Gradual Height Decrease of Augmented Vertebrae after Vertebroplasty at the Thoracolumbar Junction / 대한신경손상학회지

OBJECTIVE: Vertebroplasty is an effective treatment for vertebral compression fracture, but may progress gradual vertebral height decrease in spite of vertebroplasty. Gradual vertebral height decrease also may induce aggravation of kyphotic change without severe pain. The purpose of this study was to evaluate risk factors for gradual vertebral height decrease in the absence of recurrent severe back pain. METHODS: A retrospective analysis was performed on 44 patients who were diagnosed with a first osteoporotic compression fracture at a single level at the thoracolumbar junction. All patients were taken vertebroplasty. Possible risk factors for gradual vertebral height decrease, such as sex, age, bone mineral density, body mass index, level of compression fracture, volume of injected cement, cement leakage into disc space, and air clefts within fractured vertebrae, were analyzed. RESULTS: Gradual vertebral height decrease of augmented vertebrae occurred commonly when more than 4 cc of injected cement was used, and when air clefts within fractured vertebrae were seen on admission. In addition, the sagittal Cobb angle more commonly increased during the follow-up period in such cases. CONCLUSION: Injection of more than 4 cc of cement during vertebroplasty and air cleft within fractured vertebrae on admission induced gradual vertebral height decrease in augmented vertebrae. Thus, longer follow-up will be needed in such cases, even when patients do not complain of recurrent severe back pain.

Spinal Paraganglioma Adherent to the Cauda Equina

Paragangliomas are rare among intradural spinal tumors. Most of them are benign, but aggressive behavior and local recurrence can occur. Cases of paraganglioma are, difficult to diagnose radiologically; hence, diagnosis is confirmed histopathologically. Radiologically, paragangliomas are similar to ependymomas, and, histopathologically, they are similar to neuroendocrine tumors. We evaluated the case of a 76-year-old woman with a spinal paraganglioma that was associated with back pain and radiating pain in both the lower extremities. She underwent an operation, and her symptoms were relieved. Here, we describe a rare case of paraganglioma that was adherent to the cauda equina.

Clinical Features of Post-Traumatic Syringomyelia / 대한신경손상학회지

OBJECTIVE: The purpose of this study was to analyze the clinical manifestations, radiological findings, treatment results, and clinical significance of post-traumatic syringomyelia (PTS). METHODS: We retrospectively reviewed the medical charts of nine surgical patients with symptomatic PTS between 1992 and 2012. RESULTS: The most common clinical manifestation was development of new motor weakness. The mean interval between the initial injury and the onset of new symptoms 21.9 years. The mean length of the syringes observed on preoperative magnetic resonance images was 7.8 spinal levels. Shunting procedures were performed in five patients. Four patients underwent arachnoidolysis and duraplasty. Patients developed mechanical shunt failure. Postoperatively, one patient showed clinical improvement, four patients were stable, and four patients showed deterioration. CONCLUSION: PTS is a disabling sequelae of spinal cord injury, which develops months to years after spinal injury. We have to consider that patients with PTS may have poor long-term outcome.