Radiolucent Zones Surrounding Transpedicular Screws After Lumbar Spinal Instrumented Fusion / 대한척추외과학회지

STUDY DESIGNS: A retrospective study for radiographic and clinical assessment. OBJECTIVES: To clarify the clinical significance of the radiolucent zones surrounding transpedicular screws that occasionally appears following lumbar spinal instrumented fusion. SUMMARY OF LITERATURE REVIEW: that the formation of radiolucent zones surrounding pedicular screws are significantly frequent after transpedicular fixation. MATERIALS AND METHOD: 88 cases, age 50 or older, which underwent lumbar spinal fusion with transpedicular screws, between January 1999 and December 2002, were included in this investigation. The postoperative radiographs of all patients were analyzed for radiolucent zones around the transpedicular screws. These radiolucent zones were evaluated in relation the number of fusion levels, the existence of osteoporosis, and the fusion status and satisfaction rates. RESULTS: Radiolucent zones were observed in 30 cases (34%, 30/88), 13 (43%, 13/30) of which disappeared during the follow-up period. The average number of fixation levels in the cases with and without radiolucent zones were 2.33 (range 1-4, SD 0.94) and 1.74 (range 1-4, SD 0.82), respectively. Osteoporosis was found to accompany 43.3 and 20.7% of the cases with and without radiolucent zones, with the latter cases showing a statistically significant higher fusion rate and greater patient satisfaction. CONCLUSION: Radiolucent zones, a frequent finding following pedicle screw fixation, resulted in less favorable outcomes. Surgeons should be alert to radiolucent zones and their transformation during follow-up. Methods for improving the stability of the interface between the pedicle screw and vertebral bone will require further research.

External Fixator and External Fixator Supplemented with K-wire in the Treatment of Distal Radius Fractures

PURPOSE: To evaluate the differences of the outcome between external fixator and external fixator supplemented with K-wire in the treatment of distal radius fractures. MATERIALS AND METHODS: Twenty-one cases which underwent external fixation (external fixation group) and 28 cases, external fixation supplemented with K-wire (external fixation with K-wire group), were analyzed. Radial length, radial inclination and volar tilt were compared in preoperative, immediate postoperative radiographs, and radiographs after removal of external fixator between two groups. And functional outcome including flexion, extension, pronation and supination of wrist were compared between two groups and wrist pain, as well. RESULT: Radial length and radial inclination in the postoperative radiographs and radiographs after removal of external fixator showed no difference between two groups, but volar tilt of external fixation group measured 2.1+/-4.2 degrees, 1.3+/-3.8 degrees and external fixation with K-wire group, 8.8+/-2.3 degrees, 8.5+/-2.4 degrees respectively, so that external fixation with K-wire group showed better reduction and maintenance. Wrist flexion and extension about postoperative 6 months measured 25.6+/-8.2 degrees, 25.1+/-10.2 degrees, respectively, in external fixation group and 42.5+/-15.2 degrees, 33.6+/-9.5 degrees in external fixation with K-wire group, so that external fixation with K-wire group showed better functional results. CONCLUSION: In the treatment of distal radius fractures, to obtain better reduction and function result, external fixations supplemented with K-wire need to be taken into consideration.

Patellar metastasis from Squamous Cell Carcinoma of the Larynx: A Case Report / 대한정형외과학회잡지

Metastatic tumors of the patella are rare, espicially metastasis of the head and neck carcinoma to the patella is exceedingly rarer still. We experienced a case of patellar metastatic cancer from laryngeal squamous cell carcinoma and report the clinical, radiographic and pathologic findings in detail.

Treatment of Lumbar Spinal Stenosis with Diabetes Mellitus / 대한척추외과학회지

STUDY DESIGN: This retrograde study was designed to compare the clinical features and postoperative clinical results between diabetic and non-diabetic patients who had been performed decompression and arthrodesis with instrumentation. SUMMARY OF LITERATURE REVIEW: There are controversies in the treatment results of diabetic patients. OBJECTIVE: To identify poor results in the patients of lumbar spinal stenosis accompanied diabetes mellitus and to find out variables influencing postoperative results among diabetics. MATERIALS AND METHODS: We analyzed 27 diabetic patients and sex, age-matched 27 non-diabetic patients who were diagnosed as lumbar spinal stenosis and operated from April, 1995 to December, 1998. In all patients, duration of symtoms, sensory and motor deficits, comorbidity, level of operations were investigated and in diabetics, duration of diabetes, amount of insulin administered before operation and presence of diabetic neuropathy were included. Clinical results, postoperative complications were compared between diabetics and non-diabetics. RESULTS: Considerable improvement was reported by 19(71%) in diabetic group and 21(78%) in non-diabetic group. Complication rate such as of infection and delayed wound healing was not higher in diabetic group than non-diabetic group. Duration of diabetes and amount of insulin before operation did not affected the result of operations. CONCLUSION: The outcome of surgery was similary successful in the two groups.