2008, Vol.15, No.4

Degenerative Changes of Adjacent Segment after Anterior Cervical Discectomy and Fusion

강종원 , 김환정 , 성환일 and 4 other persons | 2008, 15(4) | pp.215~222 | number of Cited : 0

Study Design: A retrospective radiologic analysis of 34 patients Objectives: To evaluate the factors influencing the radiographic degenerative changes in the adjacent segments in one-level ACDF Summary of Literature Review: There is a 25% incidence of adjacent segment degeneration after 5 years. Materials and Method: From 2002 to 2005, 34 patients (male 23, female 11) underwent anterior cervical spine fusion using a cage or bone block for degenerative cervical spine. The mean age of the patients was 51 years and the mean follow-up period was 24 months. The degenerative findings of the upper and lower adjacent segment were measured from the pre-operative MRI. The fused segment curvature, disc heights of the adjacent segments, displacement of the vertebral bodies and angular mobility in the adjacent segments were measured from the pre-operative and final follow-up lateral views in the neutral position, in both flexion and extension. Results: Degenerative changes in the adjacent segments were observed in 19 of the 34 patients. The group with degenerative changes showed significantly more lordotic angular loss of the fusion segments (11.9±3.1˚) at the follow-up observation than the group with no degenerative changes (9.0±1.1˚) (p=0.04). The group with degenerative change showed a significantly larger increase in disc height of the fusion segments (2.8±0.2 mm) at the follow-up observation than the group with no degenerative changes (2.2±0.3 mm) (p=0.02).The group with a Grade IV or higher level of pre-operative disc degeneration showed more degenerative changes in the adjacent segments than those with Grade III or lower. Conclusions: It is important to preserve the lordotic angle of fused segments and avoid excessive increases in disc height. The recurrence of the neurological is not associated with the preoperative adjacent segmental degenerative changes in ACDF.

Predictability of Magerl & McCormack’s Load Sharing Classification on the Metal Failure after Pedicle Screw Fixation in the Thoracolumbar Spine Fracture

Ahn， Myun Whan , Sung Hyuk Park, , Min Chul Sung, and 2 other persons | 2008, 15(4) | pp.223~229 | number of Cited : 0

The Causes of Revision Arthrodesis for the Degenerative Changes at the Adjacent Segment after Lumbosacral Fusion for Degenerative Lumbar Diseases

김규형 , 송경진 , 송지훈 and 1 other persons | 2008, 15(4) | pp.230~235 | number of Cited : 1

Treatment of Combined Degenerative Lumbar Disease and Adjacent Vertebral Fracture

조재림 , SUNG IL-HOON , Seung-Wook Baek, and 1 other persons | 2008, 15(4) | pp.236~242 | number of Cited : 1

Study Design: Retrospective study Objective: To analyze the treatment results of vertebroplasty in patients who suffered osteoporotic compression fractures during conservative treatments for pre-existing degenerative lumbar disease. Summary and Literature Review: Whilst spinal fusion has shown satisfactory clinical results, solid fusion has been reported to accelerate the degenerative changes at the unfused adjacent levels. Therefore, the level of spinal fusion in patients with compression fractures and pre-existing degenerative lumbar disease is controversial. Few studies have evaluated the outcomes of spinal fusion and adjacent segment vertebroplasty. Materials and Methods: A retrospective review was carried out on 28 patients who suffered the osteoporotic compression fractures during conservative treatment for pre-existing degenerative lumbar disease. Posterolateral fusion and vertebroplasty were performed for degenerative disease and compression fractures. The average fusion level was 1.82. The mean compressed vertebral bodies were 1.68. The radiology results were evaluated to determine the progression of the compression rate and fractures in the adjacent segment. The clinical results were evaluated using the Denis pain scale for compression fractures and Katz satisfaction scale for degenerative lumbar disease. Results: The average compression rate was 30.2% preoperatively, 21.4% postoperatively, and 24.6% at the final follow-up. There was no fracture in the adjacent segment. Clinically, the preoperative Denis score was P3 and P4 in 8 and 20 patients, respectively. On the other hand, the postoperative Denis score was P1, P2 and P3 in 8, 19 and 1 patients, respectively. In regard to degenerative diseases, the overall satisfaction was 82.1%. Conclusion: The stability of fracture sites in vertebroplasty of patients with pre-existing lumbar disease was confirmed. However, further compression of the fractured vertebral body was observed after vertebroplasty in long fusion. Therefore, a followup study of more cases will be necessary to confirm the changes in the vertebroplasty site.

Metal Failure in patients with Short-segmental Pedicle Screw Fixation and Fusion for Degenerative Lumbar Disease Comparison Monoaxial with Polyaxial Screw

강종원 , 김환정 , 성환일 and 4 other persons | 2008, 15(4) | pp.243~249 | number of Cited : 0

Percutaneous Endoscopic Lumbar Discectomy (PELD) Using Interlaminar Approach in Lumbar Disc Herniation - Endoscopic Laminotomy -

김응하 , Ki-Hoon Rhyu , Cheong-Kwan Kim, | 2008, 15(4) | pp.250~256 | number of Cited : 0

Entry Point and Approaching Angle of Working Cannula in Endoscopic Lumbar Disecectomy

안영준 , Jung Ho Noh , 허정규 and 1 other persons | 2008, 15(4) | pp.257~264 | number of Cited : 0

Lumbar Discectomy Using Tubular Retractor and Microendoscopy

기성찬 , 최용수 , 김기수 and 1 other persons | 2008, 15(4) | pp.265~271 | number of Cited : 2

Study Design: Retrospective study Objectives: To compare the surgical results of microendoscopic discectomy using a tubular retractor with those of a conventional discectomy for lumbar herniated nucleus pulposus. Summary of Literature Review: Minimally invasive approaches to the lumbar spine have been attempted with success over the past 25 years. Materials and Methods: This study examined 36 cases who underwent lumbar discectomy using a tubular retractor and microendoscopy (Group A) and 30 cases who underwent a conventional discectomy (Group B). The operating time, intraoperative blood loss, postoperative hospital stay were recorded. The clinical results were assessed using the Korea Version Oswestry Disability Index (KODI), and the radiological results were evaluated from changes in disc height. Results: The patients in Group A had a longer operation time(mean, 95.56±23.57 minutes vs 81.17±35.30 minutes, p=0.062), less intraoperative blood loss (mean, 58.61±97.08 cc vs 161.00±88.64 cc, p=0.001) and a shorter hospitalization stay (mean, 8.22 ±4.99 days vs 17.33±10.98 days, p=0.001) than group B. There was significant improvement in the mean KODI score for Group A; 6.36±7.18 and Group B; 5.97±5.14. However, there was no significant difference in the pain improvement (mean, 1.14 ±1.15 vs 1.30±1.06, p=0.559) and walking index (mean, 0.25±0.44 vs 0.30±0.47, p=0.656). In terms of social life, Group A had better results (mean, 0.20±0.48 vs 0.67±1.01, p=0.018). The disc height according to radiography decreased from 8.44±1.98 mm to 7.40±1.59 mm in Group A and 9.07±1.93 mm to 7.67±1.90 mm in Group B, but there were no statistical differences in the changes in disc height between the two groups (p=0.143). Conclusion: Microendoscopic discectomy is an effective procedure with good outcomes in treating lumbar disc herniation that allows less tissue trauma, compared with conventional open discectomy.

Surgical Treatment of Spontaneous Spinal Epidural Hematoma - A Case Report

김명호 , 민상혁 , Hyun-Yul Yoo, | 2008, 15(4) | pp.272~276 | number of Cited : 0

Posterior Epidural Migration of a Sequestrated Intervertebral lumbar Disc with Cauda Equina Syndrome -Two Cases Report-

조영호 , 장세앙 , 박재영 and 2 other persons | 2008, 15(4) | pp.277~280 | number of Cited : 3

Sacral Fracture Dislocation of Suicidal Jumper (Suicidal Jumper’s Fracture) 4 Cases Report -

이상욱 , Dong-Young Shin, , 고상봉 | 2008, 15(4) | pp.281~285 | number of Cited : 1

The Crowned Dens Syndrome - A Case Report -

Jae-Ryong Cha , 조성도 , 고성훈 and 5 other persons | 2008, 15(4) | pp.286~289 | number of Cited : 2

Upper Cervical Spine Injury

박희전 | 2008, 15(4) | pp.290~298 | number of Cited : 0

KJCKorea
Journal Central

Journal of Korean Society of Spine Surgery 2023 KCI Impact Factor : 0.03

2008, Vol.15, No.4