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흉요추부에 발생한 척수내 성상세포종 : 1례 보고 Report of 1 case
최문배,유영만,문명선 대한신경외과학회 1984 Journal of Korean neurosurgical society Vol.13 No.3
The intramedullary glioma of spinal cord has occupied 22.5% of intraspinal neoplasm, and is the most common among the intramedullary spinal cord tumor, and the first successful operative removal was performed in 1907 by Elsberg. The intramedullary astrocytoma has frequent incidence in the thoracic and cervical region of the spinal cord, which has more frequent grade I astrocytoma. We experienced a case of intramedullary grade Ⅱ astrocytoma of the thoracolumbar region which has associated a paraplegia as neurological deficit. A 26 years old Korean female has admitted to our clinic because of paraplegia with incontinence for 2 years. On admission, the neurological examination revealed a paraparesis below T_(12) level with urinary and fecal incontinence, and then local tenderness from T_(10) to L₁ level. The simple X-ray film of the thracolumbar spine has showed erosion of both pedicle, widening of interpeduncular distance and scalloping change of posterior vertebral margin from T_(12) to L₁, which were similar to the picture of intramedullary spinal cord tumor. We performed a myelography by pantopaque through the lumbar and cisternal puncture for accurate site of lesion, and found a complete block at L₁ level and T_(10) level on myelogram. Then the immediate total laminectomy from T_(8) to L₁ was applied. The operative finding was a intramedullary mass with cystic fluid, which has compressed the spinal cord. After aspiration of cystic fluid, we removed the tumor mass incompletely because of intermingling with spinal cord but the decompression was enough. The neurological defict was improved gradually for post-operative 4 weeks, thereafter improvement was stopped and remained the paraparesis. The post-operative pathological diagnosis was grade Ⅱ astrocytoma, which composed of anaplastic cell and radiotherapy has followed.
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신경외과에서의 흉추 및 요추골골절의 해링톤씨봉 고정 : Clinical Study
최문배,문명선 대한신경외과학회 1985 Journal of Korean neurosurgical society Vol.14 No.2
Harrington Instrumentation to treat the unstable fracture (including the fracture dislocation) of the thraco-lumbar spine with neurologic deficits is a very effective method. This method provides rigid fixation and stability for thoracolumbar fracture, also offers the optimum condition for recovery of nerve roots, and decompresses the spinal canal with anatomical reduction. The principal advantage for this method of treatment is the early mobilization of the patient and enhanced rehabilitation. Authors, performed Harrington Instrumentation with a laminectomy experienced 20 cases of unstable thoraco-lumbar spine fracture (including the fracture-dislocation) with neurologic dificit from Aug. 1980 to Oct. 1984. The following results were obtained: 1) Of twenty patients, the patients at the age 20 to 49 were most commonly injured and predominant cause of spinal injury was falling accident. 2) The thoraco-lumber fracure( including fracture-dislocation) were thoracolumbar junction, the commonest site among them was the 1st number vertebra, and the commonest mechanism of spinal injury way flexon iniury. 3) Most commonly, paraplegia was with twelve thoracic vertebra injury, and paraparesis was with 1st lumbar vertebra. 4) Correction of the kyphotic deformity was 8 degree on the average, and the range of the correction was between 0 degree and 19 degree. 5) Neurological recoveries were gained from 14 patients (70%), and the l0 patients (50%) among them were completely recovered. 6) Average hospital periods were 78 days and after an average 21 postoperative days, ambulation was started. 7) In complication, three hook dislocations were occured. 8) Early operation (laminectomy for posterior decompression and Harrington Instrumentation for anterior decompression) was very effective in spinal cord injury.
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말초성 신경아세포종 : 두개골 발생 증례 보고 Involving Skull
박양화,권익승,류연석,신미경,최문배,홍승관,문명선 대한신경외과학회 1988 Journal of Korean neurosurgical society Vol.17 No.4
The peripheral neuroblastomas are malignant neoplasms that originate from the adrenal gland and sympathetic nervous tissues. They usually occur in childhood. They exhibit such malignant features that they metastasize early to lung, liver, bone, rarely skull and other structures. The patients with peripheral neuroblastoma have short duration of symptom and short survival period. They reveal the characteristic light microscopic features that resemble other small cell carcinomas. The establishment of final diagnosis of peripheral neuroblastoma needs various special stainings for small cell carcinomas, and the electron microscopic findings are the most reliable. The authers recently experienced a case of peripheral neuroblastoma in a 26-year old man which involved right frontoparietal skull vault. The only chief complaint was a local non-tender mass at right frontoparietal scalp. Neither headache nor any neurological deficits was detected. Simple skull X-ary revealed a punched out rediolucency at right frontoparietal bone and brain CT showed a superficial elliptical high density mass that enhanced strongly. The mass was totally removed by wide craniectomy. The tumor invaded and penetrated the dura but the arachnoid membrane. at the tumor bed was not invaded by the tumor. The tumor was confirmed as peripheral neuroblastoma by various special stainings for small cell carcinomas. Following surgical resection of the mass, post-operative radiotherpy was offered(4800 rads for about 5 weeks). The patient aggrevated progressively and showed numerous metastases to such bones as lumbar vertebrae, pelvis and humerus to became paraplegic. 8 months after the operation, the patient died.
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