Yoshinori Nishi

Anterior Plate for Anterior Fixation in Cervical Spine

Since October 1999, we have been using anterior plate for anterior fixation in the cervical spine. The clinical results of a group using a plate for anterior fixation for degenerative disorders (50 cases) and a group that did not (50 cases) were compared.No significant differences were seen between the two groups in terms of operation time, a quantity of operative hemorrhage, and clinical results.There was a tendency for delay in fusion time by shortening the postoperative time in bed. The group using a plate showed correlation between delay in fusion time and postoperative time in bed and the group that did not use the plate indicated good fusion.In addition, better alignment of the whole cervical vertebrae and fixed vertebral body could be maintained more easily with the use of the plate.

Rescurable Pulmonary Embolism after Spinal Surgery -A Case Report-

We experienced one case of pulmonary embolism in a patient after spinal surgery over the past two years. The patient was a 51-years-old man who had experienced deep vein thrombosis in the past. He under went anterior spinal fusion for C6/7 disc hernia.5 days after the operation, he suddenly experienced respiratory difficulty. Though his consciousness was clear, and his vital signs were stable, even after 3L pure oxygen supplied, his arterial saturation rate was low at 74%. We supplied 10L oxygen, used an Ambu bag, kept his venous line, and injected lactolingel, His chest pain was relieved and his arterial saturation rate improved to 95%. To investigate the cause, we examined his arterial blood gas, ECG, and chest X-p, and suspecting pulmonary embolism, we consulted cardiologists. In the UCG, the right ventricle hed apparently enlarged, and angiography showed that his right pulmonary artery the patient restricted by 80% due to thrombosis. We diagnosed as having pulmonary embolism, attempted cardiac cathetelization, and injected urokinase, the thrombosis was reduced by 1/3, and the patient survived.

A Case of L2/3 Disc Hernia and L4 Dumbbell Tumor

We experienced a 70-year-old male case suffering L3 and L4 roots impairment due to L2/3 disc hernia, and L4 root impairment due to dumbbell tumor. He complained of severe low back pain, right femoral neuralgia, weakness, and urinary infection. MRI revealed two lesions; one was a tumor in the psoas muscle at the L3-L5 level originating from the L4 root ans the other was a downward sequestrated mass from the L3/4 disc. We operated two-stages from the anterior to posterior. The anterior tumor was histologically neurinoma and the sequestarted hernia mass impinged both the L3 and L4 roots.