Multiple cervical spinous process fractures in a novice golf player.

Avulsion of spinous process, also called Clay-shoveler's fracture, is most prevalent among those engaged in hard physical labor. To the best of the author's knowledge, only one case of multiple spinous process fractures of the upper thoracic spine in a novice golfer has been reported. A 45-year-old female presented with intractable posterior neck pain.

The volumetric analysis of cement in vertebroplasty: relationship with clinical outcome and complications.

Study Design: Prospective study.

Objective: The aim of this study was to demonstrate the safe range of cement volume during percutaneous vertebroplasty.

Summary Of Background Data: A few clinical reports have addressed the relationship between cement volume and clinical outcome.

Clinical analysis of thoracic ossified ligamentum flavum without ventral compressive lesion.

The aim of this study was to analyze the clinical characteristics of thoracic ossified ligamentum flavum (OLF) and to elucidate prognostic factors as well as effective surgical treatment modality. The authors analyzed 106 thoracic OLF cases retrospectively from January 1999 to December 2008. The operative (n = 40) and the non-operative group (n = 66) were diagnosed by magnetic resonance imaging (MRI) and/or computed tomography (CT) imaging.

Percutaneous vertebroplasty for intravertebral cleft: analysis of therapeutic effects and outcome predictors.

Objective: To investigate the short-term therapeutic effect of percutaneous vertebroplasty (PVP) for intravertebral cleft (IVC) and to analyze possible outcome predictors.

Materials And Methods: After retrospective review of spot radiographs during PVP, 23 patients were included in this study. Age, sex, symptom duration, functional status, injected cement volume, and type of approach were evaluated using patients' medical and operative records.

Enhancing box sign : enhancement pattern of acute osteoprotic compression fracture.

Objective: Although gadolinium enhancement of compression fractures is well known, the enhancement pattern of the acute stage of a fracture is not completely understood. Here, we investigated the enhancement pattern of acute vertebral compression fractures (VCFs).

Methods: We conducted a retrospective study of patients with acute osteoporotic VCFs admitted to hospital between January 2004 and December 2005.

Perimedullary arteriovenous fistula of the filum terminale: case report.

Objective: Although a dural or intramedullary arteriovenous fistula involving the conus medullaris and fed by the lateral sacral artery has been reported, a case of perimedullary fistula arising from an artery in the filum terminale has not been described in the literature. The authors report the first case of perimedullary arteriovenous fistula located in the filum terminale.

Clinical Presentation: A 61-year-old man presented with a 10-year history of leg pain.

Inflammatory myofibroblastic tumor in the intradural extramedullary space of the lumbar spine with spondylolisthesis: case report and review of the literature.

An inflammatory myofibroblastic tumor (IMT) is a rare disease entity reported to arise in various organs but still thought to be a neoplastic or reactive inflammatory condition controversially. The author reports an extremely rare case of intradural extramedullary IMT of lumbar spine which was presenting radiculopathy and neurogenic intermittent claudication due to concomitant spondylolisthesis.

Pyogenic vertebral osteomyelitis: identification of microorganism and laboratory markers used to predict clinical outcome.

The aim of this study is to determine the predictive values of laboratory indicators of pyogenic vertebral osteomyelitis (PVO) and a potential cure if the microorganism cannot be identified. Forty-five consecutive patients with PVO were enrolled. Antibiotic therapy with or without surgery was performed according to microorganism.

Spinal intraosseous schwannoma : a case report and review.

A case of spinal intraosseous schwannoma (SIS) in the lumbar vertebra is reported. Clinical and radiologic characteristics of 16 reported cases of SIS were reviewed. SIS can be a rare differential diagnosis for intraosseous tumors.

Minimum 2-year follow-up result of degenerative spinal stenosis treated with interspinous u (coflex).

Objective: Clinical and radiological results of posterior dynamic stabilization using interspinous U (ISU, Coflex, Paradigm Spine Inc.(R), NY, USA) were analyzed in comparison with posterior lumbar interbody fusion (PLIF) in degenerative lumbar spinal stenosis (LSS).

Methods: A retrospective study was conducted for a consecutive series of 61 patients with degenerative LSS between May 2003 and December 2005.

Unilateral augmented pedicle screw fixation for foraminal stenosis.

Objective: The purpose of this study is to evaluate the effectiveness of unilateral decompression and pedicle screw fixation for the unilateral symptomatic foraminal stenosis.

Methods: The study group comprises consecutive 16 patients who underwent unilateral decompression and bone cement augmented pedicle screw fixation from May 2003 to January 2006. The patients were evaluated by visual analog scale (VAS) for pain and the scoring system of the Japanese Orthopedic Association (JOA) for low back pain.

Cervical transforaminal epidural steroid injection for the management of cervical radiculopathy: a comparative study of particulate versus non-particulate steroids.

Objective: To determine if a particulate steroid which has a risk for embolic infarct would be more effective than a non-particulate steroid for transforaminal epidural steroid injection (TFESI). The purpose of this study was (1) to compare the effect of cervical TFESI using particulate (e.g.

Biomechanical effect of constraint in lumbar total disc replacement: a study with finite element analysis.

Study Design: Biomechanical effect of implantation of an artificial disc (AD) was investigated using the nonlinear three-dimensional finite element model of L4-L5. The SB CHARITE and the Prodisc were chosen as the representative prosthesis of unconstrained and constrained ADs (UADs and CADs) and compared with the intact human intervertebral disc.

Objective: To investigate the effect of implantation of an AD to spinal functional unit and to evaluate the difference between the unconstrained and constrained models.

Imaging features suggestive of a conjoined nerve root on routine axial MRI.

Objective: The purpose of our study is to evaluate imaging features suggestive of a conjoined nerve root on routine axial MRI.

Methods: Two radiologists and two surgeons retrospectively reviewed the MRI of three cases in which a conjoined nerve root was discovered during operation and found three suggestive signs on routine axial MR images: "corner" (asymmetric morphology of the anterolateral corner of the dural sac), "fat crescent" (intervening extradural fat between the asymmetric dura and the nerve root), and "parallel" signs (visualization of the entire parallel course of the nerve root at the disc level). Two radiologists prospectively found these signs during routine MRI interpretation sessions over a period of 6 months.

Transforaminal epidural steroid injection for lumbosacral radiculopathy: preganglionic versus conventional approach.

Objective: The present study was undertaken to evaluate the effectiveness of transforaminal epidural steroid injection (TFESI) with using a preganglionic approach for treating lumbar radiculopathy when the nerve root compression was located at the level of the supra-adjacent intervertebral disc.

Materials And Methods: The medical records of the patients who received conventional TFESI at our department from June 2003 to May 2004 were retrospectively reviewed. TFESI was performed in a total of 13 cases at the level of the exiting nerve root, in which the nerve root compression was at the level of the supra-adjacent intervertebral disc (the conventional TFESI group).

Validation of the Korean version of the oswestry disability index.

Study Design: Validation of a translated, culturally adapted questionnaire.

Objectives: To translate and culturally adapt a Korean version of the Oswestry Disability Index (ODI) and to validate its use in Korean patients.

Summary Of Background Data: The ODI is one of the most widely used and validated instruments for measuring disability in spinal disorders.

Comparison of multifidus muscle atrophy and trunk extension muscle strength: percutaneous versus open pedicle screw fixation.

Study Design: This study was conducted by retrospective case selection and prospective observation of longitudinal changes of the multifidus muscle cross-sectional area and of trunk extension muscle strength in percutaneous and open pedicle screw fixations.

Objectives: To compare postoperative multifidus muscle atrophy and trunk muscle performance of percutaneous pedicle screw fixation against those of open pedicle screw fixation.

Summary Of Background Data: Recent attempts to combine percutaneous pedicle screw fixation with minimally invasive fusion techniques are based on an anecdotal presupposition that percutaneous pedicle screw fixation is superior to its open counterpart.

Intravertebral vacuum phenomenon in osteoporotic compression fracture: report of 67 cases with quantitative evaluation of intravertebral instability.

Object: The objectives of this study were to: 1) describe the incidence and clinical features of intravertebral vacuum phenomenon (IVVP) in a relatively large number of cases; 2) quantitatively evaluate intravertebral instability and determine the factors affecting instability; and 3) evaluate the efficacy of percutaneous vertebroplasty in the treatment of this phenomenon.

Methods: A retrospective review was conducted of the records of 67 patients with IVVP among 652 consecutive cases of osteoporotic compression fracture. Comparisons between the IVVP group and a control group, a stable group, and an unstable group were conducted.

Comparative study of laparoscopic L5-S1 fusion versus open mini-ALIF, with a minimum 2-year follow-up.

Anterior lumbar interbody fusion (ALIF) is a widely accepted tool for management of painful degenerative disc disease. Recently, the modern laparoscopic surgical technique has been combined with ALIF procedure, with good early postoperative results being reported. However, the benefit of laparoscopic fusion is poorly defined compared with its open counterpart.

Treatment of lower lumbar radiculopathy caused by osteoporotic compression fracture: the role of vertebroplasty.

The authors used vertebroplasty for the treatment of severe lower lumbar radicular pain caused by osteoporotic compression fracture. Patients presented with severe radiating leg pain rather than lower back pain from recent osteoporotic compression fracture of lower lumbar vertebra. Radiologic findings showed osteoporotic compression fracture combined with preexisting stenosis of the intervertebral foramen resulting in root compression.