• Annals of Clinical Neurophysiology
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• v.4 no.1
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• pp.67-69
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• 2002

Ossification of the ligamentum flavum(OLF) is not infrequent in the cervical and lumbar regions but is very rare in the thoracic spine. We reported a 62-year-old women with left thoracic intercostal neuralgia due to an OLF. Physical and neurological examination were normal. MRI showed an OLF with compression of the thecal sac in the posterolateral aspect of the T9-T10 level. Laminectomy and removal of the ligament resulted in marked clinical improvement. OLF is known to cause thoracic radiculomyelopathy, but presentation with intercostal neuralgia only is very rare.

• The Korean Journal of Pain
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• v.2 no.1
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• pp.78-84
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• 1989

Steroid and local anesthetics were injected into the epidural space through the posterior sacral foramen or lumbar approach in 4 patients for the purposes of relieving severe low back pain and radiculopathy. These patients were referred from other sections dealing with low back pain and radiculopathy, because one could not tolerate the surgical stress due to a heart problem, another two did not want the operation and the last had post-laminectomy status. All patients were satisfied with the results subjectively.

• Korean Journal of Radiology
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• v.23 no.2
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• pp.291-291
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• 2022

• Journal of Korean Medicine Rehabilitation
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• v.20 no.2
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• pp.1-15
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• 2010

Objectives : This study was performed to evaluate the effects of root of Cibotii rhizoma(CR) ethanol extract on the tissue and neuronal damage of the spinal cord injury(SCI). Methods : SCI was induced by mechanical contusion following laminectomy of 10th thoracic vertebra in Sprague-Dawley rats. CR was orally given once a day for 7 days after SCI. Tissue damage and nerve fiber degeneration were examined with cresyl violet and luxol fast blue(LFS) histochemistry. HSP72(as neuronal damage marker), MAP2(as nerve fiber degeneration marker), c-Fos(immediate early gene), and Bax(pro-apoptotic molecule) expressions were examined using immuno-histochemistry. Individual immuno-positive cells expressing HSP72, MAP2, c-Fos and Bax were observed on the damaged level and the upper thoracic and lower lumbar spinal segments. Results : 1. CR reduced degeneration of nerve fibers and motor neuron shrinkage in the ventral horn of the lower lumbar spinal segment, but generally it did not seem to ameliorate the tissue injury following SCI. 2. CR reduced demyelination in the ventral and lateral funiculus of the lower lumbar spinal segment. 3. CR reduced HSP72 expression on the neurons in the peri-central canal gray matter adjacent to the damaged region. 4. CR strengthened MAP2 expression on the motor neurons in the ventral horn and on nerve fibers in the lateral funiculus of the lower lumbar spinal segment. 5. CR reduced c-Fos positive cells in the peri-lesion and the dorsal horn of the damaged level and in the ventral horn of the lower lumbar spinal segment. 6. CR reduced Bax positive cells in the peri-lesion and the dorsal horn of the damaged level and in the ventral horn of the lower lumbar spinal segment. Conclusions : These results suggest that CR plays an inhibitory role against secondary neuronal damage and nerve fiber degeneration. following SCI.

• Journal of Biomedical Engineering Research
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• v.27 no.5
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• pp.210-217
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• 2006

Many types of interspinous distraction devices (IDDs) have been recently developed as an alternative surgical treatment to laminectomy and fusion with pedicle screws for the treatment of the lumbar spinal stenosis (LSS). They are intended to keep the lumbar spine in a slightly flexed posture to relieve pain caused by narrowing of the spinal canal and vertebral foramen. However, their biomechanical efficacies are not well known. In this study, we evaluated the kinematic behaviors and changes in intradiscal pressure (IDP) of the porcine lumbar spine implanted with IDD. For kinematics analysis, five porcine lumbar spines (L2-L6) were used and the IDD was inserted at L4-L5. Three markers (${\phi}{\le}0.8mm$) were attached on each vertebra to define a rigid body motion for stereophotogrammetric assessment of the spinal motion in 3-D. A moment of 7.5Nm in flexion-extension, lateral bending, and axial rotation were imparted with a compressive force of 700N. Then, IDD was implanted at L3-L4. IDPs were measured using pressure transducer under compression (700N) and additional extension moment (700N+7.5Nm). In kinematic behaviors, insertion of IDD resulted in statistically significant decrease 42.8% at the implanted level in extension. There were considerable changes in ROM at the adjacent levels, but statistically insignificant. In other motions, there were no significant changes in ROM as well regardless of levels. IDPs at the surgical level (L3-L4) under compression and extension moment decreased by 12.9% and 18.8% respectively after surgery (p<0.05). At the superiorly adjacent levels, IDPs increased by 19.4% and 12.9% under compression and extension, respectively (p<0.05). Corresponding changes at the inferiorly adjacent levels were 29.4% and 6.9%, but they were statistically insignificant (p>0.05). The magnitude of pressure changes due to IDD, both at the operated and adjacent levels, were far less than the previously reported values with conventional fusion techniques. Our experimental results demonstrated the IDDs can be very effective in limiting the extension motion that may cause narrowing of the spinal canal and vertebral foramens while maintaining kinematic behaviors and disc pressures at the adjacent levels.

• Journal of Korean Neurosurgical Society
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• v.46 no.5
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• pp.437-442
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• 2009

Objective : To characterize perioperative biomechanical changes after thoracic spine surgery. Methods : Fifty-eight patients underwent spinal instrumented fusions and simple laminectomies on the thoracolumbar spine from April 2003 to October 2008. Patients were allocated to three groups; namely, the laminectomy without fusion group (group I, n = 17), the thoracolumbar fusion group (group II, n = 27), and the thoracic spine fusion group (group III, n = 14). Sagittal (ADS) and coronal (ADC) angles for adjacent segments were measured from two disc spaces above lesions at the upper margins, to two disc spaces below lesions at the lower margins. Sagittal (TLS) and coronal (TLC) angles of the thoracolumbar junction were measured from the lower margin of the 11th thoracic vertebra body to the upper margin of the 2nd lumbar vertebra body on plane radiographs. Adjacent segment disc heights and disc signal changes were determined using simple spinal examinations and by magnetic resonance imaging. Clinical outcome indices were determined using a visual analog scale. Results : The three groups demonstrated statistically significant differences in terms of angle changes by ANOVA (p<0.05). All angles in group I showed significantly smaller angles changes than in groups II and III by Turkey's multiple comparison analysis. Coronal Cobb's angles of the thoracolumbar spine (TLC) were not significantly different in the three groups. Conclusion : Postoperative sagittal balance is expected to change in the adjacent and thoracolumbar areas after thoracic spine fusion. However, its prevalence seems to be higher when the thoracolumbar spine is included in instrumented fusion.

• Pediatric Infection and Vaccine
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• v.8 no.1
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• pp.107-113
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• 2001

Spinal epidural abscess(SEA) is a rare condition in children. Classic symptoms are spinal ache, root pain, weakness and paralysis. The earliest symptoms of SEA in the pediatric age group are nonspecific and variable. Early diagnosis may be almost impossible when local spinal pain is inconspicuous or absent, when toxic epiphenomena divert attention from subtle signs of neurologic dysfunction and when the patient is an acutely distressed and uncooperative child. Failure to diagnosis and treat condition on a timely basis may lead to permanent neurolgic dysfunction or even death. This infection, usually located in the dorsal epidural space of the mid thoracic or lower lumbar regions, is the result of hematogenous dissemination of bacteria, usually Staphylococci, from foci of infection in the skin, or respiratory or urinary tracts. MRI was the diagnostic method of choice. A combination of antibiotics and surgical drainage remains the treatment of choice. Prognosis is excellent if surgery is performed before the development of neurologic deficit. We report a case of SEA in a child whose first presenting symptom was abdominal pain rather than spinal pain. A case is diagnosed by MRI and successfully treated with laminectomy and drainage and antibiotics.

• Journal of Trauma and Injury
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• v.25 no.2
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• pp.57-62
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• 2012

Gunshot wounds are rare in Korea, but they have tended to increase recently. We experienced an interesting case of penetrating gunshot injuries to the cervical spine with migration the fragments of the bullet within the dural sac of the cervical spine, so discuss the pathomechanics, treatment and complications of gunshot wounds to the spine and present a review of the literature. A 38-year-old man who had tried to commit suicide with a gun was admitted to our hospital with a penetrating injury to the anterior neck. the patient had quadriplegia. A Computed tomography (CT) scan and 3-dimensional CT of the spine showed destruction of the left lateral mass and lamina of the 5th cervical vertebra; the bullet and fragments were found at the level of the 5th cervical vertebra. The posterior approach was done. A total laminectomy and removal of the lateral mass of the 5th cervical vertebrae were performed, and bone fragments and pellets were removed from the spinal canal, but an intradurally retained pellets were not totally removed. A dural laceration was noted intraoperatively, and CSF leakage was observed, so dura repair was done watertightly with prolene 6-0. The dura repair site was covered with fibrin glue and Tachocomb$^{(R)}$. Immediately, a lumbar drain was done. Radiographs included a postoperative CT scan and X-rays. The postoperative neurological status of the patient was improved compared with the preoperative neurological status. however, the patients developed symptoms of menigitis. He received lumbar drainage(200~250 cc/day) and ventilator care. After two weeks, panperitonitis due to duodenal ulcer perforation was identified. Finally, the patient died because of sepsis.

• Physical Therapy Korea
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• v.18 no.1
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• pp.93-103
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• 2011

This study was implemented to verify the feasibility of motor function recovery and the appropriate period for therapy. The research began with spinal laminectomy of 40 white rats of Sprague-Dawley breed and induced them spinal crush injury. Following results were obtained by using the modified Tarlov test (MTT), Basso, Beattle, Bresnahan locomotor rating scale (EBB scale) and modified inclined plate test (MIPT). First, the measurement using the MTT confirm that the most severe aggravation and degeneration of functions are observed two days after induced injury, and no sign of neuromotor function recovery. Second, better scores were achieved by open-ground movement group on BBB locomotor rating scale test, and weight-bearing on inclined plate group show better performance on MIPT. Third, both BBB and MIPT scale manifested the peak of motor function recovery during 16th day after the injury and turn into gradual recovery gradient during 16th to 24th. Fourth, the control group showed functional recovery, however, the level of recovery was less significant when compared with group open-ground movement group and weight-bearing on inclined plate group. Hence, it was clearly manifested that the lumbar region of the spinal cord had shown the best performance when its functions were measured after the execution of specific physical training; therefore it indicated the possibility of learning specific task even in damaged lumbar regions. Thus it is expected to come out with better and more effective functional recovery if concentrated physical therapy was applied starting 4 days after the injury till 16 days, which is the period of the most active recovery.

• Journal of Korean Neurosurgical Society
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• v.29 no.4
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• pp.574-579
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• 2000

Chordomas are rare central nervous system tumors that are found predominantly in the sacrococcygeal(50%) and basiosphenoidal region(35%). Most of the remainder are related to the vertebral bodies and only 1 to 2% of them are known to occur in the thoracic vertebrae. A 15-year-old girl was admitted because of paraparesis. Three months prior to admission, she underwent a lumbar laminectomy at other hospital for the treatment of herniated lumbar disc but paraparesis became rather aggravated after the operation. At admission, MRI showed a low signal T1WI, high signal T2WI mass compressing the cord at T2 vertebral body. The tumor was subtotally removed via costotransversectomy but as the tumor was proven to be a chordoma, a second stage operation via anterior route was followed. At second operation, T2 corpectomy and T1-T3 plate fixation with autogeneous ileac bone graft was performed. Shortly after the operation, preoperative paraparesis disappeared completely and no evidence of tumor recurrence was noticed both clinically and radiologically for next 2 years. Spine surgery at cervicothoracic junction may be technically demanding due to anatomical complexity and hindering large vessels. The authers reviewed this case with special emphasis on the surgical procedure in this region.