ABSTRACT
STUDY DESIGN: A retrospective study to analyze the results of posterior lumbar interbody fusion, using laminar bone and titanium block, with pedicle screw instrumentation. OBJECTIVES: To evaluate the clinical and radiological results of posterior lumbar interbody fusion, using laminar bone and titanium block, with pedicle screw instrumentation. SUMMARY OF LITERATURE REVIEW: Several studies have demonstrated the results of posterior lumbar interbody fusion, there has been no report on our method. MATERIALS AND METHODS: From March 2001 to May 2002, seventeen patients were treated by posterior lumbar interbody fusion, using laminar bone block, from spinous process and titanium block. All patients were clinically followed up over 12 months. The mean age of the patients and follow-up were 58 years and 15 months, respectively. The clinical results were evaluated by Kim's criteria and radiological union, and the subsidence of disc space and change of the lordotic curve were assessed by a simple Xray. RESULTS: The satisfactory clinical result and radiological union rates were 83.3 and 90.4%, respectively. The mean subsidence of the disc space and change of the lordotic curve were 0.8 mm and 1.6 degrees, respectively. There was one complication of a wrong insertion of the pedicle screw to the disc space. CONCLUSION: Posterior lumbar interbody fusion using laminar bone and titanium block showed an acceptable radiological union rate and clinical results. This could be a good alternative method for obtaining initial stability and bony union without taking a bone graft from the posterior ilium in various spinal lesions.
Subject(s)
Humans , Follow-Up Studies , Ilium , Retrospective Studies , Titanium , TransplantsABSTRACT
PURPOSE: To determine the frequency, level, distribution, onset, and pattern of progression of bone resorption that occurring around pedicle screws after pedicle screw plate fixation. MATERIALS AND METHODS: Bone resorption around 902 pedicle screws was analyzed in post-operative, and follow-up radiographs obtained from 156 patients who underwent pedicle screw plate fixation. To determine the resorption degree, categorized arbitrarily as grade 1 (less than 1 mm), grade 2 (1 mm or more, but less than 2 mm), or grade 3 (2 mm or more), the width of radiolucent zones was measured. In 39 patients in whom resorption was graded 1, 2, or 3, the pattern of progression of 78 screws was evaluated. RESUTLS: Resorption occurred around 78 (8.6%) screws in 39 (25%) patients, 26 of whom had more than one lesion. For 99% of screws, there was evidance of resorption within 12 weeks of pedicle screw plate fixation. During follow-up, 61.5% of screws (48/78) remained stable, while 38.5% (30 screws) showed progression to higher grades. The possibility of progression to a higher grade is less when the initial grade is lower. CONCLUSION: An understanding of the radiographic patterns of bone resorption is useful for monitoring a patient after pedicle screw plate fixation.
Subject(s)
Humans , Bone Resorption , Follow-Up StudiesABSTRACT
The Graf stabilization has been introduced in treating lumbar spinal disorder associated with posterior instability. This study reviewed some problems of the Graf instrumentation as a soft stabilizer. The purpose of this study is to analyse the problems of the soft stabilization in spinal instability. We reviewed 145 cases which were operative treatment using the Graf instrument for lumbar spinal disorder associated with posterior instability at our department from May, 1991 to Dec, 1995. The mean follow up periods was 29 months ranging from 24 months to 6 years 8 months. Of the 145 cases, 22 cases were showed the problem. The diagnostic method were simple x-ray, flexion-extension lateral stress view and CT scan. Results were as follows : Adjacent segmental instability was 10 cases(6.9%), disc space narrowing was 8 cases(5.5%), screw loosening was 3 cases(2.1%) and breakage of the Graf band was 1 case(0.6%). The problems of the soft stabilization were adjacent segmental instability, disc space narrowing, screw loosening, and breakage of the Graf band. But the rate of adjacent segmental instability and disc space narrowing was lower than other lumbar spinal instrumentation.
Subject(s)
Follow-Up Studies , Tomography, X-Ray ComputedABSTRACT
Between Feb. 1992 and Apr, 1995, the authors have performed arthroscopic abrasion arthroplasty in 78 knees of 76 patients with degenerative osteoarthritis. The followup period was between 24 and 58 months, with on an average of 41 months. All patients had Zarins grade IV articular cartilage change. The results were as follows. 1. Of the total 78 knees, results were excellent in 25(32%), good in 33(42A), fair in 12(17%), poor in 8(10%) knees respectively. 2, The best results were obtained patellofemoral abrasion arthroplasty. 3. The poor results were obtained in patients with the both femoral condyle, lesion. 4. The results were much better in young age group (below 40 years). Aroscopic abrasion arthroplasty is not a curative but palliative method. But it could be an appealing altemative to total knee arthroplasty or high tibial osteotomy or can be performed postoperated after these reconstructive proeedures.
Subject(s)
Humans , Arthroplasty , Cartilage, Articular , Follow-Up Studies , Knee , Osteoarthritis , OsteotomyABSTRACT
STUDY DESIGN: This is a retrospective study analyzing 73 patients treated by decompression, pedicular screw instrumentation and posterior lumbar interbody fusion (PLIF) for lumbosacral spondylolithesis and symptomatic spinal stenosis. we used laminected laminar and spinous process instead of iliac bone. OBJECTIVES: This is to evaluate fusion rate and clinical results of PLIF with laminected laminar and spinous process. MATERIALS AND METHODS: PLIF in 73 patients with lumbosacral disorders who carried out at Pohang St. Mary's Hospital from March 1994 to January 1996. Fusion rate was evaluated by simple X-ray and dynamic view. Clinical effect was evaluated by Kirkaldy-Willis criteria. RESULTS: The solid fusion was achieved at 67 cases(91.8%) and the average period of fusion was 6.4 months. Complications were 2 cases of superficial skin infection and 3 cases of root irritation. The functional results by Kirkaldy-Willis were as follows ; excellent 40 cases, good 23 cases, fair 9 cases and poor 1 case. CONCLUSIONS: This PLIF procedure combined with transpedicular instrumentation showed sufficient fusion rate and excellent clinical results and improvement in vertebral alignment.
Subject(s)
Humans , Decompression , Retrospective Studies , Skin , Spinal StenosisABSTRACT
OBJECTIVES: Anterior approach to achieve arthrodesis of the cervical spine has become a widely accepted and often-used approach since its earliest reports by Bailey and Badgley, Smith and Robinson and Cloward. However, anterior interbody fusion in the presence of the presence of the posterior instability may be complicated by the bone graft dislodgement, kyphotic defomity or nonunion. As an attemp to prevent this undesirable complication, additional methods such as skeletal traction, halo appratus or even posterior fusion has been utilized. Therefore, The cervical spine locking plate(CSLP) with the anterior intervertebral body bone grafting provide immediate cervical stabilization and widely successful in achieving fusion. MATERIAL AND METHODS: This study analysed 14 patients who underwent a single anterior procedure and application of CSLP for the treatment of the cervical spinal disorder. Eleven patients were disc herniations and three patients were traumatic lesion. The average ago of the patient was 47 years and the mean follow up periods was 20 months ranging from 13 to 27 months. RESULTS: Ambulation was started 2nd day after the operation with the aid of the Philadelpia orthoses. Bone union was observed 13 cases on average 12 weeks after operation. The one case was nonunion with plate breakage without clinical symptom. CONCLUSION: Anterior fusion with CSLP are thought to be a safe and valuable method for treating cervical spine disorder.
ABSTRACT
There has been considerable controversy in the treatment of acute grade 3 injuries of acromioclavicular joint. Neviaser reported that the possibility of a latent degenerative arthritis occurring in the acromioclavicular joint as the result of passing Kirschner wire through the joint was more theoretical than real and any changes that may take place in the acromioclavicular joint were the result of trauma. The acromioclavicular joint and the articular disc were not disturbed at the time of operation in Neviaser technique, but we excised the articular disc that were torn for the purpose of preventing acromioclavicular joint from degenerative arthritis. We had treated 26 cases of grade 3 injuries of acromioclavicular joint with modified Neviaser technique from June 1990 to May 1994 at the Pohang St. Mary’s Hospital. The results were as follows. 1. The clinical results by Weitzman were consisted of 18 cases(69%) of excellent, 6 cases(23%) of good, 2 cases(8%) of fair and 0 case(0%) of poor. 2. Loss of reduction was 1.6mm by stress views of final reviews and didn’t affect to functional result. 3. There were no cases of redislocation of acromioclavicular joint after removal of Kirschner wires. 4. There were no cases of degenerative arthritis of acromioclavicular joint in final review. There result suggest that excision of the articular disc that were torn may be helpful in preventing acromioclavicular joint from degenerative arthritis.
Subject(s)
Acromioclavicular Joint , Bone Wires , Joints , OsteoarthritisABSTRACT
The elbow joints are often involved in rheumatoid arthritis but it has been suggested that such as involvement is not commonly a major cause of disability in upper limb. To study the result of synovectomy of elbow in rheumatoid arthritis, synovectomy was performed in 16 elbows an 15 patient from March 1990 to April 1933 Average follow-up was 17. 1 months. The results obtained from this study are as follows; 1. Synovectomy of the elbow affected by rheumatoid arthritis is a good procedure even in the presence of advanced radiological changes. 2. All patient are satisfactory results of relief of pain and motion. 3. Although the follow-up in this series are short, averaging 17. 1 months, the results see to be maintained. 4. Synovectomy of the elbow may be performed either as an early or as a late procedure with expectation of a useful result. Synovectomy of elbow in rheumatoid arthritis is one of a good treatment if the patient is selected properly.
Subject(s)
Humans , Arthritis, Rheumatoid , Elbow Joint , Elbow , Follow-Up Studies , Upper ExtremityABSTRACT
No abstract available.
ABSTRACT
No abstract available.
ABSTRACT
Diver's bone lesion was described for the first time by Grutzmacher in 1941. Ten cases of osteonecrosis of the femoral head in divers were analysed on the basis of clinical and pathologic feature. The pathologic feature of the osteonecrosis in divers was not reported in Korea previously. The cases were observed from March, 1985 to June, 1988. The authors treated the cases with total hip replacement and obtained good results. The results were as follows:1. The average ate age at the time of operation was 41.5 years. 2. The average follow-up was 20.4 months. 3. The specimens were confirmed as osteonecrosis mieroscopically. 4. By Meyer's modification of Marcus and Enneking classification the average stage was 3.7. 5. Divers bone lesion was increased with the length of diving experiences:diving depth, diving time, age and with bends. 6. The pathologic feature of osteonecrosis in divers differ from that of idiopathic avascular or aseptic osteonecrosis and could be differentiated easily. 7. After total hip replacement, according to Harris hip rading score system, all results were good.
Subject(s)
Arthroplasty, Replacement, Hip , Classification , Decompression Sickness , Diving , Follow-Up Studies , Head , Hip , Korea , OsteonecrosisABSTRACT
An irreducible atlanto-axial rotatory dislocation(so-called fixation) is an extremely rare deformity. Its stricking features are the delay in diagnosis and the persistent clinical and roentgenographic deformities. The diagnosis is suggested by the plain roentgenograms and is confirmed by operation. A 9 year-old boy having the atlanto-axial rotatory fixation was examined at Pohang St. Mary's Hospital in July 1985 and was treated with skull traction followed by Gallie fusion. He was followed up over a year, and had satisfactory result at last follow-up.
Subject(s)
Humans , Male , Congenital Abnormalities , Diagnosis , Follow-Up Studies , Skull , TractionABSTRACT
Reiter's syndrome is a clinical triad of urethritis, conjunctivitis, and arthritis, but the characteristic mucocutaneous lesion occurs very frequently. Therefore, Reiters syndrome in fact might better be considered a tetrad, consisting in its complete form of urethritis, arthritis, conjunctivitis, and mucocutaneous lesions. In initial stage of the disease, the arthritis usually appear after the urethritis and conjunctivitis have been made. The arthritis is usually of subacute onset, reaching its full intensity within a few weeks in most cases. Additionally a man with Reiters syndrome who developed aortic insufficiency with no evidence of syphilis or rheumatic heart disease has been reported. Two cases of Reiters syndrome are presented with the review of the literature: the first case was a 60 years old male who had non-gonococcal urethritis with mucous purulent discharge, conjunctivitis, polyarthritis, and aortic insufficiency; the second case was a young man aged 21 years who had the characteristic conjunctivitis and a past history of urethritis, and he also has had obvious keratodermia blenorrhagica and polyarthritic symptoms and signs.
Subject(s)
Humans , Male , Arthritis , Conjunctivitis , Rheumatic Heart Disease , Syphilis , UrethritisABSTRACT
The pelvis is a ring structure with strong ligamentous support. This support includes the symphysis pubis, the anterior and posterior sacroiliac ligaments, and the strong sacrospinous and sacrotuberous ligaments. Since the pelvis is a ring, disruption of any protion of the ring is always associated with disruption in another portion of the ring. Massive pelvic disruption is an important and often life threathening injury. It is usually due to a motor vehicle accident, a fall from a height, industrial injury, and so on. The authors reviewed 28 cases of unstable pelvic fracture treated at the orthopaedic department of Catholic Medical Center during the period from January 1975 to December 1980, and the injury was classified according to the Pennal and Tiles method, and analyzed the clinical data as to the cause of mechanical violence, type of fracture and treatment, post-traumatic pelvic instabilities, and the results. The persistant post-traumatic pelvic instability was assessed by physical examination, and Chamberlain and Trostlers stress Roentgen view of the pelvis. The clinical results obtained were as follows: 1. The incidence of the unstable pelvic fracture was 17.7% (28) of all pelvic fractures (158). The incidence of injury in male was approximately 5 times more frequent than female, and most of the patients were in the 3rd to 5th decade of their life. The causes of injury were road accident (54%), coal mine accident and fall from a height in orders. 2. The four-rami fracture with posterior disruption due to the lateral compression injury was the most common type of unstable pelvic fractures. 3. In conservatively treated patients, the pelvic instability persisted in 37.5% (6 in 16 cases) of the cases and all of them necessitated the joint stabilizing operation. Twelve cases were treated operatively. Among them, performed operations include wiring of symphysis pubis in 2 and sacroiliac joint fusion in 4 within 4 weeks after injury. But for the other 6 cases in which pelvic instability persisted in spite of the sufficient conservative treatment, sacroiliac joint fusion or sacroiliac joint fusion together with a symphyseal plate fixation were done. 4. Satisfactory results was obtained in 62.51% (10 in 16 cases) of nonoperated cases, and 91.7% (11 in 12 cases) of operated group. Authors consider that the most important step in the management of traumatic pelvic instability are; firstly the early recognition of the correlation of the fracture-fragments; the fracture mechanism, and the possible presence or the post-traumatic pelvic instability, and secondly finalizing the therapeutic plan. Early surgical stabilization of the duration of the treatment and the residual disability.