Chondroblastoma: Analysis of 20 Cases / 대한정형외과학회잡지

Chondroblastoma is a rare primary neoplasm of bone which involves the epiphysis of the long bone and develops mostly in the 2nd decade of life. We reviewed the cases of twenty patients with chondroblastoma who were treated at the Department of Orthopaedic Surgery, Yonsei University College of Medicine between 1969 and 1989. All patients were followed for 1 year or longer. The results were as follows. 1. The proximal end of the humerus(25%) and the proximal end of the femur(25%) were the most common sites. 2. 85% of patients were between 11 to 20 years old and male to female ratio was 3:2. 3. The most common symptom was pain and in 30% of patients it was appeared after minor trauma. 4. The average diameter of lesion is 4.2cm in its long axis and the more longer the duration, the more larger the size of lesion. 5. Involvement of the epiphyseal plate was twice as common in the patients with a closing plate as in those with an open one. 6. The most common microscopic finding was the presence of chondroblast and chondroid matrix. 7. Two patients(10%) had a local recurrence. 8. The final functional results were considered to be good in sixteen(80%) patients. 9. Accurste localization of the lesion during biopsy is very important especially in the case of deep seated lesion.

A Study of Plain X / 대한정형외과학회잡지

Treatment modalities for herniated lumbar intervertebral disc are the conservative method, chemonucleolysis, percutaneous diskectomy and operation. Conservative treatment is effective in 70–80% of the acute stage and the other 20% requires chemonucleolysis, percutaneous diskectomy or operation. Indications for operation are cases not improved after conservative treatment, recurrent cases and cauda equina syndrome. Mixter and Barr(1934) demonstrated that laminectomy and surgical removal of disc material could relieve symptoms, but spinal segmental instability, incomplete removal of the disc and postoperative adhesion of the nerve root caused low back pain after long-term follow up. Thus, the authors evaluated the plain X-ray and computed tomographic findings in 21 cases of failed laminectomy to determine the cause of failure. The results were as follows ; 1. Among 21 cases, 18 cases complained of low back pain with sciatica and 3 cases complained of low back pain. 2. In all cases, disc space narrowing was detected on plain X-ray. Total laminectomy and diskectomy promote insufficiency and instability of the lumbar and lumbosacral spine. Whenever one attempts to do total laminectomy and diskectomy, it is recommended that spine fusion be performed in same operating field. 3. Several findings were detected on CT scan : 8 disc protrusions in the operation site, 6 disc protrusions in the operation site and spinal stenosis, 4 extradural scars, 1 extradural scar and other site disc protrusion and 2 cases of spinal stenosis and spondyloisthesis. 4. Computed tomography in cases of failed laminectomy offers more information than has been available by any other imaging method.