• Journal of Korean Neurosurgical Society
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• v.61 no.2
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• pp.233-242
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• 2018

Objective : A spinal cord subependymoma is an uncommon, indolent, benign spinal cord tumor. It is radiologically similar to a spinal cord ependymoma, but surgical findings and outcomes differ. Gross total resection of the tumor is not always feasible. The present study was done to determine the clinical, radiological and pathological characteristics of spinal cord subependymomas. Methods : We retrospectively reviewed the medical records of ten spinal cord subependymoma patients (M : F=4 : 6; median 38 years; range, 21-77) from four institutions. Results : The most common symptoms were sensory changes and/or pain in eight patients, followed by motor weakness in six. The median duration of symptoms was 9.5 months. Preoperative radiological diagnosis was ependymoma in seven and astrocytoma in three. The tumors were located eccentrically in six and were not enhanced in six. Gross total resection of the tumor was achieved in five patients, whereas subtotal or partial resection was inevitable in the other five patients due to a poor dissection plane. Adjuvant radiotherapy was performed in two patients. Neurological deterioration occurred in two patients; transient weakness in one after subtotal resection and permanent weakness after gross total resection in the other. Recurrence or regrowth of the tumor was not observed during the median 31.5 months follow-up period (range, 8-89). Conclusion : Spinal cord subependymoma should be considered when the tumor is located eccentrically and is not dissected easily from the spinal cord. Considering the rather indolent nature of spinal cord subependymomas, subtotal removal without the risk of neurological deficit is another option.

• Journal of Korean Neurosurgical Society
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• v.44 no.2
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• pp.84-87
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• 2008

Spontaneous spinal epidural hematoma (SSEH) is rare in children. especially in infants, in whom only 12 cases have been reported. Because of the nonspecificity of presenting symptoms in children, the diagnosis may be delayed. We report herein a case of SSEH in a 20-month-old girl who initially presented with neck pain, and developed lower extremity motor weakness and symptoms of neurogenic bladder 2 weeks prior to admission. The magnetic resonance imaging showed an epidural mass lesion extending from C7 to T4, and the spinal cord was severely compressed by the mass. After emergency decompressive surgery the neurologic function was improved immediately. Two months after surgery, the neurological status was normal with achievement of spontaneous voiding. We suggest that surgical intervention can provide excellent prognosis in case of SSEH in infants, even if surgery delayed.

• Journal of Korean Neurosurgical Society
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• v.54 no.6
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• pp.532-536
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• 2013

Charcot spine is a progressive and destructive process that affects the vertebral bodies, intervertebral discs, and posterior facets. It is the result from repetitive microtrauma in patients who have decreased joint protective mechanisms due to loss of deep pain and proprioceptive sensation, typically because of spinal cord injury. The objective of the study is to report an unusual case of Charcot spine, as a late complication of traumatic spinal cord injury, treated by a circumferential arthrodesis performed with a single staged posterolateral costotransversectomy approach.

• Journal of Korean Neurosurgical Society
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• v.58 no.5
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• pp.483-486
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• 2015

Cervical epidural steroid injection is frequently used in the conservative management of neck pain and cervical radiculopathy. Epidural cervical transforaminal injections are usually well-tolerated with mild side effects such as transient decreased sensory and motor function, or headache due to dural puncture. Although there are a few case reports about adverse effects of cervical epidural injection in the literature, it can cause severe complications such as large hematoma, infarction by spinal vascular injury. Subdural hematoma has been occurred much less common rather than epidural hematoma in the spinal cord. We report a rare catastrophic case of cervical spinal subdural hematoma with quadriparesis after cervical transforaminal epidural block.

• Journal of Korean Neurosurgical Society
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• v.29 no.6
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• pp.836-840
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• 2000

Intramedullary spinal hemagioblastomas usually develope in cervical or thoracic region of spinal cord, but rarely in conus medullaris. We report a case of hemangioblastoma developed in conus medullaris. The 19-year-old male patient presented with slowly progressing low back pain and paresthesia of both legs. MRI and spinal angiography revealed a well-vascularized mass lesion in the conus medullaris with syrinx formation. Total excision of hemangioblastoma was achieved via posterior approach. Postoperatively, patient's walking difficulty was worsened transiently, but it was improved at discharge.

• Journal of Korean Medicine Rehabilitation
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• v.24 no.4
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• pp.195-201
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• 2014

The objective of this study is to report the improvement of one patient with physical sequelas induced by spinal epidural abscess surgery. The patient was treated by acupuncture therapy with pulsed electromagnetic therapy and herb medicine. We evaluated the effectiveness by numerical rating scale (NRS). As a result, the patient improved significantly NRS score. And the patient's symptoms were alleviated. We guess that the causes of the patient symptoms are chronic inflammation and fibrosis of dural. We conclude that acupuncture therapy with pulsed electromagnetic therapy is an effective treatment to reduce the residual pain after spinal epidural abscess surgery. But there is a limit on this study due to sufficient number of case. Further studies will be needed.

• Journal of Biomedical Engineering Research
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• v.21 no.2
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• pp.189-201
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• 2000

Mechanical factors in the human body are considered to play a dominant role in low back problems. Various spinal structures. including muscles, act in unison to resist the external load. An estimation of the muscle forces in this structure requires a knowledge of the orientation, location and area of cross-section of the muscles to complete the formulation of a truly three-dimensional mathematical model of the spine. The geometric parameters which are calculated were the line of action, the centroid and physiologic area of cross-section of each muscle as a function of the spinal level. This geometric data were obtained from CT scans of 11 subjects participating in this study.

• Journal of Biomedical Engineering Research
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• v.35 no.2
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• pp.19-25
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• 2014

According to recent data more than 80% of people suffer from back pain, due to an aging and a poor posture, at least once in their life time, and 7~10% of them have chronic spine illness. Researchers over the years have studied on various spinal traction devices that utilize the force of traction, and have also reported clinical test results. However, most existing devices are too complicated and too expensive. In order to solve these problems, we have developed a new device in which the frame moves up and down and at the same time tilting angle of the frame is adjusted. We have analyzed the forces applied on the body as a function of tilting angle. And the result shows that the new device has achieved the force of traction, which is known to be effective for spinal rehabilitation.

• Journal of Acupuncture Research
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• v.34 no.4
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• pp.172-179
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• 2017

Background: This study was designed to evaluate the clinical effectiveness of traditional Korean medicine treatment for lumbar spinal stenosis as assessed by radiological criteria. Methods: This was an observational study of 122 patients who were diagnosed with lumbar spinal stenosis and admitted to Jaseng Hospital between January 2016 and June 2017. They were analyzed according to sex, age, cause of disease, disease stage, length of admission, type of stenosis, morphological grade, and dural sac cross-sectional area. All patients were treated with traditional Korean medicine. Patients were assessed with the Numeric Rating Scale (NRS), Oswestry Disability Index (ODI) and EQ-5D before and after treatment. Results: Regarding the distribution of the factors analyzed, these were of note: more females than males (1:3.52); and highest proportions were age more than 70 years (37.70%), cause of lumbar spinal stenosis unknown (67.21%), and subacute stage (42.62%). Comparing before and after treatment, the NRS score for low back and pelvic pain decreased from $6.14{\pm}1.71$ to $4.28{\pm}1.91$ (p < 0.001), and the NRS score for radiating pain and numbness decreased from $6.27{\pm}1.61$ to $2.02{\pm}1.54$ (p < 0.001). ODI decreased from $46.86{\pm}19.40$ to $33.63{\pm}18.66$ (p < 0.001), and gait-related ODI decreased from $3.34{\pm}1.23$ to $2.80{\pm}1.11$ (p < 0.001). There were no statistically significant differences in improvement of the NRS, ODI, gait-related ODI, and EQ-5D for morphological grade and dural sac cross-sectional area. Conclusion: Traditional Korean medicine is effective treatment for patients with lumbar spinal stenosis. Even in patients with severe radiological findings, it is possible to reduce pain and improve quality of life.

• Experimental and Molecular Medicine
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• v.50 no.11
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• pp.6.1-6.12
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• 2018

Morphine tolerance remains a challenge in the management of chronic pain in the clinic. As shown in our previous study, the dopamine D2 receptor (D2DR) expressed in spinal cord neurons might be involved in morphine tolerance, but the underlying mechanisms remain to be elucidated. In the present study, selective spinal D2DR blockade attenuated morphine tolerance in mice by inhibiting phosphatidylinositol 3 kinase (PI3K)/serine-threonine kinase (Akt)-mitogen activated protein kinase (MAPK) signaling in a ${\mu}$ opioid receptor (MOR)-dependent manner. Levo-corydalmine (l-CDL), which exhibited micromolar affinity for D2DR in D2/CHO-K1 cell lines in this report and effectively alleviated bone cancer pain in our previous study, attenuated morphine tolerance in rats with chronic bone cancer pain at nonanalgesic doses. Furthermore, the intrathecal administration of l-CDL obviously attenuated morphine tolerance, and the effect was reversed by a D2DR agonist in mice. Spinal D2DR inhibition and l-CDL also inhibited tolerance induced by the MOR agonist DAMGO. l-CDL and a D2DR small interfering RNA (siRNA) decreased the increase in levels of phosphorylated Akt and MAPK in the spinal cord; these changes were abolished by a PI3K inhibitor. In addition, the activated Akt and MAPK proteins in mice exhibiting morphine tolerance were inhibited by a MOR antagonist. Intrathecal administration of a PI3K inhibitor also attenuated DAMGO-induced tolerance. Based on these results, l-CDL antagonized spinal D2DR to attenuate morphine tolerance by inhibiting PI3K/Akt-dependent MAPK phosphorylation through MOR. These findings provide insights into a more versatile treatment for morphine tolerance.