Korean Journal of Spine

As medical computer-aided design (CAD) has improved, virtual 3-dimensional medical images have been gaining more easily without any special practice. These images can be applied to various clinical fields. This article illustrates virtual preoperative simulation for excision of spinal tumors using medical CAD software. The software was used directly by the surgeon. The process of virtual preoperative simulation for spinal tumor surgery was found to be not inordinately complicated. And, virtual simulation was helpful in determining surgical steps as well as understanding the surgical anatomy...

Glomangiopericytoma, also referred to as a hemangiopericytoma-like tumor or sinonasal type hemangiopericytoma, is a rare tumor of the nasal cavity and paranasal sinus that has never been reported in the spinal cord. Here, we report a case of a 47-year-old man who developed glomangiopericytoma in the thoracic spine. This lesion showed a heterogeneous high signal intensity compared to the spinal cord on a T2-weighted image and an easily enhanced isointense signal on a T1-weighted image.

Thymoma and thymic carcinoma are rare epithelial tumors that originate from the thymus gland. Extrathoracic metastases occur in the liver, kidney, and bone in 1% to 15% of patients. Although thymoma and thymic carcinoma exhibit highly aggressive biological behavior, spinal metastasis is rare. We describe a 78-year-old man with left wrist and grasp weakness that occurred 7 days before admission. The patient underwent thymoma surgery 7 years ago and was cured. Magnetic resonance images showed a rim-enhanced mass in the C6-7-T1 epidural space...

Spinal subarachnoid hematoma (SSH) following diagnostic lumbar puncture is very rare. Generally, SSH is more likely to occur when the patient has coagulopathy or is undergoing anticoagulant therapy. Unlike the usual complications, such as headache, dizziness, and back pain at the needle puncture site, SSH may result in permanent neurologic deficits if not properly treated within a short period of time. An otherwise healthy 43-year-old female with no predisposing factors presented with fever and headache. Diagnostic lumbar puncture was performed under suspicion of acute meningitis...

A 38-year-old man visited our Emergency Department for sudden onset paraplegia that occurred 1 hour ago. He felt a piercing pain in the posterior neck and became paraplegic while he was watching television, lying down on a sofa. Neurological examination showed motor power grades II-III in both arms and grade 0 in both legs. His cervical magnetic resonance imaging (MRI) showed a large ruptured disc at the C5-6 level, severely compressing the spinal cord. Emergency anterior cervical discectomy and fusion at C5-6 were performed...

OBJECTIVE: Pfirrmann disc grade is a useful scoring tool for evaluating disc degeneration, but normal values according to aging process has not been elucidated. This study was conducted to identify the prevalence and pattern of whole spine disc degeneration according to ages and gender differences. METHODS: Total 653 patients (336 male and 317 female patients, 48.1±58.7 years old) who took whole spine magnetic resonance images were enrolled in this study. There were 19 cases in their 2nd decades and 74 cases in 3rd decades, 141 cases in 4th decades, 129 cases in 5th decades, 139 cases in 6th decades, and 93 cases in 7th decades, 58 cases in over 8th decades...

OBJECTIVE: The purpose of this study was to compare the effect of atlantoaxial fixation on cervical alignment and clinical outcomes in patients with os odontoideum (OO) versus non-os odontoideum (non-OO). METHODS: A total of 119 patients who underwent atlantoaxial fixation for instability were identified between January 1998 and January 2014. Inclusion criteria included age more than 21 years and diagnosis of OO and non-OO. There were 22 OO patients, and 20 non-OO patients...

OBJECTIVE: The aim of this study was to formulate an objective clinical and geometric relationship between Cobb angle and the difference between the lengths of convex and concave sides (convexo-concave vertebral difference) of the structural curve in scoliosis. Is it possible to express Cobb angle in such a way that it could be visualized as a length, especially while planning for surgical correction of scoliosis? METHODS: Thirty consecutive patients below the age of 19 years with a scoliosis of Cobb angle more than 10 degrees were included in the study...

OBJECTIVE: Myelography has been shown to highlight foraminal and lateral recess stenosis more readily than computed tomography (CT) or magnetic resonance imaging (MRI). It also has the advantage of providing dynamic assessment of stenosis in the loaded spine. The advent of weight-bearing MRI may go some way towards improving assessment of the loaded spine and is less invasive, however availability remains limited. This study evaluates the potential role of myelography and its impact upon surgical decision making...

The purpose of this review is the current understanding of proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) following adult spinal deformity (ASD) surgery. We carried out a systematic search of PubMed for literatures published up to September 2017 with "proximal junctional kyphosis," "proximal junctional failure," and "adult spinal deformity" as search terms. A total of 98 literatures were searched. The 37 articles were included in this review. PJK is multifactorial in origin and likely results from variable risk factors...

No abstract text is available yet for this article.

Guillain-Barré syndrome (GBS) is an inflammatory demyelinating polyneuropathy characterized by areflexic paralysis. Most cases of GBS are preceded by an infection, however, posttraumatic GBS has also recently been reported. We report a case of posttraumatic GBS immediately following a traffic accident. We think this case is of clinical significance for practitioners because of the rare cause of a sudden flaccid paralysis following trauma.

Aortic injury during transforaminal lumbar interbody fusion (TLIF) is a rare but severe complication. We experienced aortic injury during TLIF at L3-4 with a 59-year-old woman diagnosed with an adjacent segment disease at L3-4. Severe bleeding occurred during disc space expansion, and the blood pressure dropped to 60/40 mmHg. The patient's vital sign stabilized after compression with gauze and Gelfoam in addition to blood transfusion. The patient was treated with endovascular repair using a percutaneous technique after intertransverse fusion at L3-4 was completed...

Lumbar disk herniation is common. Because of the posterior longitudinal ligament, migration usually occurs into the ventral epidural space. Rarely, fragments migrate into the dorsal epidural space. A 57-year-old man presented with lower back pain and weakness on right hip flexion and right knee flexion. He had lower back pain 1 day previously and received a transforaminal epidural block at a local hospital. The next day, he reported weakness of the right lower extremity. Lumbar spine magnetic resonance imaging revealed a dorsal epidural lesion with compression of the thecal sac at L2-3...

Angiolipomas are composed of mature adipose tissue and blood vessels. Spinal angiolipomas are rare benign tumors with a good prognosis, and most symptoms are due to progressive compression of the spinal cord and root. The treatment of choice is total resection without any additional therapy. We report a case of an epidural angiolipoma on the lumbar spine in a 69-year-old man with weakness of the lower extremities. Lumbar magnetic resonance images revealed a well-enhanced epidural mass. He underwent laminectomy, and the tumor was completely removed...

We report a case of a 45-year-old man with a complaint of both leg weakness and hypoesthesia. Radiological evaluation revealed an osteolytic lesion of the ninth thoracic vertebra. The patient underwent posterior corpectomy with total excision of the tumor, mesh cage insertion with posterior screw fixation and subsequent radiotherapy. Histology confirmed the diagnosis of Langerhans cell histiocytosis (LCH). This case report presents the diagnostic work-up, histopathological evaluation, and the treatment procedures of rare LCH in the thoracic spine...

Presacral ganglioneuromas are extremely rare benign tumors and fewer than 20 cases have been reported in the literature. Ganglioneuromas are difficult to be differentiated preoperatively from tumors such as schwannomas, meningiomas, and neurofibromas with imaging modalities. The retroperitoneal approach for resection of presacral ganglioneuroma was performed for gross total resection of the tumor. Recurrence and malignant transformation of these tumors is rare. Adjuvant chemotherapy or radiation therapy is not indicated because of their benign nature...

Incidental durotomies are a frequent complication during spinal surgery. Cerebrospinal fluid (CSF) leakage from a dural tear may be visually apparent intraoperatively, but occasionally, a tear may not be recognized during the procedure. We report our experience in 2 cases of postoperative incarceration of nerve root as a cause of sciatica, without CSF leakage intraoperatively. When durotomy attributable to surgical manipulation does occur, intraoperative identification is mandated. If a patient develops unexplainable postoperative pain and neurological deficits after lumbar discectomy, incarceration of nerve root should be considered in the differential diagnosis...

We report a case of a solitary osteochondroma as a dumbbell tumor compressing the spinal cord and its surgical strategy. The patient is a 16-year-old female with longstanding posterior neck pain and left arm abduction weakness. She was examined by plain X-ray, three-dimensional-computed tomography, magnetic resonance imaging, and vertebral angiography. The analyses indicated a calcified extradural mass compressing the cord in the C3-4 portion extending into the neural and vertebral foramen with eroded vertebral body...

Although the etiology of spontaneous spinal epidural hematoma (SSEH) is unclear, SSEH is known to be associated with anticoagulants, coagulopathy, vascular malformation, hypertension, and pregnancy. However, no report has been issued on the relation between SSEH and venous phlebolith. Here, the authors present an extremely rare case of SSEH associated with phlebolith in the cervical spine and suggest a possible pathogenesis. A 36-year-old man without any relevant medical history presented with neck pain and numbness and severe radiating pain on the left arm...