• 제목/요약/키워드: Disc Disease

검색결과 284건 처리시간 0.022초

자기공명 촬영상 요추 추간반 병변의 판독자내 및 판독자간 해석의 다양성 (Interobserver and Interaobserver Variability in Interpretation of Lumbar Disc Abnormalities on Magnetic Resonance Images)

  • 전인호;송준혁;박향권;신규만;김성학;박동빈
    • Journal of Korean Neurosurgical Society
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    • 제30권sup2호
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    • pp.254-258
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    • 2001
  • Objective : The terminology of degenerative disc disease lacks official standardization. Lacks of such standardization may provoke some clinical and litigation problems. The authors investigated interobserver and intraobserver variability in interpretation of lumbar disc abnormality. Methods : Magnetic resonance imaging studies of the lumbar spine performed prospectively in 50 patients, were read blindly by three doctors dealing spinal disorders, using two nomenclature. Nomenclature I was normal, bulging, protrusion, extrusion. Nomenclature II was normal, bulging, herniation without neural compression, with neural compression. Intraobserver and interobserver variation were measured statistically. Results : Interobserver agreement was 70.4-80.8% for nomenclature I, 76.2-80.2% for nomenclature II. Intraobserver agreement was 84.0-88.0% for nomenclature I, 79.2-86.8% for nomenclature II. Interobserver Kappa statistic was 0.53-0.56 for nomenclature I, 0.54-0.57 for nomenclature II. Intraobserver Kappa statistic was 0.60-0.85 for nomenclature I, 0.53-0.72 for nomenclature II. Conclusion : Experienced doctors showed only moderate interobserver agreement when interpreting disc status on lumbar magnetic resonance imaging. Intraobserver agreement was superior to interbserver. The standardization of nomenclatures for lumbar disc extension beyond interspace are needed.

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Comparative Analysis between Total Disc Replacement and Posterior Foraminotomy for Posterolateral Soft Disc Herniation with Unilateral Radiculopathy : Clinical and Biomechanical Results of a Minimum 5 Years Follow-up

  • Kim, Kyoung-Tae;Cho, Dae-Chul;Sung, Joo-Kyung;Kim, Young-Baeg;Kim, Du Hwan
    • Journal of Korean Neurosurgical Society
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    • 제60권1호
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    • pp.30-39
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    • 2017
  • Objective : To compare the clinical outcomes and biomechanical effects of total disc replacement (TDR) and posterior cervical foraminotomy (PCF) and to propose relative inclusion criteria. Methods : Thirty-five patients who underwent surgery between 2006 and 2008 were included. All patients had single-level disease and only radiculopathy. The overall sagittal balance and angle and height of a functional segmental unit (FSU; upper and lower vertebral body of the operative lesion) were assessed by preoperative and follow-up radiographs. C2-7 range of motion (ROM), FSU, and the adjacent segment were also checked. Results : The clinical outcome of TDR (group A) was tended to be superior to that of PCF (group B) without statistical significance. In the group A, preoperative and postoperative upper adjacent segment level motion values were $8.6{\pm}2.3$ and $8.4{\pm}2.0$, and lower level motion values were $8.4{\pm}2.2$ and $8.3{\pm}1.9$. Preoperative and postoperative FSU heights were $37.0{\pm}2.1$ and $37.1{\pm}1.8$. In the group B, upper level adjacent segment motion values were $8.1{\pm}2.6$ and $8.2{\pm}2.8$, and lower level motion values were $6.5{\pm}3.3$ and $6.3{\pm}3.1$. FSU heights were $37.1{\pm}2.0$ and $36.2{\pm}1.8$. The postoperative FSU motion and height changes were significant (p<0.05). The patient's satisfaction rates for surgery were 88.2% in group A and 88.8% in group B. Conclusion : TDR and PCF have favorable outcomes in patients with unilateral soft disc herniation. However, patients have different biomechanical backgrounds, so the patient's biomechanical characteristics and economic status should be understood and treated using the optimal procedure.

Can the Zero-Profile Implant Be Used for Anterior Cervical Discectomy and Fusion in Traumatic Subaxial Disc Injury? A Preliminary, Retrospective Study

  • Kim, Tae Hun;Kim, Dae Hyun;Kim, Ki Hong;Kwak, Young Seok;Kwak, Sang Gyu;Choi, Man Kyu
    • Journal of Korean Neurosurgical Society
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    • 제61권5호
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    • pp.574-581
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    • 2018
  • Objective : The zero-profile implant (Zero-P) is accepted for use in anterior cervical fusion for the treatment of degenerative cervical disease. However, evidence pertaining to its efficiency and safety in traumatic cervical injury is largely insufficient. This study aimed to compare the overall outcomes of patients who underwent Zero-P for traumatic cervical disc injury. Methods : Data from a total of 53 consecutive patients who underwent surgery for traumatic or degenerative cervical disc disease using the Zero-P were reviewed. Seventeen patients (group A) had traumatic cervical disc injury and the remaining 36 (group B) had degenerative cervical disc herniation. The fusion and subsidence rates and Cobb angle were measured retrospectively from plain radiographs. The patients' clinical outcomes were evaluated using the Japanese Orthopedic Association (JOA) score and Odom's criteria. Results : The C2-7 Cobb and operative segmental angles increased by $3.45{\pm}7.61$ and $2.94{\pm}4.59$ in group A; and $2.46{\pm}7.31$ and $2.88{\pm}5.49$ in group B over 12 postoperative months, respectively. The subsidence and fusion rate was 35.0% and 95.0% in group A; and 36.6% and 95.1% in group B, respectively. None of the parameters differed significantly between groups. The clinical outcomes were similar in both groups in terms of increasing the JOA score and producing a grade higher than "good" using Odom's criteria. Conclusion : The application of Zero-P in patients with traumatic cervical disc injury was found to be acceptable when compared with the clinical and radiological outcomes of degenerative cervical spondylosis.

Streptococcus parauberis의 디스크 확산법 결과에 대한 Epidemiological Cut-off Value의 설정 (Epidemiological Cut-off Values Generated for Disc Diffusion Data from Streptococcus parauberis)

  • 천원경;이윤항;김윤재;노형진;김아란;김남은;서정수;권문경;이지훈;김도형
    • 한국수산과학회지
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    • 제52권4호
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    • pp.382-388
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    • 2019
  • Streptococcosis caused by Streptococcus parauberis is a very important disease in farmed olive flounder Paralichthys olivaceus. For most fish pathogens, including S. parauberis, there are no analytical criteria to distinguish antibioticsusceptible strains from antibiotic-resistant strains. In this study, epidemiological cut-off ($CO_{WT}$) values were generated to classify 75 strains of S. parauberis isolated from 1999 to 2018 as wild type (WT) and non-wild type (NWT) using disc diffusion data and normalized resistance interpretation (NRI) analysis. The susceptibility of the isolates to 16 antibiotics was evaluated using CLSI guideline M42-A. The wild-type cut-off values for amoxicillin, erythromycin, oxytetracycline, and florfenicol for S. parauberis were ${\geq}35$, 31, 28, and 27 mm, respectively. The NWT ratios of S. parauberis strains to treatment with GEN, FFC, ENR, SXT, EFT, VAN, and CHL were 17% or less, indicating that these antibiotics may be used to treat streptococcosis caused by S. parauberis. For recent S. parauberis isolates, the NWT ratios for AMX, ERY, OTC and FFC are much higher than for strains isolated from 1999-2007. The $CO_{WT}$ data from this study will assist aquatic animal disease professionals in prescribing appropriate antibiotics for the treatment of streptococcosis caused by S. parauberis, which will help reduce the misuse and abuse of antibiotics in the aquaculture sector.

경추 추간판 탈출증 입원 환자 102례에 관한 한의학적 복합치료 효과의 관찰 연구 (Effects of Korean Medical Combination Treatment for 102 Cases of Cervical Disc Herniation : An Observational Study)

  • 최지훈;이순호;김상민;김현중;구자성;이현호;정성현;윤덕원
    • Journal of Acupuncture Research
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    • 제33권2호
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    • pp.11-20
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    • 2016
  • Objectives : The purpose of this study is to investigate the clinical effectiveness of Korean medical combination treatment for cervical disc herniation. Methods : This is an observational study. 102 patients diagnosed with cervical disc herniation by MRI (Magnetic Resonance Imaging) were investigated from January, 2015 through to December, 2015 at Daejeon Jaseng Hospital of Korean Medicine. They were sorted according to the distribution of sex, age, causing factor, the period of disease, admission day and pain area. All patients were treated with acupuncture, Chuna treatment, and herbal therapy and physical therapy during the admission period. After treatment, NRS (Numeric Rating Scale), NDI (Neck Disability Index) and EQ-5D were assessed to evaluate the treatment efficacy. Results : There were more females than Males with a ratio of 1 : 1.37, the age of fifty was the most with 35.29 %, reason unknown was the most with 72.55 % and the subacute stage was the most with 38.24 %. According to disc herniation types, patients with protruded disc types were the most with 66.67 % and a lesion of C5/6 was the most with 41.18 %. For patients diagnosed with cervical disc herniation, neck and shoulder pain NRS decreased from $6.43{\pm}1.77$ to $3.96{\pm}1.96$(p<0.001) and radiating pain NRS decreased from $5.64{\pm}1.96$ to $3.57{\pm}1.88$ (p<0.001). NDI decreased from $41.72{\pm}14.04$ to $30.84{\pm}15.34$(p<0.001), and the EQ-5D index increased from $0.68{\pm}0.17$ to $0.79{\pm}0.14$(p<0.001) after treating cervical disc patients. Conclusion : Korean medical combination treatment might be effective in decreasing pain and raising the life quality of patients with cervical disc herniation.

악관절원판 절제술 후 이개연골 이식 (AUTOGENOUS AURICULAR CARTILAGE GRAFT FOLLOWED BY DISCECTOMY OF THE TEMPOROMANDIBULAR JOINT)

  • 정훈;성춘수
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제15권2호
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    • pp.81-91
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    • 1993
  • Arthrosis of the temporomandibular joint is defined as a disease of a joint with chief complaint of pain, clicking, limited jaw movements. Generally, most patients with the temporomandibular arthrosis can be treated conservatively with muscle relaxation therapy combined with mandibular repositioning prostheses, followed by occlusal equilibration, restorative dentistry and/or orthodontics, and many other forms of treatment. In case prior nonsurgical treatment proved to be ineffective or the disease is chronic and severe, surgical operation is recommended. For patients with arthrosis of the temporomandibular joint, only discectomy as therapeutic method of the surgical treatment should not be applied and the removed articular disc of the temporomandibular joint should be replaced. Allograft such as Proplast-Teflon, Silastic, etc have been used as replacements of removed articular disc. However, these allograft materials have caused complications such as inflammatory changes, foreign body reactions. As a result, a replacement material which is autogenous, space occupying, easy to harvest and less inflammatory change has been developed. Auricular cartilage with perichondrium satisfies many of these requirements. The apparent advantages of autogenous auricular cartilage as an interpositional graft after a discectomy are as follows, (1) the form of the external ear corresponds to joint morphology, (2) a graft of adequate size can be harvested, (3) the form of the external ear remains unchanged after surgery, (4) the graft can be obtained adjacent to the surgical site, (5) biologically acceptable material is used, (6) the additional expense of allogenic graft is avoided. Because we considered autogenous auricular cartilage as a good replacement material, removed articular disc has been replaced with fresh autogenous auricular cartilage in the case of three patients. The result of the treatment is favorable, and the cases being presented here.

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Long-Term Follow-Up Radiologic and Clinical Evaluation of Cylindrical Cage for Anterior Interbody Fusion in Degenerative Cervical Disc Disease

  • Kim, Su-Hyeong;Chun, Hyoung-Joon;Yi, Hyeon-Joong;Bak, Koang-Hum;Kim, Dong-Won;Lee, Yoon-Kyoung
    • Journal of Korean Neurosurgical Society
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    • 제52권2호
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    • pp.107-113
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    • 2012
  • Objective : Various procedures have been introduced for anterior interbody fusion in degenerative cervical disc disease including plate systems with autologous iliac bone, carbon cages, and cylindrical cages. However, except for plate systems, the long-term results of other methods have not been established. In the present study, we evaluated radiologic findings for cylindrical cervical cages over long-term follow up periods. Methods : During 4 year period, radiologic findings of 138 patients who underwent anterior cervical fusion with cylindrical cage were evaluated at 6, 12, 24, and 36 postoperative months using plain radiographs. We investigated subsidence, osteophyte formation (anterior and posterior margin), cage direction change, kyphotic angle, and bone fusion on each radiograph. Results : Among the 138 patients, a minimum of 36 month follow-up was achieved in 99 patients (mean follow-up : 38.61 months) with 115 levels. Mean disc height was 7.32 mm for preoperative evaluations, 9.00 for immediate postoperative evaluations, and 4.87 more than 36 months after surgery. Osteophytes were observed in 107 levels (93%) of the anterior portion and 48 levels (41%) of the posterior margin. The mean kyphotic angle was $9.87^{\circ}$ in 35 levels showing cage directional change. There were several significant findings : 1) related subsidence [T-score (p=0.039) and anterior osteophyte (p=0.009)], 2) accompanying posterior osteophyte and outcome (p=0.05). Conclusion : Cage subsidence and osteophyte formation were radiologically observed in most cases. Low T-scores may have led to subsidence and kyphosis during bone fusion although severe neurologic aggravation was not found, and therefore cylindrical cages should be used in selected cases.

Antifungal Properties of Rhizopus oligosporus Against Apple Anthracnose Fungi

  • Bajpai, Vivek K.;Choi, Seak-Won;Kang, Sun-Chul
    • 한국환경농학회지
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    • 제29권1호
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    • pp.86-91
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    • 2010
  • This study was carried out to assess the antifungal potential of R. oligosporus and its ethyl acetate (EtOAc) extract against the fungal pathogens causing anthracnose disease in apple fruits using disc diffusion, antagonistic effect and morphological abnormalities in fungal mycelia. The percentage of inhibition of antifungal effect of the ethyl acetate extract (5 ${\mu}l$ $disc^{-1}$) of the R. oligosporus against C. acutatum KACC 40848, C. gloeosporioides KACC 40897, C. higginsianum KACC 40806, C. orbiculare KACC 40808, C. coccodes KACC 40008, C. musae KACC 40947, C. boninense KACC 40893, C. liliacearum KACC 40981, C. caudatum KACC 41028 and Colletotrichum sp. KACC 40811 was found to be 44.4, 35.5, 40, 31.1, 33.3, 37.7, 40, 51.1, 28.8 and 28.8%, respectively. Also the fungus R. oligosporus showed potential antagonistic effect of antifungal activity against the tested pathogens of Colletotrichum spp. Further, R. oligosporus had a potential detrimental effect on the morphology of the tested fungi of Colletotrichum spp. such as wrinkle abnormalities, abnormal cell formation, lysis of mycelium, empty cell formation, distorted cell formation and breakage of the mycelium. These findings strongly support the role of R. oligosporus to serve as a potential antifungal agent to control plant pathogenic fungi causing anthracnose disease in apple fruits.

추간판 탈출증이 발생한 개에서 동종의 지방유래 줄기세포의 임상적 적용 (Clinical Application of Mesenchymal Stem Cells in a Dog with Intervertebral Disc Disease)

  • 김영기;이승용;박세진;이스캇;김진현;이희천;장홍희;이효종;연성찬
    • 한국임상수의학회지
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    • 제28권1호
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    • pp.122-127
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    • 2011
  • 후지마비와 심부통각의 소실을 보이는 5 년령의 수컷 Cocker Spaniel이 내원하였다. 신체검사, 신경검사, 방사선검사와 컴퓨터 단층촬영결과 심부통각의 소실을 동반한 요추 2번과 3번 사이의 디스크 탈출증으로 진단하였다. 편측 추궁 절제술을 시행하여 감압술과 탈출된 디스크 물질을 제거하였으며 $1{\times}10^6$ 개의 동종 지방유래 줄기세포를 $50{\mu}l$ 생리식염수에 희석하여 손상된 척수에 직접 주입하였다. 수술 10주 후, 양쪽 후지 모두에서 심부통각과 운동기능이 완전히 회복되었으며 세포이식과 관련된 부작용은 현재까지 발견되지 않았다. 본 증례를 통해 심각한 정도의 디스크질환을 가진 환축에서 감압술과 병행된 줄기세포의 이식방법은 좀더 나은 예후를 기대하기 위한 치료방법들 중 하나로 고려해볼 수 있을 것으로 생각된다.