Septic Hip Arthritis with Iliopsoas Abscess Detected after Spine Operation: A Case Report / 대한고관절학회지

In the elderly patients who complain of pain in the buttock and leg, it is not easy to distinguish whether the pain comes from the lesion of the hip or from the spine. A 78-year-old female who was treated conservatively for persistent pain in the right buttock and leg after an operation for spinal stenosis in the local clinic visited our clinic. Septic hip arthritis with severe femoral head destruction and multiple abscesses in the buttock and iliopsoas muscle were diagnosed 2 months postoperatively, and spinal abscess in the site of the previous operation was detected by a subsequent MRI study. To avoid such a delay of the diagnosis and treatment, it is important to suspect hip joint lesion earlier for the source of persistent pain after a spine operation. Further more, diagnostic evaluation is necessary to rule out co-infection of the spine or iliopsoas muscle when a hip joint infection exists.

Is It Real False Negative Finding in Motor Evoked Potential Monitoring during Corrective Surgery of Ankylosing Spondylitis? A Case Report

We performed L1 posterior vertebral columnar resection and posterior correction for Andersson's lesion and thoracolumbar kyphosis in an ankylosing spondylitis patient during motor evoked potential (MEP) monitoring. We checked MEP intra-operatively, whenever a dangerous procedure for neural elements was performed, and no abnormal findings were seen during surgery. After the operation, we examined neurologic function in the recovery room; the patient showed a progressive neurologic deficit and no response to MEP. After emergency neural exploration and decompression surgery, the neurologic deficit was recovered. We questioned whether to acknowledge the results of this case as a false negative. We think the possible reason for this result may be delayed development of paralysis. So, we recommend that MEP monitoring should be performed not only after important operative steps but also after all steps, including skin suturing, for final confirmation.

Operative treatment to spinal multi-level tuberculosis / 中国康复理论与实践

@#ObjectiveTo investigate the effect of operation treating spinal multi-level tuberculosis.Methods45 patients with multi-level spine tuberculosis were treated with debridement completely and anterior or lateral-anterior intervertebrae autograft. Of them, 5 patients added to anterior instrumentation.Results45 patients had been followed up for 12 to 40 months.The back pain of 40 cases were relieved within 5 weeks after operation, erythrocyte sedimentation rate decreased 3 weeks after operation. 38 patients who involved in kyphosis decreased their kyphosis mostly and only one patient lost 3 degrees in follow-up.15 patients who involved in neurological deficits improved one or two grades (Frankel). Grafts fused in 44 patients and there were no recurrent in follow-up.Conclusions Operative treatment is efficacious to multi-level body spine tuberculosis.