Yoon-Suk Hyun

Surgical Results of Intradural Extramedullary Tumors

Background To report the treatment results of 12 patients who underwent a total excision of intradural extramedullary tumors. Methods Twelve cases of histopathologically confirmed intradural extramedullary tumors were treated surgically between February 2002 and March 2005. There were 8 males and 4 females with an average age of 42.6 years. The mean postoperative follow-up period was 24.2 months. The histopathological findings, locations of the tumors, and clinical results were analyzed. The neurological findings obtained during the preoperative stage and the postoperative follow-up were evaluated according to the Frankel classification. Results The histopathological results are as follows: 4 cases of a meningioma, 4 cases of a schwannoma, 2 cases of an epidermoid cyst, 1 case of an arachnoid cyst, and 1 case of an ependymoma. The locations of the tumors were as follows: 7 cases in the thoracic region, 4 cases in the lumbar region, and 1 case in the cervical region. At the final follow-up, a 2-grade and 1-grade improvement was observed in 1 and 7 cases, respectively. There were no changes in the Frankel grade in 4 cases. The preoperative neurological deficit improved within 8 postoperative weeks in most cases and within 1 postoperative year in all cases. Postoperatively, there were 2 cases of cerebrospinal fluid leakage and 2 cases of paresthesia. Conclusions Intradural extramedullary tumors detected by MRI are mostly benign and good clinical results can be obtained when treated surgically. Therefore, more active surgical approaches by orthopedic surgeons are recommended to decrease morbidity.

Effect of Weight-Bearing in Conservative and Operative Management of Fractures of the Base of the Fifth Metatarsal Bone

Background There is no established principle regarding weight-bearing in conservative and operative management of fifth metatarsal base fractures. Methods We reviewed 86 patients with acute fifth metatarsal base fractures. Conservatively treated late or early weight-bearing patients were assigned to Group A or C, respectively. Operatively treated late or early weight-bearing patients were assigned to Group B or D, respectively. Results were evaluated by clinical union, bone resorption, and the American Orthopaedic Foot and Ankle Society (AOFAS) and Visual Analogue Scale (VAS) scores. Results All 4 groups had bone union at a mean of 6.9 weeks (range, 5.1–15.0). There were no differences between the groups in the AOFAS and VAS scores. In the early weight-bearing groups, there were fewer cases of bone resorption, and the bone unions periods were earlier. Conclusions Early weight-bearing may help this patient population. Moreover, conservative treatment could be an option in patients with underlying diseases.