Percutaneous Vertebroplasty: Short-term Results of 38 Cases / 대한정형외과학회잡지

PURPOSE: To evaluate the clinical outcome of vertebroplasty, and to analyze the causes of poor results. MATERIALS AND METHODS: The radiological and clinical results of thirty-eight patients who were followed for more than one year after vertebroplasty for painful osteoporotic compression fractures were retrospectively analyzed. RESULTS: There were 10 recollapses and 6 fractures of adjacent vertebrae. Most of these occurred in the thoracolumbar junction (9 and 5 respectively). Pain was significantly improved in the immediate postoperative period, that is, from 9.3+/-0.7 points on a 10-point pain scale preoperatively to 2.0+/-0.7 points postoperatively (p<0.001). However, at the last follow-up, this was aggravated to 3.9+/-3.3, and eleven (29%) patients had moderate (5-7 points) or severe (8-10) pain. The main causes of aggravation of pain were recollapses (5 cases) and/or fractures of adjacent vertebrae (5). CONCLUSION: Vertebroplasty resulted in excellent relief from pain in the immediate postoperative period, but the more-than-one-year follow-up results were less satisfactory, and this was particularly true in the thoracolumbar junction. The possibility of recollapse or of fractures of adjacent vertebrae must be kept in mind.

The results of the Posterior Lumbar Interboby Fusion using Titanium mesh cage for Spondylolisthesis / 대한척추외과학회지

STUDY DESIGN: This is a retrospective study analysing and comparing what between posterior lumbar interbody fusion plus posterior lateral fusion(PLIF+PLF) and PLF alone for Spondylolisthesis(Degenerative type+Isthmic type). Thirty patients were treated by posterior lumbar interbody fusion(PLIF) using Harms' cage and posterolateral fusion(PLF) with transpedicular screw fixation. Forty-nine patients were treated by posterolateral fusion with transpedicular screw fixation. OBJECTIVES: This is to verify the advantages of adding posterior lumbar interbody fusion using Harms' cage to the usual posterolateral fusion with transpedicular screw fixation SUMMARY OF BACKGROUND DATA: Interbody fusions have certain distinct mechanical advantages over posterolateral ones. Autologous cancellous bone is the preferred graft material, but might be soft to maintain the disc space during fusion. METHODS: Union rate, slip reduction, sagittal angle correction, disc height restoration, and clinical results by Lin's criteria were analysed. RESULTS: Nonunion was observed in 5 PLF cases(10%) and one PLIF case(3%). Loss of slip reduction was 0.7% in PLIF and 2.59% in PLF(P<0.05). Loss of sagittal angle correction was 1.27degreein PLIF and 3.65degreein PLF(P<0.05). Loss of disc height restoration was 2.6% in PLIF and 7.6% in PLF(P<0.05). Clinical evaluation in PLIF+PLF was excellent in 67%, good in 30%, and fair in 3%. Clinical evaluation in PLF was excellent in 59%, good in 33%, and fair in 8%. More excellent results were noted in PLIF+PLFcases. CONCLUSIONS: Adding posterior lumbar interbody fusion using Harms' cage showed better radiological results and more excellent clinical results compared to posterolateral fusion with transpedicular screw fixation.

A Case of Primary Parathyroid Carcinoma with full-brown Symptom / 대한내분비학회지

Primary hyperparathyroicism is a state of hypersecretion of PTH by the parathyroid. The etiology has not been established. The three possible etiologies of piimary hyperparathyroidism and incidences are adencena(83%), hyperplasia(15%), and carcinoma(1~2%). Parathyroid carcinoma usually presents in the fourth decades. The hallmark preoperative signs are hypercalcemia(serum calcium 15mg/dl). Palpable neck mass and bane and renal disease. Patients may present with multiple signs and syrnptoms, including recurrent nephrolithiasis, peptic ulcers, mental change, less frequently, extensive bone resorption. However, with greater awareness of the disease and wider use of screening tests, including blood calcium determinations, the diagnosis is frequently made in patients who have no symptoms and minimal, if any, signs of the disease ather than hypercalcemia and elevated levels of parathyroid Hormone. An 38-years-old woman was admitted to the hospital due to pain on the left knee joint. We experienced full-brown symptom pertaining to hyperpara- thyroidism. Thus we report a case herein and also discuss clinical anifestation, histologic features and treatment.