We studied clinical utility of open door laminoplasty with foraminotomy in CSM with multilevel radiculopathy. We divided into two groups; the first group underwent laminoplasty with formainotomy, and the second group underwent laminoplasty and multiple ant. approaches. In the first group, the JOA score increased from a preoperative 13.3 to postoperative 16.0 (range, 10 to 18), and in the second group from 12.8 to 15.5 (range, 10 to 18). However, the pre-operative VAS score was 6.1, 6.5 and, 2 weeks after surgery, had decreased to 2.4, 1.4, the last score was the same, 1.8, finally. The open door lami-noplasty with foraminotomy was easily performed and clinical profiles were similar to those for the laminoplasty and multi-ple anterior approach.

The principle of treatment of type 2, 3 odontoid process fracture is controversial. The debate is in regard to which is effective between conservative treatment and surgery. We enrolled 41 patients with type 2, 3 odontoid process fracture from January 2007 to December 2011 at Chosun University Hospital. Patients in Group I (GI) received a halo vest and those in Group II (GII) underwent surgery by ant. screw fixation. The bone fusion was classified according to stable bone union, fibrous union, and unstable non-union. Patients in GI received halo vest for a mean period of 4.9 months and those in GII received a neck collar for a mean period of 3.8 months. Tweleve patients in GI and 17 patients in GII had stable bone union. Three patients in GI and two patients in GII had fibrous union. Five patients in GI and two patients in GII had non-union. The halo vest was a good conservative treatment for type 2, 3 odontoid process fracture : however, low bone fusion rate is a problem in particularly old age. However, ant. screw fixation is a better treatment in regard to short surgical time, short fusion time, and high bone fusion rate.

Spinal epidural lipomatosis (SEL) is a rare condition of adipose tissue accumulation in the epidural space. A total of 2,309 subjects from March 2011 to April 2012 were studied. We found different morphologic “variants” of dural sac compression in grade III. The trifid type, resembling the letter “Y", was the most common form. The round type and the localized mass in lateral recess were seen in other cases. Surgical decompression was performed regardless of morphologic variants in SEL grade III with neurologic symptoms. All patients recovered from neurologic symptoms. In subjects who received adequate conservative treatment, decompressive surgery could be helpful in treatment of SEL grade III with neurologic symptoms.