• Title/Summary/Keyword: Spinal Cord Removal

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Lumbar Schwannoma Associated with Hydrocephalus

  • Kim, Young-Don;Kim, Dae-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.37 no.3
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    • pp.228-231
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    • 2005
  • We describe a rare case of 52-year-old woman with lumbar schwannoma associated with hydrocephalus. In our case, the signs and symptoms of intracranial hypertension were not resolved even after the complete removal of the lumbar schwannoma. We also reviewed the literature on the association of hydrocephalus with spinal cord tumor.

Increased Intraoperative Motor Evoked Potentials and Motor Recovery after Spinal Cord Tumor Removal (척수 종양 제거 술 중 운동유발전위의 호전과 근력 호전의 관계)

  • Pyo, Soeun;Park, Yoon Ghil;Park, Jinyoung;Ko, Eu Jeong
    • Journal of Electrodiagnosis and Neuromuscular Diseases
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    • v.20 no.2
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    • pp.98-105
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    • 2018
  • Objective: To evaluate whether the increase of the amplitude of motor evoked potentials (MEPs) during surgery can imply favorable prognosis postoperatively in spinal cord tumor surgery. Method: MEPs were monitored in patients who underwent spinal cord tumor surgery between March 2016 and March 2018. Amplitude changes at the end of monitoring compared to the baselines in limb muscle were analyzed. Minimum and maximum changes were set to $MEP_{min}$ (%) and $MEP_{max}$ (%). Strengths of bilateral 10 key muscles which were documented a day before ($Motor_{pre}$), 48 h ($Motor_{48h}$) and 4 weeks ($Motor_{4wk}$) after the surgery were reviewed. Results: Difference of $Motor_{48h}$ from $Motor_{pre}$ ($Motor_{48h-pre}$) and $Motor_{4wk}$ from $Motor_{pre}$ ($Motor_{4wk-pre}$) positively correlated with $MEP_{min}$, suggesting that smaller the difference of MEPs amplitude, less recovery of muscle strength. There was a negative correlation between the amount of bleeding and $MEP_{min}$, indicating that the greater the amount of bleeding, the smaller the $MEP_{min}$, implying that MEPs amplitude is less likely to improve when the amount of bleeding is large. It also showed significant difference between patients with improved or no change of motor status and patients with motor deterioration after surgery according to anatomical tumor types. Conclusion: Improve of muscle strength was less when the increase of MEPs amplitude was small, and improvement of MEPs amplitude was less when the amount of bleeding was large. Correlation between changes of status of muscle strength after surgery and tumor types was observed. With amplitude increase in MEPs monitoring, restoration of muscle strength can be expected.

Spontaneous Spinal Epidural Hematoma with Intraoperative Acute Massive Bleeding - Case Report - (수술중 급성 대량 출혈을 동반한 자발성 척추경막외혈종 - 증 례 보 고 -)

  • Kim, Hyoung Jong;Hwang, Soo Hyun;Park, In Sung;Kim, Eun-Sang;Jung, Jin-Myung;Han, Jong Woo
    • Journal of Korean Neurosurgical Society
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    • v.29 no.9
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    • pp.1184-1187
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    • 2000
  • Spontaneous spinal epidural hematoma is rare disease and usually presents with a progressive neurological syndrome for which surgical decompression is usually indicated. The cause of bleeding in epidural hematoma remains unknown in most of the cases. The most frequently identified risk factor is coagulopathy or treatment with anticoagulants. Recently, authors experienced a case of spontaneous spinal epidural hematoma with intraoperative profuse bleeding at the cervicothoracic location. Laboratory examination showed no evidence of coagulopathy or hepatic disease. On neurologic examination, left hemiparesis(Grade : II) and left side sensory change were noted. On MRI scan, there was a mass of high signal intensity in T2WI and isosignal intensity in T1WI compressing the cord to left side. The patients had good surgical outcome after decompressive laminectomy and hematoma removal.

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Spinal Intradural Extramedullary Cavernoma Presenting with Intracranial Superficial Hemosiderosis

  • Jin, Yong-Jun;Chung, Sang-Bong;Kim, Ki-Jeong;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.49 no.6
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    • pp.377-380
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    • 2011
  • A case of intradural extramedullary cavernous angioma is presented with headache, dizziness, and bilateral sensorineural hearing loss caused by an intracranial superficial hemosiderosis. It was incidentally found in a patient with a 3-month history of sustained headache, dizziness and a 3-year history of hearing difficulty. The neurological examination was unremarkable in the lower extremity. MR images showed an intracranial superficial hemosiderosis mostly in the cerebellar region. Myelography and MR images of the thoracolumbar spine revealed an intradural extramedullary mass, which was pathologically proven to be a cavernous angioma. T12 total laminoplastic laminotomy and total tumor removal were performed without any neurologic deficits. The patient's symptoms, including headache and dizziness, have been absent for three years. Intradural extramedullary cavernous angioma can present with an intracranial superficial hemosiderosis as a result of chronic subarachnoid hemorrhage.

"DUMBBELL" Neurilemmoma -A Case Report- ("DUMBBELL" 신경종양 -1례 보고-)

  • Park, Jin-Seok;Im, Seung-Pyeong;Kim, Gwan-Tae
    • Journal of Chest Surgery
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    • v.27 no.6
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    • pp.502-505
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    • 1994
  • Neurogenic tumors of the mediastinum may have an intraspinal component connected by a narrowed segment of tumor in the intervertebral foramen,hence the descriptive term dumbbell.Recently we had an occasion to remove a dumbbell neurilemmoma in a 62 years old woman using an approach designed to allow wide posterolateral thoracotomy and concomitant laminectomy for a single stage removal of the entire tumor. The mass in the posterior mediastinum was discovered on routine chest roentgenography. CT scan demonstrated a dumbbell shaped soft tissue mass density compressing spinal canal but preserving spinal cord. There were no neurologic signs. A standard posterolateral thoracotomy incision was made to remove tumor mass and then T5 unilateral laminectomy has done by Neurosurgeon. 7 x 7 cm sized extrapleural neurilemmoma was round, cystic, soft mass which covered parietal pleural with invaded regional vertebrae. There was no postoperative neurological complication.

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Evaluation of Experimentally Induced Lumbar Spinal Cord Injury by Somatosensory Evoked Potentials(SEPs) in Dogs (개에서 Somatosensory Evoked Potentials (SEPs)을 이용한 척수기능장애의 평가)

  • Lee, Joo-Myoung;Jeong, Seong-Mok;Kweon, Oh-Kyeong;Nam, Tchi-Chou
    • Journal of Veterinary Clinics
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    • v.18 no.4
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    • pp.315-323
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    • 2001
  • Changes in somatosensory evoked potentials (SEPs) which accompanied by insertion of foreign body in spinal canal were evaluated with clinical signs and positive contrasted myelography in dogs. Foreign bodies occupied 20∼50% of spinal canal. Foreign bodies occupying about 50% of spinal canal were inserted into the animals of group II and III for 1 week and 2 days, respectively. Foreign bodies occupying about 20% of spinal canal were inserted into the animals of group IV, V, and for 1 week, 2 days, and 8 weeks, respectively. in group I (control group), sham operation (lateral laminectomy) was performed. Group III, IV and V did not severely affect on SEPs latencies and clinical signs. Group VI affects on SEPs latencies but not on clinical signs. After foreign body removal, SEPs latencies showed similar recovery patterns with clinical signs. However, group II induced severe abnormalities in SEPs latencies and clinical signs. In group III, IV and V, thoracic potentials (TN1) were abnormally recorded after foreign body insertion and firstly/normally recorded on the 6th 9.5th and 3.5th day after foreign body (removal following) insertion. In group VI, TN1 was abnormally recorded after foreign body insertion and firstly recorded on the 7.7th day and normally recorded on 34th day after foreign body insertion. In group I, TN1 was not recorded from the 3rd day after foreign body insertion and until the 8th week after foreign body removal. In group I, TN1 was firstly recorded on the 1st day after laminectomy.

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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.

Primary Intramedullary Spinal Sarcoma : A Case Report and Review of the Current Literatures

  • Kim, Su-Hyeong;Bak, Koang-Hum;Kim, Dong-Won;Kang, Tae-Hoon
    • Journal of Korean Neurosurgical Society
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    • v.48 no.5
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    • pp.448-451
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    • 2010
  • Primary central nervous system (CNS) sarcomas are exceedingly rare, and, to the best of our knowledge, there has not yet been a report of intramedullary sarcoma. Here, we report a primary intradural intramedullary sarcoma of the spinal cord in a four-year-old boy who presented with low back pain and a radiculopathy involving both lower extremities. The tumor showed significant enhancement on magnetic resonance (MR) images due to its extreme vascularity. Gross total tumor removal was performed with microelectrical pulse recording, and the patient also received adjuvant radiotherapy and chemotherapy. After the operation, the patient's sensory deficits were improved. Because CNS dissemination is common, entire neuraxis evaluation is essential, although there was no evidence of dissemination in this case. The prognosis of primary CNS sarcoma is poor due to infiltrative nature and early CNS dissemination is common, and the treatment of choice is radical surgical resection. Adjuvant therapy is also beneficial with radiotherapy and chemotherapy.

Mini-partial lateral corpectomy and hemilaminectomy for the treatment of heavily protruded thoracolumbar intervertebral disc in small dogs

  • Han, Hyun-Jung;Yoon, Hun-Young
    • Korean Journal of Veterinary Research
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    • v.59 no.4
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    • pp.213-217
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    • 2019
  • Five paraplegic dogs were diagnosed with thoracolumbar intervertebral disc disease with more than 50% compression of spinal cord. Because the lesions were determined to be disc extrusion on magnetic resonance imaging, a hemilaminectomy was initially performed, however, protruded discs were confirmed during surgery. To remove the protruded disc, modified partial lateral corpectomy (mini-PLC) was additionally performed. All dogs recovered to full ambulation within a median of 44 days without temporary deterioration or vertebral instability. Mini-PLC as described here enables successful removal of the protruded disc, while preserving vertebral stability in dogs for whom the use of hemilaminectomy is inevitable.

Minimally invasive percutaneous endoscopic thoracolumbar foraminotomy in large-breed dogs-a comparative study

  • Soo Hee Lee;Soo Young Choi;Ho Hyun Kwak;Heung Myong Woo
    • Korean Journal of Veterinary Service
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    • v.47 no.2
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    • pp.61-72
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    • 2024
  • This study aimed to evaluate the feasibility of percutaneous endoscopic foraminotomy (PEF) for the treatment of intervertebral disc herniation of the thoracolumbar spine in large-breed dogs by comparing it with open hemilaminectomy (OH). Six large-breed canine cadavers were used in the present study. A barium and agarose mixture (BA-gel) simulating intervertebral disc herniation was injected into the spinal canal at two intervertebral spaces (T12-T13, L2-L3) of the thoracolumbar spine in each cadaver. PEF and OH were randomly allocated to the sites in each cadaver. Computed tomography was performed pre- and postoperatively. The incision length, vertebral window size, procedure time, and amount of simulated disc material removed were recorded to compare PEF and OH. Both procedures clearly exposed the simulated disc material and spinal cord. The size of the incision and vertebral window created after PEF was much smaller than those after OH. The surgical duration of PEF was longer than that of OH. However, no significant difference (P>0.05) was observed in the amount of BA-gel removed between PEF and OH. Thus, PEF could be used as an effective surgical option for intervertebral disc herniation of the thoracolumbar region in large-breed dogs in that it could lead to less tissue damage as well as sufficient removal of the simulated disc material.