Minimally Invasive Transforaminal Lumbar Interbody Fusion / 대한척추외과학회지

STUDY DESIGN: A retrospective study OBJECTIVES: To introduce the technique of minimally invasive transforaminal lumbar interbody fusion and examine its clinical and radiologic results. SUMMARY OF LITERATURE REVIEW: Transforaminal lumbar interbody fusion with a mini-incision using a tubular retractor was recently developed. The aim of this procedure is to reduce the approach-related morbidity and achieve better results in an effective and safe manner. MATERIALS AND METHODS: Thirty eight patients were followed up for more than 1 year. Their mean age was 57 years and the mean follow-up was 19 months. The diagnosis was spinal stenosis, spondylolisthesis and recurred herniated nucleus pulposus in 22, 14 and 2 patients, respectively. The Oswestry disability index, intervertebral disc space height, fusion rate and complications were evaluated. RESULTS: The Oswestry disability index improved from 30 points (range, 50~16 points) to 10 points (range, 2-24 points) at the last follow-up. Thirty-four patients (90%) showed excellent or good results. The intervertebral disc space height increased from 8.7 mm to 10.8 mm. Two cases showed nonunion but the clinical results were good. Complications included one case of infectious spondylitis requiring antibiotics, one case of cage dislodgement requiring additional surgery and one case of a pedicle screw malposition showing no clinical symptoms. CONCLUSIONS: Minimally invasive transforaminal lumbar interbody fusion reduced the soft tissue injury and blood loss and shortened the recovery period compared to the traditional open techniques.

Diagnosis and Arthroscopic Treatment of Symptomatic Medial Patellar Plica Syndrome of the Knee / 대한정형외과학회잡지

PURPOSE: To evaluate the efficacy of physical examination and dynamic arthroscopy in the diagnosis and treatment of medial patellar plica syndrome which is likely to be overlooked. SUBJECTS AND METHODS: 23 cases diagnosed as medial patellar plica syndrome from August 1998 through December 1999 were evaluated. Diagnosis was made by a symptom of a pain and a click sound during knee flexion, a physical examination of mass palpation and dynamic arthroscopy. RESULT: A dynamic rotation test was an useful physical examination having 96% rate of sensitivity. The results of excellent and good cases were in 19 cases (83%) and there was no worsened case symptomatically after arthroscopic resection. Postoperative complications were 3 cases including incomplete excision (1 case), postoperative hemarthrosis (1 case) and medial meniscus instability due to incorrect arthroscopic technique (1 case). In patients younger than 30 year old, the result of arthroscopic excision was better than that in older ones. CONCLUSION: Careful physical examination with dynamic arthroscopy is a useful method to diagnose the medial patellar plica syndrome which is likely to be overlooked, and arthroscopic complete excision result in excellent results which is of benefit to fast rehabilitation.