2020, Vol.27, No.2

Volumetric Assessment of Fusion Mass and Its Clinical Correlations in Posterior Lumbar Interbody Fusion Depending on the Type of Bone Graft

Jae Won Lee

, Quan You Li , Kyoung-Tak Kang and 4 other persons | 2020, 27(2) | pp.39~47 | number of Cited : 0

Relationships and Usefulness of Cervical Lateral Radiographs Compared with Whole-Spine Lateral Radiographs for Evaluating Cervical Sagittal Alignment

Byung-Wan Choi

, Kyung-Gu Park

| 2020, 27(2) | pp.48~54 | number of Cited : 0

Study Design: Retrospective analysis. Objectives: This study was conducted to identify the correlations and usefulness of lateral cervical radiographs compared with wholespine sagittal lateral radiographs for evaluating cervical sagittal alignment. Summary of Literature Review: Few reports have compared cervical lateral radiographs with whole-spine sagittal radiographs. Materials and Methods: We retrospectively analyzed 181 patients with both cervical standing lateral radiographs and whole-spine standing lateral radiographs. The radiographs were evaluated using the following sagittal alignment parameters: C2-7 lordosis, C2-7 sagittal vertical axis (SVA), T1 slope, spino-cranial angle (SCA), and whole-spine SVA. We evaluated the relationships between the two radiographs. The patients were divided into four groups according to age and the measured sagittal parameters were compared across groups. An analysis according to clinical symptoms was also done. Results: C2-7 lordosis was 16.86° and 15.76°, C2-7 SVA was 15.76° and 16.86°, T1 slope was 29.03° and 22.49°, and SCA was 74.74° and 74.5°, respectively, on the cervical and whole spine radiographs. The whole-spine SVA was -2.64 mm. Correlation analysis between the two types of radiographs showed significant relationships for each sagittal parameter. The whole-spine SVA was related with wholespine C2-7 lordosis, T1 slope, and SCA. Cervical C2-7 lordosis and the whole-spine SVA increased with age. A decrease of C2-7 lordosis on whole-spine radiographs was shown in patients with neck pain. Conclusions: Cervical SVA and T1 slope were lower on whole-spine standing lateral radiographs than on simple cervical lateral radiographs. The cervical sagittal parameters measured on cervical radiographs were correlated with those measured on whole-spine radiographs. Cervical radiographs can be used to replace whole-spine radiographs with due consideration of these findings.

Functional Myelography as a Diagnostic Tool in Patients with a Mismatch between Symptoms and MRI Findings

Woo-Suk Song

, Young-Sang Lee

, Joonha Lee

and 1 other persons | 2020, 27(2) | pp.55~61 | number of Cited : 0

Study design: Retrospective comparative study. Objectives: The aim of this study was to analyze the usefulness of functional myelography in patients with a mismatch between symptoms and magnetic resonance imaging (MRI) findings. Summary of Literature Review: Functional myelography was a widely-used diagnostic tool decades ago, although it has been considered to be an old-fashioned technique since MRI was invented. Despite its invasiveness, functional myelography can be a useful method, with advantages in axial loading situations in symptomatic patients and its dynamic element at the point of imaging. Materials and Methods: From May 2017 to December 2018, 141 patients who underwent MRI, functional myelography, and surgical treatment were included, and the MRI and functional myelography results were compared. The independent-samples t-test and chi-square test were used to compare parameters, surgical results, and diagnoses using both methods between the matched and mismatched groups. The Fisher exact test was used for post hoc testing. Results: Ten patients (7.1%) had different diagnoses based on MRI and functional myelography. All of these patients’ symptoms matched the functional myelography results, and the patients had non-significantly different visual analogue scale scores for pain in both groups. The diagnoses made by MRI showed statistically significant differences, all of which were negative, in the mismatched group, but the patients did not show a significant difference when diagnosed by functional myelography. We performed surgical treatment according to the functional myelography results, and the patients’ symptoms were relieved, without a statistically significant difference. Conclusions: In patients with a mismatch between symptoms and MRI findings, functional myelography can be a useful additional diagnostic tool.

Comparison of Disc Degeneration between the Cervical and Lumbar Spine

Moon Soo Park

, seong hwan moon

, Hyung Joon Kim and 4 other persons | 2020, 27(2) | pp.62~70 | number of Cited : 0

The Usefulness of Selective Nerve Block in Lumbar Spinal Stenosis in Cases with Inconsistent MRI Findings and Clinical Presentations

Dae Moo Shim

, Jong Seok Baik

, Jeheon Yang

and 1 other persons | 2020, 27(2) | pp.70~76 | number of Cited : 1

Study Design: Retrospective study. Objectives: This study analyzed the diagnostic and therapeutic usefulness of selective nerve root block (SNRB) in patients with spinal stenosis who show inconsistencies between magnetic resonance imaging (MRI) and clinical findings (e.g., dermatomes). Summary of Literature Review: MRI is known to be highly accurate for diagnosing spinal stenosis, but few studies have investigated the diagnostic accuracy of MRI for spinal canal stenosis. In addition, the most suitable treatment of patients with inconsistent clinical and MRI findings has not been established. Methods: This single-center, retrospective cohort study was conducted among 93 patients treated between January 2013 and December 2018, who underwent at least two SNRBs for single-level spinal stenosis on MRI with clinical discrepancies. Seventeen patients who were diagnosed with other causes of pain (e.g., spondylolisthesis, sacroiliac joint dysfunction, lower leg arterial occlusion) were excluded. The first SNRB targeted the lesion found on MRI. One week later, patients were assessed using a visual analog scale (VAS) and a second procedure was performed on the dermatome-indicated level if there was no improvement. VAS scores were also obtained 3 months after the procedure. Results: In total, 45 patients had central stenosis and 31 patients had foraminal stenosis. The average VAS score before the SNRB was 7.4±1.4. After the first procedure, the average VAS score was 5.2±2.6. After the second procedure, the average VAS score was 2.4±1.3, and after 3 months, it was 3.6±1.9. Of the patients with foraminal stenosis, 77.4% did not respond to the first block (based on MRI), but responded well to the second procedure (based on clinical symptoms) (p<0.05). Conclusions: SNRB targeting the level corresponding to clinical symptoms may be useful for locating the symptomatic nerve root and providing pain relief in patients with foraminal stenosis on MRI with discordant clinical findings.

Evaluation of the Source and Quality of Information Regarding Cervical Disc Herniation on Websites

Yong Cheol Hong

, Kim Woo Jong

, SOH JAE WAN

and 2 other persons | 2020, 27(2) | pp.77~83 | number of Cited : 1

Study Design: In this original study, a cross-sectional analysis was performed to evaluate websites with information on cervical disc herniation. Objectives: The purpose of this study was to assess the source and quality of information regarding cervical disc herniation available to patients on websites. Summary of Literature Review: Studies have shown that 92% of the Korean population regularly accesses and searches for medical information on websites. While a large amount of information exists on websites, there is a possibility that patients will be misled due to inaccurate information because there are no established criteria for qualitative evaluation. In addition, little research has been conducted on websites that provide information about cervical disc herniation. Materials and Methods: The search term ‘‘cervical disc herniation’’ was entered into the three most popular search engines in Korea (Naver, Daum, and Google). The first 50 websites displayed by each engine were selected for inclusion in this study and were categorized as academic, commercial, physician, non-physician, government organization, and unspecified. Information was assessed in terms of DISCERN, accuracy, and exhaustivity scores, and a total summary score was calculated for each website. Results: Among the theoretical total of 150 websites, 83 unique and relevant websites were identified. The distribution by source was as follows: non-physician, 34.9%; physician, 27.7%; commercial, 13.3%; unspecified, 10.8%; academic, 9.6%; and government, 3.6%. Academic and government websites obtained the highest total summary scores, with statistical significance when compared to other types (p=0.03). Conclusions: Website information on cervical disc herniation is generally limited. Institutional improvement efforts are needed to foster an environment where patients can receive high-quality medical information, and physician groups should play a central role in this process.

Adhesive Arachnoiditis of the Lumbar Spine after Endoscopic Discectomy - A Case Report -

Dae Ho Ha

, Sung Kyun Oh

, Baek Kyu Kim

| 2020, 27(2) | pp.84~88 | number of Cited : 0

KJCKorea
Journal Central

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

2020, Vol.27, No.2