• Title/Summary/Keyword: Spinal Disorder

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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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Melanotic Schwannoma in Cervical Spine - A Case Report - (경추에 발생한 멜라닌 신경초종 - 증례보고 -)

  • Yi, Seong;Chin, Dong Kyu;Jin, Byung Ho;Cho, Yong Eun;Kim, Young Soo
    • Journal of Korean Neurosurgical Society
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    • v.30 no.7
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    • pp.916-920
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    • 2001
  • Primary melanotic schwannoma in spinal cord is a very uncommon disorder, eight cases of melanotic schwannoma in spinal cord have been found in the literature. We present a case report of a patient with an intradural, extramadullary melanotic schwannoma in cervical spine and the literature on melanotic schwannoma is reviewed. The proposed theories on the origin of these tumors and treatment are discussed.

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Idiopathic Hypertrophic Spinal Pachymeningitis with an Osteolytic Lesion

  • Jee, Tae Keun;Lee, Sun-Ho;Kim, Eun-Sang;Eoh, Whan
    • Journal of Korean Neurosurgical Society
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    • v.56 no.2
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    • pp.162-165
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    • 2014
  • Idiopathic hypertrophic spinal pachymeningitis (IHSP) is a chronic, progressive, inflammatory disorder characterized by marked fibrosis of the spinal dura mater with unknown etiology. According to the location of the lesion, it might induce neurologic deficits by compression of spinal cord and nerve root. A 58-year old female with a 3-year history of progressive weakness in both lower extremities was referred to our institute. Spinal computed tomography (CT) scan showed an osteolytic lesion involving base of the C6 spinous process with adjacent epidural mass. Magnetic resonance imaging (MRI) revealed an epidural mass involving dorsal aspect of cervical spinal canal from C5 to C7 level, with low signal intensity on T1 and T2 weighted images and non-enhancement on T1 weighted-enhanced images. We decided to undertake surgical exploration. At the operation field, there was yellow colored, thickened fibrous tissue over the dura mater. The lesion was removed totally, and decompression of spinal cord was achieved. Symptoms improved partially after the operation. Histopathologically, fibrotic pachymeninges with scanty inflammatory cells was revealed, which was compatible with diagnosis of idiopathic hypertrophic pachymeningitis. Six months after operation, motor power grade of both lower extremities was normal on physical examination. However, the patient still complained of mild weakness in the right lower extremity. Although the nature of IHSP is generally indolent, decompressive surgery should be considered for the patient with definite or progressive neurologic symptoms in order to prevent further deterioration. In addition, IHSP can present as an osteolytic lesion. Differential diagnosis with neoplastic disease, including giant cell tumor, is important.

Spinal Extradural Meningeal Cyst in Klippel-Trenaunay Syndrome

  • Choi, Kyung-Chul;Ahn, Sung-Tae;Shin, Yong-Hawn;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • v.49 no.5
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    • pp.299-301
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    • 2011
  • A case of a symptomatic spinal extradural meningeal cyst (SEMC) in Klippel-Trenaunay syndrome (KTS) is introduced. A 38-year-old woman presented with right L2 radiculopathy. She underwent operations for varicose veins in both her lower extremities. She had port-wine nevi on her trunk and extremities. The edematous change in both legs had waxed and waned. Magnetic resonance imaging showed an $11.8{\times}13$ mm extradural meningeal cyst growing through the intervertebral foramen in L2-3. Multiple meningeal cysts were located in the dorsal aspect of the spinal cord from T3 to T10. A $5.8{\times}6.2$ mm cyst was also found in left pleural cavity. The extradural meningeal cyst was completely excised and the preoperative symptom was improved. KTS is a congenital disorder due to a mesodermal abnormality, which may predispose the dura to weakness. The SEMC may occur through the dural defect or weakened point.

Effect of Benincasae Semen on Glucose Oxidase in Cultured Mouse Spinal Motor Neurons (척수운동신경세포에 있어서 Glucose Oxidase의 독성에 대한 동과의 영향)

  • Choi Yu Sun;Yang Hyun Woong;Lee Joung Hwa;Lee Kang Chang
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.17 no.2
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    • pp.457-460
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    • 2003
  • It has been suggested that oxidative stress of reactive oxygen species(ROS) may play an important role in the pathogenesis of neurological disorder. The aim of this study was to elucidate the oxidative stress of glucose oxidase(GO) in the cultured mouse spinal motor neurons and the preventing effect of Benincasae Semen(BS) on ROS-induced neurotoxicity. Cytotoxic effect of GO and protective effect of BS were performed by MTT assay. 30mU/ml GO decreased cell viability in dose-and time-dependent mannner, and BS diminished GO-induced neurotoxicity in these cultures. From above the results, ROS such as GO has toxic effect, and herb extract of BS is very effective against GO-induced neurotoxicity in cultured spinal motor neurons of neonatal mouse.

Evaluation of Pain and Its Effect on Quality of Life and Functioning in Men with Spinal Cord Injury

  • Hassanijirdehi, Marzieh;Khak, Mohammad;Afshari-Mirak, Sohrab;Holakouie-Naieni, Kourosh;Saadat, Soheil;Taheri, Taher;Rahimi-Movaghar, Vafa
    • The Korean Journal of Pain
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    • v.28 no.2
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    • pp.129-136
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    • 2015
  • Background: Pain is one of the most important consequences of spinal cord injury (SCI). It may affect several aspects of life, especially the quality of life (QoL). Hence, this study was conducted to establish an understanding of pain and its correlates and effects on patients with SCI in our community. Methods: In a cross-sectional study, 58 male veterans suffering from SCI were admitted to our center for a regular follow-up. Demographic and SCI-related descriptive information were gathered using a self-reported questionnaire. To evaluate the patients' pain quality and the effect of pain on daily life, a questionnaire in 3 parts of lumbar, cervical and shoulder pain was administered. EuroQoL questionnaire and General Health Questionnaire (GHQ) 12 were also used to assess the patients' QoL. Results: The mean age of the participants was $45.91{\pm}6.69$ with mean injury time of $25.54{\pm}5.91$. forty-four patients (75.9%) reported pain, including lumbar pain (63%), cervical pain (39%) and shoulder pain (51%). The presence of pain was associated with lower QoL. Patients with lumbar pain reported a significant amount of pain affecting their daily life and this effect was higher in patients with lower GHQ score or anxiety/depressive disorder. Conclusions: Musculoskeletal pain, is a common complaint in veterans with SCI and is inversely associated with functioning and general health status. Lumbar and shoulder pain affects patient's daily living more than cervical pain.

A Study of the Relationship between Spine Distortion and Pain of Elementary and Middle School Students - through moire measurement and questionnaire investigation - (초.중학생의 척추비틀림과 통증과의 관계고찰 - 경근무늬(모아레) 측정법과 설문지 조사를 통해 -)

  • Yoo, Han-Keel;Shin, Byung-Cheul;Min, Byung-Il
    • The Journal of Korea CHUNA Manual Medicine
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    • v.2 no.1
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    • pp.133-142
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    • 2001
  • Objectives : The aim of this study is to investigate the relationship between spinal distortion and pain in elementary and middle school students. Methods : Using the phase-shifting moire developed by KAIST(Korea Advanced Institute of Science and Technology) we measured the back surface distortion, and using questionnaire investigation, we investigated the partial pain in 1008 elementary and middle school students(532 boy students(52.8%), 476 girl students(47.2%)) in Seoul in 1999. And, we statistically analyzed the relationship between spinal distortion and partial body pain Results : This study show that the more age increase, the more the pain in head, neck, shoulder, back and low back Increase considerably among the students aged 9 to 15. The ratio of each partial body pain was 28.4%, 19.7%, 18.2%, 18.7%. 16.0% at the age of 9 and 59.7%, 67.4%, 51.8%, 51.8%, 64.4% at the age of 15 respectively. And, it was shown there was a significant correlation between spine distortion and partial body pain area. When the spinal distortion was found at the upper thoracic and cervical area, the students complained the more pain on head, neck and shoulder(p<0.05) and when the spinal distortion was found at the sacral base, the more headache(p<0.05) Conclusions : It is suggested that the significant correlation exist between the spinal distortion and pain and the pain related to spine disorder get more increase as students grow. We have to study further more about Juvenile postural distortion and it's prevention.

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Clinical Study on 1 Case of Patient with Arthalgia Syndrome Diagnosed as Acute Transverse Myelitis (급성 횡단성 척수염으로 진단된 비증 환자의 치험 1례)

  • Lee, Seung-Hyun;Phil, Kam-Heun;Jo, Eun-Heui
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.6
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    • pp.1663-1669
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    • 2007
  • Acute transverse myelitis(ATM) is defined as an acute intramedullary dysfunction of the spinal cord, ascendng or static involving both halves of the cord and appearing without any history of previous neurological diseases due to traumatic accident, tumor of all kind, encephalitis and of course excluding all possible viral, bacterial and fungal infection. It is mainly characterized by acute motor disorder of both limbs in respect to which spinal segments are affected as well as sensory disorder and dysuria & dyschezia. The exact cause is unknown, however it is recently suggested that immunological factors are highly involved. It has been reported by several reliable sources that it is often accompanied by immunological diseases such as systemic lupus erythematosus(SLE). As treatments non steroid anti-inflammatory drugs(NSAIDS) are primarily recommended as to steroids, limited doses are injected only with the proper prescription from the physician. Operative methods are not options as traumatic accidents and tumors are excluded as factors. To enhance muscle strength and prevent articular contracture physical therapy and passive exercise is imperative. The following patient whose chief complaints were mainly about hypoesthesia of Rt. lower limb and stiffness of phalanges of both fingers as well as to weakness of lower extermity. Therefore it has been diagnosed as arthalgia syndrome. In oriental medicine factors such as wind evil heat-evil, dampness-heat evil, cold evil cause the arthalgia syndrome. In this case the patient was diagnosed as dampness-heat evil and herbal medicine Chunglijagam-Tang and Dong-Qi acupuncture was applied to treat bladder disorder.

Primary Spinal Epidural Lymphoma Mimicking Epidural Abscess in a Diabetic - A Case Report - (당뇨 환자에서 경막외 농양과의 감별을 요한 원발성 척추 경막외 임파종 - 증례보고 -)

  • Kim, Se Hoon;Lim, Dong Jun;Cho, Tai Hyoung;Chung, Yong Gu;Lee, Hoon Kap;Lee, Ki Chan;Suh, Jung Keun
    • Journal of Korean Neurosurgical Society
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    • v.30 no.3
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    • pp.395-399
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    • 2001
  • Primary spinal epidural lymphoma(SEL), i.e. occurring in the absence of any detectable extraspinal lymphoproliferative disorder, is an unusual cause of spinal cord compression. The authors report a 48-year-old, diabetic woman presented with back pain followed by acute paraparesis and voiding difficulty. She had been treated with acupunctures on her back before admission, and complete blood count showed leukocytosis with neutrophilia and increased erythrocyte sedimentation rate(ESR). Thoracic spine magnetic resonance imaging(MRI) revealed an epidural mass extending from T5 to T8 with compression of the spinal cord. Emergency decompressive laminectomy was performed with a tentative diagnosis of spinal epidural abscess, but a B-cell lymphoma was final pathologic diagnosis. Further staging showed no other sites of lymphoma, and the spinal lesion was treated by chemotherapy and radiotherapy. The authors stress that primary SEL can mimic spinal epidural abscess(SEA) in the diabetic patient and should be a diagnostic consideration in patients with a syndrome of acute spinal cord compression manifested by a prodrome of back pain and neuroimaging consistent with an epidural compressive lesion, especially in a diabetic.

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Assessment of Risk Factors for Postoperative Delirium in Older Adults Who Underwent Spinal Surgery and Identifying Associated Biomarkers Using Exosomal Protein

  • Baek, Wonhee;Lee, JuHee;Jang, Yeonsoo;Kim, Jeongmin;Shin, Dong Ah;Park, Hyunki;Koo, Bon-Nyeo;Lee, Hyangkyu
    • Journal of Korean Academy of Nursing
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    • v.53 no.4
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    • pp.371-384
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    • 2023
  • Purpose: With an increase in the aging population, the number of patients with degenerative spinal diseases undergoing surgery has risen, as has the incidence of postoperative delirium. This study aimed to investigate the risk factors affecting postoperative delirium in older adults who had undergone spine surgery and to identify the associated biomarkers. Methods: This study is a prospective study. Data of 100 patients aged ≥ 70 years who underwent spinal surgery were analyzed. Demographic data, medical history, clinical characteristics, cognitive function, depression symptoms, functional status, frailty, and nutritional status were investigated to identify the risk factors for delirium. The Confusion Assessment Method, Delirium Rating Scale-R-98, and Nursing Delirium Scale were also used for diagnosing delirium. To discover the biomarkers, urine extracellular vesicles (EVs) were analyzed for tau, ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), neurofilament light, and glial fibrillary acidic protein using digital immunoassay technology. Results: Nine patients were excluded, and data obtained from the remaining 91 were analyzed. Among them, 18 (19.8%) developed delirium. Differences were observed between participants with and without delirium in the contexts of a history of mental disorder and use of benzodiazepines (p = .005 and p = .026, respectively). Tau and UCH-L1-concentrations of urine EVs-were comparatively higher in participants with severe delirium than that in participants without delirium (p = .002 and p = .001, respectively). Conclusion: These findings can assist clinicians in accurately identifying the risk factors before surgery, classifying high-risk patients, and predicting and detecting delirium in older patients. Moreover, urine EV analysis revealed that postoperative delirium following spinal surgery is most likely associated with brain damage.