Rercutaneous Radiofrequency Denervation in Lumbago

A technique radiogrequency localization and coagulation of articular nerves supplying the lumbar facets is described and reported from a series of 46 patients with clinical diagnosis of facet syndrome over a 4-year period. None of them had clinical or radiologic evidence of a lumbar disc hrniation, and all had exhausted conservative treatment. The literature reviewed for anatomical accuracies in denervation of the medial branch of posterior primary(dorsal) ramus. The technique of facet denervation is simple and safe and relief of pain was achieved in 78% of the patient, the morbidity remains quite low.

Clinical Experience of the Neurofibromatosis: Report of Three Cases

The usual form of neurofibromatosis is characterized by cafe-au-Iait skin pigmentation and pedunculated fibrous skin tumors but in the severe form, malformations and tumors of the central nervous system may be associated with von Recklinghausen's disease. Schwannoma of the spinal sensory roots, of the vestibular part of 8th cranial nerve, and of the sensory root of the 5th cranial nerve are particularly common. Outside the central nervous system, other neuroectodermal tumors may develop including renal, pancreas, and suprarenal tumors. Recently, neurofibromatosis is subdivided into type 1 and 2, according to the site of involvement. Type 1 is classic von Recklinghausen's disease, and type 2 represents bilateral acoustic neurinomas. The authors experienced 2 cases neurofibromatosis type 1 and 1 case of neurofibromatosis type 2 in which neurofibromas involve both cerebello-pontine angles, multiple levels of spinal cord and cauda equina.

A Clinical Analysis of Re-operated Cases of Herniated Intervertebral Disc

The authors experienced 32 cases of reoperation due to persistent or recurred symptoms who had once low back operation due to herniated lumbar disc. The results were summarized as follows: 1) The reoperated cases were most common in 5th decade(31.3% ) and 2nd most common in 4th decade(28.1%) of age, and the male to female ratio was 2:1. 2) The lesion sites of reoperated cases were L4-5 space(68.8%), L5-S1 space(18.8%), multiple space(9.4%) and L3-4 space(3.1%) in orders. 3) The symptom-free interval between 1st and 2nd operation were 1-5 years(34.4%), 6-10 years(15.6%) and 2-6 months(12.5%) in orders. The longest interval were above the 11 years (21.9%) and the shortest interval were below the 1 month(15.6%). 4) The main pathologic findings of reoperated 32 cases were epidural fibrosis(31.2%), incomplete disc removal+epidural fibrosis(31.2%), new disc herniation(21.8%), foraminal stenosis(9.4%) and opposite site herniation(6.3%) in orders. 5) The results of 32 reoperated cases were good(43.7%), excellent(21.8%), fair(18.7%) and poor(15.6%) in orders.

A Case of Cerebral Candidal Granuloma

Candidosis, the most common fungal infection involving the central nervous system, is rarely diagnosed during life. The authors present a case of candidal granuloma of the caudate area in a 31-year-old, otherwise healthy man with episode of intermittent antibiotic therapy. There was no extracranial fungal lesions, Ventriculoperitoneal shunt and biopsy followed by treatment with Amphotericin-B resulted in a favorable outcome.

A Case of Traumatic Spinal Epidural Hematoma in Ankylosing Spondylitis

A case of traumatic thoracolumbar epidural hemorrhage is presented in a 37-year-old man with ankylosing spondylitis. The patient complained neck and back pain right after the accident but paralegia and difficult urination followed 2 days later. Spine CT showed thoracolumbar epidural mass, which was confirmed to be hemorrhage associated with spine fracture and was solely responsible for paraplegia.