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1.  Cervical Foraminal and Discal Height after Dynamic Rotational Plating in the Cervical Discectomy and Fusion 
Asian Spine Journal  2013;7(4):289-293.
Study Design
This is a retrospective study.
Purpose
To evaluate the effect of the dynamic rotational plate to the intervertebral foraminal and discal height after anterior cervical discectomy and fusion.
Overview of Literature
There is no report regarding the changes of foraminal and discal height following cervical dynamic rotational plating.
Methods
We reviewed the outcomes of 30 patients (36 levels), who were followed-up for an average of 15 months (range, 12-57 months) after undergoing fusions with anterior cervical dynamic rotational plating for cervical radiculopathy, from March 2005 to February 2009. The changes of foraminal and intervertebral discal height of the operated levels were observed on oblique and lateral radiographs obtained at the preoperative, postoperative and follow-up examinations.
Results
The foraminal and discal height increased sufficiently, immediately following the operation. However, follow-up results showed gradual decrease in the foraminal and discal height. After 6 months of the surgery, they showed little difference compared with the preoperative heights. However, clinically, patients showed improvements in radiating pain during the follow-up period.
Conclusions
Anterior cervical dynamic rotational plating was an effective treatment modality for cervical radiculopathy without the deterioration of the foraminal and intervertebral discal height.
doi:10.4184/asj.2013.7.4.289
PMCID: PMC3863654  PMID: 24353845
Cervical spine; Cervical radiculopathy; Dynamic rotational plate
2.  Delayed Spinal Epidural Hematoma after En Block Spondylectomy for Vertebral Ewing's Sarcoma 
Asian Spine Journal  2010;4(2):118-122.
We report here on a case of a 23-year-old male who received en block spondylectomy for a vertebral Ewing's sarcoma at our hospital. Nine days after surgery, he presented with severe back pain and motor weakness of the lower extremities. Based on the physical examination and the computed tomography scan, he was diagnosed with acute cauda equina syndrome that was caused by compression from an epidural hematoma. His neurological functions recovered after emergency evacuation of the hematoma. This case showed that extensive surgery for a malignant vertebral tumor has a potential risk of delayed epidural hematoma and acute cauda equina syndrome and this should be treated with emergency evacuation.
doi:10.4184/asj.2010.4.2.118
PMCID: PMC2996623  PMID: 21165315
Epidural hematoma; Ewing's sarcoma; Spine; En block spondylectomy
3.  Antibiotic Microbial Prophylaxis for Spinal Surgery: Comparison between 48 and 72-Hour AMP Protocols 
Asian Spine Journal  2010;4(2):71-76.
Study Design
This is a prospective randomized cohort study.
Purpose
We intended to evaluate the efficacy of a 48 hour antibiotic microbial prophylaxis (AMP) protocol as compared with a 72 hour AMP protocol.
Overview of Literature
The current guideline for the prevention of surgical site infection (SSI) suggests the AMP should not exceed 24 hours after clean surgery like spinal surgery. But there exist some confusion in real clinical practice about the duration of postoperative antibiotic administration because the evidence of the guideline was not robust.
Methods
The subjects were 548 patients who underwent spinal surgery at our department from April 2007 to December 2008. The patients were classified into two groups according to the prophylaxis protocol: group A, for which AMP was employed for 72 hours postoperatively and group B, for which AMP was employed for 48 hours postoperatively. Five hundred two patients out of 548 patients were followed until 6 months postoperatively. The incidence of SSI in the two groups was analyzed.
Results
The overall infection rate was 0.8%. There was no significant difference in infection rate between the two groups. The overall infection rate for the patients who underwent instrumented fusion was 0.9%. There was no significant difference in the infection rate between the patients of the two groups who underwent instrumented fusion.
Conclusions
AMP for 48 hours is as efficient as AMP for 72 hours.
doi:10.4184/asj.2010.4.2.71
PMCID: PMC2996630  PMID: 21165308
Spine; Surgical site infection; Anti-bacterial agents
4.  Multiple Levels of Lumbar Spondylolysis - A Case Report - 
Asian Spine Journal  2009;3(1):35-38.
We report here on an unusual case of multiple levels of asymmetric lumbar spondylolysis in a 19-year-old woman. The patient had severe low back pain of increasing intensity with lumbar instability, which was evident on the dynamic radiographs. MRI demonstrated the presence of abnormalities and the three dimensional CT scan revealed asymmetric complete spondylolysis at the left L2, L3 and L4 levels and the right L1, L2 and L3 levels. This case was treated surgically by posterior and posterolateral fusion at L2-3-4 with intersegmental fixation using pedicle screws and an auto iliac bone graft. The patient was relieved of her low back pain after the surgery.
doi:10.4184/asj.2009.3.1.35
PMCID: PMC2852035  PMID: 20404945
Lower back pain; Multiple spondylolysis; Fusion
5.  20-Year-Follow up of Treatment Using Spine Osteotomy and Halo-pelvic Traction for Tuberculous Kyphosis - A Case Report - 
Asian Spine Journal  2009;3(1):27-31.
A 23-year-old male whose medical history included tuberculous spondylitis presented with a kyphotic deformity and incomplete paraplegia of twenty days duration. Preoperative radiographs demonstrated a T12-L4 kyphotic Cobb's angle of 100° with a complete block showing on the lumbar myelogram at L4-5. The patient underwent anterior osteotomy and release. After the operation, a halo-pelvic apparatus was fit onto the patient, and distraction was begun. After distraction for 2 months, posterior osteotomy and release was performed for final correction, and distraction was maintained for another three weeks. Finally, the kyphotic deformity was corrected to a Cobb's angle of 62° from T12 to L4. Supplementary anterior fusion was done, and the apparatus was removed after consolidation of the fusion mass.
Even twenty years after correction of a tuberculous kyphosis, he had no neurological deterioration, and could work as a farmer using agricultural machines. Correction angle and sagittal balance were well maintained.
doi:10.4184/asj.2009.3.1.27
PMCID: PMC2852040  PMID: 20404943
Tuberculous kyphosis; Halo-pelvic traction; Spine osteotomy
6.  Risk Factors Associated with the Halo Phenomenon after Lumbar Fusion Surgery and its Clinical Significance 
Asian Spine Journal  2008;2(1):22-26.
Study Design
Retrospective study.
Purpose
First, to examine the association between bone mineral density (BMD) and the halo phenomenon, and second, to investigate risk factors predisposing to the halo phenomenon and its correlation with clinical outcomes.
Overview of Literature
The few in vivo studies regarding the relationship between pedicle screw stability and BMD have shown conflicting results.
Methods
Forty-four female patients who underwent spine fusion surgery due to spinal stenosis were included in this study. The halo phenomenon and fusion state were evaluated through plain radiographs performed immediately after surgery and through the final outpatient follow-up examination. BMD, osteoarthritis grade in the hip and knee joints, and surgical outcome were also evaluated.
Results
BMD was not related to the halo phenomenon, but age, absence of osteoarthritis in the knee, and non-union state were found to be significant risk factors for the halo phenomenon. However, the radiological halo phenomenon did not correlate with clinical outcome (visual analogue scale for back pain and leg pain).
Conclusions
The halo phenomenon is a simple phenomenon that can develop during follow-up after pedicle screw fixation. It does not influence clinical outcomes, and thus it is thought that hydroxyapatite coating screws, expandable screws, cement augmentation, and additional surgeries are not required, if their purpose is to prevent the halo phenomenon.
doi:10.4184/asj.2008.2.1.22
PMCID: PMC2857487  PMID: 20411138
Halo phenomenon; Pedicle screw; Bone mineral density

Results 1-6 (6)