• Journal of Korean Neurosurgical Society
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• v.46 no.4
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• pp.305-311
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• 2009

Objective : The purpose of this study was to determine the efficacy, radiological findings, clinical outcomes and complications in patients with lumbar stenosis and osteoporosis after the use of polymethylmethacrylate (PMMA) augmentation of a cannulated pedicle screw. Methods : Thirty-seven patients with degenerative spinal stenosis and osteoporosis (T-score < -2.5) underwent lumbar fusion using the Dream Technology Pedicle Screw ($DTPS^{TM}$, Dream Spine Total Solutions, Dream STS, Seoul. Korea) between 2005 and 2007. The clinical outcomes were evaluated by using the visual analog scale (VAS) and the Prolo scale. Radiologic findings were documented through computed tomography (CT) and plain films. Results : Thirty-seven patients were evaluated and included, 2 males and 35 females with an average bone mineral density (BMD) of $0.47g/cm^2$. The average age of the patients was 68.7 (range, 57-88). The preoperative VAS for low back and leg pain ($7.87{\pm}0.95$ and $8.82{\pm}0.83$) were higher as compared with postoperative VAS ($2.30{\pm}1.61$ and $1.42{\pm}0.73$) with statistical significance (p = 0.006, p = 0.003). According to the Prolo scale, 11, 22, one and three patients were in excellent, good, fair and poor conditions, respectively. The average amount of the injected cement per one cannulated screw was $1.83{\pm}0.11\;mL$. Conclusion : The results show favorable outcome both clinically and radiographically for 37 patients who underwent lumbar fusion using $DTPS^{TM}$ and PMMA. Based on the results, the use of this surgical method can be a safe and effective option for the operation on the osteoporotic spine.

• Journal of Preventive Medicine and Public Health
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• v.48 no.2
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• pp.84-93
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• 2015

Objectives: The present study was conducted in order to examine the association between socioeconomic status (SES) and osteoporosis prevalence in Korea and to assess whether different associations are found in single-person households. Methods: A cross-sectional population-based study was conducted using the Korea National Health and Nutrition Examination Survey, from 2008 to 2011. The study subjects were people aged ${\geq}50$ years with osteoporosis as defined by bone mineral density. Multivariate logistic models were used to estimate prevalence odds ratios (pORs) and 95% confidence intervals (CIs). Gender differences in the likelihood of osteoporosis were analyzed based on household income, education level, and residential area. Results: There were 8221 osteoporosis patients aged ${\geq}50$ years, of whom 927 lived in single-person households. There was a gender-specific association between osteoporosis prevalence and all three SES factors that we analyzed: income, education, and residential area. After adjusting for age, SES, and health behaviors, including body mass index (BMI), low household income was only significantly associated with osteoporosis in men, whereas education level had an inverse relationship with osteoporosis only in women (p=0.01, p<0.001, respectively). However, after controlling for age and BMI, rural residency was only associated with osteoporosis in women living in single-person households (pOR, 1.59; 95% CI, 1.05 to 2.43). Conclusions: The Korean adult population showed a gender-specific relationship between SES and osteoporosis prevalence, with a different pattern found in single-person households.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.12 no.2
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• pp.31-42
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• 2017

Objectives : This review aims to assess the effect of Wuqinxi exercise for osteoporosis. Methods : We searched 9 electronic databases(Pubmed, EMBASE, Cochrane Library, CAJ, Oasis, KISS, NDSL, KMBASE, KISTI) and related 2 journals until November 2017. We included randomized controlled trials(RCTs) of testing Wuqinxi exercise for osteoporosis. The methodological quality of RCTs related assessed by the Cochrane risk of bias tool. Results : 12 RCTs were eligible in our inclusion criteria. No statistical differences were found between the Wuqinxi versus no intervention, Wuqinxi plus antiosteoporosis medications versus antiosteo-porosis medications on lumbar spine, femora bone mineral density (BMD). However, Wuqinxi significantly improved lumbar spine BMD compared with antiosteoporosis medications (P < 0.00001). Additionally, the results showed a remarkable effect in improving pain score(VAS) when Wuqinxi or Wuqinxi plus antiosteoporosis medications (P < 0.0005) was used. Conclusions : There is evidence of Wuqinxi exercise for osteoporosis with meta-analysis. However, our systematic review has limited evidence to support Wuqinxi exercise for osteoporosis. because of low quality of original articles and further well-designed RCTs should be encouraged.

• Journal of Preventive Medicine and Public Health
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• v.34 no.4
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• pp.408-416
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• 2001

Objectives : To evaluate the diagnostic value of quantitative ultrasound (QUS) in the prediction of osteoporosis as defined by dual energy x-ray absorptiometry (DEXA) in postmenopausal women. Methods : Questionnaires and height and weight measurements were used in the investigation of 176 postmenopausal women. QUS measurements were taken on the right calcaneus while bone mineral density (BMD) measurements of the lumbar spine and femoral neck were made with DEXA. The areas under the curves (AUC) of the speed of sound (SOS) for osteoporosis in the lumbar spine and femoral neck were obtained through receiver operating characteristic (ROC) analysis and evaluated. A comparison was made, for osteoporosis in the lumbar spine and femoral neck, between the AUCs of the logistic model with clinical risk factors and SOS. Results : Pearson's correlation coefficients of SOS and lumbar spine BMD, and of SOS and femoral neck BMD were 0.26 and 0.37. The AUC for the logistic model in its discrimination for lumbar spine osteoporosis was 0.764, and for SOS 0.605. The AUCs for the logistic model in its discrimination for femoral neck osteoporosis and for SOS were 0.890 and 0.892, respectively. Conclusions : These results suggest that the diagnostic value of QUS as a screening tool for osteoporosis is moderate for the femoral neck, but merely low for the lumbar spine and that the predictability provided by SOS is no better than that by the sole use of clinical risk factors in postmenopausal women.

• Journal of Nutrition and Health
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• v.32 no.2
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• pp.197-203
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• 1999

A total of 216 women of natural menopause over 40 years were interviewed to find the relationships among general environmental fctors, anthropometric measurements, daily nutrient intake, and BMD. The average age of the subjects was 54.0 years. Average ages of menarche and menopause were 16.7 years and 47.7 years, respectively. In general, energy and nutrients intake of the subjects were relatively low compared to the Korean recommended dietary allowances(RDA). Specifically, intakes of energy, protein, clcium, iron, and vitamin A were lower than Korean RDA, BMD levels of lumbar spin (LS), femoral neck(FN), ward's triangle(WT), and trochanter(TC) were significantly decreased wit age in descending order of LS, FN, TC, and WT BMD, accordingly. BMD levels of FN and TC of the subjects were higher compared to those of the same age but BMD levels of LS and WT were lower than those of the same age from the general population. For factors related to BMD levels, hight, weight, BMI, and hip circumference had positive correlations with BMD. On the other hand, menarche, and WHR had negative correlations with BMD. Protein, lipid, iron, vitamin B1, vitamin B2, and niacin intake among factors related nutrient intakes were positively correlated with BMD levels. Based on the stepwise regression analysis, the factors and vitamin B1 intakes. Overall, BMD was decreased with age as can be expected. For those being tall, moderately weighed, and smaller waist circumference, BMD levels were high when the relationships of body characteristics and BMD levels were considered. The higher BMD levels were found for those with high intake of protein and vitamin B1. From the findings, it is suggested that the women after menopause keep the optimum body weight and good eating habits. Specially intakes of good quality protein, vitamin B1 seemed to be important.

• Korean Journal of Clinical Pharmacy
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• v.16 no.2
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• pp.86-91
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• 2006

There are 3 different hypotheses on how statins may affect bones, through promoting bone formation, inhibiting bone resorption or through anti-inflammatory effect. In the 3 cross-sectional studies above, one showed increase BMD at hip and spine, one showed increase BMD only at mid-forearm and one showed that the risk reduction in fractures is not explained by the changes in BMD however, all 3 studies showed a decrease in risk of fracture associated with statins. In the 2 prospective cohort studies, one showed the use of statins was not associated with BMD at any skeletal site or decreasing the risk of fracture, and the other showed statins except pravastatin decreased in risk of vertebrate fracture but not affecting lumbar spine BMD. All of case-control studies indicated reduction in fracture risk but did not provide any data regarding BMD. 2 of the randomized, controlled studies showed no significant reduction in fracture risk as well as statins' effects on BMD. Finally, one longitudinal study showed statin use reduced fracture risk and increased BMD. Among the conflicting results shown above, even when statin use was shown to increase BMD, it does not seem to account for the reduction in fracture risk. There may be different ways that statins affect bone other than those hypotheses proposed above. Many studies seem to agree that pravastatin does not have any effect on bone. Some studies suggested that the reason statins did not achieve clinically significant increases in BMD in some studies, is due to the low affinity of statins on bone; statins are designed to act in the liver therefore their effective concentration in extrahepatic tissue is low. The limitations to those studies discussed above. Many studies did not account for the change of lifestyle while subjects' were on statins. Increases in weight bearing exercise and changes in diet might affect BMD and thus reduce risk of fractures. Mental alertness and vision acuity might prevent falls from occurring; many statin-users in the studies were young so the risk of fractures from falls would be decreased. Almost all of the studies failed exclude patients with neurological problems. During study periods, many subjects may have been started on drugs for diseases that usually occur with aging which could cause drowsiness and lead to falls. The sample sizes used in some of the trials were small and the duration of treatment and follow up might not have been long enough to see clinically relevant results.

• Journal of Korean Neurosurgical Society
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• v.65 no.1
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• pp.96-106
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• 2022

Objective : The most common complication of anterior cervical discectomy and fusion (ACDF) is cage subsidence and maintenance of disc height affects postoperative clinical outcomes. We considered cage subsidence as an inappropriate indicator for evaluating preservation of disc height. Thus, this study aimed to consider patients with complications such as reduced total disc height compared to that before surgery and evaluate the relevance of several factors before ACDF. Methods : We retrospectively reviewed the medical records of 40 patients who underwent stand-alone single-level ACDF using a polyetheretherketone (PEEK) cage at our institution between January 2012 and December 2018. Our study population comprised 19 male and 21 female patients aged 24-70 years. The minimum follow-up period was 1 year. Twenty-seven patients had preoperative bone mineral density (BMD) data on dual-energy X-ray absorptiometry. Clinical parameters included sex, age, body mass index, smoking history, and prior medical history. Radiologic parameters included the C2-7 cobb angle, segmental angle, sagittal vertical axis, disc height, and total intervertebral height (TIH) at the preoperative and postoperative periods. Cage decrement was defined as the reduction in TIH at the 6-month follow-up compared to preoperative TIH. To evaluate the bone quality, Hounsfield unit (HU) value was calculated in the axial and sagittal images of conventional computed tomography. Results : Lumbar BMD values and cervical HU values were significantly correlated (r=0.733, p<0.001). We divided the patients into two groups based on cage decrement, and 47.5% of the total patients were regarded as cage decrement. There were statistically significant differences in the parameters of measuring the HU value of the vertebra and intraoperative distraction between the two groups. Using these identified factors, we performed a receiver operating characteristic (ROC) curve analysis. Based on the ROC curve, the cut-off point was 530 at the HU value of the upper cortical and cancellous vertebrae (p=0.014; area under the curve [AUC], 0.727; sensitivity, 94.7%; specificity, 42.9%) and 22.41 at intraoperative distraction (p=0.017; AUC, 0.722; sensitivity, 85.7%; specificity, 57.9%). Using this value, we converted these parameters into a bifurcated variable and assessed the multinomial regression analysis to evaluate the risk factors for cage decrement in ACDF. Intraoperative distraction and HU value of the upper vertebral body were independent factors of postoperative subsidence. Conclusion : Insufficient intraoperative distraction and low HU value showed a strong relationship with postoperative intervertebral height reduction following single stand-alone PEEK cage ACDF.

• Journal of Korean Medicine Rehabilitation
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• v.32 no.2
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• pp.65-81
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• 2022

Objectives This study aimed to assess the effects of oral administration of deer antler extracts on an osteoporosis-induced animal model. We analyzed the results of using deer antler single extracts on animal models with osteoporosis through a systematic review and meta-analysis. Methods We included osteoporosis studies in animal experiments that administrated deer antler extracts orally. We searched the following 13 databases without a language restriction: PubMed, EMBASE, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), China National Knowledge Infrastructure (CNKI), Wanfang, Korean Medical Database (KMbase), National Digital Science Library (NDSL), Korean Traditional Knowledge (Koreantk), Oriental Medicine Advanced Searching Integrated System (OASIS), Research Information Sharing Service (RISS), Korea Institute of Science and Technology Information (KISTI), and Koreanstudies Information Service System (KISS). We used Systematic Review Centre for Laboratory Animal Experimentation's risk of bias tool for assessing the methodological quality of the included studies. Results A total of 299 potentially relevant studies were searched and 11 were included for a systematic review. Nine studies used a single deer antler extract. A study compared the effects of single extracts of deer antler and antler glue, while another study compared the effects of three single extracts of deer antler, old antler, and antler glue. For evaluating the intervention effect, bone mineral density (BMD) was measured as the primary outcome, while the histomorphometric indicators of the bone and serum alkaline phosphatase and osteocalcin levels were used as the secondary outcome variables. On conducting a meta-analysis of studies on single deer antler extract, BMD was observed to be significantly increased compared to that in control group (standardized mean difference [SMD]=2.11; 95% confidence interval [CI]=1.58~2.65; Z=7.75; p<0.00001; I²=56%). As a result of meta-analysis, according to the concentration of deer antler, the group with high concentration showed statistically significantly higher BMD than the group with low concentration (SMD=1.28; 95% CI=0.74~1.82; Z=4.63; p<0.00001; I²=9%). Conclusions The research shows that the deer antler extracts have significant anti-osteoporotic effects on the osteoporosis-induced animal model. However the studies included in this research had a high methodological risk of bias. This indicates the requirement of considerable attention in the interpretation of the study results.

• Food Science of Animal Resources
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• v.32 no.2
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• pp.234-240
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• 2012

This study was conducted to examine the effects of low molecular weight gelatin hydrolysates (GH, less than 3kDa), extracted from pig skin collagen on the bone metabolism of ovariectomized (OVX) rats. The rats in the experimental groups were randomly segregated into six different treatment groups such as 1) NC, the normal rat fed AIN 93 diet (basal diet) only; 2) OC, the OVX rat fed the basal diet only; 3) GH 0.1, the OVX rat fed the basal diet with 0.1% GH; 4) GH 0.8, the OVX rat fed the basal diet with 0.8% GH; 5) G 0.1, the OVX rat fed the basal diet with 0.1% gelatin; 6) G 0.8, the OVX rat fed the basal diet with 0.8% gelatin. Body weight gain in the GH 0.1, GH 0.8, and G 0.8 was significantly higher than those in the NC and OC. Feed intake of the GH 0.1 and GH 0.8 was higher than that of the NC and OC, while no significant difference was found in feed efficiency ratio (FER). BMD of the GH 0.8 was higher than that of the OC. However, gelatin hydrolysates and gelatin resulted in higher BMC level compare to the OC. Serum HDL-cholesterol of rat fed GH and gelatin was higher than that of OC (p<0.05). LDL-C of the GH 0.1 and the GH 0.8 tended to be less than that of OC. Serum alkaline phosphatase (ALP) of the GH 0.1 was lower than that of the OC. The serum of GH 0.8 showed lower osteocalcin value than the OC (p<0.05). In addition, GOT and GPT levels significantly decreased in all treatment groups. These results indicated that gelatin hydrolysates from pig skin gelatin hydrolysates enhanced BMD and serum biochemical parameters related to bone metabolism. Therefore, the gelatin hydrolysates could be used as a beneficial material to improve bone health.

• Journal of the Korean Society of Radiology
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• v.12 no.7
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• pp.833-844
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• 2018

Dual energy X-ray absorptiometry is mainly used as an X-ray test method. For equipment manufactured GE and Hologic, cross-calibration analyses (CCA) of machines from the same manufacturer and between units from different manufacturers have been conducted, but the CCA of equipment manufactured in Korea are inadequate. Through CCA, we present a formula of the intersections between the Korean medical equipment company (KEC) with GE and Hologic manufactured DXA, and among the KEC DXA. The CCA was conducted for the European Spine Phantom on DXA from four KEC and three global medical equipment company (GEC) manufacturers. We compared bone mineral density (BMD) values and calculated the CCA equation by linear regression analysis. The standard-deviations (SD) of the BMD values were highest for the Dexxum T for the low, medium, and high spine, which were 0.030, 0.029, and 0.037, respectively. The smallest SD in the low and medium vertebrae were 0.005 and 0.004 for the Horizon Ci, respectively, and 0.005 for the Osteo Pro Max in the high vertebrae. Based on the intersection equations of the KEC DXA established in this study, CCA of various KEC DXA should be established for more accurate follow-up of BMD tests in clinical environments.