• Journal of Biomedical Engineering Research
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• v.24 no.5
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• pp.421-425
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• 2003

In this study the occlusion of dural-sac. the outer membrane of spinal cord in the lumbar region. was quantitatively analyzed using one motion segment finite element model. Occlusion was quantified by calculating cross sectional area change of dural-sac for different compressive impact duration (loading rate) due to bony fragment at the posterior wall of the cortical shell in vertebral body. Dural-sac was occluded most highly in the range of 8∼12 msec impact duration by the bony fragment intruding into the spinal canal. $\Delta$t = 400 msec case 4 % cross sectional area change was calculated. which is the same as the cross sectional area change under 6 kN of static compressive loading.

• Neonatal Medicine
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• v.15 no.1
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• pp.84-88
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• 2008

The Jarcho-Levin syndrome is a rare genetic disorder characterized by a short neck, short trunk, and a constricted thorax, and is due to multiple vertebral and rib defects. The small size of the thorax frequently leads to respiratory insufficiency and death in neonates or infants. This syndrome also combines with various kinds of anomalies, especially renal anomalies. We report an infant with Jarcho-Levin syndrome combined with fusion of both kidneys who was referred from a local obstetric clinic for cyanosis and respiratory difficulty.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.5 no.2
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• pp.127-134
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• 2010

Objectives: The purpose of this study is the evaluation of conservative medical treatment on the herniation of intervertebral disc(HIVD) patient after the fusion surgery of a lumbar segment. Methods: We used acupuncture, herbal medication, and manipulation for this patient. And we measured of VNRS score and SLR test result to evaluate effect of conservative medical treatment. Results & Conclusions: Patient's low back and left leg pain VNRS is decreased, and the SLR test result is improved.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2002.05a
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• pp.117-120
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• 2002

In this study the occlusion of dural-sac, the outer membrane of spinal cord in the lumbar region, was quantitatively analyzed using one motion segment finite element model. Occlusion was quantified by calculating cross sectional area change of dural-sac far different compressive impact duration(loading rate) due to bony fragment at the posterior wall of the cortical shell in vertebral body. Dural-sac was occluded most highly in the range of 8∼12 msec impact duration by the bony fragment intruding into the spinal canal. t=400 msec case 4% cross sectional area change was calculated, which is the same as the cross sectional area change under 6 kN of static compressive loading.

• Journal of Yeungnam Medical Science
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• v.7 no.2
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• pp.121-130
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• 1990

Plain 0.5% bupivacaine and hyperbaric 0.5% tetracaine were compared for spinal anesthesia in 40 patients undergoing operation of lower extremities. Lumbar puncture was performed with a 22 gauge spinal needle with the patient in the lateral recumbent position. The third lumbar interspace was chosen for the puncture, when a free flow of clear CSF was obtained, the local anesthetic solution (2.5ml of 0.5% bupivacaine or 2.0ml of hyperbaric 0.5% tetracaine) was injected at a rate of 0.1ml/sec without barbotage. After injection of anesthetics, clinical features were observed and compared between the two groups. The results were as follows : 1. The two groups were well matched for age, sex, height and weight. 2. In both groups, sensory block to $T_{12}$ dermatome was obtained within 4 minutes, mean maximal level of analgesia was $T_{6-7}$, and the mean time for maximal level was around 20 minutes. 3. The onset times of motor block were similar in both groups and complete motor block was obtained in all cases within 20 minutes. 4. The duration of analgesia above the $T_{12}$ dermatome was 3 hours, postoperative analgesia was 7 hours. These values were significantly prolonged than those of the tetracaine group(p<0.05). 5. The changes in systolic pressure in the bupivacaine group were significantly less than those of the tetracaine group(p<0.05). 6. The complications after spinal anesthesia were headache, numbness, urinary retention and backpain, and were no significant difference in both groups. From the obtained results, we concluded that plain 0.5% bupivacaine was a relatively satisfactory agent for spinal anesthesia for operation of lower extremities. The time of onset, height of block and the complications of postoperative period were similar in both groups. The advantages of plain 0.5% bupivacaine were less hypotension and long duration of analgesia.

• Journal of the Korean Society of Radiology
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• v.81 no.3
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• pp.644-653
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• 2020

Purpose We aimed to analyze postoperative multidetector CT (MDCT) of acquired spondylolysis and spondylolisthesis after posterior lumbar laminectomy. Materials and Methods We enrolled 74 patients, from 2003 to 2017, who underwent posterior lumbar laminectomy with both pre and postoperative MDCT. The patients were categorized into the following two groups: group 1 without fusion and group 2 with fusion. We analyzed laminectomy width, level and location of spondylolysis or spondylolisthesis, facet changes, and fatty infiltration of paraspinal muscles on postoperative MDCT. Results Incidence of spondylolysis or spondylolisthesis was 4 of 20 patients in group 1 and 2 of 54 patients in group 2. The laminectomy width (%) was defined as the percentage of the width of laminectomy to total lamina length. Mean laminectomy width (%) in patients with spondylolysis or spondylolisthesis was 54.0 in group 1 and 53.2 in group 2, in contrast to that in patients without spondylolysis or spondylolisthesis, which was 35.0 in group 1. The spondylolysis was observed at the level of the laminectomy and below pars interarticularis in group 1 and below the fusion mass at isthmic region in group 2. Conclusion MDCT facilitates the diagnosis of postsurgical acquired spondylolysis and spondylolisthesis and demonstrates typical location of spondylolysis. Greater laminectomy width has been associated with occurrence of acquired spondylolysis and spondylolisthesis.

• Transactions of the Korean Society of Mechanical Engineers A
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• v.35 no.10
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• pp.1205-1210
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• 2011

Spinal instability known to be related to low back pain. However, the quantitative definition of spinal instability has not been established because there is a lack of consensus regarding clinical and radiological studies. In addition, the major factors affecting such instability have not been elucidated, although disc degeneration, disc injury, ligament injury, and isthmic defects are considered to result in such problems. In this study, individual and combined influences on spinal instability with a three-dimensional finite element model of a one-level lumbar spinal motion segment were investigated, under the assumption that the rotation and translation in the sagittal plane under flexion and extension represented the instability indices. The results could be helpful in understanding the causes and mechanisms of spinal instability in the lumbar spine.

• Journal of the Korean Orthopaedic Association
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• v.56 no.4
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• pp.294-304
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• 2021

Ankylosing spondylitis causes ankylosis of the spine due to ossification of the articular cartilage and ligaments around the vertebral body as well as the sacroiliac joint. This pathophysiology limits joint movement and, in many cases, causes pain and deformity of the spine. If this disease is left untreated, it ultimately causes ankylosis and ossification of the whole-body joints. The symptoms generally develop before age 30 years, and the gradual progression of the disease adversely affects the physical function, professional ability, and quality of life. This increases the likelihood of developing psychiatric disorders, such as depression. The authors are aware of this severity and introduce recent trends and studies to prevent surgical treatment with various medications before systemic ossification. This paper presents various surgical treatments and complications in patients who were unable to prevent progression and underwent surgical treatment.

• Journal of Yeungnam Medical Science
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• v.20 no.2
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• pp.160-168
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• 2003

Background: Confirm the stability of intervertebral disc sustaining each fused lumbar spine cases, comparing vertical compression, A-P shear force and rotational moment on intervertebral disc of instrumented lumbar spine with simple vertical compression load and follower load using finite element analysis. Materials and Methods: We analyze the stability of intervertebral disc L4-5 supporting fused lumbar spine segments. After performing finite element modelling about L1-L5 lumbar vertebral column and L1-L4 each fusion level pedicle screw system for fused lumbar spine fine element model. Intervertebral discs with complex structure and mechanical properties was modeled using spring element that compensate stiffness and tube-to-tube contact element was employed to give follower load. Performing geometrical non-linear analysis. Results: The differences of intervertebral disc L4-5 behavior under the follower compression load in comparision with vertical compression load are as follows. Conclusion: As a result of finite element interpretation of instrumented lumbar spine, the stability of L4-5 sustaining fused lumbar segment, the long level fused lumbar spine observed hing stability under follower load. This research method can be the basis tool of effects prediction for instrumentation, a invention of a more precious finite element interpretation model which consider the role of muscle around the spine is loaded.

• Journal of Korean Society of Spine Surgery
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• v.25 no.4
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• pp.160-168
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• 2018

Study Design: Retrospective study of prospectively-collected data. Objectives: To determine the factors associated with conversion from conservative to surgical treatment in single-level lumbar spinal stenosis patients. Summary of Literature Review: Various reports have presented clinical outcomes after the surgical and nonsurgical treatment of spinal stenosis. However, few reports have investigated factors predicting conversion to surgery during the course of conservative treatment. Materials and Methods: We analyzed 40 patients who visited our hospital from May 2010 to May 2015 and were traceable for at least 3 years after being advised to undergo surgery following 3 months of conservative treatment. Of these patients, 20 underwent surgery and 20 did not. We then investigated the factors associated with conversion to surgical treatment. Clinical assessments were conducted using a questionnaire, and the overall area of the spinal canal and the muscle area within the spinal canal were measured using magnetic resonance imaging. Results: The average area of the spinal canal was $81.40{\pm}53.61mm^2$ in the surgical group, compared to $127.75{\pm}82.55mm^2$ in the nonsurgical group (p=0.042). The muscle area in the spinal canal was $5.17{\pm}1.30cm^2$ in the surgical group, whereas it was $6.40{\pm}1.56cm^2$ in the nonsurgical group (p=0.010). The patients in the surgical group were more likely to have experienced repetitive strain and to have frequently visited health clubs (p=0.047, p=0.037, respectively). However, regular stretching was more common in the nonsurgical group (p=0.028). Conclusions: The factors associated with conversion to surgical treatment were a narrow spinal canal, a small muscle area within the spinal canal, visiting health clubs, repetitive sprain, and not stretching. A small muscle area within the spinal canal can be considered as a key factor related to surgical conversion.