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요추 경막외 지방종증 : 2례 보고 Two Cases Report
성병년,박찬지,박승준,김상욱,이택건 대한척추외과학회 1998 대한척추외과학회지 Vol.5 No.2
Study Design : We report two cases of symptomatic spinal epidural lipomatosis (SEL) associated with long-term use of steroid medication Objectives : The purpose of this study was to assess the clinical characteristics, diagnosis and treatment of symptomatic spinal epidural lipomatosis. Summary of literature review : Spinal epidural lipomatosis is a condition in which excess adipose tissue is deposited circumferentially about the spinal cord in the epidural space. It can present neurologic symptoms including back pain, radiculopathy or cauda equina. Magnetic resonance imaging is the most helpful dignostic means and should be used initially if suspected. Treatment is decompressive laminectomy and debulking of fat. Materials and methods : Two cases of lumbar epidural lipomatosis with neurologic symptoms were discussed and evaluated by physical examination , postmyelography CT and MRI. Results : Two cases were treated with decompressive laminectomy and debulking of fat. Increased accumulation of the fatty tissue was seen predominently in posterior and posterolateral epidural space of the spinal canal, displacing and compressing the lumbar spinal cord anteriorly. Both gross and histologic evaluation revealed overgrowth of unencapsulated normal appearing fat consistent with spinal epidural lipomatosis. One case was demonstrated gradual improvement in symtoms after operation but the other was died due to medical problems. Conclusion : The authors reviewed the literature and reported the results of operative treatment of patients with lumbago, radicular pain and intermitent claudication caused by epidural lipomatosis of lumbar spine and degenerative spinal stenosis.
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경추 골절 및 탈구의 관혈적 정복술 직후 발생한 사지마비 - 1례 보고 -
박동성,성병년,박찬지 대한골절학회 1999 대한골절학회지 Vol.12 No.3
Open reduction and internal fixation of the cervical spine is a commonly performed method of treatment for acute cervical fracture dislocation. A sudden or gradual worsening of the neurological status of a patient during reduction should alert the physician to the presence of high grade compression of the spinal canal. Loss of neurological function during or after manipulation or open reduction and internal fixation should raise the suspicion of compression of the spinal cord from a lesion occupying the canal, such as a herniated disc, buckling of the ligamentum flavum, an epidural hematoma or bone fragments. Magnetic resonance imaging or myelogram are the most helpful diagnostic means and should be used initially if suspected. Treatment is anterior decompression and autogenous strut bone graft. Causes of our case include ruptured disc, vertebral end plate and posterior longitudinal ligament We experienced a case of immediate quadriparesis after posterior decompression and sublaminar wiring for cervical fracture dislocation which was resulted from ruptured disc, vertebral end plate and posterior longitudinal ligament.
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성병년,박완수,이승기,박찬지,김동원,Seong, Byeong-Yeon,Park, Wan-Soo,Lee, Seung-Ki,Park, Chan-Ji,Kim, Dong-Won 대한족부족관절학회 2003 대한족부족관절학회지 Vol.7 No.1
Purpose: The purpose of this study fracture. Materials and Methods: The clinical and radiological analysis were performed on 19 cases of the talus neck fractures who had been treated with conservative treatment or variable methods of operative treatment. Each cases followed up more than 1 year and 6 months from May 1989 to June 2001. The clinical results were analyzed according to the age, cause of injury, fracture type of Hawkins classification, associated soft tissue injury, method of treatments, complications, and Hawkins scoring system. Results: According to Hawkins classification, type I was 6 cases(32%), type II was 5 cases(26%), typeIII was 7 cases(37%), and typeIV was 1 case(5%). In all cases, complete bony union was obtained. According to the Hawkins scoring system, 8 cases(42%) were excellent and good. Avascular necrosis was 4 cases(25%). Traumatic arthritis was 10 cases which were occurred in type II, III and IV. An ankle fusion was 1 case. Conclusion: In talar neck fractures, non-displaced fracture treated by the cast immobilization and displaced fracture treated by early open reduction and internal fixation were expected good results. The complications were 77% of traumatic arthritis and 31% of avascular necrosis in type II, III and IV. We should preoperatively explain to the patient for high complication rates of traumatic osteoarthritis and avascular necrosis in the talus neck fractures.
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