Asymptomatic Cervical Isthmic Spondylolisthesis and Associated Occult Spinal Bifida: A Case Report

We report a case of rare cervical isthmic spondylolisthesis of C6-7 combined occult spinal bifida at C6, and review the radiologic finding, different diagnosis and treatment. A 23-year old female presented nuchal, back pain after traffic accident. Radiologic finding showed the 6th cervical isthmic defect, spondylolisthesis and dysplasia. The patient was conservatively treated about 8 weeks, and 10 months after injury, she was symptom free with full range of motion of cervical spine and she was followed up. Cervical spondylolysis is a very rare condition. This clinical importance is vulnerable to trauma. For whatever reasons, symptomatic patients need to be treated by conservative or surgical option.

Predictive Risk Factors for Refracture after Percutaneous Vertebroplasty

OBJECTIVE: To identify risk factors for developing a vertebral refracture after percutaneous vertebroplasty. METHOD: A retrospective analysis of 60 patients who had undergone percutaneous vertebroplasty between January 2008 and April 2010 was conducted. All patients were observed for a 1 year follow-up period, and fracture was defined when it was both clinically reported and radiographically confirmed. Twenty-seven patients with a refractured vertebra and 33 patients without a refracture were included. Of the 60 patients, 20 presented with a refracture from a cemented vertebra, whereas the remaining 40 patients did not. Clinical, imaging and procedure-related factors for each group were analyzed by the Fisher's exact, chi-square, and the Mann-Whitney U-tests. RESULTS: Local kyphotic angle and sagittal index were significant as a result of researching various risk factors related to vertebral refracture (p<0.001, p<0.001, respectively) and refracture from a cemented vertebra itself (p=0.004, p<0.001, respectively). Other factors were not significant. CONCLUSION: Patients who had a high preoperative local kyphotic angle and a high sagittal index required a close follow-up and attention.

Usefulness of tibia counter rotator (TCR) for treatment of tibial internal torsion in children / 소아과

PURPOSE: Tibial internal torsion is prevalent in East Asian countries such as Korea and Japan, where sitting on the floor is common behavior. Tibial internal torsion or excessive lateral tibial torsion may cause esthetical, functional, or psychological problems and also may induce degenerative arthritis in older age. The aim of this study is to evaluate the therapeutic effect of Tibial Counter Rotator (TCR) in patients with tibial internal torsion. Method:One hundred forty nine children (274 limbs) with tibial internal torsion participated in this study. Transmalleolar angle were measured with gravity goniometer. When tibial internal torsion was detected, TCR was applied at least for 3 hours a day during sleep. The patient's progress was followed monthly and transmalleolar angle was reevaluated by the same examiner. RESULTS: Transmalleolar angle was significantly increased in patients with tibial internal torsion during TCR application (P<0.001). CONCLUSION: TCR can be one of the effective methods for correcting tibial internal torsion in children under 12 years old of age.

The Effect of Low-Level Laser Irradiation on Activities of Dorsal Horn Neurons in Rats with Experimental Muscle Pain

OBJECTIVE: This study was performed to investigate the effects of low-level laser irradiation on the dorsal horn cell activities in the rats with experimental muscle pain. METHOD: Experimental muscle pain was induced by repeated injections of acidic saline into the gastrocnemius muscle in thirty Sprague-Dawley rats. Activities of ipsilateral dorsal horn cells were recorded with a glass microelectrode at L2-L4 spinal cord level before and after low-level laser irradiation on the injected leg. Cells were categorized as wide dynamic range (WDR) and high threshold (HT) cells by the response to the cotton, vonFrey filament, and forceps stimulation at the receptive area. RESULTS: The spontaneous and mechanically evoked activities of WDR and HT cells were significantly increased in the muscle pain models. Low-level laser irradiation reduced mechanically evoked activities of WDR and HT cells. This effect was maximal at 20 minutes after irradiation and then returned to pre-treatment level in 40~50 minutes. CONCLUSION: The low-level laser irradiation was effective for the management of muscle pain by reducing activities of dorsal horn cells. Low-level laser might be clinically used for the treatment of local and referred pain of muscle origin.

The Mechanism of Contralateral Hyperalgesia in the Persistent Muscle Pain Rat Model

OBJECTIVE: This study was designed to investigate the mechanism of the primary afferent input to spread of contralateral hyperalgesia in the persistent muscle pain model in the rat. METHOD: Muscle pain was induced by twice repeated intramuscular injections of pH 6.0 buffered saline into the unilateral gastrocnemius muscle of the rats. Change of mechanical withdrawal threshold to von-Frey filament was measured after ipsilateral laser irradiation, anesthetic blockade with lidocaine and dorsal rhizotomy (L2~L6) to reduce primary afferent input from the tissue injury. RESULTS: Bilateral persistent mechanical hyperalgesia in the hind paw was evoked after second injection. Ipsilateral laser irradiation, lidocaine injection and dorsal rhizotomy had no effect on the contralateral spread of mechanical hyperalgesia. CONCLUSION: These results suggest that contralateral hyperalgesia was produced by, but didn't need to be maintained by inputs from an injury. Therefore, central nervous systems are responsible for the contralateral spread of hyperalgesia.

Acute Rhabdomyolysis and Ischemia of the Spinal Cord Following the Heavy Alcohol Ingestion: A case report

Ischemic myelopathy is a rare and uncommon disease than the cerebral ischemia. Ischemia of spinal cord usually occur in the midthoracic regions (T4-T8). The major arteries supplying spinal cord are anterior and posterior spinal arteries. Anterior spinal artery is more responsible for the ischemic change of the spinal cord. We report a 45 years old man with ischemia of the spinal cord and acute renal failure due to rhabdomyolysis following the heavy alcohol ingestion.