미세술식과 일반술식으로 시행한 요추 추간판 수술의 비교관찰 : Comparative Study

하호균,오석전,조해동,유영락,김남규,정환영 대한신경외과학회 1983 Journal of Korean neurosurgical society Vol.12 No.4

To obtain wider versatility and greater reach in microsurgical lumbar discectomy, modified procedure has been performed on 263 patients in 1979-1983. It consisted of a smaller midline incision, removal of lateral half of the spinous process, partial but sufficient microdrilling of the lamina, use of a modified slender Taylor retractor, flavotomy, preservation of epidural adipose-areolar tissue etc. Particularly a slender Taylor-Chung retractor offered yielding surgical opening and therefore secured free insertion of pituitary forceps to every direction. The microsurgical results including 72 bisegmental and 8 trisegmental discectomies were compared with those of standard operations of same number performed by same surgeon in 1972-1979, for the good contrast. Mean blood loss per operation was 94㎖ with the standard discectomy and 4.6㎖ with microsurgery. Dural tear occured in 17 cases undergoing standard operation and in 3 undergoing microsurgery. The mean time until return to duty was 8.6 weeks with the standard, compared with 4.2 weeks. In the microsurgical group, 3 patients had postoperative discitis while 2 had in the standard. In this series, the results of microsurgery surpasses the standard in the convalescent phase. Major advantages of this modified microsurgical technique were its ability to secure the greater reach to remove disc material as much as possible and to preserve the integrity of normal tissue better.

수술제거한 두개강 내·외로 전이된 간세포암 1예

하호균,오석전,조해동,유영락,김남규,정환영 대한신경외과학회 1984 Journal of Korean neurosurgical society Vol.13 No.3

A rare case of surgically extirpated intra- and extracranial metastasis of hepatocellular carcinoma is reported. This dumb-bell shaped tumor simulated malignant meningioma on computerized tomography brain scan and cerebral angiography. Removal of the mass was successfully achieved by external carotid ligation and CUSA dissection. We suggest that, when investigating patients with suspected cranial secondaries particulary if there is a bony involvement, serum α-fetoprotein and hepatic ultrasound should be carried out as screening procedures.

두부 못총상의 치험례

서면,김영태,하호균 건국대학교 의과학연구소 1996 건국의과학학술지 Vol.5 No.-

The authors report a rare case of gunshot injury to the head by a nail-gun which was treated by stereotactic surgery. The patient was arrived at our emergency room by 119 rescue. He was 23 years old with semicomatose mentality and decerebrated rigidity. On simple skull series and Brain CT scan, the large nail was located in the 3rd ventricular area in the mid-line with vertical stature. The entry point was identified 1 cm anterior to the coronal suture line and just lateral to the sagittal suture line. We planned stereotactic removal and the stereotactic frame was introduced to the patient. The foreign body was removed stereotactically with the guidance of C-arm fluoroscope. The # 8 L EVD drain was placed into the 3rd ventricle. Intensive care was performed to the young patient, but he died due to initial severe brain damage at # POD 6.

앙와위 및 복와위 요추 전산화 단층촬영의 비교 연구

김영태,조기홍,김재민,하호균 건국대학교 의과학연구소 1993 건국의과학학술지 Vol.3 No.-

For evaluating the lumbar disc space, the fact that the postmyelography computed tomography was more accurate than computed tomography or myelography was well know. But the technical difficulty is limitation of gantry angle. The prone position scanning may help to lessen this trouble. A prospective computed tomographic scanning was performed in both the prone and supine position on 43 patients, who had low back pain. The angle between the vertebral end plate and vertical line was measured in both position at ??, ?? and ?? interspaces. The adavantages of prone scanning in spinal aligment was noted at L5-S1 disc space(79.1%) and also more desirable if computed tomography was performed with metrizamide. With above advantages, the evaluation of bulging annulus was become more easier.

경동맥 조영술시 거대 후교통 동맥류의 파열 : 증례 보고 A Case Report

김재민,하호균 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.5

The authers report a case of the ruptured giant posterior communicating artery aneurysm that found during carotid angiography. The contrast agent was extravasated into the lateral ventricle through the temporal horn of it and the vasospasm localized to the vicinity of aneurysm had seen. To see the aneurysm actually bleed during angiography is a rare event.

Patterns of Epidural Venous Varicosity in Lumbar Stenosis

주정혁,하호균,정철구,김현우,이철영,김종현 대한척추신경외과학회 2012 Neurospine Vol.9 No.3

Objective: Epidural venous varicosity (congestion of the epidural vein) is rarely introduced as an influential factor of clinical symptoms. However, there are several studies suggesting that epidural venous varicosity results in neurologic symptoms. We would like to highlight evidence that epidural venous varicosity results in neurologic symptoms and the relation between epidural venous varicosity and neural structure observed during the surgery. Based on our experiences, we also propose a new classification of epidural venous varicosity. Methods: 29 patients with symptomatic lumbar stenosis received microsurgical decompression via partial hemilaminectomy. The authors retrospectively reviewed all recorded intraoperative pictures and categorized patterns of venous varicosities with relationship to neural structures. Results: Type A is conditions in which epidural veins are dilated but located parallel to the nerve root on the lateral side of the nerve root and thus do not compress the nerve root. Type B is conditions in which varices are located on the anterior lateral side of the nerve root to compress the nerve root. Type C is conditions in which varices are encircled around the nerve root and compressing the nerve root. Conclusion: Epidural venous varicosity is observed in most lumbar stenosis patients with clinical symptoms. Of the types, the types of epidural venous varicosity compressing nerve structures were Type B and Type C. All epidural venous varicosities were removed regardless of classification during operations. Most patients showed relief in clinical symptoms after the operation. We thought to epidural venous varicosity as a factor that causes clinical symptoms of lumbar stenosis. Objective: Epidural venous varicosity (congestion of the epidural vein) is rarely introduced as an influential factor of clinical symptoms. However, there are several studies suggesting that epidural venous varicosity results in neurologic symptoms. We would like to highlight evidence that epidural venous varicosity results in neurologic symptoms and the relation between epidural venous varicosity and neural structure observed during the surgery. Based on our experiences, we also propose a new classification of epidural venous varicosity. Methods: 29 patients with symptomatic lumbar stenosis received microsurgical decompression via partial hemilaminectomy. The authors retrospectively reviewed all recorded intraoperative pictures and categorized patterns of venous varicosities with relationship to neural structures. Results: Type A is conditions in which epidural veins are dilated but located parallel to the nerve root on the lateral side of the nerve root and thus do not compress the nerve root. Type B is conditions in which varices are located on the anterior lateral side of the nerve root to compress the nerve root. Type C is conditions in which varices are encircled around the nerve root and compressing the nerve root. Conclusion: Epidural venous varicosity is observed in most lumbar stenosis patients with clinical symptoms. Of the types, the types of epidural venous varicosity compressing nerve structures were Type B and Type C. All epidural venous varicosities were removed regardless of classification during operations. Most patients showed relief in clinical symptoms after the operation. We thought to epidural venous varicosity as a factor that causes clinical symptoms of lumbar stenosis.

충주 지역에서의 뇌졸중에 대한 역학적 및 임상적 고찰

나중환,하호균,최진영 건국대학교 의과학연구소 1991 건국의과학학술지 Vol.1 No.-

To evaluate the epidemiological and clinical status of cerebrovascular disease in Chung Ju area, authors have studies 224 cases of stroke patients who have been treated in Kon Kuk University Hospital from April, 1989 to March, 1991. This study have been performed by department of Neurology and Neurosurgery co-operatively. The results were as follows : 1) The ischemic stroke(54.0%) was more common than hemorrhage stroke(41.5%), and thrombotic infarction was the most frequent type(29.5%). 2) The incidence was highest in 6th and 7th decades. Female was more commonly affected(51.8%). Male was more vulnerable to ischemic stroke, while female to subarachnoid hemorrhage. In seasonal prevalence, during autumn and winter time stroke was predominant. 3) In preceding disease, hypertention was most common and previous stroke was the next. Sleep, physical work, rest and meal were the leading causes of the precipitating factors in order. Initial symptoms were altered mentality, hemiparesis, headache, dizziness, speech disturbance in order. 4) On plain chest X-ray, 67.4% was abnormal. Among them, hypertensive heart was the most common abnormal finding. On EKG, 78.6% was abnormal and LVH, myocardial ischemia, atrial fibrillation were the findings in order. 5) The overall mortality rate 18.8%. The highest mortality rate was found in subarachnoid hemorrhage. The ischemic stroke group had a better prognosis. 6) Above results suggest that needs of institution of stroke clinic where multidepartments are participated. That clinic may take the role of more advanced treatment and educating local people for prevention and rehabilitation of stroke patients.

腰椎 椎間板 造影法의 診斷的 價値에 관한 臨床的 硏究

吳錫全,河虎均,金光明,鄭煥泳,金南奎 한양대학교 의과대학 1990 한양의대 학술지 Vol.10 No.1

Discography was performed on the 2285 intervertebral disc spaces on the 1500 patients with herniated lumbar disc. Discographic findings were compared with htose of lumbar myelography and/or lumbar computed tomography(CT), performed on the same patient. Among these patients, 107 cases were operated on and the others were followed by 2ml of intradiscal chymopapain injection. These results were analyzed and summarized as follows. 1) Cottonball type, biscuit type and bilocular type of discographic findings which were classified as normal conventionally were found in cases with definite clinical manifestation and abnormal findings in the myelography and CT studies. Accordingly, these types are no longer considered as normal variations. 2) A discography demonstrated the shape of disc and whereabout of intradiscally injected materials very clearly. As far as concerned with this advantage the discography is superb than any other examination. 3) A discography, lumbar myelography, and lumbar CT were not readily correlated and one of these studies is not superior to the others in diagnostic value. It is thought that these studies are supplemental to each other.

Adult Langerhans Cell Histiocytosis of the Spine Presenting with Neurological Deficits: A Case Report

안세환,하호균,김현우,고정호 대한척추신경외과학회 2010 Neurospine Vol.7 No.3

The authors report a case of an unusual spinal Langerhans cell histiocytosis(LCH) in an adult presenting with neurological deficits. A 36-year-old woman presented with LCH involving the cervical spine and presenting with neurological deficit. Despite aggressive surgical intervention followed by chemotherapy and radiation therapy, recurrence at the other site occurred repeatedly and the patient eventually succumbed to acute respiratory distress syndrome. LCH is a benign disease that resolves spontaneously, but in cases with neurological deficits, aggressive surgical treatment followed by chemo- therapy and radiation therapy should be considered.

전방 경추 미세 추간공 확대술 : 경추증에 대한 최소침습적 전측방 접근법

박성진,하호균,정호,이상걸,박문선,Park, Sung-Jin,Ha, Ho-Gyun,Jung, Ho,Lee, Sang-Keol,Park, Moon-Sun 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.1

Objective : Various surgical approaches have been implemented to fulfill the ideal goals of treatment for cervical spondylotic lesions. Conventional approaches are represented by anterior approach with or without fusion and posterior approach. The authors has applied newly developed anterior cervical microforaminotomy for these lesions on minimally invasive basis. Materials and Method : Twenty-one patients, with cervical HIVD, or stenosis, or both, underwent anterior cervical microforaminotomy between March, 1998 and April, 1999. Fifteen patients underwent unilateral decompression, and 6 bilateral decompression via unilateral foraminotomy. Operation of one level was performed in 16 patients, 2 levels in 4 patients, and 3 in 1 patient. The foraminotomy was accomplished by resecting the uncovertebral joint. Through this hole, compressed nerve root was decompressed by removing the spondylotic spur or disc fragment, and diagonal removing of posterior osteophyte from foraminotomy site to begining of contralateral nerve root made spinal cord decompression. Results : The outcome was excellent in 17 patients(81%) and good in 4 patients(19%) based on Odom's criteria. No complication was encounterd, and average post-operation hospital stay was 3.7 days. Conclusions : These results indicate that anterior cervical microforaminotomy provide adequate neural decompression, minimum postoperative discomfort and fast recovery.