• Asian Spine Journal
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• v.12 no.6
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• pp.1060-1068
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• 2018

Study Design: Retrospective study. Purpose: Lumbar intervertebral disc degeneration is an important cause of low back pain. Overview of Literature: Spinal fusion is often reported to have a good course for adolescent idiopathic scoliosis (AIS). However, many studies have reported that adjacent segment degeneration is accelerated after lumbar spinal fusion. Radiography is a simple method used to evaluate the orientation of the vertebral column. magnetic resonance imaging (MRI) is the method most often used to specifically evaluate intervertebral disc degeneration. The Pfirrmann classification is a well-known method used to evaluate degenerative lumbar disease. After spinal fusion, an increase in stress, excess mobility, increased intra-disc pressure, and posterior displacement of the axis of motion have been observed in the adjacent segments. Methods: we retrospectively secured and analyzed the data of 15 patients (four boys and 11 girls) with AIS who underwent a spinal fusion surgery. We studied the full-length view of the spine (anterior-posterior and lateral) from the X-ray and MRI obtained from all patients before surgery. Postoperatively, another full-length spine X-ray and lumbosacral MRI were obtained from all participants. Then, pelvic tilt, sacral slope, curve correction, and fused and free segments before and after surgery were calculated based on X-ray studies. MRI images were used to estimate the degree to which intervertebral discs were degenerated using Pfirrmann grading system. Pfirrmann grade before and after surgery were compared with Wilcoxon signed rank test. While analyzing the contribution of potential risk factors for the post-spinal fusion Pfirrmann grade of disc degeneration, we used generalized linear models with robust standard error estimates to account for intraclass correlation that may have been present between discs of the same patient. Results: The mean age of the participant was 14 years, and the mean curvature before and after surgery were 67.8 and 23.8, respectively (p<0.05). During the median follow-up of 5 years, the mean degree of the disc degeneration significantly increased in all patients after surgery (p<0.05) with a Pfirrmann grade of 1 and 2.8 in the L2-L3 before and after surgery, respectively. The corresponding figures at L3-L4, L4-L5, and L5-S1 levels were 1.28 and 2.43, 1.07 and 2.35, and 1 and 2.33, respectively. The lower was the number of free discs below the fusion level, the higher was the Pfirrmann grade of degeneration (p<0.001). Conversely, the higher was the number of the discs fused together, the higher was the Pfirrmann grade. Conclusions: we observed that the disc degeneration aggravated after spinal fusion for scoliosis. While the degree of degeneration as measured by Pfirrmann grade was directly correlated by the number of fused segments, it was negatively correlated with the number of discs that remained free below the lowermost level of the fusion.

• Journal of the korean academy of Pediatric Dentistry
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• v.48 no.4
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• pp.437-448
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• 2021

The purpose of this study is to analyze morphological characteristics of maxillary primary molar's root and root canal. 268 children aged 3 - 7 years (175 boys, 93 girls) who had CBCT (152 children) and 3D CT (116 children) taken in Seoul National University Dental Hospital from January 2006 to April 2020 were included. The number of roots and root canals were analyzed in 1002 teeth without any root resorption or periapical pathologies. Curvature, angulation, length of root and root canal, as well as cross-sectional shapes of the root canal were analyzed in 218 teeth. By using Mimics and 3-Matics software, volume, surface area, and volume ratio of root canal was analyzed in 48 teeth. More than half of maxillary primary molars have 3 roots and 3 root canals. The degree of symmetry of root canal type was about 0.63 (Cohen's kappa coefficient). The most frequent shape of roots and canals was linear in 1^st primary molars and curved in 2^nd primary molars. Angulation, length of root and root canals was the largest on palatal roots. Most teeth showed ovoid or round shapes at apex. The largest root canal volume, surface area, volume ratio was found in the palatal roots.