2015, Vol.22, No.1

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

pISSN : 2093-4378 / eISSN : 2093-4386
https://journal.kci.go.kr/krspine

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.

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.

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.