• Title/Summary/Keyword: 척추경 나사못

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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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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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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.

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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The Effect of Distal Hooks in Thoracolumbar Fusion Using a Pedicle Screw in Elderly Patients (척추경 나사못을 이용한 고령 환자의 흉요추부 유합에서 원위부 갈고리의 효과)

  • Lee, Dong-Hyun;Kim, Sung-Soo;Kim, Jung-Hoon;Lim, Dong-Ju;Choi, Byung-Wan;Kim, Jin-Hwan;Kim, Jin-Hyok;Park, Byung-Ook
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.83-91
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    • 2017
  • Purpose: To investigate the clinical outcomes of distal hook augmentation using a pedicle screw in thoracolumbar fusion in elderly patients. Materials and Methods: This retrospective multicenter study recruited 20 patients aged 65 years or older, who underwent anterior support and long level posterior fusion in the thoracolumbar junction with a follow-up of one year. To assess the effect of distal hook augmentation, the patients were divided into two groups; the pedicle screw with hook group (PH group, n=10) and the pedicle screw alone group (PA group, n=10). Results: The average age was 72.4 years (65-83 years). The average fusion segment was 4.6 segments (3-6 segments). There were no significant differences in age, sex, causative diseases, bone mineral density of lumbar and proximal femur, number of patients with osteoporosis, and number of fused segments between the two groups (p≥0.05). At 1 year follow-up after surgery, parameters related with distal screw pullout were significantly worse in the PA group. No patients in the PH group had distal screw pullout. However, six patients (60%, 6/10) in the PA group had distal screw pullout. There were no significant differences in the progression of distal junctional kyphosis between the two groups. Conclusion: Distal hook augmentation is an effective procedure in protecting distal pedicle screws against the pullout when long level thoracolumbar fusion was performed in elderly patients aged 65 years or older.

Image Evaluation Analysis of CT Examination for Pedicle Screw Insertion (척추경 나사못 삽입술 CT검사의 영상평가 분석)

  • Hwang, Hyung-Suk;Im, In-Chul
    • Journal of the Korean Society of Radiology
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    • v.16 no.2
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    • pp.131-139
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    • 2022
  • The purpose of this study was to insert a pedicle screw into a pig thoracic vertebrae, a general CT scan(Non MAR), and a thoracic axial image obtained with the Metallic Artifact Reduction for Orthopedic Implants (O-MAR) to reduce artifacts. The image obtained by reconstructing the algorithm (Standard, Soft, Bone, Detail) was used using the image J program. Signal to noise ratio(SNR) and contrast to noise ratio(CNR) were compared and analyzed by obtaining measured values based on the given equation. And this study was to investigate tube voltage and algorithm suitable for CT scan for thoracic pedicle screw insertion. As a result, when non-MAR was used, the soft algorithm showed the highest SNR and CNR at 80, 100, 120, and 140 kVp, On the other hand, when MAR was used, the standard algorithm showed the highest at 80 kVp, and the standard and soft algorithms showed similar values at 100 kVp. At 120 kVp, the Soft and Standard algorithms showed similar values, and at 140 kVp, the Soft algorithm showed the highest SNR and CNR. Therefore, when comparing Non-MAR and MAR, even if MAR was used, SNR and CNR did not increase in all algorithms according to the change in tube voltage. In conclusion, it is judged that it is advantageous to use the Soft algorithm at 80, 100, 120, and 140 kVp in Non MAR, the Standard algorithm at 80 and 100 kVp in MAR, and the Soft algorithm at 120 and 140 kVp. This study is expected to serve as an opportunity to further improve the quality of images by using selective tube voltage and algorithms as basic data to help evaluate images of pedicle screw CT scans in the future.

Early Failure of Cortical-Bone Screw Fixation in the Lumbar Spinal Stenosis (요추부 협착에서의 피질골 궤도 나사못 고정의 초기 실패 사례에 대한 고찰)

  • Kwon, Ji-Won;Kim, Jin-Gyu;Ha, Joong-Won;Moon, Seong-Hwan;Lee, Hwan-Mo;Park, Yung
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.5
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    • pp.405-410
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    • 2020
  • Purpose: Pedicle screw insertion has been traditionally used as a surgical treatment for degenerative lumbar spine disease. As an alternative, the cortical-bone trajectory screw allows less invasive posterior lumbar fixation and excellent mechanical stability, as reported in several biomechanical studies. This study evaluated the clinical and radiological results of a case of early failure of cortical-bone screw fixation in posterior fixation and union after posterior decompression. Materials and Methods: This study examined 311 patients who underwent surgical treatment from 2013 to 2018 using cortical orbital screws as an alternative to traditional pedicle screw fixation for degenerative spinal stenosis and anterior spine dislocation of the lumbar spine. Early fixation failure after surgery was defined as fixation failure, such as loosening, pull-out, and breakage of the screw on computed tomography (CT) and radiographs at a follow-up of six months. Results: Early fixation failure occurred in 46 out of 311 cases (14.8%), screw loosening in 46 cases (14.8%), pull-out in 12 cases (3.9%), and breakage in four cases (1.3%). An analysis of the site where the fixation failure occurred revealed the following, L1 in seven cases (15.2%), L2 in three cases (6.5%), L3 in four cases (8.7%), L4 in four cases (8.7%), L5 in four cases (8.7%), and S1 in 24 cases (52.2%). Among the distal cortical bone screws, fixation failures such as loosening, pull-out, and breakage occurred mainly in the S1 screws. Conclusion: Cortical-bone trajectory screw fixation may be an alternative with comparable clinical outcomes or fewer complications compared to conventional pedicle screw fixation. On the other hand, in case with osteoporosis and no anterior support structure particularly at L5-S1 fusion sites were observed to have result of premature fixation failures such as relaxation, pull-out, and breakage.

Evaluation on usefulness of three dimensional reconstructive computed tomography images after pedicle screws fixation (척추경 나사못 고정술 시행 후 3차원 재구성CT영상의 유용성 평가)

  • Kim, Hyeon-Ju;Jang, Hyun-Chul;Cho, Jae-Hwan
    • Journal of Digital Contents Society
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    • v.11 no.4
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    • pp.553-559
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    • 2010
  • By applying the various reformation techniques by using a circle raw data of after computed tomography image in the patient enforcing the spine screw fixation, this research tried to look into the various information including the exact location of the position of the screw spike and accuracy of an operation. In a clinical, by applying the or multi planar reformatting(MPR), that is the re-composition technique used mainly, maximum intensity projection (MIP), and volume rendering technique(VRT) and transformation removal from a register modifying VRT, video data were compared and were analyzed by the quantitative method and qualitative method. It is judged as the transformation volume rendering technique of the re-composition technique which is most useful in minimizing the artifact shadow by the exact location of the position of a screw and metal among the analysis and evaluation result computed tomography image reformation technique of the reformation image after the spine screw fixation.