• Title/Summary/Keyword: Back surgery

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A Case of Eccrine Porocarcinoma on Back (등에 발생한 에크린한공암종의 치험례)

  • Choi, Seok Min;Kim, Cheol Hann;Kang, Sang Gue;Tark, Min Seong;Park, Sang Mo;Jin, So Young
    • Archives of Plastic Surgery
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    • v.35 no.1
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    • pp.100-103
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    • 2008
  • Purpose: Eccrine porocarcinoma is a very rare, potentially fatal tumor which arises from the intraepidermal portion of the eccrine sweat ductal apparatus. It does not have a characteristic clinical feature but does have a high incidence of metastasis. It may be developed de novo or in a preexisting benign eccrine poroma. It usually affects older people and is located most commonly on lower extremities. We report a rare case of eccrine porocarcinoma which developed on the back without metastasis. Methods: The patient was a 94-year-old woman who showed a painful, ulcerated, dark brown colored polypoid $3.5{\times}3.0cm$ sized mass on the back for 3 years. We totally excised the lesion including normal tissue. Results: After wide excision of the lesion, pathologist reported an eccrine porocarcinoma. Histopathologic findings reveal that the classic type of eccrine gland carcinoma, eccrine porocarcinoma. Immunocytochemical studies showed a positive reactivity to anti-EMA antibody and anti-CEA antibody. Conclusion: Authors experienced a rare case of primary eccrine porocarcinoma on the back. Because of the propensity to develop local recurrence, wide excision of the primary tumor with histologic confirmation of negative margins represents the only curative treatment regimen for eccrine porocarcinoma.

Application of Lumbar Artery Perforator Flap for Reconstruction of Back Ulcer: Clinical Study with Computed Tomographic Angiography

  • Cho, Jin-Woo;Kim, Deok-Woo;Kim, Deok-Yeol
    • Archives of Reconstructive Microsurgery
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    • v.22 no.2
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    • pp.43-47
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    • 2013
  • Purpose: Un-healing and centrally located defect on back area, it is sometimes a challenge for the reconstructive surgeon. Although skin grafts are considered as the first choice for reconstruction of large skin defect on the back region, it is not always helpful but vascularized flaps provide a superior functional and aesthetic outcome. The present study was designed to investigate the clinical anatomy of the lumbar artery perforator flap to reconstruct back ulcer. Materials and Methods: Clinical anatomy study was undertaken using computed tomographic angiographic analysis. We identified the courses of lumbar arteries and its perforators, measured pedicle length by layers. The location of the perforator vessel was charted against anatomical landmarks. Results: The pedicle lengths of the third and fourth lumbar artery perforator reached a mean of 27.8 mm and 37.1 mm respectively from superficial fascia to deep fascia. The fourth perforator was more laterally located than the third perforator and less than 1 cm above the iliac crest. A case in which the fourth lumbar artery perforator was used as flap pedicle is described. Conclusion: For the reconstruction of central defect on the back area, the lumbar artery perforator flap coverage may be a good alternative option. Computed tomographic angiography can easily identify the course and location of lumbar artery perforators and can be helpful to elevate the flap successfully.

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Continuous Sutures for Microarterial Anastomosis (미세혈관 수술시 혈관개존율 향상을 위한 연구)

  • Jung, Young-Sik;Jeong, Jae-Ho;Choi, See-Ho;Seul, Jung-Hyun
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.237-241
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    • 1986
  • In clinical microsurgery, limitation of space often prohibits rotation of a double clamp in an end-to-end anastomosis, or shortage of length of the secondary vessel in an end-to-side anastomosis does not allow visualization of the back wall. In these situation, back wall repair is extremely difficult. To overcome this problem, we use continuous suture technique without rotation of double clamp for end-to-end and end-to-side anastomosis of the 40 rat femoral arteries. After continuous sutures for microarterial anastomosis, the following results were obtained: Continuous sutures are useful in anastomosis where there is unavoidable limited access to the posterior wall and for some of the larger vessels now being anastomosed in free flap and other reconstructive surgery.

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A Case Report on HIVD-Cervical Spine Failed Back Surgery Syndrome Applied Chuna Treatment (추나 요법을 적용한 경추 추간판 탈출증 척추 수술 실패 증후군 환자의 경과관찰 1례)

  • Jeong, Si-Yeong;Lee, Jin-Bok
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.6 no.1
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    • pp.105-111
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    • 2011
  • Objects : This study was to report a clinical effect of Chuna Treatment for HIVD-cervical spine Failed Back Surgery Syndrome(FBSS) patient. Methods : In order to alleviate both arm tingling, numbness and neck stiffness, the patient was treated by acupuncture therapy, cervical traction technique of Chuna treatment and conservative managements. To evaluate the effect of the treatment, Recovery rate of Hirabayashi, Verbal Numerical Rating Scale(VNRS) and Neck Disability Index(NDI) score were used. Results : VNRS and NDI were improved and Recovery rate was 100%. Conclusions : Korean Treatment can be effectively used for a patient with HIVD-cervical spine FBSS patient. Further clinical studies are needed to verify the findings.

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A Case Report on Conservative Treatments with Chuna manual therapy on patient who has Failed Back Surgery Syndrome owing to herniated intervertebral lumbar disc with scoliosis (측만이 동반된 요추 추간판 탈출증 수술 실패 증후군 환자에 대한 추나요법 병행치료 증례보고)

  • Ryu, Ho-sun;Kim, Mihye
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.13 no.2
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    • pp.65-73
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    • 2018
  • Objectives : To verify Korean Medicinal Combination Treatments for patients who have Failed Back Surgery Syndrome along with scoliosis Methods : We used Acupuncture, Chuna manual therapy, Pharmacoacupuncture, Herbal medication. We measured Numeral Rating Sacle(NRS), Pain-Free walking distance(PFWD) and Oswestry Disability Index(ODI) score to evaluate the treatment effects. Results : Patients' LBP & Rt.leg pain NRS, PFWD and ODI score were improved. Conclusions : Traditional Korean medicine can be effective for FBSS patients along with scoliosis.

The Effect of Dynamic Lumbar Stabilization Exercise on Low Back Pain Patients (동적 요부 안정화 운동 치료법이 요통 환자에 미치는 영향)

  • Kim, Jong-Soon;Ju, Mu-Yeol;Bae, Sung-Soo
    • The Journal of Korean Physical Therapy
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    • v.13 no.3
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    • pp.495-507
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    • 2001
  • The purpose of this study was to find the effects of the dynamic lumbar stabilization exercise on functional recovery of low back pain patients. The subjects were consisted of sixty patients who had nonspecific subacute low back pain. All subjects randomly assigned to dynamic lumbar stabilization exercise group. Williams exercise group and modalities treatment group. The dynamic lumbar stabilization exercise group received modalities treatment with dynamic lumbar stabilization exercise. Williams exercise group received modalities treatment with Williams flexion exercise and modalities treatment group received modalities treatment without exercise. The Oswestry low back pain disability questionnaire was used to measure disability of low back pain. Assessment was carried out before treatment fur obtain baseline measurement of low back pain and reassessment were carried out at after 20 and 40 treatment sessions. The results of this study were as following: 1. The Oswestry low back pain disability questionnaire scores were significantly decreased after 20th and 40th treatment in dynamic lumber stabilization exercise group(p<.05). 2. The Oswestry low back pain disability questionnaire scores were significantly decreased after 20th and 40th treatment in Williams exercise group(p<.05). 3. The Oswestry low back pain disability questionnaire scores were significantly decreased after 20th and 40th treatment in modalities treatment group(<.05). 4. There were no statistical difference between the 3 groups at pre-treatment with Oswestry low back pain disability questionnaire scores(p>.05). 5. There were no statistical difference between the 3 groups after 20th treatment with Oswestry low back pain disability questionnaire scores(p>.05). 6. There were statistical difference between the 3 groups after 40th treatment with Oswestry low back pain disability questionnaire scores(p<.05). 7. The Oswestry low back pain disability questionnaire scores were significantly decreased after 40th treatment in all 3 groups and the decrement were greater in order of dynamic lumbar stabilization exercise group. Williams exercise group and modalities treatment group.

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The Clinical Study on the Effects of Moxibustion to FBSS(Failed Back Surgery Syndrome) (요추 수술실패증후군 환자에 대한 구법(灸法)의 임상적 연구)

  • Lee, Dong-Hwa;Park, Hee-Soo;Hwang, Jung-Su
    • Journal of Acupuncture Research
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    • v.23 no.3
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    • pp.67-75
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    • 2006
  • Objectives : The purpose of this study is to evaluate the clinical effect of moxibustion treatment for FBSS patients by VAS. Methods : This clinical study was carried out for 51 cases with FBSS, who had been treated from January, 2003 to October, 2005, in oriental medical clinic. The patients were treated by the moxibustion during 8 weeks on the pain region of lower back or legs. We measured the effects of treatment by VAS. SPSS( Statistical Program for Social Science) for Windows was used for statistical analysis and repeated measures ANOVA was performed to gauge the improvement of VAS. Results : 1. We investigated 25 female and 26 male patients. The age distribution was from early 20's to 70's, among which 50's were most common. 2. The worsening factors are usually overwork and heavy lifting, but the main reason is unknown. 3. According to VAS, The patients with FBSS were improved by moxibustion treatment. Conclusion : Through this research, moxibustion therapy is considered to be effective and safe method for FBSS(Failed Back Surgery Syndrome). Moxibustion treatment had some problems that should be overcome such as severe pain and burning. Therefore we should pay more attention.

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THE POSITIONAL RELATIONSHIP BETWEEN THE MANDIBLE AND THE HYOID BONE IN MANDIBULAR PROTRUSION AFTER ORTHOGNATHIC SURGERY EVALUATED WITH 3-D CT (3-D CT를 이용한 악교정술 전후의 하악과 설골의 위치에 관한 연구)

  • Lee, Sang-Han;Nam, Jeong-Hun;Jung, Chang-Wook;Kwon, Tae-Geon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.29 no.3
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    • pp.173-181
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    • 2003
  • Purpose : This study was intended to evaluate the positional relationship between the hyoid bone and the mandible in patients with mandibular protrusion after mandibular set-back surgery by means of 3D-CT. Materials and methods : Preoperative(3 weeks before) and postoperative (6 weeks after) 3D-CT & cephalogram were taken on 32 patients(12 male, 20 female, mean age of 23.2) treated by bilateral sagittal split osteotomy with rigid fixation. The angular measurement on 3D-CT basilar view were deviation of Me & H, long axis angle of left & right cornu majus. The lineal measurement on 3D-CT basilar view were composed of intercondylar line and coordinates(x,y) of Me & H. The angular & lineal measurement of lateral cephalogram were composed of mandibular plane angle, SNA, SNB, ANB, FH-NA & FH-NB, and coordinates(x,y) of B, Pog, Me & H, PAS, Lpw, MPH and IAS. On the frontal cephalogram, deviation of Me were evaluated. Results : The mean mandibular set-back was 8.0mm horizontally and mandibular plane angle was slightly increased. The hyoid bone was displaced postero-inferiorly, the distance between MP(mandibular plane) and H(hyoid bone) was increased and the posterior airway space values (PAS, Lpw, IAS) were decreased. The coordinates Me(x,y), H(x,y) and deviation angle Me'& H' were revealed the strong positive correlation. Conclusion : The results revealed that the horizontal, vertical and transverse relationship of the mandibular and the hyoid bone movements were significantly correlated in patients performed mandibular set-back surgery.