• Title/Summary/Keyword: 척추 전만

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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.

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 effect of Horseback riding simulat or, Sling and Kendall Exercise on a cranio-vertebral angle and neck pain in Young Adults with Forward Head Posture (승마시뮬레이터, 슬링과 Kendall 운동이 머리전방자세를 가진 젊은 성인의 머리척추각과 목 통증에 미치는 영향)

  • Kim, Hyun-Sung;Park, jae-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.6
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    • pp.468-474
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    • 2020
  • The aim of this study was to compare the effect of a horseback riding simulator, Slings and Kendall Exercise on a cranio-vertebral angle and the neck pain of the Forward Head Posture. This study included 30 young people with forward head posture. They were randomly divided into three groups. Each group performed the exercises for six weeks three times a week from September 2018 to November 2018. The variations of cranio-vertebral angle and neck pain were analyzed using paired t-tests and a one-way ANOVA test. The results of the study are as follows. Three groups showed significant variations of cranio-vertebral angle and neck pain (p < 0.05). But comparison of cranio-vertebral angle and neck pain between the groups showed no significant difference (p > 0.05). This study found that each exercise group for forward head posture was effective for inducing normal cervical alignment and neck pain relief. Therefore, various exercises can improve the forward head posture.

The Effect of 3-D Spine Stabilization Training on Trunk Muscle Strength and Body Composition in Elderly (3차원 척추 안정화 운동이 고령자의 체간 근력 및 신체구성에 미치는 효과)

  • Seo, S.B.;Kim, D.H.;Jung, H.C.
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.9 no.1
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    • pp.45-51
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    • 2015
  • This study was to verify effect on muscle strength of trunk and body composition for elderly according to spinal stability exercise with three dimension. We recruited forty elderly participants(twenties as training group, the other twenties as control group) over sixty five aged. The participant performed muscle strength estimation to exercise of eight direction using spinal stability training system. Also, we estimated body composition in participants using inbody 720. Trining group performed direction exercise(F, FOR, R, BOR, B, BOL, L, FOL) and multiple exercise with band exercise, strengthening gym and walking during thirty minute. But control group only performed multiple exercise without direction exercise. All training progressed three days a week for eight weeks. The results showed that muscle strength of trunk in training group increased significantly from 79.9 point to 85.6 point with reducement of body weight, body fat and BMI. However, control group showed a few exercise effect with increasement of amount of muscles and reducement of body fat without muscle strength of trunk. These results means that spinal stability exercise could be helped to prevent obey and fall of elderly caused by muscle strengthening and improving body composition. This could be applied to develop rehabilitation program efficiently based these data.

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A Case of Thyroid Papillary Cancer with Spinal Metastasis (유두상 갑상선 암의 척추전이 1예)

  • Yang, Suk Min;Chang, Jae Won;Shin, Yoo Seob;Kim, Chul-Ho
    • Korean Journal of Head & Neck Oncology
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    • v.29 no.2
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    • pp.79-82
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    • 2013
  • Thyroid cancer is known as its relatively high cure rate after surgical treatment and spinal metastasis of thyroid cancer is extremely rare as the prevalence is only 2-13%. Spinal metastasis is usually asymptomatic and discovered incidentally in most cases. A 66-year-old man was diagnosed as thyroid papillary cancer with spinal metastasis. We treated the patient by surgery, adjuvant radiotheraphy and radioactive iodine therapy. C6 corpectomy was followed for the residual spinal metastasis by the department of neurosurgery. The patient had no functional complication by the surgical process. At 24 months after surgery, there was no sign of recurrence and the patient led social life without any discomfort. We present this case with a review of the related literatures.

Surgical Treatment of Osteoporotic Vertebral Compression Fractures at Thoraco-Lumbar Levels: Only Pedicle Screw Constructs with Polymethylmethacrylate Augmentation (흉요추부 골다공증성 척추 압박 골절의 수술적 치료: 골시멘트 보강술을 이용한 척추경 나사 고정)

  • Jun, Deuk Soo;Baik, Jong-Min;Park, Ji Hyeon
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.4
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    • pp.327-335
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    • 2019
  • Purpose: To investigate the radiological efficacy of polymethylmethacrylate (PMMA) augmentation of pedicle screw operation in osteoporotic vertebral compression fractures (OVCF) patients. Materials and Methods: Twenty OVCF patients, who underwent only posterior fusion using pedicle screws with PMMA augmentation, were included in the study. The mean follow-up period was 15.6 months. The demographic data, bone mineral density (BMD), fusion segments, number of pedicle screws, and amount of PMMA were reviewed as medical records. To analyze the radiological outcomes, the radiologic parameters were measured as the time serial follow-up (preoperation, immediately postoperation, postoperation 6 weeks, 3, 6 months, and 1 year follow-up). Results: A total of 20 patients were examined (16 females [80.0%]; mean age, 69.1±8.9 years). The average BMD was -2.5±0.9 g/cm2. The average cement volume per vertebral body was 6.3 ml. The mean preoperative Cobb angle of focal kyphosis was 32.7°±7.0° and was improved significantly to 8.7°±6.9° postoperatively (p<0.001), with maintenance of the correction at the serial follow-up, postoperatively. The Cobb angle of instrumented kyphosis, wedge angle, and sagittal index showed similar patterns. In addition, the anterior part of fractured vertebral body height averaged 11.0±5.0 mm and was improved to 18.5±5.7 mm postoperatively (p=0.006), with maintenance of the improvement at the 3-month, 6-month, and 1-year follow-up. Conclusion: The reinforcement of pedicle screws using PMMA augmentation may be a feasible surgical technique for OVCF. Moreover, it appears to be appropriate for improving the focal thoracolumbar/lumbar kyphosis and is maintained well after surgery.

Comparison of the Results of Ultrasound-guided Caudal Epidural Block - Herniated Intervertebral Disc vs Spinal Stenosis - (초음파를 이용한 미추 경막외 차단술의 결과 비교 - 추간판 탈출증과 척추관 협착증 -)

  • Kim, Young-Tae;Cho, Kyu-Jung;Ahn, Chi-Hoon
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.7 no.2
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    • pp.105-112
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    • 2014
  • Purpose: Ultrasound-guided epidural caudal block for low back pain and radiating pain is often performed in the treatment of outpatients. However, this procedure has a failure rate of up to 25% even when it performed by an experienced physician. The authors investigate the effectiveness of Ultrasound-guided epidural caudal block in patients related to disc herniation or spinal stenosis. Materials and Methods: Ultrasound-guided caudal epidural block was performed in 55 outpatients with LBP and radiating pain. Patient was placed in the prone position and sonographic image of sacral hiatus was obtained using linear probe. A 22-gauge needle was advanced into the sacrococcygeal membrane under ultrasound guidance and then medication was injected into the caudal epidural space. There were 31 cases of disc herniation, and 24 cases of spinal stenosis. Patients were evaluated by Visual Analog Scale (VAS) pain score at pre-treatment, post-treatment, 2 weeks and 4 weeks by telephone interviews. Results: 53 of the 55 cases (96.4%) of needle insertion into the sacral canal under ultrasound guidance were successful. Gender was not significantly different between disc herniation group and spinal stenosis group. But there was a significant age difference between disc herniation group ($42.3{\pm}10.8$), and spinal stenosis group ($62.8{\pm}15.1$) [p<0.001]. The VAS score at pre-treatment, post-treatment, 2 weeks, 4 weeks in disc group were 6.84, 3.1, 1.8 & 1.77. The VAS score at pre-treatment, post-treatment, 2 weeks, 4 weeks in spinal stenosis group were 6.88, 3.58, 4.33 & 4.88. The VAS score in both groups was significantly improved after the procedure (p<0.001). Over time, the two groups were statistically significant differences in VAS score after adjusting for age (p<0.001). Conclusion: Ultrasound-guided caudal epidural block seems to provide a high success rate and a significantly better response in disc group than spinal stenosis group.

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Effects of Stretching Time on Head Spine Angle and Muscle Tone (스트레칭 후 시간 경과에 따른 머리척추각과 근긴장도 변화 연구)

  • Ji-Yun Son;Young-Chun Yu;Ji-Yoon Kim;Hee-Won Park;Ji-Hyun Yu;Yu-Gwon Lee;Byeong-Eon Lim;Ji-Myeong Choi;Jae-Hyun Kim
    • Advanced Industrial SCIence
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    • v.2 no.3
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    • pp.15-21
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    • 2023
  • In this study, we wanted to know the change in the craniovertebral angle before and after stretching and muscle tone according to rest time immediately after stretching. 57 students in their 20s and 30s were targeted, and the craniovertebral angle was compared before and after stretching. Static manual stretching was applied for stretching, and after 30 seconds, it was repeated three times with a break time of 10 seconds, and before stretching, immediately after, two minutes after, and five minutes after stretching were measured using muscle tone measuring equipment. As a result, there was no significant difference in craniovertebral angle before and after stretching, and the change in muscle tone according to the rest time after stretching was more significant after 5 minutes than before stretching. It is more effective to take five minutes to rest after stretching, reduce muscle tone than working immediately after stretching.

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.