• 제목/요약/키워드: 흉요추

검색결과 72건 처리시간 0.036초

흉(胸).요추압박골절(腰椎壓迫骨折)에 대한 봉약침(蜂藥鍼) 복합치료(複合治療) 효과(效果) (Effect of Bee Venom Acupuncture Complex Therapy of Thoracolumbar Compression Fracture)

  • 양가람;송호섭
    • Journal of Acupuncture Research
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    • 제25권3호
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    • pp.29-39
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    • 2008
  • Methods : We investigated 28 cases of patients with thoracolumbar compression fracture. We divided patients into two groups : We treated one group with complex oriental medical treatment focusing on Bee Venom Acupuncture therapy, and did the other group with complex oriental medical treatment focusing on acupuncture therapy. To investigate the effectiveness of treatment applied for two groups, we used Visual Analog Scale(VAS) and Oswestry Low-back Pain Disability Index(ODI). We compared the VAS score and ODI score of two groups statistically. Results : 1. Female is prominent in distribution of sex, the average age bracket is 70's, and the largest group was Faccidental fall in the distribution of cause. 2. In regard to level of injury, T12 was found to be most prominent, followed in turn by L1, L2. In regard to grade of clinical symptoms, Grade III was most prominent, followed by Grade IV, Grade II. 3. As a result of evaluation by using VAS score and ODI score, treatment score at final was significantly different from that at the baseline in each group. 4. After treatment, Bee Venom acupuncture therapy group showed significant difference on VAS score and ODI score compared with acupuncture therapy group. Conclusions : Bee Venom acupuncture therapy can be available for relieving symptoms related with thoracolumbar compression fracture.

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요둔통 환자에 흉요추이행부 협척혈 병행 치료 효과의 임상적 연구 (The Clinical Study on Effects of Thoracolumbar Junction's Hyeopcheok Points(夾脊穴) for Low Back Pain)

  • 박찬규;김수장;김자영;정선미;민은경;김영일
    • Journal of Acupuncture Research
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    • 제26권1호
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    • pp.15-22
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    • 2009
  • Objectives : This study was performed to evaluate the effects of thoracolumbar junction's Hyeopcheok points(夾脊穴) for low-back pain in the thoracolumbar junction syndrome. Method : 1. Measurement : We investigated 26 patients with low-back pain. The unpleasantness of pain was measured by visual analogue scale(VAS), and the Oswestry low-back pain disability index(ODI). We compared the VAS and ODI scores of the two groups statistically. 2. Intervention : Use Acupuncture and bee venom injection in thoracolumbar junction's Hyeopcheok points that display main tender points. Also, herb medication and physical therapy was used. Results and Conclusion : As a result of treatment, thoracolumbar junction's Hyeopcheok points is very effective for low-back pain. However, more cases are required to oriental medicine in order to prove the availability.

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외부조사 방사선치료 기간 중 총담도 스텐트의 위치 변화가 컸던 사례 (A Bile Duct Cancer Patient Whose Stent Shifted Significantly Over the Course of External Beam Radiotherapy)

  • 윤형근
    • Radiation Oncology Journal
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    • 제29권2호
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    • pp.121-126
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    • 2011
  • 담도암 환자의 방사선치료 기간 중, 총담도에 삽입된 스텐트가 환자 복부의 우측부터 좌측까지 매우 넓은 범위로 움직인 경우를 발견하였다. 환자는 80세 노령의 여자로 흉추가 심한 척추 후만증을 보였고 흉추와 요추 몇 부위들에 압박골절이 있어서 키가 작았고 복부장기들이 아래로 내려와 있었다. 환자는 쇠약하고 야윈 상태였는데 방사선치료 기간 중 매주 컴퓨터단층촬영을 시행하여 비교한 결과 몸의 좌우방향으로 4 cm 이상의 스텐트의 위치 이동을 보였다. 따라서 흉추 후만증이 있으며서 몸이 매우 야윈 담도암 환자의 경우 방사선치료 범위 설정 시에 치료 기간 중 담도나 스텐트가 크게 움직일 가능성을 고려해야 할 것이다.

두 개의 수준을 침범한 후주손상을 동반한 흉요추부 추체 골절의 분류 (Classification of Vertebral Body Fractures with Two-level Posterior Column Injuries of the Thoracolumbar Spine)

  • 고영도;정훈;여성구
    • Journal of Trauma and Injury
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    • 제18권1호
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    • pp.26-32
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    • 2005
  • Purpose: We evaluate the characteristics of vertebral body fractures in two level flexion-distraction injuries of the thoracolumbar spine Methods: The findings of radiographs, computed tomographs, and MRIs of 43 patients with flexion-distraction injuries combined with vertebral body fractures were retrospectively evaluated. We divided the patients with bursting fractures into two groups, the distractive group (posterior vertebral height ratio >1) and the compressive group (vertebral height ratio <1). Results: There were 23 compression fractures and 20 bursting fractures. In bursting fractures, the distractive group had 5 cases, and the compressive group 15 cases. In 24 cases (55.8%), the interspinous distances were widened. The average of the canal encroachment was 4% in the distractive group and 40% in the compressive group. At last follow-up, the average loss of correction was 2.0 degree in compression fractures and 2.7 degree in bursting fractures. Conclusion: The configurations of vertebral body fractures in flexion-distraction injuries of the thoracolumbar spine were varied as to the location of the axis of flexion. Because bursting fractures in flexion-distraction injuries had distractive or compressive features, one should consider that in establishing operative plan.

근에너지기법을 이용한 흉요추부 이중만곡 형태의 특발성 척추 측만증 호전 2례 (Two Cases of Idiopathic Scoliosis with Double Curved Thoracolumbar Spine using Muscle Energy Technique)

  • 이성준;이혁재;이유진
    • 척추신경추나의학회지
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    • 제12권2호
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    • pp.63-71
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    • 2017
  • Objectives : The purpose of this study is to report the effect of muscle energy technique(MET) on idiopathic scoliosis with double curved thoracolumbar spine. Methods : Two patients with idiopathic scoliosis with double curved thoracolumbar spine were treated by MET. To investigate the outcome of the patients' improvement, we observed the standing X-ray of cervical, thoracic, lumbar spine. And Cobb's angle, correctability and visual analog scale(VAS) were used to measure changes during treatment. Results : After treatment, Cobb's angle, correctability and VAS were improved significantly. Conclusions : MET showed significant improvement to idiopathic scoliosis with double curved thoracolumbar spine. There is limitation on this study due to insufficient number of cases. Further research should be followed.

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항과립구 항체 골수스캔을 이용한 다발성 골수종 병변의 평가: 단순골X-선점사 및 골스캔과의 비교 (Bone Marrow Scintigraphy with Antigranulocyte Antibody in Multiple Myeloma: Comparison with Simple Radiography and Bone Scintigraphy)

  • 김동환;이재태;백진호;정진태;현동우;천경아;이영학;손상균;송홍석;이규보
    • 대한핵의학회지
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    • 제32권4호
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    • pp.354-364
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    • 1998
  • 목적: 단순골X-선검사와 골스캔은 다발성 골수종 병변의 조기검출에 많은 제한점을 가진다. 본 연구는 다발성 골수종에서 방사능 표지 항백혈구항체를 이용한 골수스캔의 유용성을 평가하기 위해 실시되었다. 대상 및 방법: 다발성 골수종 환자 22례의 경우 남녀비는 2.1:1이었고 중간연령은 57세였으며, Stage II는 3례, Stage III는 19례였다. 골수스캔은 $^{99m}Tc$으로 표지된 항백혈구 항체를 이용하여 전신상을 촬영하였고, 그 결과를 단순골X-선검사 및 골스캔과 부위별로 비교하였다. 결과: 단순골X-선검사는 14명(64%), 골스캔에서는 11명(50%)의 환자에서 병변을 검출한 반면, 골수스캔에서는 19명(86%)의 환자에서 국소결손병변을 검출하였다. 골수스캔은 Stage II에서는 33%의 환자(1/3)에서 병변을 검출하였고, Stage III에서는 90%의 환자(17/19)에서 병변을 검출하였다. 골수스캔에서 골수확장의 소견은 68% (15/22)에서 관찰되었다. 전체환자 22명에서 124개의 국소결손병변이 단순골X-선 검사, 골스캔, 골수스캔에서 검출되었는데, 단순골X-선검사는 58개 병변을, 골스캔은 40개 병변을 검출한 반면 골수스캔을 통해서는 92개 병변을 검출하였고, 단순골X-선검사나 골스캔에서는 검출하지 못한 국소결손병변을 51개나 더 검출할 수 있었으며, 이는 특히 새로운 흉요추 국소결손병변의 검출에 도움이 되었다. 결론: 골수스캔은 단순골X-선검사나 골스캔보다 높은 검출율을 보였고, 흉요추병변의 검출에 많은 도움을 줄 수 있는 것으로 생각된다. 또한 골수스캔은 진행한 병기에서 더 높은 검출율을 보여주어 골수스캔소견과 임상적 병기간에 상관성을 가지는 것으로 생각된다. 다발성 골수종에서의 골수스캔은 새로운 병변의 검출뿐만 아니라 병기정도의 평가에 도움이 될 것으로 판단된다.

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개에서 발생한 요추 혈관종성수막종 증례 (Lumbar Angiomatous Meningioma in a Dog)

  • 손정민;김보은;정선영;지서연;윤대영;권오경;김대용;최민철;윤정희
    • 한국임상수의학회지
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    • 제31권2호
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    • pp.152-155
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    • 2014
  • 11년령의 중성화된 수컷 Schnauzer 가 후지마비 증상으로 내원하였다. 6개월 전부터 후지의 운동실조를 보이다가 3개월 전부터는 좌측 후지의 불완전마비를 보였으며, 2주 전부터는 양측 후지의 완전마비 증상을 나타내었다. 신경계 검사에서 양측 후지의 완전마비와 자세반사 및 심부통 소실이 확인되었으며, 척수반사는 항진되어 있었고 자발배뇨는 불가능한 상태였다. 흉요추 부위의 MR (0.3 Tesla) 영상 검사가 실시되었다. 척수를 심하게 압박하는 하나의 종괴가 요추 2번 수준에서 확인되었으며, 종괴는 좌측 및 등쪽으로 경질막과 넓게 접하고 있었다. 종괴는 T1 강조 영상에서 척수와 비슷한 신호 강도를 보였으며, T2 강조 영상에서는 고신호를 보였다. 조영 후 T1 강조 영상에서는 고도의 균일한 조영 증강을 보였으며, 경계는 명확하고 "dural tail sign" 을 동반하고 있었다. 이러한 영상학적 특징으로 부터 경질막내 척수외 종양이 고려되었으며, 그 중에서도 수막종이 가장 우선적으로 고려되었다. 좌측 편측후궁절제술 및 등쪽 후궁절제술이 실시되었다. 부분적으로 경질막과 유착되어 있는 하나의 경질막내 종괴가 척수를 압박하고 있는 것이 확인되었고, 종괴는 유착된 경질막 부분과 함께 완전히 제거되었다. 조직병리학적 검사를 통해 혈관종성수막 종으로 진단되었다.

개에서 경추 추간판 탈출증의 비수술적 치료와 수술적 치료의 결과 : 60 증례 (Outcome of Non-surgical and Surgical Treatments in Dogs with Cervical Intervertebral Disc Disease: 60 cases)

  • 성규진;류학현;박성수;강병재;임성준;김용선;이승훈;조성호;김준영;윤정희;김완희;권오경
    • 한국임상수의학회지
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    • 제27권6호
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    • pp.713-717
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    • 2010
  • 추간판 탈출증은 개에서 일반적인 신경학적 질병이다. 수의 신경학 임상에서 흉요추 추간판 탈출증의 비수술적 치료 또는 수술적 치료의 결과는 잘 보고되어 있다. 그러나 경추 추간판 탈출증의 비수술적 치료 또는 수술적 치료의 결과에 대해서는 상대적으로 적게 알려져 있다. 우리의 목적은 경추 추간판 탈출증을 가진 개에서의 수술적 치료와 비수술적 치료후의 결과에 대해 체계적으로 조사하는 것이다. 수술적 치료를 실시한 개의 치료 성공률(100%, 25/25) 이 비수술적 치료를 실시한 개의 치료 성공률(51.4%, 18/35) 에 비해 유의적으로 높았다. 비수술적 치료군에서 치료 성공률과 척수 압박률과는 부정적인 상관관계가 있음을 확인하였다. 본 연구에서는 경추 추간판 탈출증을 가진 개에서의 수술적 치료는 비수술적 치료에 비해 더 효과적이었다. 또한 CT 또는 MRI 상에서 확인된 척수압박의 정도는 비수술적 치료에서 유용한 예후의 지표가 되었다.

흉요추 방출성 압박골절의 Z-plate를 이용한 고정술후 추적검사 결과 (Follow-up Results of Z-plate Fixation in the Thoracolumbar Burst Fracture)

  • 심병수;김근수;이정청
    • Journal of Korean Neurosurgical Society
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    • 제29권6호
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    • pp.763-771
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    • 2000
  • Objectives : Thoracolumbar burst fractures(TBLF) result in not only compressive deformity of vertebral body but also spinal cord compression by bony fragments. Many thoracolumbar burst fractures demand both anterior decompression and intervertebral fusion. Most of spinal surgeons use anterior instrumentation for anteior intervertebral bony fusion. The use of Z-plate has been increased recently, however there has been only a few reports regarding its clinical long-term strength. We studied nineteen patients with TBLF to find out the long-term stability of Z-plate. Methods : We have operated 19 patients from March 1996 to August 1998. They were treated with anterior decompression through either a transthoracic, retroperitoneal extrapleural or retroperitoneal approach. Retropulsed bony fragments were removed completely by corpectomy. Iliac bone graft was used for interbody fusion in all of the cases. They were evaluated by plain X-ray films including flexion and extention lateral films. Cobbs angle was used to evaluate kyphotic and lateral wedging deformity. Results : Burst fractured sites were T11 in two, three T12, nine L1, and five L2. Mean follow-up duration was fifteen months. Preoperative average kyphotic angle was 23.7 degree. Immediate postoperative kyphotic angle was 10.2 degree. Follow-up resluts of average kyphotic angles revealed 14 degrees. Four patients(21%), including two spinal 3-column injury, showed increasement of kyphotic angle more than 5 degree or breakage of intrumentation. Two patients showed the difference of kyphotic angle more than 3 degree. Five patients(26%) revealed lateral wedging deformity more than 3 degrees. Postoperative complications were two meralgia parestheticas, one pulmonary atelectasis and two donor site infections. Four of the eight patients, who initially showed incomplete spinal cord deficits, were nerologically improved by Frankel's grade. Conclusion : Z-plate fixation and iliac bone graft after anterior decompression in thoracolumbar burst fractures is a safe and easy method. Immediate postoperative results revealed excellent correction of posttraumatic kyphosis, but long-term follow-up evalution showed insufficient strength. Therefore we believe that use of Z-plate should be carefully decided, especially in the case of large lumbar fracture or 3-column injury.

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흉요추 압박 골절의 한의학적 치료에 대한 국내 임상 근거 : 체계적 문헌 고찰 (Korean Medicine for Thoracolumbar Compression Fracture in Korean Literature : a Systematic Review)

  • 배지민;김대훈;김재규;이병렬;양기영;김건형
    • Journal of Acupuncture Research
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    • 제32권4호
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    • pp.147-156
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    • 2015
  • Objectives : This study aims to evaluate the effectiveness and safety of Korean medicine for a thoracolumbar compression fracture. Methods : We searched six Korean databases (DBPIA, Korean Studies Information Service System, Oriental Medicine Advanced Searching Integrated System, National Digital Science Library, Research Information Sharing Service, KoreaMed) (up to June 2015) and the Journal of Korean Acupuncture and Moxibustion Society. Unpublished studies were also searched. Clinical research, other than case reports involving less than 10 patients, were eligible. The effectiveness and safety of Korean Medicine was analyzed. The 'Risk of Bias' was assessed using the 'Risk of Bias' assessment tool for non-randomized studies as well as the Cochrane Collaboration's 'Risk of Bias' tool. Results : We found 12 before-after studies (374 patients). There was no randomized trial. All studies combined at least three different types of Korean medicine treatments. The period of treatment varied between less a week and 154 days. All the included studies reported improvements in pain, functional disability related to lower back pain, global assessment, and benefits in the compression ratio of a fractured vertebrae and skin temperature measured by digital infrared thermal imaging in comparison with the baseline. However, all studies had a high risk of bias and three studies reported mild adverse events. Conclusions : There is no randomized trial for the role of Korean medicine for patients with a thoracolumbar compression fracture. The effectiveness and safety of Korean medicine for this population remains unclear. Findings in this review are seriously biased due to observational design and a high risk of bias included in the studies. Future high-quality randomized trials are warranted.