• Title/Summary/Keyword: 척추 수술

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The relationship between lowest bispectral index value and age in high spinal anesthesia (고위 척추마취에서 마취심도감시장치를 이용한 나이에 따른 진정 정도의 비교)

  • Hwang, Byeong-Mun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.5
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    • pp.2322-2328
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    • 2013
  • The aim of this study was to quantify the sedative effects of high spinal anesthesia, according to patient age, by also evaluating respiratory and hemodynamic changes. A prospective study was performed in 60 patients who were electively scheduled for lower limb or lower abdominal surgery. They were allocated into one of 2 groups according to their age: older age (51-80 years) and young age (20-50 years). In all groups, the lowest intraoperative bispectral index (BIS) values significantly lower than preoperative values. Patients in the older age group had significantly lower intraoperative BIS values than younger patients. The sedative effect of high spinal anesthesia is greater in older patients than in young patients, with an increase in respiratory instability. Our study showed a negative correlation between age and lowest BIS value; the lowest BIS value was reduced in older patients.

Regarding the Problem of Clinical Application of New Medical Technology in the Field of Spine Surgery Found through the Case of Intradiscal Electrothermal Therapy (추간판 내열 치료술(Intradiscal Electrothermal Therapy)의 사례를 통해 발견되는 척수 수술 영역 신의료기술의 임상 적용 과정의 문제에 관하여)

  • Hong, Youngki
    • The Journal of the Korea Contents Association
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    • v.22 no.7
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    • pp.652-662
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    • 2022
  • Currently, in the field of spinal surgery around the world, various new technologies have been rapidly developed and applied to patients. The author believes that it is necessary to discuss whether these new technologies are being fully reviewed for efficacy and safety before being applied to patients. To consider this issue, the author analyzed the basic research data and clinical application process of the intradiscal electrothermal therapy, which was developed as a new technology for discogenic pain disease in the 2000s and has been widely used worldwide. As a result, it was found that this procedure has been performed on patients in a state where there is insufficient base research on efficacy and safety. The author judges that this case reveals an essential problem related to the clinical operation of new medical technologies in the field of spine surgery. Therefore, the author believes that in order to minimize the side effects that new medical technology in the field of spinal surgery may have on patients, more full-fledged basic research and higher clinical acceptance standards should be established.

Biomechanical Evaluation of PMMA Injection in Vertebroplasty (척추성형술 시술에서 PMMA주입에 대한 흉추의 생체역학적 평가)

  • 이준형;채수원;이태수;서중근;박정율;김상돈;이관행
    • Journal of Biomedical Engineering Research
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    • v.25 no.1
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    • pp.27-32
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    • 2004
  • In this study, method of PMMA injection is suggested for vertebroplasty in patients with osteoporotic compression fracture. The finite element analysis is used to investigate the vertebroplasty quantitatively. In order to improve previous works with simplified geometry of vertebral body more exact geometry has been constructed from CT image data with 1m thickness. An ideal method of PMMA delivery, with respect to location and amount of injectate, into vertebral body has been suggested based on evaluation of the insert positions and the insert shapes of injected PMMA. It is shown that vertebral body can be compensated most efficiently when PVIMA is highly concentrated on the top-front of trabecular bone of compressed vertebra.

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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Effect of Simultaneous Implementation of Thermal and Massage Therapy on Patients (척추 측만증에 대한 온열-마사지의 동시 적용 효과 : 증례보고)

  • Kim, Yu-Mi;Lee, Kwang-Jae;Yoon, Yong-Soon
    • Journal of Industrial Convergence
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    • v.20 no.1
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    • pp.107-114
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    • 2022
  • Scoliosis is defined as a condition in which the spine curves more than 10 degrees in frontal plane. However, it is complicated because it involves transverse and sagittal components as well as the frontal plane. Curvature can progress to growing children and cause serious problems. Treatments of Scoliosis, including observation, are casting, braces, physical therapy, exercise, and surgery. The goal of scoliosis management is to achieve minimal asymmetry by maintaining low angle values. However, it is difficult for adolescents to receive continuous treatment due to study and lack of time. We report cases of scoliosis that have experienced improvement of Cobb's angle through spinal thermal massage management at home.

Charcot Spinal Arthropathy with Extensive Vertebral Body Destruction and Cerebrospinal Fluid Collection: A Case Report Mimicking Infective Spondylitis (척추체의 광범위한 파괴와 뇌척수액 축적이 동반된 샤르코 척추 관절병증: 감염성 척추염과 유사한 소견을 보이는 증례보고)

  • Cho, Kyu-Jung;Kim, Yeo-Ju;Kim, Young-Tae;Youn, Yung-Hun
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.4
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    • pp.348-353
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    • 2020
  • A 68-year-old man presented with a bed sore with pus discharge on lower back. Radiographs showed extensive destruction of the L4 vertebral body. Magnetic resonance imaging (MRI) showed fluid collection with an enhanced wall at the defect of the L4 vertebral body extending into both psoas muscles. The primary diagnosis was neuropathic spondylopathy, but infective spondylitis was not ruled out. Initially, he was treated with antibiotics for two weeks. A follow-up MRI showed no improvement of the abscess, so surgical exploration was done. Charcot spinal arthropathy resulted in extensive vertebral body destruction that may be similar to infectious spondylitis, particularly in the case with fluid accumulation due to rupture of dura.

Cardiovascular Effects of Free Movement of Abdominal Muscle in Prone Positioning during General Anesthesia (전신마취동안에 복와위시 자유로운 복근 움직임이 심혈관계에 미치는 영향)

  • Kim, Ji-Yoon;Lee, Dong-Won;Seo, Il-Sook;Kim, Sae-Yeon
    • Journal of Yeungnam Medical Science
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    • v.24 no.2
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    • pp.206-215
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    • 2007
  • Background : The prone position is often used for operations involving the spine and provides excellent surgical access. The complications associated with the prone position include ocular and auricular injuries, and musculoskeletal injuries. In particular, the prone position during general anesthesia causes hemodynamic changes. To evaluate the cardiovascular effects of the prone position in surgical patients during general anesthesia, we investigated the effects on hemodynamic change of the prone position with the Jackson spinal surgery table. Materials and Methods : Thirty patients undergoing spine surgery in the prone position were randomly selected. After induction of general anesthesia, intra-arterial and central venous pressures (CVP) were monitored and cardiac output was measured by $NICO^{(R)}$. We measured stroke volume, cardiac index, cardiac output, mean arterial pressure, heart rate, CVP and systemic vascular resistance (SVR) before changing the position. The same measurements were performed after changing to the prone position with the patient on the Jackson spinal surgery table. Results : In the prone position, there was a significant reduction in stroke volume, cardiac index and cardiac output. The heart rate, mean arterial pressure and CVP were also decreased in the prone position but not significantly. However, the SVR was increased significantly. Conclusion : The degree of a reduced cardiac index was less on the Jackson spinal surgery table than other conditions of the prone position. The reduced epidural pressure caused by free abdominal movement may decrease intraoperative blood loss. Therefore, the Jackson spinal surgery table provides a convenient and stable method for maintaining patients in the prone position during spinal surgery.

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Endovascular Management of Iatrogenic Vertebral Artery Pseudoaneurysm: A Case Report (의인성 척추동맥 가성동맥류에 대한 중재적 치료: 증례 보고)

  • Jae Yang Park;Sanghyeon Kim;Myongjin Kang
    • Journal of the Korean Society of Radiology
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    • v.84 no.2
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    • pp.483-488
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    • 2023
  • Iatrogenic injury of the vertebral artery during cervical spine surgery though uncommon is critical. With advances in interventional endovascular techniques, the therapeutic approach for vertebral artery injuries has changed. Nonetheless, an established strategy for their management is lacking. We report a case of pseudoaneurysm due to vertebral artery injury, during cervical spine surgery for a tumor, that was treated successfully with endovascular coiling in a plug-and-patch fashion after triple stenting failed.

Construction and Management of Human Spine Database (인체 척추 정보 데이터베이스 구축 및 관리)

  • Lee, Seungwoo;Seo, Dong Min;Lee, Sang-Ho;Lee, Seung Bock;Lee, Min Ho;Hong, Soon-Chan;Sung, Won-Kyung
    • Proceedings of the Korea Contents Association Conference
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    • 2011.05a
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    • pp.261-262
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    • 2011
  • 고령화는 국가사회적 최상위 현안문제 (National Agenda)의 하나로, 최근 출산률 저하와 수명 연장에 따라 점차 심화되고 있다. 이는 이미 퇴행성 척추 질환 및 관련 수술이 큰 폭으로 증가되는 현상으로 나타나고 있다. 따라서 고령화 사회를 대비하고 노령 인구의 삶의 질 향상을 위해, 노령 척추 질환에 대한 적절한 진단과 치료, 재활에 도움을 줄 수 있는 가상 척추의 개발이 절실히 요구된다. 본 논문에서는 국가문제해경형 연구사업(NAP)의 일환으로 가상 척추의 기반이 될 인체 척추 정보 데이터베이스를 구축하고 관리하는 시스템을 소개한다.

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