• The Korean Journal of Pain
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• v.26 no.2
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• pp.199-202
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• 2013

Epiduroscopic laser discectomy and neural decompression (ELND) is known as an effective treatment for intractable lumbar pain and radiating pain which develop after lumbar surgery, as well as for herniation of the intervertebral disk and spinal stenosis. However, various complications occur due to the invasiveness of this procedure and epidural adhesion, and rarely, cranial nerve damage can occur due to increased intracranial pressure. Here, the authors report case in which double vision occurred after epiduroscopic laser discectomy and neural decompression in a patient with failed back surgery syndrome (FBSS).

• Journal of Acupuncture Research
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• v.34 no.3
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• pp.59-69
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• 2017

Objectives : This study analyzed the current status of randomized controlled trials (RCTs) of miniscalpel acupuncture for lumbar spinal stenosis (LSS) in China. Methods : A literature search was performed using the China National Knowledge Infrastructure (CNKI) database. All studies up to June 7th, 2017 were searched. The quality of included RCTs was assessed with the Jadad scale. Results : Five RCTs were finally included in this review. The overall quality of the RCTs was assessed as low. All articles evaluated miniscalpel acupuncture as monotherapy or in combination with filiform needle therapy, drug injection therapy, Tuina treatment, thermal coagulation therapy, or spinal decompression. Miniscalpel acupuncture as monotherapy or adjunctive therapy showed greater therapeutic effect and fewer adverse effects. Conclusion : Miniscalpel acupuncture is a safe and effective nonpharmacological treatment for LSS. However, high-quality studies with consistent treatment protocols are needed to confirm these findings.

• Journal of Korean Neurosurgical Society
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• v.59 no.6
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• pp.655-658
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• 2016

Parkinson's disease (PD) patients frequently have several spinal deformities leading to postural instabilities including camptocormia, myopathy-induced postural deformity, Pisa syndrome, and progressive degeneration, all of which adversely affect daily life activities. To improve these postural deformities and relieve the related neurologic symptoms, patients often undergo spinal instrumentation surgery. Due to progressive degenerative changes related to PD itself and other complicating factors, patients and surgeons are faced with instrument failure-related complications, which can ultimately result in multiple revision surgeries yielding various postoperative complications and morbidities. Here, we report a representative case of a 70-year-old PD patient with flat back syndrome who had undergone several revision surgeries, including anterior and posterior decompression and fusion for a lumbosacral spinal deformity. The patient ultimately benefitted from a relatively short segment fixation and corrective fusion surgery.

• 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.

• Journal of Korean Neurosurgical Society
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• v.57 no.3
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• pp.215-218
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• 2015

Occasionally, unexpected neurological deficits occur after lumbar spinal surgery. We report a case of monoparesis after lumbar decompressive surgery. A 63-year-old man, who had undergone decompression of L4-5 for spinal stenosis 4 days previously in the other hospital, visted the emergency department with progressive weakness in the left leg and hypoesthesia below sensory level T7 on the right side. He had been cured of lung cancer with chemotherapy and radiation therapy 10 years previously, but detailed information of radiotherapy was not available. Whole spine magnetic resonance (MR) imaging showed fatty marrow change from T1 to T8, most likely due to previous irradiation. The T2-weighted MR image showed a high-signal T4-5 spinal cord lesion surrounded by a low signal rim, and the T1-weighted MR image showed focal high signal intensity with focal enhancement. The radiological diagnosis was vascular disorders with suspicious bleeding. Surgical removal was refused by the patient. With rehabilitation, the patient could walk independently without assistance 2 months later. Considering radiation induced change at thoracic vertebrae, vascular disorders may be induced by irradiation. If the spinal cord was previously irradiated, radiation induced vascular disorders needs to be considered.

• Journal of Korean Neurosurgical Society
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• v.29 no.6
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• pp.763-771
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• 2000

Objectives : Thoracolumbar burst fractures(TBLF) result in not only compressive deformity of vertebral body but also spinal cord compression by bony fragments. Many thoracolumbar burst fractures demand both anterior decompression and intervertebral fusion. Most of spinal surgeons use anterior instrumentation for anteior intervertebral bony fusion. The use of Z-plate has been increased recently, however there has been only a few reports regarding its clinical long-term strength. We studied nineteen patients with TBLF to find out the long-term stability of Z-plate. Methods : We have operated 19 patients from March 1996 to August 1998. They were treated with anterior decompression through either a transthoracic, retroperitoneal extrapleural or retroperitoneal approach. Retropulsed bony fragments were removed completely by corpectomy. Iliac bone graft was used for interbody fusion in all of the cases. They were evaluated by plain X-ray films including flexion and extention lateral films. Cobbs angle was used to evaluate kyphotic and lateral wedging deformity. Results : Burst fractured sites were T11 in two, three T12, nine L1, and five L2. Mean follow-up duration was fifteen months. Preoperative average kyphotic angle was 23.7 degree. Immediate postoperative kyphotic angle was 10.2 degree. Follow-up resluts of average kyphotic angles revealed 14 degrees. Four patients(21%), including two spinal 3-column injury, showed increasement of kyphotic angle more than 5 degree or breakage of intrumentation. Two patients showed the difference of kyphotic angle more than 3 degree. Five patients(26%) revealed lateral wedging deformity more than 3 degrees. Postoperative complications were two meralgia parestheticas, one pulmonary atelectasis and two donor site infections. Four of the eight patients, who initially showed incomplete spinal cord deficits, were nerologically improved by Frankel's grade. Conclusion : Z-plate fixation and iliac bone graft after anterior decompression in thoracolumbar burst fractures is a safe and easy method. Immediate postoperative results revealed excellent correction of posttraumatic kyphosis, but long-term follow-up evalution showed insufficient strength. Therefore we believe that use of Z-plate should be carefully decided, especially in the case of large lumbar fracture or 3-column injury.

• Journal of Korean Neurosurgical Society
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• v.64 no.6
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• pp.901-912
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• 2021

Objective : In the cervical spine, many surgical procedures have been developed to achieve optimal results for various disorders, including degenerative diseases, traumatic injury, and tumor. In this study, we report our experience and follow-up results with a new surgical technique for cervical spine entitled posterior floating laminotomy (PFL) in comparison with conventional laminectomy and fusion (LF). Methods : Data for 85 patients who underwent conventional LF (n=66) or PFL (n=19) for cervical spine disorders between 2012 and 2019 were analyzed. Radiological parameters, including cervical lordosis (CL), T1 slope (T1S), segmental lordosis (SL), and C2-7 sagittal vertical axis (SVA), were measured with lateral spine X-rays. Functional outcomes, comprising the modified Japanese Orthopaedic Association (mJOA), neck disability index (NDI), and visual analog scale (VAS) scores, were also measured. For the patients who underwent PFL, postoperative magnetic resonance image (MRI) was performed in a month after the surgery, and the degree of decompression was evaluated at the T2-weighted axial image, and postoperative computed tomography (CT) was conducted immediately and 1 year after the operation to evaluate the gutter fusion. Results : There was no difference in CL, T1S, SL, and C2-7 SVA between the groups but there was a difference in the preoperative and postoperative SL angles. The mean difference in the preoperative SL angle compared with that at the last follow-up was -0.3° after conventional LF and 4.7° after PFL (p=0.04), respectively. mJOA, NDI, and VAS scores showed significant improvements (p<0.05) during follow-up in both groups. In the PFL group, postoperative MRI showed sufficient decompression and postoperative CT revealed gutter fusion at 1 year after the operation. Conclusion : PFL is a safe surgical method which can preserve postoperative CL and achieve good clinical outcomes.

• The Journal of Korean Medicine
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• v.42 no.2
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• pp.1-20
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• 2021

Objectives: The purpose of this study was to confirm the relavance between the dependent variables and the treatment effects of nonsurgical spinal decompression(NSD). Methods: 105 patients suffering from disc herniation and treated with NSD were investigated and analyzed. Results: The intention of retreatment showed a tendency to be higher in having occupation, western treatment only before NSD(WTB) and non-western treatment(WTN) group. As the number of NSD increased, satisfaction score and the Numeric Rating Scale(NRS) difference increased and the NRS after NSD decreased. On the other hand, as western treatment after NSD increased, satisfaction score and the NRS difference decreased and the NRS after NSD increased. The odds ratio of having intention of retreatment was lower in western treatment only after NSD(WTA) group than WTN group. The NRS difference showed a high tendency in the age group of 20s, 60s, and 70s and older. The NRS difference of group with NSD more than 10 times was higher than that of the group with less than 10 times. Satisfaction score of WTN and WTB group was higher than that of WTA group. Adjusted NRS after NSD was the lowest in non-western treatment group and the highest in WTA group. Adjusted NRS after NSD was the lowest in the group with NSD over 21 times, and the NRS after NSD increased as the number of NSD decreased. Conclusion: This study included patients with cervical or lumbar disc herniation and showed that occupation, the number of NSD, western treatment and age statistically affected the treatment effect.

• 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.

• Korean Journal of Veterinary Research
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• v.56 no.2
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• pp.113-116
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• 2016

Our retrospective study reports the clinical findings and population characteristics of 81 surgically treated dogs for spinal cord compression. We compared the outcome of dogs with different grades of neurological dysfunction due to spinal cord compression and focused on the long-term outcome of surgical treatment, for which there are only a few recent records. We recorded a 13.6% recurrence, regardless of the degree of dysfunction. However, the degree of dysfunction negatively affected the recovery length.