• Journal of Korean Neurosurgical Society
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• v.47 no.5
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• pp.338-344
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• 2010

Objective : This study assessed the safety and efficacy of one level unilateral laminotomy bilateral decompression (ULBD) with the placement of a device for intervertebral assisted motion (DIAM) compared with one level ULBD only in elderly patients with degenerative lumbar spinal stenosis (DLSS). Methods : A non randomized prospective analysis was performed on 16 patients who underwent one level ULBD with DIAM (Group A) and 20 patients with one level ULBD only (Group B) between February 2007 and March 2008. Radiographic imaging, visual analog scale (VAS) and MacNab outcome scale were obtained before and after surgery at a mean interval of 21 months (range 17-27 months). Results : The disc height, interpedicular distance, slip distance and segmental lordotic angle were similar between two groups. In the group A, there was no significant difference between the pre- and post-operative imaging in terms of the sagittal balance and disc height. Both groups showed significant improvement in the clinical outcomes. In addition, there was significantly less low-back pain in the group A than in the group B at the last follow up, while the clinical improvement of the leg pain and MacNab outcome scale showed no significant difference in the two groups. There were no major complications or DIAM associated complications. Conclusion : ULBD with DIAM is a safe and efficacious treatment for selective elderly patients with DLSS, particularly for relieving low back pain comparing to ULBD. ULBD with DIAM did not alter the disc height or sagittal alignment at the mean 21 months follow-up interval.

• Journal of Veterinary Clinics
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• v.22 no.4
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• pp.302-308
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• 2005

This study was performed to examine the absolute skin temperature and temperature difference $({\Delta}T)$ between the left and the right, the upper and the lower parts on the back of dog and to investigate the clinical usefulness of infrared thermography as diagnostic or prognostic aid on experimental spinal cord compression by using Digital Infrared Imaging System. In normal dogs, symmetrical and contouring patterns were observed in thermogram. The skin temperature difference was not significant between the left and the right, the upper and the lower parts on the back. In spinal cord compressed dog, there was symmetrical temperature reduction pattern around lesion. Patterns of ${\Delta}T$ between thoracic and lumbar portions were remarkable and showed the tendency to return to normal after 4 weeks of operation. It is considered that infrared thermography is a useful diagnostic and prognostic aid for spinal cord injury in dogs.

• Journal of the Korean Orthopaedic Association
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• v.55 no.4
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• pp.348-353
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• 2020

A 68-year-old man presented with a bed sore with pus discharge on lower back. Radiographs showed extensive destruction of the L4 vertebral body. Magnetic resonance imaging (MRI) showed fluid collection with an enhanced wall at the defect of the L4 vertebral body extending into both psoas muscles. The primary diagnosis was neuropathic spondylopathy, but infective spondylitis was not ruled out. Initially, he was treated with antibiotics for two weeks. A follow-up MRI showed no improvement of the abscess, so surgical exploration was done. Charcot spinal arthropathy resulted in extensive vertebral body destruction that may be similar to infectious spondylitis, particularly in the case with fluid accumulation due to rupture of dura.

• The Korean Journal of Pain
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• v.34 no.2
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• pp.193-200
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• 2021

Background: Local anesthetic infiltration at the site of a surgical wound is commonly used to control postoperative pain. In this study, we examined the effectiveness of continuous local infiltration at an abdominal surgical site in patients undergoing anterior lumbar interbody fusion (ALIF) surgery. Methods: Sixty-one patients who underwent ALIF surgery were enrolled. For thirtyone of them, a continuous local anesthetics infiltration system was used at the abdominal site. We collected data regarding the patients' sleep quality; satisfaction with pain control after surgery; abilities to perform physical tasks and the additional application of opioids in the postoperative 48 hours. Results: The On-Q system group showed reduced visual analogue scale scores for pain at the surgical site during rest and movement at 0, 12, 24, and 48 hours; and more was satisfied with pain control management at the first postoperative day (7.0 ± 1.2 vs. 6.0 ± 1.4; P = 0.003) and week (8.1 ± 1.6 vs. 7.0 ± 1.8; P = 0.010) than the control group. The number of additional patient-controlled analgesia (PCA) bolus and pethidine injections was lower in the On-Q group (PCA: 3.67 ± 1.35 vs. 4.60 ± 1.88; P = 0.049 and pethidine: 2.09 ± 1.07 vs. 2.73 ± 1.38; P = 0.032). Patients who used the On-Q system performed more diverse activity and achieved earlier ambulation than those in the control group. Conclusions: Continuous wound infiltration with ropivacaine using an On-Q system may be effective for controlling postoperative pain after ALIF surgery.

• Journal of Korean Neurosurgical Society
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• v.52 no.4
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• pp.281-287
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• 2012

Objective : To evaluate the effect of calcium supplementation on spinal bone fusion in ovariectomized (OVX) rats. Methods : Sixteen female Sprague Dawley rats underwent bilateral ovariectomy at 12 weeks of age to induce osteoporosis and were randomly assigned to two groups : control group (n=8) and calcium-supplemented group (OVX-Ca, n=8). Autologous spinal bone fusion surgery was performed on both groups 8 weeks later. After fusion surgery, the OVX-Ca group was supplemented with calcium in drinking water for 8 weeks. Blood was obtained 4 and 8 weeks after fusion surgery. Eight weeks after fusion surgery, the rats were euthanized and the L4-5 spine removed. Bone fusion status and fusion volume were evaluated by manual palpation and three-dimensional computed tomography. Results : The mean fusion volume in the L4-5 spine was significantly greater in the OVX-Ca group ($71.80{\pm}8.06mm^3$) than in controls ($35.34{\pm}8.24mm^3$) (p<0.01). The level of osteocalcin, a bone formation marker, was higher in OVX-Ca rats than in controls 4 weeks ($610.08{\pm}10.41$ vs. $551.61{\pm}12.34$ ng/mL) and 8 weeks ($552.05{\pm}19.67$ vs. $502.98{\pm}22.76$ ng/mL) after fusion surgery (p<0.05). The level of C-terminal telopeptide fragment of type I collagen, a bone resorption marker, was significantly lower in OVX-Ca rats than in controls 4 weeks ($77.07{\pm}12.57$ vs. $101.75{\pm}7.20$ ng/mL) and 8 weeks ($69.58{\pm}2.45$ vs. $77.15{\pm}4.10$ ng/mL) after fusion surgery (p<0.05). A mechanical strength test showed that the L4-5 vertebrae in the OVX-Ca group withstood a 50% higher maximal load compared with the controls (p<0.01). Conclusion : Dietary calcium given to OVX rats after lumbar fusion surgery improved fusion volume and mechanical strength in an ovariectomized rat model.

• Journal of Veterinary Clinics
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• v.27 no.5
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• pp.588-592
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• 2010

A 15-year-old neutered male Yorkshire terrier was presented with a gait disorder of the pelvic limbs. For differential diagnosis of neural disease, magnetic resonance imaging (MRI) and computed tomography (CT) scan were performed. CT showed bone defect in the 4th lumbar vertebra and adjacent soft tissue mass. MRI revealed a mass in left side of the 4th lumbar vertebra. The mass was uniformly enhanced on contrast-enhanced T1-weighted imaging (T1W1). Excision of the mass alleviated back pain. Vertebral osteosarcoma was identified by the histopathological examination. Therefore, CT and MRI were helpful to diagnose vertebral osteosarcoma in the dog and to plan surgical excision of the mass.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.16 no.2
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• pp.79-86
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• 2021

Objectives This study aimed to assess the role of complex Korean medicinal treatment with Chuna manual therapy in two patients with chronic pain after posterior lumbar fusion surgery. Methods A retrospective analysis was performed on 2 patients postoperatively based on their medical records. The surgery regions were verified using T2-weighted axial magnetic resonance imaging. Patients with chronic pain after spondylolisthesis posterior lumbar fusion surgery received complex Korean medicinal treatment with Chuna manual therapy during hospitalization. Numeric rating scale (NRS) in the degree of 0-10 and Oswestry disability index (ODI) were measured before and after treatment. Results Case 1 had an improved NRS score from 7 to 4, and Case 2 had an improved NRS score from 7 to 5. In addition, ODI score improved in both cases. Conclusions Complex Korean medicinal treatment with Chuna manual therapy is effective for relief from chronic pain after posterior lumbar fusion surgery.

• Asian Spine Journal
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• v.12 no.6
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• pp.1043-1052
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• 2018

Study Design: Level III retrospective cross-sectional study. Purpose: To define and characterize the presentation, symptom duration, and patient/surgical risk factors associated with 'post-decompressive neuropathy (PDN).' Overview of Literature: PDN is characterized by lower extremity radicular pain that is 'different' from pre-surgical radiculopathy or claudication pain. Although it is a common constellation of postoperative symptoms, PDN is incompletely characterized and poorly understood. We hypothesize that PDN is caused by an intraoperative neuropraxic event and may develop early (within 30 days following the procedure) or late (after 30 days following the procedure) within the postoperative period. Methods: Patients who consented to undergo lumbar laminectomy with or without an instrumented fusion for degenerative lumbar spine disease were followed up prospectively from July 2013 to December 2014. Relevant data were extracted from the charts of the eligible patients. Patient demographics and surgical factors were identified. Patients completed postoperative questionnaires 3 weeks, 3 months, 6 months, and 1 year postoperatively. Questions were designed to characterize the postoperative pain that differed from preoperative pain. A diagnosis of PDN was established if the patient exhibited the following characteristics: pain different from preoperative pain, leg pain worse than back pain, a non-dermatomal pain pattern, and nocturnal pain that often disrupted sleep. A Visual Analog Scale was used to monitor the pain, and patients documented the effectiveness of the prescribed pain management modalities. Patients for whom more than one follow-up survey was missed were excluded from analysis. Results: Of the 164 eligible patients, 118 (72.0%) completed at least one follow-up survey at each time interval. Of these eligible patients, 91 (77.1%) described symptoms consistent with PDN. Additionally, 75 patients (82.4%) described early-onset symptoms, whereas 16 reported symptoms consistent with late-onset PDN. Significantly more female patients reported PDN symptoms (87% vs. 69%, p=0.03). Patients with both early and late development of PDN described their leg pain as an intermittent, constant, burning, sharp/stabbing, or dull ache. Early PDN was categorized more commonly as a dull ache than late-onset PDN (60% vs. 31%, p=0.052); however, the difference did not reach statistical significance. Opioids were significantly more effective for patients with early-onset PDN than for those with late-onset PDN (85% vs. 44%, p=0.001). Gabapentin was most commonly prescribed to patients who cited no resolution of symptoms (70% vs. 31%, p=0.003). Time to symptom resolution ranged from within 1 month to 1 year. Patients' symptoms were considered unresolved if symptoms persisted for more than 1 year postoperatively. In total, 81% of the patients with early-onset PDN reported complete symptom resolution 1 year postoperatively compared with 63% of patients with late-onset PDN (p=0.11). Conclusions: PDN is a discrete postoperative pain phenomenon that occurred in 77% of the patients who underwent lumbar laminectomy with or without instrumented fusion. Attention must be paid to the constellation and natural history of symptoms unique to PDN to effectively manage a self-limiting postoperative issue.

• Journal of Korean Neurosurgical Society
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• v.50 no.5
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• pp.415-419
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• 2011

Objective : The purpose of this study was to investigate the possible association of estrogen receptor alpha ($ER{\alpha}$) gene polymorphisms in a cohort of degenerative spondylolisthesis (DS) patients. Methods : Accordingly, the authors examined the association between DS and $ER{\alpha}$ gene polymorphisms in 174 patients diagnosed with DS. The $Pvu$ $II$ and $Xba$ $I$ polymorphisms, bone mineral density at the lumbar spine and femoral neck, and biochemical markers were analyzed and compared in the 174 patients with DS and 214 patients with spinal stenosis (SS). Results : A comparison of genotype frequencies in DS and SS patients revealed a significant difference for the $Pvu$ $II$ polymorphism only ($p$=0.0452). No significant difference was found between these two groups with respect to the $Xba$ $I$ polymorphism, BMD or biochemical markers. No significant association was found between the$Pvu$ $II$ polymorphism of $ER{\alpha}$ and BMD, vertebral slip or biochemical markers in patients with DS. Conclusion : These results suggest that the $ER{\alpha}$ gene polymorphism using $Pvu$ $II$ restriction enzyme influences the prevalence of DS.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.3 no.1
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• pp.9-18
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• 2008

Objective : The purpose of this study is to evaluate the conservative treatment for FBSS patient. Methods : We used Herbal medication, Acupuncture, burning Acupuncture, Physical Therapy for this patient. And we measured of VAS and ODI score to evaluate treatment effects. Results : Patient's sciatica and sensory test has improved. VAS and ODI score were also decreased.