• Title/Summary/Keyword: 척추신경

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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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Sixth Cranial Nerve (Abducens Nerve) Palsy after Preoperative Halo-Pelvic Traction for Severe Scoliosis with Chiari I Malformation (키아리 1형 기형을 동반한 고도 척추 측만증에서 수술 전 Halo-Pelvic 견인 후 발생한 6번 뇌신경(외전신경) 마비)

  • Hwang, Jae-Kwang;Lee, Choon Sung;Choi, Shin Woo;Kim, Chung-Hwan
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.6
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    • pp.534-539
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    • 2020
  • The management of severe scoliosis remains a challenge to spine surgeons. The rapid intraoperative correction of severe scoliosis may increase the risk of perioperative complications, such as neurological compromise and implant failure. To minimize these risks, various preoperative traction methods have been employed to achieve partial correction before performing definitive corrective surgery. On the other hand, some studies have shown that one of the complications associated with halo traction could lead to cranial nerve palsy, with the sixth nerve (abducens nerve) being most commonly affected. To reduce the complications, gradual increases in the traction weight and detailed neurological examinations are needed, particularly for patients who have previously undergone brain or cervical surgery. The authors report a case of sixth cranial nerve palsy by preoperative halo-pelvic traction in patients with severe scoliosis who underwent previous decompression surgery for a Chiari I malformation with a review of the relevant literature.

The Effects of Systemic Morphine to Analgesic Level in Spinal Anesthesia (Morphine 정주가 척추마취의 레벨에 미치는 영향)

  • Lee, Kang-Chang;Kim, Tai-Yo;Yun, Jae-Seung;Lee, Eui-Sang
    • The Korean Journal of Pain
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    • v.8 no.1
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    • pp.51-54
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    • 1995
  • 척추마취는 국소마취제를 지주막하강에 주입하여 척수신경 전근과 후근을 차단하는 방법으로 하복부나 하지 수술 뿐 아니라 만성 통증과 암성 통증의 치료에도 이용되고 있는데 마취시간이나 제통시간의 연장 및 적절한 피부분절의 마취나 진통의 달성은 척추마취에서 중요한 사항이다. 본 연구에서는 morphine정주가 척추마취에 어떤 영향을 주는지 알아보기 위해 척추마취하에서 하지 수술을 받은 40명의 환자를 대상으로 척추마취를 시행한 80분에 척추마취 레벨, 수축기 및 이완기 혈압, 맥박 그리고 호흡수를 조사한후 morphine 10 mg을 정맥내로 주사후 20분후에 척추마취 레벨과 혈압, 맥박, 호흡수를 조사하여 다음과 같은 결과를 얻었다. 1) 척추마취 레벨은 morphine 투여진 $T_{7.5{\pm}0.32}$에 비해 morphine 투여 20분후에 $T_{6.0{\pm}0.31}$로 의의있게 상승하였다 (p<0.005). 2) 수축기 및 이완기 혈압과 맥박수는 morphine투여전과 투여후에 의의있는 변화가 없었다. 3) 호흡수는 morphine 투여전에 비해 투여후 감소가 있었다(p<0.005). 이상의 결과로 척추마취하에서 수술을 시행할 때나 통증치료시 전신적으로 morphne을 투여하여 마취와 진통부위를 넓일 수 있을 것으로 사료된다.

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A New Technique for Whole Craniospinal Irradiation (WCSI) (새로운 전중추신경 방사선 조사법 ; 방사선속의 발산에 의한 선량의 불균일성을 극복하기 위한 치료 방법)

  • Chang, Hye-Sook
    • Radiation Oncology Journal
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    • v.9 no.1
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    • pp.159-164
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    • 1991
  • To irradiate the entire neuroaxis, bilateral parallel opposed brain fields and direct posterior spinal field have been utilized and radiation dose at the junction between abutting fields has been extensilvely studied. And several workable methods were reported to achieve uniform dose at a desired depth at the juction between abutting fields whose central axis are coplanar. But the dose distribhution at the juction of orthogonal fields has been a persistent problem in radiation oncology. Author describes a new method to solve the junction problem between abutting fields whose central axis are orthogonal. Author utilized split beam/comllimator rotation or collimator/couch rotation to avoid hot or cold spots that may arise from beam divergence. Author achieved accurate and homogeneous dose distribution by mathching the $50\%$ isodose line at the junction between orthogonal central axis beam fields.

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A Study on the Application of Chuna Therapy to Patients with Post-stroke Spasticity based on Korean Reseach (중풍 후 경직완화를 위한 추나요법 제언: 국내 임상연구를 기반으로)

  • Kim, Min-Woo;Ki, Sung-hoon;Han, Chang-Ho;Nam, Hang-Woo;Song, Yun-Kyung
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.17 no.1
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    • pp.61-72
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    • 2022
  • Objectives This study aimed to the application of Chuna manual therapy in patients with stroke where much evidence is not available. Methods Domestic databases (KOREANTK, OASIS, RISS, KISS, and KMBASE) were queried for literature showing application of Chuna manual therapy in stroke patients. Additionally, insufficient evidence was supplemented with expert consensus using the Delphi method. Based on the literature review and expert consensus, the academic committee of the Korean Society of Chuna Manual Medicine reviewed and summarized the Chuna technique recommendations that can be applied to stroke patients. Results There were six studies on Chuna manual therapy in stroke patients, and Chuna therapy was applied for pelvic, shoulder, and elbow joint spasticity. The expert Delphi survey did not agree with the application of the nine of the 69 standard Chuna techniques and deliberated on matters to be considered when applying Chuna manual therapy to stroke patients. Finally, based on clinical research literature and expert opinions, Chuna technique was recommended for patients with post-stroke spasticity. Conclusions The application of Chuna therapy to non-muscular skeletal disorders, including stroke is recommended and should be applied while taking the necessary precautions.

Clinical Observation on One Case of Paraplegia by Bone Metastasis of Breast Cancer (유방암의 척추전이로 흉추골절 발생한 하지마비 환자의 한.양방 병용 치험 1례)

  • Kim, Sung-Keun;Lim, Chang-Sun;Kim, Mi-Young;Koo, Beam-Mo;Yang, Dong-Ho
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.3 no.2
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    • pp.9-18
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    • 2008
  • Objective : The purpose of this paper is to report the improvement of the patient with paraplegia after acupuncture, moxibustion, and herbal medicine. Methods : We treated the patient with acupuncture, moxibustion and herbal medication. Results : We treated one case of paraplegia. This patient improved significantly through acupuncture, moxibustion, herbal medicine, and western medicine. Conclusion : Through a collaboration of Western and Korean medicine, we were able to achieve meaningful treatment results.

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A Study on Assessment of Patient with Lumbar Spinal Stenosis (요추 척추관 협착증의 평가척도에 대한 고찰)

  • Park, Kyoung-Su;Chung, Seok-Hee
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.2 no.1
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    • pp.23-38
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    • 2007
  • Objectives : The aim of this study was to understand scale of lumbar spinal stenosis. Methods : Papers including questionnaires for assessment disability, fuction, activity limitation, or prticipation restriction in adult patients with low back pain or spinal stenosis were searched in the MEDLINE. Results and Conclusions : 1. VAS, VRS, NRS were recommended to the pain scale. 2.ODI and RMDQ were recommended to the function scale. 3. ODI, RMDQ, QBPDS, LBOS, MVAS, WDI commonly used to the fuction scale.

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A Case Report on HIVD-Cervical Spine Failed Back Surgery Syndrome Applied Chuna Treatment (추나 요법을 적용한 경추 추간판 탈출증 척추 수술 실패 증후군 환자의 경과관찰 1례)

  • Jeong, Si-Yeong;Lee, Jin-Bok
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.6 no.1
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    • pp.105-111
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    • 2011
  • Objects : This study was to report a clinical effect of Chuna Treatment for HIVD-cervical spine Failed Back Surgery Syndrome(FBSS) patient. Methods : In order to alleviate both arm tingling, numbness and neck stiffness, the patient was treated by acupuncture therapy, cervical traction technique of Chuna treatment and conservative managements. To evaluate the effect of the treatment, Recovery rate of Hirabayashi, Verbal Numerical Rating Scale(VNRS) and Neck Disability Index(NDI) score were used. Results : VNRS and NDI were improved and Recovery rate was 100%. Conclusions : Korean Treatment can be effectively used for a patient with HIVD-cervical spine FBSS patient. Further clinical studies are needed to verify the findings.

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A Study of Exercise treatment based on Schroth method of Idiopathic Scoliosis (특발성 척추 측만증(Idiopathic Scoliosis)애 대한 Schroth 운동요법에 대한 고찰)

  • Yeom, Do-Sung;Song, Yun-Kyung;Lim, Hyung-Ho
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.5 no.2
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    • pp.181-191
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    • 2010
  • Current treatment for adolescent idiopathic scoliosis(AIS) consists of three phases: observation, bracing, and surgery. Although there are many nonsurgical treatment(bracing, electrical stimulation, exercise, manipulation, acupuncture, etc), their effect is still controversial. In many paper, Schroth method was reported good immediate response to conservative care, which could be considered a sign of good prognosis. Schroth method became effective thai specialists in physiotherapy for spinal deformities teach the patient how to perform a routine of 'curve pattern' specific exercises with the purpose to facilitate the correction of the asymmetric posture and to teach the patient to maintain the corrected posture in dally activities. This Principles of correction exercise treatment are based on those developed by the German physiotherepist K. Schroth.

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The Spinal Flexibility and Response Time of Erector Spinae Muscle Following Stabilization Exercise (만성 요통 환자에서 척추 유연성과 허리 근육 반응속도 분석)

  • Sung, Paul S.
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.6 no.1
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    • pp.35-49
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    • 2000
  • 허리 근육손상은 기대치 못한 상황에서 신체의 적절한 반응이 지연될 경우 근육 염좌와 같은 상해나 요통으로 연결된다. 이 연구는 척추 안정 운동 후 척추의 유연성과 척추 근육의 반응 속도를 만성 요통 환자와 정상인을 대상으로 비교 연구 하였다. 만성 요통 환자 군은 척추 안정 운동을 4주간 20회 시행하였으며 이와 비슷한 특성을 가진 대조군을 비교하였다. 신체 유연성은 환자가 앉은 자세에서 척추를 축으로 신체의 회전 정도를 측정하였다. 척추 반응 속도 측정은 환자가 선 자세에서 두 손으로 판을 들고있는 동안 정구공이 1.8 m (6.4 N)에서 낙하시 좌, 우측 척추 근육의 반응 속도를 Wavelet 분석으로 측정하였다. 연구 결과 척추 안정 운동을 행한 만성 요통 환자군의 신체 유연성과 척추 근육 반응 속도가 통계적으로 유의하게 증가하였다. 척추 유연성은 만성 요통 환자 군에서 131.0cm에서 척추안정 운동후 144.1cm으로 증가하였다 (p<0.05). 척추 근육 반응 속도는 척추 안정 운동을 행한 만성 요통 환자 군에서 90.00msec에서 68.55msec로 (p<0.05), 정상 군에서는 86.28msec에서 75.64msec로 (p>0.05) 단축되었다. 척추 안정 운동은 근, 신경 조직의 반응속도를 증가시키며 특히 만성 요통 환자에서 척추의 안정성을 회복시킨다. 특히 척추의 안정성 증가는 기대치 못한 상황에서 선체의 적절한 반응의 속도를 회복시키며 결과적으로 허리 손상을 예방 할 수 있다. 물리치료학에서 근 골격 신경계의 반응 속도측정을 위한 연구로 Wavelet 분석과 같은 첨단장비를 통한 운동 치료의 질에 관한 연구의 도입이 필요하다. 또한 구체적인 치료적 운동결과의 측정을 통해 물리 치료의 효과성과 효율성을 높이기 위한 생체 의학적 연구가 요망된다.

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