• Title/Summary/Keyword: Herniation

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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.

Study of the enzymatic action of the chymopapain using pluronic based nano-carrier system on the cadaveric nucleus pulposus tissue (플루로닉(pluronic) 기반의 나노운반체(nano-carrier)에 충진된 카이모파파인(chymopapain)의 척추 추간판 조직내 작용성에 관한 연구)

  • Choi, Won Il;Tae, Gi Yoong;Hong, Young Ki
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.1
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    • pp.585-592
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    • 2015
  • The objective of this study is to determine if when chymopapain is loaded onto a nano-carrier, an injection of it reduces the spreading range of the drug within the discs. The materials for the experiment, which were conducted for three weeks, included fifteen intervertebral discs taken from two cadavers, which were divided according to the types of injected chymopapain solutions as follows: ordinary chymopapain group and nano-carrier system group. The nano-carrier system group was again divided into two subgroups according to the types of pluronics, the basic material for the nano-carriers: Pluronic F 127(DA-PF 127) in the nano-carrier group and Pluronic F 68(DA-PF 68) in the nano-carrier group. The results showed that the action of chymopapain using a pluronic-based nano-carrier system was localized around the center of the injection site instead of broad spreading, compared to that of the ordinary chymopapain group (p<0.01). This characteristic suggests a possible application to effective agents for minimally invasive spinal treatment through which disc lesions were removed selectively.

Awake OPCAB: Initial Experience (의식 있는 상태에서 경막외 마취를 이용한 심박동하 관상동맥우회술: 초기 경험)

  • Son Kuk-Hui;Cho Kwang-Ree;Kim Ki-Bong
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.598-603
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    • 2006
  • Background: High thoracic epidural anesthesia allows awake coronary artery bypass grafting, avoiding the drawbacks of mechanical ventilation and general anesthesia. Materian and Method: From April, 2005 to September, 2005, 12 patients were underwent awake coronary artery bypass grafting using high thoracic epidural anesthesia. There were 1 female and 11 male patients, with a mean age of $66{\pm}6$ years. Off pump coronary artery. bypass grafting was performed through a median sternotomy using arterial grafts. Result: There were no mortality. Pneumothorax was developed during surgery in 8 patients. Five patients required secondary intubation because of pneumothorax (n=3), bowel herniation (n=1), and hemothorax after chest tube insertion (n=1). Postoperative coronary angiography was performed before discharge in all patients and all the grafts were patent. Conclusion: Our intial experience demonstrated the feasibility of awake off-pump coronary artery bypass grafting. Further study is required to define the indications, advantages and limitations of this strategy.

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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    • v.61 no.5
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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.

The Use of Polypropylene Mesh for Perineal Herniorrhaphy in the Dog (개에서 polypropylene mesh를 이용한 회음부 탈장 교정술 증례)

  • Kang, Eun-Hee;Chang, Hwa-Seok;Yang, Hee-Taek;Chung, Dai-Jung;Lee, Jae-Hoon;Yang, Wo-Jong;Kim, Tae-Hoon;Lee, Young-Su;Choi, Chi-Bong;Kim, Hwi-Yool
    • Journal of Veterinary Clinics
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    • v.23 no.4
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    • pp.461-464
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    • 2006
  • Perineal hernia occurs spontaneously in older male dogs after idiopathic weakening of the pelvic diaphragm A 14-year-old uncastrated male shih tzu dog with right-sided perineal swelling was referred to the Veterinary Medical Teaching Hospital of Konkuk University. He had sign of perineal swelling for three years. Plain radiography documented the extent of rectal and colonic dilation in the herinal sac. During surgery, external anal sphincter muscle, coccygeus muscle and levator am muscle were weakened due to the three years of herniation. Internal obturator muscle transposition method was not enough for large defect, so mesh was applied to reduce the hernial sac. Internal obturator muscle transposition combined with using of polypropylene mesh was successfully performed in this dog.

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

  • Kim, Young-Ki;Lee, Seung-Yong;Park, Se-Jin;Lee, Scott-S.;Kim, Jin-Hyun;Lee, Hee-Chun;Chang, Hong-Hee;Lee, Hyo-Jong;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
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    • v.28 no.1
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    • pp.122-127
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    • 2011
  • A 5-year old, intact male, Cocker spaniel dog was referred with paraplegia and loss of deep pain perception. Physical, neurological examinations, radiography, and computed tomography were evaluated. Based on the clinical examinations, the dog was diagnosed with severe disc herniation ($L_2$ to $L_3$ intervertebral disc space). On the next day of presentation (6 days after loss of deep pain perception), hemilaminectomy was performed. After decompression of spinal cord and removal of herniated disc materials, $1{\times}10^6$ canine allogenic adipose tissue-derived mesenchymal stem cells (MSCs) diluted by $50{\mu}l$ saline were directly applied to the injured site of the spinal cord. Ten weeks of follow-up after surgery, full recovery of deep pain perception and motor function were evaluated in both hind limbs. Based on the result, we suggest that the transplantation of allogenic adipose tissue-derived MSCs to dogs with spinal cord injuries could be a considerable method to expect better clinical outcomes in veterinary practice.

Effects of Acupuncture, Electro-acupuncture, Low Level He-Ne Laser Therapy at Oe-gwan($TE_5$) ${\cdot}$ Chogimup ($GB_{41}$) on L5 Spinal Nerve Ligation Model in Rats (건측(健測) 취혈(取穴) 다종(多種) 침자법(鍼刺法)이 백서(白鼠)의 신경병리성(神經病理性) 동통(疼痛)에 미치는 영향)

  • Jung, Jung-Hee;Cho, Myung-Rae;Wei, Tung-Sheun;Ryu, Chung-Ryeol
    • Journal of Acupuncture Research
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    • v.24 no.5
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    • pp.137-150
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    • 2007
  • Objectives : To find effects of acupuncture, electro-acupuncture, low level He-Ne laser therapy(LLLT) at $TE_5$, $GB_{41}$ in the neuropathic pain. We made experiment on rats ligated L5 spinal nerve like general herniation of nucleus pulposus(HNP). Methods : A model of neuropathic pain was made by isolating Left 5th lumbar spinal nerve of rats. Three days after the neuropathic surgery, acupuncture and LLLT, electro-acupuncture was injected at $TE_5$, $GB_{41}$ one time a day for a week. Each group was divided two. one is opposite side performed the surgery which is right, another is left side performed the surgery. After that, the author examined the withdrawal response of neuropathic rats' legs by van Frey filament and acetone stimulation. And also the author examined c-Fos, Nociceptin and KOR-3 in the midbrain central gray of neuropathic rats. Results : As we have observed the effect of mechanical allodynia, LT-R group were diminished on 6th day compared with control group, EA-L group, EA-R group and LT-L group were diminished on 7th day compared with control group. As we have observed the effect of cold allodynia, EA-R group were diminished on 6th day, 7th day compared with control group. As we have observed the effect of activity of c-Fos in the central gray part, EA-R group and LT-R group were diminished compared with control group. As we have observed the effect of activity of Nociceptin in the central gray part, EA-R group were a little increased compared with control group but it is not reliability. As we have observed the effect of activity of KOR-3 in the central gray part, EA-R group were significantly increased compared with control group. Conclusions : We have noticed that effect of acupuncture at opposite side of sickness and powerful stimulation could be more effective, because of EA-R group have more controllable effect all test we have done on the other hand EA-L group have only effect on mechanical allodynia. This study can be used in clinical therapy for neuropathic pain. But it is not reliability that Nociceptin have effectively to control pain. Therefore We have to follow up about that.

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Fourty One Cases on MRI (Magnetic Resonance Imaging) Change of Hivd of L-Spine Patient Who Have Been Improvement on Megadose Pharmacoacupuncture and Korean Medical Treatments (대용량 약침 및 한방치료로 호전된 요추 추간판탈출증 환자의 영상의학적 변화 41사례 보고)

  • Yoo, Su-bin;Kim, Moon-hwui;Moon, Byung-heon;Yoon, Tae-kyung;Ju, Yeong-guk;Kwon, Ok-jun;Choo, Won-jung;Kim, Joo-won
    • Journal of Korean Medicine Rehabilitation
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    • v.26 no.4
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    • pp.117-126
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    • 2016
  • Objectives The purpose of this study is to report the effect of Megadose Pharmacoacupuncture combined with conservative Korean medicine treatment on Herniated InterVertebral Disc (HIVD) of lumbar spine patient diagnosed by Magnetic Resonance Imaging (MRI). Methods This study includes 41 patients whose Lumbar Disc Herniations were by MRIbetween 1st Aprill 2011 and 31th March 2016. All of the patients were treated with Megadose Pharmacoacupuncture combined with Korean medicine treatment. The MRI examination was performed on two or more occasions (minimally, pre-treatment and post-treatment). The volume of each herniated disc was measured. For each patient, age, sex, disc migration, morphology, initial LDH size, herniated disc resorption rate were analysed. Results The mean volumes of herniated discs at pre-treatment and post-treatment were $1321.62{\pm}467.53mm^3$ and $648.72{\pm}313.38mm^3$. The volumes of all patients were decreased. The resorption means of each class of the extent of LDH were significantly different (p=0.041). On the other hand, no difference was found in sex, age, level, herniated disc grade. Conclusions The MRI results suggest that Megadose Pharmacoacupuncture combined with Korean medicine treatment can help treat lumbar herniated disc.

A Case Report of Lumbar HIVD Treated with Korean Medicine on a Polycystic Kidney Patient (다낭신 환자의 요추 추간판탈출증에 대한 통합한방치료 1례)

  • Ju, Ah-ra;Ryu, Gwang-hyun;Park, Mi-so;Choi, Yo-sup;Choo, Won-jung;Chae, Ji-won
    • The Journal of Internal Korean Medicine
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    • v.41 no.2
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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.

The Complications of the Graf Stabilization for Lumbar Disc Herniation with Posterior Instability (후방불안정성을 동반한 요추 추간판 탈출증에서 Graf 고정술후 발생한 합병증 분석)

  • Park, Joo-Tae;Shin, Young-Shik;Yang, Jeong-Ho;Min, Kang-Woo
    • Journal of Yeungnam Medical Science
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    • v.15 no.1
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    • pp.164-172
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    • 1998
  • The Graf stabilization has been introduced in treating lumbar spinal disorder associated with posterior instability. This study reviewed some problems of the Graf instrumentation as a soft stabilizer. The purpose of this study is to analyse the problems of the soft stabilization in spinal instability. We reviewed 145 cases which were operative treatment using the Graf instrument for lumbar spinal disorder associated with posterior instability at our department from May, 1991 to Dec, 1995. The mean follow up periods was 29 months ranging from 24 months to 6 years 8 months. Of the 145 cases, 22 cases were showed the problem. The diagnostic method were simple x-ray, flexion-extension lateral stress view and CT scan. Results were as follows: Adjacent segmental instability was 10 cases(6.9%), disc space narrowing was 8 cases(5.5%), screw loosening was 3 cases(2.1%) and breakage of the Graf band was 1 case(0.6%). The problems of the soft stabilization were adjacent segmental instability, disc space narrowing, screw loosening, and breakage of the Graf band. But the rate of adjacent segmental instability and disc space narrowing was lower than other lumbar spinal instrumentation.

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