• Title/Summary/Keyword: 압박 골절

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건강관리코너 - 골다공증과 척추골절의 예방을 위한 운동

  • Kim, Don-Gyu
    • 방재와보험
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    • s.107
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    • pp.66-69
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    • 2005
  • 노인 연령층에서 비교적 흔히 발생하는 골절로는 척추압박골절과 고관절 및 손목의 골절이다. 65세이상 여성의 33~50%에서 1곳 이상의 척추압박골절이 발생하고 80세 이상 노인의 약 17%에서 고관절 골절이 발생한다. 특히 여성 노인들은 골절 발생 후 3개월 이내 20%에서 사망하고 생존자의 50%는 영구히 보호시설에서 지내게 된다는 점에서 큰 의미를 지니고 있다고 하겠다.

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Clinical Study on 16 Conservatively Treated Acute Compression Fracture Patients with Focus on Compression Ratio (급성 흉요추부 압박골절 환자 16례의 보존 치료에 따른 Compression Ratio에 중점을 둔 임상 고찰)

  • Joh, Byung-Jin;Koh, Pil-Seong;Yi, Won-Il;Baek, Yong-Hyeon;Nam, Tong-Hyun;Park, Dong-Suk
    • Journal of Acupuncture Research
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    • v.26 no.4
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    • pp.1-9
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    • 2009
  • 목적 : 한양방 협진을 통한 보존적 입원 치료를 받은 급성 흉요추 압박골절 환자군에서의 압박골절 compression ratio의 급성기 내의 변화를 기록 분석하여 차후 환자군의 예후를 예측하고자 하였다. 방법 : 한양방 협진병원 척추센터에 입원하여 보존치료를 시행한 발병 2주 내의 압박골절 환자 중 2회 이상의 시점에서 압박골절 부위의 측면 X-ray 영상이 있는 환자 16명의 기록을 수집하였다. X-ray상 급성 압박골절이 발생한 추체(n=19)의 anterior wall과 posterior wall의 높이를 입원 1주차, 입원 2주차, 입원 3주차와 최종 영상 확보 시점의 X-ray에서 측정해 wedge fracture에 해당하는 anterior column fracture가 있는 추체(n=14)에 한해 anterior height/posterior height의 공식을 통해 compression ratio를 산출하였다. 2차적 지표로 입원 1주차에서 입원 3주차까지 환자의 VAS(visual analog scale) 통증 척도 점수를 분석하였다. 그 외 연령, 성별, 입원 기간, 총 치료기간, 당뇨, 골다공증, 골밀도, 압박골절 기왕력, 압박골절의 형태의 빈도와 비율을 분석하였다. 결과 : 1. 전방 골주 단독 골절에서의 compression ratio는 입원 1주차에서 3주차, 그리고 최종 영상 확보시점까지 각각 20.92${\pm}$10.42, 25.22${\pm}$10.90, 25.57${\pm}$11.04, 25.07${\pm}$11.94로 기록되었다. 시점간에는 통계적으로 유의한 compression ratio의 차이가 나타나지 않았다. 2. 통증 VAS 점수 평균은 입원 1주차부터 3주차까지 각각 7.44${\pm}$2.07, 4.67${\pm}$1.63, 3.00${\pm}$1.80으로 기록되었다. 시점간 모두 통계적으로 유의한 감소가 있었다(1주차-2주차 p=.003, 1주차-3주차 p<.000 2주차-3주차 p=0.021). 결론 : 본 연구의 협진 입원치료 압박골절의 compression ratio는 입원 1주차 시점에서 최종 follow-up 시점까지 유의한 차이를 보일 만큼의 추가적인 추체 높이 감소를 보이지 않아 향후 좋은 예후를 예상할 수 있다. 통증 VAS 점수는 모든 주별 시점간에서 유의하게 감소되었다.

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Clinical Findings on Vertebral Compression Fracture Diagnosed with MRI (자기공명영상으로 진단된 척추 압박골절의 임상적 소견)

  • Kim, Ham-Gyum
    • Journal of radiological science and technology
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    • v.28 no.3
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    • pp.219-226
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    • 2005
  • By analyzing the severally clinical characteristics such as the prevalence by gender and age, and the developmental region, and the developmental factor in terms of vertebral compression fracture, which was diagnosed by MRI(Magnetic Resonance Imaging), the following conclusions were obtained. 1. The general characteristics in 183 research subjects, were 70 men (38.0%) and 113 women (62.0%), and aged from the minimum 16 years old to the maximum 84 years old. 2. Among 183 persons with abnormal findings in vertebral compression fracture, the single compression fracture was included 111 persons (60.7%) with 38 men (34.0%) and 73 women (66.0%), and women in their 60s were largest with 32 persons. 3. As the multiple compression fracture was included 72 persons (39.3%) among 183 research subjects, and as the incidence had 182 cases, this is what classified the case in which one person with abnormal findings has the compression fracture at the levels with more than one, and there were 70 cases (38.0%) in men and 112 cases (62.0%) in women, and it is being indicated the large frequency in women in their 60s and in their 70s. 4. The developmental regions in the single compression fracture and the multiple compression fracture, were generated about 70% of the whole at $T11{\sim}L2$. 5. In terms of the prevalence by cause for compression fracture in 183 whole subjects, it was largest with 41.4% in the fracture caused by trauma in case of men, and with 70.0% in what was caused by the osteoporosis in case of women, and as for a case that combined men and women, it was largest with 56.8% in the vertebral compression fracture caused by osteoporosis.

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Vertebral Compression Fractures: Distinction Between Benign and Malignant Causes with Tc-99m Labeled Antigranulocyte Antibody Immunoscintigraphy (Tc-99m 표지 항과립구항체 면역신티그라피(Tc-99m labeled antigranulocyte antibody immunoscintigraphy)를 이용한 척추압박골절의 원인질환 감별)

  • Cho, Ihn-Ho;Lee, Hyong-Woo;An, Sang-Ho;Won, Kyu-Chang;Bae, Jang-Ho;Cho, Soo-Ho
    • Journal of Yeungnam Medical Science
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    • v.15 no.2
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    • pp.254-262
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    • 1998
  • We evaluated the effectiveness of Tc-99m labeled antigranulocyte antibody immunoscintigraphy in differentiating the causes of vertebral compression fracture. This study involved 16 patients with vertebral compression fracture; 8 were due to trauma or osteoporosis, 3 were due to metastasis and 5 were due to tuberculous spondylitis. We retrospectively analyzed the location and the extent of decreased tracer uptake in tomographic images of Tc-99m labeled antigranulocyte antibody immunoscintigraphy. Eight patients had a 16 vertebral compression fractures due to trauma or osteoporosis, three patients had 3 vertebral compression fractures due to metastasis and 5 patients had 6 vertebral compression fractures due to tuberculous spondylitis. Sixteen vertebral compression fractures by trauma or osteoporosis showed a normal tracer uptake in pedicle, laminar and spinous process, but there was noted with 6 decreased uptake, 8 absence of tracer uptake and 2 normal tracer uptake in the vertebral body. Two vertebral compression fractures by metastasis showed the absence of uptake in vertebral body, pedicle, laminar and spinous process, and one showed an absence of vertebral body and spinous process. Six vertebral compression fractures by tuberculous spondylitis showed the absence of uptake in six compression fractures, the absence of pedicle in five compression fractures. We concluded Tc-99m labeled antigranulocyte antibody immunoscintigraphy may be helpful to differentiate the causes of vertebral compression fractures.

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SNR and ADC Changes at Increasing b Values among Patients with Lumbar Vertebral Compression Fracture on 1.5T MR Diffusion Weighted Images (1.5T MR 기기를 이용한 확산강조영상에서 b Value의 증가에 따른 요추압박골절 환자의 신호대 잡음비와 현성 확산 계수의 변화)

  • Cho, Jae-Hwan;Park, Cheol-Soo;Lee, Sun-Yeob;Kim, Bo-Hui
    • Progress in Medical Physics
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    • v.21 no.1
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    • pp.52-59
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    • 2010
  • To examine among patients with vertebral compression fracture the extent to which signal-to-noise ratio (SNR) and Apparent Diffusion Coefficient (ADC) values at the lumbar vertebral compression fracture site vary on diffusion-weighted MR images according to varying b values on the 1.5T MR device. Diffusion-weighted MR images of 30 patients with compression fracture due to chronic osteoporosis who underwent vertebral MRI from Jan. 2008 to Nov. 2009 were respectively obtained using a 1.5-T MR scanner with the b values increased from 400, 600, 800, 1,000 to $1,200\;s/mm^2$. For diffusion-weighted MR images with different b values, the signal-to-noise ratio (SNR) was assessed at three sites: the site of compression fracture of the lumbar vertebral body at L1 to L5, and both the upper and lower discs of the said fracture site, while for ADC map images with different b values, the SNR and ADC were respectively assessed at those three sites. As a quantitative analysis, diffusion-weighted MR images and ADC map images with b value of $400\;s/mm^2$ (the base b values) were respectively compared with the corresponding images with each different b value. As far as qualitative analysis is concerned, for both diffusion-weighted MR and ADC map images with b value of $400\;s/mm^2$, the extent to which signal intensity values obtained at the site of compression fracture of the lumbar vertebral body at L1 to L5 vary according to the increasing b values were examined. The quantitative analysis found that for both diffusion-weighted MR and ADC map images, as the b values increased, the SNR were relatively lowered at all the three sites, compared to the base b value. Also, it was found that as the b values increased, ADC valueswere relatively lowered at all the three sites on ADC map images. On the other hand, the qualitative analysis found that as the b values increased to more than $400\;s/mm^2$, the signal intensity gradually decreased at all the sites, while at the levels of more than $1,000\;s/mm^2$, severe image noises appeared at all of the three sites. In addition, higher signal intensity was found at the site of compression fracture of the lumbar vertebral body than at the discs. Findings showed that with the b value being increased, both the signal-to-noise ratio (SNR) and Apparent Diffusion Coefficient (ADC) values gradually decreased at all the sites of the lumbar vertebral compression fracture and both the upper and lower discs of the fracture site, suggesting that there is a possibility of a wider range of applications to assessment of various vertebral pathologies by utilizing multi b values in the diffusion-weighted MRI examination.

Cauda Equina Syndrome after Percutaneous Balloon Kyphoplasty for Pathologic Compression Fracture (병적 척추체 압박 골절 환자에서 경피적 풍선 척추 성형술 시행 후 발생한 마미 증후군)

  • Park, Sung Jun;Park, Myung Hoon;Park, Jae Woo;Cho, Kyu Jung
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.90-94
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    • 2020
  • Percutaneous balloon kyphoplasty is an option for pain relief in pathological vertebral compression fractures. Complications related to cement leakage through cortical defects have been reported. On the other hand, dural compression due to retropulsion of the tumor mass is rarely reported. The authors report a case of a 65-year female patient who had cauda equina syndrome after a percutaneous balloon kyphoplasty in a pathological vertebral fracture, even though epidural compression were not found prior to surgery. Magnetic resonance imaging revealed retropulsion of the tumor mass into the spinal canal through the disrupted posterior vertebral cortex.

Treatment of Two- and Three-Part Fracture of Proximal Humerus using LCP (잠김 압박 금속판(LCP)을 이용한 상완골 근위부 이분 및 삼분 골절의 치료)

  • Shin, Sung-Il;Song, Kyung-Won;Lee, Jin-Young;Lee, Seung-Yong;Kim, Gab-Rae;Hyun, Yoon-Suk;Park, Deok-Yong
    • Clinics in Shoulder and Elbow
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    • v.10 no.2
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    • pp.204-211
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    • 2007
  • Purpose: To evaluate the result and complication of treatment using Locking Compression Plate (LCP) for fracture of proximal humerus. Materials and Methods: Between 2004 and 2006, 21 patients with two-part and three-part fractures of the proximal humerus were treated by LCP fixation. Their average age was 54.9 years. Postoperative mean follow-up period was 22.9 months. The reduction was qualified and complication were assessed with final radiographs. The functional outcome was evaluated by Neer's rating system. Results: By Neer's functional evaluation, mean score of shoulder function was 86.3 and 18 case (86%) had excellent or satisfactory results. There was one case of nonunion but no infection or avascular necrosis of the humeral head. No correlation was found between the final result and the type of fracture, age, gender or quality of reduction. Conclusion: We obtained satisfactory result of LCP fixation for fracture of proximal humerus in this study. LCP fixation for proximal humerus fracture is a reliable method to obtain satisfactory reduction, rigid fixation and early exercise.

Early Onset Subsequent Vertebral Compression Fracture after Percutaneous Verteroplasty (경피적 척추 성형술 후 조기에 발생한 새로운 척추 압박골절)

  • Kim, Jong-Kil;Choi, Byeong-Yeol;Park, Young-Chul;Kim, Dong-Hyun
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.1
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    • pp.24-29
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    • 2019
  • Purpose: To evaluate the characteristics and the risk factors of early onset subsequent vertebral compression fractures after percutaneous vertebroplasty. Materials and Methods: A total of 44 patients, who had a new subsequent vertebral fracture after percutaneous vertebroplasty for an osteoporotic vertebral compression fracture between January 2013 and December 2015, were recruited. The patients were divided into two groups according to the onset period of subsequent fracture. The number of patients who had a fracture within 3 months following vertebroplasty were 22 cases (Group A); after 3 months were 22 cases (Group B). Variables, including age, sex, bone mineral density (BMD), body mass index (BMI), preexisting vertebral compression fracture, location of the initial fracture, intradiscal cement leakage, injected cement volume, restoration of vertebral body height, and correction of kyphosis, in the two groups were analyzed and compared retrospectively. Results: The age, sex, BMD, BMI, preexisting vertebral compression fracture, location of the initial fracture, intradiscal cement leakage, and correction of kyphosis were similar in the two groups. Both a greater volume of bone cement injected and a greater degree of vertebral height restoration contributed significantly to the risk of fracture within 3 months. Conclusion: The cement volume and degree of height restoration are risk factors for early onset fracture at the adjacent vertebrae after percutaneous vertebroplasty and close attention is needed during the follow-up period.

A Case Report on Burning Acupuncture Treatments for Stable Compression Fracture (화침을 이용한 흉요추부 압박골절 치험 1례)

  • Lee, Jong-Soo;Han, Soon-Hyun
    • The Journal of Korea CHUNA Manual Medicine
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    • v.3 no.1
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    • pp.167-174
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    • 2002
  • Stable compression fractures are most often caused by trauma as traffic accidents. Stable compression fractures can refer pain to the mid-back, which is characterized by the pain in the thoracolumbar spinous prosess. recently we experienced a 19 years old man who had lumbago originating from Stable compression fractures and condition was improved through burning acupunture.

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Treatment Effect with Weekly Teriparatide in the Vertebral Compression Fractures in Patients with Severe Osteoporosis (심한 골다공증 환자에서 발생한 척추체 압박골절에 대한 주 단위 테리파라타이드(Teriparatide)의 투여 효과)

  • Hwang, Seok-Ha;Woo, Young-Kyun;Jeon, Ho-Seung;Suh, Seung-Pyo;Kim, Joo-Young;Kim, Jae-Nam
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.528-536
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    • 2019
  • Purpose: This study examined the effects of a weekly teriparatide on the change in vertebral compression ratio, back pain, and vertebral fracture healing in osteoporosis patients with vertebral compression fractured induced by low energy trauma. Materials and Methods: From January 2016 to December 2017, 57 patients with severe osteoporotic vertebral fractures with a T score of -3.5 or less were included in this study. The changes in the vertebral compression ratio, visual analogue scale (VAS), Oswestry disability index (ODI) for at least 6 months were examined. The morphology of bone marrow edema and the presence of intervertebral cleft, osteocalcin, and N-terminal telopeptide (NTx) were also investigated. Results: The mean compression ratio was 20% in the experimental group (teripratide group) at 3 months, and 38% in the control group. A significant difference in the compression ratio of the vertebral body over time was observed (p<0.05; t-test). A comparison of the compression ratio of the vertebral body with the follow-up duration in each group showed no significant increase in the, compression (p=0.063) in the experimental group and a significant increase in the control group (p<0.05). The mean time to reach the plateau of the compression rate was one month in the experimental group and three months in the control group. The VAS score in the experimental and control group was 0.39 and 1.07 points, respectively. The ODI score in the experimental and control group was 33.72 and 39.52, respectively. At the last follow-up radiographs, there were no cases with an intervertebral cleft (0%) in the experimental group and 1 case (2.2%) in the control group. A significant difference in the osteocalcin level was observed between the injury and 6 months after the injury (p=0.003). In addition, there was no significant difference in the NTx level between the injury and 6 months after injury (p=0.960). Conclusion: In vertebral compression fractures patients with severe osteoporosis, a weekly teriparatide can promote the union of fractures, prevent further collapse of the vertebral body, and reduce the back pain faster.