http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
Early Decompression in Acute Spinal Cord Injury : Review and Update
Byung-Jou Lee,Je Hoon Jeong 대한신경외과학회 2023 Journal of Korean neurosurgical society Vol.66 No.1
Spinal cord injury (SCI) has a significant negative effect on the quality of life due to permanent neurologic damage and economic burden by continuous treatment and rehabilitation. However, determining the correct approach to ensure optimal clinical outcomes can be challenging and remains highly controversial. In particular, with the introduction of the concept of early decompression in brain pathology, the discussion of the timing of decompression in SCI has emerged. In addition to that, the concept of “time is spine” has been added recently, and the mortality and complications caused by SCI have been reduced by providing timely and professional treatment to patients. However, there are many difficulties in establishing international clinical guidelines for the timing of early decompression in SCI because policies for each country and medical institution differ according to the circumstances of medical infrastructure and economic conditions in the surgical treatment of SCI. Therefore, we aim to provide a current review of timing of early decompression in patient with SCI.
Review: Steroid Use in Patients With Acute Spinal Cord Injury and Guideline Update
Byung-Jou Lee 대한신경손상학회 2022 Korean Journal of Neurotrauma Vol.18 No.1
Acute spinal cord injury (SCI) is a devastating condition that causes enormous damage to a patient’s physical, mental, and economic situation and requires a multidisciplinary approach to treatment. Research on SCI has been performed for a long time, and the management of SCI has developed dramatically in recent decades as a mechanism of injury and the pathophysiology of SCI have been revealed from the primitive stage in the past. In the treatment of patients with acute SCI, there is a lot of debate regarding surgical treatment strategies and pharmacological management, such as steroid use. In particular, the efficacy of steroid use, such as methylprednisolone sodium succinate, has been increasing and decreasing and is still intensely debated. The practice guidelines reported so far for this are also at the “suggest” stage with weak recommendations. Therefore, this review aims to summarize the effects of steroid use on SCI. This review provides an overview of current practical guidelines and clinical studies on steroid use in patients with SCI.
Byung-Jou Lee,Min cheol Seok,Hae-Won Koo,Je Hoon Jeong,Myeong Jin Ko 대한신경손상학회 2023 Korean Journal of Neurotrauma Vol.19 No.4
Spinal trauma accounts for a large portion of injuries to the spine area, particularly as societies are entering an era of aging populations. Consequently, spine fractures accompanied by osteoporosis are becoming more prevalent. Achieving successful fusion surgery in patients with spine fractures associated with osteoporosis is even more challenging. Pseudarthrosis in the spine does not yield clinically favorable results; however, considerable effort has been made to achieve successful fusion, and the advancement of bone graft substitutes has been particularly crucial in this regard. Autograft bone is considered the best fusion material but is limited in use due to the quantity that can be harvested during surgery and associated complications. Accordingly, various bone graft substitutes are currently being used, although no specific guidelines are available and this mainly depends on the surgeon's choice. Therefore, the purpose of this review, across part I/II, is to summarize bone graft substitutes commonly used in spine surgery for spine fusion in patients with spine trauma and to update the latest knowledge on the role of recombinant human bone morphogenetic protein-2.
Byung-Jou Lee 대한신경손상학회 2022 Korean Journal of Neurotrauma Vol.18 No.2
Spinal cord reperfusion injury is defined as a sudden expansion of the compressed cord after decompression surgery and an acute increase in the blood supply to the cord, leading to disruption of the blood-spinal cord barrier and eventually causing acute neurologic deterioration.4,8) Preferred diagnostic criteria for spinal cord reperfusion injury include (1) severe preoperative spinal cord compression, (2) surgical decompression, and (3) motor and sensory dysfunction occurring within 3 hours postoperatively. Furthermore, it should not include postoperative surgical disease that may require additional treatment and surgery, such as hematoma, residual cord compression lesion, direct intraoperative cord trauma, and spine displacement.
Advancements in Neurointensive Care Medicine for the Treatment of Central Nervous System Injuries
Byung-Jou Lee,Je Hoon Jeong,Hyuk Jin Oh 대한신경손상학회 2023 Korean Journal of Neurotrauma Vol.19 No.2
Advancements in medicine over the past centuries have significantly improved the treatment of various incurable diseases. In parallel, remarkable developments have occurred in the medical management of patients with brain and spinal cord trauma. However, due to the irreversible nature of the central nervous system injuries beyond a certain threshold and the severity of the illness experienced by these patients, treatment outcomes still remain unsatisfactory. To enhance the treatment outcomes for individuals with such injuries, the field of neurointensive care medicine has been established.
Byung-Jou Lee 대한신경손상학회 2021 Korean Journal of Neurotrauma Vol.17 No.2
Dear Editor, Thank you for the opportunity to review the paper titled “Spinal Surgery and Subsequent ESR and WBC Changes Pattern: A Single Center Prospective Study.” Postoperative infection management is an important issue in spine surgery. Therefore, we believe that this paper will be helpful in assessing surgical site infections in actual clinical practice. However, the statistical method applied to the data presented by the authors and its interpretation are lacking. It is insufficient to simply determine the correlation between the factors and white blood cell (WBC) and erythrocyte sedimentation rate (ESR) values using Pearson correlation, which analyzes the correlation with one-to-one matching.1) In future studies, the authors need to perform a multivariate analysis to determine the complex relationship among several factors and correlation between WBC and ESR values.
Lee, Byung-Jou,Sohn, Moon-Jun,Han, Seong-Rok,Choi, Chan-Young,Lee, Dong-Joon,Kang, Jae Heon The Korean Neurosurgical Society 2013 Journal of Korean neurosurgical society Vol.54 No.3
Objective : Spinal dysraphism defects span wide spectrum. Wound dehiscence is a common postoperative complication, and is a challenge in the current management of cerebrospinal fluid (CSF) leaks and wound healing. The purpose of this study is to evaluate the risks of CSF-related morbidity in the surgical treatment of spinal dysraphism. Methods : Ten patients with spinal dysraphism were included in this retrospective study. The median age of the cohort was 4.8 months. To assess the risk of CSF morbidity, we measured the skin lesion area and the percentage of the skin lesion area relative to the back surface for each patient. We then analyzed the relationship between morbidity and the measured skin lesion area or related factors. Results : The overall median skin lesion area was 36.2 $cm^2$ (n=10). The percentage of the skin lesion area relative to the back surface ranged from 0.6% to 18.1%. During surgical reconstruction, 4 patients required subsequent operations to repair CSF morbidity. The comparison of the mean area of skin lesions between the CSF morbidity group and the non-CSF morbidity group was statistically significant (average volume skin lesion of $64.4{\pm}32.5cm^2$ versus $27.7{\pm}27.8cm^2$, p<0.05). CSF morbidity tended to occur either when the skin lesion area was up to 44.2 $cm^2$ or there was preexisting fibrosis before revision with an accompanying broad-based dural defect. Conclusion : Measuring the lesion area, including the skin, dura, and related surgical parameters, offers useful information for predicting wound challenges and selecting appropriate reconstructive surgery methods.
Intraventricular Cavernous Hemangiomas Located at the Foramen of Monro
Lee, Byung-Jou,Choi, Chan-Young,Lee, Chae-Heuck The Korean Neurosurgical Society 2012 Journal of Korean neurosurgical society Vol.52 No.2
Intraventricular cavernous hemangiomas are uncommon. Among them, those occurred at the foramen of Monro in the third ventricle may be of particular interest because of its rarity, development of hydrocephalus, being differentiated from other brain lesions. We present a rare case of intraventricular cavernous hemangioma at foramen of Monro which was resected through microsurgery and also review the relevant literatures.
Byung-Jou Lee 대한신경손상학회 2021 Korean Journal of Neurotrauma Vol.17 No.2
Dear Editor, Thank you for the opportunity to review the paper titled “Spinal Surgery and Subsequent ESR and WBC Changes Pattern: A Single Center Prospective Study.” Postoperative infection management is an important issue in spine surgery. Therefore, we believe that this paper will be helpful in assessing surgical site infections in actual clinical practice. However, the statistical method applied to the data presented by the authors and its interpretation are lacking. It is insufficient to simply determine the correlation between the factors and white blood cell (WBC) and erythrocyte sedimentation rate (ESR) values using Pearson correlation, which analyzes the correlation with one-to-one matching.1) In future studies, the authors need to perform a multivariate analysis to determine the complex relationship among several factors and correlation between WBC and ESR values.