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pISSN : 2093-4378 / eISSN : 2093-4386

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2015, Vol.22, No.1

  • 1.

    The Prognostic Factors of Neurologic Recovery in Spinal Cord Injury

    서종호 | 김효종 | 이규열 and 2other persons | 2015, 22(1) | pp.1~7 | number of Cited : 0
    Study Design: Retrospective study. Objectives: To evaluate and compare the factors affecting recovery of spinal cord injury following cervical and thoracolumbar spine injuries. Summary of the Literature Review: Several authors have reported the factors to predict the prognosis of spinal cord injury, but the objective prognostic factors are still controversial. Materials and Methods: From June 2006 to March 2013, a total of 44 patients with spinal cord injury were evaluated. Prognostic factors analyzed were sex, age, neurologic status, fracture type, time to operation, use of steroid, and signal change on MRI. We analyzed the relation between each factor and the neurologic recovery. The mean follow-up period was 12 months. The neurologic recovery was analyzed by the ASIA impairment scale at the first and the last neurologic examination. Results: Among 44 patients, 15 sustained complete cord injury while 29 had incomplete cord injury. Significant neurologic recovery using the ASIA impairment scale was evaluated in the incomplete spinal cord injury group. Among this group, the prognosis for Brown-sequard syndrome is better than for central cord syndrome and anterior cord syndrome. There was no significant difference in other factors (fracture site, time to operation, use of steroid or signal change on MRI). Conclusions: The prognosis in spinal cord injury is determined by the initial neurologic damage and neurologic recovery is not related with the fracture type, time to operation, use of steroid and signal change on MRI.
  • 2.

    The Role of Ultrasound Investigation: Sacral Dimples and Other Stigmata of Spinal Dysraphism in Infants

    Jung Yun Bae | Kim Yong Woo | Sang-Min Lee and 1other persons | 2015, 22(1) | pp.8~12 | number of Cited : 0
    Study Design: A retrospective study. Objectives: Using ultrasound to evaluate association of minor cutaneous stigmas with occult spinal dysraphism (OSD) according to thepresence of co-morbidities. Summary of Literature Review: OSD can be associated with various cutaneous markers. Ultrasound of the spine is an effective, noninvasivescreening method. Materials and Methods: Over a 5-year period (2009-2013), a total of 180 infants with various skin stigmas were evaluated. Ninetysevenpatients were normal infants, eighty-three had other co-morbidities. The type of skin stigmata and/or co-morbidities as well aslumbar ultrasound results were reviewed for all patients. Results: Three of the 97 normal infants had abnormalities. One of the three had OSD. Eighteen of the 83 infants with congenitalanomalies had abnormalities, and eleven of the 18 had OSD. Infants with congenital anomalies were 6 times more likely to have OSDthan normal infants (OR 5.98, 95% CI 1.927 to 18.612, p=0.001) and there was no significant correlation between the presence of minorskin lesions and the presence of dysraphism. Conclusions: So-called minor skin lesions were not markers of OSD in normal infants. However, because of the feasibility, simplicity,and low cost of spinal ultrasound, the examination is justified by the benefits of early diagnosis.
  • 3.

    Neurophysiologic Mechanism of Pain

    라인후 | Woo-Kie Min | 2015, 22(1) | pp.13~19 | number of Cited : 2
    Study Design: A review of the literature regarding neurophysiologic mechanism of pain. Objectives: To review and discuss neurophysiologic mechanism of pain, including neuropathic pain. Summary of Literature Review: The neurophysiology of pain has been established at the cellular and molecular biology level throughmany studies. Also, multiple modalities to manage pain have been developed. Materials and Methods: A literature review. Results: Pain develops by actions of multiple receptors, ion channels and neurotransmitters along the pain pathway. Pathologic states,such as persistent pain, allodynia, and hyperalgesia, arise from alteration of the pain pathway. Especially, neuropathic pain results fromnerve injury and its pathology is rather different from the neuroplasty of normal individuals. Conclusion: Multiple modalities, including individualized pain treatment based on pain phenotype, are introduced. However, optimaltreatment is uncertain, therefore, further studies are needed.
  • 4.

    Laminoplasty and Recapping Procedure of C7 for Intradural Tumor Excision - A Case Report -

    강성식 | Sung-Hwan Moon | HWAN MO LEE | 2015, 22(1) | pp.20~25 | number of Cited : 0
    Study Design: A case report. Objectives: To report laminoplasty and recapping procedure of C7 for intradural tumor excisionSummary of Literature Review: Various surgical techniques have been attempted to decrease postoperative axial neck pain. Material and Methods: Kurokawa laminoplasty of C7 was performed. Autogenous bone graft material was harvested from partial T1laminectomy. Intradural tumor was removed without any complications. Four mini plates were applied at hinge sites of laminoplasty andone lag screw was fixed at the longitudinally splitted lamina of C7. Results: Early range of motion without braces was possible following laminoplasty and recapping procedure. Solid union was achievedat the hinge sites of laminoplasty at the 3-month postoperative follow-up. No instability was observed at the 2-year postoperative followup. The visual analog scale of axial neck pain at the 2-year postoperative follow-up was 2. Conclusions: Laminoplasty and recapping procedure might be a good option for intradural tumor excision to facilitate early range ofmotion and decrease postoperative axial neck pain.
  • 5.

    Intradural Extramedullary Epidermoid Cyst - A Case Report -

    정광환 | 조성도 | KO, SANG-HUN and 5other persons | 2015, 22(1) | pp.26~30 | number of Cited : 0
    Study Design: A case report. Objectives: To report a rare case of epidermoid cyst in the spinal canal. Summary of Literature Review: Epidermoid cyst in the spinal canal is rare. Idiopathic epidermoid cyst in the spinal canal notassociated with a trauma or infection is even rarer. Material and Methods: A 73 year-old female presented with a 1 year history of progressive paresthesia and motor weakness of bothlower extremeties. MRI showed a cystic mass on the 7th thoracic canal. We performed total laminectomy at the T6 –T8 level. The cysticmass was excised after durotomy using a posterior approach. Results: We confirmed the presence of an epidermoid cyst for histopathology. Conclusion: Idiopathic epidermoid cyst in the spine is very rare and requires accurate differential diagnosis. Preoperative MRI scans arenecessary to differentiatie epidermoid cysts from other intradural masses. Confirmative diagnosis can be done by histopatholoty.
  • 6.

    Psoas and Thigh Abscess Caused by Perforated Retrocecal Appendicitis - A Case Report -

    Dong-Soo Kim | 김용민 | Eui-Sung Choi and 4other persons | 2015, 22(1) | pp.31~35 | number of Cited : 0
    Study Design: A case report. Summary of Literature Review: The symptoms of psoas abscess are fever, low back pain, and spasm of the psoas muscle. Objectives: To report a case of psoas and thigh abscess caused by ruptured appendicitis. Materials and Methods: A 53- year old male patient visited the complaining of fever, low back pain and thigh pain. Imaging studiesrevealed psoas abscess and thigh abscess, accompanied by ruptured appendicitis. Therefore, surgical treatment with percutaneousdrainage was performed. Results: The patient recovered and returned to his normal life after 2 months. Conclusion: It is necessary to identify the cause of the infection using physical examination as well as abdominal and pelvis computedtomography when a patient has fever, psoas abscess and thigh abscess. It is also important to be aware that the cause of psoas abscessmay also be gastrointestinal tract disease with non specific symptoms.