• Title/Summary/Keyword: Anterior cervical surgery

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Arthroscopic Anterior Acromioplasty for the Treatment of Chronic Impingement Syndrome of the Shoulder (관절경적 전방 견봉 성형술을 이용한 만성 견관절 충돌 증후군의 치료)

  • Park Tae-Soo;Kim Jae-Young
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.1
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    • pp.49-53
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    • 2000
  • Purpose : The purpose of this study was to evaluate clinical efficacy of the arthroscopic anterior acromioplasty for the treatment of chronic impingement syndrome of the shoulder. Materials and Methods : Between July 1995 and December 1997, twenty seven consecutive shoulders of 26 patients with chronic impingement syndrome of the shoulder were treated by arthroscopic anterior acromioplasty. The patients who had severe osteoarthritis of the shoulder full thickness tear of the rotator cuff, and nonoutlet impingement were excluded. The clinical results were evaluated by using UCLA shoulder rating scale. The average follow-up was 2years 3months(range, 1year 7months to 3years 1 11months). Results : Twenty three patients$(85.2\%)$ were rated as excellent or good results, while four patients$(14.8\%)$ were fair. Twenty six cases$(96.3\%)$ were satisfied with the results of the operations, while one case$(3.7\%)$, who had Parkinsonian syndrome, ossification of posterior longitudinal ligament(OPLL) of the cervical spine, and spinal stenosis of the 5th and 6th cervical spine was not satisfied. Conclusion : Arthroscopic anterior acromioplasty was an effective treatment method, especially for relief of pain, for the treatment of chronic impingement syndrome of the shoulder. If the patient has the combined lesions in the cervical spine and the shoulder, and systemic lesions, these lesions may influence the results of treatment after operation, and cause the unpredictable results.

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Pigmented Villonodular Synovitis of the Ankle and Subtalar Joint Treated by Surgical Excision and Ligament Reconstructions: A Case Report

  • Shin, Jae-Hyuk;Lee, Byung Hoon;Kim, Gab-Lae;Kim, Kwon
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.4
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    • pp.192-195
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    • 2016
  • Diffuse pigmented villonodular synovitis (PVNS) involving ankle joint needs complete mass excision and total synovectomy to reduce recurrence rate, while surrounding ligaments can be easily damaged. So the concurrent ligament reconstruction should be considered for post-excisional instability in subtalar joint as well as lateral ankle joint. We describe our experience in the management of a diffuse type PVNS, invades lateral talocrural joint extended to subtalar joint and introduce a new technique of all-in-one reconstruction for anterior talofibular,calcaneofibular and cervical ligament. Our new reconstruction technique applying modified Chrisman and Snook technique is useful in stabilization for deficiencies of the ligament complexafter PVNS excisionat lateral ankle and subtalar joint.

Acute Descending Necrotizing Mediastinitis Secondary to Spontaneous Rupture of Hypopharynx -A Case Report- (자연성 인두천공에 의한 급성하행 괴사성 종격동염 - 1례 보고 -)

  • 조규도;박찬범;조덕곤;김치경;왕영필;곽문섭
    • Journal of Chest Surgery
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    • v.35 no.11
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    • pp.842-846
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    • 2002
  • A rare case of acute descending necrotizing mediastinitis(DNM) secondary to spontaneous rupture of hypopharynx is reported. Due to the right lower cervical abscess the patient had undertaken limited right anterior cervical drainage at other department. After transferring to our department he undertook combined wide cervical mediastinal drainage and mediastinal drainage via right thoracotomy. However mediastinal drainage was ineffective. So the second operation was performed and chest tubes were relocated. He had an uneventful postoperative course. As far as the cause of acute descending necrotizing mediastinitis was concerned, we couldn't find any literature in Korean or English except one case that dealt with spontaneous rupture of the hypopharynx.

Arterial Thoracic Outlet Syndrome - a case report- (동맥성 흉곽출구 증후군 -1례 보고-)

  • 이철범;함시영;정원상;김영학;강정호;이홍기;박충기
    • Journal of Chest Surgery
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    • v.31 no.9
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    • pp.903-906
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    • 1998
  • A 17-year-old-boy with a bilateral incomplete cervical rib, upon abduction of his left arm at 45 degrees, had immediately begun to show symptoms of severe tingling, claudication, pallor, and weakness of his left upper extremity. These symptoms were aggravated at 90 degrees, leaving him debilitated from his work in the printing office. Transfemoral positional subclavian arteriography revealed total occlusion of the subclavian artery immediately distal to a cervical rib during 90 degrees abduction. Resection of the anterior scalene and medial aspect of the middle scalene muscles, cervical and first ribs, and arteriolysis were performed via a combined supraclavicular and infraclavi cular approach. He has returned to work as a printer with marked relief of symptoms and has remained asymptomatic over follow-up periods of 10 months.

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Thymic Cyst Causing Tracheal Stenosis : one case report (기도협착을 유발한 흉선낭종)

  • Hwang, Jung-Joo;Yang, Hong-Seok;Paik, Hyo-Chae;Hong, Soon-Won;Lee, Doo-Yun
    • Korean Journal of Bronchoesophagology
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    • v.10 no.2
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    • pp.68-71
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    • 2004
  • Thymic cysts are uncommon tumors which usually occur in the neck and mediastinum. It is known to arise from embryonic remnants of the thymopharyngeal duct or from inflammation of thymic tissues. Patients with thymic cyst are often asymptomatic and identified after surgical removal and histologic examination. We experienced a 73 year-old man with recently developed dyspnea. During the examination, chest CT showed a $5\times6cm$ sized cystic mass causing deviation of the trachea. It was located in between the right thyroid gland and anterior mediastinum. It also caused tracheal narrowing noted by bronchoscopy. Right anterior cervical incision and removal of the mass was performed and a histological diagnosis of thymic cyst was confirmed. The patient was discharged without complication.

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Thymic Cyst Causing Tracheal Stenosis : one case report (기도협착을 유발한 흉선낭종)

  • Hwang, Jung-Joo;Yang, Hong-Seok;Paik, Hyo-Chae;Hong, Soon-Won;Lee, Doo-Yun
    • Korean Journal of Bronchoesophagology
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    • v.11 no.1
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    • pp.25-27
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    • 2005
  • Thymic cysts are uncommon tumors which usually occur in the neck and mediastinum. It is known to arise from embryonic remnants of the thymopharyngeal duct or from infammation of thymic tissues. Patients with thymic cyst are often asymptomatic and identified after surgical removal and histologic examination. We experienced a 73 year-old man with recently developed dyspnea. During the examination, chest CT showed a $5{\times}6cm$ sized cystic mass causing deviation of the trachea. It was located in between the right thyroid gland and anterior mediastinum. It also caused tracheal narrowing noted by bronchoscopy. Right anterior cervical incision and removal of the mass was performed and a histological diagnosis of thymic cyst was confirmed. The patient was discharged without complication.

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Comparative Study of Clinical and Radiological Outcomes of a Zero-Profile Device Concerning Reduced Postoperative Dysphagia after Single Level Anterior Cervical Discectomy and Fusion

  • Son, Doo Kyung;Son, Dong Wuk;Kim, Ho Sang;Sung, Soon Ki;Lee, Sang Weon;Song, Geun Sung
    • Journal of Korean Neurosurgical Society
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    • v.56 no.2
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    • pp.103-107
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    • 2014
  • Objective : This study analyzed clinical and radiological outcomes of a zero-profile anchored spacer (Zero-P) and conventional cage-plate (CCP) for single level anterior cervical discectomy and fusion (ACDF) to compare the incidence and difference of postoperative dysphagia with both devices. Methods : We retrospectively reviewed our experiences of single level ACDF with the CCP and Zero-P. From January 2011 to December 2013, 48 patients who had single level herniated intervertebral disc were operated on using ACDF, with CCP in 27 patients and Zero-P in 21 patients. Patients who received more than double-level ACDF or combined circumferential fusion were excluded. Age, operation time, estimated blood loss (EBL), pre-operative modified Japanese Orthopaedic Association (mJOA) scores, post-operative mJOA scores, achieved mJOA scores and recovery rate of mJOA scores were assessed. Prevertebral soft tissue thickness and postoperative dysphagia were analyzed on the day of surgery, and 2 weeks and 6 months postoperatively. Results : The Zero-P group showed same or favorable clinical and radiological outcomes compared with the CCP group. Postoperative dysphagia was significantly low in the Zero-P group. Conclusions : Application of Zero-P may achieve favorable outcomes and reduce postoperative dysphagia in single level ACDF.

Can the Zero-Profile Implant Be Used for Anterior Cervical Discectomy and Fusion in Traumatic Subaxial Disc Injury? A Preliminary, Retrospective Study

  • Kim, Tae Hun;Kim, Dae Hyun;Kim, Ki Hong;Kwak, Young Seok;Kwak, Sang Gyu;Choi, Man Kyu
    • Journal of Korean Neurosurgical Society
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    • v.61 no.5
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    • pp.574-581
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    • 2018
  • Objective : The zero-profile implant (Zero-P) is accepted for use in anterior cervical fusion for the treatment of degenerative cervical disease. However, evidence pertaining to its efficiency and safety in traumatic cervical injury is largely insufficient. This study aimed to compare the overall outcomes of patients who underwent Zero-P for traumatic cervical disc injury. Methods : Data from a total of 53 consecutive patients who underwent surgery for traumatic or degenerative cervical disc disease using the Zero-P were reviewed. Seventeen patients (group A) had traumatic cervical disc injury and the remaining 36 (group B) had degenerative cervical disc herniation. The fusion and subsidence rates and Cobb angle were measured retrospectively from plain radiographs. The patients' clinical outcomes were evaluated using the Japanese Orthopedic Association (JOA) score and Odom's criteria. Results : The C2-7 Cobb and operative segmental angles increased by $3.45{\pm}7.61$ and $2.94{\pm}4.59$ in group A; and $2.46{\pm}7.31$ and $2.88{\pm}5.49$ in group B over 12 postoperative months, respectively. The subsidence and fusion rate was 35.0% and 95.0% in group A; and 36.6% and 95.1% in group B, respectively. None of the parameters differed significantly between groups. The clinical outcomes were similar in both groups in terms of increasing the JOA score and producing a grade higher than "good" using Odom's criteria. Conclusion : The application of Zero-P in patients with traumatic cervical disc injury was found to be acceptable when compared with the clinical and radiological outcomes of degenerative cervical spondylosis.

Intradural Involvement of Multicentric Myxoid Liposarcoma

  • Cho, Su-Hee;Rhim, Seung-Chul;Hyun, Seung-Jae;Bae, Chae-Wan;Khang, Shin-Kwang
    • Journal of Korean Neurosurgical Society
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    • v.48 no.3
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    • pp.276-280
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    • 2010
  • Liposarcomas are malignant tumors of the soft tissue, with myxoid liposarcoma being the second most common subtype, tending to occur in the limbs, particularly in the thighs. Myxoid liposarcomas have an intermediate prognosis between well-differentiated and pleomorphic tumors. Spinal metastasis is usual but intradural involvement is extremely rare. We present an unusual case of a multicentric myxoid liposarcoma with intradural involvement. A 41-year-old woman complained of tingling sensation on her left arm. Radiological evaluation revealed multiple masses in her cervical spine, abdominal wall, liver, heart and right thigh, all of which were resected. She was histologically diagnosed with small round cell myxoid sarcoma and underwent adjuvant chemotherapy. However, magnetic resonance imaging analysis after 1 year revealed a large metastatic mass with bony invasion at the C6-T1 level. This mass consisted of extradural and intradural components causing severe compression of the spinal cord. She underwent resection via a posterior facetectomy of C6-7 and an anterior C7 corpectomy. However, the patient died of multiple metastases 18 months after the first diagnosis.

Clinical Experience of H-type Tracheoesophageal Fistula (H형 기관지 식도루에 대한 임상 경험)

  • Cho, Hwui-Dong;Nam, So-Hyun;Cho, Min-Jeng;Kim, Tae-Hoon;Kim, Dae-Yeon;Kim, Seong-Chul;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.17 no.2
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    • pp.154-161
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    • 2011
  • Tracheoesophageal fistula without esophageal atresia (H-type TEF) is a congenital anomaly that is characterized by a fistula between the posterior wall of the trachea and the anterior wall of the esophagus, not accompanied by esophageal atresia. The purpose of this study is to investigate the clinical characteristics, diagnostic time, the side of cervical approach and short term result after surgery by searching medical records of patients treated for H-type TEF. The search was done at University of Ulsan, Department of Pediatric Surgery of Asan Medical Center, and the total number of patients from May 1989 to December 2010 was 9 with M:F ratio of 1:2. The median gestational age was $39^{+6}$ ($32^{+6}{\sim}41^{+0}$) wks. Seven out of nine patients were born at term and the other two were born premature. The clinical presentation was aspiration pneumonia, difficulty in feeding, chronic cough, vomiting, abdominal distension and growth retardation. The symptoms presented right after birth. The diagnosis was made with esophagography and the median time of diagnosis was 52 days of life. The majority of surgical corrections were performed within two weeks of diagnosis (median; 15d, range; 1d - 6m). Six patients had associated anomalies, and cardiac anomalies were most common. The cervical approach was utilized in all cases (right 2, left 7). Transient vocal cord palsy and minor esophageal leakage complicated two cases. Although the diagnosis of H-type TEF was difficult and often delayed, we had a good short term result. The left cervical approach was preferred.

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