• Title/Summary/Keyword: spinal

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Leiomyosarcoma of the Posterior Mediastinum Extending into the Adjacent Spinal Canal

  • Lee, Deok-Heon;Park, Chang-Kwon;Keum, Dong-Yoon;Kim, Jae-Bum;Hwang, Il-Seon
    • Journal of Chest Surgery
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    • v.45 no.3
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    • pp.192-195
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    • 2012
  • Leiomyosarcoma of the mediastinum and primary leiomyosarcoma of the spine are exceedingly rare. In most cases, spinal leiomyosarcoma is metastatic. In this report, we describe the case of a 58-year-old man who presented with a large leiomyosarcoma of the posterior mediastinum that extended into the adjacent spinal canal. The tumor was completely resected from the mediastinum, but only subtotally removed from the spinal canal because the spinal mass had tightly invaded the spinal cord. Because the patient's postoperative condition was poor, no adjuvant radiotherapy or chemotherapy was administered. He expired 3 months after the surgery due to relapse; the spinal and mediastinal tumor remained at the preoperative size.

Removal of Intradural-Extramedullary Spinal Cord Tumors with Unilateral Limited Laminectomy

  • Sim, Jong-Eun;Noh, Seung-Jin;Song, Young-Jin;Kim, Hyung-Dong
    • Journal of Korean Neurosurgical Society
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    • v.43 no.5
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    • pp.232-236
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    • 2008
  • Total laminectomy for the removal of intradural-extramedullary spinal cord tumors has been used widely, but postoperative complications often develop, such as kyphosis, spinal instability, and persistent back pain. In this study, we evaluated seven patients with intradural-extramedullary spinal cord tumors with respect to the value of unilateral limited laminectomy. Our cases included six schwannomas, and one meningioma. The cervical region was involved in four cases, the thoracolumbar region in two cases, and the lumbar region in one case. The rationale for choosing a unilateral approach is to preserve musculoligamentous attachments and posterior bony elements as much as possible. The patients were mobilized on the third postoperative day and preoperative neurological symptoms were recovered within a few weeks. We did not observe any complication relating to unilateral limited laminectomy and at follow-up evaluation (at 3 and 12 months postoperatively), none of the patients showed spinal deformity or spinal instability. We think that the unilateral limited laminectomy is a safe and efficient technique for the treatment of intradural-extramedullary spinal cord tumors. We suggest that this technique is one of the best treatments for these tumors.

Therapeutic Approach for Stroke Patients based on Central Pattern Generator (중추유형발생기에 근거한 뇌졸중 환자의 치료적 접근)

  • Kim Joong-Hwi;Kim Chung-Sun
    • The Journal of Korean Physical Therapy
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    • v.14 no.4
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    • pp.131-146
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    • 2002
  • In the last years, it has become possible to regain some locomotor activity in patients with incomplete spinal cord injury (SCI) through intense training on a treadmill. The ideas behind this approach owe much to insights derived from animal studies. Many studies showed that cats with complete spinal cord transection(spinalized animals) can recover locomotor function. These observations were at the basis of the concept of the central pattern generator located at spinal level. The neural system responsible for the locomotor restoration in both cats and humans is thought to be located at spinal level and is referred to as the central pattern generator(CPG). The evidence for such a spinal CPG in human is emphasis on some recent developments which support the view that there is a human spinal CPG for locomotion. An important element in afferent inputs for both spinal injured cats and humans is the provision of adequate sensory input related locomotor, which can possibly activate and/or regulate the spinal locomotor circuitry This review article deals with the afferent control of the central pattern generator. Furthermore, the application of adequate afferent inputs related locomotor for stroke patients will be able to facilitate locomotion ability, which is automatic, cyclic, rhythmic. These insights can possibly contribute to a better therapeutic approach for the rehabilitation of gait in patients with stroke.

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The Influence Factor Analysis of Spinal Cord Independence Measure(SCIM) on Walking in Spinal Cord Injury (척수손상환자의 보행에 영향을 주는 SCIM 요인 분석)

  • Jung, Dae-In
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.2 no.1
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    • pp.83-92
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    • 2004
  • This study aims to the influenced factor analysis of spinal cord independence measure(SCIM), on walking velocity, walking endurance, time up & go(TUG), and subject characteristics. The subject of this study were 12 persons with incomplete spinal cord injury(ASIA C, D). All subject ambulatory with or without an assistive device. All participants were assessed on SCIM(score), walking velocity(m/s), walking endurance(m) and TUG(s). The data were analyzed using independent t-test and stepwise multiple regression. The results revealed that no statistical difference was noted in subject characteristics among SCIM, walking velocity, walking endurance, TUG(p>0.5). The independence score, breathing-sphincter control and ambulation were important factors in TUG(31.4%). The results suggest that SCIM may be an inappropriate assessment tool to predict gait ability of patient with incomplete spinal cord injury. Further study about gait speed, gait endurance and TUG by change of SCIM is needed using to patient of incomplete spinal cord injury.

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Comparison of the Level and Side Effects of Spinal Anesthesia with Hyperbaric Bupivacaine in the Supine, Lateral, and Prone Positions (고비중 Bupivacaine 척추마취 후 체위에 따른 마취수준과 부작용의 비교)

  • Moon, Ji Young;Kim, Bo Hwan
    • Journal of Korean Biological Nursing Science
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    • v.17 no.2
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    • pp.114-122
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    • 2015
  • Purpose: This study attempted to test whether there are differences in the level and hemodynamic side effects (blood pressure, heart rate, $O_2$ saturation), and nausea & vomiting of spinal anesthesia using hyperbaric bupivacaine according to position (supine, lateral, and prone positions) in orthopedic surgery patients who received podiatric surgery under spinal anesthesia. Methods: This study was conducted with 53 patients who had received orthopedic surgery under spinal anesthesia at I General Hospital. Data were analyzed using SPSS 20.0 through repeated-measures ANOVA, post-hoc test, Chi-test, and Fisher's exact test. Results: The change of position after spinal anesthesia with hyperbaric bupivacaine caused a change in the level of spinal anesthesia (F=12.768, p<.001). However, no difference of blood pressure, heart rate, $O_2$ saturation and nausea and vomiting caused by the change in anesthesia level was observed, and in prone position, drug was administered for the correction of side effects. Conclusion: As expected, recognizing that there can be a change in the level of spinal anesthesia after the change of position in surgical patients, nurse anesthetists should monitor their conditions carefully and continuously.

The Study on the Somatotype and Spinal Deformity among Middle and High School Girls (중·고 여학생의 체형분류 및 척추변형에 관한 연구)

  • Lee, Hea-Ju;Ham, Ok-Song
    • Fashion & Textile Research Journal
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    • v.1 no.2
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    • pp.137-147
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    • 1999
  • The purpose of this study was to classify female students' somatotypes, to investigate the relationship between five somatotypes obtained from anthropometric measurements and to examine the relationship between the spinal deformity and somatotypes. The subjects for anthropometric measurements were 844 female middle and high school students. The data were analyzed by cluster analysis, correspondence analysis, Duncan test, and T-test. The results were as follows. Cluster analysis on the factors extracted from directly measured items classified subjects into five types (middle height and a little slim type (39.6%), low height and a little slim type (13.1%), middle height and a little fat type (18.0%), tall and very fat type (7.7%), and very tall and standard type (21.6%). In examining the relationship between the normal people and those of the spinal deformity, the normal showed higher mean value in almost all the items of the girth, the depth, and the length. High school students had more spinal deformity in number than middle school students. The degree of deformity was higher in the right spinal deformity than in the left spinal deformity as the age increased. In terms of the distribution of the spinal deformity classified by the somatotype, Type 1 (middle height and a little slim type) and Type 5 (very tall and standard type) appeared the highest.

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Illness Experiences of Patients Following Spinal Surgery (척추수술 환자의 질병경험)

  • Jeong, Hyo-Ju;Sohn, Sue-Kyung
    • Journal of muscle and joint health
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    • v.29 no.3
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    • pp.151-164
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    • 2022
  • Purpose: The purpose of this study was to explore the illness experiences of patients who had spinal surgery. Methods: Colaizzi's phenomenological method was used for the data analysis. Patients who had spinal surgery were included in this study. The data was collected between April and October 2022 by conducting a one-on-one, in-depth interview. Results: Five theme clusters were identified based on the illness experiences of patients who had spinal surgery: "An agonizing life changed by pain", "Efforts to alleviate the pain", "Surgery was determined to be the best way to relieve pain", "Recovered daily life after relieving pain caused by surgery", and "Dedicated to living a healthy, pain-free life". The analysis further yielded 20 themes. Patients used various treatment methods to relieve pain, but ultimately chose surgery due to unbearable pain. Patients who had spinal surgery felt grateful that they were feeling good and healthy because they could return to their normal daily lives. After all, the pain was relieved after the surgery. Even though some pain remained unrelieved, the patients had the hope of getting better through exercise and rehabilitation. Conclusion: This study provides an in-depth understanding and meaning of the illness experiences of patients who had spinal surgery and presents new perspectives on clinical practice. The findings of this study are expected to be useful in developing and applying systematic and customized nursing interventions before and after spinal surgery.

Extra-spinal sciatica and sciatica mimics: a scoping review

  • Siddiq, Md Abu Bakar;Clegg, Danny;Hasan, Suzon Al;Rasker, Johannes J
    • The Korean Journal of Pain
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    • v.33 no.4
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    • pp.305-317
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    • 2020
  • Not all sciatica-like manifestations are of lumbar spine origin. Some of them are caused at points along the extra-spinal course of the sciatic nerve, making diagnosis difficult for the treating physician and delaying adequate treatment. While evaluating a patient with sciatica, straightforward diagnostic conclusions are impossible without first excluding sciatica mimics. Examples of benign extra-spinal sciatica are: piriformis syndrome, walletosis, quadratus lumborum myofascial pain syndrome, cluneal nerve disorder, and osteitis condensans ilii. In some cases, extra-spinal sciatica may have a catastrophic course when the sciatic nerve is involved in cyclical sciatica, or the piriformis muscle in piriformis pyomyositis. In addition to cases of sciatica with clear spinal or extra-spinal origin, some cases can be a product of both origins; the same could be true for pseudo-sciatica or sciatica mimics, we simply don't know how prevalent extra-spinal sciatica is among total sciatica cases. As treatment regimens differ for spinal, extra-spinal sciatica, and sciatica-mimics, their precise diagnosis will help physicians to make a targeted treatment plan. As published works regarding extra-spinal sciatica and sciatica mimics include only a few case reports and case series, and systematic reviews addressing them are hardly feasible at this stage, a scoping review in the field can be an eye-opener for the scientific community to do larger-scale prospective research.

Percutaneous Vertebroplasty in Spinal Metastasis and Myeloma : 25 Cases Experience (척추 전이암 및 골수종 환자를 대상으로 시행한 경피적 척추체 성형술)

  • Park, Woo-Min;Jang, Jee-Soo;Rhee, Chang-Hun;Gwak, Ho-Shin;Lee, Seung-Hoon
    • Journal of Korean Neurosurgical Society
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    • v.29 no.11
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    • pp.1484-1490
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    • 2000
  • Objectives : In spinal metastasis and myeloma, percutaneous vertebroplasty could be an effective treatment method to provide spinal stabilization and to relief pain for early rehabilitation. The authors report twenty-five cases the clinical results of percutaneous vertebroplasty for twenty-five cases of spinal metastasis and myeloma. Materials and Methods : From September 1998 to December 1999, seventy percutaneous vertebroplasties(PVP) were performed for spinal metastases and myeloma in 25 patients, sixteen women and nine men ranging in age from 34 to 74. The primary malignancies were 6 multiple myelomas, and in metastatic tumore from various origin. All patients complained of severe pain and had osteolytic vertebral body destructions without spinal cord compression. To evaluate clinical improvement, suObjective verbal analogue pain score(VAS) and Karnofsky performance scale(KPS) were used. Thin sliced(2mm-thickness) sectional computed tomography(CT) was performed before and after PVP. Plain X-ray film was followed up every 1 month to assess the vertebral column stability. Results : In 25 patients, a total of seventy PVPS were performed successfully : 6 cervical, 33 thoracic and 31 lumbar vertebrae. Most patients had clear improvement of pain after PVP ; mean as score was 8.1 and 2.9 before and after PVP, respectively. Improvement was maintained in most patients. No further collapse of treated vertebrae was observed(mean follow-up, 7 months). Leakage of PMMA was notod in the spinal canal(13 levels), neural foramen (2 levels), adjacent disk(15 levels), paravertebral soft tissue(14 levels) and vein(8 levels). Pulmonary embolism was detected in three patients after the procedure, but was not associated with clinical symptoms. Conclusion : These results indicate that percutaneous vertebroplasty can be valuable treatment method in osteolytic spinal metastasis and myeloma, providing immediate pain relief and spinal stabilization and contributing to early rehabilitation.

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Analysis of Prognostic Factors Relating to Postoperative Survival in Spinal Metastases

  • Yang, Soon-Bum;Cho, Won-Ik;Chang, Ung-Kyu
    • Journal of Korean Neurosurgical Society
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    • v.51 no.3
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    • pp.127-134
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    • 2012
  • Objective: To analyze the prognostic factors thought to be related with survival time after a spinal metastasis operation. Methods: We retrospectively analyzed 217 patients who underwent spinal metastasis operations in our hospital from 2001 to 2009. Hematological malignancies, such as multiple myeloma and lymphoma, were excluded. The factors thought to be related with postoperative survival time were gender, age (below 55, above 56), primary tumor growth rate (slow, moderate, rapid group), spinal location (cervical, thoracic, and lumbo-sacral spine), the timing of radiation therapy (preoperative, postoperative, no radiation), operation type (decompressive laminectomy with or without posterior fixation, corpectomy with anterior fusion, corpectomy with posterior fixation), preoperative systemic condition (below 5 points, above 6 points classified by Tomita scoring), pre- and postoperative ambulatory function (ambulatory, non-ambulatory), number of spinal metastases (single, multiple), time to spinal metastasis from the primary cancer diagnosis (below 21 months, above 22 months), and postoperative complication. Results: The study cohort mean age at the time of surgery was 55.5 years. The median survival time after spinal operation and spinal metastasis diagnosis were 6.0 and 9.0 months. In univariate analysis, factors such as gender, primary tumor growth rate, preoperative systemic condition, and preoperative and postoperative ambulatory status were shown to be related to postoperative survival. In multivariate analysis, statistically significant factors were preoperative systemic condition (p=0.048) and postoperative ambulatory status (p<0.001). The other factors had no statistical significance. Conclusion: The factors predictive for postoperative survival time should be considered in the surgery of spinal metastasis patients.