• Title/Summary/Keyword: 신경감압

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A Case Report on Peripheral Facial Nerve Palsy and Sleep Disorders After Microvascular Decompression (미세혈관 감압술 후 발생한 말초성 안면신경 마비와 수면장애에 대한 한방치험 1례)

  • Min-jin Kwon;Tae-ju Kim;Na-young Kim;Oh-bin Kwon;Do-Hoon Lee;Sang-Joon Yoo;Dong-Hyeob Kang;Seon-Woo Jang
    • The Journal of Internal Korean Medicine
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    • v.44 no.5
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    • pp.929-940
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    • 2023
  • Objectives: This study reports on the efficacy of Korean medicine treatments for peripheral facial nerve palsy and sleep disorders that occur after microvascular decompression. Methods: A 57-year-old female patient with right facial palsy was treated with herbal medicines and acupuncture for 36 days. The treatment effect was evaluated using the House Brackmann Grading System (HBGS), Yanagihara's Unweighed Grading System (Yanagihara's score), and the Korean Modified Leeds Sleep Evaluation Questionnaire (KMLSEQ). Results: Following treatment, the patient showed a decrease in HBGS and an improvement in Yanagihara's score and KMLSEQ score. Conclusions: Korean medicine treatments appeared to be effective in reducing facial nerve palsy. Further clinical research on patients with facial nerve palsy is needed.

Decompression and Medial Epicondyloplasty in Ulnar Nerve Entrapment Syndrome at Elbow (주관절부 척골신경 포착증후군의 수술적 감압술 및 내상과 성형술)

  • Lee Dong Wha;Shin Kyoo Seog;Kim Jong Soon;Kim Jung Seok
    • Clinics in Shoulder and Elbow
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    • v.3 no.1
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    • pp.54-60
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    • 2000
  • As a surgical treatment of ulnar nerve entrapment syndrome includes simple decompression, medial epicondylectomy, and anterior transposition of the ulnar nerve into a subcutaneous or submuscular bed have been widely used. Despite many reports of these surgical procedure, there is little to guide the choice of one surgical technique. The purpose of our study is to analyse clinical and electrodiagnostic result after minimal invasive decompression by decompression and medial epicondyloplasty(deepening of ulnar groove). We have experienced 9 cases of ulnar nerve entrapment syndrome who were treated with decompression and medial epicondyloplasty. Male were five and female were four. The mean age at operation was 36 years ranging from 23 to 47 years. Operative procedure was to incise the medial intermuscular septum and aponeurotic arch of flexor carpiulnaris and to deepen the ulnar groove. Patients are allowed to do range of motion(ROM) exercise on the average 5days. All patient were relieved pain and improved motor and sensory function, and this procedure allows early ROM exercise after operation because the muscle have not been detached.

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Clinical Analysis of Postoperative Prognostic Factors of Cervical Anterior Decompression and Interbody Fusion for Ossification of Posterior Longitudinal Ligament (경추 후종인대 골화증의 전방경유 감압술 및 골 융합술후 예후인자에 대한 임상분석)

  • Sim, Sang Joon;Cho, Jun Ho;Yoo, Soo Il;Kwon, Young Dae;Lee, Yong Sung
    • Journal of Korean Neurosurgical Society
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    • v.29 no.3
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    • pp.360-364
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    • 2000
  • Objective : To investigate the prognostic factors associated with outcome in patients with ossification of posterior longitudinal ligament. Method : During the past 4 years, we have operated on 35 patients with cervical OPLL. Anterior cervical decompression(total or subtotal corpectomy, discectomy, and removal of the OPLL) and interbody fusion with iliac bone were performed in all patients. Results : Eight cases(22.9%) were continuous type, 11(31.4%) segmental, 13(37.1%) Mixed, and 3(8.6%) localized type. Thirty-two patients(91.4%) showed an excellent or good results. Conclusion : These results indicate that surgical treatment should be considerated in case of clinical grading higher than II and the surgical outcome is worse when duration of preoperative symptom is longer and when percentage of spinal narrowing is higher. Anterior cervical decompression and interbody fusion seems to be a better method in patients with lesions limited to one or two level. Age at surgery did not significantly affect the outcom.

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Primary Non-Hodgkin's Lymphomas Presenting with Extradural Spinal Cord Compression as the Initial Manifestation (초기 증상으로 척수 압박 증세를 보인 원발성 Non-Hodgkin 임파종)

  • Kim, Se Hoon;Lim, Dong Jun;Cho, Tai Hyoung;Park, Jung Yul;Chung, Yong Gu;Lee, Hoon Kap;Lee, Ki Chan;Suh, Jung Keun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.10
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    • pp.1365-1371
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    • 2000
  • Objectives : Spinal cord compression is a rare presentation of non-Hodgkin's lymphoma(NHL), occurring in 0.1% to 10.2% of patients. Primary spinal extradural NHL, i.e. occurring in the absence of any detectable extraspinal lymphoproliferative disorder, has a potentially favourable outcome if diagnosed and treated early. The authors describe two patients with a clinical picture of acute spinal cord compression as the first presentation of NHL. Methods : The patients were 48-year-old female and 27-year-old female. Both presented with back pain followed by acute paraparesis and voiding difficulty. One patient was diabetic. Plain radiographs of the spine were not specific. Thoracic spine magnetic resonance imaging(MRI) revealed evidence of extradural soft tissue mass extending multiple vertebral segments. Results : The patients underwent emergency laminectomy for decompression and tissue diagnosis. Histological and immunohistochemical study revealed B-cell lymphoma, intermediate grade in both patients. Postoperative staging did not reveal any additional lesions other than extradural manifestation of the malignant lymphoma. Surgery with additional chemotherapy and radiotherapy allowed the clinical improvement of both patients. Conclusion : The authors report two patients with a clinical picture of acute spinal cord compression as the first presentation of NHL, and stress that primary spinal epidural NHL should be a diagnostic consideration in the patient without prior history of malignancy who presents with a prodrome of back pain followed by a rapid neurological deterioration.

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Clinical Application of Mesenchymal Stem Cells in a Dog with Intervertebral Disc Disease (추간판 탈출증이 발생한 개에서 동종의 지방유래 줄기세포의 임상적 적용)

  • Kim, Young-Ki;Lee, Seung-Yong;Park, Se-Jin;Lee, Scott-S.;Kim, Jin-Hyun;Lee, Hee-Chun;Chang, Hong-Hee;Lee, Hyo-Jong;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
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    • v.28 no.1
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    • pp.122-127
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    • 2011
  • A 5-year old, intact male, Cocker spaniel dog was referred with paraplegia and loss of deep pain perception. Physical, neurological examinations, radiography, and computed tomography were evaluated. Based on the clinical examinations, the dog was diagnosed with severe disc herniation ($L_2$ to $L_3$ intervertebral disc space). On the next day of presentation (6 days after loss of deep pain perception), hemilaminectomy was performed. After decompression of spinal cord and removal of herniated disc materials, $1{\times}10^6$ canine allogenic adipose tissue-derived mesenchymal stem cells (MSCs) diluted by $50{\mu}l$ saline were directly applied to the injured site of the spinal cord. Ten weeks of follow-up after surgery, full recovery of deep pain perception and motor function were evaluated in both hind limbs. Based on the result, we suggest that the transplantation of allogenic adipose tissue-derived MSCs to dogs with spinal cord injuries could be a considerable method to expect better clinical outcomes in veterinary practice.

Cholinergic Mechanisms on Cardiovascular Regulation in the Ventrolateral Medulla of the Rat (흰쥐 복외측 연수에서 심혈관 조절에 대한 Choline성 기전)

  • Kim, Seong-Yun;Koh, Taek-Lip;Lee, Sang-Bok
    • The Korean Journal of Pharmacology
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    • v.23 no.2
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    • pp.77-85
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    • 1987
  • This study was carried out to determine the role of cholinoceptors in the ventrolateral medulla on central control of blood pressure (BP) and heart rate (HR). In rats anesthetized with urethane and paralyzed, microinjections of the neuroexcitatory amino acid L-glutamate (300 ng/site) were performed to functionally identity the vasopressor area (VLPA) and the vasodepressor area (VLDA) in the ventrolateral medulla oblongata. 1. The bilateral microinjection of carbachol (300 ng/site) into the VLPA produced significantly an increase in BP and HR which was not blocked by bilateral pretreatment of hexamethoium ($4\;{\mu}g/site$). 2. The bilateral microinjection of physostigmine (200 ng/site) and oxotremorine (300 ng/site) into the VLPA produced significantly an increase in BP respectively. 3. The bilateral microinjection of atropine ($4\;{\mu}g/site$) into the VLPA produced significantly a decrease in BP and HR. 4. The bilateral micro injection of acetylcholine (500 ng/site) and dimethylphenylpiperazinium (500 ng/site) into the VLDA produced significantly a decrease in BP and HR respectively. 5. The depressor and bradycardiac responses elicited by the bilateral microinjection of acetylcholine (500 ng/site) into the VLDA were blocked by bilateral pretreatment of hexamethonium ($4\;{\mu}g/site$). The results suggest that the activation of cholinoceptors in VLPA produce hypertensive and tachycardiac responses which may be mediated by muscarinic receptors, and the activation of cholinoceptors in VLDA produce hypotensive and bradycardiac responses which may be mediated by nicotinic receptors.

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Short Term Result of Total en Bloc Spondylectomy in Spine Tumor (원발성 및 전이성 척추종양에 대한 전 척추 절제술의 단기 추시 결과)

  • Kim, Jae-Do;Jang, Jae-Ho;Park, Chan-Jae;Chung, Jae-Yoon
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.1
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    • pp.37-42
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    • 2007
  • Purpose: Because of the anatomical characteristics, it is difficult to perform radical operation in spinal tumor. Numerous operations on primary and metastatic spinal tumor have been performed and among those total en bloc spondylectomy has produced decent clinical result. Clinical and radiological results have been analyzed based on five total en bloc spondylectomy on primary and metastatic spinal tumor. Materials and Methods: Patients included in this study were one with primary and four with metastatic spinal tumors, from June 1997 to January 2006. Two of the four were originated form kidney. One was from breast and the other one was not identified. McAfee's 4 point scale, VAS and Frankel's classification have been used as clinical assessment of pain and neurological symptoms. Clinical assessment have been conducted for every 3 months after operation including local recurrence, bone union and complications. Results: Assessment of pain decreased from average of 3 before operation to 1.6 after operation in McAfee's scale and VAS decreased from average of 9.2 to 1.6. Neurological deficit after operation improved from C to D in Frankel's category. Local recurrence has been detected on metastatic adenocarcinoma of L4 during follow up. Conclusion: Total en bloc spondylectomy is evidently useful operational method for primary and metastatic spinal tumor since it completely decompresses spinal nerves, decreases axial pain immediately and improves the quality of remaining life.

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The Effect of Peripheral Neurolysis in Diabetic Feet (말초 신경 감압술이 당뇨발에 미치는 효과)

  • Park, Bong-Ju;Kim, Ju-O;Yang, Gyoung-Ho;Choi, Soeng-Jun
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.1
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    • pp.52-57
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    • 2004
  • Purpose: We evaluated the effect of nerve decompression for restoration of plantar sweating and sensation in diabetic neuropathic feet, and we selected diabetic neuropathic patients with the possibility of overlying entrapmental neuropathy. Materials and Methods: From June 2002 to May 2003, we have investigated and follow-up examed 10 patients with diabetic neuropathic feet, with decreased sensation in their lower limb, who underwent peripheral nerve decompression. The surgical procedure was multiple neurolysis of the common peroneal nerve, posterior tibial nerve and its three branches of one limb. We compared the operated limb with the opposite, unoperated limb. We performed history taking, physical examination, sweat secretion test, touch sensory test using Semmes-Weinstein monofilaments and electrodiagnostic study, pre-operatively and post-operatively. Results: On 6 months after the operation, the post-operative tests showed that there were noticeable improvements to sensation, statistically (P<0.05), but there was no change in the sweat secretion test. According to the Cseuz criteria, 7 patients out of the 10 patients who received the multiple neurolysis showed excellent or good results. Conclusion: We observed that the peripheral nerve neurolysis could be benefit for improving sensation and alleviating pain of the diabetic neuropathic feet with nerve entrapmental symptoms, but there was no change in the sweat secretion on short-term follow-up. To identify whether the effect will be continued or not, additional follow-up will be required.

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Invasion of Hemangiosarcoma from Lung to the Spinal Cord in a Dog (개에서 발생한 폐 원발성 혈관육종의 척수로의 전이)

  • Choi, Sung-Jin;Nam, Eun-Ryel;Lee, Gi-Ja;Kim, Nam-Soo;Murahashi, Tatsumi;Nishimura, Ryouhei;Mochizuki, Manabu
    • Journal of Veterinary Clinics
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    • v.31 no.2
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    • pp.145-148
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    • 2014
  • 11-year-old neutered male dog was presented with paralysis with decreased postural reaction in the bilateral pelvic limbs. On MRI and CT, the spinal cord from T13 had a slightly swollen area and lost the central canal. A well circumscribed mass was observed at anterior of a right kidney and invaded the spinal canal through the pleura without the fusion and destruction of the spines. Hemilaminectomy was performed to identify the mass pathohistologically and decompress the spinal cord. The mass was diagnosed as hemangiosarcoma. The dog had showed neither progressive neurologic disorders nor improvement and passed away 58 days after the surgery.

Microsurgical Decompression for Lumbar Stenosis via Unilateral Laminotomy (요추 협착증에 대한 일측성 추궁절개술을 통한 미세 수술적 감압술)

  • Shim, Yong-Jin;Ha, Ho-Gyun;Lee, Jong-Sun;Kim, Yong-Seog;Park, Moon-Sun;Kim, Joo-Seung
    • Journal of Korean Neurosurgical Society
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    • v.29 no.11
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    • pp.1505-1513
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    • 2000
  • Objectives : Many surgical procedures have been introduced to a symptomatic lumbar stenosis. Most of these procedures still have been regarded as an extensive surgical intervention with respect to normal aging process of the lumbar spine. We adopted a microsurgical decompression procedure via unilateral exposure as a minimally invasive intervention for symptomatic lumbar stenosis without instability. Materials and Methods : Fifty-seven patients with symptomatic lumbar stenosis underwent microsurgical decompression via unilateral laminotomy between March 1998 and December 1999. The conceptual modification and technical refinements were added to the previously reported microsurgical decompression procedure. Bilateral decompression through a unilateral laminotomy hole was performed in 11 patients. These patients profile also included 9 cases of degenerative spondylolisthesis(Grade I) without instability. Results : Preoperative neurogenic intermittent claudication(NIC) was more notably improved than low back pain, 60% to 82% during the follow-up period. Overall clinical results were excellent in 20(35%), good in 29(51%), fair in 6(11%) and poor in 2(3%). Conclusions : Microsurgical decompression for lumbar stenosis with stable spine provided a satisfactory symptomatic improvement without extensive destruction of the weight-bearing structures and functional mobile segments, even bilateral symptoms existed.

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