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편측 후궁절제술로 치료한 결핵성 척추염에 대한 임상적 고찰
송경배,조규용,박승규,김용수,임신길,임준섭 대한신경외과학회 2004 Journal of Korean neurosurgical society Vol.35 No.4
Objective : The variable operative methods are underwent as a treatment of tuberculous spondylitis. We propose hemilaminectomy and debridement as a one of operative method at a certain circumstance. Methods : From July 1998 to June 2002, 13 consecutive patients with spinal tuberculosis were treated surgically in our institution. Among them, the authors analysed 7 patients in whom posterior approach were performed. The lumbar spine was involved in 6 patients, the thoracic in 1. The hemilaminectomy with debridement was done in all cases. The changes in the Kyphotic angle and the height of involved vertebras retrospectively measured from lateral spinal radiographs obtained preoperatively and postoperatively. Mean follow up periods were 16 months. Results : Clinical symptoms and signs were improved in all cases. One patient(14%) was needed anterior fusion because of aggravation of lesion. Another one needed reoperation because of relapse of epidural abscess. The arithmethical average of kyphotic angle was worsened about 2 degrees and that of height loss was lesser than 5% postoperatively. Conclusion : The hemilaminectomy with debridement for spinal spondylitis can be a first therapeutic modality in a mild neurologic deficit and minor lesions with extended epidural abscess and granulation tissue to the adjacent vertebras in radiologic finding. Especially if epidural abscess and granulation tissue involve the multiple vertebras, we recommend this operative method.
임신길,오민석,임준섭,강명기,곽연상,박승규,송경배,김한웅,Yim, Sin Gil,Oh, Min Suk,Lim, Jun Seob,Kang, Myung Gi,Kwak, Yeon Sang,Park, Seung Gyu,Song, Gyung Bae,Kim, Han Yung 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.2
Arteriovenous malformations of the face and scalp are uncommon. We report a patient with facial AVM feeding from external carotid artery. This 26-year old man presented with an arteriovenous malformation involving left forehead. The patient first noted a coin-sized lesion on the site 20 years previously after blunt trauma which progressively enlarged. Surgical resection of AVM was performed after ligation of feeding artery.
임신길,오민석,임준섭,강명기,곽연상,박승규,송경배,김한웅,Yim, Sin Gil,Oh, Min Suk,Lim, Jun Seob,Kang, Myung Gi,Kwak, Yeon Sang,Park, Seung Gyu,Song, Gyung Bae,Kim, Han Yung 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.2
Objectives : CT-guided stereotactic evacuation for spontaneous intracerebral hemorrhage can minimize the brain damage and can be performed safely and simply under local anesthesia. But that procedure is time consuming and has a risk of rebleeding because of the stress during head pin fixation. So authors describe easy and precise guidelines for FHA of putaminal hemorrhage without stereotactic instrument. Methods and Materials : We analyzed the data of 298 patients who underwent CT-guided stereotactic aspiration of putaminal hematoma in our hospital between January 1990 and December 2000. We divided the patients into three groups according to the location of hematoma : anterior portion, middle portion and posterior portion of putamen. Total number of catheters inserted into the hematoma were 345 and there were with regard to the direction and depth of catheters. Results : Proposed guidelines of catheter insertion to putaminal hemorrhage in our institution. 1) hematoma at the anterior portion of putamen ; Direction of catheter was the midpupillary line of the eye and the point intersecting a line drawn from the burr hole to a point between external auditory meatus(EOM) and 1cm posterior to EOM. Depth of catheter was 6-6.5cm. 2) hematoma at the middle portion of putamen ; Direction of catheter was the midpupillary line of the the eye and the point intersecting a line drawn from the burr hole to a point between 1cm and 2cm posterior to EOM. Depth of catheter was 6.5-7cm. 3) hematoma at the posterior portion of putamen ; Direction of catheter was 15 degree laterally from the midpupillary line of the eye and the point intersecting a line drawn from the burr hole to a point between 2cm and 3cm posterior to EOM. Depth of catheter was 7-7.5cm. We have performed FHA of putaminal hemorrhage in 48 cases according to this guideline. All catheter were inserted exactly at the center of hematoma and average operation time was about 30 minutes. Conclusion : Our proposed guidelines for putaminal hemorrhage are considered to be safe and simple method with similar accuracy and rapid decompression compared with traditional stereotactic method. Main advantages of this technique were unnecessity of stereotactic frame application and less time requirement for hematoma removal.