• Title/Summary/Keyword: 척수 손상환자

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Risk Factor Analysis for Spinal Cord and Brain Damage after Surgery of Descending Thoracic and Thoracoabdominal Aorta (하행 흉부 및 흉복부 대동맥 수술 후 척수 손상과 뇌손상 위험인자 분석)

  • Kim Jae-Hyun;Oh Sam-Sae;Baek Man-Jong;Jung Sung-Cheol;Kim Chong-Whan;Na Chan-Young
    • Journal of Chest Surgery
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    • v.39 no.6 s.263
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    • pp.440-448
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    • 2006
  • Background: Surgery of descending thoracic or thoracoabdominal aorta has the potential risk of causing neurological injury including spinal cord damage. This study was designed to find out the risk factors leading to spinal cord and brain damage after surgery of descending thoracic and thoracoabdominal aorta. Material and Method: Between October 1995 and July 2005, thirty three patients with descending thoracic or thoracoabdominal aortic disease underwent resection and graft replacement of the involved aortic segments. We reviewed these patients retrospectively. There were 23 descending thoracic aortic diseases and 10 thoracoabdominal aortic diseases. As an etiology, there were 23 aortic dissections and 10 aortic aneurysms. Preoperative and perioperative variables were analyzed univariately and multivariately to identify risk factors of neurological injury. Result: Paraplegia occurred in 2 (6.1%) patients and permanent in one. There were 7 brain damages (21%), among them, 4 were permanent damages. As risk factors of spinal cord damage, Crawford type II III(p=0.011) and intercostal artery anastomosis (p=0.040) were statistically significant. Cardiopulmonary bypass time more than 200 minutes (p=0.023), left atrial vent catheter insertion (p=0.005) were statistically significant as risk factors of brain damage. Left heart partial bypass (LHPB) was statistically significant as a protecting factor of brain (p=0.032). Conclusion: The incidence of brain damage was higher than that of spinal cord damage after surgery of descending thoracic and thoracoabdominal aorta. There was no brain damage in LHPB group. LHPB was advantageous in protecting brain from postoperative brain injury. Adjunctive procedures to protect spinal cord is needed and vigilant attention should be paid in patients with Crawford type II III and patients who have patent intercostal arteries.

Effect of fludrocortisone in cervical spinal cord injury patients with orthostatic hypotension - randomized controlled trial (경수부 척수손상 환자의 기립성 저혈압에서 플루드로코티손의 효과 - 무작위 대조군 연구)

  • Lee, Do-Hee;Joo, Min-Cheol
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.6
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    • pp.108-115
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    • 2021
  • The purpose of this study was to investigate the therapeutic effect of fludrocortisone in patients suffering from cervical spinal cord injury (SCI) with orthostatic hypotension (OH). Twenty-six patients with cervical SCI diagnosed with OH through a head-up tilt test were randomly assigned, and they were given either conservative treatment or additional fludrocortisone treatment. Fludrocortisone was administered for 2 weeks, increasing from 0.1 mg to 0.2 mg week . Blood pressure (BP), heart rate (HR), and blood parameters were measured at the beginning and after 2 weeks. After 2 weeks of treatment, there was a significant increase in the baseline BP of the treatment groups (p<.05). When analyzing the drop ratio, there was a tendency for a lower orthostatic BP drop in the treatment groups. Mild adverse events were reported in 7.69% of the treatment groups. Fludrocortisone exhibited therapeutic effects such as preventing cardiovascular complications and continuing rehabilitation through increased baseline BP and reduced OH, and can therefore be considered as a treatment option for OH in patients with SCI.

Effect of Visual Biofeedback Simulation Training for Balance in Patients with Incomplete Spinal Cord Injury (시각적 바이오피드백 시뮬레이션훈련이 불완전 척수손상환자의 균형에 미치는 효과)

  • Park, Chang-Sik;Kang, Kwon-Young
    • The Journal of the Korea Contents Association
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    • v.11 no.11
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    • pp.194-203
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    • 2011
  • This study investigated the effectiveness of visual biofeedback simulation training for patients with incomplete spinal cord injuries. Fifteen people with an ASIA impairment scale of C and D, according to the intervention method, were studied. They were randomly divided into two groups, seven people in the experimental group and eight people in the control group. They were studied three times a week for six weeks using a Tetrax Interactive Balance System, for a total of eighteen times, and each test took fifteen minutes. Paired t-tests were used to evaluate the changes before and after intervention. The difference between the groups was compared using an independent t-test. The experimental group showed significantly increased general stability, fall risk index, weight distribution (A, C, D, LEFT, HEEL) and weight distribution index, except for synchronization AC, BD. However, the control group only showed significantly increased weight distribution (A, C, LEFT). In a variation, experimental and control groups showed significantly increased weight distribution (A, B, C, HEEL), general stability, fall risk index and synchronization AD. Consequently, it was found that visual biofeedback simulation training was effective for the balance ability of incomplete spinal cord injury patients, and further studies are required.

A Survey on the Present Situation and Satisfaction in Assistive Technology of Person with Physical Disabilities (지체장애인의 보조공학 이용 실태 및 만족도 조사)

  • Lee, Chun-Yeop;Kim, Eun-Joo;Noh, Dong-Hee;Moon, Seo-Jin;Park, Sung-Ho;Chae, Gang-Seok;Chang, Moon-young
    • The Journal of Korean society of community based occupational therapy
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    • v.3 no.1
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    • pp.21-31
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    • 2013
  • Objective : This study was aimed to survey the present situation and satisfaction in assistive technology of the physically disabled person. Method : 110 patients, being diagnosed with spinal cord injury and stroke, were chosen and structured interview was carried out using by a questionnaire. Result : The followings are the results of this study. First, spinal cord injury(76.2%) and stroke(72.5%) patients used the most wheelchair and mobility devices in assistive technology device. Second, they were satisfied in effectiveness of assistive technology device. Third, spinal cord injury(39.4%) patients used the most repair service in assistive technology service. Fourth, stroke(28.2%) patients used the most application and training service. Fifth, they were satisfied in professionality while were dissatisfied in service delivery program. Conclusion : The results of this study would contribute to better assistive technology for the physically disabled person.

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A Study of Occurrence of Secondary Complications and Chronic Diseases due to Aging of Spinal Cord Injury (척수손상환자의 고령화에 따른 2차합병증 발생과 만성질환발병에 관한 연구)

  • Min, Yeo Jin;Kim, Jong Bae
    • 재활복지
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    • v.22 no.4
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    • pp.83-102
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    • 2018
  • The purpose of this study is to provide basic data for effective management and prevention of chronic diseases and secondary complications as elderly spinal cord injuries(SCI). The subjects were 200 spinal cord injuries admitted to S hospital from April, 2013 to April, 2018. We investigated the occurrence of chronic diseases and secondary complication through medical records. The results showed that SCI were affected chronic diseases and secondary complications over 50years. The prevalence of chronic diseases and secondary complications over 50 years of age had the odds ratio 11.8 times higher in hypertension and 6.7 times diabetes mellitus. Secondary complications had the odds ratio Osteoporosis 7.5 times, Pneumonia 5.2 times, and central pain 0.4 times. We suggest that continuous management and service of chronic diseases and secondary complications of elderly SCI are necessary. It will be necessary to expand the target population and to study various characteristics including.

Effects on Exercise Training in person with Incomplete Hemisection cord injury after Discharge (불완전 척수손상자의 퇴원 후 운동훈련의 효과 사례보고)

  • Park, Mi-Hee
    • Journal of Korean Physical Therapy Science
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    • v.12 no.4
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    • pp.25-31
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    • 2005
  • 이 사례연구는 2002년 10월 15일 칼에 의한 좌상으로 경추 3-4번의 불완전 척수손상을 입은 25세의 남자 환자가 최초 병원에서 2002년 12월 한달 간의 치료를 마친 후, 2003년 1월 3일부터 4월 28일까지 태릉에 위치한 N 재활센터에서 주 5회 2시간의 자세조절 훈련, 심폐지구력 훈련, 웨이트 훈련, 스포츠(축구, 소프트 볼), 여가활동(등산)의 프로그램을 적용하여 척추손상 환자의 사회적응을 돕기위한 재활 프로그램의 다양화를 꾀하기 위한 기초 선행 작업으로 시작되었다. 신체능력을 평가하기 위한 측정도구는 관절가동범위(Range of Motion), 수동근력검사(Muscle Manual Test), 경직(Spasticity), 신체체력(Physical Fitness), 발란스(Balance: one leg stand), 상대적인 등속성 하지근력(Isokinetic Muscle Strength) 그리고 신체조성(Body Composition)로 하였다. 재활기간을 통해 처음 시작 일자에서 45일 간격으로 3차례의 측정을(1월 3일부터 4월 28일까지 실시하였다) 실시하였다. 최초 환자의 상태는 부분적으로 일상생활의 도움을 받아야 하는 상태로 동작을 시작하려 할 때 경직이 발생되어 옷을 입고 벗기, 신발 신고 벗기, 운전, 식사, 보행과 계단보행, 경사보행에서 보조자의 도움이 필요했으며, 작은 물건 잡기와 글씨쓰기, 타이핑 작업은 불가능 한 상태였다. 또한 스포츠 활동과 여가활동 역시 불가능 한 상태였다. 3달 15일간의 기간 동안 환자는 복학을 준비하기 위해 적극적으로 치료에 임했으며, 결과는 다음과 같았다. 신체조성은 재활 훈련을 통해 체중, 체지방율(%), 복부지방율(WHR)의 많은 감소를 가져왔다. 경직을 측정하는 Ashworth Scale은 정상에 가깝게 감소하였다. 관절가동범위는 고관절, 무릎, 발목에서 모두 증가하였다. 수동근력검사(0-9)는 많은 향상을 가져왔다. 신체체력능력 항목에서 근지구력의 윗몸일으키기와 팔굽히기, 악근력, 유연성으로 앉아 체간 숙이기, 민첩성으로 사이드 스텝, 순발력의 서전트는 모두 크게 향상되었다. 환자의 일상능력에서도 옷을 입고 벗기, 신발 신고 벗기, 운전, 식사, 보행과 계단보행, 경사보행에서 보조자의 도움이 필요없었으며, 타이핑 작업은 5손가락을 모두 사용하지는 않았지만, 1분에 80타로 큰 향상을 가져왔다. 또한 축구와 소프트볼, 등산을 달에 1회 정도 실시하여 약간의 도움만으로 가능하게 되었다.

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An Effective Transcranial Electric Motor-Evoked Potentials Method in Spinal Dural Arteriovenous Fistula Ligation Surgery (척수경막동정맥루 결찰술에서의 효과적인 경두개운동유발전위 검사방법)

  • Jang, Min Hwan;Lee, In Seok;Lim, Sung Hyuk
    • Korean Journal of Clinical Laboratory Science
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    • v.53 no.2
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    • pp.193-198
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    • 2021
  • The purpose of spinal dural arteriovenous fistula (SDAVF) ligation is to prevent neurological injury and the poor blood supply through ligation of arteriovenous fistula. Therefore, intraoperative neurophysiological monitoring (INM) is required via multimodal neurological examination for minimizing the side effects after surgery based on the patient's symptoms. Transcranial electric motor-evoked potentials (TceMEP) help to check the condition of the corticospinal tract. Whenever ligation is performed, TceMEP should be performed every minute to check for abnormalities. However, an examiner's lack of knowledge about the operation procedure and examination and also poor communication between the examiner and surgeon can cause incorrect timing of the stimulation of TceMEP that interferes with the procedure and causes side effects such as paralysis and motor weakness. As a result of this SDAVF ligation survey, it is believed that for proper INM, case reports will be needed along with further research and the examiner will also have to work closely with the surgeon to minimize neurological damage to patients.

Trachea, Esophagus, and Spinal Cord Injury Caused by Stab Wound - A case report- (기관, 식도, 척수를 관통한 자상 치험 - 1예 보고 -)

  • Kim, Jong-In;Cho, Sung-Rae;Park, Eok-Sung;Kim, Hyung-Chul
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.808-811
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    • 2010
  • Simultaneous occurrence of the trachea, esophagus, and spinal cord injuries due to stabbing is rare. The incidence is decreasing, but early diagnosis and surgical treatment is important because it can be life-threatening. We present one case of simultaneous trachea, esophagus, and spinal cord injury caused by self-stabbing complicated with paraplegia.