Anterior Cervical Fusion with the PCB Instrumentation (Cervical Plate Cage System) in Degenerative Cervical Disease

OBJECTIVE: The anterior interbody fusion for cervical spine disorder may not provide adequate immediate stabilization, whereas anterior cervical spine plating has overcome this main disadvantage. Recently, several types of hardware were introduced and the complications related to these were also reported. In case of degenerative cervical spine disorders, the adequate intervertebral disc space height and lordotic curvature are the major factors for preventing recurrence of symptoms. So we used the PCB instrumentation(cervical plate cage system) for these purpose. MATERIAL AND METHOD: From April 1998 to October 1998, 16 patients with degenerative cervical spine disorders who had radiculopathy or myelopathy were underwent anterior cervical spine fusion with the PCB instrumentation(cervical plate cage system). Single level fusion was accomplished in 8 patients and two level fusion in 8. The mean follow-up period was 4 month. RESULT: All patients show some recovery at discharge. There were no hardware problems. The intervertebral disc space height and lordotic curvature were not changed during follow up. CONCLUSION: These finding suggest that PCB instrumentation can be considered to be one of the useful hardwares for anterior cervical spine fusion in degenerative cervical spine disorders.

Alpha Receptor Stimulation by Norepinephrine and Blockade by Benoxathian in spinal Pial Arteries of Rabbit

The effect of norepinephrine and benoxathian on the diameter of spinal pial arteries in rabbits was studied by topical microapplication of the drug to the perivascular environment. Arterial diameter was determined with the micrometer eyepiece on operating microscope through laminectomized area. Physiological parameters(PaO2, PaCO2, blood pH, and systolic blood pressure) were not significantly changed during all experiments. The results of this study are summerized as follow. 1) Application of norepinephrine over the range of 5x10(-8)M to 5x10(-3)M to spinal pial arteries resulted in significant constriction which were shown to be proportional to concentration, with exception of 5x10(-8)M. The dose response curve showed constriction of 30.5+/-7.1% at 5x10(-3)M. 2) Benoxathian produced the vasodilatation which were shown to be proportional to concentration. The dose response curve showed vasodilatation of 21.4+/-4.4% at 5x10(-3)M 3) The vasoconstriction due to microapplication of norepinephrine was prevented by the inclusion of an equimolar concentration of the alpha-adrenergic receptor blocker, benoxathian. 4) The vasoconstriction due to norepinephrine was present in the concentration of norepinephrine more than that of benoxathian, and the vasoconstriction was proportional to the concentration of norepinephrine. The results indicate that alpha-adrenergic receptor is present in the smooth muscle of spinal pial arteries for the sympathetic control of blood flow to the spinal cord.

A Case of Axis Spondylolysis Causing Quadriparesis: Case Report

Cervical spondylolysis is an extremely rare abnomality of unknown etilogy, first described by Hadley. It is defined s a corticated cleft between the superior and inferior articular facets of the articular pillar, the cervical equivalent of the pars interarticularis in the lumbar spine. A 50-yar-old woman was presented with occipital headache, and pain in the upper neck region. Neurological examination revealed the patients inability to walk because of quadriparesis with mild hypesthesia in both hands and feet. The DTR was hyperactive and pathological reflexes, including Babinski's and Hoffman's, were positive bilaterally. CT showed the bilateral pars interarticularis defects and spinal canal stenosis. MRI revealed signal alteration on the upper spinal cord which was compromised due to the hypertrophied ligamentum flavum. Decompressive laminectomy of C2 was performed and the patient's neurological deficits had recovered to some extent and resulting to her ability to walk without assistance.

Primary Central Nervous System Lymphoma Associated with Systemic Lymphoma: Case Report

Primary central nervous system(CNS) lymphoma is an uncommon neoplasm which is considered to be radiosensitive. We have recently experienced one of such cases with a history of systemic lymphoma(diffuse histiocytic lymphoma) of the left cheek and left forearm in a 56-year-old man. Chief complaints include headache and generalized weakness for 1 month. MRI(magnetic resonance imaging) revealed an enhancing irregular mass lesion in both the basal ganglia and corpus callosum with minimal surrounding brain edema. CSF analysis and cytology revealed no specific abnormal findings. Without brain biopsy, we concluded that the lesion was a primary CNS lymphoma based on the fact that the patient have had a history of diffuse histiocytic lymphoma and MRI findings were compatible to primary CNS lymphoma. He was treated with dexamethasone for 2 weeks and 3900 cGy radiation therapy for 5 weeks. He improved gradually, and control MRI after radiotherapy showed complete resolution of the lesion.

A Case Ritter's Disease

We experienced a patient of 13 days old female who was diagnosed with Ritter's disease and reported with brief review of literatures. 3 days before entry, she was suffered from fever, irritability and bullous skin lesions suddenly. And then coagulase-positive staphylococcus aureus was isolated from skin lesions and treated with systemic and local supportive measures.

A Case of Posterior Urethral Valve

The most common site of posterior urethral valve is that in which there is an exaggeration of the normal ridges which extend from the midline dorsal urethral ridge and from the verumontanum to surround the urethra just before the membranous region. Obstruction to urine flow may be complete or partial. In patients with partial obstruction, failure to thrive, systemic acidosis with renal failure and continuous over-flow dribbling rather than a good urinary stream may be seen. Apart from the problem of renal damage consequent to the obstruction, these children are subject to recurrent urinary infections. Excretory urography and retrograde cystourethrography are needed to establish the diagnosis. The characteristic proximal ballooning of the urethra is best seen during micturition or attempts to express urine from the bladder. Early surgical decompression is warranted. A temporary diversionary procedure is recommended, with a definitive operation at a later age to correct the valvular obstruction. We experienced a case of posterior urethral valve which was developed in a 4 years old boy, treated this case by destruction of posterior urethral valve and report it with brief review of literatures.

Duchenne Type Muscular Dystrophy Occuring in 3 Brothers

We were experienced Duchenne type muscular dystrophy occuring in 3 brothers among 6 siblings. In all cases, the clinical symtoms were started at about 6 years old age, And diagnosis was easily confirmed by clinical symptoms and laboratory examination with muscle biopsy. We report with brief review of the literature.