• 대한정형외과학회지
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• 제56권6호
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• pp.519-524
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• 2021

척추 수술 후 뇌수막염은 매우 드물게 발생하지만 치명적일 수 있다. 49세 남자 환자가 제5, 6 경추부의 추간판 탈출증에 의한 압박성 척수증 진단하에 전방 경추부 감압술 및 유합술을 시행받았다. 술 후 심한 경부통 및 경부 강직, 발열이 발생하였고 수술 일주일 째 갑자기 사지 마비 증상을 보였다. 추시 자기공명영상 검사 및 뇌척수액 검사상 세균성 뇌수막염과 동반된 척수염이 확인되었다. 환자는 항생제 및 스테로이드 치료를 시행받았으나 결과는 불량하였다. 저자들은 전방 경추 수술 이후 발생한 뇌수막염과 동반된 척수염 증례에 대하여 문헌 고찰과 함께 보고하고자 한다.

• Anatomy and Cell Biology
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• 제56권4호
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• pp.448-455
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• 2023

The azygos vein can be formed as a single root, two roots, and three roots, namely lateral, intermediate and the medial roots respectively. The hemiazygos vein and the accessory hemiazygos vein are the tributaries of azygos vein rather than its left side equivalents. Its variations, especially in young persons without any relevant risk factors, may result in thromboembolic illness. This study aimed to describe the morphological and morphometric variations of azygos system of veins. The present study was conducted on thirty formalin fixed adult human cadavers by dissecting azygos vein from formation to termination and variations were noted. The azygos vein was formed by a single root in 56.7%, by two roots: the lateral root and intermediate root in 36.7% cases and by the lateral root and medial root in 6.6%. The vertebral level of termination of azygos vein was seen at the level of T4 vertebrae in 70% cases, at the level of T3 vertebrae in 20% of cases and at the level of T5 vertebrae in 10% cases. The course of azygos vein was varying in 13.3%. These morphological variations can be useful while performing mediastinal surgery, mediastinoscopy, surgery of the deformations of the vertebral column, neurovascular surgeries of the retroperitoneal organs, disc herniation and fracture of thoracic vertebrae.

• Journal of Korean Neurosurgical Society
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• 제67권2호
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• pp.194-201
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• 2024

Objective : This study aimed to evaluate the clinical feasibility of the combination of ultrasound and nerve stimulator guidance in transforaminal epidural steroid injections (TESIs) to manage lumbosacral chronic radicular pain. Methods : Using the combination of nerve stimulator and ultrasound guidance, TESIs were performed in 125 segments of 78 patients who presented with chronic lumbar radicular pain. Demographic characteristics and surgical outcomes were recorded on admission, pre-procedural and post-procedural for 1-week, 1-month, 3-month, and 6-month follow-ups. The result was measured using the Numeric rating scale (NRS) and Oswestry disability index (ODI). Results : Patients who received TESIs showed significant improvements on two evaluation tools (NRS, ODI), compared to that before procedure (p<0.001). No significant complications were observed for 6 months' follow-up. Conclusion : The result suggests that a combination of ultrasound and nerve stimulator guidance in transforaminal epidural injections is safe, reliable and effective for short-term management of lumbar disc herniation. It is a promising technique and has shown good results in providing intermediate pain relief.

• 척추신경추나의학회지
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• 제8권2호
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• pp.21-29
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• 2013

Objectives : The purpose of this study is to investigate the relation between cervical spine lateroflexion and upper limb numbness after whiplash injury by traffic accident. Methods : Outpatients who visited Jaseng korean medicine hospital after traffic accident took cervical MRI. Patients who had Normal disc and bulging disc were reviewed to measure the cervical lateroflexion by C2-C7 Cobb's angle & scalenus muscle's length through neutrality AP X-ray views. For statistics, we used SPSS version 18.0 for windows. Results : Groups classified into difference of scalenus muscle's length were showen statistical significance than into cobb's angle. Means of numbness group's length difference are $4.18{\pm}2.26mm$ and that of non-numbness group is $1.59{\pm}1.17mm$. Unilateral numbness group had greater angle and longer of length's difference than non-numbness group. Conclusions : The more severe the lateroflexion of the upper extremity numbness occurs well. Group classifed into difference of scalenus muscle's length has more tendency of occurrence of upper limb numbness than that into cobb's angle. And upper limb numbness occurs more frequently at the same direction of lateroflexion.

• 대한영상의학회지
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• 제82권4호
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• pp.862-875
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• 2021

목적 요추신경근병증이 있는 60세 이상의 환자의 신경공 협착에 영향을 줄 수 있는 인자를 자기공명영상 평가를 통해 알아보고자 하였다. 대상과 방법 요추신경근병증이 있는 60세 이상의 환자 133명이 본원에서 시행 받은 2018년 1월부터 4월까지의 요추 자기공명영상을 대상으로 하였다. 제4/5 요추간과 제5 요추/제1 천추간에서 신경공 협착이 있는 군과 없는 군으로 나눈 후 척추전방전위증, 척추후방전위증, 추간판 간격 감소, 추간판탈출증, 중심성 척추관 협착, 황색인대비후, 척추후관절 비후 여부를 2명의 판독자가 분석한 후 단변량 및 다변량 로지스틱 회귀분석을 시행하였다. 결과 단변량 분석에서 제4/5 요추간에 대해 추간판 간격 감소(p = 0.006), 제5 요추/제1 천추간에 대해서는 척추전방전위증(p = 0.005)과 척추후관절 비후(p = 0.006)가 신경공 협착과 유의한 연관성을 보였다. 다변량 분석에서는 제4/5 요추간에 대해 추간판 간격 감소[odds ratio(이하 OR) = 4.272; 95% confidence interval (이하 CI) 1.736~10.514]가 신경공 협착과 관련된 인자였다. 제5 요추/제1 천추간에서는 척추전방전위증(OR = 3.696; 95% CI 1.297~10.530)과 척추후관절 비후(OR = 6.468; 95% CI 1.238~32.617)가 이와 관련된 인자였다. 결론 제4/5 요추간에서는 추간판 간격 감소가, 제5 요추/제1 천추간에서는 척추전방전위증과 척추후관절 비후가 신경공 협착과 관련된 인자였다.

• 한국산학기술학회논문지
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• 제16권1호
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• pp.585-592
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• 2015

이 연구의 목적은 척추 추간판 융해제인 카이모파파인을 나노캐리어 시스템에 충진시켜 주입시, 추간판내 약제의 확산범위가 감소하는지 평가하기 위한 것이다. 총 3주간 시행된 실험의 재료로는 두 개의 카데바에서 채취된 열다섯 개의 척추 추간판이 쓰였고, 이들은 주입되는 카이모파파인의 종류에 따라 일반 카이모파파인 그룹과 나노캐리어 시스템 그룹으로 나뉘었다. 나노캐리어 시스템 그룹은 다시 그 기반재료가 되는 플루로닉의 종류에 따라 플루로닉 F 127(DA-PF 127) 나노캐리어 그룹과 플루로닉 F 68(DA-PF 68) 나노캐리어 그룹으로 나뉘었다. 실험결과 나노캐리어 시스템을 사용한 그룹은 일반 카이모파파인 그룹에 비해, 척추 추간판 내부로 주입되었을 때, 주입지점에서 멀리 확산되지 않고 국소적으로 작용하는 특성을 보였다(p<0.01). 이러한 특성은 향후 추간판 내 병소만을 선택적으로 제거하는 최소침습적 척추시술의 기반약제로 응용될 가능성을 제시해준다.

• 대한한방내과학회지
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• 제41권2호
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• pp.132-140
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• 2020

Objectives: This research study aimed to determine the effect of Korean medicine treatments on a patient with lumbar disc herniation accompanying polycystic kidney disease. Methods: Acupuncture, herbal medicine, pharmacopuncture, spine decompression therapy, Motion Style Acupuncture Treatment (MSAT), and Chuna were preceded for treatment. We checked the patient's Oswestry Disability Index (ODI), numeric rating scale (NRS), and straight leg raise test (SLRT) on admission and discharge; we also used the NRS and SLRT to evaluate the patient's symptoms on every third day during the hospital stay. Because it is important to manage blood urea nitrogen (BUN), serum creatinine, and blood pressure during the early stage of polycystic kidney disease, BUN and serum creatinine levels were checked weekly while blood pressure was checked every morning. Results: Twelve days after admission, the NRS for lower back pain and right leg pain decreased from 7 to 3 and from 7 to 2, respectively. The ODI value also decreased from 56 to 20 while the SLRT value increased from 30/70 to 60/70. The BUN and serum creatinine levels and the blood pressure readings were all within normal range every time they were checked. Conclusions: The use of Korean medicine treatments resulted in improvements in NRS, ODI, and SLRT on a patient with a herniated lumbar disc herniated who had a past history of polycystic kidney disease; thus, the patient was able to maintaining kidney functioning. Herbal medicine, an alternative method of analgesic anti-inflammatory drugs that has been evaluated as relatively safe on liver and kidney function, could be suggested on a patient with a past history of polycystic kidney disease to maintain kidney function when renal function and blood pressure are monitored.

• Journal of Korean Neurosurgical Society
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• 제46권1호
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• pp.11-15
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• 2009

Objective: Two findings easily found at coronal source images of MR myelography (MRM) were evaluated : dorsal root ganglion (DRG) swelling and running course abnormality (RCA) of L5 exiting root at foramen or extraforamen. We tried to find the sensitivity of each finding when root was compressed. Methods: From 2004 July to 2006, one hundred and ten patients underwent one side paraspinal decompression for their L5 root foraminal or extraforaminal compression at L5-S1 level. All kinds of conservative treatments failed to improve leg symptom for several months. Before surgery, MRI, CT and MRM were done. Retrospective radiologic analysis for their preoperative MRM coronal source images was done to specify root compression sites and L5 root morphologic changes. Results: DRG swelling was found in 66 (60%) of 110 patients. DRG swelling has statistically valuable meaning in foraminal root compression (chi-square test, p<0.0001). Seventy-two (66%) in 110 patients showed abnormal alteration of running course. Abnormal running course has statistically valuable meaning in foraminal or extraforaminal root compression (chi-square test, p<0.0001). Conclusion: Three-dimensional MRM provides precise thin sliced coronal images which are most close to real operative views. DRG swelling and running course abnormality of L5 exiting root are two useful findings in diagnosing L5 root compression at L5-S1 foramen or extraforamen. MRM is thought to provide additional diagnostic accuracy expecially in L5-S1 foraminal and extraforaminal area.

• 척추신경추나의학회지
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• 제10권2호
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• pp.61-71
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• 2015

Objective : To report cases of HIVD of C&L-Spine successfully treated with conservative Korean Traditional Medicine treatment with Megadose Pharmacoacupuncture. Methods : Four patients diagnosed with HIVD of C&L-Spine were treated with Megadose Pharmacopuncture, acupuncture and herbal medicine. Numeric Rating Scale(NRS), Neck Disablility Index(NDI) and Oswestry low back pain Disablility Index(ODI) scores were collected before and after treatment for comparison. Results : There was a significant decrease in NRS, NDI and ODI scores. The mean NRS score decresed from 9 to 2.25, NDI from 45 to 14 and ODI from 46.66 to 11.33. Conclusion : The result suggests Megadose Pharmacoacupuncture can be an effective treatment on patients with HIVD of C&L-Spine.

• Journal of Korean Neurosurgical Society
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• 제41권3호
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• pp.157-160
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• 2007

Objective : The purpose of this study was to evaluate the efficacy and safety of the surgical treatment for lumbar spinal stenosis in elderly patients. Methods : The authors reviewed the medical records of 49 patients older than 65 years of age with lumbar spinal stenosis who underwent surgical treatment from January 2002 to December 2004 in our institute. Results : Average age of patients was 70 years old [32 women, 17 men]. Twenty-four patients had chronic medical disorders. All patients were operated under the general anesthesia of these, 29 patients underwent decompressive laminectomy and decompressive laminectomy with instrumentation and fusion in 20 patients. The mean operation time was 193.5 minutes, mean estimated blood loss was 378cc and mean postoperative hospital stay length was 15.3 days. The mean follow-up duration was 11.9 months. The evaluation of outcome was assessed by Macnab classification. At first month after operation, the outcome showed excellent in 7 [14.3%]. good in 35 [71.4%], fair in 5 [10.2%], and poor in 2 [4.1%]. And at 6 months after operation, 17 patients were lost in follow-up, the outcome showed excellent in 4 [12.5%], good in 25 [78.1%], fair in 3 [9.4%], and no poor cases. There was no significant difference between outcome of laminectomy alone and that of laminectomy with fusion. Six patients [12.2%] experienced postoperative complications which included wound infection [3], nerve root injury [1], disc herniation [1], and reoperation due to insufficient decompression [1]. There were no deaths related to operation. Conclusion : We conclude that the surgical treatment for lumbar spinal stenosis in elderly patients can provide good results with acceptable morbidity when carefully selected. In addition, decision on lumbar spinal fusion should not be against solely on advanced age.