• Title/Summary/Keyword: Compression treatment

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Efficacy of Decompression and Fixation for Metastatic Spinal Cord Compression : Analysis of Factors Prognostic for Survival and Postoperative Ambulation

  • Park, Jin-Hoon;Rhim, Seung-Chul;Jeon, Sang-Ryong
    • Journal of Korean Neurosurgical Society
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    • v.50 no.5
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    • pp.434-440
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    • 2011
  • Objective : The goals of surgical intervention for metastatic spinal cord compression (MSCC) are prolonging survival and improving quality of life. Non-ambulatory paraplegic patients, either at presentation or after treatment, have a much shorter life expectancy than ambulatory patients. We therefore analyzed prognostic factors for survival and postoperative ambulation in patients surgically treated for MSCC. Methods : We assessed 103 patients with surgically treated MSCC who presented with lower extremity weakness between January 2001 and December 2008. Factors prognostic for overall survival (OS) and postoperative ambulation, including surgical method, age, sex, primary tumor site, metastatic spinal site, surgical levels, Tokuhashi score, and treatment with chemo- or radiation therapy, were analyzed retrospectively. Results : Median OS was significantly longer in the postoperatively ambulatory group [11.0 months; 95% confidence interval (CI), 9.29-12.71 months] than in the non-ambulatory group (5.0 months; 95% CI, 1.80-8.20 months) ($p$=0.035). When we compared median OS in patients with high (9-11) and low (0-8) Tokuhashi scores, they were significantly longer in the former (15.0 months; 95% CI, 9.29-20.71 months vs. 9.0 months; 95% CI, 7.48-10.52 months; $p$=0.003). Multivariate logistic regression analysis showed that preoperative ambulation with or without aid [odds ratio (OR) 5.35; 95% CI 1.57-18.17; $p$=0.007] and hip flexion power greater than grade III (OR 6.23; 95% CI, 1.29-7.35; $p$=0.038) were prognostic of postoperative ambulation. Conclusion : We found that postoperative ambulation and preoperative high Tokuhashi score were significantly associated with longer patient survival. In addition, preoperative hip flexion power greater than grade III was critical for postoperative ambulation.

The Retrial of Percutaneous Vertebroplasty for the Treatment of Vertebral Compression Fracture

  • Kim, Han-Woong;Kwon, Austin;Lee, Min-Cheol;Song, Jae-Wook;Kim, Sang-Kyu;Kim, In-Hwan
    • Journal of Korean Neurosurgical Society
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    • v.47 no.4
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    • pp.278-281
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    • 2010
  • Objective : For the treatment of osteoporotic vertebral compression fracture, percutaneous vertebroplasty (PVP) is currently widely used as an effective and relatively safe procedure. However, some patients do not experience pain relief after PVP. We performed several additional PVP procedures in those patients who did not have any improvement of pain after their initial PVP and we obtained good results. Our purpose is to demonstrate the effective results of an additional PVP procedure at the same previously treated level. Methods : We reviewed the medical records and the radiologic data of the PVP procedures that were performed at our hospital from November 2005 to May 2008 to determine the patients who had undergone additional PVP. We identified ten patients and we measured the clinical outcomes according to the visual analogue scale (VAS) score and the radiologic parameters, including the anterior body height and the kyphotic angulation. Results : The mean volume of polymethylmethacrylate injected into each vertebrae was 4.3 mL (range: 2-8 mL). The mean VAS score was reduced from 8 to 2.32. The anterior body height was increased from 1.7 cm to 2.32 cm. The kyphotic angulation was restored from 10.14 degrees to 2.32 degrees. There were no complications noted. Conclusion : The clinical and radiologic outcomes suggest that additional PVP is effective for relieving pain and restoring the vertebral body in patients who have unrelieved pain after their initial PVP. Our study demonstrates that additional PVP performed at the previously-treated vertebral levels could provide therapeutic benefit.

Variation of Fatigue Properties in Nanoskinned Ti-6Al-4V - Rotating Bending and Axial Loading Tension-Compression Cycle - (Ti-6Al-4V 재의 UNSM 처리에 의한 피로특성변화 - 회전굽힘 피로시험과 축하중 인장압축 피로시험 비교 -)

  • Suh, Min-Soo;Pyoun, Young-Shik;Suh, Chang-Min
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.36 no.4
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    • pp.443-449
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    • 2012
  • Nanoskins were fabricated on a Ti-6Al-4V material by carrying out various surface treatments, i.e., deep rolling, laser shot peening, and ultrasonic nanocrystal surface modification (UNSM). These surface treatments are newly developed techniques and are becoming more popular for industrial applications. Fatigue tests were carried out using material test system (MTS); these tests included the axial loading tension-compression fatigue test (R = -1, RT, 5 Hz, sinusoidal wave) and rotating bending fatigue test (R = -1, RT, 3200 rpm). The analysis of the crack initiation pattern in the UNSM-treated material indicated that the crack was interior originating in the axial loading tension-compression cycle, and was surface originating in the bending fatigue test. UNSM treatment significantly improved the fatigue strength for the regime of above $10^6$ cycles that S-N curve of rotating bending stress clearly show the performance of a 5 mm titanium specimen after UNSM treatment is similar to that of an untreated 6 mm titanium specimen.

The Clinical Study on 40 Cases of Patient with Thoracolumbar Fracture (흉·요추 골절 환자 40례에 대한 임상적 고찰)

  • Oh, Hei-hong;Kim, Il-du;Byun, Jae-yung;Ahn, Soo-gi
    • Journal of Acupuncture Research
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    • v.18 no.2
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    • pp.227-236
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    • 2001
  • Objectives : This study was performed to evaluate the clinical results of the thoracolumbar fracture patients treated with oriental medical methods. Methods : We reviewed 40 patients of thoracolumbar fracture, who were hospitalized at WonKwang University KwangJu Oriental Medical Hospital and treated by oriental medical methods. We classified thoracolumbar fracture according to three column theory and then analyzed the cause of injury, sex-age distribution, treatment, and etc.. Results : 1. The distribution showed female predominance(72.5%) in sex and 70age-bracket predominance in age. 2. In the distribution of causes, the largest group was "lifting heavy objects"(40%) and the next was "slip down"(37.5%). 3. In the duration of symptoms, the largest group was the group of "acutest" (40%). 4. The distribution of injured level was L1 body the most(20%). 5. In classification of fracture, "compression fracture" was the most(57.5%) and the next was "burst fracture", "unstable fracture" in order. 7. Therapeutic effects above "fair" were 37 cases(92.5%). 8. The higher grade of clinical symptoms is, the lower therapeutic effect is. 9. In the distribution of treatment results according to classification of fracture, both the compression fracture and the burst fracture were almost same high and the unstable fracture is relatively lower than them. Conclusions : The result to treating thoracolumbar fracture by oriental medical methods is satisfactory.

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Surgical Management Options for Trigeminal Neuralgia

  • Lunsford, L. Dade;Niranjan, Ajay;Kondziolka, Douglas
    • Journal of Korean Neurosurgical Society
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    • v.41 no.6
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    • pp.359-366
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    • 2007
  • Trigeminal neuralgia is a condition associated with severe episodic lancinating facial pain subject to remissions and relapses. Trigeminal neuralgia is often associated with blood vessel cross compression of the root entry zone or more rarely with demyelinating diseases and occasionally with direct compression by neoplasms of the posterior fossa. If initial medical management fails to control pain or is associated with unacceptable side effects, a variety of surgical procedures offer the hope for long-lasting pain relief or even cure. For patients who are healthy without significant medical co-morbidities, direct microsurgical vascular decompression [MVD] offers treatment that is often definitive. Other surgical options are effective for elderly patients not suitable for MVD. Percutaneous retrogasserian glycerol rhizotomy is a minimally invasive technique that is based on anatomic definition of the trigeminal cistern followed by injection of anhydrous glycerol to produce a weak neurolytic effect on the post-ganglionic fibers. Other percutaneous management strategies include radiofrequency rhizotomy and balloon compression. More recently, stereotactic radiosurgery has been used as a truly minimally invasive strategy. It also is anatomically based using high resolution MRI to define the retrogasserian target. Radiosurgery provides effective symptomatic relief in the vast majority of patients, especially those who have never had prior surgical procedures. For younger patients, we recommend microvascular decompression. For patients with severe exacerbations of their pain and who need rapid response to treatment, we suggest glycerol rhizotomy. For other patients, gamma knife radiosurgery represents an effective management strategy with excellent preservation of existing facial sensation.

Early Vertebroplasty versus Delayed Vertebroplasty for Acute Osteoporotic Compression Fracture : Are the Results of the Two Surgical Strategies the Same?

  • Son, Seong;Lee, Sang-Gu;Kim, Woo-Kyung;Park, Chan-Woo;Yoo, Chan-Jong
    • Journal of Korean Neurosurgical Society
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    • v.56 no.3
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    • pp.211-217
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    • 2014
  • Objective : In Korea, early vertebroplasty (EVP) or delayed vertebroplasty (DVP, which is performed at least 2 weeks after diagnosis) were performed for the treatment of acute osteoporotic compression fracture (OCF) of the spine. The present study compared the outcomes of two surgical strategies for the treatment of single-level acute OCF in the thoracolumbar junction (T12-L2). Methods : From 2004 to 2010, 23 patients were allocated to the EVP group (EVPG) and 27 patients to the DVP group (DVPG). Overall mean age was $68.3{\pm}7.9$ and minimum follow-up period was 1.0 year. Retrospective study of clinical and radiological results was conducted. Results : No significant differences in baseline characteristics were observed between the two groups. As expected, mean duration from onset to vertebroplasty and mean duration of hospital stay were significantly longer in the DVPG ($17.1{\pm}2.1$ and $17.5{\pm}4.2$) than in the EVPG ($3.8{\pm}3.3$ and $10.8{\pm}5.1$, p=0.001). Final clinical outcome including visual analogue scale (VAS), Oswestry Disability Index, and Odom's criteria did not differ between the two groups. However, immediate improvement of the VAS after vertebroplasty was greater in the EVPG ($5.1{\pm}1.3$) than in the DVPG ($4.0{\pm}1.0$, p=0.002). The proportion of cement leakage was lower in the EVPG (30.4%) than in the DVPG (59.3%, p=0.039). In addition, semiquantitative grade of cement interdigitation was significantly more favorable in the EVPG than in the DVPG (p=0.003). Final vertebral body collapse and segmental kyphosis did not differ significantly between the two groups. Conclusion : Our findings suggest that EVP achieves a better immediate surgical effect with more favorable cost-effectiveness.

Comparison of the Effect of Ischemic Compression Therapy and Extracorporeal Shock Wave Therapy on the Trigger Point of the Upper Trapezius Muscle (위등세모근의 발통점에 대한 허혈성 압박치료와 체외충격파치료의 효과비교)

  • Joo, Ji-Kyun;Park, Sam-Ho;Shin, Won-Seob
    • Journal of The Korean Society of Integrative Medicine
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    • v.9 no.2
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    • pp.141-152
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    • 2021
  • Purpose: This study aimed to compare the effects of ischemic compression (IC) therapy and extracorporeal shock wave therapy (ESWT) in patients with upper trapezius myofascial pain syndrome and to present an effective treatment method for these patients. Methods: A total of 42 patients with upper trapezius myofascial pain syndrome were randomly assigned to the IC group (n = 21) and ESWT group (n = 21). IC therapy and ESWT were performed in the IC and ESWT groups, respectively. Treatment was applied to the trigger point of the upper trapezius muscle. Visual analog scales (VAS), pain pressure threshold (PPT), range of motion, neck disability index (NDI), and fear-avoidance belief questionnaire (FABQ) were evaluated before and after the intervention to compare its effectiveness. Results: Both groups showed significant differences before and after the intervention in VAS, PPT, NDI, FABQ, flexion, extension, right side bending, and left side bending (p <.05). In addition, there were significant differences in the IC group compared to the ESWT group in VAS, PPT, and NDI (p <.05). Conclusion: IC therapy and ESWT applied to patients with upper trapezius myofascial pain syndrome are mediating methods of pain, function, and psychosocial effects. In addition, IC therapy may be a more effective mediating method for pain and dysfunction than ESWT.

Outcomes of Internal Fixation with Compression Hip Screws in Lateral Decubitus Position for Treatment of Femoral Intertrochanteric Fractures

  • Park, Cheon-Gon;Yoon, Taek-Rim;Park, Kyung-Soon
    • Hip & pelvis
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    • v.30 no.4
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    • pp.254-259
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    • 2018
  • Purpose: Internal fixation using compression hip screws (CHS) and traction tables placing patients in the supine position is a gold standard option for treating intertrochanteric fractures; however, at our institution, we approach this treatment with patients in a lateral decubitus position. Here, the results of 100 consecutive elderly (i.e., ${\geq}45$ years of age) patients who underwent internal fixation with CHS in lateral decubitus position are analyzed. Materials and Methods: Between March 2009 and May 2011, 100 consecutive elderly patients who underwent internal fixation with CHS for femoral intertrochanteric fracture were retrospectively reviewed. Clinical outcomes (i.e., Koval score, Harris hip score [HHS]) and radiographic outcomes (i.e., bone union time, amount of sliding of lag screw, tip-apex distance [TAD]) were evaluated. Results: Clinical assessments revealed that the average postoperative Koval score decreased from 1.4 to 2.6 (range, 0-5; P<0.05); HHS was 85 (range, 72-90); and mean bone union time was 5.0 (range, 2.0-8.2) months. Radiographic assessments revealed that anteroposterior average TAD was 6.95 (range, 1.27-14.63) mm; lateral average TAD was 7.26 (range, 1.20-18.43) mm; total average TAD was 14.21 (range, 2.47-28.66) mm; average lag screw sliding was 4.63 (range, 0-44.81) mm; and average angulation was varus $0.72^{\circ}$(range, $-7.6^{\circ}-12.7^{\circ}$). There were no cases of screw tip migration or nonunion, however, there were four cases of excessive screw sliding and six cases of varus angulation at more than $5^{\circ}$. Conclusion: CHS fixation in lateral decubitus position provides favorable clinical and radiological outcomes. This technique is advisable for regular CHS fixation of intertrochanteric fractures.

Micro-computed tomography evaluation of the effects of orthodontic force on immature maxillary first molars and alveolar bone mineral density of Sprague-Dawley rats

  • Jingwei Wang;Ruofang Zhang;Zhuoying Zhang;Chao Geng;Yanpeng Zhang
    • The korean journal of orthodontics
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    • v.53 no.3
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    • pp.205-216
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    • 2023
  • Objective: To investigate changes in the immature teeth of Sprague-Dawley rats during orthodontic treatment and to explore the changes in the peri-radicular alveolar bone through micro-computed tomography (CT). Methods: Twenty-five 26-day-old male Sprague-Dawley rats were included. The maxillary left first molar was moved mesially under a continuous force of 30 cN, and the right first molar served as the control. After orthodontic treatment for 7, 14, 21, 28, and 42 days, the root length, tooth volume, and alveolar bone mineral density (BMD) around the mesial root were measured through micro-CT. Results: The immature teeth continued to elongate after application of orthodontic force. The root length on the force side was significantly smaller than that on the control side, whereas the differences in the volume change between both sides were not statistically significant. Alveolar bone in the coronal part of the compression and tension sides showed no difference in BMD between the experimental and control groups. The BMD of the experimental group decreased from day 14 to day 42 in the apical part of the compression side and increased from day 7 to day 42 in the apical part of the tension side. The BMD of the experimental group decreased in the root apex part on day 7. Conclusions: The root length and volume of immature teeth showed continued development under orthodontic forces. Alveolar bone resorption was observed on the compression side, and bone formation was observed on the tension side.

Plastic Deformation Behavior of Ti-51.5at.%Ni Shape Memory Alloy Single Crystals (Ti-51.5at.%Ni 형상기억합금 단결정의 소성변형 거동)

  • Jun, Joong-Hwan;Sehitoglu, Huseyin
    • Journal of the Korean Society for Heat Treatment
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    • v.15 no.1
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    • pp.9-15
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    • 2002
  • Deformation behavior of nickel-rich Ti-51.5at.%Ni single crystals was investigated over a wide range of temperatures(77 to 440K) and strain levels(up to 9%) in compression. These alloys combined superior strength with wide range of pseudoelasticity temperature interval(~200K). The slip deformation in [001] orientation did not occur due to the prevailing slip system, and consequently, exhibited pseudoelastic deformation at temperatures ranging from 77 to 283K and 273 to 440K for the solutionized and over-aged cases, respectively. The critical transformation stress levels were in the range of 800 to 1800MPa for the solutionized case, and 200 to 1000MPa for the over-aged case depending on the temperature and specimen orientation. These stress levels are considerably higher compared to these class of alloys having lower Ni contents. The maximum transformation strains, measured from incremental straining experiments in compression, were lower compared to the phenomenological theory with Type II twinning. A compound twinning model depending on the successive austenite(B2) to intermediate phase(R) to martensite(B19') transformation predicts lower transformation strains compared to the Type II twinning case.