Mitsuyoshi Oda

Two Cases of Phrenic Nerve Palsy in a Cervical Myelopathy Caused by Ossification of Posterior Longitudinal Ligament

Two cases of phrenic nerve palsy in an ossification of posterior longitudinal ligament (OPLL) were admitted and underwent operations on cervical spine. A 57-year-old man had been performed cervical laminoplasty (C2-C7). A month after surgery, he was weaned from artificial respirator, and gained vital capacity by 1, 230ml, and %vc, 36.6%. Seven months post-Operation he was discharged on his feet.A 55-year-old woman had been operated (C2-C7) on due to left phrenic palsy and myelopathy in OPLL. Three months after surgery the neurological deficits were almost fully recovered.Cervical X-ray films of Both cases revealed the peak of OPLL to be on the third cervical spine and the myelogram showed block at C2-3 level. In case of upper cervical OPLL, we need an attention to phrenic nerve palsy.

Luque Instrumentation after Posterior Decompression for Lumbar Degeneration of High Aged Patients

Eighteen cases of Luque instrumentation with spinous process wiring after posterior decompression for lumbar degeneration of high aged patients were discussed.The operative time and intraoperative bleeding of them were not so different from those of the cases without Luque instrumentation. The mean duration until ambulation was 10 days. The improvement rate of JOA score was 72%.Comfortable stabilization for decompressed segment was obtained. The decrease in total lumbar motion was about 10 degree, and it did not disturb the ADL so much.This method is easy, and has good application when high aged patients need early ambulation, and when the instability of multiple segments exists or will occur by decompression.

Treatment of Hypermobile Meniscus

Eleven patients (14 joints) of hypermobile meniscus were treated in our hospital in the last 6 years approximately. Their mean age was 16 years with a range from 13 to 22 years, and 4 patients were male and 7 patients were female. An affected side of meniscus was all lateral. Only 3 patients had traumatic episode on the knee joint. Giving way was seen in all patients but locking was seen in only one patient. McMurray test was positive in the majority of patients, but Apley test was positive in only one patient.The tendency of general joint laxity was seen in 6 patients (3 patients showed involvement in bilateral knee joints). These were considered to be characteristic findings and one of the geneses of hypermobile meniscus.Arthroscopic partial meniscectomy was performed in 6 patients (8 joints) and arthroscopic meniscoresis in 5 patients (5 joints). These results were more satisfactory in the cases of arthroscopic meniscoresis than the cases of arthroscopic meniscectomy. So, arthroscopic meniscoresis should be chosen in the case of hypermobile meniscus requiring surgery.