Morphologic changes on magnetic resonance imaging mainly corresponded to clinical outcomes but tended to lag behind improvement of leg pain. Disappearance of herniate nucleus pulposus was seen frequently in the cases of migrating disc herniation, and it was presumed that exposure to the vascular supply had a lot to do with this phenomenon.

Segmental instability influences the whole lumbar motion in patients with degenerative spondylolisthesis. The patients with chronic low back pain did not show a significant difference when compared with the volunteers.

Surgery with needle aspiration of the gas resulted in clinical improvement in all cases, confirming that intraspinal gas is an important cause of lumbar radiculopathy. The composition of the gas in one patient was analyzed by gas chromatography, which revealed an overwhelming preponderance of nitrogen. A relationship between a gas-containing pseudocyst in the spinal canal and a degenerated intervertebral disc was identified, a key finding for understanding the precise nature of this disorder. Intradiscal gas formation and its outward migration as a sequel of intervertebral disc degeneration also has been addressed in this report.

The anterior floating method appears to yield adequate long-term outcomes when used to manage ossification of the posterior longitudinal ligament.

No abstract

Sixty-one patients with trigeminal neuralgia who underwent microvascular decompression were analysed. Vascular compression of the trigeminal nerve root was found in all cases. The recurrence rate of pain in this series was 18% with an average follow-up of 80 months (range: 13 to 126 months). Ten patients developed recurrence of their trigeminal neuralgia during follow-up. Fifteen factors, including the clinical and operative findings in the pain-free patients versus the 10 patients with recurrence were analysed. Only the patients with venous compression singly or in combination with arteries were significantly related to recurrence. There was no relationship between recurrence and the duration of symptoms or the degree of compression. Based on vascular compression as the sole cause of TN, the results and interesting findings can not be explained. With reference to the hypothesis that vascular compression is only one of at least two causative factors for the development of trigeminal neuralgia, it is suggested that the intrinsic lesion in trigeminal neuralgia may be responsible for late recurrence.

Posterior decompression, as well as anterior decompression, is effective in the first pattern in the cervicothoracic region. In case of the second pattern, the responsible ossification of the posterior longitudinal ligament always lies one or two levels above the apical vertebra and should be removed by anterior approach, regardless of the extent of kyphosis. Transthoracic anterior decompression surgery is considered the best method for most patients under the second and third patterns.

A 26-year-old male presented with recurrence of an enterogenous cyst in the intracranial region 10 years after the first operation. The cyst was drained and the cyst wall partially resected at both operations with good outcome. Histological examination showed a change from one layer epithelium in the first specimen to glandular structures in the second. Alcian blue, periodic acid-Schiff, and immunohistochemical staining for epithelial membrane antigen, S-100 protein antigen, keratin, and carcinoembryonic antigen were used to confirm the accurate diagnosis. Immunohistochemical staining showed CA19-9 antigen was positive in both specimens. The CA19-9 level in the cerebrospinal fluid was extremely high (621.5 U/ml) at the second operation. Patients with enterogenous cyst should be monitored to detect possible recurrence.