• Journal of Korean Neurosurgical Society
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• v.29 no.7
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• pp.904-909
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• 2000

Objectives : Most cases of cervical ossification of the posterior longitudinal ligament(OPLL) present with myelopathy or myeloradiculopathy, which sometimes is further complicated by minor trauma to the spinal cord. The main purpose of surgery in these patients is the alleviation symptoms but also as protection against further deterioration. The purpose of this study is to analyze the influence of trauma on the surgical outcome in patients with cervical OPLL. Methods : Over the past 13 years, we have operated on 123 patients with myelopathy associated with cevical OPLL. Among these, thirty patients had cervical cord injury associated with major or minor trauma and their clinical and radiographic data were reviewed retrosepctively. Results : As to cause of trauma, seventeen were related with traffic accident and 13 were related with minor slipping injury. The pre- and post-operative motor power were significantly weaker in the patients with trauma, but the degree of motor improvement was significantly higher(trauma group : $0.90{\pm}1.49$, non-trauma group : $0.41{\pm}0.80$). Conclusion : These results indicate that even indirect minor trauma to the cervical spine can cause irreversible changes to the spinal cord if this is associated with underlying cervical stenosis with OPLL. Although less favorable results may be anticipated in patients with trauma, operative decompression could improve motor power and protect further deterioration.

• Journal of Korean Neurosurgical Society
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• v.48 no.4
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• pp.335-341
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• 2010

Objective : Anterior cervical corpectomy with fusion (ACF) or laminoplasty may be associated with substantial number of complications for treating multilevel cervical ossification of the posterior longitudinal ligament (OPLL) with significant cord compression. For more safe decompression and stabilization in multilevel cervical OPLL with prominent cord compression, we propose circumferential cervical surgery (selective ACF and laminoplasty) based on our favorable experience. Methods : Twelve patients with cervical myelopathy underwent circumferential cervical surgery and all patients showed multilevel OPLL with Signal change of the spinal cord on magnetic resonance imaging (MRI). A retrospective review of clinical, radiological. and surgical data was conducted. Results : There were 9 men and 3 women with mean age of 56.7 years and a mean follow up period of 15.6 months. The average corpectomy level was 1.16 and laminoplasty level was 4.58. The average Japanese Orthopedic Association score for recovery was 5.1 points and good clinical results were obtained in 11 patients (92%) (p < 0.05). The average space available for the cord improved from 58.2% to 87.9% and the average Cobb's angle changed from 7.63 to 12.27 at 6 months after operation without failure of fusion (p < 0.05). Average operation time was 8.36 hours, with an estimated blood loss of 760 mL and duration of bed rest of 2.0 days. There were no incidences of significant surgical complications, including wound infection. Conclusion : Although the current study examined a small sample with relatively short-term follow-up periods, our study results demonstrate that circumferential cervical surgery is considered favorable for safety and effectiveness in multilevel OPLL with prominent cord compression.

• The Journal of Korean Institute of Electromagnetic Engineering and Science
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• v.18 no.10
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• pp.1163-1171
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• 2007

In this paper, the design techniques required to design heterodyned OPLL such as frequency-phase deference detector, loop filter and phase noise of semiconductor laser are presented. Through the experiments with the calculated parameters, we confirmed that the frequency-phase difference detector simply develops an error component that is proportional to the frequency-phase difference between heterodyned optical signals. The achieved frequency-phase locking range of the input laser diode frequency is around ${\pm}150MHz$. This paper describes the details of the designed as well as experimental results.

• Journal of Korean Neurosurgical Society
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• v.54 no.2
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• pp.145-147
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• 2013

We present a case of acute hydrocephalus secondary to cervical spinal cord injury in a patient with diffuse ossification of the posterior longitudinal ligament (OPLL). A 75-year-old male patient visited the emergency department with tetraparesis and spinal shock. Imaging studies showed cervical spinal cord injury with hemorrhage and diffuse OPLL from C1 to C4. We performed decompressive laminectomy and occipitocervical fusion. Two days after surgery, his mental status had deteriorated to drowsiness with dilatation of the right pupil. Findings on brain computed tomography revealed acute hydrocephalus and subarachnoid hemorrhage in the cerebellomedullary cistern, therefore, extraventricular drainage was performed immediately. Acute hydrocephalus as a complication of cervical spine trauma is rare, however, it should be considered if the patient shows deterioration of neurologic symptoms.

• Journal of Korean Neurosurgical Society
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• v.56 no.2
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• pp.121-129
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• 2014

Objectives : Patients with cervical ossification of posterior longitudinal ligament (OPLL) are susceptible to cord injury, which often develops into myelopathic symptoms. However, little is known regarding the prognostic factors that are involved in minor trauma. We evaluated the relationship between minor trauma and neurological outcome of OPLL and investigated the prognostic factors with a focus on compressive factors and intramedullary signal intensity (SI). Methods : A total of 74 patients with cervical myelopathy caused by OPLL at more than three-levels were treated with posterior decompression surgeries. We surveyed the space available for spinal cord (SAC), the severity of SI change on T2-weighted image, and diabetes mellitus (DM). The neurological outcome using Japanese Orthopedic Association (JOA) scale was assessed at admission and at 12-month follow-up. Results : Among the variables tested, preoperative JOA score, severity of intramedullary SI, SAC, and DM were significantly related to neurological outcome. The mean preoperative JOA were $11.3{\pm}1.9$ for the 41 patients who did not have histories of trauma and $8.0{\pm}3.1$ for the 33 patients who had suffered minor traumas (p<0.05). However, there were no significant differences in the recovery ratios between those two groups. Conclusions : Initial neurological status and high intramedullary SI in the preoperative phase were related to poorer postoperative outcomes. Moreover, the patients with no histories of DM and larger SACs exhibited better improvement than did the patients with DM and smaller SACs. Although the initial JOA scores were worse for the minor trauma patients than did those who had no trauma prior to surgery, minor trauma exerted no direct effects on the surgical outcomes.

• Journal of Korean Neurosurgical Society
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• v.38 no.2
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• pp.102-106
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• 2005

Objective : The purposes of this study are to evaluate the efficacy of en bloc open-door laminoplasty and to investigate the validity of various factors as prognotic indicators in patients with multisegmental spondylotic myelopathy and ossification of posterior longitudinal ligament[OPLL]. Methods : The authors reviewed 43 cases in whom laminoplasty were performed for cervical myelopathy between January 2000 and December 2002. Clinical symptoms and results were evaluated using the Japanese Orthopaedic Association[JOA] scale. The recovery rate was calculated and then assessed for prognostic factors such as preoperative JOA scores, ages, history of previous trauma, duration of symptoms and signal change in cord on T2-weighted magnetic resonance Image. Results : In cervical stenosis, canal widening of antero-posterior diameter and dimension after laminoplasty is 4.16mm, $87.43mm^2$ and in OPLL is 6.20mm, $117.61mm^2$. In all cases there wasn't neurologic deterioration, mild postoperative complications developed in seven cases. Four patient had a limitation of range of neck motion and the other one showed kyphotic change and another two showed C5 radiculopathy. The recovery rate of JOA score in cervical stenosis and OPLL was 62% and 68% respectively. Duration of symptoms, the severity[preoperative JOA score], and signal change in cord on T2-weighted magnetic resonance image had close relationship to the clinical outcomes. Conclusion : Unilateral en bloc laminoplasty is simultaneous expansile and decompressive method. And preoperative JOA score, symptom duration and high signal intensity on T2-weighted magnetic resonance image can be used to predict prognosis.

• Journal of Korean Neurosurgical Society
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• v.64 no.1
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• pp.69-77
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• 2021

Objective : Classification systems for cervical ossification of the posterior longitudinal ligament (OPLL) have traditionally focused on the morphological characteristics of ossification. Although the classification describes many clinical features associated with the shape of the ossification, including the concept of spondylosis seems necessary because of the similarity in age distribution. Methods : Patients diagnosed with OPLL who presented with increase signal intensity (ISI) on magnetic resonance imaging were surgically treated in our department. The patients were divided into two groups (pure versus degenerative) according to the presence of disc degeneration. Results : Of 141 patients enrolled in this study, more than half (61%) were classified into the degenerative group. The pure group showed a profound male predominance, early presentation of myelopathy, and a different predilection for ISI compared to the degenerative group. The mean canal compromise ratio (CC) of the ISI was 47% in the degenerative group versus 61% in the pure group (p<0.0000). On the contrary, the global and segment motions were significantly larger in the degenerative group (p<0.0000 and p=0.003, respectively). The canal diameters and global angles did not differ between groups. Conclusion : Classifying cervical OPLL based on the presence of combined disc degeneration is beneficial for understanding the disorder's behavior. CC appears to be the main factor in the development of myelopathy in the pure group, whereas additional dynamic factors appear to affect its development in the degenerative group.

• Journal of Yeungnam Medical Science
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• v.6 no.2
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• pp.141-146
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• 1989

In an attempt to eliminate some negative aspects of conventional extensive laminectomy, 4 cases of multiple level of cervical compression myelopathy, 1 OPLL(ossification of posterior longitudinal ligament) and 3 cervical stenosis, were treated with a technique of expansive laminoplasty. Operative results in all patients were satisfactory without surgical complications and all patients had a neurological improvement. We suggest that our technique is more effective one for cervical canal enlargement with preservation of stability for treating multiple level of cervical canal stenosis, OPLL, and spondylosis than conventional extensive laminectomy.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.4 no.1
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• pp.85-94
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• 2009

Objects : This study was to report a clinical effect of Korean Treatment for a patient diagnosed by Computed Tomography as Cervical Spinal Stenosis with Ossification of posterior Longitudinal Ligament. Methods : In order to alleviate left shoulder pain and neck stiffness, the patient was treated by acupuncture therapy, herbal medicine, distilled herbal injection, cervical traction technique of Chuna treatment and conservative managements. To evaluate the effect of the treatment, Recovery rate of Hirabayashi, VAS(Visual Anlaogue Scale), NDI and ROM(Range of Motion) were used. Lhermitte's sign, Valsalva test, Distraction test, Compression test and Spurling test were carried out. Results : VAS, NDI and ROM were improved and Recovery rate was 100%. Conclusions : Korean Treatment can be effectively used for a patient with Cervical Spinal Stenosis with OPLL. Further clinical studies are needed to verify the findings.

• Journal of Korean Neurosurgical Society
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• v.29 no.3
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• pp.360-364
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• 2000

Objective : To investigate the prognostic factors associated with outcome in patients with ossification of posterior longitudinal ligament. Method : During the past 4 years, we have operated on 35 patients with cervical OPLL. Anterior cervical decompression(total or subtotal corpectomy, discectomy, and removal of the OPLL) and interbody fusion with iliac bone were performed in all patients. Results : Eight cases(22.9%) were continuous type, 11(31.4%) segmental, 13(37.1%) Mixed, and 3(8.6%) localized type. Thirty-two patients(91.4%) showed an excellent or good results. Conclusion : These results indicate that surgical treatment should be considerated in case of clinical grading higher than II and the surgical outcome is worse when duration of preoperative symptom is longer and when percentage of spinal narrowing is higher. Anterior cervical decompression and interbody fusion seems to be a better method in patients with lesions limited to one or two level. Age at surgery did not significantly affect the outcom.