Pub Date : 2017-12-01Epub Date: 2017-12-31DOI: 10.14245/kjs.2017.14.4.143
Farid Yudoyono, Jiin Kang, Yoon Ha
Objective: The purpose of this study was to compare the effect of atlantoaxial fixation on cervical alignment and clinical outcomes in patients with os odontoideum (OO) versus non-os odontoideum (non-OO).
Methods: A total of 119 patients who underwent atlantoaxial fixation for instability were identified between January 1998 and January 2014. Inclusion criteria included age more than 21 years and diagnosis of OO and non-OO. There were 22 OO patients, and 20 non-OO patients. Measuring the Oc-C1 Cobb angle, C1-2 Cobb angle, C2-7 Cobb angle, and C2-7 sagittal vertical axis (SVA) was assessed. Clinical outcome was assessment of suboccipital pain was determined using a visual analogue scale (VAS), and Japanese Orthopedic Association (JOA) scores were obtained in all patients pre- and postoperatively.
Results: The preoperative C1-2 angle in the OO group (26.02°±10.53°) was significantly higher than the non-OO group (p=0.04). After C1-2 fixation, the OO group had significantly higher kyphotic change in the C1-2 angle (ΔC1-2) (3.2°±7.3° [OO] vs. -1.46°±7.21° [non-OO]) (p=0.04), and higher decrease in postoperative C2-7 SVA (ΔC2-7 SVA) (5.64±11.56 mm [OO] vs. -0.51± 6.57 mm [non-OO]) (p=0.04). Both groups showed improvements in the health related quality of life (HRQOL) after surgery based on the VAS and JOA score (p<0.001).
Conclusion: After fixation, kyphotic angular change in atlantoaxial joint and decrease C2-7 SVA were marked in the OO group. Both the OO and non-OO groups improved in neurological function and outcome after surgery.
目的:本研究的目的是比较寰枢固定对齿状突(OO)和非齿状突(非OO)患者颈椎对位的影响和临床结果。方法:在1998年1月至2014年1月期间,共有119例因寰枢椎不稳定而接受固定治疗的患者。纳入标准为年龄大于21岁,诊断为OO和非OO。22 OO例患者,20例非OO例患者。测量Oc-C1 Cobb角、C1-2 Cobb角、C2-7 Cobb角和C2-7矢状垂直轴(SVA)。临床结果采用视觉模拟量表(VAS)评估枕下疼痛,并对所有患者术前和术后进行日本骨科协会(JOA)评分。结果:OO组术前C1-2角度(26.02°±10.53°)明显高于非OO组(p=0.04)。C1-2固定后,OO组C1-2角度的后凸变化(ΔC1-2)明显高于对照组(3.2°±7.3°[OO] vs. -1.46°±7.21°[非OO]) (p=0.04),术后C2-7 SVA (ΔC2-7 SVA)(5.64±11.56 mm [OO] vs. -0.51±6.57 mm[非OO]) (p=0.04)。基于VAS和JOA评分,两组术后健康相关生活质量(HRQOL)均有改善(p)。结论:固定后,OO组寰枢关节后凸角度改变,C2-7 SVA明显降低。OO组和非OO组术后神经功能和预后均有改善。
{"title":"Comparison of Cervical Alignment and Clinical Outcomes in Patients with Os Odontoideum versus Non-Os Odontoideum after Atlantoaxial Fixation.","authors":"Farid Yudoyono, Jiin Kang, Yoon Ha","doi":"10.14245/kjs.2017.14.4.143","DOIUrl":"https://doi.org/10.14245/kjs.2017.14.4.143","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to compare the effect of atlantoaxial fixation on cervical alignment and clinical outcomes in patients with os odontoideum (OO) versus non-os odontoideum (non-OO).</p><p><strong>Methods: </strong>A total of 119 patients who underwent atlantoaxial fixation for instability were identified between January 1998 and January 2014. Inclusion criteria included age more than 21 years and diagnosis of OO and non-OO. There were 22 OO patients, and 20 non-OO patients. Measuring the Oc-C1 Cobb angle, C1-2 Cobb angle, C2-7 Cobb angle, and C2-7 sagittal vertical axis (SVA) was assessed. Clinical outcome was assessment of suboccipital pain was determined using a visual analogue scale (VAS), and Japanese Orthopedic Association (JOA) scores were obtained in all patients pre- and postoperatively.</p><p><strong>Results: </strong>The preoperative C1-2 angle in the OO group (26.02°±10.53°) was significantly higher than the non-OO group (p=0.04). After C1-2 fixation, the OO group had significantly higher kyphotic change in the C1-2 angle (ΔC1-2) (3.2°±7.3° [OO] vs. -1.46°±7.21° [non-OO]) (p=0.04), and higher decrease in postoperative C2-7 SVA (ΔC2-7 SVA) (5.64±11.56 mm [OO] vs. -0.51± 6.57 mm [non-OO]) (p=0.04). Both groups showed improvements in the health related quality of life (HRQOL) after surgery based on the VAS and JOA score (p<0.001).</p><p><strong>Conclusion: </strong>After fixation, kyphotic angular change in atlantoaxial joint and decrease C2-7 SVA were marked in the OO group. Both the OO and non-OO groups improved in neurological function and outcome after surgery.</p>","PeriodicalId":17867,"journal":{"name":"Korean Journal of Spine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/12/76/kjs-14-4-143.PMC5769938.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35708550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-09-01Epub Date: 2017-09-30DOI: 10.14245/kjs.2017.14.3.99
Ju Hyung Lee, Sung Han Oh, Pyung Goo Cho, Eun Mi Han, Je Beom Hong
We report a case of a solitary osteochondroma as a dumbbell tumor compressing the spinal cord and its surgical strategy. The patient is a 16-year-old female with longstanding posterior neck pain and left arm abduction weakness. She was examined by plain X-ray, three-dimensional-computed tomography, magnetic resonance imaging, and vertebral angiography. The analyses indicated a calcified extradural mass compressing the cord in the C3-4 portion extending into the neural and vertebral foramen with eroded vertebral body. The tumor was successfully excised using a modified combined anterior and posterior approach. Histopathologic study of the resected material confirmed the diagnosis. The postoperative assessment was followed by clinical and radiologically therapy for 5 years after surgery. Osteochondroma arises from enchondral bone but it rarely involves the spine, especially not as s dumbbell type. In this patient, the tumor may have arisen from the neural arch and extended into the extradural and extraforaminal space over a long period. We successfully removed the dumbbell tumor with a combined anterior oblique and posterior approach. However, further observation is essential because of the possibility of recurrence and sarcomatous change.
{"title":"Solitary Osteochondroma Presenting as a Dumbbell Tumor Compressing the Cervical Spinal Cord.","authors":"Ju Hyung Lee, Sung Han Oh, Pyung Goo Cho, Eun Mi Han, Je Beom Hong","doi":"10.14245/kjs.2017.14.3.99","DOIUrl":"https://doi.org/10.14245/kjs.2017.14.3.99","url":null,"abstract":"<p><p>We report a case of a solitary osteochondroma as a dumbbell tumor compressing the spinal cord and its surgical strategy. The patient is a 16-year-old female with longstanding posterior neck pain and left arm abduction weakness. She was examined by plain X-ray, three-dimensional-computed tomography, magnetic resonance imaging, and vertebral angiography. The analyses indicated a calcified extradural mass compressing the cord in the C3-4 portion extending into the neural and vertebral foramen with eroded vertebral body. The tumor was successfully excised using a modified combined anterior and posterior approach. Histopathologic study of the resected material confirmed the diagnosis. The postoperative assessment was followed by clinical and radiologically therapy for 5 years after surgery. Osteochondroma arises from enchondral bone but it rarely involves the spine, especially not as s dumbbell type. In this patient, the tumor may have arisen from the neural arch and extended into the extradural and extraforaminal space over a long period. We successfully removed the dumbbell tumor with a combined anterior oblique and posterior approach. However, further observation is essential because of the possibility of recurrence and sarcomatous change.</p>","PeriodicalId":17867,"journal":{"name":"Korean Journal of Spine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/73/88/kjs-14-3-99.PMC5642089.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35595014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-09-01Epub Date: 2017-09-30DOI: 10.14245/kjs.2017.14.3.103
Young-Jin Kim
Incidental durotomies are a frequent complication during spinal surgery. Cerebrospinal fluid (CSF) leakage from a dural tear may be visually apparent intraoperatively, but occasionally, a tear may not be recognized during the procedure. We report our experience in 2 cases of postoperative incarceration of nerve root as a cause of sciatica, without CSF leakage intraoperatively. When durotomy attributable to surgical manipulation does occur, intraoperative identification is mandated. If a patient develops unexplainable postoperative pain and neurological deficits after lumbar discectomy, incarceration of nerve root should be considered in the differential diagnosis.
{"title":"Incarceration of Spinal Nerve Root through Incidental Durotomy as a Cause of Sciatica.","authors":"Young-Jin Kim","doi":"10.14245/kjs.2017.14.3.103","DOIUrl":"https://doi.org/10.14245/kjs.2017.14.3.103","url":null,"abstract":"<p><p>Incidental durotomies are a frequent complication during spinal surgery. Cerebrospinal fluid (CSF) leakage from a dural tear may be visually apparent intraoperatively, but occasionally, a tear may not be recognized during the procedure. We report our experience in 2 cases of postoperative incarceration of nerve root as a cause of sciatica, without CSF leakage intraoperatively. When durotomy attributable to surgical manipulation does occur, intraoperative identification is mandated. If a patient develops unexplainable postoperative pain and neurological deficits after lumbar discectomy, incarceration of nerve root should be considered in the differential diagnosis.</p>","PeriodicalId":17867,"journal":{"name":"Korean Journal of Spine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f5/a7/kjs-14-3-103.PMC5642102.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35595015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-09-01Epub Date: 2017-09-30DOI: 10.14245/kjs.2017.14.3.71
Jun-Hwan Kim, Young-Joon Kwon
Objective: There are many technical modifications of decompressive lumbar laminectomy. The purpose of this study was to report long-term clinical and radiological outcomes of central decompressive laminoplasty (CDL), the corresponding author's own modification of lumbar laminectomy for lumbar spinal stenosis (LSS).
Methods: Among 100 patients who underwent CDL by a single surgeon between December 2010 and March 2014, 68 patients were included in this study. Mean follow-up time was 37.7 months. Clinical and radiological data were gathered prospectively and reviewed retrospectively. Clinical outcome was measured by using visual analog scale (VAS) for back/buttock and leg, and the Oswestry Disability Index (ODI). Radiological outcome was measured by neutral slippage percentage, dynamic slippage percentage, and dynamic intervertebral angel on sagittal X-ray. Outcomes after CDL were assessed by changes of clinical and radiological parameters from the baseline. Mixed effect model with random patients' effect as used to test for differences in the repeated measured clinical and radiological data.
Results: The patients had no serious complications with an uneventful recovery during the early postoperative period. In the early postoperative period, VAS scores for back/buttock and leg improved significantly and were kept with time (p<0.001). ODI also improved significantly during the postoperative follow-up period (p<0.001). The radiologic parameters were well maintained and showed no progression of instability. During the follow-up, a case of herniated disc at same level recurrence was noted after lifting trauma, and 2 adjacent foraminal stenosis needed additional surgery.
Conclusion: CDL provides long-term pain relief and functional restoration without progression of radiological instability.
{"title":"Long-term Clinical and Radiological Outcomes after Central Decompressive Laminoplasty for Lumbar Spinal Stenosis.","authors":"Jun-Hwan Kim, Young-Joon Kwon","doi":"10.14245/kjs.2017.14.3.71","DOIUrl":"https://doi.org/10.14245/kjs.2017.14.3.71","url":null,"abstract":"<p><strong>Objective: </strong>There are many technical modifications of decompressive lumbar laminectomy. The purpose of this study was to report long-term clinical and radiological outcomes of central decompressive laminoplasty (CDL), the corresponding author's own modification of lumbar laminectomy for lumbar spinal stenosis (LSS).</p><p><strong>Methods: </strong>Among 100 patients who underwent CDL by a single surgeon between December 2010 and March 2014, 68 patients were included in this study. Mean follow-up time was 37.7 months. Clinical and radiological data were gathered prospectively and reviewed retrospectively. Clinical outcome was measured by using visual analog scale (VAS) for back/buttock and leg, and the Oswestry Disability Index (ODI). Radiological outcome was measured by neutral slippage percentage, dynamic slippage percentage, and dynamic intervertebral angel on sagittal X-ray. Outcomes after CDL were assessed by changes of clinical and radiological parameters from the baseline. Mixed effect model with random patients' effect as used to test for differences in the repeated measured clinical and radiological data.</p><p><strong>Results: </strong>The patients had no serious complications with an uneventful recovery during the early postoperative period. In the early postoperative period, VAS scores for back/buttock and leg improved significantly and were kept with time (p<0.001). ODI also improved significantly during the postoperative follow-up period (p<0.001). The radiologic parameters were well maintained and showed no progression of instability. During the follow-up, a case of herniated disc at same level recurrence was noted after lifting trauma, and 2 adjacent foraminal stenosis needed additional surgery.</p><p><strong>Conclusion: </strong>CDL provides long-term pain relief and functional restoration without progression of radiological instability.</p>","PeriodicalId":17867,"journal":{"name":"Korean Journal of Spine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.14245/kjs.2017.14.3.71","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35439034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-09-01Epub Date: 2017-09-30DOI: 10.14245/kjs.2017.14.3.96
Dong Hwan Kim, Dong Ha Kim, Kyoung Hyup Nam, Byung Kwan Choi, In Ho Han
Although the etiology of spontaneous spinal epidural hematoma (SSEH) is unclear, SSEH is known to be associated with anticoagulants, coagulopathy, vascular malformation, hypertension, and pregnancy. However, no report has been issued on the relation between SSEH and venous phlebolith. Here, the authors present an extremely rare case of SSEH associated with phlebolith in the cervical spine and suggest a possible pathogenesis. A 36-year-old man without any relevant medical history presented with neck pain and numbness and severe radiating pain on the left arm. Magnetic resonance imaging showed epidural hematoma at the C5-7 level, and computed tomography revealed a calcified nodule in the left epidural hemorrhage at C6 level. During left partial laminectomy, epidural venous plexus, and thick epidural hematoma were found, and hematoma removal revealed a white, ovoid, smooth, hard mass of diameter 3 mm. Histopathologic examination confirmed the mass as a venous phlebolith. The presence of a calcified solitary nodule in dorsal epidural space indicates the presence of phlebolith and the risk of SSEH. In such cases, the authors recommend spine surgeons should take into consideration the possibility of epidural hemorrhage.
{"title":"Spontaneous Epidural Hematoma Associated with Venous Phlebolith in Cervical Spine and Possible Pathogenesis.","authors":"Dong Hwan Kim, Dong Ha Kim, Kyoung Hyup Nam, Byung Kwan Choi, In Ho Han","doi":"10.14245/kjs.2017.14.3.96","DOIUrl":"https://doi.org/10.14245/kjs.2017.14.3.96","url":null,"abstract":"<p><p>Although the etiology of spontaneous spinal epidural hematoma (SSEH) is unclear, SSEH is known to be associated with anticoagulants, coagulopathy, vascular malformation, hypertension, and pregnancy. However, no report has been issued on the relation between SSEH and venous phlebolith. Here, the authors present an extremely rare case of SSEH associated with phlebolith in the cervical spine and suggest a possible pathogenesis. A 36-year-old man without any relevant medical history presented with neck pain and numbness and severe radiating pain on the left arm. Magnetic resonance imaging showed epidural hematoma at the C5-7 level, and computed tomography revealed a calcified nodule in the left epidural hemorrhage at C6 level. During left partial laminectomy, epidural venous plexus, and thick epidural hematoma were found, and hematoma removal revealed a white, ovoid, smooth, hard mass of diameter 3 mm. Histopathologic examination confirmed the mass as a venous phlebolith. The presence of a calcified solitary nodule in dorsal epidural space indicates the presence of phlebolith and the risk of SSEH. In such cases, the authors recommend spine surgeons should take into consideration the possibility of epidural hemorrhage.</p>","PeriodicalId":17867,"journal":{"name":"Korean Journal of Spine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5e/35/kjs-14-3-96.PMC5642097.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35595013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-09-01Epub Date: 2017-09-30DOI: 10.14245/kjs.2017.14.3.106
Donguk Lee, Woo Jin Choe, So Dug Lim
Presacral ganglioneuromas are extremely rare benign tumors and fewer than 20 cases have been reported in the literature. Ganglioneuromas are difficult to be differentiated preoperatively from tumors such as schwannomas, meningiomas, and neurofibromas with imaging modalities. The retroperitoneal approach for resection of presacral ganglioneuroma was performed for gross total resection of the tumor. Recurrence and malignant transformation of these tumors is rare. Adjuvant chemotherapy or radiation therapy is not indicated because of their benign nature. We report a case of a 47-year-old woman with a presacral ganglioneuroma.
{"title":"Ganglioneuroma of the Sacrum.","authors":"Donguk Lee, Woo Jin Choe, So Dug Lim","doi":"10.14245/kjs.2017.14.3.106","DOIUrl":"https://doi.org/10.14245/kjs.2017.14.3.106","url":null,"abstract":"<p><p>Presacral ganglioneuromas are extremely rare benign tumors and fewer than 20 cases have been reported in the literature. Ganglioneuromas are difficult to be differentiated preoperatively from tumors such as schwannomas, meningiomas, and neurofibromas with imaging modalities. The retroperitoneal approach for resection of presacral ganglioneuroma was performed for gross total resection of the tumor. Recurrence and malignant transformation of these tumors is rare. Adjuvant chemotherapy or radiation therapy is not indicated because of their benign nature. We report a case of a 47-year-old woman with a presacral ganglioneuroma.</p>","PeriodicalId":17867,"journal":{"name":"Korean Journal of Spine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f8/09/kjs-14-3-106.PMC5642092.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35595016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-09-01Epub Date: 2017-09-30DOI: 10.14245/kjs.2017.14.3.89
Byoung Hun Lee, Seung-Jae Hyun, Jong-Hwa Park, Ki-Jeong Kim
The neurogenic tumor of frequent occurrence in the presacral area is a schwannoma. Giant presacral schwannoma has a risk for anterior surgical approach because of its massive size and proximity to abundant vascularity of presacral region. We report a single stage posterior approach for total resection of a giant presacral schwannoma. A 40-year-old female patient experienced left buttock pain and tingling sensation at left S1 dermatome. Magnetic resonance imaging showed that the presacral huge mass at S1-3 level with osseous extension and structural remodeling in left sacral ala. The presacral mass was ranging in maximum diameter from 8.0 to 8.6 cm. S2 foramen laminectomy was performed to expose the mass. The tumor capsule and the root were carefully dissected away. The tumor was removed while preserving the capsule by dissecting the plane between the inner wall of the capsule and the tumor. The single stage posterior approach for presacral giant schwannoma is feasible, and it can be a good surgical alternative to prevent pelvic organ or vascular damage and anterior approach related dystocia and infertility.
{"title":"Single Stage Posterior Approach for Total Resection of Presacral Giant Schwannoma: A Technical Case Report.","authors":"Byoung Hun Lee, Seung-Jae Hyun, Jong-Hwa Park, Ki-Jeong Kim","doi":"10.14245/kjs.2017.14.3.89","DOIUrl":"https://doi.org/10.14245/kjs.2017.14.3.89","url":null,"abstract":"<p><p>The neurogenic tumor of frequent occurrence in the presacral area is a schwannoma. Giant presacral schwannoma has a risk for anterior surgical approach because of its massive size and proximity to abundant vascularity of presacral region. We report a single stage posterior approach for total resection of a giant presacral schwannoma. A 40-year-old female patient experienced left buttock pain and tingling sensation at left S1 dermatome. Magnetic resonance imaging showed that the presacral huge mass at S1-3 level with osseous extension and structural remodeling in left sacral ala. The presacral mass was ranging in maximum diameter from 8.0 to 8.6 cm. S2 foramen laminectomy was performed to expose the mass. The tumor capsule and the root were carefully dissected away. The tumor was removed while preserving the capsule by dissecting the plane between the inner wall of the capsule and the tumor. The single stage posterior approach for presacral giant schwannoma is feasible, and it can be a good surgical alternative to prevent pelvic organ or vascular damage and anterior approach related dystocia and infertility.</p>","PeriodicalId":17867,"journal":{"name":"Korean Journal of Spine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cc/0d/kjs-14-3-89.PMC5642101.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35439037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-09-01Epub Date: 2017-09-30DOI: 10.14245/kjs.2017.14.3.77
Ji Won Moon, James Ki Shinn, Dalsung Ryu, Se-Yang Oh, Yu Shik Shim, Seung Hwan Yoon
Objective: Computed tomography (CT), rather than conventional 2-dimensional radiography, was used to scan and measure pelvic parameters. The results were compared with measurements using X-ray.
Methods: Pelvic parameters were measured using both CT and X-ray in 254 patients who underwent both abdomino-pelvic CT and X-ray at the pelvic site. We assessed the similarity of the pelvic parameters between the 2 exams, as well as the correlations of pelvic parameters with sex and age.
Results: The mean values of the subjects' pelvic parameters measured on X-ray were: sacral slope (SS), 31.6°; pelvic tilt (PT), 18.6°; and pelvic incidence (PI), 50.2°. The mean values measured on CT were: SS, 35.1°; PT, 11.9°; and PI, 47.0°. PT was found to be 4.07° higher on X-ray and 2.98° higher on CT in women, with these differences being statistically significant (p<0.001, p<0.001). PI was 4.10° higher on X-ray and 2.78° higher on CT in women, with these differences also being statistically significant (p<0.001, p=0.009). We also observed a correlation between age and PI. For men, this correlation coefficient was 0.199 measured using X-ray and 0.184 measured using CT. For women, this correlation coefficient was 0.423 measured using X-ray and 0.372 measured using CT.
Conclusion: When measured using CT compared to X-ray, SS increased by 3.5°, PT decreased by 6.7°, and PI decreased by 3.2°. There were also statistically significant differences in PT and PI between male and female subjects, while PI was found to increase with age.
目的:采用计算机断层扫描(CT)而非传统的二维放射摄影来扫描和测量骨盆参数。方法:对 254 名接受 CT 和 X 光检查的患者进行盆腔参数测量:方法:对 254 名同时接受腹盆腔 CT 和骨盆部位 X 光检查的患者进行了骨盆参数的 CT 和 X 光测量。我们评估了两种检查之间盆腔参数的相似性,以及盆腔参数与性别和年龄的相关性:X光测量的受试者骨盆参数平均值为:骶骨斜度(SS),31.6°;骨盆倾斜度(PT),18.6°;骨盆入射角(PI),50.2°。CT 测量的平均值为SS,35.1°;PT,11.9°;PI,47.0°。发现女性的 X 光片 PT 值比 CT 值高 4.07°,PT 值比 CT 值高 2.98°,这些差异具有统计学意义(p 结论:与 X 光片相比,使用 CT 测量时,SS 上升 3.5°,PT 下降 6.7°,PI 下降 3.2°。男性和女性受试者的 PT 和 PI 差异也有统计学意义,而 PI 则随着年龄的增长而增加。
{"title":"Pelvic Incidence Can Be Changed not only by Age and Sex, but also by Posture Used during Imaging.","authors":"Ji Won Moon, James Ki Shinn, Dalsung Ryu, Se-Yang Oh, Yu Shik Shim, Seung Hwan Yoon","doi":"10.14245/kjs.2017.14.3.77","DOIUrl":"10.14245/kjs.2017.14.3.77","url":null,"abstract":"<p><strong>Objective: </strong>Computed tomography (CT), rather than conventional 2-dimensional radiography, was used to scan and measure pelvic parameters. The results were compared with measurements using X-ray.</p><p><strong>Methods: </strong>Pelvic parameters were measured using both CT and X-ray in 254 patients who underwent both abdomino-pelvic CT and X-ray at the pelvic site. We assessed the similarity of the pelvic parameters between the 2 exams, as well as the correlations of pelvic parameters with sex and age.</p><p><strong>Results: </strong>The mean values of the subjects' pelvic parameters measured on X-ray were: sacral slope (SS), 31.6°; pelvic tilt (PT), 18.6°; and pelvic incidence (PI), 50.2°. The mean values measured on CT were: SS, 35.1°; PT, 11.9°; and PI, 47.0°. PT was found to be 4.07° higher on X-ray and 2.98° higher on CT in women, with these differences being statistically significant (p<0.001, p<0.001). PI was 4.10° higher on X-ray and 2.78° higher on CT in women, with these differences also being statistically significant (p<0.001, p=0.009). We also observed a correlation between age and PI. For men, this correlation coefficient was 0.199 measured using X-ray and 0.184 measured using CT. For women, this correlation coefficient was 0.423 measured using X-ray and 0.372 measured using CT.</p><p><strong>Conclusion: </strong>When measured using CT compared to X-ray, SS increased by 3.5°, PT decreased by 6.7°, and PI decreased by 3.2°. There were also statistically significant differences in PT and PI between male and female subjects, while PI was found to increase with age.</p>","PeriodicalId":17867,"journal":{"name":"Korean Journal of Spine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/25/5a/kjs-14-3-77.PMC5642093.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35439035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-09-01Epub Date: 2017-09-30DOI: 10.14245/kjs.2017.14.3.118
Hee Jin Bae, Tack Geun Cho, Chang Hyun Kim, Ho Kook Lee, Jae Gon Moon, Jong Il Choi
Aortic injury during transforaminal lumbar interbody fusion (TLIF) is a rare but severe complication. We experienced aortic injury during TLIF at L3-4 with a 59-year-old woman diagnosed with an adjacent segment disease at L3-4. Severe bleeding occurred during disc space expansion, and the blood pressure dropped to 60/40 mmHg. The patient's vital sign stabilized after compression with gauze and Gelfoam in addition to blood transfusion. The patient was treated with endovascular repair using a percutaneous technique after intertransverse fusion at L3-4 was completed. She recovered and is being followed-up in the outpatient department.
{"title":"Aortic Injury during Transforaminal Lumbar Interbody Fusion.","authors":"Hee Jin Bae, Tack Geun Cho, Chang Hyun Kim, Ho Kook Lee, Jae Gon Moon, Jong Il Choi","doi":"10.14245/kjs.2017.14.3.118","DOIUrl":"https://doi.org/10.14245/kjs.2017.14.3.118","url":null,"abstract":"<p><p>Aortic injury during transforaminal lumbar interbody fusion (TLIF) is a rare but severe complication. We experienced aortic injury during TLIF at L3-4 with a 59-year-old woman diagnosed with an adjacent segment disease at L3-4. Severe bleeding occurred during disc space expansion, and the blood pressure dropped to 60/40 mmHg. The patient's vital sign stabilized after compression with gauze and Gelfoam in addition to blood transfusion. The patient was treated with endovascular repair using a percutaneous technique after intertransverse fusion at L3-4 was completed. She recovered and is being followed-up in the outpatient department.</p>","PeriodicalId":17867,"journal":{"name":"Korean Journal of Spine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.14245/kjs.2017.14.3.118","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35595020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-09-01Epub Date: 2017-09-30DOI: 10.14245/kjs.2017.14.3.115
Jin-Sang Kil, Jong-Tae Park
Lumbar disk herniation is common. Because of the posterior longitudinal ligament, migration usually occurs into the ventral epidural space. Rarely, fragments migrate into the dorsal epidural space. A 57-year-old man presented with lower back pain and weakness on right hip flexion and right knee flexion. He had lower back pain 1 day previously and received a transforaminal epidural block at a local hospital. The next day, he reported weakness of the right lower extremity. Lumbar spine magnetic resonance imaging revealed a dorsal epidural lesion with compression of the thecal sac at L2-3. Initial differential diagnoses included epidural hematoma after the block, neoplasm, and a sequestrated disk. Posterior lumbar decompression was performed. The lesion was identified intraoperatively as a large herniated disk fragment. Posterior epidural herniation of a lumbar disk fragment is rare and may be difficult to diagnose preoperatively. It may present as a variety of clinical scenarios and, as in this case, may mimic epidural hematoma.
{"title":"Posterior Epidural Herniation of a Lumbar Disk Fragment at L2-3 That Mimicked an Epidural Hematoma.","authors":"Jin-Sang Kil, Jong-Tae Park","doi":"10.14245/kjs.2017.14.3.115","DOIUrl":"https://doi.org/10.14245/kjs.2017.14.3.115","url":null,"abstract":"<p><p>Lumbar disk herniation is common. Because of the posterior longitudinal ligament, migration usually occurs into the ventral epidural space. Rarely, fragments migrate into the dorsal epidural space. A 57-year-old man presented with lower back pain and weakness on right hip flexion and right knee flexion. He had lower back pain 1 day previously and received a transforaminal epidural block at a local hospital. The next day, he reported weakness of the right lower extremity. Lumbar spine magnetic resonance imaging revealed a dorsal epidural lesion with compression of the thecal sac at L2-3. Initial differential diagnoses included epidural hematoma after the block, neoplasm, and a sequestrated disk. Posterior lumbar decompression was performed. The lesion was identified intraoperatively as a large herniated disk fragment. Posterior epidural herniation of a lumbar disk fragment is rare and may be difficult to diagnose preoperatively. It may present as a variety of clinical scenarios and, as in this case, may mimic epidural hematoma.</p>","PeriodicalId":17867,"journal":{"name":"Korean Journal of Spine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2b/9a/kjs-14-3-115.PMC5642095.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35595019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}