Spinal Surgery
Online ISSN : 1880-9359
Print ISSN : 0914-6024
ISSN-L : 0914-6024
Volume 12, Issue 1
Displaying 1-34 of 34 articles from this issue
  • Article type: Cover
    1998 Volume 12 Issue 1 Pages Cover1-
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    Download PDF (1844K)
  • Article type: Appendix
    1998 Volume 12 Issue 1 Pages App1-
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    Download PDF (73K)
  • Article type: Appendix
    1998 Volume 12 Issue 1 Pages App2-
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    Download PDF (59K)
  • Article type: Index
    1998 Volume 12 Issue 1 Pages Toc1-
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    Download PDF (58K)
  • Article type: Index
    1998 Volume 12 Issue 1 Pages Toc2-
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    Download PDF (53K)
  • Article type: Appendix
    1998 Volume 12 Issue 1 Pages App3-
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    Download PDF (12K)
  • Toussaint A. Leclercq
    Article type: Article
    1998 Volume 12 Issue 1 Pages 1-9
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    The purpose of this study was to research the use of Titanium cage implantation as a spacer for re-expansion and maintenance of disc height in association with interbody fusion. Between June 1992 and May 1993, twenty patients (14 males and 6 females, mean age of 38.8 years with range 26 to 65) were implanted at 22 levels (9 at L4-5 and 13 at L5-S1). After removal of disc material and preparation of the intervertebral space by tapping the end plates, 2 cages were implanted per level and packed with autogenous bone. Follow-up spine X-rays were done at 6 weeks, and 3, 6, 12 and 24 months and yearly thereafter. Disc height was measured pre, intra and postoperatively. Ten levels demonstrated improvement of disc space from a mean of 6.8mm pre-operatively to 11.1mm postoperatively. Ten levels were maintained at 11.7mm. In 1 patient, both spaces collapsed postoperatively. At 3 to 5 years follow-up, the results on disc height were maintained and X-rays showed satisfactory fusion. There were no cases of infection, radicular deficit or CSF leak. The functional states improved on the Prolo scale. Posterior lumbar interbody fusion (PLIF) with Titanium cages was found to be a safe and efficacious technique. The rationale for maintaining or improving the disc space with cages is discussed.
    Download PDF (2027K)
  • Article type: Appendix
    1998 Volume 12 Issue 1 Pages App4-
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    Download PDF (13K)
  • Hiroshi Takahashi
    Article type: Article
    1998 Volume 12 Issue 1 Pages 11-18
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    In the present paper, a lateral approach to the lesions located atlanto-axial region is described. We adopted this approach in seven cases. Four cases had dumbbell type neurinoma, two had large pannus formation by RA compressing the upper cervical cord, and one had non-reducible atlanto-axial dislocation. For dumbbell type neurinomas, the lateral approach enabled us to identify the location of vertebral artery at an early stage of the operation and to expose easily the interface between the tumor and the cord. As to the extradural lesions, by drilling the lateral atlanto-axial joint or lateral mass, we could approach the ventral extradural areas without difficulty. In a case with non-reducible atlanto-axial dislocation, the two thirds of the odontoid process was located posterior to the vertebral artery and the atlanto-axial interlaminar space was wide due to C1 occipitalization. These anatomical characteristics made the lateral approach to the odontoid process easier. Postoperatively, unilateral drilling of the lateral mass did not induce instability as reported before. However after drilling of the lateral mass and odontoidectomy, we had to add posterior fusion with instrumentation. In all cases, follow up results were satisfactory and this operative approach can be recommended in cases with intradural or extradural atlanto-axial ventral lesions.
    Download PDF (2312K)
  • Kiyoshi Hidaka, Yasuhiro Chiba, Hiroto Takada
    Article type: Article
    1998 Volume 12 Issue 1 Pages 19-24
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    When performing a spinous process splitting laminoplasty, several instruments such as an air drill system, a T-saw and an airtome have been used for osteotomy. Recently we have experienced an use of ultrasonic osteotome (SONOPET UST-2000 M&M Co., Ltd) for spinal surgery. This instrument has two different types of blade tip ; a scalpel type and a scratch type. Either type is useful for the spinous process splitting laminoplasty, particulary a scratch type being suitable for C2 dome laminectomy. A great advantage of this instrument for osteotomy is that the incidence of injury to the dura mater or nerves is less frequent than that by an use of the air drill system. Other advantages and usefulness of the instrument are discussed in this paper. In conclusion, the ultrasonic osteotome has been proved to be useful and safe, and may likely to supersede the air drill system.
    Download PDF (1612K)
  • Motoi Shoda, Shigehiko Kuno, Katsuhiko Akashi, Sachiko Yamaguchi, Isao ...
    Article type: Article
    1998 Volume 12 Issue 1 Pages 25-32
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    The lumbar interbody fusion cage has been newly developed for PLIF. The benefits are easy handing, good disc space holding and early mobilization for the patient. The materials used to make the titanium, or carbonfiber or ceramic. Each material has its merits and demerits. For example, carbonfiber is evaluated highly for fusion, but when it is used, it is difficult to check the migration of lumbar X-P. We use the SDIC and CCD because of good fixation provided for the lumbar spine by this system. We report the result of the SDIC system with CCD (rigid fixation) in this paper. 30 cases of patients with spondylolisthesis were operated on in our institute. Patient age distribution was 38-70 (mean 57.9) y. o. and gender was male, 15 cases; female, 15 cases. Follow up term was 4-57 (mean 35) months. We also measured the FACET SAGITTAL ANGLE by CT to check the indication for the instrumentation. Facet sagittal angle was significantly small in degenerative spondylolisthesis patients compared to the control group. All patients experienced relief of radicular pain of the foot and intermittent claudication but complaints of lower-back pain continued for 2-5 months postoperatively. The results were evaluated using the JOA disability scale and neurological signs showed an 82.5% improvement. No serious complication was observed except in one patient who fell on the floor and fractured the L5 pedicle. He recovered after reoperation to fix the lumbar from L3, 4 to S1. It is reported that the interbody fusion cage by itself is enough to stabilize the lumbar spine, but we observed some cases of kyphosis post operatively when only cage fixation was used. As the follow-up term has not been long enough to evaluate properly the effect of this manipulation, it is important to carefully select which instrumentation system we should use.
    Download PDF (2134K)
  • Norio Harata, Tatsuo Harata
    Article type: Article
    1998 Volume 12 Issue 1 Pages 33-40
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    Introduction : We accidentally found in a case of lumbar spinal canal stenosis (LSCS) with a highly rotated spine that we could reach the other side of the laterel recess through the one-sided approach without sacrificing the spinal process and the posterior ligaments. Subjects : Sixty patients with LSCS underwent the above described operation from August 1995 to December 1996. All the patients had degenerative LSCS, including 6 cases (6%) of developmental type, 15 cases (25%) of listhetic type. Age; 32 to 79, average age 64.5 years. Thirty three female patients and 27 male patients. Methods : Skin incision; 4cm for one level, 6cm for two levels. Unilateral fascial incision and muscle dissection are followed by fenestration procedure using Casper's retractor. On the opposite side, beginning with drilling the basal portion of the spinal process, the inner surface of the other side lamina is drilled out using air drill or rongeur. After removing the yellow ligament, we can see the lateral recess, the inner aspect of the joint and even the nerve root on that side. Most of the patients can leave the hospital on the 14th day after operation, and discharge might be possible within one week after the operation. Operative results : excellent-8 (13%), good-49 (82%), unchanged-3 (5%), worse-0. Re-expansion of the dural canal was ascertained by postoperative MRIs in all cases, and by myelography and CT-myelography in the selected cases. Conclusion : This is one of the less invasive operation for expanding the spinal canal. Superior results of this operation suggest to us that preservation of the posterior supporting structures of the spine (muscle, ligament, joint, lamina) is essential to success of this operation.
    Download PDF (1657K)
  • Hiroyuki Imamura, Yoshinobu Iwasaki, Kazutoshi Hida, Izumi Koyanagi, M ...
    Article type: Article
    1998 Volume 12 Issue 1 Pages 41-48
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    The clinical findings in five intradural and two extradural arachnoid cysts were discussed. All patients of intradural arachnoid cyst were female, and their lesions were located at the upper or mid thoracic level. Three patients showed sensory disturbance and five showed motor weakness of the lower extremities. MRI and CTM showed enlargement of the subarachnoid space and displacement of the spinal cord. One patient had syringomyelia, two had cervical disc disease, and two had spinal cord herniation at the thoracic level. During the operation, the cyst walls were removed in all patients. Simaltaneously, herniated spinal cords were replaced intradurally. Later, cervical anterior fusion was performed in one patient, but another patient was follow-up without recourse to an operation. Syringomyelia disappeared without any direct treatment. The patients showed good recovery after operation, but the patients of extradural arachnoid cyst showed weakness and sensory disturbance of the lower extremities. Their dural defects were located at the thoracic level. MRI and CTM showed large cysts and bone erosion. After removal of the cyst wall and closure of the dural defect, each patient made a good recovery. Although MRI and CTM were helpful both for diagnosis and operation, 3D MR myelography would have been helpful to show the three dimentional relationship of the cyst and the subarachnoid space, as well as the pathogenesis of the arachnoid cyst and/or spinal cord herniation.
    Download PDF (2453K)
  • Toru Koizumi, Teruaki Kawano, Kiyoshi Kazekawa, Tsutomu Kawaguchi, Ter ...
    Article type: Article
    1998 Volume 12 Issue 1 Pages 49-56
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    We report a case of cruciate paralysis with a Jefferson's fracture and atlanto-occipital dislocation. A58-year-old man was referred to our hospital because of an accidental fall. At the neurological examination, a bilateral motor deficit was observed in the upper limbs, but the lower limbs did not appear to be affected. Left lower cranial nerves (IX, X, XII) dysfunction were noted. Three-dimensional CT of the cervical spine demonstrated an atlanto-occipital dislocation. MRI showed that the medullocervical junction was squeezed between the occipital bone and the axis. The patient was treated using a halo vest and, about three months later, he was treated by occipitocervical fusion. About one month after the operation, he was discharged from our hospital without any neurological deficits. Cruciate paralysis is an uncommon injury at the medullo-cervical junction. It was characterized by weakness of the upper extremities and with minimal or no lower extremity involvement. It was caused by focal and reversible damage of the pyramidal tract at the level of the decussation. About thirty cases of cruciate paralysis have been reported in the literature that were reviewed.
    Download PDF (1802K)
  • Article type: Appendix
    1998 Volume 12 Issue 1 Pages 56-82
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    Download PDF (149K)
  • Mutsumi Nagai, Keiji Oguro, Gen Kusaka, Souji Shinoda, Toshio Masuzawa
    Article type: Article
    1998 Volume 12 Issue 1 Pages 57-62
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    A case of cervical spinal enterogenous cyst is reported. A 33-year-old woman visited the hospital. Sensory examination showed slight diminution of sensation to pinprick on her right side up to the C4 dermatomere level. Magnetic resonance (MR) imaging revealed an intradural cystic mass located on the ventral side at the C5 level of the cervical vertebra. We removed the cyst totally, with laminectomy of C4-6 and right side partial facetectomy of C4/5 and C5/6. The cyst was composed of an epithelial layer and connective tissue, and was only slightly stained for periodic acid-Schiff. The cyst wall had no goblet cells at all. Electron microscopic findings revealed ciliated cells, non-ciliated cells and basal cell-like cells, which showed no evidence of mucin secretion. Although the cyst was lacking in one of the characteristics of enterogenous cyst, namely, mucin secretion, we still diagnosed it as an enterogenous cyst because the cyst wall was similar to bronchiolar epithelium and showed only endodermal elements. To our knowledge, an enterogenous cyst like the one in our case is very rare.
    Download PDF (1281K)
  • Kenta Fujimoto, Hideaki Iwanaga, Naoki Koshimae, Masaaki Kakiuchi, Ryo ...
    Article type: Article
    1998 Volume 12 Issue 1 Pages 63-68
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    We treated a 61-year-old man with metastatic lesions in the first and second thoracic vertebrae. The histological diagnosis was papillary-type thyroid carcinoma. Before resection of the tumor, external fixation with a halo vest and posterior fixation with titanium rods was carried out. An oblique skin incision was made along the anterior border of the right sternocleidomastoid muscle to the sternal notch, and continued along the midline of the sternum. After sternotomy, the right common carotid artery, trachea, esophagus, bracheocephalic vein and aortic arch were retracted. This process permits exposure from the seventh cervical vertebra to the upper border of the third thoracic vertebra. When removing the tumor, bleeding occured easily, and exposure of the third thoracic vertebra was limited. Gross total removal of the tumor and iliac bone autograft were performed, but the bone graft was deviated to the right because of the inadequate exposure of the vertebra. However, the patient was ambulatory at the time of discharge. We conclude that adequate tumor removal and stabilization should be performed for patients with spinal metastasis if there is a possibility that it will improve their quality of life.
    Download PDF (1793K)
  • Mitsunori Shimazaki, Takayuki Matsuzaki, Shuhei Takahashi, Hideto Yosh ...
    Article type: Article
    1998 Volume 12 Issue 1 Pages 69-74
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    Lumbar intraspinal ganglion cysts are relatively rare lesions. We report a case with a lumbar intraspinal ganglion cyst which was treated by surgical excision. A 64-year-old man presented with low back pain radiating to the left leg. Neurological examination on admission revealed decreased pinprick sensation below the level of left L-5 and decresed deep tendon reflex in both legs. T2-weighted image of MRI revealed a high signal intensity mass with a very low intensity rim and an extradural mass displacing the cord anteriorly and to the right. The preoperative diagnosis was that it was an extradural cyst. The mass was then resected through a hemilaminectomy. The histological diagnosis was that it was a ganglion cyst. MRI was useful for a preoperative diagnosis of lumbar intraspinal ganglion cysts. Surgery was a safe, effective treatment for patients with lumbar intraspinal ganglion cysts.
    Download PDF (1629K)
  • Susumu Yasuda, Kazuya Uemura, Tomoyuki Shibata, Yoji Komatsu, Eiki Kob ...
    Article type: Article
    1998 Volume 12 Issue 1 Pages 75-82
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    We report three cases of spontaneous acute spinal epidural hematoma (one male and two females). Two hematomas were located at cervical levels and one at the thoracic level on the dorsal side of the spinal epidural space. There were no predisposing conditions before onset. All cases complained of sudden onset of severe back pain, followed by progressive neurological deficits. Laminectomy or laminoplasty together with evacuation of the hematomas were performed. The patients followed a satisfactory postoperative course and made quick recovery. Histologically, the small vascular tissues near the hematomas revealed a minor anomaly in the vessel walls in all cases. In patients presenting with clinical symptoms of sudden back and radicular pain with progression to paralysis, acute spinal epidural hematoma should be considered as a possible differential diagnosis. As soon as the diagnosis has been established, surgical decompression and microscopic examination for the origin of bleeding are imperative to obtain a better neurological outcome, even in patients in the chronic stage.
    Download PDF (2094K)
  • Article type: Appendix
    1998 Volume 12 Issue 1 Pages 83-
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    Download PDF (59K)
  • Article type: Appendix
    1998 Volume 12 Issue 1 Pages 84-
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    Download PDF (145K)
  • Article type: Appendix
    1998 Volume 12 Issue 1 Pages 85-
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    Download PDF (53K)
  • [in Japanese]
    Article type: Article
    1998 Volume 12 Issue 1 Pages 86-88
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    Download PDF (606K)
  • [in Japanese]
    Article type: Article
    1998 Volume 12 Issue 1 Pages 89-90
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    Download PDF (472K)
  • Article type: Appendix
    1998 Volume 12 Issue 1 Pages 91-93
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    Download PDF (251K)
  • Article type: Appendix
    1998 Volume 12 Issue 1 Pages 94-
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    Download PDF (19K)
  • Article type: Appendix
    1998 Volume 12 Issue 1 Pages 95-
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    Download PDF (25K)
  • Article type: Appendix
    1998 Volume 12 Issue 1 Pages 96-98
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    Download PDF (225K)
  • Article type: Appendix
    1998 Volume 12 Issue 1 Pages 99-
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    Download PDF (22K)
  • Article type: Appendix
    1998 Volume 12 Issue 1 Pages 100-
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    Download PDF (24K)
  • Article type: Appendix
    1998 Volume 12 Issue 1 Pages 101-
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    Download PDF (78K)
  • Article type: Appendix
    1998 Volume 12 Issue 1 Pages App5-
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    Download PDF (54K)
  • Article type: Appendix
    1998 Volume 12 Issue 1 Pages App6-
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    Download PDF (54K)
  • Article type: Cover
    1998 Volume 12 Issue 1 Pages Cover2-
    Published: March 30, 1998
    Released on J-STAGE: September 16, 2016
    JOURNAL FREE ACCESS
    Download PDF (80K)
feedback
Top