• Title/Summary/Keyword: Disc Height

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Minimum 3-Year Outcomes in Patients with Lumbar Spinal Stenosis after Bilateral Microdecompression by Unilateral or Bilateral Laminotomy

  • Yang, Sang-Mi;Park, Hyung-Ki;Chang, Jae-Chil;Kim, Ra-Sun;Park, Sukh-Que;Cho, Sung-Jin
    • Journal of Korean Neurosurgical Society
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    • v.54 no.3
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    • pp.194-200
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    • 2013
  • Objective : Lumbar spine stenosis (LSS) can result in symptomatic compression of the neural elements, requiring surgical treatment if conservative management fails. Minimally invasive surgery has come to be more commonly used for the treatment of LSS. The current study describes outcomes of bilateral microdecompression by unilateral or bilateral laminotomy (BML) for degenerative LSS after a minimum follow-up period of 3 years and investigates factors that result in a poor outcome. Methods : Twenty-one patients who were followed-up for at least 3 years were included in this study. For clinical evaluation, the Japanese Orthopedic Association (JOA) scoring system for low back pain was used. The modified grading system of Finneson and Cooper was used for outcome assessment. Radiographic evaluation was also performed for spondylolisthesis, sagittal rotation angle, and disc height. Results : Twenty-one patients (10 men, 11 women) aged 53-82 years ($64.1{\pm}8.9$ years) were followed-up for a minimum of 3 years (36-69 months). During follow-up, two patients underwent reoperation. Average preoperative JOA score and clinical symptoms, except persistent low back pain, improved significantly at the latest follow-up. There were no significant differences in radiological findings preoperatively and postoperatively. Thirteen patients (61.9%) had excellent to fair outcomes. Conclusion : BML resulted in a favorable and persistent outcome for patients with degenerative LSS without radiological instability over a mid-term follow-up period. Persistent low back pain unrelated to postoperative instability adversely affects mid-term outcomes.

Balloon Kyphoplasty through Extrapedicular Approach in the Treatment of Middle Thoracic Osteoporotic Compression Fracture : T5-T8 Level

  • Kim, Hyeun-Sung;Kim, Seok-Won;Ju, Chang-Il
    • Journal of Korean Neurosurgical Society
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    • v.42 no.5
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    • pp.363-366
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    • 2007
  • Objective : Kyphoplasty performed in the middle thoracic spine presents technical challenges that differ from those in the lower thoracic or lumbar region due to small pedicle size and angular severity for thoracic kyphosis. The purpose of this study was to evaluate the efficacy of balloon kyphoplasty through extrapedicular approach for the treatment of intractable osteoporotic compression fractures in the middle thoracic spine. Methods : The patients who were performed with one level balloon kyphoplasty through extrapedicular approach due to painful osteoporotic compression fractures at T5-T8 from June 2003 to July 2005 were retrospectively analyzed. Imaging and clinical features were analyzed including involved vertebrae level, vertebral height, Injected cement volume, clinical outcome and complications. Results : Eighteen female patients (age ranged from 60 to 77 years old) were included in this study. The average amount of the implanted cement was $4.2{\pm}1.5\;cc$. The mean cobb angle and compression rate were improved from $12.1{\pm}6.5^{\circ}$ to $8.5{\pm}7.2^{\circ}$ and from 30% to 15%, respectively. The mean pain score (visual analogue scale) prior to kyphoplasty was 7.9 and it decreased to 3.0 after the procedure. Cement leakage to the adjacent disc (2 cases) and paravertebral soft tissues (1 case) were seen but there were no major complications such as pneumothorax, segmental arte 이 Injury, pulmonary embolism, or epidural leakage. Conclusion : Balloon kyphoplasty through extrapedicular approach is considered as a safe and effective in treating the middle thoracic regions with low complication rate.

Direct Lateral Lumbar Interbody Fusion : Clinical and Radiological Outcomes

  • Lee, Young Seok;Park, Seung Won;Kim, Young Baeg
    • Journal of Korean Neurosurgical Society
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    • v.55 no.5
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    • pp.248-254
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    • 2014
  • Objective : According to the recent development of minimally invasive spinal surgery, direct lumbar interbody fusion (DLIF) was introduced as an effective option to treat lumbar degenerative diseases. However, comprehensive results of DLIF have not been reported in Korea yet. The object of this study is to summarize radiological and clinical outcomes of our DLIF experience. Methods : We performed DLIF for 130 patients from May 2011 to June 2013. Among them, 90 patients, who could be followed up for more than 6 months, were analyzed retrospectively. Clinical outcomes were compared using visual analog scale (VAS) score and Oswestry Disability Index (ODI). Bilateral foramen areas, disc height, segmental coronal and sagittal angle, and regional sagittal angle were measured. Additionally, fusion rate was assessed. Results : A total of 90 patients, 116 levels, were underwent DLIF. The VAS and ODI improved statistically significant after surgery. All the approaches for DLIF were done on the left side. The left and right side foramen area changed from $99.5mm^2$ and $102.9mm^2$ to $159.2mm^2$ and $151.2mm^2$ postoperatively (p<0.001). Pre- and postoperative segmental coronal and sagittal angles changed statistically significant from $4.1^{\circ}$ and $9.9^{\circ}$ to $1.1^{\circ}$ and $11.1^{\circ}$. Fusion rates of 6 and 12 months were 60.9% and 87.8%. Complications occurred in 17 patients (18.9%). However, most of the complications were resolved within 2 months. Conclusion : DLIF is not only effective for indirect decompression and deformity correction but also shows satisfactory mechanical stability and fusion rate.

Outcome Analysis of the Patients with and without Anterior Plating in Multi-Level Degenerative Cervical Diseases (다분절 퇴행성 경추질환에서의 전방 금속판 사용 유무에 따른 환자의 예후분석)

  • Kim, Sang Woo;Kim, Sung Min;Shin, Dong Ik;Cho, Yong Jun;Shim, Young Bo;Choi, Sun Kil
    • Journal of Korean Neurosurgical Society
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    • v.30 no.12
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    • pp.1369-1374
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    • 2001
  • Objectives : The rates of pseudarthrosis for two- and three level fusion have been reported to be 17-63 and 50% without anterior cervical plating. The purpose of this study is to assess the effects of anterior cervical plating in the treatment of multilevel degenerative cervical disease such mostly the additional risks associated with hardware implants and its benefits, fusion rate and radiographic results, and clinical outcomes. Methods : Forty-seven patients who underwent operations between 1993 and 1997 were retrospectively reviewed. The technique for operation was same for both groups(Smith Robinson with autologous iliac bone graft). Group I consisted of 35 consecutive patients treated with anterior cervical decompression and fusion with anterior cervical plate fixation. Group II consisted of 12 consecutive patients treated without plate fixation. We compared clinical outcomes by Prolo score, radiographic results in the rate of fusion, cervical lordosis by Gore angle, disc height by Farfan method, and surgical complications between two groups. Results : The favorable clinical outcomes(excellent and good) by Prolo score were observed with the use of anterior cervical plate fixation(89% vs 75%). The successful fusion rate of multilevel cervical fusion was as seen with anterior cervical plate fixation(97% vs 75%). The overall graft complication rate in multilevel fusions was decreased, with anterior cervical plate fixation, and the hardware related complications were relatively minimal without serious consequences. Conclusion : Anterior cervical plate fixation in the treatment of multilevel cervical disorders is an effective stabilizing method which provides increased bony fusion rate, decreased graft complications, maintained cervical lordosis, early mobilization of the these patients without serious hardware related complications.

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Comparison between Instrumented Mini-TLIF and Instrumented Circumferential Fusion in Adult Low-Grade Lytic Spondylolisthesis : Can Mini-TLIF with PPF Replace Circumferential Fusion?

  • Kim, Jin-Sung;Kim, Dong-Hyun;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • v.45 no.2
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    • pp.74-80
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    • 2009
  • Objective : To evaluate clinical and radiological results of two different fusion techniques in adult low-grade isthmic spondylolisthesis. Methods : Between November 2003 and December 2004, 46 consecutive patients underwent instrumented mini-transforaminal lumbar interbody fusion (mini-TLIF) (group I) at Wooridul Spine Hospital, Seoul, Korea. Between February 2003 and October 2006, 32 consecutive patients underwent instrumented circumferential fusion (group II) at Leon Wiltse Memorial Hospital, Suwon, Korea. The mean follow-up periods were 29.7 and 26.1 months, respectively. Results : Mean visual analog scale (VAS) scores for back and leg pain decreased, respectively, from 6.98 and 6.33 to 2.3 and 2.2 in group I and from 7.38 and 6.00 to 1.7 and 1.0 in group II. Mean Oswestry disability index (ODI) improved from 51.85% to 14.4% in group I and from 60% to 9.1% in group II. In both groups, VAS and ODI scores significantly changed from pre- to postoperatively (p<0.001), but postoperative outcome between groups was statistically not significant. Radiologic evidence of fusion was noted in 95.7% and 100% of the patients in group I and II, respectively. In both groups, changes in disc height, segmental lordosis, degree of listhesis, and whole lumbar lordosis between the pre- and postoperative periods were significant except whole lumbar lordosis in both groups. Conclusion : Clinical and functional outcomes demonstrate no significant differences between groups in treating back and leg pain of adult patients with low-grade isthmic spondylolisthesis. However, in terms of operative data (i.e. operation time and hospital stay), instrumented mini-TLIF demonstrated better results.

Lateral Lumbar Interbody Fusion and in Situ Screw Fixation for Rostral Adjacent Segment Stenosis of the Lumbar Spine

  • Choi, Young Hoon;Kwon, Shin Won;Moon, Jung Hyeon;Kim, Chi Heon;Chung, Chun Kee;Park, Sung Bae;Heo, Won
    • Journal of Korean Neurosurgical Society
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    • v.60 no.6
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    • pp.755-762
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    • 2017
  • Objective : The purpose of this study is to describe the detailed surgical technique and short-term clinical and radiological outcomes of lateral lumbar interbody fusion (LLIF) and in situ lateral screw fixation using a conventional minimally invasive screw fixation system (MISF) for revision surgery to treat rostral lumbar adjacent segment disease. Methods : The medical and radiological records were retrospectively reviewed. The surgery was indicated in 10 consecutive patients with rostral adjacent segment stenosis and instability. After the insertion of the interbody cage, lateral screws were inserted into the cranial and caudal vertebra using the MISF through the same LLIF trajectory. The radiological and clinical outcomes were assessed preoperatively and at 1, 3, 6, and 12 months postoperatively. Results : The median follow-up period was 13 months (range, 3-48 months). Transient sensory changes in the left anterior thigh occurred in 3 patients, and 1 patient experienced subjective weakness; however, these symptoms normalized within 1 week. Back and leg pain were significantly improved (p<0.05). In the radiological analysis, both the segmental angle at the operated segment and anterior disc height were significantly increased. At 6 months postoperatively, solid bony fusion was confirmed in 7 patients. Subsidence and mechanical failure did not occur in any patients. Conclusion : This study demonstrates that LLIF and in situ lateral screw fixation may be an alternative surgical option for rostral lumbar adjacent segment disease.

A STUDY ON THE MORPHOLOGY OF MANDIBULAR CONDYLE (MRI를 이용한 한국인 하악과두의 형태에 관한 연구)

  • Lee, Doo-Hee;Oh, Soon-Ho;Suh, Chang-Ho;Kim, Joon-Bae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.5
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    • pp.423-427
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    • 2001
  • Objective: This study was prepared to figure out a certain dimension and morphology of the condyle at the central, medial and lateral aspects on MR images of asymptomatic volunteers, which could be comparable with those of the TMD patients' condyle. Materials: Sixty TMJs from 30 asymptomatic volunteers(15 male, 15 female) who had no clinical symptoms and no disc displacement on sagital and coronal view of MRI were served as normal. Method: MR images were taken from the asymptomatic volunteers and the dimension of the anteroposterior length, mediolateral width, height, convexities were measured through the images on the sagittal and coronal sections of mandibular condyle. Then, these data were collected and analyzed. Result: The mean value of anteroposterior length was $8.00{\pm}1.21mm$ at central section and mediolateral length was $21.40{\pm}2.32mm$ on coronal view. The anterior condylar length at medial side was the shortest and the convexity of anterior slop at the lateral side was proved to be the flattest among 3 sections. There were little dimensional and morphological differences at sagittal sections, but the mediolateral width of condyle at coronal section was significantly different between male and female. Conclusion: In sagittal sections, the anterior condyle length was shortest at medial side and the convexity of anterior slop was flattest at lateral side, and there were little dimensional and morphologic differences between male and female. In coronal section, male's condyle was more wider and flatter than female's.

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A New Gerbera Variety "Red Line"; High-yielding Cultivar with Red and Semi-double for Cut-flower (적색 대륜 반겹꽃 절화용 다수성 거베라 신품종 "레드라인")

  • Park, Sang Kun;Lim, Jin Hee;Shin, Hak Ki;Kim, Mi Seon;Joung, Hyang Young;Cho, Hae Ryong;Rhee, Hye Kyung
    • Korean Journal of Breeding Science
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    • v.41 no.4
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    • pp.591-594
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    • 2009
  • A new gerbera variety "Red Line" was released by the National Institute of Horticultural & Herbal Science (NIHHS) in 2008. A cross was made between "Mirage" with orange and double and "Rose" with red and semi-double in 2005. After investigation of the characteristics for four years (from 2005 to 2008), it was selected specially for the use of cut flower. "Red Line" is a vigorous cultivar with red (RHS R44B), black center and semi-double. The average flower diameter is 12.7 cm, large flower. And inner ray floret and disc diameter are 8.10 cm and 2.80 cm, respectively. It produces a large yield with continuous supply of flowers and has adequate peduncle height. We believe that "Red Line" has a great potential for expanding cultivated area of domestic gerbera cultivars and increasing farmers-income.

A New Gerbera Cultivar 'Lovely Moon' : High-yielding Cultivar with Yellow and Semi-double for Cut-flower (대륜계통의 황색 반겹꽃 절화용 다수성 거베라 신품종 'Lovely Moon')

  • Park, Sang Kun;Lim, Jin Hee;Shin, Hak Ki;Kim, Mi Seon;Joung, Hyang Young;Cho, Hae Ryong;Rhee, Hye Kyung
    • FLOWER RESEARCH JOURNAL
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    • v.17 no.4
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    • pp.316-319
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    • 2009
  • A new gerbera cultivar 'Lovely Moon' was released by the National Institute of Horticultural & Herbal Science (NIHHS) in 2008. A cross was made between 'Sever Line' and 'Angel' with yellow and semi-double flower in 2005. After investigation of the characteristics for four years (from 2005 to 2008), it was selected specially for the use of cut flowers. 'Lovely Moon' is a vigorous cultivar with yellow (RHS Y13B), yellow green center and semi-double flower. The average flower diameter is 12.7 cm, a large flower. And inner ray floret and disc diameter are 6.10 cm and 2.80 cm, respectively. It produces a large number of flowers with continuous supply of flowers and has a long peduncle height. We believe that 'Lovely Moon' has a great potential for expanding cultivated area of domestic gerbera cultivars and increasing farm income.

A New Yellow and Semi-double Gerbera Cultivar 'Sunny Lemon' with Early Flowering and High Yielding (조기개화성 및 다수성 황색 반겹꽃 거베라 신품종 'Sunny Lemon')

  • Park, Sang Kun;Lim, Jin Hee;Choi, Seong Youl;Shin, Hak Ki;Lee, Jung Soo
    • Korean Journal of Breeding Science
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    • v.42 no.6
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    • pp.703-706
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    • 2010
  • A new gerbera cultivar 'Sunny Lemon' was released by the National Institute of Horticultural and Herbal Science (NIHHS) in 2009. A cross was made between 'Pavlov' and 'Patrick' with pink and semi-double in 2006. After investigation of the characteristics for four years (from 2006 to 2009), it was selected for the use of cut flower. 'Sunny Lemon' is a vigorous cultivar with yellow flower color (RHS Y9C), brown center and semi-double. The average flower diameter is 11.0 cm. And inner ray floret and disc diameter are 7.63 cm and 2.59 cm, respectively. Days to first blooming are 84.5, approximately 2 weeks earlier than the standard cultivar. It produces a large yield with continuous supply of cut flowers and has adequate peduncle height. We believe that 'Sunny Lemon' has a great potential for expanding cultivated area of domestic gerbera cultivars and increasing farmers' income.