• Journal of Korean Neurosurgical Society
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• 제30권8호
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• pp.1042-1046
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• 2001

경추간판탈출증 환자에서 척수조술을 위해 요추천자를 시행한 후에 갑자기 양하지마비가 발생한 1례를 보고 한다. 척추종괴환자에서 요추천자후 합병증으로 나타나는 운동마비는 요추천자후 1~4일째에 서서히 오는 경우가 일반적이며, 수시간내에 급성으로 하지마비를 나타내는 경우는 매우 드물어 현재까지 6례 정도만 보고되고 있을뿐이며 그 원인질환은 대부분 척수종양이다. 경추간판탈출증 환자에서 척수조술을 위해 요추천자를 시행한 후에 갑자기 양하지마비가 발생한 임상보고례는 현재까지 없다. 이러한 합병증을 막기위해서는 척수장애증상을 보이는 경추간판탈출증 환자에게 척수조술대신에 자기공명촬을 시행함이 현명하리라 본다. 이러한 합병증이 올 수 있는 기전과 예방방법에 대해 고찰하다.

• Journal of Korean Neurosurgical Society
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• 제41권1호
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• pp.1-6
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• 2007

Objective : The purpose of this study is to determine the factors that have effects on the neurological deficit in the patients with thoracolumbar fracture. Methods : Forty-eight patients were included. Cause of injury, type of injury, time interval, combined injury, kyphotic angle, spinal canal compromise, sagittal diameter, the most narrow sagittal diameter, transverse diameter, the most narrow transverse diameter, and remained height of vertebra body were concerned as the factors. The patients with American Spinal Injury Association[ASIA] impairment scale grade A to D were considered as having neurology while others with ASIA grade E were considered to be without neurology. The patients with ASIA grade A were classified to paraplegia group and the patients with ASIA grade B to E were not thought to be paraplegia. Statistical analysis for these groups were performed. Results : Spinal canal compromise [P<0.001] have correlation with neurological deficit. The most narrow sagittal diameter was smaller in the group with deficit than that in the group without deficit [P<0.004]. Also, combined injury have correlation with neurology [P=0.028]. Spinal canal compromise [P<0.001], sagittal diameter [P=0.032], the most narrow sagittal diameter [P=0.025], and Denis type [P<0.001] also have correlation with paraplegia. Conclusion : The factors of percentage of spinal canal compromise, the most narrow sagittal diameter, and combined injury are predictive of neurological deficit. The patients with paraplegia may be predicted by the factors such as type of injury, spinal canal compromise, sagittal diameter, the most narrow sagittal diameter, and Denis type.

• The Korean Journal of Pain
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• 제21권2호
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• pp.159-163
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• 2008

Paraplegia is a relatively rare complication of epidural anesthesia. Several possible factors may contribute to the development of paraplegia including arachnoiditis, trauma and ischemia. We experienced a case where paraplegia had developed after epidural anesthesia for cesarean section. So we present the case and consider the possible etiologies. A 30-year-old previously healthy woman was referred to our hospital for postpartum motor weakness of the lower limbs. Six days prior, the patient was admitted at a local obstetric clinic for delivery at 39 weeks gestation. The patient underwent a Cesarean section under epidural anesthesia induced with 20 ml 2% lidocaine and 5 ml 0.5% bupivacaine. In the early morning of the day following the Cesarean section, a motor and sensory deficit in both lower extremities was noted. A lumbar MRI showed diffuse enhancement along the cauda equina and spinal cord surface in the lower lumbar spine, suggesting diffuse arachnoiditis.

• Physical Therapy Rehabilitation Science
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• 제8권2호
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• pp.79-85
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• 2019

Objective: The purpose of this study was to investigate the relationship between physical features, strength, function, and upper extremity musculoskeletal pain during rehabilitation of manual wheelchair users with spinal cord injuries. Design: Cross-sectional study. Methods: The degree and frequency of upper extremity musculoskeletal pain were measured in persons with spinal cord injuries using manual wheelchairs with the use of questionnaires. The pain scores of the hand, wrist, and shoulder joints were calculated by multiplying the seriousness and frequency of pain. We collected data on the manual muscle test, Spinal Cord Independent Measure-III, and the Body Mass Index. Statistical analysis was performed by descriptive analysis and Pearson's correlation analysis. Results: A total of 47 patients participated in this study and the neurological level of the injuries ranged from C2 to S5. Pain in the shoulder joints was the most common in persons with tetraplegia and paraplegia. Pain was experienced as mild to moderate, and occurred one or more times a week. Of the 32 persons with paraplegia, the most common area of complaint was the shoulder. Of the 15 persons with paraplegia, the shoulder joints were the most common site of pain. The independence levels of the persons with spinal cord injuries were highly correlated to muscle strength levels (p<0.05). Conclusions: This study investigated upper extremity musculoskeletal pain during rehabilitation of manual wheelchair users with spinal cord injuries and the relationship between physical features, strength, and function. In most persons with spinal cord injuries, pain and frequency of shoulder joints were high and pain levels were also related to functional levels.

• Journal of Korean Neurosurgical Society
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• 제30권1호
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• pp.95-98
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• 2001

Acute intraabdominal aortic obstruction ends in progressive fatal course or severe permanent disability unless it is diagnosed and treated promptly. However, the incidence of such disease is very rare, so there is very little chance for a neurosurgeon to encounter a patient with acute intraabdominal aortic obstruction. The authors present a case of 62-year-old man with severe low back pain and acute paraplegia caused by acute intraabdominal aortic obstruction.

• 한국소음진동공학회:학술대회논문집
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• 한국소음진동공학회 2002년도 추계학술대회논문집
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• pp.446-452
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• 2002

This paper Presents a 3-D design and a Vibration control of a new walking R.G.O.(Robotic Gait Orthosis) and would like to develop a simulation by this walking system. The vibration control and evaluation of the new knee joint mechanism on the biped walking R.G.O.(Robotic Gait Orthosis) was a very unique system and was to obtain by the 3-axis accelerometer with a low frequency vibration for the paraplegia It will be expect that the spinal cord injury patients are able to recover effectively by a biped walking R.G.O.. The new knee joint system of both legs were adopted with a good kinematic characteristics. It was designed attached a DC-srevo motor and controller, with a human wear type. It was able to accomodate itself to a environments of S.C.I. Patients. It will be expect that the spinal cord injury patients are able to recover effectively by a new walking R.G.O. system.

• 한국전문물리치료학회지
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• 제10권2호
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• pp.1-10
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• 2003

This study was carried out to help the comprehensive rehabilitation of spinal cord injuries by measuring propulsion force and endurance exerted on wheelchair handrims, and predicting the differences among three different rear axle positions. The BTE (Baltimore Therapeutic Exerciser) work simulator was used on 9 paraplegia to test the force and endurance during wheelchair propulsion. The 141 large wheel of the BTE work simulator and a standard wheelchair with removed handrims were used for simulating wheelchair propulsion. The neurological and demographical characteristics of the patients were collected by personal interviews and direct examinations. The Kruskal-Wallis test was used to compare force and endurance among the groups. The strongest maximum isometric strength was produced when the rear axle of the wheelchair and the acromion process were on the same coronal plane. Although there were no significant differences statistically, moving the rear axle forward did result in greater isotonic strength. The research suggests that better functional activity of persons with paraplegia is possible when the rear axle of the wheelchair is appropriately adjusted.

• 대한한방내과학회지
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• 제39권2호
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• pp.130-138
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• 2018

Neuromyelitis optica (NMO) is an autoimmune inflammatory disorder of the central nervous system characterized by optic neuritis and longitudinally extensive myelitis. Painful tonic spasm is a common complication of NMO, but there have been no reports about it in Korean medicine studies. In this case, we treated a 53-year-old woman diagnosed with NMO with paraplegia, painful tonic spasm, and decreased visual acuity using Korean medicine treatment, including acupuncture, herbal medicine, cupping, and moxibustion. We measured changes in clinical symptoms using the manual muscle testing (MMT), the numeric rating scale (NRS), the modified Barthel Index (MBI), and the Functional Independence Measure (FIM). After treatment, clinical symptoms were improved. The results indicate that Korean medicine treatment may be effective in the treatment of an NMO patient with paraplegia and painful tonic spasm.

• The Korean Journal of Pain
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• 제6권1호
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• pp.129-132
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• 1993

Paraplegia complicating a block of the celiac plexus with alcohol for recurrent stomach cancer is described. A 33 year old male patient was admitted to control for severe epigastric pain. With the patient in prone position, the needle was advanced further than 2 cm on the anterior margin of $L_1$ vertebral body under fluoroscopy. 3 ml of 1% lidocaine and 5 ml of conray were injected through each needle, and the diffusion of the contrast medium was checked, This was followed by 7 ml of pure alcohol and 8 ml of 50% alcohol for each needle. At that time, the patient was very satisfied with loss of abdominal pain. About 30 minutes after injection of alcohol, suddenly patient complained of severe burning pain on back and both extremities. Thereafter, loss of sensation and paralysis in both extremities were developed slowly. The senstivity to cold recovered 3 days after block. By the 33rd day after the block, sensation had recovered in both extremities, the bladder and rectum. Movement of the right ankle joint and left great toe was also possible.

• 대한간호
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• 제10권3호통권53호
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• pp.54-60
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• 1971