The Fusion Rate and Clinical Effect of PLIF with Laminected Lamina and Spinous Process / 대한척추외과학회지

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.

The complications of the Graf stabilization for lumbar disc herniation with posterior instability / 영남의대학술지

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.

The Treatment of Grade 3 Acute Acromioclavicular Joint Injuries with Modified Neviaser Technique / 대한정형외과학회잡지

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.

Synovectomy Of The Elbow In Rheumatoid Arthritis / 대한류마티스학회지

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.

Treatment of Fracture of the Thoraco / 대한정형외과학회잡지

The main goals of surgical teatment of thoracolumbar vertebral fractures are to achieve reduction, stability and early, painless mobilization. A further aim is to avoid late malposition and to preserve mobility and lordosis. The main disadvantage of Harrington instrumentation and similar methods are that this device fixate five to seven vertebrae. The Cotrel-Dubousset(C-D) instrumentation provides a stable construct for fixation of spine fracture. The advantages of C-D pedicle screw for thoracolumbar spinal fractures are that compression or distraction force can be applied in the same rod and used to achieve anatomical reduction of spinal fractures and rigid fixation can be obtained with short instrumentation. The C-D instumentation was done for 15 unstable thoracolumbar spinal fractures at Seoul Red Cross Hospital from January, 1988 to January, 1990. The results were as follows. 1. The most common cause of the spine fracture was fall down, and majority are within 20-40 old age. 2. The most common involved site was T12 and Ll vertebrae (66.7%). 3. The most common type of injury was burst fracture by according to Denis classification(60%). 4. The complication was developed mostly in neurological deficient patient. 5. The advantage of the C-D instrumentation: (1) rigid and short osteosynthesis of spine fracture, (2) compression or distraction force can be applied in the same rod, (3) early mobilization with a brace is possible. 6. The rigid fixation can be obtained.