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比較的稀な外傷である上腕三頭筋腱皮下断裂を経験したので報告する．症例は69歳女性．二分脊椎に伴う両下肢不全麻痺のため，両松葉杖歩行中，転倒し右肘痛を生じた．近医を受診し，上腕三頭筋腱断裂の診断で当科紹介された．初診時，右上腕遠位に腫脹・圧痛・皮下出血，肘頭近位に陥凹を触知．可動域制限，筋力低下はあるも，肘伸展は可能であった．MRIで三頭筋腱の連続性消失，周囲にT2高信号の浮腫，出血像を認めた．腱縫合術を施行し，肘頭に骨孔を作成し断端を縫着した．術後3週間のシーネ固定を予定したが安静を保てず，術後17日目に再断裂を確認．再度肘頭に縫着し，人工靭帯で補強を行った．再手術後は3週よりROM訓練開始し，術後8週にはROM 20～120°となり，筋力も回復した．上腕三頭筋腱皮下断裂の治療では腱縫合が推奨され，一般に予後も良好である．再断裂の報告は少ないが，慎重な後療法を行う必要がある．

Lumbar disk hernia (LDH) is a typical desease which causes low back pain (LBP). We analysed LBP in 45 operated cases with L4/5 LDH except for cases of relapse, spondylolysis, and pondylolisthesis between March 1999 and March 2001. 29 patients were treated by microscopic Love operation, 12 patients by laminoplasty and microscopic herniotomy, 4 patients by posterior lumbar interbody fusion (PLIF). 31 patients (68.9%) had LBP as a primary symptom of LDH, and only 3 patients (6.7%) continued to complain of LBP until preoperation. LBP with LDH changed to lower extremity pain. Patients who continue to complain of LBP should undergo fusion if LBP is caused by discography.

We report a case of a 16-year-old man with late kyphosis after hyperflexion sprain. He first visited our hospital 3 weeks after suffering hyperflexion sprain while exercising on a mat. The chief clinical symptom was posterior neck pain, and no neurologic impairment was seen. At first, he was immobilized with a cervical collar, but radiographs showed late instability that progressed gradually. We therefore performed posterior wiring and fusion from C2 to C3. From the sixth week after operation, radiograph showed progressive kyphotic angulation from C3 to C5, so we performed traction by Halo vest after anterior release from C3 to C5, and anterior fusion from C3 to C5 in a two-stage procedure. Radiographic evidence showed bony fusion, and no deterioration of instability was seen after operation.

A 57-year-old man suffering arm pain and numbness in the with left upper extremities subacute onset visited our hospital. He had hypersthesia at the left upper extremities and disturbance of fine movement of fingers. MRI revealed an abnormal lesion behind the C7 vertebra body. CT revealed a cystic body at the extradural area, compressing the spinal cord. Surgical resection was performed. Pathology identified the cyst as ganglion. Based on other reported cases, we made the assumption that this kind of ganglion has some relation with cervical spondlyosis.

Two patients with dysplastic spondylolisthesis were treated by two-weeks preoperative traction and posterior lumbar inter body fusion using the Steffee VSP system. Both patients were relieved of their symptoms, and solid interbody fusion was obtained and loss of correction was not observed at one year after surgeny. Posterior lumbar interbody fusion using the Steffee VSP system is a useful method for treaing dysplastic spondylolisthesis.

There are only a few reports following the osteomyelitis using MRI. We experienced a case of bacterial osteomyelitis of the femur which formed a broad subperiosteal abscess.We used MRI for the diagnosis and follow up and found it to be useful.The case was a 12 year old male, who presented with a 40°C fever and swelling and local heat of his right thigh were observed. On blood examination, WBC number was decreased, with a shift to the left, and CRP was strongly positive. MRI T2WI showed a broad high intensity area in the subperiosteal space. Puncture showed bloody abscess and the patient was hospitalized for examination and treatment. Bacterial culture of the abscess and blood were performed and both of which were positive for Staphylocossus aureus.We performed an irrigatim of the abcsess fenestration of the bone, and continuos intramedullary drip infusion of antibiotics. MRI was also useful for observation of the recovery stage.

We experinced a rare case of osteochondromatosis in the subacromial bursa. The patient was a 65-year-old man who complained of left shoulder pain, touchable mass lesion and slightly limited of range of shoulder motion. Roentgenograms and arthrography showed several calcified or ossified mass lesions in the extraarticular region. He was treated with a surgical procedure that consisted of anterior acromioplasty, removal of the mass lesion and resection of the subacromial bursa. Histologic examination showed this case might be a different etiology from the typical synovial osteochondromatosis.

In 1992 J. A. Herring et al. reported that lateral pillar classification based on radiographic data could predict the outcome of Legg-Calve-Perthes disease. Lateral pillar was defined as the lateral remainder of the epiphysis in its fragmentation stage. The lateral pillars were compared to their contralateral femoral heads and then classified into three groups. Group A: non-involvement of the lateral pillar, Group B: >50% of lateral pillar height maintained and Group C

Fifteen patients were treated by posterior lumbar interbody fusion using the Steffee VSP system for degenerative lumbar spine lesions. They were evaluated independently with an average follow-up of 1 year. Fusion rates were 94% (15/16). Anterior slipping was well reduced and the alignment was corrected. Acceptable clinical results were seen in most of the patients with low back and leg pain. However, several problems remain in the reduction and alignment-corrertion of lateral slip of the lumbar spine. In addition, treatment of patients with osteoporosis or long term hemodialysis required careful surgical technique and extensive external fixation.

Fourteen patients with spinal cord lesion were studied using MRI (Magnetic Resonance Imaging). The findings in the plain roentgenogram, CT and myelography were compared with those in MRI. MRI revealed abnormal contours of the spinal cord in case of intramedullary tumor, atlanto-axial dislocation and A-V malformation. In the diagnosis of intrathecal extramedullary tumor and disc herniation, MRI seems to be less valuable then myelography from the viewpoint of demonstrating precise obstructed level of the spinal canal.

Two cases of Sacral Agenesis, which is a rare deformation and is included in Caudal Regression Syndrome, were reported. The first case, 7 years old girl, has short trunk, tiny underdeveloped pelvis, dorsal prominence of the lowest vertebra and telescoping back which seems to be caused by spino-pelvic instability and flexible lumbar scoliosis. The second case, 4 years old girl, also has a short trunk, severe contracture of the lower extremities and progressive congenital scoliosis.