Stereotaxic Transcerebellar Approach for the Posterior Fossa Lesions with C.R.W. System

6 patients underwnet CT-guided stereotactic biopsy or hematoma aspiration procedure for posterior fossa lesions. Trajectory for biopsy or aspiration was transcerebellar approach. The patients were placed under general endotracheal anesthesia and positioned prone or sitting. No complications were encountered in the postoperative period when this technique was used. Stereotaxic transcerebellar multiple biopsy can safely provide tissue conformation of the neoplastic nature of a posterior fossa lesion thought to be a tumor. In addition, hematoma aspiration has been demonstrated to be safe, reliable, and efficient.

Eosinophilic Granuloma in Cervical Spine: Case Report

Eosinophilic granuloma of the cervical spine is an uncommon disease. A 20-year old male patient noticed cervical pain, restricted range of movement, torticollis and tenderness. On computed tomographic scan, myelographic imaging and plain radiographic imaging demonstated a bony destruction in the left side of the third cervical vertebral body and a part of the pedicle. Preoperative radioisotope bone scan demonstrated an hot uptake in the third cervical vertebral body. Gross total removal of the lesion and radiation therapy were performed. Postoperative course was favorable. The lesion is readily curable and should be considered in the diferential diagnosis of pain or neurological deficit in association with a lytic defect in the cervical spine. Occasionally, a solitary lesion characteristic of eosinophillic granuloma in found in cases of otherwise classic Hand-Schuller-Christian. So, close chinical and radiologic follow-up sholuld be obtained.

The Posterolateral Decompression for Burst Fracture in the Thoracolumbar Spine

The posterolateral approaches to the spine is an effective method for the neural decompression and the spinal stabilization. This procedure has an advantages of an one-stage posterolateral decompression-stabilization. We have experienced 8 patients with burst fracture in the thoracolumbar junction. A three-quater prone position was used for patient positioning. No patient showed neurologic deterioration after surgery. Patient positioning and the operative approach are described and illustrated.

Hemorrhage into Intracranial Neurinoma: Case Report

Massive hemorrhage into an intracranial neurinoma is a rare event. A 42-year old man noticed hearing loss, nystagmus, diplopia and paresthesia on the left side of the face. A computerized tomography scan demonstrated a large high density mass in the left cerebellopontine angle. The tumor was successfully removed and postoperative course was favorable. Such a case of acoustic neurinoma which revealed itself through intratumoral hemorrhage has not been previously reported in Korea.

Plain Radiological Measurement of Relationships Between Intervertebral Disc Space and Spinous Process

The mean values of the height, depth and lateral shifting of the spinous processes and the height of the intervertebral disc spaces of 100 patients were measured in the lumbar region. The application of microsurgical techniques in the operation for lumbar disc herniation clearly reduced the overall surgical trauma suffered by patient, but the spinous process might disturb the insertional course and multidirectional activities of the pituitary forceps due to a very small skin incision. The purpose of this study was to prove the relationships between intervertebral disc space and spinous process in the lumbar region. The results were as follows; 1) The height of the intervertebral disc space from L3-4 to L5-S1 intervertebral disc space was 12.63mm, 12.57mm and 11.71mm respectively. 2) The depth of the spinous process from L3 to L5 was 28.87mm, 27.87mm and 23.97mm respectively. 3) The lateral shifting of the spinous process from midline to the right side was 4.39mm, 4.35mm and 4.01mm at L3, L4 and L5 spinous process respectively and to the left side was 3.61mm, 3.70mm and 3.69mm at L3, L4 and L5 spinous process respectively. Conclusively, the lower part of the spinous process was overlapped above the intervertebral disc space at L3-4, L4-5 and L5-S1 intervertebral disc space. About 4mm of the lateral shifting of the spinous process was protruded to both right and left side in the insertional course(about 2-3cm) of the pituitary forceps. The spinous process might disturb the multidirectional activities and perpendicular insertion of the pituitary forceps. So, the removal of the spinous process to the midline was recommended to perform the complete removal of disc materials in microlumbar discectomy.