• 한국임상수의학회지
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• 제31권2호
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• pp.152-155
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• 2014

11년령의 중성화된 수컷 Schnauzer 가 후지마비 증상으로 내원하였다. 6개월 전부터 후지의 운동실조를 보이다가 3개월 전부터는 좌측 후지의 불완전마비를 보였으며, 2주 전부터는 양측 후지의 완전마비 증상을 나타내었다. 신경계 검사에서 양측 후지의 완전마비와 자세반사 및 심부통 소실이 확인되었으며, 척수반사는 항진되어 있었고 자발배뇨는 불가능한 상태였다. 흉요추 부위의 MR (0.3 Tesla) 영상 검사가 실시되었다. 척수를 심하게 압박하는 하나의 종괴가 요추 2번 수준에서 확인되었으며, 종괴는 좌측 및 등쪽으로 경질막과 넓게 접하고 있었다. 종괴는 T1 강조 영상에서 척수와 비슷한 신호 강도를 보였으며, T2 강조 영상에서는 고신호를 보였다. 조영 후 T1 강조 영상에서는 고도의 균일한 조영 증강을 보였으며, 경계는 명확하고 "dural tail sign" 을 동반하고 있었다. 이러한 영상학적 특징으로 부터 경질막내 척수외 종양이 고려되었으며, 그 중에서도 수막종이 가장 우선적으로 고려되었다. 좌측 편측후궁절제술 및 등쪽 후궁절제술이 실시되었다. 부분적으로 경질막과 유착되어 있는 하나의 경질막내 종괴가 척수를 압박하고 있는 것이 확인되었고, 종괴는 유착된 경질막 부분과 함께 완전히 제거되었다. 조직병리학적 검사를 통해 혈관종성수막 종으로 진단되었다.

• Journal of Korean Neurosurgical Society
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• 제30권5호
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• pp.642-646
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• 2001

A 12-years-old female admitted to the hospital with the complaint of pain on the right upper chest area which persisted about 1 month prior to admission. $Caf{\acute{e}}$-au-lait spots of various size laying on a whole body and freckling on the axilla were found on physical examination. A huge mass was found on the plain chest X-ray and on chest MRI. The mass encroached thoracic spine, posterior rib, back muscles, and then into the neural canal and compressed thoracic spinal cord. On the 5th day of hospitalization, the patient complained tingling on the both legs and 2 days later, monoparesis on the right leg. Open thoracotomy and decompressive laminectomy was done to remove mass. Pathologic reports confirmed rhabdomyosarcoma, embryonal type.

• Journal of Korean Neurosurgical Society
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• 제64권5호
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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.

• 한국임상수의학회지
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• 제27권5호
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• pp.546-552
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• 2010

대부분 척수손상 모델에서의 척수 손상 정도 평가는 자기공명 영상 등을 통한 유발 후 평가를 실시하고 있으며, 유발 전 평가를 위해 풍선 카테타에 주입된 공기 양을 기준한 예가 있으나 종 특이성과 개체 차이를 고려하지 못하는 단점이 있다. 이러한 단점을 극복한 척수손상 기준모델을 제시하기 위해 본 실험을 실시하였다. 방사선 평가를 통해 요추 1 번 척수강 높이가 8 mm로 측정된 임상적으로 건강한 비글견 8 마리를 풍선카테타의 직경과 척수 압박시간을 기준으로 4개 군 (4 mm/3 시간, 4 mm/6 시간, 4 mm/12 시간 그리고 6 mm/3 시간)으로 구분하였다. 손상 정도는 행동 관찰, 자기공명영상 해석, 체성감각유발전위평가 그리고 병리조직검사를 실시하여 평가하였다. 실험결과, 행동평가와 체성감각유발전위평가는 단지 손상 유발 여부만 지시할 뿐 정도 평가에는 유용하지 못하였다. 자기공명영상 평가에서 척수손상 부위는 단시간반전회복영상과 T2강조영상에서 불균질한 고신호강도 영역으로 관찰되었다. 고신호강도 영역은 삽입된 풍선 직경과 압박시간 증가에 따라 보다 확장되어 관찰되었으며, 이러한 소견은 공포화 등의 손상부위 증가와 카스파제-3 및 PARP 면역반응 세포의 수적 증가로 나타난 병리조직검사 결과와 일치하였다. 이러한 결과로 미루어 정형화된 척수손상 모델 유발을 위한 척수강 직경과 풍선카테타 직경 그리고 압박시간의 변수 이용과 손상 정도 평가를 위해 자기공명영상은 매우 유용할 것으로 판단된다.

• Journal of Korean Neurosurgical Society
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• 제55권1호
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• pp.48-50
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• 2014

Brucellosis is caused by gram-negative, aerobic, non-motile, facultative, intracellular coccobacilli belonging to the genus Brucella. A 50-year-old man working as an employee was admitted to neurosurgery clinic with severe low back, radicular right leg pain and hypoesthesia in right L4-5 dermatomes for 2 months. Brucella tube agglutination (Wright) test was positive in serum sample of the patient with a titer of 1/640. Brucella melitensis was isolated from blood culture. X-ray and MRI of the lomber spine showed massive collapse of L4 vertebral body. Neural tissue was decompressed and then posterior L3-5 short segment transpedicular screw fixation and stabilization was performed. Brucella melitensis was isolated from microbiologic culture of pathologic specimen. Antibiotic therapy was given as doxycycline 200 mg/day and rifampicin 600 mg/day for 6 months. Brucellosis is a systemic zoonotic infection and still an important public health problem in many geographical parts of the world. Vertebral body collapse caused by brucellosis occurs very rarely but represents a neurosurgical emergency because of its potential for causing rapidly progressive spinal cord compression and permanent paralysis. Neurosurgeons, emergency department personnel as well as infectious disease specialists should always keep a high index of suspicion and include brucellosis in the differential diagnosis of vertebral body collapse.

• Journal of Korean Neurosurgical Society
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• 제48권3호
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• pp.276-280
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• 2010

Liposarcomas are malignant tumors of the soft tissue, with myxoid liposarcoma being the second most common subtype, tending to occur in the limbs, particularly in the thighs. Myxoid liposarcomas have an intermediate prognosis between well-differentiated and pleomorphic tumors. Spinal metastasis is usual but intradural involvement is extremely rare. We present an unusual case of a multicentric myxoid liposarcoma with intradural involvement. A 41-year-old woman complained of tingling sensation on her left arm. Radiological evaluation revealed multiple masses in her cervical spine, abdominal wall, liver, heart and right thigh, all of which were resected. She was histologically diagnosed with small round cell myxoid sarcoma and underwent adjuvant chemotherapy. However, magnetic resonance imaging analysis after 1 year revealed a large metastatic mass with bony invasion at the C6-T1 level. This mass consisted of extradural and intradural components causing severe compression of the spinal cord. She underwent resection via a posterior facetectomy of C6-7 and an anterior C7 corpectomy. However, the patient died of multiple metastases 18 months after the first diagnosis.

• 대한수의학회지
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• 제59권4호
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• pp.213-217
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• 2019

Five paraplegic dogs were diagnosed with thoracolumbar intervertebral disc disease with more than 50% compression of spinal cord. Because the lesions were determined to be disc extrusion on magnetic resonance imaging, a hemilaminectomy was initially performed, however, protruded discs were confirmed during surgery. To remove the protruded disc, modified partial lateral corpectomy (mini-PLC) was additionally performed. All dogs recovered to full ambulation within a median of 44 days without temporary deterioration or vertebral instability. Mini-PLC as described here enables successful removal of the protruded disc, while preserving vertebral stability in dogs for whom the use of hemilaminectomy is inevitable.

• Journal of Korean Neurosurgical Society
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• 제40권1호
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• pp.47-50
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• 2006

This 51-year-old man suffered from paraparesis of 1-week history. On preoperative images, spinal cord compression by infiltrative vertebral mass was shown at T3 and T4 level. Several months earlier, he underwent surgical resection of left 2nd to 4th ribs, due to painful growing chest wall mass, which was proved to be hepatocellular carcinoma. All available diagnostic procedure failed to uncover origin of malignancy. Operation was followed by adjuvant irradiation and chemotherapy to the vertebral mass, however he only to die in 3 months after operation. This is an extremely rare case of ectopic hepatocellular carcinoma at thoracic vertebrae which showed very aggressive clinical course. Possible pathogenic process is presented and discussed.

• Journal of Korean Neurosurgical Society
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• 제40권1호
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• pp.54-57
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• 2006

Central nervous system[CNS] involvement of acute lymphoblastic leukemia may occur. However, CNS involvement as a first manifestation of leukemia is very rare. An 8-year-old girl complained of a backache after playing in the water. Neurological examination detected progressing paraparesis. Magnetic resonance imaging[MRI] of the thoracolumbar spine showed a well-circumscribed homogeneous posterior extradural mass lesion extending from T7 to T9. MRI of the brain showed diffused fatty marrow replacement of the calvarium and the skull base. We report a patient with epidural Burkitt's lymphoma of the thoracic and lumbar vertebra causing compression of the spinal cord after pathologic evaluation. The tumor consisted mainly of lymphoblastic cells, which were identical to those originally seen in the bone marrow aspiration and biopsy. After decompressive laminectomy she began consolidation chemotherapy.

• Journal of Korean Neurosurgical Society
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• 제40권2호
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• pp.114-116
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• 2006

A Solitary plasmacytoma of bone[SPB] is a rare disease. This paper reports a case of SPB with massive aggregation of histiocytes known as pseudo-Gaucher cells. A 40-year-old male presented with progressive paraparesis and paraesthesia. The Magnetic Resornance Image[MRI] revealed a tumor mass in the thoracic spine that occupied the three colum. The tumor invaded the epidural space of T6 vertebra with compression of the spinal cord. There were no laboratory abnormalities. It was gross totally resected and his neurological symptoms improved. The microscopic examination revealed a plasmacytoma with massive aggregation of histiocytes. Futher neuroradiological studies were carried out and no other lesions were detected.