Surgical Experience of transpediculr Screw Fixation of the Spine

Vertebral transpedicular screws provide secure attachment for posterior spinal fixation device, the authors had experienced 29 cases of transpedicular screw fixation to obtain fixations of the thorcolumbar and lumbar spine instability, the patients were operated between February, 1992, and May, 1995. Spinal Fusion was attempted at one to four levels of thoracic and lumbar spine. Follow-up period was from 6 to 33 months, averaging 16 months. The result was summerized as follows: 1) Of the 29 cases, 20 were spondylolisthesis and 9 were fracture and dislocation. 10 patients(34.5%) were 30 years old, and 20 cases(69%) were female. Mean age was 42 years. 2) The symptom included low back pain, sciatica and intemittant claudificaton in the order of incidence. 3) The sites of spondylolisthesis were L4-5 in 12 cases(60%) and L5-S1 in 8 cases(40%). The average degree of slippage in spondylolisthesis was Meyerding's grade I(85%). The sites of fracture were T12 in 5 cases(55.6%), L1 in 2 cases(22.2%), L2 with L3 in 1case(11.1%) and L1 in 1 case(11.1%). 4) There was no patient with significant neurologic injury or functional root loss. A screw malposition was observed in one case. 5) The results of operations were considered exellent in 16 cases(55%), good in 10 cases(35%) and fair in 3 cases(10%), and satisfactory bony fusion was obtained.

A Clinical Analysis of Pure Traumatic Intraventricular Hemorrhage

Although intraventricular hemorrhage is readily identifiable with computerized tomography, there has been little systematic study of its significance in head trauma. The authors had analysed 13 patients with pure intraventricular hemorrhage among a total of 104 patients who had traumatic intraventricular hemorrhage(TIVH). Clinical evaluation of patients was made according to the Glasgow Coma Scale(GCS) and their outcome was graded according to the Glasgow Outcome Scale(GOS). The initial clinical findings, the site and amount of ventricular hematoma, and the final outcome were analysed. Pure-TIVH was identified in 13(0.8%) out of 1596 patients who were admitted following head trauma. Hemorrhage involved only in the lateral ventricle in 9 cases; the 3rd or 4th ventricle in 3 cases, and involved all ventricles in 1 case. Eleven patients(GCS>7) had good outcomes, while the outcomes were poor in two patients(GCS<6).