• Title/Summary/Keyword: Intraspinal

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Clinical Applications of the Tubular Retractor on Spinal Disorders

  • Kim, Young-Baeg;Hyun, Seung-Jae
    • Journal of Korean Neurosurgical Society
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    • v.42 no.4
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    • pp.245-250
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    • 2007
  • Tubular retractor system as a minimally invasive surgery (MIS) technique has many advantages over other conventional MIS techniques. It offers direct visualization of the operative field, anatomical familiarity to spine surgeons, and minimizing tissue trauma. With technical advancement, many spinal pathologies are being treated using this system. Namely, herniated discs, lumbar and cervical stenosis, synovial cysts, lumbar instability, trauma, and even some intraspinal tumors have all been treated through tubular retractor system. Flexible arm and easy change of the tube direction are particularly useful in contralateral spinal decompression from an ipsilateral approach. Careful attention to surgical technique through narrow space will ensure that complications are minimized and will provide improved outcomes. However, understanding detailed anatomies and keeping precise surgical orientation are essential for this technique. Authors present the technical feasibility and initial results of use a tubular retractor system as a minimally invasive technique for variaties of spinal disorders with a review of literature.

Congenital Elongated Lumbar Dermoid Cyst Combined with Sacral Meningocele

  • Kim, Chang-Hyun;Gill, Seung-Bae;Choi, Soo-Jung;Kang, Gil-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.40 no.5
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    • pp.391-393
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    • 2006
  • Dermoid cysts of the spinal canal are rare benign congenital tumors, accounting for $1{\sim}2%$ of all intraspinal tumors. We report a case of lumbar extramedullary cyst, combined with congenital sacral meningocele. The clinical features, characteristics on MRI, pathologic findings, and surgical treatment of such a rare extramedullary benign tumor is discussed with the relevant literature.

Anterior Surgical Approach in Recurrent Cervical Neurenteric Cyst - Case Report - (재발한 경추 신경장성 낭종의 전방경유 치험 - 증 례 보 고 -)

  • Bae, Kwang Ju;Kim, Il-Man
    • Journal of Korean Neurosurgical Society
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    • v.29 no.9
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    • pp.1258-1261
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    • 2000
  • Intraspinal neurenteric cyst is rare congenital lesion derived from disorder of notochord formation. Most of these are located ventral to the spinal cord and conventional posterior approach is considered to be effective method as initial treatment modality. This cyst can recur, but the risk of reccurence after partial removal through long term follow-up has not been determined. We experienced one case of cervical neurenteric cyst which recurred after partial removal through laminectomy. The magnetic resonance imaging and postmyelography computerized tomography revealed an intradural extramedullary cystic lesion anterior to the cervical cord at the fifth cervical vertebra level. We performed anterior cervical corpectomy and cyst was totally removed. The patient's neurological symptom was improved postoperatively. Neurenteric cyst located ventrally to the cervical spinal cord should be removed through anterior route for direct visualization of the relationship between the cyst wall and the spinal cord.

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Intracranial Lipoma in Medulla Oblongata

  • Yun, Ji-Kwang;Kim, Dae-Won;Kim, Tae-Young;Kim, Jong-Moon
    • Journal of Korean Neurosurgical Society
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    • v.41 no.5
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    • pp.330-332
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    • 2007
  • Intracranial lipomas are rare, and most of these tumors are found in the region of the corpus callosum, followed by cerebellopontine angle. We present a case of a intracranial lipoma in 30-year-old man. Brain computed tomography [CT] scan and magnetic resonance images [MRI] showed a mass in the medulla oblongata extending to foramen magnum. The histopathologically, diagnosis of lipoma was confirmed. Although there were several cases of cervical intraspinal lipoma extending into posterior cranial fossa, there have been no previous reports of a lipoma arising from the medulla oblongata that extended into the foramen magnum. We describe a rare case of intradural subpial lipoma in the medulla oblongata with a review of the literature.

Surgical Treatment of "Dumb-bell" Neurosarcoma and Intrathoracic Meningocele Associated with Von Recklinghausen`s Disease -A case report- (신경섬유종증을 동반한 신경성 육종과 흉강내 뇌척수막류의 치험 1례)

  • 최순호
    • Journal of Chest Surgery
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    • v.28 no.10
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    • pp.946-950
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    • 1995
  • Neurosarcoma is relatively rare, but is seen frequently in association with stigmata of neurofibromatosis ie., Cafe au lait pigmentation and cutaneous neurofibromatosis. Both advanced age and association with neurofibromatosis increase the likelihood of malignant degeneration to neurosarcoma. It also may be dumb bell-shaped with intraspinal extension. Thoracic meningocele is rare and represents a protrusion of the dural sac through an abnormally large or malformed intervertebral foramen. The patient is usually asymptomatic, with evidence of paravertebral mass on the chest rentgenogram. In one operation we removed a "Dumb-bell" neurosarcoma and intrathoracic meningocele in a 52 year old woman using a cervical laminectomy with a trap-door incision. She was discharged at 17 days after the operation with a sequelae of excision of nerve roots C8 and T1. Postoperative radiation therapy was performed during the follow-up period.up period.

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A Case of Primary Endobronchial Neurilemmoma Without Intraspinal Extension

  • Kim, Mi-Young;Kim, Hyun-Ji;Kim, Ah-Lim;Kim, Hyeong-Seok;Shin, Hyun-Woong;Jeong, Seung-Wook
    • Journal of Yeungnam Medical Science
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    • v.29 no.1
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    • pp.54-57
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    • 2012
  • Neurilemmoma is a benign and slowly growing neurogenic tumor. Intrathoracic neurilemmoma often develops in the chest wall and posterior mediastinum, but endobronchial neurilemmoma is extremely rare. The diagnosis of endobronchial neurilemmoma with preoperative imaging findings is challenging and is usually made via postoperative pathological examination. These authors encountered a case of primary endobronchial neurilemmoma in a 52-year-old woman who had no symptoms. A $3.0{\times}2.6$ cm mass in the right lower lobe projecting into the mediobasal segmental bronchus was shown in the results of the contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) of the chest. Benign neurilemmoma was confirmed via bronchoscopic biopsy, and surgical resection (sleeve bronchial excision and end-to-end anastomosis) was performed.

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Spinal Subarachnoid Hematoma as a Complication of an Intramuscular Stimulation : Case Report and a Review of Literatures

  • Lee, Myeong Jong;Chung, Young Sun
    • Journal of Korean Neurosurgical Society
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    • v.54 no.1
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    • pp.58-60
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    • 2013
  • Intramuscular stimulation (IMS) is widely used to treat myofascial pain syndrome. IMS is a safe procedure but several complications have been described. To our knowledge, spinal subarachnoid hematoma has never been reported as a complication of an IMS. The authors have experienced a case of spinal subarachnoid hematoma occurring after an IMS, which was tentatively diagnosed as intracranial subarachnoid hemorrhage because of severe headache. Patient was successfully treated with surgery. Here, we report our case with a review of literature.

Thoracic Interdural Aspergillus Abscess Causing Rapid Fatal Spondylitis in the Presence of Posterior Mediastinitis

  • Kim, Joon-Seok;Kim, Sung-Bum;Yi, Hyeong-Joong;Chung, Won-Sang
    • Journal of Korean Neurosurgical Society
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    • v.37 no.2
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    • pp.146-149
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    • 2005
  • Most primary spinal abscesses, irrespective of pathogens and anatomical locations, have better prognosis than that of secondary abscesses with spondylitis. We report a 68-year-old man, previously undertaken pulmonary resection due to tuberculosis, presented with paraparesis. Imaging studies showed primary intraspinal abscesses at T-1 and T-3 vertebral levels, semi-invasive pulmonary Aspergillosis and inflammation of the posterior mediastinum. Operative procedure and histopathological examination revealed interdural Aspergillus abscess. Despite chemotherapy, he deteriorated progressively, and spondylitis developed at corresponding vertebrae. He eventually died 6 weeks postoperatively due to pulmonary complication. The authors intended to inform that such an extradural inflammatory lesion of Aspergillus abscess should be treated carefully.

Stellate Ganglion Phenol Block -Case reports- (성상신경절 페놀차단 -증례 보고-)

  • Kim, Dae-Young;Cho, Hee-Won;Oh, Hung-Kun
    • The Korean Journal of Pain
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    • v.8 no.2
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    • pp.312-318
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    • 1995
  • Stellate ganglion block is extensively performed in pain closing to treat a diversity of diseases. Stellate ganglion phenol neurolysis, however, has not been not popular because of risk and complications such as: permanent horner's syndrome, hoarseness, pneumothorax and intravascular or intraspinal injection. But Racz recently performed stellate ganglion phenol neurolysis successfully, under fluoroscopic guide, minus significant complication. Three patients were recently treated at our pain clinic by repeated stellate ganglion block with local anesthetics. Patients showed immediate signs of improvement but prolonged pain relief was not achieved. Therefore we reported to performing stellate ganglion phenol neurolysis following Racz's technique. We successfully treated: two cases of reflex sympathetic dystrophy of the upper extremity, and a case of postherpetic neuralgia of jaw, neck and upper chest wall, by stellate ganglion phenol neurolysis, devoid of any significant complications.

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"DUMBBELL" Neurilemmoma -1 case Report- (DUMBBELL 신경종양 -1례 보고-)

  • 박영환
    • Journal of Chest Surgery
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    • v.23 no.3
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    • pp.556-560
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    • 1990
  • A 22 year old soldier was discovered on routine study for discharge to have a mass in the posterior mediastinum He was admitted due to high fever and improved by antibiotic treatment for 2 weeks. Chest PA, apicogram, myelogram and CT scan demonstrated enlargement of the neural foramen at the T1 level with erosion of the posterior aspect of the vertebral body and the pedicle contiguous with the intrathoracic mass, A myelogram showed a large extradural defect at the T1 level on the left. There were no clinical signs of cord compression. A standard posterolateral thoracotomy incision was made with extension to high thoracic vertebra. The 3rd rib was resected and the angles of the posterior portion of 1st and 2nd ribs were cut and rib heads were removed. Extrapleural neurilemmoma 6x6 cm was resected intrathoracically. And after removal of the pedicle and the lamina, intraspinal extradural mass 3 X 2 cm was resected carefully with trivial tearing of the dura which was sealed with gel-foam and pleura. There was ma postoperative neurological complication.

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