenging. We analyzed the clinical and radiological results of ankle arthrodesis by our fixation method in Charcot neuroarthropathy. Materials and Methods: Seven cases that were diagnosed as charcot neuroarthropathy of ankle arthrodesis were followed for more than 16 months postoperatively. Mean age was 57 years, and the mean follow-up period was 27 months. Anterior approach was used in arthrodesis, and internal fixation by 3 or more cannulated screws and hybrid type external fixation were used. Auto iliac bone for grafting was combined in all cases. External fixator was kept for 3 months without weight-bearing. Then, boots brace was applied for more 3 months allowing partial weight-bearing. Four cases had minor complications such as pin site infection. Preoperative and postoperative AOFAS score, time to fusion and postoperative complications were checked. Results: Postoperative fusion was completed in all cases, and the mean time to fusion was 3.4 months. No postoperative complication was checked. At the last follow-up, the mean AOFAS score had increased from 54 points to 72 points. Patient's satisfaction was over 80%. Conclusion: Satisfactory results were obtained after ankle arthrodesis using internal and hybrid type external fixation combined with auto iliac bone graft in charcot neuroarthropathy with minor complications.

Analysis of Peripheral Nerve Function and Echogenicity of Skeletal Muscle in Type II Diabetic Patient's (제2형 당뇨환자의 말초신경기능 및 골격근의 Echogenicity 분석)

  • Yoon, Se-Won;Hwang, Tae-Yeun;Kim, Young-Nam;Yoon, Hee-Jong;Jeong, Jin-Gyu;Kim, Tae-Youl
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.4 no.1
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    • pp.13-25
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    • 2006
  • This study aims to suggest clinical basis of physical therapy of neuromuscular system complication in type diabetic patients through a variety II of analysis methods including echogenicity using ultrasound image and measurement of peripheral nerve function to their neuromuscular system and provide basic materials for preparing evaluation of physical therapy and intervention program. Subjects of this study were 75 type II diabetic patients between 40 and 80 years old and it obtained the following results through echogenisity and function of peripheral nerve. Incidence of neuropathy in type II diabetes was 55.8% in men and 53.1% in women, and total incidence of neuropathy was 54.7%. Echogenicity of patients with neuropathy was significantly increased compared to that of patients with neuropahty. It was also found that there were correlations between function of peripheral nerve and echogenicity of tibialis anterior and gastrocnemius muscle. In addition, it will be important for physical therapists to divide type II diabetic patients into neuropathy and myopathy and interpret and approach changes of neuro-muscular system from comprehensive side.

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Effect of Taping and Virtual Reality Combined Exercise on Static and Dynamic Balance With Functional Ankle Instability

  • Kim, Ki-jong;Gang, Mi-yeong
    • Physical Therapy Korea
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    • v.27 no.4
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    • pp.292-297
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    • 2020
  • Background: Ankle sprain is one of the most common musculoskeletal injuries in the sports population or during usual daily life activities. The sprain can cause functional ankle instability (FAI), and it is very important to treat FAI. However, the optimum intervention method for FAI has yet to be determined. Objects: This study investigated the impact that virtual reality (VR) training program on balance with ankle kinesio taping for FAI. Methods: Twenty-two people were selected for the study and randomly divided into the experimental (n = 11) and the control group (n = 11). The experimental group had attached kinesio taping on the ankle and then implemented a virtual reality exercise program for 30 minutes a day. Nintendo Wii Fit Plus was used for the VR intervention three times a week for four weeks. The control group performed only two measurements without intervention. Results: There were no statistically significant differences in overall, anterior-posterior (AP), medial-lateral (ML) index of the static balance, and significant differences in overall, AP, ML index of the dynamic balance when taping and VR exercise were applied at the same time (p < 0.05). There were no significant differences in overall and ML index of static and dynamic balance compared with before and after assessment between the experimental and the control group, and found differences in AP index of static and dynamic balance (p < 0.05). Conclusion: Kinesio taping may not influence the balance of FAI as great as people expected. VR approach does not affect the static balance of FAI, but it influences dynamic balance in overall, AP, ML index. The authors suggest that VR-based exercises can be used as an additional concept in clinicians for FAI or as part of a home program because the exercises still have limitations.

Case Reports about Brainstem Infarction -Dejerine′s syndrome and Wallenburg′s syndrome- (뇌간 경색에 대한 고찰 -Dejerine′s syndrome 1례 및 Wallenburg′s syndrome 1례-)

  • Cho Gwon Il;Han Myoung Ah;Lee Ji Yeon;Choi Jin Young;Kim Dong Woung;Jung Dae Young;Kim Kwan Sik
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.16 no.6
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    • pp.1291-1296
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    • 2002
  • Blood circulation of brain is divided into two major categories; anterior one from carotid artery and posterior one from vertebrobasilar artery. In stroke patients, it is important to diagnose which is involved, because there is many difference in the aspects of clinical menifestations and prognosis, especially in the acute stage. In some cases of vertebrobasilar infarction, such as Wallenberg's syndrome, charicteristic cranial nerve signs, eye movement disorders and cerebellar signs are appeared. And in Dejerine's syndrome, only pure motor or sensory defecits can be appeared without any brainstem signs. So It shoud be differenciated by Brain MRI from those of the cerebral hemisphere lesions. And in the cases that nausea, vomitting and dysphagia are the first menifestations, it is frequently misdiagnosed as internal medical disease, causing appropriate treatment delayed. In this case report, we are to describe the clinical menifestations and progresses of two cases of brainstem infarctions, review previously published case reports about them and compare them to our cases. The first is Dejerine's syndrome i.e. medial medullary infarction, the second is Wallenberg's syndrome i.e. lateral medullary infarction. Simultaneously we are to investigate the oriental medical approach in the bran stem infarctions.

Endoscopic-Assisted Curettage of Brodie Abscess in Proximal Tibia - A Case Report - (경골 근위부에 발생한 Brodie 농양에서 내시경을 이용한 소파술 - 증례 보고 -)

  • Ku, Jung-Hoei;Cho, Hyung-Lae;Park, Man-Jun;Choi, Seung-Hyun
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.2
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    • pp.134-138
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    • 2007
  • Brodie abscess is a localized form of subacute or chronic osteomyelitis which is common in children but may also occur in adulthood. When Brodie abscess is located in the posterior metaphysis of the proximal tibia, open biopsy and curettage have a difficulty in approach to the lesion and can cause neurovascular injury or soft tissue contamination. We report a case wherein a novel surgical technique was used to treat a Brodie abscess in the posterior proximal tibial metaphysis in 48 year-old-male with endoscopic-assisted curettage by commercial anterior cruciate ligament targeting device(Rigid Fix; Mitek, Johnson & Johnson, Norwood, MA). Two portals were created toward the abscess site and, through each portal interchangeably, the granulation tissue and sclerotic bone could be excised. We believe that endoscopic-assisted curettage presents safe technique, decreased morbidity, accurate assessment of the extent of the abscess and possible improvement in long-term outcomes.

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Treatment of Micromastia with Pectus Excavatum: A Case Report (오목가슴을 동반한 작은유방증 환자의 치험례)

  • Kim, Sang Wha;Choi, Yun Seok;Lim, Jin Soo;Han, Ki Taik
    • Archives of Plastic Surgery
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    • v.35 no.6
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    • pp.739-742
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    • 2008
  • Purpose: Breast augmentation is one of the common procedures in plastic surgery today. The shape, size and insertion plane of the implant is decided preoperatively by physical examination of the breast. Pectus excavatum is one of the most common anomalies of chest wall, characterized by a depression of the anterior chest wall. For patients with a mild type of pectus excavatum, the main purpose of the treatment is aesthetic rather than functional improvement. Two most surgical treatment options for skeletal deformity are the Ravitch technique and minimally invasive Nuss repair. Other options for soft tissue repair are implant insertion and autologous soft tissue augmentation. We performed a surgical operation with Nuss procedures and breast augmentation for a patient with mild pectus excavatum and hypoplastic breast. Methods: A 32 year-old female was presented with hypoplastic breast. Preoperative chest CT was performed, showing pectus excavatum. After Nuss procedure, we inserted saline implant(275 cc textured round breast implant, moderate profile) submuscularly to restore adequately projected breast. Results: Patient's postoperative course was uneventful without any complication. After 6 months of follow-up period, the patient had an excellent result, with high patient satisfaction and no complications. Conclusion: For patients with a mild type of pectus excavatum, who do not have cardiopulmonary symptoms and requires for aesthetic improvement, this simple approach with Nuss procedure and breast augmentation achieves excellent aesthetic correction with low complication rate and high patient satisfaction.