2013, Vol.20, No.3

Union Rates of Local Autobone and β-Tricalcium Phosphate Mixed Graft in Lumbar Posterolateral Fusion

Man-Jun Park , Chul-Young Jung , Il-Soo Eun and 4 other persons | 2013, 20(3) | pp.71~76 | number of Cited : 0

Efficacy of Prophylactic Antibiotics in Spinal Surgery

박정욱 , 정남수 , 서현석 and 2 other persons | 2013, 20(3) | pp.77~85 | number of Cited : 0

Study Design: Retrospective comparative study. Objectives: The aim of this study was to compare the efficacy of prophylactic antibiotics in spinal surgery for the occurrence of postoperative surgical site infection (SSI) and host immune reactions depending on various administration regimens and protocols. Summary of Literature Review: The superiority of one regimen or protocol of prophylactic antibiotics over others for SSI in spinal surgery has not been clearly demonstrated. We designed a controlled clinical trial to compare the occurrence of SSI with the changes of hematologic results depending on prophylaxis regimens and protocols. Materials and Methods: Between January 2007 and February 2011, two hundred consecutive patients who had undergone thoracolumbar/lumbar surgery for degenerative or traumatic disease were included. Postoperative protocol was altered for each group of fifty consecutive patients; 1st generation cephalosporins for 5-days (group A), 2nd generation cephalosporins for 5-days (group B),1st generation cephalosporins for 3-days (group C), and 2nd generation cephalosporins for 3-days (group D). Preoperative antibiotic prophylaxis was administrated within 1 hour prior to surgical incision with the same trial antibiotics. Intraoperative bacterial culture was performed from the surgical site. The occurrences of SSI were evaluated as either incisional or organ/space SSI. Serial changes in hematologic inflammatory markers (WBC, ESR, CRP) and DIC markers (fibrinogen, FDP, D-dimer) were compared until postoperative 2weeks. Results: The study groups were homogeneous regarding age, sex, body mass index, estimated blood loss, diabetes mellitus, smoking,diagnosis, baseline laboratory values, and type of surgery including instrumentation. Overall, 13 cases of incisional SSI (6.5%) and 3cases (1.5%) of organ/space SSI occurred. There was no difference in the occurrence of incisional and organ/space SSI among the 4groups (P=0.690, 0.799). Laboratory results revealed that postoperative changes in hematologic inflammatory markers and DIC markers were not influenced by prophylaxis regimens and protocols (all P>0.05). Conclusions: The occurrences of SSI and host immune responses were not influenced by postoperative antibiotics regimens and protocols. Hematologic investigation revealed that host immune responses did not depend on the type of prophylactic antibiotics.

Long Term Results of Vertebroplasty in the Treatment of Osteoporotic Compression Fracture

오용승 , 서종연 , Sun Hyo Kim and 1 other persons | 2013, 20(3) | pp.86~91 | number of Cited : 1

The Short Term Results of Selective Nerve Root Block in Spinal Stenosis by Contrast Pattern

Young Joon Ahn , Seung Rim Yi , 김성완 and 4 other persons | 2013, 20(3) | pp.92~98 | number of Cited : 0

Study Design: Retrospective study. Objectives: To observe the short term effect of selective nerve root block (sNRB) depending on the contrast pattern and spinal canal size. Summary of Literature Review: A number of studies have demonstrated that sNRB is quite effective not only for patients with herniated intervertebral discs but also for those with spinal stenosis. Materials and Methods: The Visual Analog Scale(VAS) score was collected before and after the procedure from 217 subjects with lumbar spinal stenosis and underwent sNRB. Two types were classified after observing the contrast’s spreading pattern, Type I contrast reaching the spinal canal and Type II not reaching the spinal canal. Efficacy of the treatment for each type was also compared. In addition,the spinal canal size was classified into three categories. Treatment efficacy depending on the contrast pattern was also compared in each category. Results: When divided into two types based on the contrast pattern, type I showed a more significant reduction in VAS score according to T-test although both types showed a decrease in VAS score after the procedure. In regards to spinal canal dimension, both types showed decreased VAS scores after the procedure in patients with spinal canal size larger than 172.2mm2; however, there were no changes in VAS score before and after the procedure for those with spinal canal size smaller than 73mm2.Conclusions: There was a short term effect of selective nerve root block (sNRB) in patients with spinal stenosis regardless of their contrast pattern, type I group showing a stronger correlation. In regards to spinal canal dimension, patients with larger spinal canal sizes not only showed a significant decrease in VAS score after selective nerve root block (sNRB) but also showed differences depending on the contrast pattern. On the contrary, there was no significant difference in VAS score before and after selective nerve root block (sNRB)in patients with small spinal canal sizes, and there was also no difference in the outcome depending on the contrast pattern in patients with small spinal canal sizes. Therefore, when performing selective root nerve block (sNRB), the operator should remember to manipulate the angle and position of the spinal needle when injecting the appropriate drug after confirming that the contrast material reached the spinal canal. The operator should also consider surgical management when performing selective nerve root block (sNRB) in patients with severe central spinal stenosis.

The Comparison of Clinical and Radiologic Results Classified by Translation Type and Fusion Method in the Isthmic Spondylolisthesis

이규열 , 한동훈 , 서종연 | 2013, 20(3) | pp.99~106 | number of Cited : 0

Study Design: A retrospective study. Objectives: To examine the radiologic and clinical results of patients classified as excessive translation and excessive angulation,treated by posterolateral fusion only, or posterolateral fusion with posterior lumbar interbody fusion in isthmic spondylolisthesis. Summary of Literature Review: Isthmic spondylolisthesis is usually treated by PLF only or PLF with PLIF. But it is not reported the clinical and radiologic results classified by translation type. Materials and Methods: Patients who had received surgery for spondylolisthesis between January 2005 to January 2010, there were 56 for whom follow-up observations were possible for 2 years. According to the fusion methods and preoperative flexion-extension simple radiograph, we classified as excessive translation and excessive angulation by segmental instability and as PLF and PLIF by surgical methods. We examine the clinical results(Visual Analogue Scale, Oswestry Distability Index, operation time, blood loss,complication rate) and the radiologic results(reduction rate of slippage, change of segmental angle, reduction ratio of disc height , bone union). Results: In radiologic results, excessive angulation(group II) did not show significant difference from excessive translation(group I)in terms of reduction rate of slippage, change of segmental angle, reduction ratio of disc height, bone union. But we found excessive translation-PLIF(group I-B) was better than excessive translation-PLF(group I-A) and excessive angulation-PLIF(group II-B) was better than excessive angulation-PLF(II-A) in terms of reduction ratio of disc height(P<0.05). In clinical results, both sides group did not show significant difference in operation time, blood loss, complication rate. Conclusions: In spondylolisthesis patients, excessive translation group(I) and excessive angulation group(II) did not show significant difference in radiologic results and clinical results. But both sides group showed the PLF with PLIF was better than the PLF only in terms of reduction ratio of disc height.

Operative Risk Assessment of Degenerative Spinal Disorder Comparing with Total Hip Replacement

양준영 , 이준규 , 이호진 and 4 other persons | 2013, 20(3) | pp.107~112 | number of Cited : 0

Complications of Iliac Screw in Spinopelvic Fixation With Adult Spinal Deformity - Complications of Iliac Screw in Spinopelvic Fixation -

Whoan Jeang Kim , 지용주 , 강종원 and 4 other persons | 2013, 20(3) | pp.113~117 | number of Cited : 1

Primary Osteosarcoma of the Thoracic Vertebra - A Case Report -

Kee-Yong Ha , Tae-Wook Yoo , Kim Young Hoon | 2013, 20(3) | pp.118~122 | number of Cited : 0

Subacute Delayed Ascending Myelopathy after Spinal Cord Injury from Flexion-distraction Injury of Low Thoracic Spine - A Case Report -

박상재 , 조재환 , 신상익 and 2 other persons | 2013, 20(3) | pp.123~128 | number of Cited : 0

KJCKorea
Journal Central

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

2013, Vol.20, No.3