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1.  Posterior Interspinous Fusion Device for One-Level Fusion in Degenerative Lumbar Spine Disease : Comparison with Pedicle Screw Fixation - Preliminary Report of at Least One Year Follow Up 
Objective
Transpedicular screw fixation has some disadvantages such as postoperative back pain through wide muscle dissection, long operative time, and cephalad adjacent segmental degeneration (ASD). The purposes of this study are investigation and comparison of radiological and clinical results between interspinous fusion device (IFD) and pedicle screw.
Methods
From Jan. 2008 to Aug. 2009, 40 patients underwent spinal fusion with IFD combined with posterior lumbar interbody fusion (PLIF). In same study period, 36 patients underwent spinal fusion with pedicle screw fixation as control group. Dynamic lateral radiographs, visual analogue scale (VAS), and Korean version of the Oswestry disability index (K-ODI) scores were evaluated in both groups.
Results
The lumbar spine diseases in the IFD group were as followings; spinal stenosis in 26, degenerative spondylolisthesis in 12, and intervertebral disc herniation in 2. The mean follow up period was 14.24 months (range; 12 to 22 months) in the IFD group and 18.3 months (range; 12 to 28 months) in pedicle screw group. The mean VAS scores was preoperatively 7.16±2.1 and 8.03±2.3 in the IFD and pedicle screw groups, respectively, and improved postoperatively to 1.3±2.9 and 1.2±3.2 in 1-year follow ups (p<0.05). The K-ODI was decreased significantly in an equal amount in both groups one year postoperatively (p<0.05). The statistics revealed a higher incidence of ASD in pedicle screw group than the IFD group (p=0.029).
Conclusion
Posterior IFD has several advantages over the pedicle screw fixation in terms of skin incision, muscle dissection and short operative time and less intraoperative estimated blood loss. The IFD with PLIF may be a favorable technique to replace the pedicle screw fixation in selective case.
doi:10.3340/jkns.2012.52.4.359
PMCID: PMC3488645  PMID: 23133725
Degenerative; Fusion device; Interspinous; Lumbar disease; Posterior; Adjacent segmental degeneration
2.  Primary Intramedullary Spinal Sarcoma : A Case Report and Review of the Current Literatures 
Primary central nervous system (CNS) sarcomas are exceedingly rare, and, to the best of our knowledge, there has not yet been a report of intramedullary sarcoma. Here, we report a primary intradural intramedullary sarcoma of the spinal cord in a four-year-old boy who presented with low back pain and a radiculopathy involving both lower extremities. The tumor showed significant enhancement on magnetic resonance (MR) images due to its extreme vascularity. Gross total tumor removal was performed with microelectrical pulse recording, and the patient also received adjuvant radiotherapy and chemotherapy. After the operation, the patient's sensory deficits were improved. Because CNS dissemination is common, entire neuraxis evaluation is essential, although there was no evidence of dissemination in this case. The prognosis of primary CNS sarcoma is poor due to infiltrative nature and early CNS dissemination is common, and the treatment of choice is radical surgical resection. Adjuvant therapy is also beneficial with radiotherapy and chemotherapy.
doi:10.3340/jkns.2010.48.5.448
PMCID: PMC3030088  PMID: 21286485
Central nervous system; Intramedullary; Primary; Sarcoma
3.  Rod Migration into the Posterior Fossa after Harms Operation : Case Report and Review of Literatures 
C1 lateral mass and C2 pedicle (C1LM-C2P) fixation is a relatively new technique for atlantoaxial stabilization. Complications from C1LM-C2P fixation have been rarely reported. The authors report unilateral rod migration into the posterior fossa as a rare complication after this posterior C1-C2 stabilization technique. A 23-year-old man suffered severe head trauma and cervical spine injury after vehicle accident. He was unconscious for 2 months and regained consciousness. He underwent C1LM-C2P fixation for stabilization of type II odontoid process fracture described by Harms. The patient recovered without a major complication. Twenty months after operation, brain computed tomogram performed at psychology department for disability evaluation showed rod migration into the right cerebellar hemisphere. The patient had mild occipital headache and dizziness only regarding the misplaced rod. He refused further operation for rod removal. To our knowledge, this complication is the first report regarding rod migration after Harms method. We should be kept in mind the possibility of rod migration, and C1LM-C2P fixation should be performed with meticulous technique and long-term follow-up.
doi:10.3340/jkns.2010.47.3.221
PMCID: PMC2851083  PMID: 20379477
Atlantoaxial fixation; Harms technique; Migration; Odontoid process fracture; Rod

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