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Prognostic Factors of Neurological Complications in Spinal Surgeries
신원식,안동기,이정수,구기혁,유인선 대한척추외과학회 2018 Asian Spine Journal Vol.12 No.4
Study Design: Retrospective study. Purpose: To determine prognostic factors of neurological complications (NCs) of posterior thoracolumbar surgeries. Overview of Literature: There have been few reports on the prognosis of NCs according to the causes and treatment methods. Methods: The subjects were 65 patients who had NCs for 19 years (1995–2013) after posterior thoracolumbar surgeries in Seoul Sacred Heart General Hospital. The degree of neurological injury was assessed using numeric scales as follows: G1, increased leg pain or sensory loss; G2, hemiparesis; G3, paraparesis; G4, cauda equine syndrome; and G5, complete paraplegia. The relative degree of neurological recovery was evaluated using four numeric scales as follows: Gr1, complete recovery; Gr2, almost complete recovery with residual sensory loss or numbness; Gr3, partial recovery with apparent neurological deficit; and Gr4, no recovery. The prognostic factors were investigated in terms of demographic and surgical variables that were available in a retrospective review. Results: The causes were as follows: epidural hematoma (EH), 25 patients (38.5%); insufficient decompression and fusion, 14 patients (21.5%); mechanical injury, 11 patients (16.9%); insufficient discectomy, four patients (6.2%); and unknown, 11 patients (23.1%). The grade of neurological injury was as follows: G1, 11 patients (16.9%); G2, 34 patients (52.3%); G3, 15 patients (23.1%); G4, three patients (4.6%); and G5, two patients (3.1%). Thirteen patients received conservative treatment, and 52 underwent revision surgeries. Neurological recovery was as follows: Gr1, 21 patients (32.3%); Gr2, 17 patients (26.2%); Gr3, 20 patients (30.8%); and Gr4, seven patients (10.8%). The prognosis depended on the causes (p=0.041). The subgroup analysis of the revision group revealed a significant correlation between the degree of neurological recovery and the timing of revision, irrespective of causes (r=0.413, p=0.002). Conclusions: The prognosis of NC depended on the causes. EH was the best and unknown was the worst prognostic factor. Revision should be performed as soon as possible for a better prognosis.
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신원식,송동익 한국지질과학협의회 2005 Geosciences Journal Vol.9 No.3
Single- and bisolute competitive sorption of phenols(2-chlorophenol, 3-cyanophenol and 4-nitrophenol) onto montmorillonitemodified with cationic surfactant (hexadecyltrimethylamonium,HDTMA cation) was investigated. In single-solute sorption, sorptionaffinity increased in the order of 2-chlorophenol > 4-nitrophenol >3-cyanophenol, as expected from the magnitude of the octanol-water partition coefficient (Kow). The difference in affinity is mainlyattributed to the hydrogen bonding with the water moleculesincorporated in the sorbed phase. The sorption affinity of thephenolic compounds onto the HDTMA-montmorillonite was inthe order of pH 7 > pH 3 >> pH 11.5. Compared to uptake at pH3 and 7, the uptake at pH 11.5 was quite low. The reduced uptakeat pH 1.5 is attributed to lower solubility of anions in the core ofthe organic medium due to the unfavorable hydrophobic inter-action between hydrated anions and nonpolar organic mediumand thus anions adsorbing near the surface of the nonpolarthe single-solute sorption data well. Competition between thesolutes in bisolute sorption reduced the sorbed amount of eachsolute compared with that in the single-solute system. The idealadsorbed solution theory (IAST) coupled with the solubility-normalized Freundlich model predicted the bisolute competitivesorption data successfully. The solubility-normalized model wasanalyzed to characterize sorption mechanism of phenols ontoHDTMA-montmorillonite at very low (Henry’s law resion) and athigh concentration (Ralout’s law region).
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