• Journal of Acupuncture Research
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• 제17권4호
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• pp.79-87
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• 2000

Objectives : To evaluate the findings useful for differential diagnosis and associated abnormaiities of isthmic spondylolisthesis and degenerative spondylolisthesis on CT. Materials and methods : We reviewed retrospectively the CT images of 65 patients who were diagnosed spondylolisthesis during 3 years period. Our technique was 5mm slices at 5mm intervals with gantry angle to parallel the interspaces. Also reformatted sagittal views were taken. 41 patients were isthmic spondylolisthesis and 24 patients were degenerative spondylolisthesis. Resuits : Isthmic spondylolisthesis. 1. Isthmic type was more common at L5-S1. 2. The degree of anterior displacement was grade I and II. 3. The plane of defect was more horizontal than the usual facet joint. 4. The defect had an irregular shape. 5. Medial aspect of bone just anterior to defect had a small round prominence. 6. Anteroposterior elongation of the spinal canal was common. 7. Pseudobulging disk was common. 8. The most common associated abnormality was a HNP at the upper level of the defect. Degenerative spondylolisthesis. 1. Degenerative type was more common at L4-5. 2. The degree of anterior disptacement was grade I and II. 3. The Plane of facet joint was oriented obliquely instead of horizontally. 4. The posterior facet(inferior facet of superior vertebra) was anteriorly displaced. 5. Bony spur of the posterior portion of anterior facet was seen. 6. The facet joints often contain gas(vaccum phenomenum). 7. The most common associated abnormality was a HNP at the level of the displacement. Conclusions : CT is a highly accurate and most sensitive technique for recognition, differential diagnosis of isthmic and degenerative types and the detection of associated abnormalities.

• Journal of Korean Neurosurgical Society
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• 제30권12호
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• pp.1388-1393
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• 2001

Objective : In the retrospective analyzing 19 consecutive patients with subaxial cervical spine(C3~T1) injury treated by posterior cervical fixation and fusion, clinical manifestation, radiologic finding, operative technique, and postoperative results following 6 months were analyzed. Materials and Methods : Most common fracture level was C4-5, mean age 41, and male to female ratio 13 : 6. The most common cause of injury was motor vehicle accident(17 cases). In 19 cervical procedures, interspinous triple wiring was done in 14 cases, lateral mass plating in 5 cases, and additional anterior fusion in 2 cases. Results : Twelve weeks after operation, all cases were reviewed by plain cervical radiogram. In 17 cases that treated by posterior fusion only, 14 cases(81%) had kyphotic angle change less than $5^{\circ}$, 2 cases(12%) $5-20^{\circ}$, and 1 case(6%) more than $20^{\circ}$. Overall fusion rate was 88%, and there was no significant difference of bone fusion rate between autogenous bone graft and allogenous bone graft. Conclusion : In the case of severe posterior column injury or displacement, posterior approach seems superior to anterior approach, but in the case of combined anterior column injury, anterior approach is considered necessary. In this study, posterior fixation and fusion might be acceptable procedure for subaxial cervical fracture and dislocation, owing to its high fusion rate, low kyphotic angulation and low operation related complication rate.

• 한국운동역학회지
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• 제19권3호
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• pp.557-566
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• 2009

본 연구에서 KPGA소속 프로골퍼 5명, KLPGA소속 프로골퍼 5명 총 10명을 대상으로 골프 드라이브 스윙시 내측광근, 외측광근, 전경골근, 비복근의 근전도 분석을 통하여 운동역학적 요인을 비교분석하였으며, 그 결과 다음과 같은 결론을 얻었다. 성별에 따른 근 활동전위 차이는 어드레스부터 백스윙탑까지 구간에서 남성의 오른쪽 비복근이 가장 높게 나타났고, 백스윙탑에서 임팩트까지 구간에서 여성의 오른쪽 전경골근이 가장 높게 나타났으며, 모든 구간과 국면에서 남성의 경우 왼쪽 하지근이 주동근이었고, 여성의 경우 오른쪽 하지근이 주동근으로 나타났으며, 통계적으로 유의한 차이가 있는 것으로 나타났다. 남자의 경우 백스윙탑에서 임팩트 구간까지 체중을 이동시키면서 왼쪽 전경골근이 주동근으로 활동하는 것으로 판단되며, 여성의 경우 오른쪽 무릎을 왼쪽 무릎 쪽으로 밀어주는 동작에서 오른쪽 외측광근과 전경골근이 주동근으로 나타났다. 따라서 남성의 경우 왼쪽 외측광근과 전경골근을, 여성의 경우 오른쪽 외측광근과 전경골근을 발달시킬 수 있는 트레이닝을 수행한다면 비거리와 방향성을 향상시킬 수 있을 것으로 판단된다.

• Clinics in Shoulder and Elbow
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• 제10권1호
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• pp.33-41
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• 2007

목적: 이 논문의 목적은 다방향견관절 불안정증의 수술적 치료에 있어서 내측 전하방 관절낭 이동술의 유용성을 알아보고자 함이다. 대상 및 방법: 1998년 3월부터 2003년 12월까지 내측 전하방 관절낭 이동술을 시행한 19명의 환자를 대상으로 하였다. 이들 중 15례에서는 반복적인 탈구를 경험하였으며, 양측성 견관절에서만 이완을 보인 경우가 8례(42.0%), 견관절을 포함한 전신 인대 이완은 11례(58%)였으며 수의성 아탈구가 2례(10.5%)가 있었다. 평균 추시 기간은 24개월이었다(범위: 9-32 개월) 결과: 19례중 18례에서 통증이 호전되었으며, 평균 10도 정도의 외회전 감소가 있었으나 일상생활에 제한은 없었다. 술 후 모든 예에서 재탈구나 아탈구는 없었으나 2례에서는 스포츠 활동에서 불안감을 호소하였다. Rowe점수에서 모든 환자에서 최우수 또는 우수로 나타났으며 혈종 1례 및 가벼운 국소 피부 감염이 1례에서 있었으나 추후 모두 치료되었다. 결론: 다방향 견관절 불안정증에서 내측 전하방 관절낭 이동술은 통증감소, 환자의 만족도 및 견관절 안정성에 있어 만족스러운 결과를 나타냈다. Hill-Sachs병변 및 Bankart병변이 일부 있었으나 만족스러운 결과를 보였다.

• Journal of Korean Neurosurgical Society
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• 제29권1호
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• pp.58-65
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• 2000

Objective : Thoracolumbar junction is second most common level of injury next to cervical spine. The object of this study is to study the usefulness of surgical titanium mesh instead of bone graft, as well as to evaluate the correction of spinal deformity and safety of early ambulation in patients with injury at thoracolumbar junction. Patients and Methods : This review included 51 patients who were operated from July 1994 to December 1997. The injured spine is considered to be unstable, if it shows involvement of two or more columns, translatory displacement more than 3.5mm, decrease more than 35% in height of vertebral body and progression of malalignment in serial X-ray. The decision to operate was determined by (1) compression of spinal cord or cauda eguina, (2) unstable fracture, (3) malalignment and (4) fracture dislocation. The procedure consisted of anterior decompression through corpectomy and internal fixation with anterior instrument and surgical titanium mesh which was impacted with gathered bone chip from corpectomy. Results : Fifty-one patients were followed up for at least 12 months. The main causes of injury were fall and vehicle accident. The twelfth thoracic and the first and the second lumbar vertebrae were frequently involved. Complete neural decompression was possible under direct vision in all cases. Kyphotic angulation occurred in a patient. Radiologic evaluation showed correction of deformity and no distortion or loosening of surgical titanium mesh with satisfactory fixation postoperatively. Conclusions : We could obtain neurological improvement, relief of pain, immediate stabilization and early return to normal activities postoperatively. Based on these results, authors recommend anterior decompression and internal fixation with surgical titanium mesh in thoracolumbar unstable spine injuries.

• Clinics in Shoulder and Elbow
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• 제12권1호
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• pp.102-108
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• 2009

목적: 견관절 전방 불안정성에서 골 결손에 동반되면 관절경 하 재건술에서 실패 요인이 될 수 있다. 외상성으로 발생하는 견관절 불안정성의 치료에서 관절와의 골 결손과 상완골 두의 골 결손에 대한 관절경 술식을 이용한 해결방법에 대하여 알아보고자 하였으며, 골 결손이 동반된 견관절 전방 불안정성에서 관절경 재건술의 수술 술기에 대하여 고찰하는 것이 이 논문의 목적이다. 대상 및 방법: 견관절 전방 불안정성에서 최근 발표된 논문을 분석하여 관절경적 수술방법에 대하여 고찰하였고, 재발의 원인으로 간주되는 전하방 관절와의 골 결손과 후외방 견관절 두의 골 결손에 대한 관절경 수술 방법에 대하여 논문 고찰과 저자의 방법을 비교하였다. 결과: 전방 불안정성에서 발생하는 골 결손에는 관절와의 전하방 골 결손과 Hill-Sachs 병소가 있다. 이러한 골 결손은 현재까지 견관절 불안정성에서 관절경적인 수술의 실패의 원인이다. 결론: 의미 있는 관절와의 골 결손과 상완골 두의 골 결손을 가진 견관절 불안정성에 대하여 가장 좋은 치료방법은 개방적 수술이라고 할 수 있으나, 관절경적인 접근법으로 개방적 수술의 단점을 극복하기 위한 노력이 주목되고 있다.

• 대한정형외과 초음파학회지
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• 제8권1호
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• pp.31-37
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• 2015

이두건 장두(long head of biceps tendon)의 병변은 견관절의 전방부 통증의 여러 원인 중에 하나에 해당한다. 이두구의 형태에 대한 해부학적인 연구에 따르면, 폭, 깊이, 내측벽 각(medial wall angle)의 의미를 제시하였다. 이두건 장두 자체의 영상 소견 및 위치를 확인함으로써 진단에 도움을 받을 수 있다.

• Journal of Yeungnam Medical Science
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• 제19권2호
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• pp.73-91
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• 2002

Method of management of the spine injury should be determined, based on the status of neurological injury as well as on the presence of traumatic instability. At the thoracic and lumbar spine, patterns of neurological injury are different from the cervical spine due to their neuro-anatomical characteristics. Especially, at the thoracolumbar junction, neurological injury patterns with their respective prognosis vary from the complete cord injury or conus medullaris syndrome to the cauda equina syndrome according to the injury level. The concept of Holdsworth's instability based on the posterior ligament complex theory has evolved into the current 3-column theory of Denis. Flexion-rotation injury and fracture-dislocation are well known to be unstable that surgical fixation is frequently needed for these injuries. However, there have been some controversies for the stability of burst fractures and their treatment, such as indirect or direct decompression and anterior or posterior approach. In this article, current concepts and management of traumatic instabilities at the thoracic and lumbar spine have been reviewed and summarized.

• 대한기관식도과학회지
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• 제7권1호
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• pp.76-79
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• 2001

A 60-year-old male was admitted due to cervical spine injury (C7-T1 fracture dislocation) and quadriparesis after slip down. During conservative management in department of neurologic surgery, he complainted of fever, dyspnea, neck swelling. Follow up cervicothoracic CT revealed abscess pocket in paraglottic, retropharyngeal, anterior cervical spaces and mediastinum. Also noted bilateral pleural effusions. Under impression of descending necrotizing mediastinitis (DNM). cervical drainage and bilateral chest tube insertion was performed immediately. On next day. mediastinal drainage through mediastinotomy was performed with careful handling of cervical spine. Escherichia coli was identified in bacteriologic culture. Wire fixation of dislocated C7-T1 spine through Posterior approach was performed on 30th days after mediastinotomy. Right chest tube was removed on 40th days. At now, the patient is on rehabilitation and physical training program. DNM is relatively rare, but lethal disease with high mortality. Immedate and sufficient mediastinal drainage is essential in treatment.

• Clinics in Shoulder and Elbow
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• 제24권3호
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• pp.178-182
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• 2021

A 50-year-old woman who had been previously diagnosed with systemic lupus erythematosus consulted our clinic for pain and weakness in her right shoulder. On examination, she had an atrophied deltoid muscle, a painful right shoulder on movement, and a tender mass in the deltoid area. The patient was diagnosed with corticosteroid-induced deltoid myopathy, shoulder pain, and loss of range of motion that did not resolve with conservative treatment. We decided to perform reverse shoulder arthroplasty. No complications were observed at the last follow-up visit at 3 years postoperative. Unlike deltoid insufficiency that results from axillary nerve injury, deltoid myopathy due to corticosteroid use contains intact fibers,. Therefore, we increased the effectivity of the remaining deltoid fibers by extending the moment arm of the anterior fibers using reverse shoulder arthroplasty and achieved reliable improvements in clinical symptoms and function without increasing the risk of dislocation.