• Title/Summary/Keyword: Anterior longitudinal ligament

Search Result 31, Processing Time 0.02 seconds

Surgical Treatment of a Life-Threatening Large Retropharyngeal Hematoma after Minor Trauma : Two Case Reports and a Literature Review

  • Park, Jin Hoon;Jeong, Eui-Kyun;Kang, Dong-Ho;Jeon, Sang Ryong
    • Journal of Korean Neurosurgical Society
    • /
    • v.58 no.3
    • /
    • pp.304-307
    • /
    • 2015
  • Only a few cases of anterior longitudinal ligament (ALL) injury related with retropharyngeal hematoma without fracture have previously been reported. The treatment of choice for retropharyngeal hematoma is generally considered to be conservative care, but we believe that early surgery of this pathology would be better in certain situations. Here, we describe two cases with life-threatening large retropharyngeal hematomas related with ALL injuries and operated on at an early stage. Two previously healthy patients visited the emergency room with neck pain and dyspnea after falling. Serious neck swelling was observed and lateral neck X-ray showed severe widening of the prevertebral space. Due to dyspnea progression, emergency endotracheal intubation was performed. Although there was no primary cause of the retropharyngeal hematoma on preoperative examination, ALL tearing was intraoperatively confirmed during early surgery. The in-hospital evolutions of the patients were favorable after surgery. We should bear in mind the possibility of ALL injury and perform early surgery where possible given the earlier convalescence and good prognosis.

Indirect Reduction and Spinal Canal Remodeling through Ligamentotaxis for Lumbar Burst Fracture

  • Kang, Wu Seong;Kim, Jung Chul;Choi, Ik Sun;Kim, Sung Kyu
    • Journal of Trauma and Injury
    • /
    • v.30 no.4
    • /
    • pp.212-215
    • /
    • 2017
  • The choice of the most appropriate treatment for thoracolumbar or lumbar spine burst fracture remains controversial from conservative treatment to fusion through a posterior or anterior approach. There are many cases where ligamentotaxis is used to reduce the burst fracture. However, indirect reduction using ligamentotaxis is often limited in the magnitude of the reduction that it can achieve. In our patient with severe burst fracture, we were able to restore an almost normal level of vertebral height and secure spinal canal widening by using only ligamentotaxis by posterior instrumentation. Before the operation, the patient had more than 95% encroachment of the spinal canal. This was reduced to less than 10% after treatment.

The Role of Meniscal Arrow in the Treatment of the Meniscal Tear (반월상 연골 파열의 치료에서 meniscal arrow의 역할)

  • Bae, Dae Kyung;Yim, Chang Moo;Jeong, Ki Woong
    • Journal of the Korean Arthroscopy Society
    • /
    • v.3 no.1
    • /
    • pp.24-29
    • /
    • 1999
  • Purpose : The purpose of this paper is to analyze the clinical results after meniscal repair using meniscal arrow. Materials and Methods : Between May 1997 and Aug 1998, we repaired 22 tom menisci in 22 patients using meniscal arrows. There were nineteen males and three females with an average age of 27 years. There were longitudinal tear in 14 cases, Bucket-handle tear were 7 cases and horizontal tear was in 1 case. In 22 meniscus tears, 16 cases were associated with anterior cruciate ligament tear. Average number of meniscal arrow that was used were 2.5(ranged 1 to 4). Average follow-up period was 14.7 months(ranged 6 to 22 months). We evaluated the clinical results by the Tapper and Hoover's grading system. Results : There were excellent in 16 cases, good in 4 cases and fair in 2 cases on the clinical results. At the last follow up, the range of the motion of the knee joint were average 135 degrees(ranged 125 to 140 degrees). Mean time elapsed for meniscal repair were 25 minutes(ranged 15 to 40 minutes). Conclusion : Meniscal arrow has many advantages such as short operative time, easy fixation technique, and less neurovascular injury. We think that arthroscopic meniscal repair using meniscal arrow is effective treatment method in selected patient who have longitudinal, bucket-handle tear at the posterior hom associated with anterior cruciate ligament tear.

  • PDF

Dystrophic Calcification in the Epidural and Extraforaminal Space Caused by Repetitive Triamcinolone Acetonide Injections

  • Jin, Yong-Jun;Chung, Sang-Bong;Kim, Ki-Jeong;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
    • /
    • v.50 no.2
    • /
    • pp.134-138
    • /
    • 2011
  • The authors report a case of epidural and extraforaminal calcification caused by repetitive triamcinolone acetonide injections. A 66-year-old woman was admitted presenting with lower extremity weakness and radiating pain in her left leg. Ten months before admission, the patient was diagnosed as having an L4-5 spinal stenosis and underwent anterior lumbar interbody fusion followed by posterior fixation. Her symptoms had been sustained and she did not respond to transforaminal steroid injections. Repetitive injections (10 times) had been performed on the L4-5 level for six months. She had been taking bisphosphonate as an antiresorptive agent for ten months after surgery. Calcification in the ventral epidural and extraforaminal space was detected. The gritty particles were removed during decompressive surgery and these were proven to be a dystrophic calcification. The patient recovered from weakness and radiating leg pain. Repetitive triamcinolone acetonide injections after discectomy may be the cause of dystrophic calcification not only in the degenerated residual disc, but also in the posterior longitudinal ligament. Possible mechanisms may include the toxicity of preservatives and the insolubility of triamcinolone acetonide. We should consider that repetitive triamcinolone injections in the postdisectomy state may cause intraspinal ossification and calcification.

Retropharyngeal abscess coinfected with Staphylococcus aureus and Mycobacterium tuberculosis after rhinoviral infection in a 1-month-old infant

  • Shin, Jeong Hee;Sung, Se In;Kim, Jin Kyu;Jung, Ji Mi;Kim, Eun Sun;Choi, Soo Han;Kim, Yae Jean;Ahn, Kang Mo;Chang, Yun Sil;Park, Won Soon
    • Clinical and Experimental Pediatrics
    • /
    • v.56 no.2
    • /
    • pp.86-89
    • /
    • 2013
  • A retropharyngeal abscess is a rare disease entity in young infants but can develop after nasopharyngeal viral infection. Group B Streptococcus and Staphylococcus aureus are the most common pathogens in young infants, however, Mycobacterium tuberculosis is very rare. We report the case of retropharyngeal abscess and coinfection with S. aureus and M. tuberculosis in a very young infant presenting with respiratory symptoms due to upper airway obstruction. Usually tuberculous retropharyngeal abscesses are caused by the direct invasion of the bacteria from the spine via anterior longitudinal ligament of the spine. However, in this case, no associated spinal disease was observed.

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
    • /
    • v.4 no.1
    • /
    • pp.49-53
    • /
    • 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.

  • PDF

Comparision of Trans-Tibial and Anteromedial Portal Approach in Femoral Tunneling of Anterior Cruciate Ligament Reconstruction (전방십자인대 재건술의 대퇴골 터널 굴착시 경경골 접근법과 전내측통로 접근법의 비교)

  • Sohn, Sung-Keun;Chang, Yun-Suk;Chung, ll-Kwon;Kim, Kyung-Taek
    • Journal of the Korean Arthroscopy Society
    • /
    • v.8 no.2
    • /
    • pp.75-81
    • /
    • 2004
  • Purpose: Recent development and advances in arthroscopic surgical techniques for Anterior Cruciate Ligament(ACL) reconstruction have led to the ideal location for the etric point from 10 o'clock (in right knee) and 13:30 (in left knee) to 10:30 (in right knee) and 14 o'clock (in left knee) in the frontal plane. This study was performed to compare operative methods and the radiologic results of femoral tunnels made through the tibial tunnel(trans-tibial approach) and the anteromedial portal. Material and Methods: From January 2003 to May 2004, one-hundred reconstructions of anterior cruciate ligament were performed. Group I (femoral tunnel through tibial tunnel) was composed of 50 cases and group ll (femoral tunnel through anteromedial portal) was consisted of 50 cases. The study was performed to compare the radiographic results of femoral tunnels made through the tibial tunnel and the anteromedial portal and operative methods. Results: In operative methods at Group II, femoral tunnel was made more easily at isometric point than Group I, a good visual field was achived because 100$^{\circ}$ flxion of knee, they can be reduced risk of posterior cortical breakage and tunnel-graft mismatching and decreased divergence of femoral interference screw in radiology (P<0.05). The angle between femoral tunnel and longitudinal axis of ACL wae increased at Group ll. Conclusion: Aanteromedial portal technique was more useful in ACL reconstruction for femoral tunnel toward 10 o'clock to10:30(in right) or 1:30 to 2 o'clock(in left).

  • PDF

Longitudinal Tracking of Alteration Pattern on Trabecular Bone Microarchitecture at Tibial Epiphysis Induced by Post Traumatic Osteoarthritis Over Time (외상성 관절염 진행에 따른 경골 골단 해면골에서의 골 미세구조 변화 패턴 추적 관찰)

  • Lee, Joo-Hyung;Chun, Keyoung-Jin;Lee, Kwon-Young;Kim, Dae-Jun;Kim, Han-Sung;Lim, Do-Hyung
    • Transactions of the Korean Society of Mechanical Engineers B
    • /
    • v.36 no.11
    • /
    • pp.1081-1090
    • /
    • 2012
  • This study aims to track the longitudinal alteration pattern on the trabecular bone microarchitecture at tibial epiphysis induced by T-OA over time using in vivo micro computed tomography (${\mu}CT$). Ten SD rats were divided into control (n = 5) and T-OA (n = 5) groups. Anterior cruciate ligament transaction was performed for the T-OA group. The results showed that the alteration pattern on the trabecular bone microarchitecture at tibial epiphysis in the T.OA group was definitely different compared with that in the CON group from 0 to 8 weeks (approximately 4-16%, P > 0.05). In particular, a difference was observed in the bone formation and density distributions over time (from 0 or 4 to 8 weeks; approximately 5.15%, P < 0.05). An improved understanding of the alteration pattern on the trabecular bone microarchitecture at tibial epiphysis may assist in developing more targeted treatment interventions for T-OA.

The Analysis on Surgical Result and Prognostic Factors of Thoracic Spinal Stenosis (흉추강 협착증의 수술적 치료 결과와 예후인자에 관한 분석)

  • Chang, Ung Kyu;Chung, Sang Kee;Kim, Dong Yoon;Chung, Chun Kee;Kim, Hyun Jib
    • Journal of Korean Neurosurgical Society
    • /
    • v.30 no.6
    • /
    • pp.761-768
    • /
    • 2001
  • Objective : To describe the underlying causes, surgical results, and prognostic factors in thoracic stenosis causing myelopathy, retrospective analysis for 28 cases of thoracic stenosis with surgery was performed Materials & Method : Twenty-eight patients(male, 15 ; female, 13) who underwent decompressive surgery for thoracic stenosis between 1987 and 1997 were analyzed. The mean age was 49 and the mean follow-up was 30.6 months. Statistical analysis with $SPSS^{(R)}$ was performed. Chi-square test was used for the analysis of relationship between subjects and multivariate analysis with general linear model was used to find prognostic factors. Result : Degenerative spondylosis was the most common cause, and three cases were associated with systemic diseases. Decompressive laminectomy was done in 23 cases, anterior decompression in four cases, and combined decompression in one case. Ossification of ligamentum flavum was found in 18 cases, facet hypertrophy in 13, ossification of posterior longitudinal ligament in six, and ventral spur in four. Postoperatively, 16 patients improved functionally and 4 patients worsened. The group of which initial symptom duration was less than two years showed better result(p=0.003). The group with sufficient decompression and no additional proximal stenosis had better outcome(p=0.002, p=0.001). Conclusion : Chronic myelopathy caused by thoracic stenosis can be reversible with appropriate decompression.

  • PDF

Results of Microsurgical Anterolateral Tunnel Approach for Cervical Disc Herniation (경추간판탈출증에 대한 미세 전측방 Tunnel Approach의 결과)

  • Jang, Woo-Young;Kim, Keun-Soo;Lee, Jung-Chung;Kim, Chul-Jin;Choi, Ha-Young;Xuan, Xiu-Nan;Han, Dong-Han
    • Journal of Korean Neurosurgical Society
    • /
    • v.30 no.5
    • /
    • pp.600-604
    • /
    • 2001
  • Objective : The authors report the microsurgical anterolateral tunnel approach for the treatment of the cervical disc diseases and its postoperative surgical results. Methods : All surgical procedures followed the method of classical microsurgical anterior discectomy. Small tunnel(7-8mm) was made on the disc space reaching to the posterior longitudinal ligament. The disc materials and bony spurs were removed through this tunnel. Thirty-one patients of cervical disc herniation(24 cases with pure disc herniation, 7 cases with combined cervical spondylosis) were evaluated on the symptoms, conformation in plain X-ray, C-T, and MRI. The follow up time was over 2 years. Results : Postoperatively the result(following the out come scale) was excellent and good in Twenty-nine patients. One with fair result showed remnant disc particle and spur and another one is combined with cord contusion. One patient with lesion in C 3-4 space and two cervicothoracic junction showed excellent result. Two patients with osteoporosis also showed good results. Cervical spine curvature and disc space height were not changed on the plain X-ray and MRI in all patients. Twenty-nine patients were discharged within 3 days after surgery without any postoperative complications. Conclusions : The microsurgical anterolateral tunnel approach could be indicated for the treatment of patients with cervical disc diseases and with difficulty in achieving interbody fusion(the higher cervical level and cervicothoracic junction, osteoporosis etc.).

  • PDF