• Journal of Korean Neurosurgical Society
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• 제50권6호
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• pp.528-531
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• 2011

Although posterior segmental fixation technique is becoming increasingly popular, surgical treatment of craniovertebral junctional disorders is still challenging because of its complex anatomy and surrounding critical neurovascular structures. Basilar invagination is major pathology of craniovertebral junction that has been a subject of clinical interest because of its various clinical presentations and difficulty of treatment. Most authors recommend a posterior occipitocervical fixation following transoral decompression or posterior decompression and occipitocervical fixation. However, both surgical modalities inadvertently sacrifice C0-1 and C1-2 joint motion. We report two cases of basilar invagination reduced by the vertical distraction between C1-2 facet joint. We reduced the C1-2 joint in an anatomical position and fused the joint with iliac bone graft and C1-2 segmental fixation using the polyaxial screws and rods C-1 lateral mass and the C-2 pedicle.

• 대한정형외과학회지
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• 제52권1호
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• pp.65-72
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• 2017

목적: 후관절 근접 낭종이 동반된 퇴행성 요추부 질환으로 수술 받은 23명의 환자를 대상으로 방사선적 특징과 임상적 결과를 분석하고자 한다. 대상 및 방법: 23명의 환자를 대상으로 척추관 협착증 동반 여부, 불안정성, 척추 전방 전위증 동반 여부, 낭종의 위치 및 방향, 후관절의 퇴행성 변화 정도, 후관절 각도, 추간판 퇴행 정도를 확인하였다. 모든 환자에게 광범위 감압술 및 기기고정 유합술을 시행하였다. 임상적 결과를 Oswestry low back pain disability questionnaire 및 visual analogue scale을 이용하여 평가하였다. 결과: 23예 중 19예(82.6%)에서 척추관 협착증이 동반되었고, 4예(17.4%)에서는 후관절 낭종이 독립적으로 존재하였다. 이 중 7예(30.4%)에서 불안정성과 전방 전위가 동반되었다. 낭종의 발생은 제4-5 요추간(69.6%)이 가장 많았으며 이환된 병변측의 후관절이 반대측에 비하여 심한 퇴행성 변화를 보였다. 후관절 각도는 좌 우측에 유의한 차이가 없었으며 해당 분절의 추간판은 17예(69.6%)에서 퇴행성 변화를 보였다. 임상적 결과는 수술 후 2년 추시 양호하였다. 결론: 낭종의 발생과 퇴행성 변화는 유의한 상관관계가 있었으며 후관절 낭종과 동반된 퇴행성 요추부 질환에서 광범위 감압술 및 유합술이 좋은 임상적 결과을 얻어 유용한 술식으로 생각된다.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2004년도 추계학술대회 논문집
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• pp.1154-1159
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• 2004

Unexpected postoperative changes, such as growth in rib hump, has been occasionally reported after corrective surgery for scoliosis. However there has been experimental data for explanation of these changes, nor the suggestion of optimal correction method. This numerical study was designed to investigate the main correlating elements in operative kinematics with post-operative changes of vertebral rotation and rib cage deformation in the corrective surgery of scoliosis. To develop a scoliotic spine model automatically, a special program for converting normal spine model to scoliotic spine model was developed. A mathematical finite element model of normal spine including rib cage, sternum, both clavicles, and pelvis was developed with anatomical details. The skeletal deformity of scoliosis was reconstructed, by mapping the X-ray images of a scoliosis into this three dimensional normal spine and rib cage model. The geometric mapping was performed by translating and rotating the spinal colume with the amount analyzed from the digitized 12 built-in coordinate axes in each vertebral image. By utilizing this program, problems generated in mapping procedure such as facet joint overlapping, vertebral body deformity could be automatically resolved.

• 한방재활의학과학회지
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• 제15권2호
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• pp.169-181
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• 2005

Objectives : The 5th lumbar - 1st sacrum facet joint is unstable area from an anatomical viewpoint, so that it is clinically major causes of low back pain. The purpose of this study is to assess the difference of the Van Akkerveeken measurement and intervertebral disc angle, Ferguson angle between the 5th lumbar - 1st sacrum facet syndrome patients and sample group patients. Methods : Van Akkerveeken measurement, intervertebral disc angle and Ferguson angle were measured in 30 patients who had 5th lumbar - 1st sacrum facet syndrome and 31 sample group patients. Results : 1. Van Akkerveeken measurement of 5th lumbar - 1st sacrum facet syndrome patients is statistically larger that of than sample group patients. 2. Intervertebral disc angle of the 5th lumbar - 1st sacrum facet syndrome patients is statistically larger that of than sample group patients. 3. Ferguson angle is the 5th lumbar - 1st sacrum facet syndrome patients is statistically larger than that of sample group patients. Conclusions : These results suggest that Van Akkerveeken measurement and intervertebral disc angle is able to be used for diagnosis of facet syndrome.

• Journal of Korean Neurosurgical Society
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• 제48권3호
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• pp.193-198
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• 2010

Objective : The purpose of this study is to compare the incidence of possible complications of cervical lateral screw fixation and the achievements of bicortical purchase using the Roy-Camille, Magerl and the modified methods. Methods : Six fresh-frozen cervical spine segments were harvested. The Roy-Camille technique was applied to C3 and C4, and the Magerl technique was applied to C5, C6, and C7 of one side of each cadaver. The modified technique was applied to the other side of each cadaver. The nerve root injury, violation of the facet joint, vertebral artery injury, and the bicortication were examined at each screwing level. Results : No vertebral artery injury was observed in any of the three methods. One nerve root injury was observed in each cervical spine segment using the Roy-Camille method (8.3%), the Magerl method (5.6%), and the modified method (3.3%). Facet joint injuries were observed in two cervical spinal segments using the Roy-Camille method (16.7%) and three with the Magerl method (16.7%), while five facet joint violations occurred when using the modified method (16.7%). Bicortical purchases were achieved on ten cervical spinal segments with the Roy-Camille method (83.3%) and Magerl method (55.6%), while twenty bicortical purchases were achieved in the modified method (66.7%). Conclusion : The advantages of the modified method are that it is performed by using given anatomical structures and that the complication rate is as low as those of other known methods. This modified method can be performed easily and safely without fluoroscopic assistance for the treatment of many cervical diseases.

• 대한족부족관절학회지
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• 제6권2호
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• pp.149-155
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• 2002

Purpose: To propose a new comprehensive classification system of intraarticular calcaneal fracture based on CT images. Materials and methods: Fourty intraarticular calcaneal fractures which were treated operatively were evaluated retrospectively. We classified fracture types according to severity of comminution on the posterior facet and calcaneocuboid joint by CT images. And we evaluated postoperative results of each fracture types in terms of the quality of fixation and reduction by the postoperative plain radiograghs. Results: By the classification of the posterior facet, 18 cases were P-I, 15 were P-II, and 7 were P-III. Among the P-I cases, 7 were P-IA, 9 were P-IL, 1 was P-IM and 2 were P-IT. According to the classification of calcaneocuboid joint, II cases were C-I, 18 were C-II and 11 were C-III. Qualities of fixation were excellent in 27 cases (67.5%), fair in 9(22.5%) and poor in 4(10%). Qualities of reduction were excellent 23 cases(57.5%), fair in 11(27.5%) and poor in 6(15%). Conclusion: Our new classification system based on the CT images could provide informations about the fracture configuration and severity of comminution around calcaneocuboid joint as well as the posterior facet. And the high grade fractures such as type P-III are need to be taken care of fixation of articular surfaces.

• 대한영상의학회지
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• 제82권1호
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• pp.162-172
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• 2021

목적 요추 후궁절제술 시행 부위 후관절 활액낭에 대해 투시유도 하 경피적 낭종파열술 및 스테로이드 주입술을 시행 받은 환자에 관하여 후향적으로 시술의 성공률 및 임상적 효과를 분석하였다. 대상과 방법 투시유도 하 경피적 후관절 낭종파열술과 관절 내 스테로이드 주입술을 시행 받은 환자이면서, 시술 전 6개월 이내 촬영한 요추 자기공명영상 상 이전 후궁절제술 부위와 후 관절 활액낭종의 위치가 일치하는 것이 증명된 환자, 그리고 그 낭종의 위치가 신경학적 증상을 설명하는 것으로 판단되는 환자를 대상(14명)으로 하였으며 시술 후 낭종파열의 성공유무와 증상의 호전 정도를 조사하였다. 결과 시술이 반복될수록 낭종파열의 성공률은 감소하였지만(첫 시술에서는 62.5%, 그 이후의 시술에서는 0~33%), 80%의 환자가 시술 후 증상 호전을 보였다. 추적관찰 기간 내 낭종에 대한 수술률은 14.3%였다. 결론 요추 후궁절제술 시행 부위 후관절 활액낭에 대한 투시유도 하 경피적 낭종파열술 및 스테로이드 주입술은 효과적인 치료 방법으로서, 수술적 치료를 고려하기 전에 먼저 시도해 볼 수 있다.

• Journal of Oral Medicine and Pain
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• 제40권4호
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• pp.140-145
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• 2015

Purpose: Bruxism is commonly considered a major risk factor for temporomandibular disorders (TMD), and the psychosocial factors had been one of the etiologic factor of bruxism. But there are still unsolved issues on the relationship between sleep bruxism and TMD and the etiologic factors of bruxism. This study is aim to evaluate the clinical and psychosocial characteristics according to diagnostic grade of bruxism in TMD patients. Methods: Three hundred subjects were enrolled who were under the stabilization splint therapy for TMD. Recently international consensus proposed a diagnostic grading system of "possible", "probable", and "definite" sleep or awake bruxism for clinical and research purpose. According to their suggestion, we classified these subjects as self-reported bruxism (SRB) and wear facet bruxism (WFB). We investigated the clinical characteristics (sex, age, chief complaint, pain duration, visual analogue scale), sum of tenderness (temporomandibular joint, masticatory muscles, cervical muscles), diagnosis of TMD according to research diagnostic criteria (the Research Diagnostic Criteria for Temporomandibular Disorders, RDC/TMD), headache, subjective sleep quality (Pittsburgh Sleep Quality Index, PSQI), and psychosocial characteristics (Symptom Checklist-90-Revised, SCL-90-R) in enrolled subjects. We compared the clinical and psychosocial characteristics between these bruxism groups. Results: There were no significant correlation between self-reported and WFB (p=0.13). SRB subjects more reported pain as a chief complain than subject who did not report bruxism (p=0.014). The mean score of global PSQI was significantly higher in SRB than in did not report positively subjects (p=0.045). The mean score of anxiety and phobic anxiety was significantly higher in SRB than in did not reported positively subjects (p=0.045, p=0.041). Conclusions: Although bruxism is regarded as risk factor of TMD, this study showed inconsistent result between SRB and clinically detected bruxism by wear facet on slpint. We suggest that the clinician should consider with extreme caution when they assess SRB.

• 한국정밀공학회지
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• 제23권3호
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• pp.187-194
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• 2006

Unexpected postoperative changes, such as growth in rib hump and shoulder unbalance, have been occasionally reported after corrective surgery for scoliosis. However there has been neither experimental data fer explanation of these changes, nor the suggestion of optimal correction method. Therefore, the numerical study was designed to investigate the post-operative changes of vertebral rotation and rib cage deformation after the corrective surgery of scoliosis. A mathematical finite element model of normal spine including rib cage, sternum, both clavicles, and pelvis was developed with anatomical details. In this study, we also developed a special program which could convert a normal spine model to a desired scoliotic spine model automatically. A personalized skeletal deformity of scoliosis model was reconstructed with X-ray images of a scoliosis patient from the normal spine structures and rib cage model. The geometric mapping was performed by translating and rotating the spinal column with an amount analyzed from the digitized 12 built-in coordinate axes in each vertebral image. By utilizing this program, problems generated in mapping procedure such as facet joint overlapping, vertebral body deformity could be automatically resolved.

• 한국정밀공학회지
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• 제24권8호통권197호
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• pp.122-129
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• 2007

To evaluate the effect of artificial disc implantation and fusion on the biomechanics of adjacent motion segment, a nonlinear three-dimensional finite element model of whole lumbar spine (L1-S1) was developed. Biomechanical analysis was performed for two different types of artificial disc, ProDisc and SB $Charit{\acute{e}}$ III model, inserted at L4-L5 level and these results were also compared with fusion case. Angular motion of vertebral body, forces on the spinal ligaments and facet joint under sagittal plane loading with a compressive preload of 150 N at a nonlinear three-dimensional finite element model of Ll-S1 were compared. The implant did not significantly alter the kinematics of the motion segment adjacent to the instrumented level. However, $Charit{\acute{e}}$ III model tend to decrease its motion on the adjacent levels, especially in extension motion. Contrast to motion and ligament force changes, facet contact forces were increased in the adjacent levels as well as implanted level for constrained instantaneous center of rotation model, i.e. ProDisc model.