• The Journal of the Korean bone and joint tumor society
• /
• v.17 no.2
• /
• pp.106-110
• /
• 2011

In the patient who has intradural mass associated with spinal stenosis, if the operation for spinal stenosis is performed alone, the symptom may remain. We report with literature review that we achieved the successful outcome after simultaneous decompression of spinal stenosis and space occupying mass removal in the case of intradural and extradural compression. A 71-year-old female patient suffering from low back pain and radiating pain of both lower extremities admitted. In magnetic resonance imaging, spinal stenosis on L4-5 and spondylolisthesis on L5-S1 compressed dural sac and intradural space occupying mass on L4 level compressed. By posterior approach, decompression and interbody fusion were carried out. Then mass was removed with median durotomy. Pathologic diagnosis was schwannoma and the symptom was improved remarkably.

• Journal of Korean Neurosurgical Society
• /
• v.50 no.3
• /
• pp.268-270
• /
• 2011

Spinal subdural hematoma (SSDH) is an extremely uncommon condition. Causative factors include trauma, anticoagulant drug administration, hemostatic disorders, and vascular disorders such as arteriovenous malformations and lumbar punctures. Of SSDH cases, those that do not have any traumatic event can be considered cases of nontraumatic acute spinal subdural hematoma, which is known to have diverse clinical progress. Treatment typically consists of surgical decompression and cases in which the condition is relieved with conservative treatment are rarely reported. We report two nontraumatic acute spinal subdural hematoma patients who were successfully treated without surgery.

• Journal of Korean Neurosurgical Society
• /
• v.47 no.3
• /
• pp.228-231
• /
• 2010

Posttraumatic syringomyelia may result from a variety of inherent conditions and traumatic events, or from some combination of these. Many hypotheses have arisen to explain this complex disorder, but no consensus has emerged. A 28-year-old man presented with progressive lower extremity weakness, spasticity, and decreased sensation below the T4 dermatome five years after an initial trauma. Magnetic resonance imaging (MRI) revealed a large, multi-septate syrinx cavity extending from C5 to L1, with a retropulsed bony fragment of L2. We performed an L2 corpectomy, L1-L3 interbody fusion using a mesh cage and screw fixation, and a wide decompression and release of the ventral portion of the spinal cord with an operating microscope. The patient showed complete resolution of his neurological symptoms, including the bilateral leg weakness and dysesthesia. Postoperative MRI confirmed the collapse of the syrinx and restoration of subarachnoid cerebrospinal fluid (CSF) flow. These findings indicate a good correlation between syrinx collapse and symptomatic improvement. This case showed that syringomyelia may develop through obstruction of the subarachnoid CSF space by a bony fracture and kyphotic deformity. Ventral decompression of the obstructed subarachnoid space, with restoration of spinal alignment, effectively treated the spinal canal encroachment and post-traumatic syringomyelia.

• The Korean Journal of Pain
• /
• v.21 no.2
• /
• pp.143-149
• /
• 2008

Background: Traction has often been utilized to treat patients with a herniated lumbar disc. Currently, the most advanced type of traction therapy is non-surgical spinal decompression. Therefore, this study was conducted to evaluate the effectiveness of decompression therapy in patients with a herniated lumbar disc based on clinical findings and symptoms. Methods: Sixty patients with herniated lumbar discs were included in this study. The patients were randomly divided into two groups, a decompression group (n = 30) and a traction group (n = 30). To evaluate the impact of decompression and traction therapy on the herniated disc, the clinical symptoms for each group were evaluated prior to and after treatment using the visual analogue scale (VAS), straight leg raising (SLR), the herniation index, and the disc height. Results: The VAS score was significantly lower in the decompression group ($2.0{\pm}0.2$) than the traction group ($3.9{\pm}0.2$) following treatment. In addition, the SLR angle was significantly higher in the decompression group ($79{\pm}1.5$) than the traction group ($63.3{\pm}1.9$). The herniation index was significantly lower in the decompression group ($217.6{\pm}19.1$) than the traction group ($259.5{\pm}16.4$). Finally, the disc height was not significant differences between pre-treatment and follow-up in two groups. Conclusions: The results of this study suggest that decompression therapy for the treatment of patients suffering from a herniated lumbar disc has an effect on the pain, SLR, and herniation indices, not disc heights.

• Journal of The Korean Society of Integrative Medicine
• /
• v.6 no.4
• /
• pp.139-148
• /
• 2018

Purpose : The purpose of this study was to examine the effects of waist mobilization technique intervention for patients with chronic back pain on balance and the low back pain disability index. Methods : The subjects were 30 patients with chronic back pain. They were sampled and divided into a manual therapy group and a spinal decompression group. 15 subjects were randomly assigned to each group. Each training in this study participated for 6 weeks, 5 times a week, once a day, 15 minutes a day. Balance ability was measured with a balance analyzer, and the low back pain disability index was measured using the Oswestry Disability Index (ODI). Results : In the balance abilities, there was a significant difference in the manual therapy group compared to the spinal decompression group. In the low back pain disability index, there was a significant difference in the manual therapy group compared to the spinal decompression group. Conclusion : The analysis results of the effect of 6 weeks of waist mobilization technique intervention on the balance and low back pain disability index for patients with chronic back pain revealed that the manual therapy is more effective for static and dynamic balance ability and the low back pain disability index. In the future, we can promote independent life skills and expect a rapid recovery of patients with chronic back pain. Based on this study, further studies are needed on the effects of balance, the mechanical properties of muscle, and the low back pain disability index depending on various manual therapy techniques.

• Journal of Korean Neurosurgical Society
• /
• v.42 no.4
• /
• pp.245-250
• /
• 2007

Tubular retractor system as a minimally invasive surgery (MIS) technique has many advantages over other conventional MIS techniques. It offers direct visualization of the operative field, anatomical familiarity to spine surgeons, and minimizing tissue trauma. With technical advancement, many spinal pathologies are being treated using this system. Namely, herniated discs, lumbar and cervical stenosis, synovial cysts, lumbar instability, trauma, and even some intraspinal tumors have all been treated through tubular retractor system. Flexible arm and easy change of the tube direction are particularly useful in contralateral spinal decompression from an ipsilateral approach. Careful attention to surgical technique through narrow space will ensure that complications are minimized and will provide improved outcomes. However, understanding detailed anatomies and keeping precise surgical orientation are essential for this technique. Authors present the technical feasibility and initial results of use a tubular retractor system as a minimally invasive technique for variaties of spinal disorders with a review of literature.

• Journal of Korean Neurosurgical Society
• /
• v.57 no.5
• /
• pp.371-375
• /
• 2015

Spontaneous spinal subdural hematoma is reported at a rare level of incidence, and is frequently associated with underlying coagulopathy or those receiving anticoagulant or antiplatelet agents; some cases accompany concomitant intracranial hemorrhage. The spontaneous development of spinal subdural hemorrhage (SDH) is a neurological emergency; therefore, early diagnosis, the discontinuation of anticoagulant, and urgent surgical decompression are required to enable neurological recovery. In this report, we present a simultaneous spinal subdural hematoma and cranial subarachnoid hemorrhage, which mimicked an aneurysmal origin in a female patient who had been taking warfarin due to aortic valve replacement surgery.

• Journal of the Korean Orthopaedic Association
• /
• v.56 no.2
• /
• pp.178-182
• /
• 2021

Spinal hematomas are a rare but serious complication that is typically observed in the epidural space. Spinal subdural hematomas are a dangerous clinical situation because of their potential to cause significant compression of the neural elements and can be mistaken easily for spinal epidural hematomas. This paper reports a case of a severe whole lumbar subdural hematoma after a simple epidural injection that was treated with surgical decompression with excellent clinical results.

• Journal of Korean Neurosurgical Society
• /
• v.64 no.6
• /
• pp.922-932
• /
• 2021

Objective : It is challenging to make solid fusion by posterior screw fixation and laminectomy with posterolateral fusion (PLF) in thoracic and thoracolumbar (TL) diseases. In this study, we report our experience and follow-up results with a new surgical technique entitled posterior thoracic cage interbody fusion (PTCIF) for thoracic and TL spine in comparison with conventional PLF. Methods : After institutional review board approval, a total of 57 patients who underwent PTCIF (n=30) and conventional PLF (n=27) for decompression and fusion in thoracic and TL spine between 2004 and 2019 were analyzed. Clinical outcomes and radiological parameters, including bone fusion, regional Cobb angle, and proximal junctional Cobb angle, were evaluated. Results : In PTCIF and conventional PLF, the mean age was 61.2 and 58.2 years (p=0.46), and the numbers of levels fused were 2.8 and 3.1 (p=0.46), respectively. Every patient showed functional improvement except one case of PTCIF. Postoperative hematoma as a perioperative complication occurred in one and three cases, respectively. The mean difference in the regional Cobb angle immediately after surgery compared with that of the last follow-up was 1.4° in PTCIF and 7.6° in conventional PLF (p=0.003), respectively. The mean durations of postoperative follow-up were 35.6 months in PTCIF and 37.3 months in conventional PLF (p=0.86). Conclusion : PTCIF is an effective fusion method in decompression and fixation surgery with good clinical outcomes for various spinal diseases in the thoracic and TL spine. It provides more stable bone fusion than conventional PLF by anterior column support.

• The Korean Journal of Pain
• /
• v.32 no.3
• /
• pp.147-159
• /
• 2019

Lumbar foraminal pathology causing entrapment of neurovascular contents and radicular symptoms are commonly associated with foraminal stenosis. Foraminal neuropathy can also be derived from inflammation of the neighboring lateral recess or extraforaminal spaces. Conservative and interventional therapies have been used for the treatment of foraminal inflammation, fibrotic adhesion, and pain. This update reviews the anatomy, pathophysiology, clinical presentation, diagnosis, and current treatment options of foraminal neuropathy.