Clinical Recovery after Surgical Treatment of Lumbar HIVD / 대한척추외과학회지

STUDY DESIGN: The authors retrospectively analysed the recovery of clinical symptoms after surgical treatment of lumbar HIVD. OBJECTIVES: To investigate the incidence of clinical symptoms, the recovery rate and time after surgical treatment and the difference between L4-5 and L5-S1 lesion. SUMMARY OF LITERATURE REVIEW: There are many reports concerning the clinical result of surgical treatment for the HIVD. They usually describe the result as excellent, good, fair and poor. We can't get any information about the recovery rate and recovery time of each clinical symptom from the reports . MATERIALS AND METHODS: Thirty-eight patients were treated by one level open discectomy from march 1991 to december 1995, The clinical symptoms and signs including SLR, motor deficit, sensory deficit, change of DTR and severity of radiating pain were periodically followed up on the predesigned protocol. RESULTS: In preoperative examination, SLR was positive in 82%, motor deficit in 76%, sensory deficit in 74%, DTR change in 50%, and radiating pain in 100%. The recovery rate of SLR was 96.8%, motor deficit ; 93.6%, sensory deficit ,78.6%, DTR change ; 21% and radiating pain ,84.2%. The average recovery time of SLR was 3.4 months, motor deficit ; 1.9 months, sensory deficit ; 5.3 months, DTR change ; 4.1 months and radiating pain ; 3.2 months. Motor and sensory deficit was more frequent in L4-5 lesion but DTR change was usually noted in L5-S1 lesion. The recovery rate and time showed no great difference between the two level. CONCLUSIONS: The recovery rate was higher in SLR, motor deficit and radiating pain rather than sensory deficit and DTR change. The recovery time was fastest in radiating pain but variable nature was noted in sensory deficit. Above results may be helpful to explain the prognosis of the lumbar HIVD.

Comparison between Total and Partial Resection with Arthroscope in the Lateral Discoid Meniscus / 대한정형외과학회잡지

In the treatment of meniscal injury of the knee joint, it has been known that the result of partial meniscectomy to prevent degenerative change of the knee joint after meniscectomy. However the result of lateral discoid meniscectomy is controversial between partial and total meniscectomy. In the treatment of lateral discoid meniscal injury, Fujikawa and Dickhaut reported the better results with partial meniscectomy than total resection, but Ikeuchi and Kobayashi reported the better results with total meniscectomy. The purpose of this paper is to compare the results of arthroscopic partial and total meniscectomy. Five hundred ninety-five patients with meniscal injury was treated by meniscectomy between January, 1983 and December, 1994 at the department of orthopaedic surgery, Soonchunhyang Univ. Hospital. 119 patients of all were done lateral discoid meniscectomy had no other combined findings. Wr wrre able to follow up 42 patients(44 cases) of 84 patients with interview and/or questionnaire. WR analysed the 44 cases and summarized the results as follow: 1) A discoid lateral meniscus was presented in 20.0% of all meniscal resection. 2) Postoperative click sound was presented in 7 cases of 25 cases(28.0%) with partial meniscectomy and in 5 cases of 19 cases(26.3%) with total meniscectomy. Giving way was presented in 2 cases(8.0%), 1 case(5.3%) and Locking in 1 case(4.0%), 0case(0.0%) respectively. 3) In the post operative. Pain, no pain and mild pain were presented in 88.0% of partial meniscectomy and in 94.8% of total meniscectomy. 4) In the degree of activity level, “same before symptoms was developed(no symptom)”. was presented in 84.0% of partial meniscectomy and in 84.2% of total meniscectomy. 5) In the return to work, all patients returned to original job with/without limitation. 6) In the knee rating scale of Ikeuch, excellent or good was presented 72.0% of partial meniscectomy and in 89.5% of total meniscectomy. 7) Roentgenologic degenerative changes were more presented after total than partial meniscectomy. We concluded that the total meniscectomy is better than the partial meniscectomy in the symptom and functional results, but long term follow up secondary degenerative change must be followed.

Giant Epidermal Cyst / 대한정형외과학회잡지

Epidermal cysts slowly growing, intradermal or subcutaneous tumors that usually cease growing after having reached 1 to 5 cm in diameter. We report a case of giant epidermal cyst on the scapular region with the appearance of well delineated huge mass measured 19×17×14cm in size. Its clinical and surgical management are illustrated.