ABSTRACT
OBJECTIVE: The diagnosis of acute cervical sprain was done based on rigidity in the cervical area on X-ray and the symptoms reported by the patient so that it was difficult to differentiate those patients who complain of cervical sprain for an secondary gain. Thus, the present study is done for differential diagnosis of those fake patients who want the diagnosis of cervical sprain for the purposes of financial gain using the thermography, which is effective for objectifying pain by detecting the change in body temperature in the area of pain. METHODS: This study was done in 327 patients who were admitted to the neurosurgery department at Chosun University Hospital between January 1, 2001 to January 31, 2002, mainly complaining of cervical pain from traffic accidents. According to the previous methods of diagnosis, the presence of rigidity in the cervical region was determined on X-ray and this result was compared with the result from thermal imaging. RESULTS: When the verbal numerical rating scale of patient's subjective pain was classified into severe, moderate and mild, cold spot and disruption of normal thermographic shape increased significantly on thermal imaging as the severity of pain increases. CONCLUSION: Thermal imaging is not only effective for differentiating the presence or absence of cervical pain but also for determining the pain severity, fake patients, and pain recovery.
Subject(s)
Humans , Accidents, Traffic , Body Temperature , Diagnosis , Diagnosis, Differential , Neck Pain , Neurosurgery , Sprains and Strains , ThermographyABSTRACT
Fifty-two patients with unstable cervical spine injuries underwent operations between January 1, 1990 to June 30, 1997 in our institution and this is retrospective study on clinical results about these patients. Patients with cervical instability resulted from injury posterior column, being included in White's criteria, were treated with Hafifax interlaminar clamps for cervical instability. We followed up forty-two cases for more than one year. All of the forty- two cervical fixations showed immediate and long term stability and there were no neurological complication. Neu rologic improvements were seen in thirty three, but thirteen cases were unchanged. These results indicate that Halifax interlaminar clamps are consider to be a safe and effective method for posterior stabilization of va rious causes of cervical spine instability.
Subject(s)
Humans , Retrospective Studies , SpineABSTRACT
Cerebral ependymal cysts are very rare. About 30 cases have been reported in the literature. They mimic arachnoid cysts clinically and on imaging studies but are different from arachnoid cysts in pathological findings. They are believed to arise by the sequestration of a small segment of the primitive ependymal lining into either the cortical mantle or the perimedullary mesh. They occupy the central white matter of the frontal or temporoparietal lobes. The authors describe a case of septate ependymal cyst involving left sylvian fissure. The clinicopathological features, treatment, and results of previously reported cases are reviewed, and the etiology and pathogenesis of these cysts are discussed.
Subject(s)
Arachnoid CystsABSTRACT
Among the 98 patients who underwent operations for thoracolumbar spinal lesions from May 1989 to September 1994, the authors performed clinical analysis of 72 patients who were followed-up for more than 12 months. There were 52 cases of trauma, 18 cases of tuberculous spondylitis, and 2 cases of metastatic tumor. After partial or toal vertebrectomy, interbody fusion was performed using autogenous iliac bone or autogenous ribs which were taken while approaching the thoracic spine, and stabilized using Kaneda devices. Complete neural decompression was possible under direct vision in all cases. Neurologic deficits improved to an average of 1.7 grades using a modified Frankel scale. Patients with tuberculous spondylitis did not show recurrence or any evidence of increased risk of secondary infection caused by instrumentation. Loosening or breakdown of instruments occurred in 4 patients, and spinal deformity in 7 patients, but reoperation was not needed in any of these patients. By anterior decompression, interbody fusion and stabilization using Kaneda device in thoracolumbar spinal lesions, we could obtain satisfactory neurologic improvement as well as immediate firm stability and high fusion rate involving only a minimum(usually two) number of motion segments as compared with the posterior approach.
Subject(s)
Humans , Coinfection , Congenital Abnormalities , Decompression , Neurologic Manifestations , Recurrence , Reoperation , Ribs , Spine , SpondylitisABSTRACT
A case of a ruptured aneurysm originating at the proximal portion of the left posterior inferior cerebellar artery and an arteriovenous malformation in the left cerebellar hemisphere fed by the same artery is reported. The coincidental occurrence of these two vascular anomalies within the posterior fossa is uncommon. Aneurysms of the posterior inferior cerebellar artery require special consideration during surgical planning and operation because of the proximity of the posterior inferior cerebellar artery to the brain stem and to the origin of the lower cranial nerves. In our reported case, the aeurysm was located 2.7mm from the midline and 4.7mm from the clivus when measured radiometrically. The operation was carried out with the patient in a three quarter prone position through a left lateral suboccipital approach. Clipping of the neck of the aneurysm and total removal of the arteriovenous malformation were performed successfully in a one-stage operation.