• Title/Summary/Keyword: 척추경

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The Change in Range of Motion after Removal of Instrumentation in Lumbar Arthrodesis Stiffness of Fusion Mass: Finite Element Analysis (척추 유합술 후, 척추경 나사못 제거에 따른 인접 분절의 운동범위에 대한 유한요소해석)

  • Kang, Kyoung-Tak;Lee, Hwa-Yong;Son, Ju-Hyun;Chun, Heoung-Jae;Kim
    • Proceedings of the Computational Structural Engineering Institute Conference
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    • 2009.04a
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    • pp.283-286
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    • 2009
  • 척추경 나사못을 이용한 요추 유합술은 가장 보편적으로 사용되어지는 수술적 치료 방법이다. 과거 여러 연구들에서 이러한 척추 유합술의 임상적 우수성은 이미 입증 되었으며, 척추경 나사못은 시술 부위의 운동을 완전히 제한함으로써 높은 유합율을 얻을 수 있으나, 상대적으로 인접 분절의 조기 퇴행성 변화의 요인 중 하나로 보고되고 있다. 따라서 본 연구에서는 유한요소해석 방법을 이용하여 척추경 나사못 시술에 따른 척추체의 운동범위 및 인접 분절 추간판의 스트레스 증가량을 계산하였고, 척추경 나사못 모델과 유합 후 나사못 제거에 따른 모델 또 시술하기 전 정상모델과 비교하여 생체 역학적 측면에서 분석하여 척추경 나사못을 이용한 요추 유합술 후, 척추경 나사못의 제거의 임상적 효과와 그 이론적 근거를 제시하고자 한다.

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Measurement of Ideal Trajectory of The Cervical Pedicle for Robotic Surgery (로봇 수술을 위한 경추 척추경에 대한 이상적 궤적의 측정)

  • Kwak, Ho-Young;Huh, Jisoon;Lee, Won Joo
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2017.07a
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    • pp.99-100
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    • 2017
  • 많은 연구에서 측면 나사 고정(laminar screw fixation)보다 척추경 나사 고정(pedicle screw fixation)의 생체 역학 강도가 더 나은 것으로 알려져 있다. 그러나 비교적 작은 크기의 척추경(pedicle)과 척수(spinal code), 신경 뿌리 및 척추 동맥에 대한 상해의 위험으로 일반적으로 이 방법은 사용에 제한이 있었다. 최근 3차원 모델링 및 3D 프린팅 기술의 진보는 해부학적인 연구, 특히 척추를 포함한 뼈와 관련된 연구를 용이하게 하고 있으며, 로봇 수술을 위한 다양한 아이디어를 제공하고 있다. 본 연구는 로봇 암(robotic arm)으로 경추 척추경에 나사를 삽입할 때 사용될 수 있는 척추경 나사 삽입을 위한 이상적인 궤적을 계산하는 방법을 제시하였다.

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Effects of Operative Technique, Pedicle Screws, or Fusion on Loading of Adjacent Segments after Lumbar Fusion: Finite Element Biomechanical Analysis (요추 유합술 후, 인접분절의 위험을 초래하는 원인들에 대한 생체 역학적 분석)

  • Kang, Kyoung-Tak;Jung, Hyung-Jin;Chun, Heoung-Jae;Kim, Ho-Joong
    • Proceedings of the Computational Structural Engineering Institute Conference
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    • 2010.04a
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    • pp.280-283
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    • 2010
  • 척추경 나사못을 이용한 요추 유합술은 가장 보편적으로 사용되는 수술 적 치료 방법이다. 과거 여러 연구들에서 이러한 척추 유합술의 임상적 우수성은 이미 입증 되었으며, 척추경 나사못은 시술 부위의 운동을 완전히 제한함으로써 높은 유합율을 얻을 수 있으나, 상대적으로 인접 분절의 조기 퇴행성 변화의 요인 중 하나로 보고되고 있다. 또한 유합술을 수행 할 때 후방조직의 절제 또한 인접 분절의 퇴행을 초래하는 원인으로 보고되고 있다. 따라서 본 연구에서는 유한요소해석 방법을 이용하여 척추경 나사못 과 후방조직을 절제하는 시술 방법을 비교하여 척추체의 운동범위의 증가량을 계산하였고, 척추경 나사못 모델과 후방조직을 제거한 모델을 개발하여 시술하기 전 정상모델과 비교하였다. 개발된 모델과 정상 모델을 생체 역학적 측면에서 분석하여 인접분절의 조기 퇴행성 변화를 일으키는 가장 큰 원인이 무엇인지 정량적으로 분석하였고, 이를 근거 하여 임상적 효과와 그 이론적 근거를 제시하고자 한다.

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A Development and Estimation about Flexible Rod for Flexibility of Pedicle Screw System (인공 척추경 나사시스템의 유연성 증가를 위한 플렉시블 로드의 개발 및 평가)

  • Yoon, Gil-Sang;Sohn, Jong-In;Kim, Gun-Hee;Seo, Tae-Il
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.4
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    • pp.1775-1780
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    • 2011
  • In this paper, it is analyzed about the mechanical characteristics of pedicle screw system which is a artificial implant for surgery to treatment serious lumbar vertebra diseases. The disk of lumbar vertebra to be fixed by pedicle screw system shows regressive phenomena. But if flexible rod, to give a flexibility(under 6 degree) to fixable disk is applied, it can protect against the degeneration of disk. This research is carried out a mechanical characteristic of pedicle screw system used flexible rod through finite elements analysis, and then flexible rod system was verified about safe movement through compression, tension and torsion test which is the pedicle screw system official recognition test(ASTM F 1717).

Biportal Percutaneous Endoscopic Spinal Surgery for Lumbar Spinal Stenosis (요추 척추관 협착증 환자의 양방향 경피적 내시경을 이용한 척추 수술)

  • Kang, Taewook;Lee, Soon Hyuck;Park, Si Young
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.3
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    • pp.219-226
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    • 2019
  • Lumbar decompressive surgery is a standard surgery for lumbar spinal stenosis. Many surgical techniques have been introduced, ranging from open surgery to percutaneous procedures. Minimally invasive techniques are preferred because of the less postoperative pain and shorter hospital stay. Uniportal percutaneous endoscopic decompression has technical difficulties due to the narrow field. Biportal percutaneous endoscopic decompression is a satisfactory technique that can compensate for the shortcomings and provide sufficient decompression.

Is It Appropriate to Insert Pedicle Screws at an Infected Vertebral Body in the Treatment of Lumbar Pyogenic Spondylodiscitis? (요추부 화농성 척추염의 수술적 치료: 이환된 추체에 척추경 나사 고정이 타당한가?)

  • Na, Hwa-Yeop;Jung, Yu-Hun;Lee, Joo-Young;Kim, Hyung-Do
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.5
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    • pp.419-426
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    • 2021
  • Purpose: In the surgical treatment of pyogenic lumbar spondylodiscitis, screw insertion at the affected vertebra has been avoided because of biofilm formation, and the risk of infection recurrence. The authors analyzed the success rate of infection treatment while minimizing the number of instrumented segments by inserting pedicle screws into the affected vertebrae. Therefore, this study examined the usefulness of this technique. Materials and Methods: From January 2000 to June 2018, among patients with pyogenic lumbar spondylodiscitis treated surgically, group A consisted of patients with pedicle screws inserted directly at the affected vertebrae (28 cases), and group B underwent fusion by inserting screws at the adjacent normal vertebrae due to bone destruction of the affected vertebral pedicle (20 cases). The classified clinical results were analyzed retrospectively. All patients were treated via the posterior-only approach, so the affected disc and sequestrum were removed. Posterior interbody fusion was performed with an autogenous strut bone graft, and the segments were then stabilized with pedicle screw systems. The hospitalization period, operation time, amount of blood loss, EQ-5D index, duration of intravenous antibiotics, and the clinical and radiological results were analyzed. Results: In group A, the number of instrumented segments, operation time, blood loss, and EQ-5D index at one month postoperatively showed significant improvement compared to group B. There were no significant differences in the duration of antibiotic use, hospitalization, radiological bone union time, sagittal angle correction rate, and recurrence rate. Conclusion: Minimal segmental fixation, in which pedicle screws were inserted directly into the affected vertebrae through the posterior approach, reduced the surgery time and blood loss, preserved the lumbar motion by minimizing fixed segments and showed rapid recovery without spreading or recurrence of infection. Therefore, this procedure recommended for the surgical treatment of lumbar pyogenic spondyodiscitis.

Mechanical Characterization of the Pedicle Screw System for Thoracolumbar Spine (흉요추용 척추경 나사못시스템의 기계적 특성)

  • 이효재;최화순;안면환;송정일
    • Journal of Biomedical Engineering Research
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    • v.23 no.1
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    • pp.17-26
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    • 2002
  • The purpose of this study was to investigate the important Parameters of the Pedicle screw by estimating the mechanical characteristics of screws under static and dynamic loads. Methodology for estimating Parameters under static load was proposed. It was also shown that the fatigue life of the one-level system could be increased by changing the shape of screws. Load parameters of the single pedicle screw were friction force. bending moment. and holding force. The test results of the one-level system could be inferred from teat results of the sin91e screw under bending force Fatigue life of the one-level system with flexible rod was longer than that of the upper Part test without rod . Considering the drop of flexibility of the rod due to muscles and ligament, fatigue life of the one-level system could be estimated b? that of the single screw.

Effects of Fusion Level for Scioliotic Spine Correction Simulation with Pedicle Screw and Rod Derotation Method (척추경 나사못 고정과 강봉 감염술을 이용한 척추 측만증 교정 해석시 유합 범위에 따른 교정 효과 분석)

  • 김영은;손창규;최형연;하정현;이춘기
    • Journal of Biomedical Engineering Research
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    • v.25 no.1
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    • pp.71-76
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    • 2004
  • In order to investigate the Post-operative changes in scoliotic spine according to selection of fusion level a mathematical finite element model of King-Moe type II scoliotics spine system was developed. By utilizing this finite element scoliosis model surgical correction simulation procedures of pedicle fixation and derotation were simulated. In consequence of the calculation by changing the fusion Levels, postoperative changes like Cobb angle, apical vertebrae axial rotation (AVAR), thoracic kyphosis, and rib hump were Qualitatively analyzed. In the analysis of operative kinematics, the decrease or Cobb angle was most prominent in distraction than in deroation. Applying the rod derotation only was not effective in decrease of Cobb angle but just caused increase of At AR and rib hump. From the operative simulation, co-action or distraction and translation during rod insertion has major impact on Cobb angle decrease and maintenance of kyphosis. With rod rotation, Cobb angle decrease was obtained, but combined increase of AVAR and rib hump was simulation observed as well. The case of most extended instrumentation range with 60o rod rotation produced double decrease of Cobb angle, but the increase of rib hump and AYAR occurred corresponding1y. The optimum selection of fusion level was proved as one level less than inflection position of the thoracic spine curvature.

The effect of pre-load and fatigue life for one-level pedicle screw system (단분절 척추경 나사못의 피로수명과 Pre-Load의 영향)

  • 김병일;이효재;송정일
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2003.06a
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    • pp.1298-1301
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    • 2003
  • The purpose of this research is to evaluate the effect of pre-load and fatigue life of the distracted one-level pedicle screw system. A spring, which acted as a substitute of the ligament, was installed in the one-level pedicle screw system before testing. The static and fatigue properties are now being tested, which includes 6mm rod to 6mm screw, 6mm rod to 6.5mm screw and 6.35mm rod to 6.5mm screw, under pre-load. Until now as test data were analyzed, 6mm rod to 6.5mm screw was found to have the best performances of stillness and fatigue lift, while 6mm rod to 6mm screw showed the shortest fatigue life. If the stiffness of screw was bigger than that of rod. the fatigue life was prolonged. The fatigue life of the distracted pedicle screw was proved to be shorter than that of the one-level pedicle screw system. So the fatigue life was shortened because of the effect of the spring on the flexibility and stiffness of the rod. In order to obtain the stability of the pedicle screw, more tests are under doing on this topic.

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