Journal of Korean Neurosurgical Society
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J Korean Neurosurg Soc · Mar 2010
Clinically correlated anatomical basis of cricothyrotomy and tracheostomy.
Cricothyrotomy and tracheostomy are performed by physicians in various disciplines. It is important to know the comprehensive anatomy of the laryngotracheal region. Hemorrhage, esophageal injury, recurrent laryngeal nerve injury, pneumothorax, hemothorax, false passage of the tube and tracheal stenosis after decannulation are well known complications of the cricothyrotomy and tracheostomy. Cricothyrotomy and tracheostomy should be performed without complications and as quickly as possible with regards the patients' clinical condition. ⋯ Tracheostomy and cricothyrotomy have a low complication rate if the person performing the procedure has thorough knowledge of the neck anatomy. The choice of tracheostomy or cricothyrotomy to establish an airway depends on the patients' clinical condition, for instance; cricothyrotomy should be preferred in patients with cervicothoracal injury or dislocation who suffer from respiratory dysfunction. Furthermore; if a patient is under risk of hypoxia or anoxia due to a difficult airway, cricothyrotomy should be preferred rather than tracheostomy.
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J Korean Neurosurg Soc · Mar 2010
Characterization of the anatomic location of the pituitary stalk and its relationship to the dorsum sellae, tuberculum sellae and chiasmatic cistern.
The normal anatomic relationships characteristic of the pituitary stalk area were previously thought to involve only one location. The purpose of this study was to re-evaluate the anatomic location of the pituitary stalk and possible varying locations in relation to the tuberculum sellae and dorsum sellae using morphometric evaluation and anatomic dissection of human cadaveric specimens. The surgical implications of the variations are discussed. ⋯ When opening the chiasmatic cistern, neurosurgeons should be aware about the relationship between the pituitary stalk and the surrounding structures to prevent inadvertent injury to the pituitary stalk.
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J Korean Neurosurg Soc · Feb 2010
High-level cervical spinal cord stimulation used to treat intractable pain arising from transverse myelitis caused by schistosomiasis.
The efficacy of spinal cord stimulation (SCS) for treatment of various chronic painful conditions is well established. Very few reports have documented the use of SCS for treatment of chronic pain after spinal cord injury. We present a case showing a good outcome after such treatment, and suggest that high cervical stimulation may be efficacious. ⋯ High cervical SCS significantly improved the pain in the upper extremities and at the T3-T10 dermatome level. The patient continues to report excellent pain relief 9 months later. The present case suggests that high cervical stimulation may improve chronic pain in the upper extremities and the T3-T10 dermatome level arising from spinal cord injury.
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J Korean Neurosurg Soc · Feb 2010
Development of postdural puncture headache following therapeutic acupuncture using a long acupuncture needle.
Acupuncture appears to be a clinically effective treatment for acute and chronic pain. A considerable amount of research has been conducted to evaluate the role that acupuncture plays in pain suppression; however, few studies have been conducted to evaluate the side effects of the acupuncture procedure. ⋯ Considering the high opening pressure, cerebrospinal fluid leakage, and the patient's history of acupuncture in the lower back area, our diagnosis was iatrogenic postdural puncture headache. Full relief of the headache was achieved after administration of an epidural blood patch.
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J Korean Neurosurg Soc · Feb 2010
Clinical outcomes and complications after pedicle subtraction osteotomy for fixed sagittal imbalance patients : a long-term follow-up data.
Clinical, radiographic, and outcomes assessments, focusing on complications, were performed in patients who underwent pedicle subtraction osteotomy (PSO) to assess correction effectiveness, fusion stability, procedural safety, neurological outcomes, complication rates, and overall patient outcomes. ⋯ Intraoperative or postoperative complications are relatively common following PSO. Most late-onset complications in PSO patients were related to PJK and instrumentation failure. Correcting the C7 plumb line value with minimal operative complications seemed to lead to better clinical results.