Thoracic Spinal Stenosis

A stenotic spinal canal in the cervical or lumbar region is a well-known clinical entity. However, stenosis involving a thoracic vertebra is rarely mentioned in the literature. Improved neuroimaging facilities, especially MRI, let us detect the thoracic canal stenosis not so infrequently as in the past years. The authors are reporting six operative cases of thoracic myelopathy associated with thoracic spinal stenosis. Motor & sensory abnormalities were found in all cases during the clinical course. Magnetic resonance imaging and Metrizamide CT scanning were useful in the diagnosis of thoracic spinal stenosis. Treatment consited of wide posterior decompression resulting in symptomatic improvement in five of six patients.

Management of Intracranial Arachnoid Cysts in Children

14 supratentorial and 6 infratentorial arachnoid cysts, diagnosed and treated at Kangnam St Mary's Hospital from 1983 to 1988, are reported. The most common presenting symptoms in children were craniomegaly, delayed development, increased ICP and neurological focal signs. Neuroradiological examination included plain skull X-ray, brain CT and metrizamide CT or isotope study. Therapeutic criteria according to the clinical and radiological findings were reviewed. The results were as follows; 1) The patient below age of 2 yrs who's brain had a potent ability of growth should be operated in any cases for reducing mass effect. 2) In sylvian lesion, Type II and III according to the classification of Galassi were well treated with C-P snunt. 3) In infratentorial lesion, all patients had hydrocephalus and the patient who had communicated with subarachnoid space in metrizamide CT were well treated with V-P shunt and who not communicated with subarachnoid space was well treated with Y-shunt. 4) We had good results by fenestration above the age of 3 yrs and by C-P shunt under the age of 2 yrs in supratentorial lesion.

Comparison of CT and Myelography in spine Lesion / 대한정형외과학회잡지

CT and myelography, separately or combined together, have been used for the study of spine lesion. Metrizamide enhanced CT is a new diagnostic modality for the study of spine lesion. The purpose of this study was to compare the efficacy of metrizamide enhanced CT with those of CT and metrizamide myelography. Among 163 surgically proven cases, metrizamide CT was carried out on 49 cases, CT on 50 cases and myelography on 64 cases, at Department of Orthopedic Surgery, Seoul University Hospital for 3 years period from August 1981 to July 1984. 1. Overall diagnostic accuracy of CT was 90%, that of metrizamide myelography was 82.8%and that of metrizamide CT was 93. 9%. 2. Diagnostic accuracy of metrizamide CT in HIVD was 95%, in spinal stenosis 94.4% and in spondylolisthesis 80%. 3. Most of complications were observed in myelography, even they were minor. 4. It was concluded that plain CT was advisable on a clinically typical HIVD, considering complications and expenses of myelography and metrizamide CT. 5. Metrizamide CT was indicated on previously operated cases or atypical HIVD, spinal stenosis and spondylolisthesis.