• The Korean Journal of Nuclear Medicine
• /
• v.35 no.6
• /
• pp.371-377
• /
• 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.

• Journal of the Korean Society for Precision Engineering
• /
• v.20 no.11
• /
• pp.188-193
• /
• 2003

To predict changes in biomechanical parameters such as intradiscal pressure, and the shock absorbing mechanism in the spinal motion segment under different impact duration/loading rates, a three dimensional L3/L4 motion segment finite element model was modified to incorporate the poroelastic properties of the motion segment. The results were analyzed under variable impact duration for normal and degenerated discs. For short impact duration and a given maximum compressive force, relatively high cancellous pore pressure was generated as compared with a case of long impact duration, although the amount of impulse was increased. In contrast relatively constant pore pressure was generated in the nucleus. Disc degeneration increased pore pressure in the disc and decreased pore pressure in the cancellous core, which is more vulnerable to compressive fracture compared with intact case.

• Proceedings of the Korean Society of Precision Engineering Conference
• /
• 2003.06a
• /
• pp.1298-1301
• /
• 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.

• The Korean Journal of Pain
• /
• v.8 no.1
• /
• pp.51-54
• /
• 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.

• The Korean Journal of Zoology
• /
• v.37 no.4
• /
• pp.545-553
• /
• 1994

척추동물의 초기 발생에 관여하는 물질로 알려져 있는 retinoic acid(RA)를 Xenopus 배(embryo)에 처리한 결과, 체절의 형성에 이상 발생이 나타났다 즉 낭배 초기에 RA에 노출된 개체의 체절은 대조군의 화살머리 모양((((() 대신 기등 모양(1111)을 형성하고 있었으며, 고농도일수록 직선에 가까운 모습을 하고 있었다. 신경배 시기에 노출된 개체의 체절은 정상적인 분절이 이루어지지 않았으며, 이들 이상 체질의 위치는 처리 시기에 따라 다르게 나타났으나 농도에는 영향을 받지 않았다. 그러나 분절 과정중 일어나는 체절 세포들의 회전은 RA에 의해 억제되지 않았다. 이와 같은 결과는 체절의 형성에 분절 이전의 세포의 행동을 주도하는 프로그램과 분절을 주도하는 프로그램이 분리되어 있음을 암시한다. 한 가지 특이한 사항은 열처리 등으로 유발된 혼란이 수 개의 체절에 국한되어 나타나는 점과는 달리 RA의 처리는 어느 지점 이 후부터 모든 체절에 혼란을 야기시킨다는 점이다. 이와 같은 연속적인 분절의 흔란 현상은 RA가 다른 저해제에 의해 영향을 받는 유전자의 활동을 조절하는 전 단계의 유전자에 영향을 주기 때문인 것으로 사료된다. 또한 신경배 시기에 RA에 노출된 배의 a-cardiac actin은 정상적으로 발현되는데 비해 낭배 초기에 RA에 노출된 배는 감소된 양의 a-cardiac actin myNA의 축적을 보였다. 그러나 EFI-u은 RA의 처리 시기와는 무관하게 정상적으로 발현되었다.

• Journal of the Korean Orthopaedic Association
• /
• v.52 no.1
• /
• pp.83-91
• /
• 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.

• The Journal of Churna Manual Medicine for Spine and Nerves
• /
• v.5 no.2
• /
• pp.113-125
• /
• 2010

Objectives: We have evaluated the effects of conservative treatment on one patient who was diagnosed to thoraco-lumbar junction and lumbo-sacral junction transitional zone syndrome. so, we investigate thoraco-lumbar junction and Jumbo-sacral junction tranzitional zone syndrome that was suggested by Maigne R. Methods : One patient was diagnosed as T12-L1 herinated intervetebral disc through MRI. We diagnosed the patient to transitional zone syndrome by symptoms and physical examination and used Acupuncture therapy, Cox technique to the patient. We measured Visual Analog Scale(VAS) before and after treatment. Results: After treating Acupuncture therapy, Cox technique in the case, We find out that the patient was improved. VAS score changed from 7 to 2 and physical examinations are improved. Conclusions: We improved the patient who had thoraco-lumbar junction and lumbo-sacral junction transitional zone syndrome by Cox technique and Acupuncture therapy, and we found that thoraco-lumbar junction related lumbo-sacral junction.

• Proceedings of the KSME Conference
• /
• 2008.11a
• /
• pp.664-667
• /
• 2008

Since the advent of pedicle screw fixation system, posterior spinal fusion has markedly increased This intemal fixation system has been reported to enhance the fusion rates, thereby becoming very popular procedure in posterior spinal arthrodesis. Although some previous studies have shown the complications of spinal instruments removal, i.e. loss of correction and spinal collapse in scoliosis or long spine fusion patients, there has been no study describing the benefit or complications in lumbar spinal fusion surgery of one or two level. In order to clarify the effect of removal of instruments on mechanical motion profile, we simulated a finite element model of instrumented posterolateral fused lumbar spine model, and investigated the change of mechanical motion profiles after the removal of instrumentation.

• Proceedings of the Materials Research Society of Korea Conference
• /
• 2009.11a
• /
• pp.6.1-6.1
• /
• 2009

신경외과는 뇌수술과 척추수술로 나눈다. 이중뇌수술 분야에서는 두개강내압 항진시 감압술이라고 '머리의 뚜껑을 연다'라는 표현과 마찬가지로 두개골의 일부분(손바닥크기)을 절제하는 수술이 있다. 이때 과거에는 떼어낸 뼈를 복부의 피하지방밑에 심어서 보관을 하다가 3-6개월 후 환자의 뇌상태가 안정이 되면 다시 꺼내어 제자리에 놓았는데, 골편이 피하지방에서 녹는 경우가 다소 있고, 복부에 이식한 장소가염증이 생기는 경우도 있어서 요즘은 냉동고에서 -70도를 유지하여 보관 후 나중이 복원 수술을 할 때녹여서 사용한다. 이를 '자가골 두개성형술' 이라 한다. 하지만골편의 오염이나 소실 혹은 1차 두개성형술 후 감염 등 어쩔 수 없이 자가골을 사용 못하는 경우에는인공으로 두개골편 모형을 제작하여 '뚜껑'으로 사용해야 한다. 현재PMMA를 이용하여 수술 시 모형을 제작하는 방법이 많이 사용되며 최근 단단한 스펀지 형태의 인공제품이 사용되고 있으나 가격이 매우비싸지만 스펀지 기공내로 자가골이 자란다는 장점이 있다. 척추수술 분야에서는 뼈 대치품을 비교적 많이필요로 한다. 즉 척추 후방고정을 하는 경우 원래 수술의 목적인 감압술이나 교정술 등을 한 후 척추분절간 쇠(티타늄사용)고정을 한 뒤에 뼈조직(자가골이나 동종이식골, DBM, HA stick) 등을 충분히 사용하여덮어줌으로써 분절간 골유합을 유도할 때 많은 양이 필요하며, 척추 전방으로 수술을 하는 경우에도 디스크공간이 빈 상태에서 Cage(추체와 추체를 지지하는 작은 상자모양) 내에뼈조직을 넣어서 척추분절간 골유합이 일어나도록 한다. 최근 HA를 cage 대용품으로 사용한 경우에서 HA가 부서지는 경우가 기사화된바 있다. 또한 경추의 추체 내에 작은 구멍만 뚫고 디스크 수술을 한 후에 그 구멍에 HA+B-TCP 소재를 넣어 천연뼈의 성장 유도를 위해 사용되는 등 신경외과의 다양한 분야에서 생체소재들이 사용되고 있다.

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