• The Korean Journal of Pain
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• 제21권3호
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• pp.197-201
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• 2008

Background: Kyphoplasty is a minimally invasive procedure that can stabilize osteoporotic and neoplastic vertebral fractures. We retrospectively evaluated the clinical outcomes of kyphoplasty for the treatment of vertebral compression fractures in cancer patients. Methods: We reviewed the clinical data of 27 cancer patients who were treated with kyphoplasty (55 vertebral bodies) between May 2003 and Feb 2008. The clinical parameters, using a visual analog 10 point scale (VAS) and the mobility scores, as well as consumption of analgesic, were evaluated preoperatively and at 1 week after kyphoplasty. Results: A total 55 cases of thoracic and lumbar kyphoplasties were performed without complications. The mean age of the patients was 66 years. All the patients experienced a significant improvement in their subjective pain and mobility immediately after the procedures. The pain scores (VAS), mobility scores and other functional evaluations using the Oswestry disability score and the SF-36 showed significant differences between the pre- and postoperational conditions. Conclusions: Kyphoplasty is an effective, minimally invasive procedure that can relieve the pain of patients with vertebral compression fractures and these fractures are the result of metastasis.

• Journal of Trauma and Injury
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• 제23권1호
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• pp.1-5
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• 2010

Purpose: To investigate the results of treatment of reverse oblique trochanteric fractures with compression hip screw. Methods: We reviewed the results of 12 cases of reverse oblique trochanteric fracture treated with compression hip screw from January 2000 to December 2006 which could be followed up for more than 1 year. The mean follow up period was 26 months (15~40). The mean age was 48 years old. Injury mechanism was composed of 6 cases of traffic accident and 6 cases of fall down. 8 persons were man. We investigated the union time, degree of neck-shaft angle change, amount of sliding of compression hip screw, complications, functional and clinical results. Results: 10 cases were united and the mean union time were 5 months (3~8). The mean neck-shaft angle change was 3.5 degrees (0~12). The amount of sliding of compression hip screw was 8.9 mm (2~24). There were six coxa vara, six leg due to coxa vara shortening, two nonunion, and one superficial infection. Unsatisfactory results of Jensen's social function score and Parker and Palmer's mobility score were studied. Conclusion: The results of treatment of reverse oblique trochanteric fractures with compression hip screw were relatively unsatisfied.

• 대한족부족관절학회지
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• 제20권3호
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• pp.131-134
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• 2016

Purpose: This study aimed to evaluate the outcomes, including the complications, of open reduction and internal fixation using a headless cannulated compression screw for a fifth metatarsal base fracture. Materials and Methods: We retrospectively investigated 11 patients with 5th metatarsal base fracture who were treated with a headless cannulated compression screw. The mean follow-up period was 13 months (8~15 months), and the mean age was 46.5 years (21~70 years). We analyzed the patients' sex, age, time to union, amount of fracture displacement, and complications. The American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score was used for clinical assessment. Results: The average amount of displacement decreased significantly from 3.4 mm (2.1~5.2 mm), preoperatively, to 0.4 mm (0~1.3 mm), postoperatively (p<0.001). The average bone union time was 54.1 days (41~68 days). There were no complications, such as a metal failure, irritation, and loss of a reduction. The mean AOFAS midfoot score was 97.7 (90~100) at 6 months, postoperatively. Conclusion: We suggest that a headless cannulated compression screw for 5th metatarsal base fracture is a useful and alternative method for a firm fixation without complications.

• 대한정형외과스포츠의학회지
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• 제5권2호
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• pp.100-104
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• 2006

서혜부 손상은 축구 손상의 약 10% 정도를 차지하고 있다. 이런 손상은 경기 중 컷팅이나, 사이드 스텝, 가속, 감속, 급격한 방향 전환 등의 긴장력이 서혜부에 가해질 때 발생 할 수 있다. 증상 또한 다양해서, 수일 내에 복귀 할 수도 있으나 동통이 심해져서 운동을 포기해야 할 경우까지 있다. 또한, 어느 한 질환에 국한된 것이 아니기 때문에 서혜부에 동통이 발생할 경우 여러가지 질환을 염두에 두어야 하며, 흔한 손상으로는 서혜부 주변의 근육 및 인대 손상이며 그 외에 신경압박 증상(nerve entrapment), 탈장(hernia), 복부 근육 약화(sportsman's hernia), 치골유합부염(symphysitis), 피로골절 (stress fracure) 및 고관절 질환 등을 들 수 있다.

• Journal of Trauma and Injury
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• 제27권4호
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• pp.186-191
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• 2014

Purpose: The objectives of this study were to assess pain relief according to the time after kyphoplasty and to evaluate the factors affecting pain relief after kyphoplasty in the treatment of a single-level osteoporotic vertebral compression fracture. Methods: A retrospective review of 34 kyphoplasties for single-level osteoporotic vertebral compression fractures was performed. Pain relief was assessed by using the visual analogue scale (VAS) at preoperatively and postoperatively at 6 weeks, 3 months, and 6 months. Associated factors, including age, sex, pain duration, bone mineral density, and cement leakage, were evaluated using the patients' medical records. Statistical analyses were conducted using the paired t-test to assess pain relief and using the independent t-test and Pearson's correlation coefficient to evaluate the relationship between those factors and pain relief. Results: Preoperatively, the mean VAS score was 7.06. Postoperatively, it declined to 3.66 (p=0.001), 2.81 (p=0.001) and 2.24 (p=0.001) at 6 weeks, 3 months and 6 months, respectively. Also, statistically significant pain relief was observed during the periods from 6 weeks to 3 months (p=0.001) and from 3 months to 6 months (p=0.001). However, reduction of the VAS score showed no significant correlation with age, sex, pain duration, bone mineral density, or cement leakage (p>0.05). Conclusion: Our study suggests that a kyphoplasty may be effective in osteoporotic vertebral compression fracture patients with acute pain and that after the kyphoplasty, pain is reduced remarkably for 6 weeks and then continuously for 6 months.

• The Korean Journal of Pain
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• 제20권2호
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• pp.224-229
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• 2007

Vertebral compression fractures can occur due to trauma, a malignancy, or most commonly, osteoporosis. These fractures are frequently seen in elderly women; 30% of postmenopausal women are affected by vertebral compression fractures. These fragile fractures frequently result in both acute and chronic pain, but more importantly, are a source of increased morbidity and possibly, mortality. These injuries can be treated both conservatively and with surgery. The use of percutaneous vertebral augmentation offers a minimally invasive approach for the treatment of vertebral compression fractures. We experienced two cases of compression fractures diagnosed during the treatment of thoracic postherpetic neuralgia. Two patients suffering from postherpetic neuralgia with a sharp and stabbing pain in the thoracic dermatomes that was unresponsive to conservative treatment were transferred to our clinic. During the management of postherpetic neuralgia, we incidentally found thoracic compression fractures after obtaining fluoroscopic guided images. After a balloon kyphoplasty, the preoperative pain related to the postherpetic neuralgia was successfully relieved soon after the procedure, and there were no complications.

• 대한한방내과학회지
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• 제42권5호
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• pp.1027-1034
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• 2021

Objectives: This study aimed to determine the effects of Korean medical treatment on a patient with compression fractures. Methods: The patient was treated with herbal medicine and acupuncture for 51 days. Symptom changes were measured using the Numerical Rating Scale (NRS), Range of Motion (ROM), Oswestry Disability Index (ODI), and European Quality of Life Five Dimensions (EQ-5D) Scale. Results: The NRS score for lower back pain decreased from 7 to 3, and the ODI score decreased from 51.11 to 22.22. Range of motion (ROM) increased meaningfully in flexion(from 30 to 60), Left/Right lateral bending(from 10/30 to 30/45), Left/Right rotation (from 10/30 to 30/45), and the EQ-5D score also increased from 0.506 to 0.677. Conclusion: The results indicate that Korean medical treatment may be effective for managing patients' acute compression fractures.

• 대한영상의학회지
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• 제82권1호
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• pp.82-98
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• 2021

종자골과 부골은 정상 해부학적 변이로 그 빈도와 형태는 다양하며 일반적으로 크기가 작고 둥근 모양으로 피질로 잘 둘러싸여 있고 뼈나 관절 주위에 인접하여 관찰되고 드물게 이분 혹은 다분 형태를 보일 수 있다. 대부분의 종자골과 부골은 무증상이며 판독 업무 중에 흔히 마주치게 된다. 하지만 때때로 종자골과 부골이 증상을 일으킬 수 있는데, 종자골과 부골 자체의 골절이나 탈구, 관절염, 골괴사, 감염 등의 질환이 이환되거나, 주변에 신경압박이나 건초염, 연부조직의 포착 등에 의하여 증상을 유발할 수 있다. 이 종설에서는 다양한 해부학적 위치에서 발생한 증상이 있는 종자골과 부골의 영상을 보고, 이들의 임상적 양상과 영상의학적 감별진단을 정리해보고자 한다.

• Journal of Yeungnam Medical Science
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• 제8권2호
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• pp.106-113
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• 1991

저자들은 1983년 5월부터 1990년 2월까지 영남대학병원 내과에서 다발성 골수종으로 진단 되었던 총 31예의 환자를 대상으로 임상적 고찰을 실시하여 다음과 같은 결과를 얻었다. 1. 연령적으로 60대(45%)에서 가장 많았으며 남녀비는 1.8 : 1로 남성 우위를 보였다. 2. 진단당시 주증상으로는 골통증(58%)이 가장 많았고, 발열, 호흡곤란, 현기증, 종물촉지 등이 있었다. 3. Southwest Oncology Group(SWOG)의 진단기준에 따른 검사소견의 분포는 골이나 연부조직의 생검상 골수종을 보인 예가 6예, 골수검사상 총유핵세포 중 형질세포의 비율이 10%이상인 예가 22예, 혈청단백 전기영동상에서 Monoclonal splike를 보인 예가 24예, X-선검사상 골붕괴소견을 보인 예가 22예에서 관찰되었다. 4. 병기분류에 따른 환자의 분포는 stage I이 2예, stage II가 3예, stage III가 26예로 전체 대상환자의 84%였다. 5. 면역전기영동검사결가 IgG가 19예로 64%로 가장 많았으며, Light chain이 7예로 23%, IgA가 3예로 10% 순이었다. Light chain중 Kappa와 Lambda의 비는 1.1 : 1로 거의 비슷하였다. 6. 혈액학적소견상 혈색소치가 8.5g%미만이 42%를 차지하였고, 10.6mg%이상의 고칼슘혈증을 보인 환자는 22%였고, 혈청 creatinine치의 경우 2.0mg%이상이 19%를 차지하였다. 7. 골 X-선학적 검사소견상 다발성 골용성 병변은 두개골에 65%로 가장 많았고, 다음이 늑골로 42%, 요추 35%, 골반 23%, 흉추 순으로 관찰되었다. 골조송증과 골붕괴 및 골절이 동반된 예가 55%, 골붕괴만 보인 예가 23%, 골조송증만 보인 예가 10%였다. 8. 합병증으로는 신기능 장애가 10예, 감염이 8예, 척추의 압박골절이 16예에 관찰되었다.

• 한국방사선학회논문지
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• 제11권1호
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• pp.43-48
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• 2017

최근 동위원소를 이용한 뼈 스캔 (Bone Scan)검사 후 골밀도 (BMD; Bone Mineral Density)검사를 당일검사로 병행한 경우 이로 인한 골밀도 측정값에 오차 발생 가능성이 제기되고 있으나 방사성의약품 표지화합물 투여 후 이중에너지 X선을 이용한 골밀도 측정값 변화에 대한 임상적 자료가 미비하여 핵의학 체내검사 후 당일 골다공증 검사의 측정값에 대한 논란의 소지가 있다. 따라서 동위원소 표지화합물인 $^{99m}Tc-MDP$가 골밀도 측정값에 영향을 미치는지 임상적 측면에서 실험하였다. 실험에 참가한 대상자의 평균 나이는 $35.17{\pm}9.45$세로 실험 대상자 17명 중 대사성 질환과 골밀도 측정에 영향을 줄 수 있는 허리뼈 압박골절 및 몸쪽 넓적다리뼈 골절이 있는 자를 제외한 12명 중 정상 골밀도 T-scores>-1.0의 환자 6명을 대상으로 $^{99m}Tc-MDP$ 투여 전 후 측정값을 분석한 결과 허리뼈에서 전 후 각각 평균 $0.975{\pm}0.084g/cm^2$, $0.966{\pm}0.078g/cm^2$으로 $0.009g/cm^2$ 증가, 우측 몸쪽 넓적다리뼈에서는 전 후 각각 평균 $0.909{\pm}0.078g/cm^2$, $0.913{\pm}0.086g/cm^2$으로 $0.004g/cm^2$ 감소, 좌측 몸쪽 넓적다리뼈에서는 각각 평균 $0.887{\pm}0.099g/cm^2$, $0.881{\pm}0.103g/cm^2$으로 $0.007g/cm^2$의 증가를 보여 몸쪽 넓적다리뼈 보다 허리뼈에서 더 큰 골밀도 변화를 보여주었다. 그러나 허리뼈와 몸쪽 넓적다리뼈 전체에서 전 후 변화 평균은 $0.0038{\pm}0.014g/cm^2$으로 골밀도 측정값에 유의한 영향이 없음을 알 수 있으며, 또한 두 실험간 전체 상관계수는 0.987으로 방사성동위원소 표지화합물인 $^{99m}Tc-MDP$ 투여가 골밀도 측정값에 영향을 주지 않았다. 따라서 140 keV의 감마선 에너지를 방출하는 테크네슘 표지화합물을 이용한 뼈 스캔검사 후 골밀도 측정값에 유의한 영향을 미치지 않음을 확인하였다. 그러나 핵의학적 체내검사와 골다공증 검사를 당일로 검사함으로 인한 환자의 피폭을 고려한다면 시간 간격을 두고 검사를 시행하는 것이 좋을 것으로 사료된다.