에너지 소고(小考)

김긍년 한국제품안전협회 2000 제품안전 Vol.73 No.-

Klippel-Feil 증후군 환자에서 외상 후 발생한 점진적 사지약화- 증 례 보 고 -

김긍년,박경석,김현우,정철구 대한신경외과학회 2002 Journal of Korean neurosurgical society Vol.31 No.2

Klippel-Feil syndrome is characterized by congenital fusion of cervical vertebrae with a wide range of associated anomaly. The authors present a 50-year-old Klippel-Feil syndrome patient with a minor trauma followed progressive quadriparesis. He had typical radiologic findings of type II Klippel-Feil syndrome and presented progressive myelopathy due to cord compression at foramen magnum level with cervical instability. The patient underwent craniocervical decompression and fusion. The authors reviewed the pertinent literatures and discussed this rare syndrome. Key words:Klippel-Feil syndrome;Myelopathy;Spinal instability;Occipitocervical fusion.

뇌실질내 발생한 표피양 낭종 1예 : Case Report

김긍년,최중언,윤수한,김태승 대한신경외과학회 1994 Journal of Korean neurosurgical society Vol.23 No.5

Intraparenchymal epidermoid cyst is extremely rare. The authors treated a case of intraparenchymal, temporal lobe epidermoid cyst in 21-year old male who had presented with a generalized seizure attack and headache without any neurological deficits The diagnosis was based on the characteristics of CT Scan and MR imaging. The cyst was totally removed via transtemporal approach. Postoperative course was uneventful . The authors report this rare case with a review of the literature.

Clinical and Radiological Outcome of an Interspinous Dynamic Stabilization System in Degenerative Lumbar Disease: 24 Cases with Over 24 Months of Follow-up

김긍년,노태훈,윤도흠,하윤,이성,신동규,권영민 대한척추신경외과학회 2009 Neurospine Vol.6 No.3

Objective: The purpose of this study was to analyze the clinical and radiological outcomes of dynamic stabilization with DIAM implants. Methods: We evaluated 24 cases in which lumbar decompressive surgery was performed with dynamic stabilization using DIAM and having more than 24 months of follow up. Indications consisted of spinal stenosis with or without a herniated disc and transition level stenosis of the instrumented fusion segment. Operative data, clinical outcome, and plain and flexion/extension radiographs were obtained and compared to preoperative and postoperative data. Results: The mean age at operation was 56.2 years (range 47-68); the mean follow-up duration was 28.4 months (range 24-37 months). The mean pain and function scores improved significantly from baseline to follow-up, as follows: back pain VAS score from 6.2 to 2.5, leg pain VAS score from 7.2 to 2.4, and Prolo’s economic and functional rating score from 5.8 to 8.2. Radiological data demonstrated that the heights of the intervertebral foramen and the posterior disc increased significantly after the procedure. There were no implant-associated complications except for two spinous process fractures which occurred during DIAM insertion, and one case of wound infection. Flexion instability and spondylolisthesis occurred in two cases during the follow-up period. Conclusion: These mid-term results suggest that DIAM is a safe and effective alternative surgical option in the treatment of degenerative lumbar stenosis without flexion instability. Careful follow-up is needed to watch for the development of flexion instability and spondylolisthesis. Objective: The purpose of this study was to analyze the clinical and radiological outcomes of dynamic stabilization with DIAM implants. Methods: We evaluated 24 cases in which lumbar decompressive surgery was performed with dynamic stabilization using DIAM and having more than 24 months of follow up. Indications consisted of spinal stenosis with or without a herniated disc and transition level stenosis of the instrumented fusion segment. Operative data, clinical outcome, and plain and flexion/extension radiographs were obtained and compared to preoperative and postoperative data. Results: The mean age at operation was 56.2 years (range 47-68); the mean follow-up duration was 28.4 months (range 24-37 months). The mean pain and function scores improved significantly from baseline to follow-up, as follows: back pain VAS score from 6.2 to 2.5, leg pain VAS score from 7.2 to 2.4, and Prolo’s economic and functional rating score from 5.8 to 8.2. Radiological data demonstrated that the heights of the intervertebral foramen and the posterior disc increased significantly after the procedure. There were no implant-associated complications except for two spinous process fractures which occurred during DIAM insertion, and one case of wound infection. Flexion instability and spondylolisthesis occurred in two cases during the follow-up period. Conclusion: These mid-term results suggest that DIAM is a safe and effective alternative surgical option in the treatment of degenerative lumbar stenosis without flexion instability. Careful follow-up is needed to watch for the development of flexion instability and spondylolisthesis.

Adult stem cell therapy for acute and subacute spinal cord injury: Early clinical results and combined therapy strategy

김긍년 한국발생생물학회 2009 한국발생생물학회 학술발표대회 Vol.2009 No.1

뇌동맥류와 고혈압의 관계에 대한 임상적 연구

김긍년,주진양,이규창 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.9

To investigate relationship between intracranial aneurysm and systemic hypertension, 199 consecutive cases of intracranial aneurysm which were treated surgically were analized in regard to the incidence of hypertension and to the effect of hypertension on their outcome. The incidence of hypertension in cases with aneurysm was higher than in general population. Multiple aneurysm patients had significantly higher incidence of hypertension than single aneurysm paients did. The amount of subarachnoid clot on postictal CT scan and neurological status on admission were not statistically different between hypertensive and normotensive group. Frequency of rebleeding was significantly higher in hypertensive group than in normotensive group. The incidence of cerebral vasospasm or hydrocephalus was statistically not significant between hypertensive group and normotensive group. The clinical outcome was similar between two groups.

백서 후궁 절제술 모델에서 Anti-adhesion Barrier Gel의 유착 방지 효과

윤도흠,김긍년,신동아,이종은,이정원,김도훈 대한신경외과학회 2003 Journal of Korean neurosurgical society Vol.34 No.5

Objective:The authors compare peridural scar formation and adhesion with and without the use of Antiadhesion Barrier Gel(Adba) in an animal model of laminectomy. Methods : Forty-five Sprague-Dawley rats underwent a two level lumbar laminectomy. The Adba was applied to randomly assigned 30 rats around the dura. Remaining 15 rats underwent same operation without the use of Adba. The rats were sacrificed 2, 4, 8 weeks after surgery by 15 numbers. A gross anatomic assessment of scar formation was done using microdissection by an observer blinded to treatment. Amount of scar formation and tenacity were compared between experimental and control group by a numerical rating system. The histological comparing was also performed. Results : The amount of scar tissue and tenacity were reduced grossly and histologically at postoperative 2, 4, 8 weeks in animal model using Adba. Adba material was absorbed around 4 weeks of postoperative period in model. No special inflammatory reaction was observed, and the healing of wound was not affected by Adba. Conclusion : Adba significantly reduces the amount of scar formation and tenacity in rat laminectomy model without impacting the healing of operation wound and other complications. Key words:Adba(Anti-adhesion Barrier Gel);Scar formation;Adhesion;Laminectomy.

Huge Thoracolumbar Extradural Arachnoid Cyst

이동엽,김긍년,윤도흠,박성우 대한신경외과학회 2003 Journal of Korean neurosurgical society Vol.34 No.6

A case is presented to demonstrate the image findings of a patient with a recent onset of progressive spinal cord compression caused by a huge arachnoid cyst. A 45-year-old woman with progressive paraparesis and dysaesthesia on both legs had extradural mass on thoracolumbar junction and she was cured successfully with surgery. The tumor mass turned out to be arachnoid cyst histologically. By the time of discharge all neurologic deficits and symptoms were cured. Thoracolumbar extradural arachnoid cyst is rare cause of the spastic paraparesis. It is an unusual expanding lesion in the spinal canal which may communicate with the subarachnoid space. The goal of surgery is to decompress the spinal cord and close the connection with the subarachnoid space. We report a case of huge thoracolumbar arachnoid cyst presenting spastic paraparesis with a review of literatures. Key words:Extradural;Arachnoid cyst;Cord compression.

Posterior Atlantoaxial Fixation with Lateral Mass Screw in the Atlas and Pedicle Screw in the Axis

신동아,김긍년,윤도흠 대한신경외과학회 2003 Journal of Korean neurosurgical society Vol.34 No.5

Objective:The authors report the successful use of a recently described technique of posterior fixation of the C1 lateral mass and the C2 pedicle with polyaxial screws and rods. Methods : After posterior exposure of the C1-C2 complex, the polyaxial screws were inserted into the lateral mass of C1 and the pedicle of C2 with the guidance of anatomic landmarks and fluoroscopy. Then, the pedicle screws of each side were linked with a rod. Because the C1-C2 pedicle screw fixation was sufficiently rigid, an additional posterior wiring or structural bone graft is unnecessary. Results : The early clinical and radiologic follow-up data indicated solid fusion of C1 and C2 vertebrae with no observed neural or vascular damage related to this technique. Conclusion : The posterior fixation of the C1-C2 complex using polyaxial screws and rods seems to be a reliable technique and an efficient alternative to the more commonly accepted procedures. Key words:Atlantoaxial instability;Atlantoaxial fixation;Polyaxial screw.

Robot-assisted Resection of Paraspinal Schwannoma

양문술,김긍년,윤도흠,William Pennant,하윤 대한의학회 2011 Journal of Korean medical science Vol.26 No.1

Resection of retroperitoneal tumors is usually perfomed using the anterior retroperitoneal approach. Our report presents an innovative method utilizing a robotic surgical system. A 50-yr-old male patient visited our hospital due to a known paravertebral mass. Magnetic resonance imaging showed a well-encapsulated mass slightly abutting the abdominal aorta and left psoas muscle at the L4-L5 level. The tumor seemed to be originated from the prevertebral sympathetic plexus or lumbosacral trunk and contained traversing vessels around the tumor capsule. A full-time robotic transperitoneal tumor resection was performed. Three trocars were used for the robotic camera and working arms. The da Vinci Surgical System® provided delicate dissection in the small space and the tumor was completely removed without damage to the surrounding organs and great vessels. This case demonstrates the feasibility of robotic resection in retroperitoneal space. Robotic surgery offered less invasiveness in contrast to conventional open surgery.