• Title/Summary/Keyword: neurogenic pain

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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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Clinical Evaluation of the Primary Mediastinal Tumors and Cysts (원발성 종격동 종양 및 낭종의 임상적 고찰)

  • 이재덕;이계선
    • Journal of Chest Surgery
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    • v.29 no.7
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    • pp.763-768
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    • 1996
  • This report is an analysis of 43 cases of primary mediastinal tumors and cysts which were treated in the Department of Thoracic and Cardiovascular Surgery, Tae Jeon Eul li General Hospital from January, 1986 to April, 1995. There were 19 males and 24 females, and their ages ranged from 4 years to 68 years, with mean age of 31.3 years. The most common symptoms were dyspnea 48.8%, chest disconyort 39.5%, cough )4.9%, and chest pain 23.3%, and the most frequently encountered location of tumor was anterior mediastinum followed by posterior, and middle mediastinum. From the pathologic viewpoint, teratoma was the most frequent type followed by neurogenic tumors, cysts, thymoma, and Iymphoma. The most useful diagnostic method was plain X-ray examination of the chest, and final diagnosis could usually be made only after an operation. All of benign tumors were completely removed and malignant tumors were treated with chemotherapy and radiotherapy after operation There were 7 (16.3 %) cases of postoperative complications, and there was no postoperative mortality.

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Clinical Evaluation of Mediastinal Tumors and Cysts - 50 cases report - (종격동 종양 및 낭종의 임상적 고찰: 50례 보고)

  • 오창근
    • Journal of Chest Surgery
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    • v.24 no.3
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    • pp.245-252
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    • 1991
  • For the purpose of evaluation of clinical characteristics and histopathological properties in mediastinal tumors and cysts, 50 patients with mediastinal tumors and cysts treated at the department of thoracic and cardiovascular surgery in Chosun University Hospital during the period from January, 1978 to Mach, 1990 were reviewed. The results of this cases analysis were as follows; 1. of all 50 mediastinal tumors and cysts, 27 patients were male and 23 patients were female. There was no sex preference. The age distribution was from 10 months to 84 years, and mean age was 37 years old, and no age preference. 2. Subjective symptoms were as follows : Dyspnea[54%], Chest pain[44%], Coughing [34%] Fever[16%] and General malaise[12%]. Objective signs were as follows: Decreased breathing sound[46%], Pleural effusion and hemothorax[32%], Palpable neck mass[24%] and SVC syndrome[14%]. But, there were no definitive symptoms in 5 cases[10%]. 3. The most frequently encountered tumors were teratodermoid tumors[26%] followed by lymphomas[22%], thymomas[12%] and benign cysts[8%] in decreasing order of frequency. 4. Based on the subdivision of the mediastinum, 44% of the tumors were in the anterior mediastinum, 24% in the middle mediastinum, 18% in the superior mediastinum and 14% in the posterior mediastinum. 5. The malignant tumors were 25 cases[50%]. 6. The successful removal was possible in all the benign mediastinal tumors and cysts. In malignant cases, the surgical removal had been 12 cases and inoperable cases were treated to radiation and chemotherapy. 7. Postoperative complications were bleeding, wound infection, pneumothorax and vocal cord paralysis. The recurrence was 3 cases. 8. The most frequent mediastinal tumor in the west is neurogenic tumor but is teratoma in Korea.

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Clinical Experience of Mediastinal Tumors and Cysts (종격동 종양과 낭종의 임상 경험)

  • 최준영;옥창대
    • Journal of Chest Surgery
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    • v.30 no.7
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    • pp.708-712
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    • 1997
  • We report on nine years experience of surgical treatment of mediastinal tumors in 47 patients. Their ages ranged from 5 o 67 years with an average of 36.4 years and the sex ratio of male and female was 1:1.5. The most frequent symptom was chest pain(27.7%), followed by ptosis(14.9%), general weatuless(12.8%) and eight patients(17.0%) were asymptomatic. The most prevalent location of the tumor was anterosuperior mediastinum(63.8%). Pathologically, thymoma(32.9%) was the most common tumor, followed by cyst(21.3%), neurogenic tumor(17.0%), germ cell tumor(12.8%), and mesenchymal tumor(6.4%). Complete removal was achieved in 41 cases of all benign tumors and 3 cases of malignant tumors. All the malignant tumor patients were treated with chemotherapy, radiotherapy or both after surgery. Postoperative complications developed in 4 cases and there was no operative death.

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Clinical Evaluation of the Mediastinal Tumors (종격동 종양의 임상적 고찰)

  • 이준복;서성구
    • Journal of Chest Surgery
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    • v.29 no.10
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    • pp.1148-1151
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    • 1996
  • For the purpose of clinical analysis In mediastinal tumors, 51 patients with mediastinal tumor who were surgically treated from February 1984 to February 1994 in Chunan hospital of Soonchunhyang university were reviewed. There were 21 male and 30 female patients in the study. Age ranges from 11 months to 75 years, with the mean 39.4$\pm$ 18.8 years. Symptoms and signs were asymptom(21.6%), chest d scomfort(19.6%), dyspnea(15.7%), ptosls(15.7%), general weakness(13.7%) and chest pain(9.8%). The most frequent tumor location was anterosuperior mediastinum(60.8%) followed by posterior(25.5%) and middle(13.7%) mediastinum. In the pathological viewpoint, thymoma(33.3%) was the most frequent type followed by neurogenic tumor(25.5%) an'd germ cell tumor(19.6%). All of benign tumors(46 cases) were completely removed and malignant tumors(5 cases) were treated with rAdiotherapy after operation. The postoperative complications were 2 wound dehesences, 1 pneumothorax, 1 vocal cord palsy and 1 prolonged mechanical ventilation.

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Two Cases of Benign Solitary Schwannoma with Pleural Effusion (흉수를 동반한 양성 고립자 신경초종 2예)

  • Cho, Jin-Hoon;Kim, Ki Uk;Park, Hye-Kyung;Jeong, Yeon Joo;Kim, Young Dae;Kim, Yun Seong;Lee, Min Ki;Park, Soon Kew
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.1
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    • pp.78-82
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    • 2007
  • Schwannoma represents approximately 40% of neurogenic tumors arising in the mediastinum, and develops along the sympathetic or parasympathetic chain, intercostals nerve, and spinal ganglia. It is usually asymptomatic, and is confronted accidentally but can produce chest pain, cough and dyspnea. However, dyspnea with pleural effusion is rare in patients with benign schwannoma. We encountered two cases of benign schwannoma with pleural effusion. Both cases had similar initial symptoms and the characteristics of a mass but the characteristics of pleural effusion analysis were different. The benign schwannoma was confirmed in two cases using VATS (video-assisted tharawswpic surgery).

Recent study of Acupuncture in Treatment of Urianry Disturbance (배뇨장애(排尿障碍)에 대한 침구치료(鍼灸治療)의 연구동향(硏究動向))

  • Kim, Kyung-tai;Ko, Young-jin;Kim, Yong-suk;Kim, Chang-hwan
    • Journal of Acupuncture Research
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    • v.22 no.3
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    • pp.123-135
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    • 2005
  • Objective : The aim of this study was to rivew systemically literature and clinical trials in the treatment of urinary incontinence or lower urinary tract syndrome(LUTS). Methods : Computerized literature searches were carried out on two electronic database, and computerized searching on some korea oriental medicine journals in library of Kyung-Hee Medical center. Results : 1. Three reports of review study, six reports of experimental study and fourteen reports of clinical trials were collected and reviewed. Three reports of review study were all printed in the korea oriental medicine journal. From 2000, researches and studies have been increased in quantity and improved in quality. 2. Urinary disturbance include variable symptoms of lower urinary tract symptoms, urinary incontinence, in theaspect of Oriental medicine these symptoms are anurin, dysuria, urinary incontinence, nochumal enuresis, uracratia and so on. 3. Roughly physiological procedure of Acupuncture in Treatment of Urianry Disturbance may be that effect of acupuncture stimulation for parasympathetic nerve, sleep-arousal system in cerebrum, pontine/spinal urination center and pudendal/pelvic nerve affect bladder in expansion of bladder capacity, inhibition of urinary contraction and affection in periurethral muscle by continuous excitement of spinal annular circuit and synapse of neuron. 4. Clinical result for acupuncture treatment in urinary disturbance is summarized that acupuncture treatment in urianation disturbance of Neurogenic Bladder, Incontinence, Cycitis, Nocturnal Enuresis, Prostatitis/Pelvic Pain Syndrom and so on is significant clinical trials and technique. Conclusion : Hereafter, in the old age society these variable urinary disturbance patients are increased and desire of treatment may be also increased. So study of various and formal treatment and tecnnique is needed.

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Preservation of the Posterior Ligaments for Preventing Postoperative Spinal Instability in Posterior Decompression of Lumbar Spinal Stenosis: Comparative Study between Port-Hole Decompression and Subtotal Laminectomy (요추부 척추관 협착증의 후방 감압술에서 후방 인대의 보존 여부와 술 후 척추 불안정성과의 연관성: 포트홀(Port-Hole) 감압술과 후궁 아전절제술 간 비교 연구)

  • Jung, Yu-Hun;Na, Hwa-Yeop;Choe, Saehun;Kim, Jin;Lee, Joon-Ha
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.71-77
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    • 2020
  • Purpose: To determine if sparing the interspinous and supraspinous ligaments during posterior decompression for lumbar spinal stenosis is significant in preventing postoperative spinal instability. Materials and Methods: A total of 83 patients who underwent posterior decompression for lumbar spinal stenosis between March 2014 and March 2017 with a minimum one-year follow-up period, were studied retrospectively. The subjects were divided into two groups according to the type of surgery. Fifty-six patients who underwent posterior decompression by the port-hole technique were grouped as A, while 27 patients who underwent posterior decompression by a subtotal laminectomy grouped as B. To evaluate the clinical results, the Oswestry disability index (ODI), visual analogue scale (VAS) for both back pain (VAS-B) and radiating pain (VAS-R), and the walking distance of neurogenic intermittent claudication (NIC) were checked pre- and postoperatively, while simple radiographs of the lateral and flexion-extension view in the standing position were taken preoperatively and then every six months after to measure anteroposterior slippage (slip percentage), the difference in anteroposterior slippage between flexion and extension (dynamic slip percentage), angular displacement, and the difference in angular displacement between flexion and extension (dynamic angular displacement) to evaluate the radiological results. Results: The ODI (from 28.1 to 12.8 in group A, from 27.3 to 12.3 in group B), VAS-B (from 7.0 to 2.6 in group A, from 7.7 to 3.2 in group B), VAS-R (from 8.5 to 2.8 in group A, from 8.7 to 2.9 in group B), and walking distance of NIC (from 118.4 m to 1,496.2 m in group A, from 127.6 m to 1,481.6 m in group B) were improved in both groups. On the other hand, while the other radiologic results showed no differences, the dynamic angular displacement between both groups showed a significant difference postoperatively (group A from 6.2° to 6.7°, group B from 6.5° to 8.4°, p-value=0.019). Conclusion: Removal of the posterior ligaments, including the interspinous and supraspinous ligaments, during posterior decompression of lumbar spinal stenosis can cause a postoperative increase in dynamic angular displacement, which can be prevented by the port-hole technique, which spares these posterior ligaments.

Periosteal Ewing's Sarcoma of the Rib (늑골 막에 생긴 골 외 유잉 육종)

  • Shin, Dong-Il;Kim, Jung-Tae;Chang, Woon-Ha;Oh, Tae-Yoon;Lee, Won-Jin;Bang, Yun-Yi
    • Journal of Chest Surgery
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    • v.42 no.3
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    • pp.404-407
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    • 2009
  • A 43-yr-old patient visited our department with intermittent chest pain he had suffered with for the past 2 months. Chest CT showed an egg shaped mass in the left chest wall. Local resection was performed for distinguishing the mass from a neurogenic tumor. The diagnosis was periosteal Ewing sarcoma of the rib. Since there was no evidence of metastasis based on the PET-CT, a 2nd operation was done with wide resection and thoracoplasty. The patient was then treated with combined chemotherapy. There has been no local recurrence for the fast 1 year. The patient's age and tumor origin were distinct from the usual characteristics of Ewing's sarcoma. Periosteal Ewing's sarcoma of the rib has rarely been reported. We report here on a case of periosteal Ewing's sarcoma of the rib along with a review of the relevant medical literature.

Clinical Analysis of Primary Mediastinal Tumors (원발성 종격동 종양의 임상적 고찰)

  • 변정욱;조창욱
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.55-60
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    • 1997
  • We reviewed 40 cases of primary mediastinal tumors which were operated on at Seoul Paik Hospital from September, 1987 to December, 1995. Of these, 18 were male and 22 were female. The patient ranged in age from 4 years to 68 years with a mean age of 34.1 years. The most common symptoms included chest pain(12.5%), cough(12.5%), dyspnea(7.5%). and palpable neck mass(7.5%), and symptoms were absent at the time of diagnosis in 37.5% of cases. Chest roentgenography and computed tomography(CT) were performed in all patients, and magnetic resonance imaging(MRI) in 5 patients, and transthoracic needle aspiration (TTNA) performed In 22 patients. The sensitivity of TTNA was 72.7%(16 of 22 patients). The lesion was located 60% in the anterosuperior mediastinum, 35% in the posterior mediastinum, and 5% in the middle mediastinum. The primary tumors included thymic neoplasms(11 cases), germ cell tumors(7 cases), neurogenic tumors(10 cases) and a miscellaneous group. The malignant tumors(12.5%) were invasive thymoma(3 cases), spindle cell sarcoma(1 case), and non-Hodgkin's Iymphoma(1 case). A complete excision was done in all 35 benign tumors and 3 malignant tumors. There was no operative mortality, and postoperative complications occurred in 3 cases.

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