• Journal of Korean Neurosurgical Society
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• v.40 no.4
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• pp.273-276
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• 2006

Although cavernous angioma itself is not rare, the epidural spinal localization is uncommon and makes preoperative differential diagnosis difficult. An extraordinary case of a thoracic epidural cavernous angioma in very young age, causing sudden paraplegia is presented. Only 79 cases have been reported in the literatures and among them, this kid was the youngest. A 23-month-old boy was referred to us with a 2-day history of sudden both lower limb weakness. Two days before admission, he got up at morning and was unable to stand and even to move the legs. MRI revealed an epidural mass surrounding spinal cord associated with cord compression at the level of the C5 through T3. Through posterior approach with exposure of C6 to T3 level, the hematomatous mass was removed subtotally due to intraoperative bleeding and its ventral location. After the first operation, the weakness of bilateral lower extremities was improved so as to move gainst the gravity. But the next day, the limb weakness was aggravated as same as preoperative status due to mass effect of new hematoma. The second operation was performed to remove the hematoma and to control the bleeding focus. Several weeks later, the limb weakness was improved and he was able to walk. The literatures about spinal cavernous angioma are reviewed.

• Journal of Korean Neurosurgical Society
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• v.60 no.5
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• pp.534-539
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• 2017

Objective : Patients with hematological malignancies frequently encounter spine-related symptoms, which are caused by disease itself or process of treatment. However, there is still lack of knowledge on their epidemiology and clinical courses. The purpose of this article is to review clinical presentations and surgical results for spinal involvement of hematologic malignancies. Methods : From January 2011 to September 2014, 195 patients (98 males and 97 females) suffering from hematological malignancies combined with spinal problems were retrospectively analyzed for clinical and radiological characteristics and their clinical results. Results : The most common diagnosis of hematological malignancy was multiple myeloma (96 patients, 49.7%), followed by chronic myeloid leukemia (30, 15.2%), acute myeloid leukemia (22, 11.2%), and lymphoma (15, 7.56%). The major presenting symptoms were mechanical axial pain (132, 67.7%) resulting from pathologic fractures, and followed by radiating pain (49, 25.1%). Progressive neurologic deficits were noted in 15 patients (7.7%), which revealed as cord compression by epidural mass or compressive myelopathy combined with pathologic fractures. Reconstructive surgery for neurologic compromise was done in 16 patients. Even though surgical intervention was useful for early paralysis (Frankel grade D or E), neurologic recovery was not satisfactory for the progressed paralysis (Frankel grade A or B). Conclusion : Hematological malignancies may cause various spinal problems related to disease progression or consequences of treatments. Conservative and palliative treatments are mainstay for these lesions. However, timely surgical interventions should be considered for the cases of pathologic fractures with progressive neurologic compromise.

• Neurospine
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• v.15 no.4
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• pp.368-375
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• 2018

Objective: To evaluate the results of operative management of subaxial spine injuries managed with 2-level anterior cervical corpectomy and fusion with a cervical locking plate and autologous bone-filled titanium mesh cage. Methods: This study included 23 patients with a subaxial spine injury who matched the inclusion criteria, underwent 2-level anterior cervical corpectomy and fusion at our institution between 2013 and 2016, and were followed up for neurological recovery, axial pain, fusion, pseudarthrosis, and implant failure. Results: According to Allen and Ferguson classification, there were 9 cases of distractive extension; 4 of compressive extension; 3 each of compressive flexion, vertical compression, and distractive flexion; and 1 of lateral flexion. Sixteen patients had a score of 6 on the Subaxial Injury Classification system, and the rest had a score of more than 6. The mean follow-up period was 19 months (range, 12-48 months). Neurological recovery was observed in most of the patients (78.21%). All patients experienced relief of axial pain. None of the patients received a blood transfusion. Twenty-one patients (91.3%) showed solid fusion and 2 (8.69%) showed possible pseudarthrosis, with no complications related to the cage or plate. Conclusion: Two-level anterior cervical corpectomy and fusion, along with stabilization with a cervical locking plate and autologous bone graft-filled titanium mesh cage, can be considered a feasible and safe method for treating specific subaxial spine injuries, with the benefits of high primary stability, anatomical reduction, and direct decompression of the spinal cord.

• Journal of Korean Neurosurgical Society
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• v.64 no.5
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• pp.677-692
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• 2021

Many studies have focused on pre-operative sagittal alignment parameters which could predict poor clinical or radiological outcomes after laminoplasty. However, the influx of too many new factors causes confusion. This study reviewed sagittal alignment parameters, predictive of clinical or radiological outcomes, in the literature. Preoperative kyphotic alignment was initially proposed as a predictor of clinical outcomes. The clinical significance of the K-line and K-line variants also has been studied. Sagittal vertical axis, T1 slope (T1s), T1s-cervical lordosis (CL), anterolisthesis, local kyphosis, the longitudinal distance index, and range of motion were proposed to have relationships with clinical outcomes. The relationship between loss of cervical lordosis (LCL) and T1s has been widely studied, but controversy remains. Extension function, the ratio of CL to T1s (CL/T1s), and Sharma classification were recently proposed as LCL predictors. In predicting postoperative kyphosis, T1s cannot predict postoperative kyphosis, but a low CL/T1s ratio was associated with postoperative kyphosis.

• Radiation Oncology Journal
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• v.12 no.3
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• pp.393-399
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• 1994

Spinal cord compression, an oncologic emergency, is a rare complication of hematologic malignancy Our experience was obtained with a series 32 Patients following retrospective analysis for assessing the role of radiation therapy and identifying the prognostic factors affecting on treatment outcome. Diagnosis was usually made by means of radiologic study such as myelography or computerized tomography (CT) or magnetic resonance imaging (MRI) and neurologic examination. Five cases were diagnosed by subjective symptom only with high index of suspicion. In 31 cases, the treatment consisted in radiation therapy alone and the remained one patient had laminectomy before radiation therapy because of diagnostic doubts. Total treatment doses ranged from 800 cGy to 4000 cGy with median of 2000 cGy. Initially large fraction size more than 250 cGy were used in 13 patients with rapidly progressed neurologic deficit. The clinical parameters considered in evaluating the response to treatment were backache, motor-sensory performance and sphincter function. Half of all patients showed good response. Partial response and no response were noted in $37.5\%$ and $12.5\%$, respectively. Our results showed higher response rate than those of other solid tumor series. The degree of neurologic deficit at that time of diagnosis was the most important predictor of treatment outcome. The elapsed time from development of symptoms to start of treatment was significantly affected on the outcome. But histology of primary tumor total dose and use of initial large fraction size were not significantly affect on the outcome. These results confirmed the value of early diagnosis and treatment especially in radiosensitive hematologic malignancy.

• Journal of Veterinary Clinics
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• v.27 no.5
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• pp.546-552
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• 2010

Previous studies could not offer available guideline to decide size of balloon and grade of injury before induction of spinal cord injury (SCI) because grade of SCI was assessed after inserting a catheter and each experimental animal were different in body size and weight as well as in species. This study was performed to provide guideline for standardized SCI model. Eight healthy adult beagle dogs that had 8 mm of spinal canal height were assigned to four groups according to the diameter of balloon and compression time: 4 mm/3hrs, 4 mm/6hrs, 4 mm/12hrs and 6 mm/3hrs group. Radiography was performed to standardize between experimental animal and balloon before selecting balloon diameter to induce SCI. Behaviors outcomes, somatosensory evoked potentials (SEPs), magnetic resonance imaging (MRI) and histopathological examination were evaluated. Behaviors outcomes and SEPs were not available to assess grade of SCI and those only indicate SCI. The damaged area was revealed clear hyperintensity on STIR image and T2WI after induction of SCI. The hyperintense area on MRI was cranially and caudally expanded with increasing of the diameter of balloon or the compression time. Well corresponded to expanding of hyperintense area on MRI, the damaged region and the numbers of caspase-3 and PARP immunoreactive cells were increased on histopathological findings. Therefore, these results will be considered fundamental data to induce standardized SCI model in experimental animal that has various weight and size.

• Journal of Veterinary Clinics
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• v.27 no.6
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• pp.713-717
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• 2010

Outcomes of non-surgical and surgical treatments for thoracolumbar intervertebral disc disease (IVDD) are well-reported. However, little is known regarding the outcome for treatments of cervical IVDD. This study systematically reviewed the outcomes in dogs with cervical IVDD that were managed non-surgically and surgically. Clinical success rates for surgical treatment were significantly higher (100%) than for non-surgical treatment (51.4%). In the non-surgical treatment group, clinical success rates were negatively correlated with spinal cord compression rates. Based on the results of this study, surgical treatment is deemed more effective than non-surgical treatment for dogs with cervical IVDD. Also, the degree of spinal cord compression on computed tomography or magnetic resonance imaging is a useful prognostic indicator before non-surgical treatment.

• Journal of radiological science and technology
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• v.29 no.3
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• pp.157-165
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• 2006

In order to analyze clinical characteristics like sex- and age-based onset frequency and onset region from vertebral disease cases, this study investigated total 1,291 cases of vertebral disease that were diagnosed via magnetic resonance imaging(MRI) from January to December 2004 at B University Hospital in metropolitan area. For higher diagnostic accuracy in cases of spinal disorder diagnosed, this study analyzed findings from data reading conducted by veteran specialists in diagnostic radiology. But this study excluded uncertain lesion cases, the cases requiring differential diagnosis from other disorders and so on from subjects under analysis. This study employed superconductive 1.5 Tesla SIGNA MR/i for MRI test and basically received resulting images via FSE(fast spin echo). In particular, this study obtained T1 and T2 myelogram with regard to regional characteristics(such as cervical vertebrae, thoracic vertebrae and lumbar vertebra) and imaging characteristics for sagittal and transverse section. As a result, this study came to the following conclusions : 1. In terms of general characteristics of subjects under analysis, male group comprised 53.5% and female 46.5% out of total 1,291 subjects. 2. The regional onset frequency of spinal disorders was converged primarily on lumbar vertebra(65.5%), which was followed by cervical vertebrae(27.3%) and thoracic vertebrae(7.0%) respectively. 3. Top 10 cases with high onset frequency of spinal disorders can be listed as follows : 1) posterior bulging disc 65.8% 2) narrowing of neural foramen 23.8% 3) herniated intervertebral disc (HIVD) 22.4% 4) spinal stenosis 16.7% 5) osteochondrosis 6.4% 6) compression fracture 6.4% 7) facet joint arthropathy 6.2% 8) spondylolisthesis 6.0% 9) spinal cord tumor 3.5% 10) inter body fusion 2.6%

• Journal of Yeungnam Medical Science
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• v.30 no.2
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• pp.116-119
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• 2013

A burnt-out prostate cancer tumor is a very rare clinical entity. The term 'burnt-out' refers to a primary tumor that has spontaneously and nearly completely regressed without treatment. Since metastasis of prostate cancer is usually encountered in the presence of advanced disease, distant metastasis with an undetectable primary tumor is very rare. We report herein a case of a burnt-out prostate cancer tumor that metastasized to the thoracic (T) spine and caused cord compression. A 66-year-old man visited the Emergency Department due to weakness of both legs for the past two days. His blood and urine tests were normal at the time. His spine magnetic resonance imaging (MRI) scans looked like bone metastasis that involved the T-7 vertebral body and a posterior element, and caused spinal cord compression. Other images, including from the brain MRI, neck/chest/abdomino-pelvic computed tomography (CT) scan and 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) and endoscopy, revealed no lesions that suggested malignancy. After total corpectomy T-7 and screw fixation/fusion at T5 to T10, the pathology report revealed a metastatic carcinoma that was strongly positive for prostate-specific antigen (PSA). The serum PSA value was 1.5 ng/mL. The transrectal 12-core prostate biopsy and ultrasonography showed no definitive hypoechoic lesion, but one specimen had slight (only 1%) adenocarcinoma with a Gleason score of 6 (3+3). The final diagnosis was burned-out prostate cancer with an initial normal PSA value. Although metastatic disease with an unknown primary origin was confirmed, a more aggressive approach in seeking the primary origin could provide a more specific treatment strategy and greater clinical benefit to patients.

• Journal of Oriental Medical Thermology
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• v.1 no.1
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• pp.28-37
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• 2002

Stable Compression Fractures(SCF hereafter) are most often caused by trauma such as traffic accidents. These SCFs usually occur in the thoracic and lumbar regions of the spinal cord. Human life spans have increased as a result of medical advances, which in turn has led to an increase in the elderly population. SCFs are divided into the categories of stable and unstable. The categories are determined through X-rays and P/Ex tests. The D.I.T.I. is then used to diagnose the severity and prognosis of the fracture injuries, and it allows an objective evaluation of the symptoms. This author researched 40 patients who were treated at Wonkwang University Oriental Medical Center from October 1995 to December 1996. The patients were diagnosed by X-ray as having SCFs and treated primarily with acupuncture. Both the changes in D.I.T.I. and patients' self-diagnoses of their conditions before and after treatment yielded the meaningful results which have been presented here. 1. 75% of those who suffer from Stable Compression Fractures are 60 years of older. Of those, the ratio of male to female is 1 to 4. This is due in part to the fact that many elderly women seek Oriental medicine treatment for conditions associated with advanced age. 2. 53.3% of these injuries occurred between T11 and L2. 3. 65% of patients were hospitalized for 10 to 29 days, and then able to be treated on an outpatiens basis. 4. The D.I.T.I. results showed 50% below $0.2^{\circ}C$, 30% between 0.3 and $0.5^{\circ}C$, 10% between 0.5 and $0.7^{\circ}C$, 10% between 0.7 and $0.9^{\circ}C$, and 0% over $0.9^{\circ}C$. 5. The results of treatment using Modified Evaluation System in Thoracolumbar Vertebral Fractures Method showed that 55% of patients achieved excellent recovery and 40% achived good recovery. After comparing the D.I.T.I. results before and after treatment, we found 50% of patients showed excellent recovery $({\Delta}T{\leq}0.2)$ and 40% showed good recovery$(0.2<{\Delta}T{\leq}0.5)$.