• The Journal of the Korean bone and joint tumor society
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• v.4 no.1
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• pp.37-43
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• 1998

Between 1992 and 1996, 5 patients with the giant-cell tumor of the spine were treated. Four were female and one was male. The mean age was 34 years old, and the mean follow-up time was 36 months. The locations of the lesions were the cervical spine in 1, the thoracic spine in 3, and the lumbar spine in 1. Pain was the predominant presenting symptom in all cases and four had a neurological deficit. A combined anterior and posterior surgical approach wds as performed in all cases, which were also treated with AIF(anterior interbody fusion) and anterior and/or posterior instrumentation. Adjuvant radiation therapy was performed in 1 case of cervical spine. At the final follow-up, the pain and neurologic symptoms were improved. Radiologic examination showed no evidence of local recurrence and no failure of instrumentation of the spine.

• Journal of Chest Surgery
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• v.31 no.9
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• pp.903-906
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• 1998

A 17-year-old-boy with a bilateral incomplete cervical rib, upon abduction of his left arm at 45 degrees, had immediately begun to show symptoms of severe tingling, claudication, pallor, and weakness of his left upper extremity. These symptoms were aggravated at 90 degrees, leaving him debilitated from his work in the printing office. Transfemoral positional subclavian arteriography revealed total occlusion of the subclavian artery immediately distal to a cervical rib during 90 degrees abduction. Resection of the anterior scalene and medial aspect of the middle scalene muscles, cervical and first ribs, and arteriolysis were performed via a combined supraclavicular and infraclavi cular approach. He has returned to work as a printer with marked relief of symptoms and has remained asymptomatic over follow-up periods of 10 months.

• Journal of Korean Neurosurgical Society
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• v.61 no.5
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• pp.600-607
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• 2018

Objective : It has been reported in recent studies that 50-80% of patients with cervical disc hernia have concomitant sleep disorders. The aim of this study was to evaluate the quality of sleep before and after surgical treatment in patients with cervical disc hernia and to assess the effects on treatment. Methods : The study included 32 patients performed discectomy and fusion with an intervertebral cage through the right anterior cervical approach. Oswestry Disability Index (ODI), Visual Analog Scale (VAS) and Pittsburgh Sleep Quality Index (PSQI) were applied to all patients preoperatively and at one month postoperatively. Results : The postoperative PSQI total points and all the PSQI subscale points, the ODI and VAS scores were significantly reduced compared to the preoperative values. A positive correlation was determined between the preoperative ODI points and the PSQI total points and sleep duration, sleep latency and daytime functional loss subscale points. A positive correlation was also found between preoperative ODI points and VAS points. A positive correlation was determined between the preoperative VAS points and and the PSQI total points and sleep duration, and sleep latency subscale points. A negative correlation was determined between the postoperative ODI and the daytime functional loss subscale points. Conclusion : The results of the study showed that in patients with cervical disc hernia, sleep quality and daytime functionality were negatively affected by severity of pain that limited daily activities. Bringing the pain under control with surgical treatment was observed to increase sleep quality. It can be concluded that when planning treatment for these patients, it should be taken into consideration that there could be a sleep disorder in addition to the complaints and symptoms such as pain, hypoestesia and loss of strength.

• Journal of Chest Surgery
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• v.26 no.9
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• pp.705-709
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• 1993

The mediastinoscopy was a well known useful diagnostic tool for detection of certain mediastinal tumors ,mediastinal lymph nodes invasion by bronchogenic carcinoma and metastatic cancer. A total of 33 cases of mediastinoscopies were reviewed, which were experienced at Chon Buk National University Hospital from August,1980 to October 1991. Mediastinoscopy was performed through anterior or parasternal approach in 18 cases, cervical approach in 14 cases and both in 1 case. In 12 cases which were used for preoperative stagig of lung cancer, 10 cases[83.3%] had the positive biopsy results at mediastinal nodes. In 11 cases for diagnosis of lymph nodes and masses with unknown lung lesion, small cell carcinoma revealed in 3 cases,squamous cell carcinoma in 2 , adenocarcinoma in 1 case and the others were had the negative biopsy results. In 10 cases for diagnosis of mediastinal tumors, lymphoma revealed in 2 cases, malignant thymoma in 2, sarcoidosis in 2, tuberculous granuloma in 1, mesothelioma in 1, metastatic cancer with unknown origin in 1 case. Thoracotomy was performed in 3 cases of lung cancers, 2 patients with negative biopsy results in preoperative staging and 1 patient with subcarinal lymph node involvement only. Bleeding complications during mediastinoscopy were developed in 2 cases, managed by anterior mini-thoracotomy.

• Journal of Chest Surgery
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• v.34 no.5
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• pp.426-429
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• 2001

Superior sulcus or pancoase tumor refers to any primarty lung cancer locating in thoracic inlet and causing pain in the periscapular region or aim. These originate inperipheral, and involve th extrapulmonary structures more than parenchyma of the lung. We experienced l case of superior sulcus tumor radically resected via anterior transcervical approach, which provide more safe exposure of cervical structures of thoracic inlet than classis posterolateral thoracotomy. Therefore were report this case with review of literature.

• Korean Journal of Bronchoesophagology
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• v.3 no.1
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• pp.61-69
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• 1997

A total of 55 patients underwent surgical managements for postintubation tracheal stenosis from July 1975 through March 1997. All but 8 had received ventilatory assistance. The patients had S cuff lesions, 17 stoma lesions, 7 at both levels, 5 at subglottic lesions. Thirty two patients underwent the sleeve tracheal resection and end-to-end anastomosis. Five patients performed a wedge resection and end-to-end anastomosis. Twenty two patients received the Montgomery T-tube for relief of airway obstruction. Simple excision of granulation tissue was done in 7 patients. Rethi procedures(anterior division of cricoid cartilage, partial wedge resection of lower thyroid cartilage and T-tube molding) were performed in 2 subglottic stenosis patients. And the other subglottic patient was received permanent tracheal fenestration at 1975. The tracheoesophageal fistula patient was done sleeve tracheal resection and end-to-end anastomosis with interrupted double layer closure of esophageal fistula site. Cervical approach was used in 49 cases, cervicomediastinal in 13 cases and median stemotomy In 6 cases. Techniques for obtaining tension-free anastomosis included a cervical neck flexion(15-30$^{\circ}$) in all sleeve resection patients and laryngeal release in one. The length of resection was 1.5 to 5.0 on A total of 41 patients(74.5%) had good(24 patients) or satisfactory(17 patients) results. But in ten cases, the restenosis of anastomosis site which is the most common complication was developed Two of them underwent a second reconstruction and 8 patients required T-tube insertion for airway maintenance. Three patients(5.4%) died. The causes of death were tracheo-innominate artery fistula(2) and sudden obstruction of airway(1).

• Advances in pediatric surgery
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• v.17 no.2
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• pp.154-161
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• 2011

Tracheoesophageal fistula without esophageal atresia (H-type TEF) is a congenital anomaly that is characterized by a fistula between the posterior wall of the trachea and the anterior wall of the esophagus, not accompanied by esophageal atresia. The purpose of this study is to investigate the clinical characteristics, diagnostic time, the side of cervical approach and short term result after surgery by searching medical records of patients treated for H-type TEF. The search was done at University of Ulsan, Department of Pediatric Surgery of Asan Medical Center, and the total number of patients from May 1989 to December 2010 was 9 with M:F ratio of 1:2. The median gestational age was $39^{+6}$ ($32^{+6}{\sim}41^{+0}$) wks. Seven out of nine patients were born at term and the other two were born premature. The clinical presentation was aspiration pneumonia, difficulty in feeding, chronic cough, vomiting, abdominal distension and growth retardation. The symptoms presented right after birth. The diagnosis was made with esophagography and the median time of diagnosis was 52 days of life. The majority of surgical corrections were performed within two weeks of diagnosis (median; 15d, range; 1d - 6m). Six patients had associated anomalies, and cardiac anomalies were most common. The cervical approach was utilized in all cases (right 2, left 7). Transient vocal cord palsy and minor esophageal leakage complicated two cases. Although the diagnosis of H-type TEF was difficult and often delayed, we had a good short term result. The left cervical approach was preferred.

• The Korean Journal of Pain
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• v.25 no.3
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• pp.183-187
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• 2012

The use of fluoroscopy guidance together with the loss of resistance technique during epidural injections has been advocated lately; moreover, epidural injections in the absence of fluoroscopic guidance have a high rate of inaccurate needle-tip placement during the injections. However, the approach to the lower cervical and upper thoracic epidural space may be challenging due to its obscure lateral fluoroscopic views from overlying normal tissue structures. In this case, we report an alternative oblique C-arm fluoroscopy guided view approach to supplement the standard anterior-posterior and lateral fluoroscopic views to facilitate successful needle placement and precise anatomical localization of the epidural space.

• Journal of Yeungnam Medical Science
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• v.19 no.2
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• pp.73-91
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• 2002

Method of management of the spine injury should be determined, based on the status of neurological injury as well as on the presence of traumatic instability. At the thoracic and lumbar spine, patterns of neurological injury are different from the cervical spine due to their neuro-anatomical characteristics. Especially, at the thoracolumbar junction, neurological injury patterns with their respective prognosis vary from the complete cord injury or conus medullaris syndrome to the cauda equina syndrome according to the injury level. The concept of Holdsworth's instability based on the posterior ligament complex theory has evolved into the current 3-column theory of Denis. Flexion-rotation injury and fracture-dislocation are well known to be unstable that surgical fixation is frequently needed for these injuries. However, there have been some controversies for the stability of burst fractures and their treatment, such as indirect or direct decompression and anterior or posterior approach. In this article, current concepts and management of traumatic instabilities at the thoracic and lumbar spine have been reviewed and summarized.

• The Journal of the Korean bone and joint tumor society
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• v.15 no.2
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• pp.138-145
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• 2009

Purpose: Giant cell tumor of the spine is very rare, and the treatment is very difficult. However, surgical techniques and diagnostic modalities are developed, and postoperative functional results are improved. To evaluate the efficacy of total spondylectomy for giant cell tumor of the spine, the clinical results of the surgical treatments for the giant cell tumor of the spine with intralesional curettage or total spondylectomy were evaluated. Materials and Methods: From April 1987 to March 2006, 10 patients who were underwent surgical treatments using total spondylectomy or intralesional curettage were studied. There were 3 men and 7 women. The mean age of the patients was 32 years (range, 25~44 years). The mean duration of follow-up was 8 years (range, 3~15 years). Locations of the tumor were 2 cervical spines, 4 thoracic spines, 2 lumbar spines and 2 sacrum. Initial main symptom of 10 patients was pain, and 7 patients had neurologic impairments too. Four patients were treated with total spodylectomy using anterior and posterior combined approach, 1 patient was treated with total sacrectomy using posterior approach only, and 5 patients were treated with intralesional curettage using anterior approach. Results: Nine patients improved pain and neurologic impairments. Local recurrences developed in 4(40%) patients (2 cervical spines, 1 thoracic spine, 1 sacrum). While a local recurrence developed from 5 total spondylectomy, 3 local recurrences developed from 5 intralesional curettage. Conclusion: Local recurrence rate after surgical treatment with intralesional curettage for the giant cell tumor of the spine was very high. Total spondylectomy using anterior and posterior approach is advisable to prevent the local recurrence after surgical treatment.