• Title/Summary/Keyword: Ankylosing Spondylitis

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The Incidence and Management of Dural Tears and Cerebrospinal Fluid Leakage during Corrective Osteotomy for Ankylosing Spondylitis with Kyphotic Deformity

  • Jo, Dae-Jean;Kim, Ki-Tack;Lee, Sang-Hun;Cho, Myung-Guk;Seo, Eun-Min
    • Journal of Korean Neurosurgical Society
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    • v.58 no.1
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    • pp.60-64
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    • 2015
  • Objective : To present the incidence and management of dural tears and cerebrospinal fluid leakage during corrective osteotomy [Pedicle Subtraction Osteotomy (PSO) or Smith-Petersen Osteotomy (SPO)] for ankylosing spondylitis with kyphotic deformity. Methods : A retrospective study was performed for ankylosing spondylitis patients with fixed sagittal imbalance, who had undergone corrective osteotomy (PSO or SPO) at lumbar level. 87 patients were included in this study. 55 patients underwent PSO, 32 patients underwent SPO. The mean age of the patients at the time of surgery was 41.7 years (21-70 years). Of the 87 patients, 15 patients had intraoperative dural tears. Results : The overall incidence of dural tears was 17.2%. The incidence of dural tears during PSO was 20.0%, SPO was 12.5%. There was significant difference in the incidence of dural tears based on surgical procedures ( PSO vs. SPO) (p<0.05). The dural tears ranged in size from 12 to $221mm^2$. A nine of 15 patients had the relatively small dural tears, underwent direct repair via watertight closure. The remaining 6 patients had the large dural tears, consequently direct repair was impossible. The large dural tears were repaired with an on-lay graft of muscle, fascia or fat harvested from the adjacent operation site. All patients had a successful repair with no patient requiring reoperation for the cerebrospinal fluid leak. Conclusion : The overall incidence of dural tears during PSO or SPO for ankylosing spondylitis with kyphotic deformity was 17.2%. The risk factor of dural tears was complexity of surgery. All dural tears were repaired primarily using direct suture, muscle, fascia or fat graft.

Development and Examination of the Online and Offline Educational Programs for Ankylosing Spondylitis Patients (강직성 척추염 환자의 오프라인 교육과 온라인 교육 프로그램 개발 및 효과 검증)

  • Lee, In-Ok;Lee, Eun-Ok
    • Journal of muscle and joint health
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    • v.10 no.2
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    • pp.167-187
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    • 2003
  • Ankylosing spondylitis(AS) is one of the most common forms of chronic arthritis causing pain and progressive disability. The purposes of this study were 1) to develop an offline educational program and online educational program for the patients with ankylosing spondylitis; and 2) to test the effectiveness of each program in terms of changes in ankylosing spondylitis self-efficacy, exercise continuity disease activity, physical functioning, and depression. The convenient samples for three groups were selected acceding to the inclusion criteria. Online education group consists of 7 patients, and 14 patients were included for the offline group, while 12 patients were assigned to the control group. Outcomes variables included self efficacy, exercise continuity, disease activity, physical function, and depression and the reliability of each measure was ranged from .88 to .95 in the present study. The offline educational program demonstrated positive effects on self-efficacy, exercise continuity, disease activity, and depression, whereas the online educational program on exercise continuity, disease activity, and depression. The self-efficacy was showed positive effect only in the offline educational program, whereas physical functioning did not improve in both intervention groups. These partial improvements may be due to the small sample size and the methods of online education program. In conclusion, the effectiveness of the offline and online educational programs was partially supported in the present study. For the improvement of these programs, the further study would be necessary to apply this kind of intervention program with larger sample and to test the psychometric of the newly development tools.

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The Influence of Disease Activity and Uncertainty on Anxiety and Depression in Patients with Ankylosing Spondylitis (강직성 척추염 환자의 질병활성도와 불확실성이 불안과 우울에 미치는 영향)

  • Lim, Jong-Mi;Cho, Ok-Hee
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.24 no.1
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    • pp.61-68
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    • 2017
  • Purpose: The purpose of this study was to understand how disease activity and uncertainty influence anxiety and depression in patients with ankylosing spondylitis Methods: Participants were 125 patients with ankylosing spondylitis who had attended the rheumatology division of a university hospital. A structured questionnaire was used to assess disease activity, uncertainty, anxiety, and depression. The data gathered were analyzed using t-tests, ANOVAs, Pearson correlation coefficients, and a multiple regression. Results: Differences were observed in anxiety based on job status, and in depression based on age, marriage, and job status. Uncertainty and disease activity predicted patients' anxiety and explained 40% of the variance in this measure, and the relative influence of uncertainty (${\beta}=.38$, p<.001) was larger than that of disease activity (${\beta}=.30$, p<.001). Furthermore, uncertainty and disease activity predicted depression and explained 36% of the variance therein, and the relative influence of uncertainty (${\beta}=.27$, p=.002) and disease activity (${\beta}=.27$, p=.003) was similar. Conclusion: This study confirmed that disease activity and uncertainty influenced anxiety and depression in patients with ankylosing spondylitis. Therefore, efforts to decrease anxiety and depression in patients with this condition must take into consideration disease activity when implementing nursing interventions and should include strategies to lower uncertainty.

A Clinical Report on the Case of Bilateral Sacroilitis with Synovitis in Rt. Hip Joint Caused by Ankylosing Spondylitis, treated by Conservative Korean Medical Treatment Including Hip Joint MST(Motion Style Treatment) (강직성 척추염으로 인한 천장관절염 및 고관절 윤활막염 환자를 대상으로 시행한 고관절 MST 및 한방 보존적 치료 치험 1례)

  • Kim, Hee-Jung;Bae, Sang-Eun;Lee, Seung-Yeol;Jung, You-Hwa
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.9 no.2
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    • pp.125-132
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    • 2014
  • Objectives : The Purpose of this study is to investigate the clinical application of conservative Korean treatment including hip joint MST for Bilateral Sacroillitis with Synovitis in Rt. Hip Joint Caused by Ankylosing Spondylitis. Methods : Patient is hospitalized at Dept. of Korean Internal Medicine, Jaseng Korean Medicine Hospital, diagnosed as Bilateral Sacroilitis with Synovitis in Rt. Hip Joint Caused by Ankylosing Spondylitis, and treated by herbal medicine, acupuncture, moxibustion, and hip joint MST. This study was measured by NRS(Numeric Rating Scale), SLRT(Straight leg raising test), Patrick test, and Blood test(ESR, CRP). Result : After conservative treatment, the patient's pain was controlled and NRS score was decreased. SLRT score also improved. Patrick test unchanged. ESR, CRP score was decreased. Conclusion : As seen in this one case, conservative Korean treatment including hip joint MST has a positive effect to control pain with Bilateral Sacroillitis with Synovitis in Rt. Hip Joint Caused by Ankylosing Spondylitis.

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Clinical Significance of Bone Scan with $^{99m}Tc-MDP$ in Ankylosing Spondylitis (강직성 척추염에서 $^{99m}Tc-MDP$ 골스캔의 임상적 의의)

  • Kim, Deog-Yoon;Kim, Sang-Eun;Lee, Dong-Soo;Chung, June-Key;Lee, Myung-Chul;Cho, Bo-Youn;Koh, Chang-Soon;Kang, Heung-Sik
    • The Korean Journal of Nuclear Medicine
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    • v.25 no.1
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    • pp.87-94
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    • 1991
  • To evaluate the diagnostic usefulness of quantitative sacroiliac joint scintigraphy and its clinical significance in the ankylosing spondylitis, we measured SIS ratio (Sacroiliac Joint/Sacrum Uptake ratio) by region of interest method in 52 patients with ankylosing spondylitis. As compared with radiological grade, SIS ratio was significantly elevated in the early stage of ankylosing spondylitis and returned to normal range in the late stage. Scintigraphic finding of focal uptakes of radiotracer at multiple spinal apophyseal joints was characteristic and proximal large joints were more involved than distal joints. The incidence and extent of the arthropathy revealed by scnitigraphy exceeded that which was clinically evident, and scintigraphy was more sensitive to detect symptomatic lesion than radiography. Therefore, it is suggested that bone scan is useful for the early diagnosis and the assessment of clinical activity of involved joints of ankylosing spondylitis.

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Effect of Disease-Specific Exercise on Temporomandibular Joint Function and Neck Mobility in Temporomandibular Joint Dysfunction Associated With Ankylosing Spondylitis (강직성척추염과 관계된 측두하악관절장애에 대한 특수 운동치료의 효과)

  • Oh, Duck-Won;Jeon, Hye-Seon;Kwon, Oh-Yun;You, Sung-Hyun;Park, Si-Bok;Hwang, Kyung-Gyun
    • Physical Therapy Korea
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    • v.15 no.1
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    • pp.61-68
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    • 2008
  • The aim of the study was to evaluate the effect of a disease-specific exercise (DSE) on temporomandibular joint (TMJ) function and neck mobility in TMJ dysfunction associated with ankylosing spondylitis (AS). Ten AS patients (seven males and three females) with TMJ dysfunction were recruited for this study. The DSE included exercises to correct head and neck posture and to improve the flexibility of the neck and TMJs. The patients attended treatment three times a week for 4 weeks, averaging 1 hour each session. Assessments were performed pretreatment, posttreatment, and 6 weeks after the completion of treatment. General physical status was assessed by four clinical measures (tragus-to-wall distance, modified Schober test, lumbar side flexion, and intermalleolar distance), the Bath ankylosing spondylitis function index (BASFI), and the Bath ankylosing spondylitis disease activity index. The main outcome measures included TMJ function (craniomandibular index (CMI)), and neck mobility (flexion, extension, rotation, and lateral rotation). None of the measures of general physical status, with the exception of BASFI, were significant1y different between the pretreatment, posttreatment, and 6-week follow-up (p>.05). However, CMI and all neck movements, except for extension, significant1y improved after the treatment (p<.05). These improvements were maintained during the follow-up period. The DSE used in the present study seems to be a clinical1y useful method for managing patients with symptoms from the stomatognathic system in AS. Further studies with more subjects and longer treatment times, including the follow-up period, will be conducted to validate these findings.

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A Prediction Model of Exercise Level in Patients with Ankylosing Spondylitis (강직성 척추염 환자의 운동정도 예측모형)

  • Kim, Moon Ja;Lee, Eun Nam
    • Journal of Korean Academy of Nursing
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    • v.52 no.2
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    • pp.157-172
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    • 2022
  • Purpose: This study aimed to construct and test a hypothetical model to explain the predictive factors and causal pathways for exercise levels in patients with ankylosing spondylitis based on the self-determination theory. A conceptual framework was constructed assuming that autonomy support by health care providers would satisfy the three basic psychological needs of patients, which would increase their autonomous motivation for exercise, resulting in its initiation and continuation. Methods: This cross-sectional study included 221 patients with ankylosing spondylitis who were visiting rheumatology clinics in two tertiary hospitals. Health Care Climate Questionnaire-exercise regularly, Basic Psychological Needs Satisfaction scale, Behavior Regulation in Exercise Questionnaire-2, and exercise level were used to collect data. Results: The fitness of the hypothetical model met the recommended level (𝛘2/df ≤ 3, SRMR ≤ .08, RMSEA ≤ .08, GFI ≥ .90, AGFI ≥ .85, NFI ≥ .90, TLI ≥ .90, CFI ≥ .90). The model effect analysis revealed that autonomy support by health care providers had a positive effect on patients' autonomy, competence, relatedness, autonomous motivation, and exercise level. Competence and relatedness had positive effects on autonomous motivation and exercise level, respectively. Autonomous motivation had a positive effect on exercise level. Conclusion: The predictive factors of exercise level in patients with ankylosing spondylitis were autonomous motivation, health care providers' autonomy support, competence, and relatedness. Considering these factors, we recommend the development of an effective program for improving exercise levels in these patients.

A Case Report of Chengsim Yeunja-Tang for Ankylosing Spondylitis associated with Severe Ulcerative Colitis (청심연자탕(淸心蓮子湯)으로 치료하여 호전된 강직성 척추염을 동반한 중증 궤양성 대장염 1례)

  • Jang, Hae-Jin;Sun, Joong-Ki;Sun, Teh-Cheng
    • The Journal of Internal Korean Medicine
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    • v.26 no.3
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    • pp.685-691
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    • 2005
  • A 33 year-old male who had been diagnosed with severe ulcerative and ankylosing spondylitis was treated and observed. Even though he had been treated with western medicine, he still complained of severe diarrhia, hemafecia, abdominal pain, general weakness, mild fever($37.8^{\circ}C$) and lower back pain. On radiologic examination, the lumbar view revealed the sacroliac joint space are irregular with adjacent bony sclerosis on both sides. He was treated with Chengsim Yeunja-Tang. Having been treated for 99 days, severity of ulcerative colitis changed from severe to mild ade, lower back pain reduced from nine to three, and all other symptoms improved.

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Surgical Experience of Neglected Lower Cervical Spine Fracture in Patient with Ankylosing Spondylitis

  • Jo, Dae-Jean;Kim, Sung-Min;Kim, Ki-Tack;Sea, Eun-Min
    • Journal of Korean Neurosurgical Society
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    • v.48 no.1
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    • pp.66-69
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    • 2010
  • The management of lower cervical fractures in patients with ankylosing spondylitis (AS) differs from normal cervical fractures. Patients with AS are highly susceptible to extensive neurologic injuries and spinal deformities after cervical fractures from even minor traumatic forces. These injuries are uniquely complex, require careful imaging assessment, and aggressive surgical management to optimize spinal stability and functional outcomes.

A Case of Bilateral Ankylosis of Temporomandibular Joint Secondary to Ankylosing Spondylitis (강직성 척추염에서 발생한 양측 측두하악관절 강직)

  • Suh, Bong-Jik;Lee, Jeong-Yeon
    • Journal of Oral Medicine and Pain
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    • v.24 no.2
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    • pp.117-122
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    • 1999
  • The author experienced a diagnosis of bilateral ankylosis of temporomandibular joint secondary to ankylosing spondylitis based on comprehensive data obtained from (1) clinical examination and (2) radiologic findings of irregular bone formation between articular fossa of temporal bone and mandibular condyle, narrowing and partial obscuring of the temporomandibular joint space in Korean male of 30-year-old.

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