• Title/Summary/Keyword: Lumbar Spine

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Clinical Analysis of Metastatic Tumors of Bone - Survivorship Analysis after Bony Metastasis - (전이성 골종양에 대한 임상적 분석 - 골전이 후의 생존분석 -)

  • Kim, Kyung-Je;Kang, Ho-Seong;Kim, Yon-Il;Shin, Byung-Joon
    • The Journal of the Korean bone and joint tumor society
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    • v.7 no.4
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    • pp.133-138
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    • 2001
  • Purpose : To analyze the clinical behaviors and survivorship of metastatic bone tumors. Materials and Methods : One hundred and ninty-eight metastatic bone tumors had been diagnosed from January 1982 to December 1998. Age and sex distribution, primary cancer types. metastatic sites, duration from diagnosed of primary tumors to bony metastases and survivorship were analysed. Results : Mean age was 57(24~86) years old. Lung(32.3%) and breast(16.2%) cancers were two most common primary foci. The spines was the most common site of metastases especially lumbar region(38%). Survivorship analysis was done in one hundred and fifteen patients who had been followed up. The mean survival period was 15.3 months. The survivorship of hepatoma(7.1 Mons), lung(8.72 Mons) and renal cell(4.8 Mons)cancers was relatively shorter and breast cancer(54.1 Mons) longest. Conclusion : The mean age of metastatic bone tumors of this study was older than the past reports. The axial skeletons especially spine was predominant metastatic site. The survivorship of metastatic bone tumor decreased sharply as time goes by, so early diagnosis is clue for longer survival after bony metastases.

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Anatomical and Functional Recovery of Neurotized Remnant Rectus Abdominis Muscle in Muscle-Sparing Pedicled Transverse Rectus Abdominis Musculocutaneous Flap

  • Jeong, Woonhyeok;Son, Daegu;Yeo, Hyeonjung;Jeong, Hoijoon;Kim, Junhyung;Han, Kihwan;Lee, Soyoung
    • Archives of Plastic Surgery
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    • v.40 no.4
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    • pp.359-366
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    • 2013
  • Background Pedicled transverse rectus abdominis musculocutaneous flaps typically sacrifice the entire muscle. In our experience, the lateral strip of the rectus abdominis muscle can be spared in an attempt to maintain function and reduce morbidity. When the intercostal nerves are injured, muscle atrophy appears with time. The severed intercostal nerve was reinserted into the remnant lateral strip of the rectus abdominis muscle to reduce muscle atrophy. Methods The authors retrospectively reviewed 9 neurotized cases and 10 non-neurotized cases. Abdominal computed tomography was performed to determine the area of the rectus muscles. Electromyography (EMG) was performed to check contractile function of the remnant muscle. A single investigator measured the mean areas of randomly selected locations (second lumbar spine) using ImageJ software in a series of 10 cross-sectional slices. We compared the Hounsfield unit (HU) pre- and postoperatively to evaluate regeneration quality. Results In the neurotization group, 7 of 9 cases maintained the mass of remnant muscle. However, in the non-neurotization group, 8 of 10 lost their mass. The number of totally atrophied muscles in each of the two groups was significantly different (P=0.027). All of the remnant muscles showed contractile function on EMG. The 9 remaining remnant rectus abdominis muscles showed declined the HU value after surgery but also within a normal range of muscle. Conclusions Neurotization was found to be effective in maintaining the mass of remnant muscle. Neurotized remnant muscle had contractile function on EMG and no fatty degeneration by HU value.

The Relationship Between Bone mineral Density and The Environmental Factors in Korean Pubescent Girls (한국 사춘기 소녀들의 골밀도와 환경요인들과의 관계(II))

  • 최미자
    • Journal of the East Asian Society of Dietary Life
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    • v.5 no.1
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    • pp.41-51
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    • 1995
  • Bone mass accretion during puberty appears to be critical in the development of peak bone mass. Although bone density of females in Korea has been studied, only a few studies have related bone mass with anthropometric patterns or puberty in the pubescent girls. This study was conducted as part of a study of major determinants of bone development during puberty. Subjects were aged 14∼16 yr(mean 14.97), and had no history of disorders or dedication use likely to influence bone or calcium metabolism. Bone mineral density and content were measured by dual energy X-ray absorptiometry using a Lunar DPX+Scanner (Lunar Madison, WI). Also, total body fat, and total lean body mass were assessed using a Lunar DPX dual-energy X-ray absorptiometer, Pubertal status was assessed according to the Marshall and Tanner guidelines. Serum levels of osteocalcin was measured by RIA using a commercial kit assay. Skinfold measurements were taken with a skinfold caliper(Lange Caliper, USA). Data were analyzed using the regression and GLM procedure of the statistical package SAS. The results indicated that the observed means for lumbar spine BMD and femoral BMD correspond to approximately 91% and 96% of the means for young adult females, respec tively. All subjects were menarchal, with the majority being in the middle to end stages of pubertal development. Total body BMD was positively related to fat mass(P<0.001), lean body mass and time since menarche, and negatively related to urine pyridinoline, serum alkaline phosphatase and osteocalcin. The data indicate that girls who reported lower age for menarche had significantly higher bone densities than girls who reported higher age for menarche. Attaining peak skeletal bone mass during puberty may reduce the incidence of osteoporosis in later life. this finding suggests that early menarche may augment peak bone mass, influencing the extent of bone loss later in adulthood. The results suggest that good nutrition in childhood appears to be needed not for growth and development, but possibly also to assure an optimal peak of bone mass and thus greater latitude for the maintenance or skeletal integrity in the face of bone losses. Troeps skinfold thickness was a better predictor of total BMD and total BMC than was any other skinfold thickness. The study did not find a relationship between total BMD and body fat %, but total fat was significantly positively related to total BMD(r=0.49) and total BMC(r=0.60). It supports earlier report that there was a significant correlation between TBMD and body weight. Conclusively, total fat, lean body mass and pubertal development could influence BMD in pubescent girls. Clearly, longitudinal studies are required to assess the effect of puberty on peak bone mass, and to define further the potential determinants of peak bone mass.

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A Comparison between Postmenopausal Osteoporotic Women and Normal Women of Their Nutrient Intakes and the Evaluation of Diet Quality (폐경 후 골다공증 여성과 정상 여성의 영양소 섭취상태와 식사의 질 평가에 관한 비교 연구)

  • Bae Yun-Jung;Sung Chung-Ja
    • Korean Journal of Community Nutrition
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    • v.10 no.2
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    • pp.205-215
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    • 2005
  • The purpose of this study was to compare the nutrient intake and diet quality of postmenopausal osteoporotic women to those of control subjects, and to investigate the relationship among diet quality and bone mineral density in postmenopausal women. In this study, we classified the subjects into the postmenopausal osteoporotic women (n =38) and control (n = 43) according to their lumbar spine bone mineral density and age. Dietary intakes, anthropometric measurements and dietary quality indices were measured and evaluated. The average age of osteoporotic and control group were 60.4 yrs and 58.3 yrs, respectively and there was no significant difference. Body weight, body mass index of osteoporotic group were significantly lower than those of control group. The average energy intake of osteoporotic and control group were 1243.3 kcal and 1475.8 kcal, respectively and there was a significant difference. The osteoporotic group consumed significantly lower quantities of protein, plant protein, vitamin A, vitamin $B_1,\;vitamin\;B_2$, folate, vitamin C, calcium, animal calcium, plant calcium, iron and zinc compared to the control group. The osteoporotic group consumed significantly lower of food, vegetables, mushrooms, fruits intakes compared to the control group. In the diet quality, protein, vitamin A, vitamin $B_1,\;vitamin\;B_2$, folate, vitamin C, calcium, iron, Zinc nutrient adequacy ratio (NAR) of osteoporotic group were significantly lower than that of control group. Mean adequacy ratio (MAR) of osteoporotic and control group were 0.63 and 0.78, respectively and there was significant difference. To evaluate nutrient density, Index of nutritional quality (INQ) was calculated by dividing nutrient content per 1,000 kcal of diet with RDA per 1,000 kcal. The average dietary variety score (DVS) of osteoporotic and control group were 22.4 and 33.2, respectively and there was significant difference. DVSs of pulses (p<0.01), seeds (p<0.01) and vegetables (p<0.05) in osteoporotic group were significantly lower than those of the control. In conclusion, postmenopausal osteoporotic women had lower protein, vitamin A, folate, vitamin C, calcium, iron zinc intake quality and vegetables, mushrooms, fruits DVSs than those of the control. Therefore, to promote skeletal health enough energy and food should be consumed, and the maintenance of vitamin and mineral balance by increasing of vitamin A, folate, vitamin C, calcium, iron of intakes are very important.

Rutin Improves Bone Histomorphometric Values by Reduction of Osteoclastic Activity in Osteoporosis Mouse Model Induced by Bilateral Ovariectomy

  • Lee, Hye-Hwa;Jang, Jae-Won;Lee, Jung-Kil;Park, Choon-Keun
    • Journal of Korean Neurosurgical Society
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    • v.63 no.4
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    • pp.433-443
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    • 2020
  • Objective : Osteoporosis is a disease of unbalanced bone metabolism that results in low bone mineral density with increased bone fragility and propensity for fractures. The increased rate of bone fracture due to osteoporosis places a significant burden on public health care expenditures. Therefore, numerous studies have been designed and performed to identify the drugs or health foods that can improve the bone quality or quantity. This study was designed to evaluate and analyze the therapeutic effects of rutin on histomorphometric values of the spine and femur in an osteoporotic mouse model induced by bilateral ovariectomy. Methods : Thirty female ICR mice (8 weeks old) underwent either a sham operation (only abdominal incision, sham group, n=10) or bilateral ovariectomy (n=20). The ovariectomized (OVX) animals were randomly divided into two groups : untreated OVX group (OVX-C, n=10), or rutin-administered group (OVX-R, n=10). The OVX-C group received weight-adjusted doses of saline vehicle and the OVX-R group received 50 mg/kg of rutin intraperitoneally, starting 1 day after surgery. At 4 and 8 weeks after surgery, serum estrogen, osteocalcin, alkaline phosphatase (ALP), and the telopeptide fragment of type I collagen C-terminus (CTX-1) were analyzed. Interleukin (IL)-1β, IL-6, IL-10, and tumor necrosis factor (TNF)-α were also analyzed. Bone histomorphometric parameters of the 4th lumbar vertebra and femur were determined by micro-computed tomography. Results : In OVX-C group, ALP, osteocalcin, CTX-1, IL-1β, IL-6, and TNF-α levels were significantly increased at 4 and 8 weeks compared to sham operation group. Rutin administration after OVX statistically significantly reduced ALP, CTX-1, IL-1β, IL-6, and TNF-α levels at 4 and 8 weeks. Rutin administration also improves bone histomorphometric parameters including trabecular bone volume fraction, trabecular thickness, and trabecular number. Trabecular separation was also decreased in OVX-R group compared to OVX-C group. Conclusion : The present study demonstrated that rutin has therapeutic effects on improving bone histomorphometric values in an OVX mouse model. The improvement in histomorphometric values may be associated with the reduction of osteoclastic activity via inhibition of IL-1β, IL-6, and TNF-α. In future studies, the mechanism for the effect of rutin on osteoporosis should be demonstrated more clearly to use rutin in human osteoporosis.

Microbiology and Epidemiology of Infectious Spinal Disease

  • Jeong, Se-Jin;Choi, Seung-Won;Youm, Jin-Young;Kim, Hyun-Woo;Ha, Ho-Gyun;Yi, Jin-Seok
    • Journal of Korean Neurosurgical Society
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    • v.56 no.1
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    • pp.21-27
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    • 2014
  • Objective : Infectious spinal disease is regarded as an infection by a specific organism that affects the vertebral body, intervertebral disc and adjacent perivertebral soft tissue. Its incidence seems to be increasing as a result of larger proportion of the older patients with chronic debilitating disease, the rise of intravenous drug abuser, and the increase in spinal procedure and surgery. In Korea, studies assessing infectious spinal disease are rare and have not been addressed in recent times. The objectives of this study are to describe the epidemiology of all kind of spinal infectious disease and their clinical and microbiological characteristics as well as to assess the diagnostic methodology and the parameters related to the outcomes. Methods : A retrospective study was performed in all infectious spinal disease cases presenting from January 2005 to April 2010 to three tertiary teaching hospitals within a city of 1.5 million in Korea. Patient demographics, risk factors, clinical features, and outcomes were assessed. Risk factors entailed the presence of diabetes, chronic renal failure, liver cirrhosis, immunosuppressants, remote infection, underlying malignancy and previous spinal surgery or procedure. We comparatively analyzed the results between the groups of pyogenic and tuberculous spinal infection. SPSS version 14 statistical software was used to perform the analyses of the data. The threshold for statistical significance was established at p<0.05. Results : Ninety-two cases fulfilled the inclusion criteria and were reviewed. Overall, patients of tuberculous spinal infection (TSI) and pyogenic spinal infection (PSI) entailed 20 (21.7%) and 72 (78.3%) cases, respectively. A previous spinal surgery or procedure was the most commonly noted risk factor (39.1%), followed by diabetes (15.2%). The occurrence of both pyogenic and tuberculous spondylitis was predominant in the lumbar spine. Discs are more easily invaded in PSI. At initial presentation, white cell blood count and C-reactive protein levels were higher in PSI compared to TSI (p<0.05). Etiological agents were identified in 53.3%, and the most effective method for identification of etiological agents was tissue culture (50.0%). Staphyococcus aureus was the most commonly isolated infective agent associated with pyogenic spondylitis, followed by E. coli. Surgical treatment was performed in 31.5% of pyogenic spondylitis and in 35.0% of tuberculous spondylitis cases. Conclusion : Many previous studies in Korea usually reported that tuberculous spondylitis is the predominant infection. However, in our study, the number of pyogenic infection was 3 times greater than that of tuberculous spinal disease. Etiological agents were identified in a half of all infectious spinal disease. For better outcomes, we should try to identify the causative microorganism before antibiotic therapy and make every effort to improve the result of culture and biopsy.

Effects of Back Muscle Stretching on the Flexibility of Spinal Column of Normal Adults (정상성인에 있어 배부근 스트레칭 운동이 척주 유연성에 미치는 영향)

  • Gong, Won-Tae;Lee, Sang-Yong
    • Journal of the Korean Society of Physical Medicine
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    • v.1 no.1
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    • pp.23-36
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    • 2006
  • Purpose : The purpose of this study was to evaluate the effects of back muscle stretching on the flexibility of spinal column. Methods : The subjects were consisted of healthy adults (18 of females, 22 males ; mean aged 21.83) from 18 to 29. All subjects randomly assigned to the control group, back muscle stretching group. back muscle stretching group received back muscles stretching for 20 minutes per day and 3 times a week during 3 week period. Spine motion analyzer (Spinal Mouse) was used to measure the flexibility of spinal column. All measurement of each subjects were measured at pre-experiment, after 10 days, and after 21 days. Results : The results of this study were summarized below 1. The sacral tilt angle of the hip joint of control group, back muscle stretching group was no significantly differences at pre-experiment and after 10 days(p>0.5), but differency of each group occurred at after 21 days(p<0.5). the sacral tilt angle significantly increased at the back muscle stretching group rather than the control group. 2. The thoracic vertebral tilt angle of the control group, back muscle stretching group was no significantly differences at pre-experiment, after 10 days, after 21 days(p>0.5). 3. The lumbar vertebral tilt angle of the control group, back muscle stretching group was no significantly differences at pre-experiment, after 10 days, after 21 days(p>0.5). 4. The spinal tilt angle of control group, back muscle stretching group was no significantly differences at pre-experiment and after 10 days(p>0.5), but differency of each group occurred at after 21 days(p<0.5). the spinal tilt angle significantly increased at the back muscle stretching group rather than the control group(p>0.5). 5. The length of the spinal column of control group, back muscle stretching group was no significantly differences at pre-experiment and after 10 days (p>0.5), but differency of each group occurred at after 21 days(p<0.5). the length of the spinal column significantly increased at the back muscle stretching group rather than the control group(p<0.5). Conclusion : These data suggests that 3-week back muscle stretching improved the flexibility of sacrum, spinal column, and also improved spinal column lengthening. Additional randomized controlled trials to more fully investigate treatment effects and factors that may mediate these effects are needed.

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Comparison of the Values of Bone Mineral Density Between DEXAs (DEXA 측정기 간 골밀도 값 비교)

  • Lee, In-Ja
    • Journal of radiological science and technology
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    • v.34 no.4
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    • pp.271-276
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    • 2011
  • Statistical analysis was performed on the patients who took bone densitometry using Lunar and Hologic equipments for 5 months from January $1^{st}$ 2010 to May $30^{st}$, 2010. Patients consisted of 50 in their 40s, 100 in 50s and 50 in 60s. In addition, the results from bone densitometry were carried out on the same subject with two equipments on the same day. In case of 200 subjects, who received the bone densitometry with two equipments, the average age was 54.5 and 54.4 years old, respectively. There was no difference. The T- score of Lunar equipment was $-1.377{\pm}1.221$ and that of Hologic equipment was $-1.806{\pm}1.123$. The T-score of Lunar equipment was measured higher than that of Hologic equipment. T-test was conducted to determine the equality of the mean of two groups with 200 patients. Since the pvalue was 0.000, the value of bone mineral density was significant in two equipments. Furthermore, the patients, who were diagnosed by Lunar, showed more 'normal' and who were diagnosed by Hologic, showed more osteoporosis, which cartegorized by WHO, such as normal, osteopenia, and osteoporosis. Thus, compared results of bone densitometry on lumbar spine L1 - L4 of four normal people with the same equipment showed that T- score of Lunar equipment was $-0.4{\pm}1.2$, and T- score of Hologic equipment was $-1.1{\pm}1.5$. It showed the higher T- score was measured in Lunar equipment as well. Therefore, the correction factor should be considered to use, since T- scores are different between two equipments.

The Relation between Bone Mineral Density and Lifestyle in College Students (일부 대학생의 골밀도와 생활습관간의 관련성)

  • Kang, Tae-Hun;Lee, Mu-Sik;Bae, Suk-Hwan;Kim, Yong-Kwon
    • Journal of radiological science and technology
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    • v.39 no.3
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    • pp.429-434
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    • 2016
  • This study was performed in order to identify the relation between bone nineral density and life styles of some of Korean colleage students. A total of 121 college students were assessed through bone mineral density test on femoral neck and lumbar spine using dual energy X-ray absorptiometry(DEXA). The survey about their lifestyles with a self-rating questionnaire, was conducted from September 2014 to November 2014. SPSS 18.0 Program was used for those research data analyses such as the frequency analysis, the cross analysis. The percentage of the osteoporisis, osteopenia and normal groups were 0.0%, 24.8% and 75.2%. BMI, Regular menstrual cycle, Walking and Regular exercise in adolescence were positively related with T-score. But Using time of electronic devices was negative related with T-score. It can be concluded that desirable life style in time of college students and adolescence is important for their bone health. The necessity of preparing guideline for preventing bone disease in old age connected with the school curriculum should be recognized to the public and educational authorities.

The Effects of Back Muscle Stretching and Abdominal Muscle Strengthening Exercises on the Flexibility of Spinal Column of Normal Adults (정상 성인에 있어 배부근 스트레칭 운동과 복부근력강화 운동이 척주 유연성에 미치는 영향)

  • Gong, Won-Tae
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.12 no.1
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    • pp.1-15
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    • 2006
  • Purpose: The purpose of this study was to evaluate the effects of abdominal muscle strengthening exercises and back muscle stretching on the flexibility of spinal column. Methods: The subjects were consisted of healthy adults ( 28 of females, 32 males; mean aged 21.6) from 18 to 29. All subjects randomly assigned to the control group, back muscle stretching group, abdominal muscle strengthening exercises group. back muscle stretching group received back muscles stretching for 20 minutes, abdominal muscle strengthening exercises group received abdominal muscle strengthening exercises for 30 minutes per day and 3 times a week during 3 week period. Spine motion analyzer (Spinal Mouse) was used to measure the flexibility of spinal column. All measurement of each subjects were measured at pre-experiment, after 10 days, and after 21 days. Results: The results of this study were summarized below 1. The sacral tilt angle of the hip joint of control group, back muscle stretching group, abdominal strengthening exercises group was no significantly differences at pre-experiment and after 10 days(p>0.5), but differency of each group occurred at after 21 days(p<0.5). the sacral tilt angle significantly increased at the back muscle stretching group, abdominal muscle strengthening exercises group, rather than the control group. 2. The thoracic vertebral tilt angle of the control group, back muscle stretching group, abdominal muscle strengthening exercises group was no significantly differences at pre-experiment, after 10 days, after 21 days(p>0.5). 3. The lumbar vertebral tilt angle of the control group, back muscle stretching group, abdominal muscle strengthening exercises group was no significantly differences at pre-experiment, after 10 days, after 21 days(p>0.5). 4. The spinal tilt angle of control group, back muscle stretching group, abdominal muscle strengthening exercises group was no significantly differences at pre-experiment and after 10 days(p>0.5), but differency of each group occurred at after 21 days(p<0.5). the spinal tilt angle significantly increased at the back muscle stretching group, abdominal muscle strengthening exercises group, rather than the control group(p<0.5). 5. The length of the spinal column of control group, back muscle stretching group, abdominal muscle strengthening exercises group was no significantly differences at pre-experiment and after 10 days (p>0.5), but differency of each group occurred at after 21 days(p<0.5). the length of the spinal column significantly increased at the back muscle stretching group, abdominal muscle strengthening exercises group, rather than the control group(p<0.5). Conclusion: these data suggests that 3-week abdominal muscle strengthening exercises and back muscle stretching improved the flexibility of sacrum, spinal column, and also improved spinal column lengthening. Additional randomized controlled trials to more fully investigate treatment effects and factors that may mediate these effects are needed.

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