Exoskeleton-assisted Gait Training in Spinal Disease With Gait Disturbance / 대한신경손상학회지

Objective@#Gait impairment reduces a patient’s quality of life. Exoskeletons and wearable robotics enable patients with gait disturbance to stand up and walk. An exoskeleton was developed for use in patients with stroke and spinal cord injuries. This study aimed to evaluate the effectiveness of overground exoskeleton-assisted gait training (OEGT) in spine diseases with gait disturbance. @*Methods@#This was a single-group preliminary study. Five participants with gait disorders because of root dysfunction accompanying spinal stenosis were included in this study. All participants underwent surgical treatment and an exoskeleton training protocol scheduled for 2 or 3 days per week for 4 weeks. Each session was 60 minutes. Clinical tests were performed before (T1) and at the end of the training (T2). @*Results@#One patient dropped out of the study because of medical issues that were not associated with the exoskeleton. Exoskeleton-assisted rehabilitation was feasible for all participants. All participants showed positive changes in gait performance, balance, proximal muscle strength, psychological state, and satisfaction with the rehabilitation. However, there was no significant improvement in neurological deficits. @*Conclusion@#OEGT is a feasible rehabilitation method for patients with gait disorders caused by degenerative spinal disease.

Contralateral Interhemispheric Transcallosal Approach for Thalamic Cystic Cavernous Malformation

A 42-year-old man presented with a headache and right hemiparesis and was found to have a cystic mass with a calcified mural nodule in the left thalamus. Because the thalamus is surrounded by vital neurovascular structures, the surgical approach to thalamic lesions can be challenging. We decided to remove the mass for decompression and pathological diagnosis. The mass was removed through a contralateral interhemispheric transcallosal transchoroidal approach with less retraction and parenchymal injury than other approaches to avoid brain retraction and cortical injury. The pathological diagnosis was cavernous malformation. Temporary worsening of the preoperative hemiparesis was recovered over two months following surgery. Tolerable thalamic pain syndrome remained. Here, we report a rare case of thalamic cavernous malformation with a favorable outcome through a contralateral surgical approach.