• Title/Summary/Keyword: Intervertebral Disc

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Characteristiis of Dynamic Response in the Human Head and Neck to Implusive Loading (충격력에 대한 인체의 머리와 목의 동력학적 응답특성)

  • 김영은;김정훈
    • Journal of Biomedical Engineering Research
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    • v.16 no.4
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    • pp.491-498
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    • 1995
  • A numerical human head/neck model was constructed for analyzing the implication in decleration injuries. This model consists of nine rigid bodies representing the head, cervical vertebrae C1-C7, and T1. These rigid bodies were connected by intervertebral disks described by massless beam elements. Muscles and ligaments were also incoperated in the model represented by nonlinear spring and viscoblastic element respectively Agreement of the analytical kinematic response with the results of experimental data from a volunteer run was satisfactory. Moreover, possible injury estimation from the calculated moment, force variations in the disc, and force variation in ligaments matched well with clinical observations.

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Four Case of HIVD-Lumbar Spine Patient Treated with Acupotomy (침도침 시술을 통한 요추추간판탈출증 환자 4명의 증례보고)

  • Kwak, Byung-Min;Hong, Kwon-Eui
    • Journal of Acupuncture Research
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    • v.25 no.4
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    • pp.149-156
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    • 2008
  • Objectives : The purpose of this study is to report the effect of acupotomy for patients with Lumbar intervertebral disc Herniation. Methods : We treated Four patients who have HIVD of L-spine with acupotomy. Visual analog scores(VAS) and Oswestry Low-back pain Disabiliby Index(ODI) were compared before-treatment with after-tretment. When the patients is discharged, the satisfaction of acupotomy were graded by Five-point Likert scale. Results : VAS and ODI were decreased at all case. Likert scale point were cheked as grade 4 at all case. Conclusions : This study shows acupotomy has useful effect on HIVD of L-spine.

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A Case with Spondyloepiphyseal Dysplasia Tarda with TRAPPC2 Mutation

  • Kim, Hyun-Jin;Lee, Beom-Hee;Kim, Yoo-Mi;Kim, Gu-Hwan;Kim, Ok-Hwa;Yoo, Han-Wook
    • Journal of Genetic Medicine
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    • v.9 no.1
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    • pp.31-34
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    • 2012
  • Spondyloepiphyseal dysplasia tarda (SEDT) is an X-linked skeletal dysplasia. Patients show disproportionate short stature with short trunk and barrel-shaped chest, which usually become pronounced in late childhood. The radiologic findings are characterized by narrow intervertebral disc spaces and moderate epiphyseal dysplasia of long bones. Here we report a case of SEDT with a novel frameshift mutation in TRAPPC2, the disease-causing gene of SEDT. This is the first Korean report with SEDT confirmed by genetic testing.

Discal Cyst Diagnosed by Radiologic Finding

  • Lim, Hyung-Guhn;Kim, Hyeun-Sung;Kim, Seok-Won;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.41 no.6
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    • pp.418-420
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    • 2007
  • Discal cyst is a very rare lesion that can result in refractory low back pain and leg radiating pain. Because they are so uncommon, their exact origin and pathophysiology are still unknown. A 31-year-old man visited our institute due to low back pain and severe left leg radiating pain. Magnetic resonance images [MRI] revealed spherically shaped extradural cystic lesion at L2-L3 level. Computed tomography [CT] discography demonstrated obvious communication between the intervertebral disc and the cyst. The patient underwent posterior decompression and excision of cyst. The symptoms were remarkably improved immediately after surgery.

Discospondylitis with pyometra in a dog (개에서 자궁축농증과 병발한 척추원반염 1례)

  • Kim, Haksang;Choi, Jihye;Jung, Joohyun;Chang, Jinhwa;Choi, Mincheol;Yoon, Junghee
    • Korean Journal of Veterinary Research
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    • v.46 no.4
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    • pp.381-385
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    • 2006
  • Discospondylitis is an infection of intervertebral discs, associated end plates, and adjacent vertebral bodies causing destruction and proliferation. A 10-year-old intact female Rhodesian Ridgeback dog was referred to the Veterinary Medical Teaching Hospital, Seoul National University with paraparesis and severe pain at T13-L1 region for one week duration. The treatment with PDS for one week by referring veterinarian showed no clinical improvement. At time of presentation, clinical signs of the patient included depression, vaginal discharge, and fever. In T-L spine radiography, osteolytic change was found between caudal endplate of T13 and cranial endplate of L1. The affected vertebral bodies were shortened and intervertebral disc space was widened. In abdominal radiography, a dilated soft tissue opacity tubular structure was found in mid-caudal abdomen. The abdominal ultrasonography revealed the uterus dilated with echogenic fluid. The CT findings showed concentric lysis of T13-L1 endplates. The dog was diagnosed as diskospondylitis at T13-L1 and pyometra. Urine and blood were cultured, and Staphylococcus (S.) intermedius was identified. The patient had surgical treatment for pyometra but died for septicemia.

Efficacy of Korean Medicine Combination Treatments for Recurrent Back Pain after Medical Procedures: A Retrospective Study

  • Jeong, Wu-Jin;Noh, Je-Heon;Huh, Hyo-Seung;Lee, Sun-Ho;Kim, Sun-A;Kim, Min-Kyung;Roh, Ji-Ae;Lee, Ji-Won
    • Journal of Acupuncture Research
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    • v.36 no.4
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    • pp.230-237
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    • 2019
  • Background: The purpose of this study was to investigate the clinical efficacy of Korean medicine combination treatments for recurring back pain after medical procedures. Methods: This was a retrospective study performed on 311 patients admitted to Daejoen Jaseng hospital who were diagnosed with lumbar spine herniated intervertebral discs. The patients were divided into 2 groups according to whether or not they had undergone at least one medical procedure on the lumbar spine. They were assessed with Numeric Rating Scale (NRS), Oswestry Disability Index (ODI) and EuroQol-5 Dimensions Index (EQ-5D) before and after treatment. Results: Patients who experienced a medical procedure on the lumbar spine in the prehospital phase (Group A), statistically significantly improved EQ-5D and ODI scores. The NRS scores also decreased however it was not statistically significant. Patients who had not undergone a medical procedure on the lumbar spine in the prehospital phase (Group B) had statistically significantly improved ODI and NRS scores. The average EQ-5D score decreased however, there was no statistically significant difference before and after scores in Group B. There was no statistically significant difference in variation in EQ-5D, ODI, and NRS scores before and after treatment between the groups. Conclusion: The results of this study indicated that even after a bilateral procedure and surgery, when pain in patients with lumbar spine herniated intervertebral disc did not decrease, (as in failed back surgery syndrome), Korean medicine combination treatment of postoperative pain was helpful and there was improvement in daily life.

Risk Factors of Allogenous Bone Graft Collapse in Two-Level Anterior Cervical Discectomy and Fusion

  • Woo, Joon-Bum;Son, Dong-Wuk;Lee, Su-Hun;Lee, Jun-Seok;Lee, Sang Weon;Song, Geun Sung
    • Journal of Korean Neurosurgical Society
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    • v.62 no.4
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    • pp.450-457
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    • 2019
  • Objective : Anterior cervical discectomy and fusion (ACDF) is commonly used surgical procedure for cervical degenerative disease. Among the various intervertebral spacers, the use of allografts is increasing due to its advantages such as no harvest site complications and low rate of subsidence. Although subsidence is a rare complication, graft collapse is often observed in the follow-up period. Graft collapse is defined as a significant graft height loss without subsidence, which can lead to clinical deterioration due to foraminal re-stenosis or segmental kyphosis. However, studies about the collapse of allografts are very limited. In this study, we evaluated risk factors associated with graft collapse. Methods : We retrospectively reviewed 33 patients who underwent two level ACDF with anterior plating using allogenous bone graft from January 2013 to June 2017. Various factors related to cervical sagittal alignment were measured preoperatively (PRE), postoperatively (POST), and last follow-up. The collapse was defined as the ratio of decrement from POST disc height to follow-up disc height. We also defined significant collapses as disc heights that were decreased by 30% or more after surgery. The intraoperative distraction was defined as the ratio of increment from PRE disc height to POST disc height. Results : The subsidence rate was 4.5% and graft collapse rate was 28.8%. The pseudarthrosis rate was 16.7% and there was no association between pseudarthrosis and graft collapse. Among the collapse-related risk factors, pre-operative segmental angle (p=0.047) and intra-operative distraction (p=0.003) were significantly related to allograft collapse. The cut-off value of intraoperative distraction ${\geq}37.3%$ was significantly associated with collapse (p=0.009; odds ratio, 4.622; 95% confidence interval, 1.470-14.531). The average time of events were as follows: collapse, $5.8{\pm}5.7months$; subsidence, $0.99{\pm}0.50months$; and instrument failure, $9.13{\pm}0.50months$. Conclusion : We experienced a higher frequency rate of collapse than subsidence in ACDF using an allograft. Of the various preoperative factors, intra-operative distraction was the most predictable factor of the allograft collapse. This was especially true when the intraoperative distraction was more than 37%, in which case the occurrence of graft collapse increased 4.6 times. We also found that instrument failure occurs only after the allograft collapse.

Current Concepts of Degenerative Disc Disease -A Significance of Endplate- (퇴행성 추간판 질환의 최신 지견 -종판의 중요성-)

  • Soh, Jaewan;Jang, Hae-Dong;Shin, Byung-Joon
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.4
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    • pp.283-293
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    • 2021
  • Degenerative disc disease has traditionally been thought of as low back pain caused by changes in the nucleus pulposus and annulus fibrous, in recent studies, however, changes in the upper and lower endplates cause degeneration of the disc, resulting in mechanical pressure, inflammatory reactions and low back pain. Recently, the bone marrow of the vertebral body-endplate-nucleus pulposus and annulus fibrous were considered as a single unit, and the relationship was explained. Once the endplate is damaged, it eventually aggravates the degeneration of the bone marrow, nucleus pulposus, and annulus fibrosus. In this process, the compression force of the annulus fibrosus increases, and an inflammatory reaction occurs due to inflammatory mediators. Hence, the sinuvertebral nerves and the basivertebral nerves are stimulated to cause back pain. If these changes become chronic, degenerative changes such as Modic changes occur in the bone marrow in the vertebrae. Finally, in the case of degenerative intervertebral disc disease, the bone marrow of the vertebral body-endplate-nucleus pulposus and annulus fibrous need to be considered as a single unit. Therefore, when treating patients with chronic low back pain, it is necessary to consider the changes in the nucleus pulposus and annulus fibrosus and a lesion of the endplate.

Analysis of Lumbar Herniated Intervertebral Disc Patients' Healthcare Utilization of Western-Korean Collaborative Treatment: Using Health Insurance Review & Assessment Service's Patients Sample Data (요추 추간판 탈출증 환자의 의·한의 협진 의료이용 현황 분석: 건강보험심사평가원 환자표본 데이터를 이용하여)

  • Ko, Jun-Hyuk;Yu, Ji-Woong;Seo, Sang-Woo;Seo, Joon-Won;Kang, Jun-Hyuk;Kim, Tae-Oh;Cho, Whi-Sung;Seo, Yeon-Ho;Ahn, Jong-Hyun;Lee, Woo-Joo;Kim, Bo-Hyung;Choi, Man-Khu;Kim, Sung-Bum;Kim, Hyung-Suk;Kim, Koh-Woon;Cho, Jae-Heung;Song, Mi-Yeon;Chung, Won-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.31 no.4
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    • pp.105-116
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    • 2021
  • Objectives Lumbar herniated intervertebral disc (L-HIVD) is common disease in which Western-Korean collaborative treatment is performed in Korea. This study aimed to analyze Western-Korean collaborative treatment utilization of Korean patients with L-HIVD using Health Insurance Review & Assessment Service's Patients Sample Data. Methods This study used the Health Insurance Review & Assessment Service-National Patient Sample (HIRA-NPS) in 2018. Claim data of L-HIVD patients were extracted. The claim data were rebuilt with the operational concept of 'episode of care' and divided into Korean medicine episode group (KM), Western medicine episode group (WM) and collaborative treatment episode group (CT). General characteristics, medical expenses and healthcare utilization were analyzed. In addition, the difference of average visit day and average medical expenses between non-collaborative group (KM plus WM) and CT were analyzed by the propensity score matching method. Results A Total of 64,333 patients and 365,745 claims were extracted. The number of episodes of WM, KM and CT was 69,383 (92.97%), 3,903 (5.23%), and 1,341 (1.80%) respectively. The frequency of collaborative treatment episode was higher in women and the age of 50s. The most frequently described treatment in CT was acupuncture therapy. As a result of the propensity score matching, the number of visit days and medical expenses in the collaborative treatment group was higher than in the non-collaborative group. Conclusions The analysis of healthcare utilization of Korean-Western collaborative treatment may be used as basic data for establishing medical policies and systematic collaborative treatment model in the future.