• Title/Summary/Keyword: Spinal surgery

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Multiple Spinal Revision Surgery in a Patient with Parkinson's Disease

  • Malla, Hridayesh Pratap;Kim, Min Ki;Kim, Tae Sung;Jo, Dae Jean
    • 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.

Contemporary treatment with radiosurgery for spine metastasis and spinal cord compression in 2015

  • Ryu, Samuel;Yoon, Hannah;Stessin, Alexander;Gutman, Fred;Rosiello, Arthur;Davis, Raphael
    • Radiation Oncology Journal
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    • v.33 no.1
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    • pp.1-11
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    • 2015
  • With the progress of image-guided localization, body immobilization system, and computerized delivery of intensity-modulated radiation delivery, it became possible to perform spine radiosurgery. The next question is how to translate the high technology treatment to the clinical application. Clinical trials have been performed to demonstrate the feasibility of spine radiosurgery and efficacy of the treatment in the setting of spine metastasis, leading to the randomized trials by a cooperative group. Radiosurgery has also demonstrated its efficacy to decompress the spinal cord compression in selected group of patients. The experience indicates that spine radiosurgery has a potential to change the clinical practice in the management of spine metastasis and spinal cord compression.

One Case Report on Physical Sequelas after Spinal Epidural Abscess Surgery (척추 경막외 농양 수술 후유증 치험 1례)

  • Kwon, Jeong-Gook;Lee, Jong-Ha;Keum, Dong-Ho
    • Journal of Korean Medicine Rehabilitation
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    • v.24 no.4
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    • pp.195-201
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    • 2014
  • The objective of this study is to report the improvement of one patient with physical sequelas induced by spinal epidural abscess surgery. The patient was treated by acupuncture therapy with pulsed electromagnetic therapy and herb medicine. We evaluated the effectiveness by numerical rating scale (NRS). As a result, the patient improved significantly NRS score. And the patient's symptoms were alleviated. We guess that the causes of the patient symptoms are chronic inflammation and fibrosis of dural. We conclude that acupuncture therapy with pulsed electromagnetic therapy is an effective treatment to reduce the residual pain after spinal epidural abscess surgery. But there is a limit on this study due to sufficient number of case. Further studies will be needed.

Multiple Myeloma and Epidural Spinal Cord Compression : Case Presentation and a Spine Surgeon's Perspective

  • Ha, Kee-Yong;Kim, Young-Hoon;Kim, Hyun-Woo
    • Journal of Korean Neurosurgical Society
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    • v.54 no.2
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    • pp.151-154
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    • 2013
  • Multiple myeloma, a multicentric hematological malignancy, is the most common primary tumor of the spine. As epidural myeloma causing spinal cord compression is a rare condition, its therapeutic approach and clinical results have been reported to be diverse, and no clear guidelines for therapeutic decision have been established. Three patients presented with progressive paraplegia and sensory disturbance. Image and serological studies revealed multiple myeloma and spinal cord compression caused by epidural myeloma. Emergency radiotherapy and steroid therapy were performed in all three cases. However, their clinical courses and results were distinctly different. Following review of our cases and the related literature, we suggest a systematic therapeutic approach for these patients to achieve better clinical results.

Cervicothoracic Spinal Epidural Hematoma after Anterior Cervical Spinal Surgery

  • Lee, Dong-Yeob;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • v.48 no.6
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    • pp.541-543
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    • 2010
  • The purpose of this case report is to describe a rare case of a cervicothoracic spinal epidural hematoma (SEH) after anterior cervical spine surgery. A 60-year-old man complained of severe neck and arm pain 4 hours after anterior cervical discectomy and fusion at the C5-6 level. Magnetic resonance imaging revealed a postoperative SEH extending from C1 to T4. Direct hemostasis and drainage of loculated hematoma at the C5-6 level completely improved the patient's condition. When a patient complains of severe neck and/or arm pain after anterior cervical spinal surgery, though rare, the possibility of a postoperative SEH extending to non-decompressed, adjacent levels should be considered as with our case.

Effects of Structured Education Program Using CD-ROM on Anxiety and Self-Care Compliance in Patients Undergoing Orthopedic Spinal Surgery (척추환자 대상 수술 전 구조화된 동영상 교육프로그램이 수술 후 불안과 자가간호 이행에 미치는 효과)

  • Koo, Eun-Jung;Kim, Ju-Sung
    • Journal of muscle and joint health
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    • v.18 no.1
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    • pp.39-49
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    • 2011
  • Purpose: The purpose of this study was to identify the effects of CD-ROM education on anxiety and self-care compliance in patients undergoing spinal surgery. Method: This study used a nonequivalent control time difference design. A sample of 51 participants received both CD-ROM education (n=25) or booklet education (n=26) regarding spinal surgery procedure and postoperative self-care. The data were collected using a self-administered questionnaire containing State-Trait Anxiety Inventory (STAI Form Y-2), Visual analog scale, and self-care compliance. Result: The level of trait anxiety in the experimental group was not significantly different from that in the control group (t=-6.44, p=.523). The level of state anxiety in the experimental group was significantly lower than in that the control group according to time changes (F=4.17, p=.018). State anxiety showed significantly negative correlation to self-care compliance (r=-.30, p=.034). Conclusion: The education program using CD-ROM for spinal surgery patients can be applied to nursing practice for relieving state anxiety and promoting self-care compliance.

Intraoperative Neurophysiology Monitoring for Spinal Dysraphism

  • Kim, Keewon
    • Journal of Korean Neurosurgical Society
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    • v.64 no.2
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    • pp.143-150
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    • 2021
  • Spinal dysraphism often causes neurological impairment from direct involvement of lesions or from cord tethering. The conus medullaris and lumbosacral roots are most vulnerable. Surgical intervention such as untethering surgery is indicated to minimize or prevent further neurological deficits. Because untethering surgery itself imposes risk of neural injury, intraoperative neurophysiological monitoring (IONM) is indicated to help surgeons to be guided during surgery and to improve functional outcome. Monitoring of electromyography (EMG), motor evoked potential, and bulbocavernosus reflex (BCR) is essential modalities in IONM for untethering. Sensory evoked potential can be also employed to further interpretation. In specific, free-running EMG and triggered EMG is of most utility to identify lumbosacral roots within the field of surgery and filum terminale or non-functioning cord can be also confirmed by absence of responses at higher intensity of stimulation. The sacral nervous system should be vigilantly monitored as pathophysiology of tethered cord syndrome affects the sacral function most and earliest. BCR monitoring can be readily applicable for sacral monitoring and has been shown to be useful for prediction of postoperative sacral dysfunction. Further research is guaranteed because current IONM methodology in spinal dysraphism is still deficient of quantitative and objective evaluation and fails to directly measure the sacral autonomic nervous system.

Penetrating Neck Trauma: A Case of Spinal Cord Injury by Embedded Scissor (척수 손상을 일으킨 경부 가위 관통상)

  • Kim, Seon Hee;Choi, Sun Woo;Park, Sung Jin;Yeo, Kwang Hee;Kim, Chang-Wan;Lee, Sang Bong;Kim, Ho Hyun;Park, Chan-Yong;Kim, Jae Hun;Hwang, Jung Joo;Cho, Hyun Min
    • Journal of Trauma and Injury
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    • v.28 no.2
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    • pp.71-74
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    • 2015
  • Penetrating neck trauma involving spinal cord injury is relatively uncommon, but can be life-threatening. We report a case of 59-year-old female who presented with hypotension after stab injury self-inflicted with a scissor to her neck. Although Open removal of the scissor and control of bleeding were successfully done, penetration of spinal cord resulted in a neurologic impairment.

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Functional Evaluation of Spinal Accessory Nerve and Shoulder after Neck Dissection (경부청소술 후 어깨 및 척수 부신경의 기능평가)

  • Tae Kyung;Han Jang-Hee;Park In-Beom;Jeong Jin-Hyeok;Lee Hyung-Seok;Choi Ki-Sub
    • Korean Journal of Head & Neck Oncology
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    • v.20 no.2
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    • pp.161-166
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    • 2004
  • Objective: The aim of this study is to evaluate shoulder function and preoperative and postoperative electrophysiological changes related to the spinal accessory nerve with reference to neck dissection technique. Materials and Methods: We evaluated shoulder function by pain, strength and range of motion in a total of 35 neck dissection cases of 29 patients with head and neck cancer or thyroid papillary cancer. Electrophysiologic studies were performed before surgery, after third postoperative weeks and 6 months respectively. The results of each test according to the types of neck dissection were compared. Results: Clinical parameters of shoulder function and electrophysiologic study showed deterioration in early postoperative periods and improvements in late postoperative periods when the spinal accessory nerve was spared and permanent nerve damage was observed in radical neck dissection. There were correlations between the clinical parameters and electrophysiologic studies. Conclusion: The shoulder function after spinal accessory nerve sparing procedure is better than the function after nerve sacrificing procedure.

Effects of Patient Controlled Analgesia Convergence Education on Postoperative Pain Management in Spinal Surgery Patients (통증자가조절기 융합교육이 척추수술환자의 수술 후 통증관리에 미치는 효과)

  • Choi, Ga-Young;Kim, Ju-Sung
    • Journal of the Korea Convergence Society
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    • v.9 no.2
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    • pp.371-380
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    • 2018
  • The purpose of this study was to investigate the effects of patient controlled analgesia(PCA) convergence education on postoperative pain management in spinal surgery patients. Sixty spinal surgery patients were included. For the experimental group(n=30), PCA education using video, booklet, and a PCA model practice was provided before surgery. The data were collected using questionnaire and were analyzed using descriptive statistics, ${\chi}^2-test$, Fisher's exact test, t-test and repeated measures ANOVA. PCA knowledge-attitude, PCA satisfaction and pain control satisfaction were higher in the experimental group than the control group(p<.001; p=.001; p<.001). Postoperative pain and frequency of additional analgesia use of the experimental group were significantly lower than those of the control group(p<.001; p=.001). This findings showed that the convergence PCA education of audiovisual aids with PCA practice training could be effective pain management intervention in patients undergoing spinal surgery. These apply to development of convergence nursing interventions in clinical practice.