• Title/Summary/Keyword: Spinal column

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Surgical Management of Cervical Spinal Epidural Abscess Caused by Brucella Melitensis : Report of Two Cases and Review of the Literature

  • Ekici, Mehmet Ali;Ozbek, Zuhtu;Gokoglu, Abdulkerim;Menku, Ahmet
    • Journal of Korean Neurosurgical Society
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    • v.51 no.6
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    • pp.383-387
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    • 2012
  • Spinal epidural abscess, if especially caused by Brucellosis is a very rare disease which is usually a consequence of spondylodiscitis. The spinal column can be affected at any joint; however, the lumbar spine is the most common region, especially at the level of the L4-5 and L5-S1. The frequency of spinal involvement usually seen at the lumbar, thoracic and cervical spine respectively. As an occupational disease in farmers, veterinaries, butchers, laboratory staff and shepherds, brucellosis can also occur by direct contact to animals and infected materials or ingestion of raw cheese, milk or unpasteurized milk products. In this study, we presented two cases with cervical spinal epidural abscess caused by brucella melitensis, which was successfully treated by surgical approach. Initial treatment was combined with antibiotic therapy after the surgery for 3 months.

Charcot Arthropathy of the Lumbosacral Spine Mimicking a Vertebral Tumor after Spinal Cord Injury

  • Son, Soo-Bum;Lee, Sun-Ho;Kim, Eun-Sang;Eoh, Whan
    • Journal of Korean Neurosurgical Society
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    • v.54 no.6
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    • pp.537-539
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    • 2013
  • Charcot spinal arthropathy is a rare, progressive type of vertebral joint degeneration that occurs in the setting of any preexisting condition characterized by decreased afferent innervation to the extent that normal protective joint sensation in the vertebral column is impaired. The authors report on a case of Charcot arthropathy of the lower lumbar spine mimicking a spinal tumor following cervical cord injury.

Spinal Hydatid Cyst Disease : Challenging Surgery - an Institutional Experience

  • Caglar, Yusuf Sukru;Ozgural, Onur;Zaimoglu, Murat;Kilinc, Cemil;Eroglu, Umit;Dogan, Ihsan;Kahilogullari, Gokmen
    • Journal of Korean Neurosurgical Society
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    • v.62 no.2
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    • pp.209-216
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    • 2019
  • Objective : Hydatid cyst disease is caused by the parasite Echinococcus granulosus. It is rarely seen in the vertebral system, occurring at a rate of 0.2-1%. The aim of this study is to present 12 spinal hydatid cyst cases, and propose a new type of drainage of the cyst. Methods : Twelve cases of spinal hydatid cysts, surgical operations, multiple operations, chronic recurrences, and spinal hydatic cyst excision methods are discussed in the context of the literature. Patients are operated between 2005 and 2016. All the patients are kept under routine follow up. Patient demographic data and clinicopathologic characteristics are examined. Results : Six male and six female patients with a median age of 38.6 at the time of surgery were included in the study. Spinal cyst hydatid infection sites were one odontoid, one cervical, five thoracic, two lumbar, and three sacral. In all cases, surgery was performed, with the aim of total excision of the cyst, decompression of the spinal cord, and if necessary, stabilization of the spinal column. Mean follow up was 61.3 months (10-156). All the patients were prescribed Albendazole. Three patients had secondary hydatid cyst infection (one lung and two hepatic). Conclusion : The two-way drainage catheter placed inside a cyst provides post-operative chlorhexidine washing inside the cavity. Although a spinal hydatid cyst is a benign pathology and seen rarely, it is extremely difficult to achieve a real cure for patients with this disease. Treatment modalities should be aggressive and include total excision of cyst without rupture, decompression of spinal cord, flushing of the area with scolicidal drugs, and ensuring spinal stabilization. After the operation the patients should be kept under routine follow up. Radiological and clinical examinations are useful in spotting a recurrence.

The Ergonomic Perspectives on Chair Design (인간공학이 의자디자인에 미치는 영향에 관한 연구)

  • 김명태;김정호
    • Journal of the Korea Furniture Society
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    • v.13 no.2
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    • pp.53-62
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    • 2002
  • Due to the industrial development some scholars insist that homo sapiens has become a new race--homo sedens. Since this great degree of behavioral change often cause problems in the spinal column, the appropriate sitting became critical. The nineteenth-century idea of sitting upright position is not considered as a proper sitting any longer. Recent studies by such psychological scientists as A. C. Mandal, Ernest McCormick, and Karl Kroemer show that the spinal column in s-curve with forward bends should be efficiently supported in that manner. Designing a chair sometimes focuses on aesthetic points rather than true ergonomic considerations. Therefore, these result in deleterious effects on human bodies such as lordosis and kyphosis. In fact, it has been overlooked due to the lack of technical and scientific supports. Also, in a mass production, it is hard to meet everyone's need. However, the well adapted ergonomic considerations should meet the needs for wide ranges of people. Indeed, in this study we will examine designing chairs in ergonomic perspectives and suggest additional controversial points and alternatives.

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Percutaneous Vertebroplasty in Spinal Metastasis and Myeloma : 25 Cases Experience (척추 전이암 및 골수종 환자를 대상으로 시행한 경피적 척추체 성형술)

  • Park, Woo-Min;Jang, Jee-Soo;Rhee, Chang-Hun;Gwak, Ho-Shin;Lee, Seung-Hoon
    • Journal of Korean Neurosurgical Society
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    • v.29 no.11
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    • pp.1484-1490
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    • 2000
  • Objectives : In spinal metastasis and myeloma, percutaneous vertebroplasty could be an effective treatment method to provide spinal stabilization and to relief pain for early rehabilitation. The authors report twenty-five cases the clinical results of percutaneous vertebroplasty for twenty-five cases of spinal metastasis and myeloma. Materials and Methods : From September 1998 to December 1999, seventy percutaneous vertebroplasties(PVP) were performed for spinal metastases and myeloma in 25 patients, sixteen women and nine men ranging in age from 34 to 74. The primary malignancies were 6 multiple myelomas, and in metastatic tumore from various origin. All patients complained of severe pain and had osteolytic vertebral body destructions without spinal cord compression. To evaluate clinical improvement, suObjective verbal analogue pain score(VAS) and Karnofsky performance scale(KPS) were used. Thin sliced(2mm-thickness) sectional computed tomography(CT) was performed before and after PVP. Plain X-ray film was followed up every 1 month to assess the vertebral column stability. Results : In 25 patients, a total of seventy PVPS were performed successfully : 6 cervical, 33 thoracic and 31 lumbar vertebrae. Most patients had clear improvement of pain after PVP ; mean as score was 8.1 and 2.9 before and after PVP, respectively. Improvement was maintained in most patients. No further collapse of treated vertebrae was observed(mean follow-up, 7 months). Leakage of PMMA was notod in the spinal canal(13 levels), neural foramen (2 levels), adjacent disk(15 levels), paravertebral soft tissue(14 levels) and vein(8 levels). Pulmonary embolism was detected in three patients after the procedure, but was not associated with clinical symptoms. Conclusion : These results indicate that percutaneous vertebroplasty can be valuable treatment method in osteolytic spinal metastasis and myeloma, providing immediate pain relief and spinal stabilization and contributing to early rehabilitation.

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The Effects of Joint Mobilization and Therapeutic Exercise on Difference for Length of Lower Limbs (운동치료와 관절가동술이 하지길이 차이에 미치는 영향)

  • Jung, Yeon-Woo;Gong, Won-Tae;Kim, Byoung-Gon
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.13 no.2
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    • pp.55-68
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    • 2007
  • Object: to evaluate the effects of two different treatments-joint mobilization and therapeutic exercise on difference for length of lower limbs. Method: The subjects were participated twenty six who has difference for length of lower limbs more 10mm. All subjects randomly assigned to Joint mobilization group(n=13) and therapeutic exercise group. Joint mobilization group received joint mobilization for 2 minutes, Therapeutic exercise group received for 15 minutes per day and 3 times a week during 4 week period. Tape measure method was used to measure the difference for length of lower limbs. Biodex was used to measure the muscle power of lower limbs(Knee flexion, extension). Finger to floor test was used to measure the mobility of spinal column. All measurement of each subjects were measured at pre-experiment, after 2weeks and post-experiment. Result: The result of this study were summarized as follows : 1. Both treatment decreased difference for length of lower limbs while joint mobilization more decreased difference for length of lower limbs than therapeutic exercise. 2. Both treatment increased mobility of spinal column while joint mobilization more increased mobility of spinal column than therapeutic exercise. 3. Joint mobilization increased muscle power while therapeutic exercise decreased muscle power. Conclusion: in a group-wise comparison joint mobilization is more effective than therapeutic exercise.

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The Effectiveness of Using a Spinal Column Thermal Massage Device on Muscle Pain, Depression and Stress (척주 온열 마사지 기기를 이용한 근육통, 우울감 및 스트레스 개선 효과)

  • Lee, Mi-Hyun;Kim, Ka-Eun;Jang, Hong-Young;Cho, Il-Young
    • Journal of the Korea Convergence Society
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    • v.11 no.7
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    • pp.361-368
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    • 2020
  • This study aims to examine whether the use of a spinal column thermal massage device for patients with muscle pain is effective in improving muscle pain, and to verify whether it is also effective in improving affective depression and stress. To this end, 16 study participants (male 31.25%) were treated with a thermal massage device during 5 sessions a week for 4 weeks and 40 minutes per session. According to the study results, the subjective pain level changed by a rate of VAS -46.32% and PDI -44.86%; a significant decrease was observed in, both, VAS and PDI. The depression and stress levels changed by a rate of BDI -21.84% and SRI -11.48%; a significant decrease was observed in, both, BDI and SRI. Therefore, the use of a thermal massage device to treat patients with muscle pain is expected to have a positive effect in improving not only subjective muscle pain, but also depression and stress.

Clinical Analysis of Video-assisted Thoracoscopic Spinal Surgery in the Thoracic or Thoracolumbar Spinal Pathologies

  • Kim, Sung-Jin;Sohn, Moon-Jun;Ryoo, Ji-Yoon;Kim, Yeon-Soo;Whang, Choong-Jin
    • Journal of Korean Neurosurgical Society
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    • v.42 no.4
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    • pp.293-299
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    • 2007
  • Objective : Thoracoscopic spinal surgery provides minimally invasive approaches for effective vertebral decompression and reconstruction of the thoracic and thoracolumbar spine, while surgery related morbidity can be significantly lowered. This study analyzes clinical results of thoracoscopic spinal surgery performed at our institute. Methods : Twenty consecutive patients underwent video-assisted thoracosopic surgery (VATS) to treat various thoracic and thoracolumbar pathologies from April 2000 to July 2006. The lesions consisted of spinal trauma (13 cases), thoracic disc herniation (4 cases), tuberculous spondylitis (1 case), post-operative thoracolumbar kyphosis (1 case) and thoracic tumor (1 case). The level of operation included upper thoracic lesions (3 cases), midthoracic lesions (6 cases) and thoracolumbar lesions (11 cases). We classified the procedure into three groups: stand-alone thoracoscopic discectomy (3 cases), thoracoscopic fusion (11 cases) and video assisted mini-thoracotomy (6 cases). Results : Analysis on the Frankel performance scale in spinal trauma patients (13 cases), showed a total of 7 patients who had neurological impairment preoperatively : Grade D (2 cases), Grade C (2 cases), Grade B (1 case), and Grade A (2 cases). Four patients were neurologically improved postoperatively, two patients were improved from C to E, one improved from grade D to E and one improved from grade B to grade D. The preoperative Cobb's and kyphotic angle were measured in spinal trauma patients and were $18.9{\pm}4.4^{\circ}$ and $18.8{\pm}4.6^{\circ}$, respectively. Postoperatively, the angles showed statistically significant improvement, $15.1{\pm}3.7^{\circ}$ and $11.3{\pm}2.4^{\circ}$, respectively(P<0.001). Conclusion : Although VATS requires a steep learning curve, it is an effective and minimally invasive procedure which provides biomechanical stability in terms of anterior column decompression and reconstruction for anterior load bearing, and preservation of intercostal muscles and diaphragm.

Effect of Spinal Cord Removal before or after Splitting and Washing on CNST Decontamination of Beef Carcasses

  • Lim, D.G.;Kim, D.H.;Lee, M.
    • Asian-Australasian Journal of Animal Sciences
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    • v.20 no.11
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    • pp.1770-1776
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    • 2007
  • Beef carcasses were examined to explore the effects of spinal cord removal and washing on central nervous system tissue (CNST) decontamination of the surface during the slaughtering process. A total of 15 carcasses were split by sawing centrally down the vertebral column and left sides of split carcasses were used for analysis. Samples were collected by swabbing the surface from 4 defined parts on the interior and 4 on the exterior of carcasses from the abattoir and analyzed using an ELISA-based test. The results showed that automatic and manual spray washing decreased CNST contamination, especially on the interior ventral parts of carcass surfaces (p<0.01), but did not decrease CNST on the interior dorsal parts. Increasing washing time to 60 s did not affect the reduction of CNST contamination. Samples following spinal cord removal prior to splitting showed lower calculated levels of "risk material" than the stated limit of detection (0.1%) of the ELISA kit on interior and exterior carcass parts (p<0.01). Therefore, spinal cord removal prior to splitting could be a very effective way to minimize CNST contamination of beef carcasses.

Clinical Experience of Traumatic C7-T1 Spondyloptosis

  • Lee, Dong-Geun;Hwang, Soo-Hyun;Lee, Chul-Hee;Kang, Dong-Ho
    • Journal of Korean Neurosurgical Society
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    • v.41 no.2
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    • pp.127-129
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    • 2007
  • Two unusual cases of traumatic spondyloptosis of the cervical spine at the C7-T1 level are reported. One patient was treated with a single-stage combined anterior-posterior and anterior operation to achieve realignment of the cervical spondyloptosis, decompression of the spinal cord and keep of a three-column stabilization of the spine. The other patient was treated with conservative management that consisted of a rigid neck collar and pain control for two months. The patients were managed successfully and both had good neurological outcomes. We present here a summary of the clinical presentations, the surgical technique and results, and a review of the relevant literature.