ABSTRACT
Single-balloon kyphoplasty via an extrapedicular approach has been reported to be effective because it requires less time than conventional two-balloon kyphoplasty and has comparable therapeutic efficacy. However, single-balloon kyphoplasty is not popular because the extrapedicular approach is believed to be complicated and unsuitable for the thoracolumbar and lumbar spine. The authors describe a standardized surgical technique that utilizes a far-lateral extrapedicular approach for single-balloon kyphoplasty, which can be performed in any part of the spine by physicians without substantial difficulty.
Subject(s)
Fractures, Compression , Kyphoplasty , Osteoporosis , SpineABSTRACT
PURPOSE: To assess the biomechanical effects and effectiveness of an interspinous spinal spacer (ISS) on the intradiscal pressure using in vitro biomechanical tests. MATERIALS AND METHODS: Six calf spine specimens (less than 2 weeks of age, L1-L5) were divided to two groups the intact and the surgery groups (n=3 each). For the surgery group, an ISS made from PMMA (Greek pi=12-mm) were inserted into the space between the spinous processes of L3-L4. The intradiscal pressures at the various regions of the annulus (anterior, posterior, and posterolateral locations) and the nucleus pulposus were measured using the four pressure transducers under pure compression (700 N) and extension loads (700 N+7.5 Nm). RESULTS: An increase in pressure was observed from neutral to extension at the posterior and posterolateral annulus. After inserting the ISS, the changes in pressure at the adjacent disc levels (L2-L3, L4-L5) were negligible regardless of the loading conditions (p>0.05). However, at the implanted level (L3-L4) statistically significant changes in the pressure were found under extension loading at the nucleus pulposus, posterior and posterolateral regions of the annulus with a pressure drop from 1.48 MPa, 1.42 MPa, 1.71 MPa to 1.11 MPa, 0.961 MPa, 1.08 MPa, at the respective locations (p<0.05). The relative percentage decrease were 25%, 31.7%, and 36.8%. CONCLUSION: On the implanted level, these results showed that the insertion of the ISS with PMMA can effectively reduce the intradiscal pressures by at least 25% quite uniformly over the intravertebral disc during extension. More effective reduction was observed at the posterolateral location. The pressure changes at the adjacent levels were negligible in contrast to the abnormal pressure changes that are frequently reported after conventional rigid fusion. This suggests that the likelihood of adjacent level degeneration after surgery can be minimized using the ISS insertion.
Subject(s)
Polymethyl Methacrylate , Spinal Stenosis , Spine , Transducers, PressureABSTRACT
Primary ovarian pregnancy is comparatively rare in ectopic pregnancy. Ovarian pregnancy occurs in corpus luteum cyst and is usually accompanied with the rupture of ovary and a massive hemoperitoneum. It presents as a hemorrhagic ovary and frequently misdiagnosed as a ruptured corpus luteum. Spiegelberg's criteria should be fulfilled for the diagnosis of ovarian pregnancy. Two cases of ovarian pregnancy were presented with a brief review of the literatures.
Subject(s)
Female , Pregnancy , Corpus Luteum , Diagnosis , Hemoperitoneum , Ovarian Cysts , Ovary , Pregnancy, Ectopic , RuptureABSTRACT
Chronic hepatitis associated with the idiopathic hypereosinophilic syndrome has been very rarely reported worldwide. Recently, we experienced a case of chronic hepatitis with piecemeal necrosis as the clinical feature of the idiopathic hypereosinophilic syndrome. The patient was a 49-year-old woman who complained of a mild fever, nausea, vomiting, and pain in the right upper quadrant. The eosinophil count of peripheral blood increased up to 14,020/microliter (64% of WBC). Liver biopsy specimen showed severe porto-periportal inflammation with marked eosinophilic infiltration and ballooning degeneration of hepatocytes. Corticosteroid therapy significantly normalized the eosinophil count of peripheral blood.