• Title/Summary/Keyword: 척추

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Spine Surgery Using Augmented Reality (증강현실을 이용한 척추 수술)

  • Park, Sang-Min;Kim, Ho-Joong;Yeom, Jin S.;Shin, Yeong Gil
    • Journal of Korean Society of Spine Surgery
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    • v.26 no.1
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    • pp.26-32
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    • 2019
  • Study Design: Review article. Objectives: To present the latest knowledge on spine surgery using augmented reality (AR). Summary of Literature Review: AR is a new technology that simulates interactions with real-world surroundings using computer graphics, and it is a field that has recently been highlighted as part of the fourth industrial revolution. Materials and Methods: Review of related literature and introduction of latest research. Results: Spine surgery using AR is currently in its early stages. If industry, academia, and research institutes cooperate and develop, spine surgery using AR is highly likely to develop to the next level. Conclusions: Spine surgeons should strive to develop relevant technology.

Analysis of Medical Decisions related to Epidural Hematoma after Spinal Surgery -Focusing on the Lumbar MRI- (척추 수술 후 발생한 경막외 혈종 관련 의료 판결 분석 -요추 MRI 시행 여부를 중심으로-)

  • Lee Dongjin
    • The Korean Society of Law and Medicine
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    • v.25 no.1
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    • pp.61-86
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    • 2024
  • The purpose of this study was to investigate the importance of continuous and detailed follow-up of patients after spinal surgery by reviewing the literature on epidural hematoma and the lower court ruling on lumbar MRI during the judgment on the negligence of postoperative follow-up. In the case of neglecting MRI examination or cooperation after surgery, delaying MRI examination after pain and symptom appeal after surgery, and returning home immediately after neurological symptom development after surgery, negligence in progress observation was recognized. In the case of the case where the negligence was not recognized even after the occurrence of the aftereffects by taking measures against the symptoms, and the case where the scope of the doctor's discretion for the execution of the test was recognized, It is hoped that this study will help prevent medical accidents and disputes related to follow-up after spinal surgery by increasing awareness of the importance of prompt MRI examination, diagnosis, surgical treatment, and power, especially in the case of new neurological symptoms.

Differential Diagnosis of Metastatic Bone Disease and Benign Bone Disease on Spine SPECT in Patients with Low Back Pain (요통 환자의 척추골 SPECT에서 골전이 병변과 양성골질환의 섭취 양상 분석을 통한 감별진단이 가능한가)

  • Lee, Seung-Hun;Choi, Yun-Young;Cho, Suk-Shin
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.6
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    • pp.371-377
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    • 2001
  • Purpose: One or more abnormal vertebrae detected on bone scintigraphy is a common finding in clinical practice, and it could pose a diagnostic dilemma especially in cancer patients. as either metastasis or benign disease may cause scintigraphic abnormality. The purpose of this study was to determine whether additional spine SPECT has a role in differentiating malignant from benign lesions in patients with back pain. Materials and Methods: We reviewed spine SPECT studios obtained over a three-year period in 108 patients. Among them, forty-five patients with abnormal SPECT and clinically followed records were evaluated (20 cancer patients were included). Uptake patterns were classified as follows: 1. Body: diffusely increased uptake, linear increased uptake of end plate, segmental increased uptake, and cold defect, 2. Posterior element: posterior to body (pedicle), posterior to Intervertebral disc space (facet joint), and spinous process. Lesions were correlated with radiological findings and with final diagnosis. Results: Sixty-nine bone lesions were detected on SFECT images, including 18 metastases, 28 degenerative diseases and 21 compression fractures. Cold defect (6) and segmental increased uptake (5) were dominant findings in metastasis; linear increased uptake (12), and facet joint uptake (15) were in degenerative change; and diffuse increased uptake (9), and linear increased uptake (9) were in compression fracture. Conclusion: Cold defect and segmental increased uptake of body were characteristic findings of metastasis, but care should be taken because compression fracture also shows segmental increased uptake in some cases. Degenerative disease was easily diagnosed because of the typical finding of linear increased uptake of end plate and facet joint. Therefore, additional bone SPECT after planar bone scan would be helpful for differentiating metastasis from benign condition in cancer patients.

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Prevalence of Incidentally Detected Spondylolysis in Children (소아 환자에서 우연히 발견되는 척추분리증의 유병률)

  • Boram Song;Sun Kyoung You;Jeong Eun Lee;So Mi Lee;Hyun-Hae Cho
    • Journal of the Korean Society of Radiology
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    • v.83 no.1
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    • pp.127-137
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    • 2022
  • Purpose To assess the prevalence of incidentally detected lumbar spondylolysis in children. Materials and Methods We retrospectively reviewed the data of 809 patients under the age of 11 years (mean age, 7.0 ± 2.7 years; boys:girls = 479:330) who underwent abdominal and pelvic CT between March 2014 and December 2018. We recorded the presence, level, and laterality (unilateral or bilateral) of spondylolysis. Patients were divided into two groups based on the presence of spondylolysis: the spondylolysis (SP) and non-SP groups. Results In total, 21 cases of spondylolysis were detected in 20 patients (20/809, 2.5%). The mean age of the SP group was higher than that of the non-SP group (7.8 ± 1.8 vs. 6.9 ± 2.7 years, p > 0.05). The prevalence of spondylolysis in boys was higher than that in girls (15/479 [3.1%] vs. 5/330 [1.5%], p > 0.05). The prevalence of spondylolysis in school-age children (6-10 year olds) was higher than that in preschool-age children (0-5 year olds) (17/538 [3.2%] vs. 3/271 [1.1%], p > 0.05). L5 was the most common level of spondylolysis (76.2%); one 8-year-old boy had two-level spondylolysis. One case of isthmic spondylolisthesis was detected in a 10-year-old boy (1/809, 0.1%). There were 11 unilateral spondylolysis cases (11/21, 52.4%). Conclusion In our study, the prevalence of spondylolysis in children under the age of 11 was 2.5%. The prevalence was higher in boys than in girls and in school-age than in preschool-age children, despite the lack of any statistically significant differences.

Characteristic of Cross-sectional Area of Lumbar Paraspinal Muscle in Patients of Acute and Chronic LBP (20대와 40대의 급성 및 만성요통환자의 척추주위 근육에 관한 횡단면의 비교)

  • Kim, Dae-Hun;Park, Jin-Kyu;Park, Yun-Jin;Jung, Dae-In;Kim, Seong-Su
    • The Journal of the Korea Contents Association
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    • v.11 no.6
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    • pp.270-278
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    • 2011
  • The purpose of this study was to compare acute and chronic LBP patient in twenties and forties, respectively by size measure paraspinal muscle (cross-sectional area; CSA). CSA of paraspinal muscle (psoas, multifidus, erector muscle) size was measured by free-handling technique of the picture archiving and communication system(PACS) using MRI at the level(lower end-plate of L4) in twenties(9 males, 10 females) and forties(9 males, 8 females) in acute and chronic LBP patient. The results of this study showed no significantly difference between acute and chronic LBP (p>0.05) in twenties patients. However, there was significant difference between acute and chronic LBP (p<0.05) in forties patients. Also, there was significant difference in paraspinal muscle CSA between chronic LBP patients in twenties and chronic LBP patients in forties (p<0.05). This study showed that paraspinal muscle atrophy was observed in forties with various cause, but Not chronic LBP patients in twenties. Accordingly it is required for chronic LBP patients in forties to minimize trunk muscle atrophy through immediate back muscle dynamic exercise and early functional activity.

Primary Spinal Epidural Lymphoma Mimicking Epidural Abscess in a Diabetic - A Case Report - (당뇨 환자에서 경막외 농양과의 감별을 요한 원발성 척추 경막외 임파종 - 증례보고 -)

  • Kim, Se Hoon;Lim, Dong Jun;Cho, Tai Hyoung;Chung, Yong Gu;Lee, Hoon Kap;Lee, Ki Chan;Suh, Jung Keun
    • Journal of Korean Neurosurgical Society
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    • v.30 no.3
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    • pp.395-399
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    • 2001
  • Primary spinal epidural lymphoma(SEL), i.e. occurring in the absence of any detectable extraspinal lymphoproliferative disorder, is an unusual cause of spinal cord compression. The authors report a 48-year-old, diabetic woman presented with back pain followed by acute paraparesis and voiding difficulty. She had been treated with acupunctures on her back before admission, and complete blood count showed leukocytosis with neutrophilia and increased erythrocyte sedimentation rate(ESR). Thoracic spine magnetic resonance imaging(MRI) revealed an epidural mass extending from T5 to T8 with compression of the spinal cord. Emergency decompressive laminectomy was performed with a tentative diagnosis of spinal epidural abscess, but a B-cell lymphoma was final pathologic diagnosis. Further staging showed no other sites of lymphoma, and the spinal lesion was treated by chemotherapy and radiotherapy. The authors stress that primary SEL can mimic spinal epidural abscess(SEA) in the diabetic patient and should be a diagnostic consideration in patients with a syndrome of acute spinal cord compression manifested by a prodrome of back pain and neuroimaging consistent with an epidural compressive lesion, especially in a diabetic.

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The Measurement of Size of the Pedicle Using 3 Dimensional Reconstruction Image in Idiopathic Scoliosis (특발성 척추측만증 환자에서의 3차원적 재구성을 이용한 척추경의 크기 측정)

  • Heo, Jae-Hee;Ahn, Myun-Hwan
    • Journal of Yeungnam Medical Science
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    • v.21 no.1
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    • pp.40-50
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    • 2004
  • Background: This study was conducted to analyze the height and width of the pedicle of the upper and lower levels on the concave and the convex sides. In addition, we checked for the appropriate pedicle screw size which could be screwed in without complications. Materials and Methods: Taking a simple AP radiography in a standing position, 99 vertebrae on the major curve with the possibility of 3-D reconstruction were analyzed after checking the CT in a supine position of 22 idiopathic scoliosis. We measured Cobb's angle from a simple radiograph, and measured the size of the isthmus by the Inner Space 3-D Editor after 3-D reconstruction with the Inner Space 3-D program in the DICOM file transformed from CT image. We then analyzed the size of pedicles of the upper and lower levels on the concave and the convex sides by measuring the height and width of the pedicle. Results: All pedicles on the concave side were smaller than those on the convex side. Their size increased as the measurement moved from the upper to lower vertebra, except for the upper thoracic vertebra. When the width of the pedicle through 3-D reconstruction was compared with the narrowest width of the pedicle measured by using CT, the width of the pedicles through 3-D reconstruction was statistically smaller (P<0.01). Most of the pedicles were tear-drop or kidney shaped rather than cylindrical. Conclusion: These results suggest that the use of the coronal plane through 3-D reconstruction would be necessary for an accurate measurement of the size of the pedicle. It is important to pay careful attention to the screw size and the screwing method considering the pedicle shape through 3-D reconstruction.

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A Micro Finite Element Analysis on Effects of Altering Monomer-to-Powder ]Ratio of Bone Cement During Vertebroplasty (골 시멘트 중합 비율 변경이 척추성형술 치료에 미치는 영향에 대한 비교 분석)

  • 김형도;탁계래;김한성
    • Journal of Biomedical Engineering Research
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    • v.23 no.6
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    • pp.451-458
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    • 2002
  • Osteoporosis is a systemic skeletal disease caused by low bone mass and the decrease of bone density in the microstructure of trabecular bone. Drug therapy(PTH Parathyroid hormone) may increase the trabecular thickness and thus bone strength. Vertebroplasty is a minimally invasive surgery foy the treatment of osteoporotic vertebral compression fracture. This Procedure includes Puncturing vertebrae and filling with Polymethylmethacrylate(PMMA). Although altering recommended monomer-to-Powder ratio affects material properties of bone cement, clinicians commonly alter the mixture ratio to decrease viscosity and increase the working time. The Purposes of this study were to analyze the effect of 4he monomer-to-powder ratio on the mechanical characteristics of trabecular. In this paper, the finite element model of human vertebral trabecualr bone was developed by modified Voronoi diagram, to analyze the relative effect of hormone therapy and vertebroplasty at the treatment of osteoporotic vertebrae. Trabeuclar bone models for vertebroplasty with varied monomer-to-Powder ratio(0.40∼1.07 ㎖/g) were analyzed. Effective modulus and strength of bone cement-treated models were approximately 60% of those of intact models and these are almost twice the values of hormone-treated models. The bone cement models with the ratio of 0.53㎖/g have the maximum modulus and strength. For the ratio of 1.07㎖/g, the modulus and strength were minimum(42% and 49% respectively) but these were greater than those for drug therapy. This study shows that bone cement treatment is more effective than drug therapy. It is found that in vertebroplasty, using a monomer-to-powder ratio different from that recommended by manufacturer nay significantly not only reduce the cement's material Properties but also deteriorate the mechanical characteristics of osteoporotic vertebrae.

A Qualitative Analysis on Paraspinal Muscles in Patients with Acute Low Back Pain and Chronic Low Back Pain (급성 요통환자와 만성 요통환자에서 척추주변근육의 정량적 분석)

  • Jeong, Dae-Keun
    • Journal of Digital Convergence
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    • v.11 no.11
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    • pp.613-620
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    • 2013
  • This study was conducted to measure and analyze the changes in paraspinal muscles of acute and chronic low back pain patients using MRI, and to provide clinical basic data for diagnosis and treatment for low back pain. For this purpose, 20 patients with acute low back pain frome August 2012 to January 2013 which occurred within 12 weeks, and 20 patients with chronic low back pain that progressed over 12 weeks, were chosen as subjects, and their MRI measurements were compared with one another. As a result, in relation to in the fatty degeneration ratio of the left spine and right spine, there were significant differences in erector spinae and multifidus(p<.001), and in relation to the Fat Infiltration ratio between all the groups, there were significant differences in psoas major, erector spinae and multifidus between the acute low back pain patient group and the chronic low back pain patient group(p<.001). In the post-hoc test, multifidus and erector spinae in the acute low back pain group and chronic low back pain group showed the highest Fat Infiltration ratio. The serious Fat Infiltration of multifidus and erector spinae in the chronic low back pain group led to weakened strength of muscles that stabilize the spine. In conclusion, it is considered that this study would present important data and basis in making acute and chronic low back pain patients pay more attention to multifidus and psoas major during rehabilitation exercise, and selecting a rehabilitation exercise program.

Relationship between Environmental Factors and Macrobenthos Assemblages in Geum Estuary Tidal-flat (금강하구 갯벌 내 환경요인과 저서성무척추동물 군집 분포의 상관관계)

  • Yoo, Jae-Won;Lee, Chae-Lin;Park, Mi-Ra;Yoon, Jihyun;Kang, Sung-Ryong
    • Journal of Wetlands Research
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    • v.21 no.1
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    • pp.84-94
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    • 2019
  • The Seocheon and Yubu Island mudflats in Geum Estuary are important stopover sites for migratory birds as energy supplementation area in the East Asia-Australasian Flyway. Benthic invertebrates in the tidal flats are important food resources for the migratory birds. In other words, benthic invertebrates in the tidal flats play an important ecological role in energy flow. This study was conducted to investigate the relationship between benthic invertebrate assemblages and environmental factors in Seocheon and Yubudo tidal flats in the Geum Estuary. As a result of the benthic invertebrate assemblage during the fall migration season, the total species number was 147, density and biomass were $1,772{\pm}1,342individuals/m^2$ and $445.1{\pm}807.6g/m^2$, respectively. Based on the appearance species and the density data, the result of analysis of mutual similarity among sampling sites was divided into two groups. Group A was the Macrophthalmus-Heteromastus community and Group B was the Spio-Urothoe-Mandibulophoxus community. Group B showed higher mean species number, density and biomass than Group A. The BIO-ENV analysis showed that the benthic invertebrate assemblages were most affected by the combination of sand content % and sediment sorting (${\rho}=0.500$). The variables of significant relationship with species number and biomass were sediment sorting (p=0.015) and the pore water DO(Dissolved Oxygen, p=0.003) in sediment, respectively.