Clinical Comparison of Anterior Cervical Plating System in Acute Cervical Injury

We compare the safety and efficacy of locked and non-locked plating systems with retrospective review of 51 consecutive acute cervical injury patients who underwent anterior cervical plating procedures. The two groups were comparable in demographic details, mean age(locked 40.8, non-locked 37.9), average fusion level(locked 1.53, non-locked 1.67) and fusion rate(locked 100%, non-locked 86.7%). Hardware related complication in locked plate group was seen in one patient(2.78%), but did not required the reoperation. In the non-locked plate group, 4 patients developed screw loosening and, in 1 patient, the inferior screw was found to be 2mm posterior to posterior cortex. Reoperation was needed for this case due to symptomatic myelopathy. In the non-locked plate group instrument related reoperations was done in 5 patients(33.4%) and longer operation time was required than locked system. In this study, anterior cervical fusion with plating was nessessory for stabilizing of acute cervical instability and improving neurological outcome and fusion rate. For this purpose, locked system was theoratically safter and technically easier than non-locked system.

A Case of Choroid Plexus Carcinoma with Rapid Dissemination after Gross Total Resection

One to three percent of childhood brain tumors are choroid plexus tumors. Of these, 30-40% are considered to be choroid plexus carcinoma. We report one case of choroid plexus carcinoma without parenchymal invasion, which showed rapid dissemination along whole CSF pathway and developed postoperative hydrocephalus in spite of gross total resection.

Tethered Cord Syndrome in Adulthood

The clinical, radiological and pathological features of nine cases of adult-onset neurological dysfunction secondary to tethered cord were studied. Sixty-seven percent of these patients had symptomatic onset under specific circumstances: additional tugging of the already tight conus, narrowing of the spinal canal, or direct trauma to the buttocks. Pain in the non-dermatomal leg and perineal area was the most common presenting symptom. Progressive sensory-motor deficit in the lower extremities, as well as sphincter dysfunction were also common findings. Unlike in tethered cord syndrome in children, however, foot and spinal deformities were not seen. The surgical outcome was excellent in relation to pain and sensory-motor deficit, but recovery of sphinctor dysfunction was disappointing. Successful treatment depends on early diagnosis and adequate surgical management of the tethered conus.