• Title/Summary/Keyword: Surgical decompression

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Facial Nerve Decompression via Middle Fossa Approach : Report of Three Cases (말초성 안면마비에서 중두개와 접근법에 의한 안면신경 감압술 : 3례 보고)

  • Cho, Joon;Park, Sung-Ho;Kim, Jae-Young
    • Journal of Korean Neurosurgical Society
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    • v.30 no.4
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    • pp.479-485
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    • 2001
  • Objective : Several conservative treatments have been tried in peripheral facial nerve paralysis, because 80% of patients recover spontaneously. Surgical decompression may be helpful to the residual, medically intractable patients. We present here our experiences of facial nerve decompression via middle fossa approach, which seems to be one of good surgical therapeutic options for medically refractory peripheral facial nerve paralysis. Method : Three cases of medically intractable peripheral type facial paralysis were microscopically operated via middle cranial fossa approach to decompress the labyrinthine segment of the facial nerve and geniculate ganglion by searching landmarks of middle meningeal artery, greater superficial petrosal nerve and facial hiatus. Results : After operation, two cases of Bell's palsy improved substantially and one case of post-traumatic facial paralysis improved partially. Conclusion : This report is presented to describe the surgical facial nerve decompression via middle fossa for early control of peripheral type facial paralysis. Surgical decompression of edematous peripherally paralysed facial nerve could be preferred to conservative treatment in some patients although more surgical experience should be required.

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Decompression and Medial Epicondyloplasty in Ulnar Nerve Entrapment Syndrome at Elbow (주관절부 척골신경 포착증후군의 수술적 감압술 및 내상과 성형술)

  • Lee Dong Wha;Shin Kyoo Seog;Kim Jong Soon;Kim Jung Seok
    • Clinics in Shoulder and Elbow
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    • v.3 no.1
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    • pp.54-60
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    • 2000
  • As a surgical treatment of ulnar nerve entrapment syndrome includes simple decompression, medial epicondylectomy, and anterior transposition of the ulnar nerve into a subcutaneous or submuscular bed have been widely used. Despite many reports of these surgical procedure, there is little to guide the choice of one surgical technique. The purpose of our study is to analyse clinical and electrodiagnostic result after minimal invasive decompression by decompression and medial epicondyloplasty(deepening of ulnar groove). We have experienced 9 cases of ulnar nerve entrapment syndrome who were treated with decompression and medial epicondyloplasty. Male were five and female were four. The mean age at operation was 36 years ranging from 23 to 47 years. Operative procedure was to incise the medial intermuscular septum and aponeurotic arch of flexor carpiulnaris and to deepen the ulnar groove. Patients are allowed to do range of motion(ROM) exercise on the average 5days. All patient were relieved pain and improved motor and sensory function, and this procedure allows early ROM exercise after operation because the muscle have not been detached.

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Early Decompression in Acute Spinal Cord Injury : Review and Update

  • Byung-Jou, Lee;Je Hoon, Jeong
    • Journal of Korean Neurosurgical Society
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    • v.66 no.1
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    • pp.6-11
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    • 2023
  • Spinal cord injury (SCI) has a significant negative effect on the quality of life due to permanent neurologic damage and economic burden by continuous treatment and rehabilitation. However, determining the correct approach to ensure optimal clinical outcomes can be challenging and remains highly controversial. In particular, with the introduction of the concept of early decompression in brain pathology, the discussion of the timing of decompression in SCI has emerged. In addition to that, the concept of "time is spine" has been added recently, and the mortality and complications caused by SCI have been reduced by providing timely and professional treatment to patients. However, there are many difficulties in establishing international clinical guidelines for the timing of early decompression in SCI because policies for each country and medical institution differ according to the circumstances of medical infrastructure and economic conditions in the surgical treatment of SCI. Therefore, we aim to provide a current review of timing of early decompression in patient with SCI.

Effect of the Combination of Electroacupuncture and Surgical Decompression on Experimental Spinal Cord Injury in Dogs (개에서 실험적으로 유발한 척수손상에 대한 전침과 감압술의 병용 효과)

  • Kim Sun Young;Kim Min-Su;Seo Kang-Moon;Nam Tchi-Chou
    • Journal of Veterinary Clinics
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    • v.22 no.4
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    • pp.297-301
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    • 2005
  • This study was performed to evaluate the effects of the combination of electroacupuncture (EA) and surgical decompression on paraplegia due to spinal compression in dogs. Ten clinically healthy dogs were assigned into two groups (group A and group B). The one is for the combination of EA and surgical decompression, and the other is for surgical decompression alone. After decompression, neurological function was evaluated daily with modified Tarlov grading system. SEPs were measured as objective evaluation of normal spinal cord function before spinal compression and after neurological recovery. The period of rehabilitation in group A was significantly shorter than that in group B (p<0.05). Conduction velocity of SEPs showed a tendency to return to normal when the dogs got full recovery. According to these results, it was considered that the EA with surgical decompression was more effective than surgical decompression alone for paraplegia resulting from spinal cord injury in dog.

Central Decompressive Laminoplasty for Treatment of Lumbar Spinal Stenosis : Technique and Early Surgical Results

  • Kwon, Young-Joon
    • Journal of Korean Neurosurgical Society
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    • v.56 no.3
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    • pp.206-210
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    • 2014
  • Objective : Lumbar spinal stenosis is a common degenerative spine disease that requires surgical intervention. Currently, there is interest in minimally invasive surgery and various technical modifications of decompressive lumbar laminectomy without fusion. The purpose of this study was to present the author's surgical technique and results for decompression of spinal stenosis. Methods : The author performed surgery in 57 patients with lumbar spinal stenosis between 2006 and 2010. Data were gathered retrospectively via outpatient interviews and telephone questionnaires. The operation used in this study was named central decompressive laminoplasty (CDL), which allows thorough decompression of the lumbar spinal canal and proximal two foraminal nerve roots by undercutting the lamina and facet joint. Kyphotic prone positioning on elevated curvature of the frame or occasional use of an interlaminar spreader enables sufficient interlaminar working space. Pain was measured with a visual analogue scale (VAS). Surgical outcome was analyzed with the Oswestry Disability Index (ODI). Data were analyzed preoperatively and six months postoperatively. Results : The interlaminar window provided by this technique allowed for unhindered access to the central canal, lateral recess, and upper/lower foraminal zone, with near-total sparing of the facet joint. The VAS scores and ODI were significantly improved at six-month follow-up compared to preoperative levels (p<0.001, respectively). Excellent pain relief (>75% of initial VAS score) of back/buttock and leg was observed in 75.0% and 76.2% of patients, respectively. Conclusion : CDL is easily applied, allows good field visualization and decompression, maintains stability by sparing ligament and bony structures, and shows excellent early surgical results.

A Comparison of the Clinical Outcomes of Decompression Alone and Fusion in Elderly Patients with Two-Level or More Lumbar Spinal Stenosis

  • Son, Seong;Kim, Woo Kyung;Lee, Sang Gu;Park, Chan Woo;Lee, Keun
    • Journal of Korean Neurosurgical Society
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    • v.53 no.1
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    • pp.19-25
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    • 2013
  • Objective : We compared the results of two surgical techniques by retrospective study of 60 elderly patients (65 years or older) who underwent either decompression alone or fusion for the treatment of two-level or more lumbar spinal stenosis. Methods : During the period of 2003 and 2008, two-level or more decompression alone or fusion was performed for lumbar spinal stenosis by three surgeons at our institution. Patients were allocated to two groups by surgical modality, namely, to a decompression group (31 patients) or a fusion group (29 patients). Overall mean age was 71.1 years (range, 65-84) and mean follow-up was 5.5 years (range, 3-9). A retrospective review of clinical, radiological, and surgical data was conducted. Results : No significant difference between the two groups was found with respect to age, follow-up period, surgical levels, or preoperative condition. At the last follow-up, correction of lumbar lordotic angle (determined radiologically) was better in the fusion group. However, clinical outcomes including visual analogue scale, Oswestry Disability Index, and the Odom's criteria were not significantly different in the two groups. On the other hand, surgical outcomes, such as, operation time, estimated blood loss, and surgical complications were significantly better in the decompression alone group. Conclusion : Our findings suggest that decompressive laminectomy alone achieves good outcomes in patients with two-level or more lumbar spinal stenosis, associated with an advanced age, poor general condition, or osteoporosis.

The Clinical Effects of Non Sugical Spinal Decompression Treatment on HIVD (요추추간판탈출증환자 15예의 척추감압치료 병용에 대한 임상적 고찰)

  • Won, Jae-Kyun;Park, Darn-Seo;Pi, Chien-Hsin;Song, Yong-Sun;Kwon, Young-Mi;Park, Tae-Yong
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.2 no.2
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    • pp.41-48
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    • 2007
  • Objectives : These studies are designed to make a survey of the effectiveness of the non surgical decompression treatment. Methods : These studies 15 cases of L-spine herniated lumbar intervertebral disc(HIVD) which was treated with non surgical spinal decompression and other medicine treatment(acupuncture, cupping, interferential current therapy, ultra-sound therapy and hot poultice). Each patient has been treated with spine decompression and other medicine treatment. And degree of improvement has been evaluated by Visual Analogue Scale and the Roland-Morris Disability Questionnaire score for low back pain. Results and Conclusions : Through the results, the medical treatment proved to have valid effect for L-spine HIDV. And further clinical studies comparing non surgical spinal decompression treatment and other medicine treatment is necessary.

The Clinical Studies for Non Surgical Spinal Decompression Treatment on Cervical Disc Herniation (경추추간판 탈출증환자의 감압치료 병행효과에 대한 임상적 연구)

  • Seo, Sang-Kyoung;Kim, Byoung-Jung;Park, Kuk-Ji;Kang, Jun-Hyuk;Kim, Seong-Ki;Seo, Deok-Won
    • Journal of Korean Medicine Rehabilitation
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    • v.21 no.4
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    • pp.131-143
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    • 2011
  • Objectives: The purpose of this study is to make a survey of the effectiveness of the non surgical spinal decompression treatment in patients with cervical disc herniation documented on magnetic resonance imaging(MRI). Methods: We studied about 27 cases of cervical disc herniation which were treated with non surgical spinal decompression and other medical treatment (acupuncture, interferential current therapy and ice poultice). Each patient has been treated with spine decompression and other medical treatment. And degree of improvement has been evaluated by short form-McGill pain questionnaire(SF-MPQ), visual analogue scale(VAS) and neck disability index(NDI) before treatment and 5th, 10th times after treatments. Results: 1. The VAS SF-MPQ and NDI scores showed statistically significant improvement after 5th and 10th treatment. 2. The VAS, SF-MPQ and NDI scores after 5th treatment showed better improvement than those of after 10th treatment. 3. The VAS, SF-MPQ and NDI scores in Subacute stage showed more statistically significant improvement among the other stages. Conclusions: As a result, non surgical spinal decompression treatment has clinical effects of pain reduction on patient with cervical disc herniation.

Conservative surgical treatment for ameloblastoma: a report of three cases

  • Kim, Se-Won;Jee, Yu-Jin;Lee, Deok-Won;Kim, Hyung Kyung
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.44 no.5
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    • pp.242-247
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    • 2018
  • Ameloblastoma treatment varies based on the clinical, histopathologic, and radiographic characteristics. Aggressive surgical treatments, such as marginal or segmental resection, have traditionally been implemented, but some conservative surgical methods are also being introduced, including decompression, enucleation, or curettage. The aim of the present study was to evaluate the possibility of applying these conservative surgical treatments to ameloblastoma and to analyze the prognosis of the procedures and their healing aspects. Among all patients who visited our clinic (Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gangdong) from 2009 to 2017, three who had undergone conservative surgery were recruited. One of these three patients underwent both excision of the lesion and an iliac bone graft during the same procedure. In the other two patients, due to the size of the lesion, decompression was performed to reduce the size of the lesion, and then conservative surgical treatments followed. As shown in the cases of this study, patients were only treated with conservative surgical methods, such as decompression or enucleation. During the follow-up period, there were no recurrences. In conclusion, the use of conservative surgical treatment in ameloblastoma can be a reliable, safe, and successful method.

Quantitative Assessment of Orbital Volume and Intraocular Pressure after Two-Wall Decompression in Thyroid Ophthalmopathy

  • Park, Sang Min;Nam, Su Bong;Lee, Jae Woo;Song, Kyeong Ho;Choi, Soo Jong;Bae, Yong Chan
    • Archives of Craniofacial Surgery
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    • v.16 no.2
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    • pp.53-57
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    • 2015
  • Background: Surgical outcomes after orbital wall decompression have focused on the degree of exophthalmos and intraocular pressure. The aim of this research was to evaluate intraorbital volume using computed tomography (CT) images following two-wall decompression using a combined subcilliary and endoscopic approaches. Methods: A retrospective review was performed for all patients who had undergone the two-wall decompression method. The pre/postoperative CT images were used to evaluate changes in intraocular volume. Intraocular pressure was evaluated using applanation tonometry. Surgical details are discussed within the body of text. Results: Two-wall decompression thru the medial wall and floor was associated with an average intraorbital volume change of $7.3cm^3$, with maximal accommodation up to $13cm^3$. Changes in intraocular pressures were not statistically significant. Conclusion: Two-wall decompression was effective in accommodation of up to $13cm^3$ of soft tissue herniation. There was no statistically significant association between changes in volume to pressure.