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심한 척수 압박을 일으킨 흉추부 골화된 추간판탈출증 치험 1례 : 증례보고 Case report and Review of the literature
최율,신호 조선대학교 부설 의학연구소 2002 The Medical Journal of Chosun University Vol.27 No.1
Disk herniations in the thoracic spine are rare, representing 0.25% to 0.57% of all symptomatic disk herniations in the spine. Because of the popularity of magnetic resonance imaging and computered tomography with myelography, asymptomatic thoracic disk herniations, some rather large and compressing the spinal cord, are recognized in up to 15% of patients. We report a case of ossified disc causing severe cord compression. We removed the disc successfully through anterior retropleural approach without causing cord injury.
경추간판 탈출증에 기인된 Brown-Sequard Syndrome : 증례보고 Case report and Review of the literature
최율,김찬,이승명 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.2
It has been estimated that 2-4% of all traumatic spinal cord injuries is occured to Brown-Sequard syndrome. Degenerative spinal disease is not often cited, particularly in cervical disc herniation. A 35-yearold man presented with an 3-month history of posterior neck pain. At the 1 week prior to admission, he also noted left hemiparesis and right side numbness. Cervical MR image showed a large, left posterolateral disc herniation at C3-4, with left sided cord compression. The patient underwent an anterior cervical decompression at C3-4 with fusion. The patient’s symptoms have steadily improved(with pain relief within several days and almost recovery of both motor and sensory deficits). The Brown-Sequard syndrome can be caused by a cervical disc herniation. The MRI scan should represent the initial investigative procedure, and would be wise to consider in all cases of progressive spinal cord dysfunction.
내측 후궁하 접근법 또는 척추측방 접근법을 이용한 흉요추부의 추간공 확대술
최율,신호,이승명 조선대학교 부설 의학연구소 2002 The Medical Journal of Chosun University Vol.27 No.2
Objective: Foraminal stenosis may be caused by various spinal diseases. In some of these patients, we conducted foraminotomy in a way which would not cause spinal instability. Materials and Method: 31 patients who showed formainal stenosis on MRI underwent forminotomy between October of 2000 to August of 2001. Two types of technique were used. First method, medial sublaminar approach, in this approach we removed lower 1/3 of spinous process to the base, to expand interlaminar space, and exposed yellow ligament was removed. Through this hole, all sublaminar and foraminal part of yellow ligament was detached and removed under operating microscope. 2nd method, paraspinal approach, we removed intertransverse ligament and dilated the foramen by removal of yellow ligament composing posterior part of the foramen. Operation time was an hour in case of one level bilateral foraminal stenosis. Results: The clinical state after surgery was assessed by Prologs outcome scale. Satisfactory results were obtained in 96%. Conclusions: Although follow-up period was short(mean 18months), Laminar and facet joint damage was minimal, and as the result low back pain, and instability could be prevented with satisfactory results, but in spinal stenosis of L5-S1 level, these techniques were not appropriate.