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1.  Psoas Abscess Caused by Spontaneous Rupture of Colon Cancer 
Clinics in Orthopedic Surgery  2011;3(4):342-344.
Spontaneous rupture of colon cancer, combined with psoas abscess formation, is rare. A 44-year-old male visited for back pain and left buttock mass. Abdominal computed tomography and magnetic resonance image revealed a large abscess in the left psoas muscle and in the left lower quadrant area. Ten days after incision and drainage, a skin defect around the left anterior superior iliac spine remained. A local flap was performed using a superficial skin graft. Ten days after the stitches had been removed, fecal discharge was observed around the anterior superior iliac spine at the flap site. An operation was performed by a general surgeon who had diagnosed this as a case of enterocutaneous fistula. Operative findings included a ruptured tumor mass in the descending colon, which was connected to a retroperitoneal abscess. Pathologic report findings determined adenocarcinoma of the resected colon. Herein, we report a case of psoas abscess resulting from perforating colon cancer.
doi:10.4055/cios.2011.3.4.342
PMCID: PMC3232364  PMID: 22162799
Psoas abscess; Colon cancer; Spontaneous rupture
2.  Comparative Study of Clinical Outcomes of Anterior Cervical Discectomy and Fusion Using Autobone Graft or Cage with Bone Substitute 
Asian Spine Journal  2011;5(3):169-175.
Study Design
A retrospective study.
Purpose
To compare the clinical and radiological outcomes of autogenous bone graft and cage with bone substitute for anterior cervical discectomy and fusion.
Overview of Literature
The clinical outcomes of cage with bone substitute for anterior cervical discectomy and fusion is satisfactory.
Methods
Eighty four patients who underwent cervical spine surgery between February 2004 and April 2009 were included. Fifty-nine patients were approached anteriorly and underwent anterior cervical discectomy and fusion by the Smith-Robinson method (Group A), and 25 patients underwent fusion by decompression of the cervical spine and cage with bone substitute (Group B). We measured and evaluated the postoperative period until patients were able to ambulate, for pre- and postoperative symptomatic improvement, postoperative complications, pre- and postoperative change of lordosis, degree of endplate collapse or subsidence, and fusion rate and period of union.
Results
By Robinson's criteria, respectively 45, 10 and 4 patients in Group A experienced excellent, good and fair symptomatic improvement, and respectively 19, 5 and 1 patients in Group B experienced excellent, good and fair symptomatic improvement. The postoperative period in which patients became ambulant and the period of hospital stay was significantly shorter in Group B. Increase of lordosis at final follow up after surgery was significantly larger in Group A, as was the fusion period. Significantly more endplate collapse occurred in Group B.
Conclusions
Of patients who had anterior cervical discectomy and fusion, results of both groups were both satisfactory.
doi:10.4184/asj.2011.5.3.169
PMCID: PMC3159065  PMID: 21892389
Cervical vertbrae; Anterior cervical discectomy and fusion; Autobone graft; Cage; Bone substitutes
3.  Prognostic Factors That Affect the Surgical Outcome of the Laminoplasty in Cervical Spondylotic Myelopathy 
Clinics in Orthopedic Surgery  2010;2(2):98-104.
Background
This study examined the prognostic factors that affect the surgical outcome of laminoplasty in cervical spondylotic myelopathy patients by comparative analysis.
Methods
Thirty nine patients, 26 males and 13 females, who were treated with laminoplasty for cervical myelopathy from September 2004 to March 2008 and followed up for 12 months or longer, were enrolled in this study. The mean age of the subjects was 62.4 years (range, 37 to 77 years). The patients' age, number of surgical segments, spinal cord compression ratio, segment number, level, localized marginal pattern of high signal intensity within the spinal cord in the T2 image, preoperative Japanese Orthopaedic Association Scoring System (JOA) score with the recovery ratio were compared respectively. The JOA score was used for an objective assessment of the patients' preoperative and postoperative clinical status. The recovery ratios of surgery were graded using the Hirabayashi equation. Statistical analysis was carried out using Pearson correlation analysis.
Results
The patients' JOA score increased from a preoperative score of 11.1 (range, 5 to 16) to a postoperative score of 14.9 (range, 7 to 17). The average recovery ratio was 65.8% (range, 0 to 100%). The number of segments with high signal changes in the T2 image, a localized marginal pattern with high signal change, signal intensity changes in the upper cervical spinal cord were inversely associated with the recovery ratio, whereas the spinal cord compression ratio showed a significant positive correlation. However, the currently known prognostic factors, such as number of surgical segment, age, and preoperative JOA score, showed no statistically significant correlation.
Conclusions
The number of segments, localized marginal pattern, rostral location of signal intensity changes with a high signal change in the T2 image and a low spinal cord compression ratio in cervical spondylotic myelopathy patients treated by laminoplasty can indicate a poor prognosis.
doi:10.4055/cios.2010.2.2.98
PMCID: PMC2867205  PMID: 20514267
Cervical spondylosis; Myelopathy; Laminoplasty; Prognostic factor
4.  Diagnosis and Treatment of Tuberclous Spondylitis and Pyogenic Spondylitis in Atypical Cases 
Asian Spine Journal  2007;1(2):75-79.
Study Design
A retrospective study.
Purpose
This is a study of the diagnosis and treatment of tuberculous spondylitis and pyogenic spondylitis in atypical cases.
Overview of Literature
There have been several reports about clinical, hematological, pathological and radiological findings to differentiate pyogenic & tuberculous spondylitis.
Methods
We screened 55 patients diagnosed with tuberculous spondylitis and pyogenic spondylitis from January 1999 to June 2003. There were seven cases where it was difficult to make an accurate diagnosis. We reviewed the clinical manifestation, laboratory tests, radiological findings and confirmed the diagnoses by the use of biopsies and/or clinical response to treatment.
Results
Four cases, which were initially diagnosed as pyogenic spondylitis, had a clinical presentation of fever (37.4~38.5℃) on the day of hospitalization. These cases later turned out to be tuberculous spondylitis, as confirmed by an open biopsy and pathologic study. Three cases initially diagnosed as pyogenic spondylitis were treated with broad-spectrum antibiotics. Symptoms were aggravated in these cases, but improved after the use of an anti-tubercular drug. Bony union was observed in all cases in an averageof 4 months (range, 3~6 months).
Conclusions
In infectious spondylitis, it is important to establish an accurate diagnosis. An accurate diagnosis can be made by laboratory findings and by estimation of the response to treatment during follow-up. If there is no response or aggravation of symptoms despite treatment based on an initial diagnosis, the etiologic organism must be re-evaluated. A biopsy and observation of clinical response are needed to confirm the diagnosis.
doi:10.4184/asj.2007.1.2.75
PMCID: PMC2857479  PMID: 20411128
Tuberclous spondylitis; Pyogenic spondylitis

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