• Journal of the Korean Orthopaedic Association
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• v.56 no.4
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• pp.283-293
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• 2021

Degenerative disc disease has traditionally been thought of as low back pain caused by changes in the nucleus pulposus and annulus fibrous, in recent studies, however, changes in the upper and lower endplates cause degeneration of the disc, resulting in mechanical pressure, inflammatory reactions and low back pain. Recently, the bone marrow of the vertebral body-endplate-nucleus pulposus and annulus fibrous were considered as a single unit, and the relationship was explained. Once the endplate is damaged, it eventually aggravates the degeneration of the bone marrow, nucleus pulposus, and annulus fibrosus. In this process, the compression force of the annulus fibrosus increases, and an inflammatory reaction occurs due to inflammatory mediators. Hence, the sinuvertebral nerves and the basivertebral nerves are stimulated to cause back pain. If these changes become chronic, degenerative changes such as Modic changes occur in the bone marrow in the vertebrae. Finally, in the case of degenerative intervertebral disc disease, the bone marrow of the vertebral body-endplate-nucleus pulposus and annulus fibrous need to be considered as a single unit. Therefore, when treating patients with chronic low back pain, it is necessary to consider the changes in the nucleus pulposus and annulus fibrosus and a lesion of the endplate.

• Journal of the Korean Orthopaedic Association
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• v.56 no.5
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• pp.413-418
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• 2021

Purpose: To investigate the effect of facet tropism on the degeneration of facet joint and intervertebral disc in the cervical spine. Materials and Methods: From January 2017 to December 2018, cervical tropism of 100 patients at the C5/6 level was analyzed retrospectively. In computed tomography (CT), the orientation and tropism of the facet joint with respect to the sagittal, coronal, and horizontal planes were measured. Regression of the facet joint in magnetic resonance imaging (MRI) and CT was assessed using a grading system. Intervertebral disc degeneration was assessed and divided into five grades on MRI. For the left and right asymmetry, a difference between two facet angles of less than 7° was classified as the control group, more than 7° was classified as the tropism group. Results: The mean age of the patients was 55.44±12.3 years (31-81 years) in the tropism group and 55.66±10.7 years (32-76 years) in the control group. In the tropism group, 32 were male and 18 were female. In the control group, 24 were male and 26 were female. Facet joint degeneration was identified in 24 patients (48.0%) in the tropism group and 14 patients (28.0%) in the control group, showing a significant difference. Intervertebral disc degeneration was identified in 29 patients (58.0%) in the tropism group and 17 patients (34.0%) in the control group, showing a significant difference. Multivariate revealed, tropism to be a factor that affected the facet joint and intervertebral disc degeneration. Conclusion: Facet joint and intervertebral disc degeneration occurred significantly in the tropism group, and tropism is a factor affecting the degeneration of facet joint and intervertebral disc in the C5/6 level.

• Proceedings of the KSME Conference
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• 2005.11a
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• pp.154.2-154.2
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• 2005

• Journal of the Korean Society of Radiology
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• v.85 no.1
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• pp.54-76
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• 2024

Facet joint arthrosis is a progressive degenerative disease that is frequently associated with other spinal degenerative disorders such as degenerative disc disease or spinal stenosis. Lumbar facet joint arthrosis can induce pain in the proximal lower extremities. However, symptoms and imaging findings of "facet joint syndrome" are not specific as they mimic the pain from herniated discs or nerve root compression. Currently, evidence for therapeutic intra-articular lumbar facet joint injections is still considered low, with a weak recommendation strength. Nevertheless, some studies have reported therapeutic effectiveness of facet joint injections. Moreover, the use of therapeutic facet joint injections in clinical practice has increased. This review article includes opinions based on the authors' experience with facet joint injections. This review primarily aimed to investigate the efficacy of lumbar facet joint injections and consider their associated safety aspects.

• Journal of the Korean Orthopaedic Association
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• v.52 no.1
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• pp.65-72
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• 2017

Purpose: The purpose of this study was to evaluate the radiologic features of juxtafacet cyst and determine the correlation between these features and clinical outcome. Materials and Methods: We analyzed a total of 23 patients. The degree of facet joint degeneration was classified using the Fujiwara method. The facet joint angles were measured with an magnetic resonance imaging to determine whether there was a difference between the cystic lesion that was occupied and the cystic lesion that was not occupied. Disc degeneration was measured by the Pfirrmann classification method. The clinical result was evaluated using the Oswestry disability index score and visual analogue scale. Results: The L4-5 level of juxtafacet cyst was mostly affected, as found in previous studies. Facet joint arthritis was more severe within the side with the cystic lesion. Significant correlation was found between disc degeneration and juxtafacet joint cyst. All patients underwent wide decompression and fusion. Clinical result was excellent. No patients had signs of recurrence during the follow-up periods. Conclusion: Juxtafacet cyst has a significant correlation with facet joint degeneration. Therefore, aggressive surgical treatment-not just simple cyst excision-should be considered as the treatment option for juxtafacet cyst associated with degenerative lumbar disease.

• Composites Research
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• v.34 no.3
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• pp.186-191
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• 2021

The lumbar spinal fusion is a treatment performed to restore the stability of the degenerated lumbar. In this study, the intervertebral discs between two or more segments are removed and a bone graft is inserted to harden the segments. The pedicle screw system is inserted to vertebral bodies to fix two or more segments so that they can be firmly fused. In this study, a total of 7 patient-specific lumbar finite element models were created and pedicle screw systems were installed. The connecting rods made of titanium and CFR-PEEK was inserted to the generated models. Finite element analysis was conducted for four representative spine behaviors and statistical analysis was performed to investigate the biomechanical effects by the material properties of connecting rods. The intradiscal pressure of adjacent segments and the range of motion of the joints of each segment were investigated. In the subjects who used CFR-PEEK instead of Ti for connecting rods, the intradiscal pressure of adjacent segments tend to decrease and the range of motion of each segment tend to increase. However, no statistically significant difference in tendency was observed under all loading conditions.

• Proceedings of the Computational Structural Engineering Institute Conference
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• 2009.04a
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• pp.283-286
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• 2009

척추경 나사못을 이용한 요추 유합술은 가장 보편적으로 사용되어지는 수술적 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. 따라서 본 연구에서는 유한요소해석 방법을 이용하여 척추경 나사못 시술에 따른 척추체의 운동범위 및 인접 분절 추간판의 스트레스 증가량을 계산하였고, 척추경 나사못 모델과 유합 후 나사못 제거에 따른 모델 또 시술하기 전 정상모델과 비교하여 생체 역학적 측면에서 분석하여 척추경 나사못을 이용한 요추 유합술 후, 척추경 나사못의 제거의 임상적 효과와 그 이론적 근거를 제시하고자 한다.

• Journal of the Korean Orthopaedic Association
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• v.54 no.3
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• pp.203-210
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• 2019

The aim of this review was to evaluate minimally invasive lateral lumbar interbody fusion on the latest update. Lumbar interbody fusion was introduced recently. This study performed, a literature review of the indications, clinical outcomes, fusion rate, and complications regarding recently highlighted minimally invasive lateral lumbar interbody fusion. The indications of lateral lumbar interbody fusion are similar to the conventional anterior and posterior interbody fusion in degenerative lumbar diseases. In particular, lateral lumbar interbody fusion is an effective minimally invasive surgery in spinal stenosis, degenerative spondylolisthesis, degenerative adult deformity, degenerative disc disease and adjacent segment disease. In addition, the clinical outcomes and fusion rates of lateral lumbar interbody fusion are similar compared to conventional lumbar fusion. On the other hand, non-specific complications including hip flexor weakness, nerve injury, vascular injury, visceral injury, cage subsidence and pseudohernia have been reported. Lateral lumbar interbody fusion is a very useful minimally invasive surgery because it has advantages over conventional anterior and posterior interbody fusion without many of the disadvantages. Nevertheless, nonspecific complications during lateral lumbar interbody fusion procedure remain a challenge to be improved.

• Journal of the Korean Orthopaedic Association
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• v.56 no.6
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• pp.512-518
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• 2021

Purpose: This study compared the change in foraminal space on magnetic resonance imaging (MRI) and the clinical outcome after anterior cervical discectomy and fusion (ACDF) versus foraminotomy in cervical foraminal stenosis. Materials and Methods: A retrospective case-control study was conducted from January 2018 to March 2019 on 186 patients who underwent ACDF and foraminotomy. One hundred and two cases were selected considering age, sex, and body mass index. MRI was performed before and on the 5^th day after surgery to compare the changes in the foraminal diameter between the ACDF group (group A-51) and foraminotomy group (group B-51). Results: Between groups A and B, the average change in foraminal vertical diameter was 1.7 mm and 1.2 mm, respectively; group A was 0.5 mm larger difference (p=0.042). The average change in foraminal transverse diameter was 1.2 mm and 1.8mm, respectively; group B showed a 0.6 mm larger change (p=0.21). Both the neck disability index (NDI) and Japanese orthopaedic association (JOA) scores improved in both groups. Group A showed more improvement, but there was no significant difference (p=0.356, p=0.607, respectively). Conclusion: Foraminotomy is a useful option for patients with foraminal stenosis of the cervical spine because it showed comparable clinical and morphological results to ACDF and could minimize motion segment loss and muscle and ligament damage.

• Journal of the Korean Society of Radiology
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• v.82 no.6
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• pp.1413-1440
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• 2021

On MRI, abnormal signals of the intervertebral disc, destruction of the upper and lower vertebral body endplate around the disc, and bone marrow edema around the endplate are considered typical findings of infectious spondylitis. These findings can also appear in various non-infectious spinal diseases, such as degenerative changes, acute Schmorl's node, spondyloarthropathy, synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO), chronic recurrent multifocal osteomyelitis, and calcium pyrophosphate dihydrate crystal deposition disease. The imaging findings of infectious spondylitis that can be differentiated from these non-infectious spinal diseases on MRI are high signal intensity and abscess of the disc space, an abscess in the paraspinal soft tissue, and the loss of the linear low signal intensity on T1-weighted images of the bony endplate. However, these differentiation points do not always apply since there are many similarities in the imaging findings of infectious and non-infectious diseases. Therefore, for an accurate diagnosis, it is important to know the imaging characteristics related to the pathophysiology of not only infectious spondylitis but also non-infectious spinal diseases, which requires differentiation from infection.