• Title/Summary/Keyword: Dural fibrosis

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One Case Report on Physical Sequelas after Spinal Epidural Abscess Surgery (척추 경막외 농양 수술 후유증 치험 1례)

  • Kwon, Jeong-Gook;Lee, Jong-Ha;Keum, Dong-Ho
    • Journal of Korean Medicine Rehabilitation
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    • v.24 no.4
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    • pp.195-201
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    • 2014
  • The objective of this study is to report the improvement of one patient with physical sequelas induced by spinal epidural abscess surgery. The patient was treated by acupuncture therapy with pulsed electromagnetic therapy and herb medicine. We evaluated the effectiveness by numerical rating scale (NRS). As a result, the patient improved significantly NRS score. And the patient's symptoms were alleviated. We guess that the causes of the patient symptoms are chronic inflammation and fibrosis of dural. We conclude that acupuncture therapy with pulsed electromagnetic therapy is an effective treatment to reduce the residual pain after spinal epidural abscess surgery. But there is a limit on this study due to sufficient number of case. Further studies will be needed.

Analysis of Risk Factors and Management of Cerebrospinal Fluid Morbidity in the Treatment of Spinal Dysraphism

  • Lee, Byung-Jou;Sohn, Moon-Jun;Han, Seong-Rok;Choi, Chan-Young;Lee, Dong-Joon;Kang, Jae Heon
    • Journal of Korean Neurosurgical Society
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    • v.54 no.3
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    • pp.225-231
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    • 2013
  • Objective : Spinal dysraphism defects span wide spectrum. Wound dehiscence is a common postoperative complication, and is a challenge in the current management of cerebrospinal fluid (CSF) leaks and wound healing. The purpose of this study is to evaluate the risks of CSF-related morbidity in the surgical treatment of spinal dysraphism. Methods : Ten patients with spinal dysraphism were included in this retrospective study. The median age of the cohort was 4.8 months. To assess the risk of CSF morbidity, we measured the skin lesion area and the percentage of the skin lesion area relative to the back surface for each patient. We then analyzed the relationship between morbidity and the measured skin lesion area or related factors. Results : The overall median skin lesion area was 36.2 $cm^2$ (n=10). The percentage of the skin lesion area relative to the back surface ranged from 0.6% to 18.1%. During surgical reconstruction, 4 patients required subsequent operations to repair CSF morbidity. The comparison of the mean area of skin lesions between the CSF morbidity group and the non-CSF morbidity group was statistically significant (average volume skin lesion of $64.4{\pm}32.5cm^2$ versus $27.7{\pm}27.8cm^2$, p<0.05). CSF morbidity tended to occur either when the skin lesion area was up to 44.2 $cm^2$ or there was preexisting fibrosis before revision with an accompanying broad-based dural defect. Conclusion : Measuring the lesion area, including the skin, dura, and related surgical parameters, offers useful information for predicting wound challenges and selecting appropriate reconstructive surgery methods.