• Title/Summary/Keyword: Disc Degeneration

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AN EXPERIMENTAL STUDY ON THE EFFECT OF RABBIT TEMPOROMANDIBULAR JOINT BY TRAUMATIC OCCLUSION (외상성교합(外傷性咬合)이 가토악관절(家兎顎關節)에 미치는 영향(影響)에 관(關)한 실험적(實驗的) 연구(硏究))

  • Son, Han-Gee
    • The Journal of Korean Academy of Prosthodontics
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    • v.15 no.1
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    • pp.34-42
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    • 1977
  • The author attempted to observed the histological changes of the temporomandibular joints of rabbits by including malocclusion. Thirth-two healthy male rabbits were devided into two groups; control and experimental group. Eight rabbits were kept as control group, while metal crowns were seated on unilateral lower molar teeth of twenty-four rabbits as experimental group. And the interocclusal distance of the incisal edge was kept 1.5mm from the begining to the end of the experimental periods. Rabbits of each group, one of control group and three of the experimental gorup, were killed at the intervals of one day, three days, one week, two weeks, four weeks, six weeks, eight weeks, and twelve weeks after experiment. The temporomandibular joint including condyle head, articular disc and glenoid fossa were excised and decalcified. The decalcified sections were made histologic sections. The results obtained were as follows. 1. The regressive changes of the condylar head were the main reaction in this experiment that consist of decreasing or increasing thickness of the fibrocartilage zone with hyaline degeneration, decreasing of the cellularity of the proliferative zone, and the irregularity of the arrangement of chondrocytes and size of the lacunae of cartilage cells with chondroclasia and osteoclasia in hypertrophic zone. 2. The regressive changes of the condylar surface of the crown seated side were persisted to the end of the experiment. 3. On the non-crown seated side, severe aggressive changes occurred in initial stage, but hyperplastic changes of the condylar surface noted in the middle of the experimental periods. 4. Although aggressive changes occurred in initial stage of experiment on the non-crown seated side, hyperplastic changes of the condylar surface were noted in the middle of the experimental periods, and remodeling appeared at the termination of the experimental periods. 5. The articular disc exhibited pannus formation on both crown seated and non crown seated side from the beginning of the experiment. The pannus persisted throughout the experiment on the crown seated side, but on the non-crown seated side it disappeared from six week group.

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Biomechanical Comparison of Spinal Fusion Methods Using Interspinous Process Compressor and Pedicle Screw Fixation System Based on Finite Element Method

  • Choi, Jisoo;Kim, Sohee;Shin, Dong-Ah
    • Journal of Korean Neurosurgical Society
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    • v.59 no.2
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    • pp.91-97
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    • 2016
  • Objective : To investigate the biomechanical effects of a newly proposed Interspinous Process Compressor (IPC) and compare with pedicle screw fixation at surgical and adjacent levels of lumbar spine. Methods : A three dimensional finite element model of intact lumbar spine was constructed and two spinal fusion models using pedicle screw fixation system and a new type of interspinous devices, IPC, were developed. The biomechanical effects such as range of motion (ROM) and facet contact force were analyzed at surgical level (L3/4) and adjacent levels (L2/3, L4/5). In addition, the stress in adjacent intervertebral discs (D2, D4) was investigated. Results : The entire results show biomechanical parameters such as ROM, facet contact force, and stress in adjacent intervertebral discs were similar between PLIF and IPC models in all motions based on the assumption that the implants were perfectly fused with the spine. Conclusion : The newly proposed fusion device, IPC, had similar fusion effect at surgical level, and biomechanical effects at adjacent levels were also similar with those of pedicle screw fixation system. However, for clinical applications, real fusion effect between spinous process and hooks, duration of fusion, and influence on spinous process need to be investigated through clinical study.

Bertolotti Syndrome: A Diagnostic and Management Dilemma for Pain Physicians

  • Jain, Anuj;Agarwal, Anil;Jain, Suruchi;Shamshery, Chetna
    • The Korean Journal of Pain
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    • v.26 no.4
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    • pp.368-373
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    • 2013
  • Background: Bertolotti's syndrome (BS), a form of lumbago in lumbosacral transitional vertebrae, is an important cause of low back pain in young patients. The purpose of this study was to assess the etiology of low back pain and the efficacy of treatment offered to patients with BS. Methods: All patients of BS Castellvi type1a during a period of 6 months were enrolled in the study. The patients underwent interventional pain procedures for diagnosis and pain relief. Response to the therapy was assessed based on VAS and ODI scores. A 50% decrease in VAS score or a VAS score less than 3 would be considered adequate pain relief. Results: All 20 patients diagnosed with BS during the 6-month observation period had scoliosis. Common causes of back pain were the ipsilateral L5-S1 facet joint, neoarticulation, the SI joint, and disc degeneration. Responses to various interventions for pain relief were different and inconsistent from patient to patient. In particular, responses to interventions for neoarticular pain were generally poor. Conclusions: Pain in patients with BS does not usually respond to interventional pain treatment. A very dynamic treatment approach must be pursued while managing BS patients, and the treatment plan must be individualized at various stages in order to obtain satisfactory pain relief.

Radicular Pain due to Subsidence of the Nitinol Shape Memory Loop for Stabilization after Lumbar Decompressive Laminectomy

  • Son, Byung-Chul;Kim, Deog-Ryeong
    • Journal of Korean Neurosurgical Society
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    • v.57 no.1
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    • pp.61-64
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    • 2015
  • A number of dynamic stabilization systems have been used to overcome the problems associated with spinal fusion with rigid fixation recently and the demand for an ideal dynamic stabilization system is greater for younger patients with multisegment disc degeneration. Nitinol, a shape memory alloy of nickel and titanium, is flexible at low temperatures and regains its original shape when heated, and the Nitinol shape memory loop (SML) implant has been used as a posterior tension band mostly in decompressive laminectomy cases because the Nitinol implant has various characteristics such as high elasticity and a tensile force, flexibility, and biological compatibility. The reported short-term outcomes of the application of SMLs as posterior column supporters in cervical and lumbar decompressive laminectomies seem to be positive, and complications are minimal except for the rare occurrence of pullout and fracture of the SML. However, there was no report of neurological complications related to neural compression in spite of the use of the loop of SML in the epidural space. The authors report a case of delayed development of radiating pain caused by subsidence of the SML resulting epidural compression.

A Study of the Relationship between Modic Type Changs 2 and Facet Joint Arthrosis (Modic Type Change 2와 Facet Joint Arthrosis의 연관성 연구)

  • Kim, Moon Hwi;Youn, Deok Won;Lee, Se Min;Kim, Sung Hwan;Yoo, Su Bin
    • Journal of Acupuncture Research
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    • v.32 no.4
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    • pp.187-194
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    • 2015
  • Objectives : The purpose of this study was to observe the correlation between modic type changes 2 and facet joint arthrosis. Methods : We randomly selected the 93 patients with Lumbar MRI films who had been admitted to Haeundae Jaseng Korean Medicine Hospital from January to June 2015. Modic type changes 2 and facet joint arthrosis data were collected and statistically analyzed. Results : In this study, if the findings of the MRI showed modic type changes 2, the cases of facet joint arthrosis increased. Conclusions : There was a significant correlation between modic type changes 2 and facet joint arthrosis.

Clinical, ophthalmological, and pathological findings of hypovitaminosis A in cattle

  • Yoon, Soon-Seek;Jeong, Soon-Wuk;Seo, Kang-Moon;Kim, Jae-Hoon;Jean, Young-Hwa;Hwang, Eui-Kyung;Chung, Gab-Soo;Han, Hong-Ryul
    • Korean Journal of Veterinary Pathology
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    • v.7 no.1
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    • pp.17-21
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    • 2003
  • From February to September in 1996, a lot of blind cattle were reported in Dangjin Area of Chungnam Province. Blindness were observed in the 143 calves of the 1,496 calves from 79 farms. Blind cattle were found only in the farms where green pasture was not fed. After administration of vitamin A as the type of feed additives and parenteral injection, the blindness cases were not occurred in those farms. Both pupils were totally dilated with the absence of pupillary light reflex in all blind cattle. In the ophthalmoscopic examination, the fundus revealed multi focal linear white mottling which was more severe in nontapetal fundus than tapetal fundus. Serum vitamin A concentration was as low as 4.1 ,$\mu\textrm{g}$/dl in the calves of the affected farms. Narrowing of optic foramen, retinal degeneration and optic disc atrophy were shown in pathological findings.

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The Relationship between Neural Foraminal Stenosis and Imaging Features of Lumbar Spine MRI in Patients Older Than 60 Years with Lumbar Radiculopathy (요추신경근병증이 있는 60세 이상의 환자에서 신경공 협착과 자기공명영상 평가를 통한 인자와의 상관관계)

  • Kyeyoung Lee;Hee Seok Jeong;Chankue Park;Maeran Kim;Hwaseong Ryu;Jieun Roh;Jeong A Yeom;Jin Hyeok Kim;Tae Un Kim;Chang Ho Jeon
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.862-875
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    • 2021
  • Purpose To investigate the MRI features associated with neural foraminal stenosis (NFS) in patients older than 60 years with lumbar (L) radiculopathy. Materials and Methods This study included 133 retrospectively selected patients older than 60 years with lumbar radiculopathy who had undergone a lumbar spine MRI (from January 2018 to April 2018). For L4/L5 and L5/sacral (S)1 levels, NFS was reviewed blindly by two radiologists. Spondylolisthesis, retrolisthesis, disc height loss, disc bulging/herniation/central canal stenosis, ligamentum flavum thickening, and facet hypertrophy were evaluated separately for the NFS and non-NFS groups, and they were compared using univariate and multivariate analyses. Results The univariate analysis revealed that disc height loss (p = 0.006) was associated with NFS for L4/L5. For L5/S1, both spondylolisthesis (p = 0.005) and facet hypertrophy (p = 0.006) were associated with NFS. The multivariate logistic analysis revealed that disc height loss was associated with NFS for L4/L5 [odds ratio (OR) = 4.272; 95% confidence interval (CI) 1.736-10.514]. For L5/S1, spondylolisthesis (OR = 3.696; 95% CI 1.297-10.530) and facet hypertrophy (OR = 6.468; 95% CI 1.283-32.617) were associated with NFS. Conclusion Disc height loss was associated with NFS for L4/L5 and spondylolisthesis and facet hypertrophy were associated with NFS for L5/S1.

Posterior Interspinous Fusion Device for One-Level Fusion in Degenerative Lumbar Spine Disease : Comparison with Pedicle Screw Fixation - Preliminary Report of at Least One Year Follow Up

  • Kim, Ho Jung;Bak, Koang Hum;Chun, Hyoung Joon;Oh, Suck Jun;Kang, Tae Hoon;Yang, Moon Sool
    • Journal of Korean Neurosurgical Society
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    • v.52 no.4
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    • pp.359-364
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    • 2012
  • Objective : Transpedicular screw fixation has some disadvantages such as postoperative back pain through wide muscle dissection, long operative time, and cephalad adjacent segmental degeneration (ASD). The purposes of this study are investigation and comparison of radiological and clinical results between interspinous fusion device (IFD) and pedicle screw. Methods : From Jan. 2008 to Aug. 2009, 40 patients underwent spinal fusion with IFD combined with posterior lumbar interbody fusion (PLIF). In same study period, 36 patients underwent spinal fusion with pedicle screw fixation as control group. Dynamic lateral radiographs, visual analogue scale (VAS), and Korean version of the Oswestry disability index (K-ODI) scores were evaluated in both groups. Results : The lumbar spine diseases in the IFD group were as followings; spinal stenosis in 26, degenerative spondylolisthesis in 12, and intervertebral disc herniation in 2. The mean follow up period was 14.24 months (range; 12 to 22 months) in the IFD group and 18.3 months (range; 12 to 28 months) in pedicle screw group. The mean VAS scores was preoperatively $7.16{\pm}2.1$ and $8.03{\pm}2.3$ in the IFD and pedicle screw groups, respectively, and improved postoperatively to $1.3{\pm}2.9$ and $1.2{\pm}3.2$ in 1-year follow ups (p<0.05). The K-ODI was decreased significantly in an equal amount in both groups one year postoperatively (p<0.05). The statistics revealed a higher incidence of ASD in pedicle screw group than the IFD group (p=0.029) Conclusion : Posterior IFD has several advantages over the pedicle screw fixation in terms of skin incision, muscle dissection and short operative time and less intraoperative estimated blood loss. The IFD with PLIF may be a favorable technique to replace the pedicle screw fixation in selective case.

A Multi-center Clinical Study of Posterior Lumbar Interbody Fusion with the Expandable Stand-alone Cage($Tyche^{(R)}$ Cage) for Degenerative Lumbar Spinal Disorders

  • Kim, Jin-Wook;Park, Hyung-Chun;Yoon, Seung-Hwan;Oh, Seong-Hoon;Roh, Sung-Woo;Rim, Dae-Cheol;Kim, Tae-Sung
    • Journal of Korean Neurosurgical Society
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    • v.42 no.4
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    • pp.251-257
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    • 2007
  • Objective : This multi-center clinical study was designed to determine the long-term results of patients who received a one-level posterior lumbar interbody fusion with expandable cage ($Tyche^{(R)}$ cage) for degenerative spinal diseases during the same period in each hospital. Methods : Fifty-seven patients with low back pain who had a one-level posterior lumbar interbody fusion using a newly designed expandable cage were enrolled in this study at five centers from June 2003 to December 2004 and followed up for 24 months. Pain improvement was checked with a Visual Analogue Scale (VAS) and their disability was evaluated with the Oswestry Disability Index. Radiographs were obtained before and after surgery. At the final follow-up, dynamic stability, quality of bone fusion, interveretebral disc height, and lumbar lordosis were assessed. In some cases, a lumbar computed tomography scan was also obtained. Results : The mean VAS score of back pain was improved from 6.44 points preoperatively to 0.44 at the final visit and the score of sciatica was reduced from 4.84 to 0.26. Also, the Oswestry Disability Index was improved from 32.62 points preoperatively to 18.25 at the final visit. The fusion rate was 92.5%. Intervertebral disc height, recorded as $9.94{\pm}2.69\;mm$ before surgery was increased to $12.23{\pm}3.31\;mm$ at postoperative 1 month and was stabilized at $11.43{\pm}2.23\;mm$ on final visit. The segmental angle of lordosis was changed significantly from $3.54{\pm}3.70^{\circ}$ before surgery to $6.37{\pm}3.97^{\circ}$ by 24 months postoperative, and total lumbar lordosis was $20.37{\pm}11.30^{\circ}$ preoperatively and $24.71{\pm}11.70^{\circ}$ at 24 months postoperative. Conclusion : There have been no special complications regarding the expandable cage during the follow-up period and the results of this study demonstrates a high fusion rate and clinical success.

Regional Morphological and Mechanical Characteristics in the Human Thoracic Vertebral Trabecular Bones (인체 흉추 해면골의 영역별 형태학적 및 기계적 특성 연구)

  • Lee, Tae-Woo;Woo, Dae-Gon;Ko, Chang-Young;Kim, Han-Sung
    • Journal of the Korean Society for Precision Engineering
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    • v.27 no.1
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    • pp.134-141
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    • 2010
  • This study analyzed the regional morphological and mechanical characteristics of vertebrae by using micro-computed tomography (micro-CT) and micro finite element analysis (FEA). For the present study, the $12^{th}$ human thoracic vertebral bones (an 85-years female and a 48-years male) were used. These were scanned by using micro-CT. Structural parameters were evaluated from the acquired 20 image data for fifteen $4{\times}4mm^2$ regions (five regions in respective layers of superior, middle and inferior part) in the thoracic vertebral trabecular bones. $4{\times}4{\times}4mm^3$ cubic finite element models of each regions were created at $70{\mu}m$ voxel resolution to investigate effective modulus ($E^+$). The present study indicated that there were significant differences in morphological and elastic mechanical characteristics of each region. There are close relationship between effective modulus and structural model index (SMI) in the bone of the 48-years male and between effective modulus and bone volume fraction (BV/TV) in the bone of the 85-years female. In addition, the effective modulus of central regions is about 80% stiffer than that of lateral regions at transverse plane. These findings may be likely to explain the previous result that a change of loading distribution of the vertebral trabecular bones is caused by spinal curvature and nucleus pulpous degeneration of the intervertebral disc.