• 대한골관절종양학회지
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• 제18권1호
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• pp.32-36
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• 2012

56세 여자 환자로 약 8주 전부터 시작된 연하곤란과 2주 전부터 발생한 발성 장애를 주소로 내원하였다. 방사선 및 연하 검사상 제 4-5 경추체 전방에 위치한 종괴로 인한 식도 및 후인두 후벽의 압박 소견이 관찰되었다. 수술적 치료로 종괴의 완전 절제를 시행하였고 술 후 임상 증상에서 완전히 회복되었다. 본 증례는 골연골종이 비교적 발생이 드문 경추체 전방에 발생하여 연하 곤란 및 발성 장애를 유발한 예로 저자들은 문헌고찰과 더불어 보고하는 바이다.

• Journal of Korean Neurosurgical Society
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• 제54권3호
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• pp.189-193
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• 2013

Objective : It remains debatable whether cervical spine fusion cages should be filled with any kind of bone or bone substitute. Cortical and subcortical bone from the anterior and posterior osteophytes of the segment could be used to fill the cage. The purposes of the present study are to evaluate the clinical outcomes and radiological outcomes including bone fusion and subsidence that occurred after anterior cervical discectomy and fusion using a stand-alone cage packed with local autobone graft. Methods : Thirty-one patients who underwent anterior cervical fusion using a stand-alone polyetheretherketone (PEEK) cage packed with local autobone graft from July 2009 to december 2011 were enrolled in this study. Bone fusion was assessed by cervical plain radiographs and computed tomographic scan. Nonunion was evaluated according to the absence of bony bridge on computed tomographic scan. Subsidence was defined as a ${\geq}2$ mm decrease of the interbody height at the final follow-up compared to that measured at the immediate postoperative period. Results : Subsidence was observed in 7 patients (22.6%). Of 7 patients with subsidence greater 2 mm, nonunion was developed in 3. Three patients with subsidence greater 2 mm were related with endplate damage during intraoperative endplate preparation. Solid bone fusion was achieved in 28 out of 31 patients (90.3%). Conclusion : With proper patient selection and careful endplate preparation, anterior cervical discectomy and fusion (ACDF) using a stand-alone PEEK cage packed with local autobone graft could be a good alternative to the standard ACDF techniques with plating.

• Journal of Korean Neurosurgical Society
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• 제63권2호
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• pp.202-209
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• 2020

Objective : The purpose of this study was to evaluate the efficacy of the anterior approach following intraoperative reduction under general anesthesia in patients with cervical facet fracture and dislocation. Methods : Twenty-three patients with single level cervical facet fracture and dislocation who were subjected to the anterior approach alone following immediate intraoperative reduction under general anesthesia from March 2013 to December 2017 were enrolled in this study. Neurological status, clinical outcome, and radiological studies were evaluated preoperatively, postoperatively, and during the follow-up period. Results : The cohort comprised 15 men and eight women with a mean age of 57 years (from 24 to 81). All patients were operated on within the first 8 hours following the injury. After gentle manual reduction or closed reduction with Gardner-Wells traction, under general anesthesia monitored by somatosensory-evoked potentials, all operations were successfully completed using the anterior approach alone except in two patients, who had a risk of over-distraction. In them, a satisfactory gentle manual reduction or closed reduction was not possible, and required open posterior reduction of the locked facets followed by anterior cervical discectomy and fusion. In one patient, screw retropulsion was observed in 1 month after surgery. There were no reduction-related complications or neurological aggravations after surgery. All patients showed evidence of stability at the instrumented level at the final follow-up (mean follow-up, 12 months). Conclusion : Anterior approach following intraoperative reduction monitored by somatosensory-evoked potentials under general anesthesia for cervical dislocation and locked facets is a relatively safe and effective alternative when cervical alignment is achieved by intraoperative reduction.

• 척추신경추나의학회지
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• 제6권2호
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• pp.121-132
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• 2011

Objectives : The purpose of this study is to investigate the cervical spine curvature after whiplash injury by traffic accident. Methods : The cervical lateral radiographs of 102 outpatients who visited emergency room in Kyung-Hee university hospital at Gangdong after whiplash injury by road traffic accident were reviewed to measure the cervical spine angle using C1-7, C2-7 Cobb method, Sagittal tangent method, Jochumsen method and the Ishihara index by two oriental medical doctors. For statistics, we used SPSS version 17.0 for windows. Results : Means of cervical angle are $37.63{\pm}11.34^{\circ}$, $12.92{\pm}9.13^{\circ}$, $16.19{\pm}10.62^{\circ}$, $1.78{\pm}3.37$ and $8.51{\pm}9.78$ by C1-C7 Cobb Method, C2-C7 Cobb Method, Sagittal tangent method, Jochumsen method and Ishihara index, respectively. Hypolordosis is most numeral in patients by C1-C7 Cobb Method(n=40; 39.22%), Sagittal tangent method(n=68; 66.67%). And Straight is the most by Jochumsen method(n=54; 52.94%), but Normal is the most by Ishihara index(n=53; 51.96%). And Female has smaller curvature in cervical spine than male significantly by C2-C7 Cobb method and Sagittal tangent method(P<0.05). Conclusions : Whiplash injury tends to make hypolordosis or straight. And female has more vulnerable curvature than male in whiplash injury.

• PNF and Movement
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• 제20권3호
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• pp.451-459
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• 2022

Purpose: Temporomandibular disorder (TMD) is a common musculoskeletal problem that causes pain in and disability of masticatory muscles, the temporo-mandibular joint (TMJ), and related structures. The purpose of this study was to compare pressure pain thresholds (PPTs) of masticatory muscles, cervical ranges of motion (ROM), and pelvic mobility during gait of subjects with or without TMD. Methods: In this study, pain thresholds and changes in the mobility of the cervical vertebrae and pelvis were measured in 25 patients with TMD and 25 healthy controls. Using a pressure algometer, the pressure pain thresholds (PPTs) of the masseter and temporalis muscles were measured in both groups. A gyroscope sensor with a mobile application was used to determine cervical ROM in the frontal and sagittal planes. A 3D-motion analysis system was used to evaluate pelvic mobility in the sagittal, frontal, and transverse planes during gait. Results: The TMD group showed significantly decreased PPTs of masseter and temporalis muscles compared with the control group (p < 0.05). Cervical ROM in flexion, extension, and lateral bending were significantly decreased in the TMD group compared with the control group (p < 0.05). In addition, antero-posterior pelvic tilt was significantly decreased in the TMD group (p < 0.05). Conclusion: The results of the current study suggest that there are close anatomical and functional relationships between TMD and muscle chains related to the cervical spine and pelvis. Therefore, more comprehensive body posture assessments, especially of painful areas, should be undertaken when studying TMD patients.

• Journal of Korean Neurosurgical Society
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• 제38권2호
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• pp.102-106
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• 2005

Objective : The purposes of this study are to evaluate the efficacy of en bloc open-door laminoplasty and to investigate the validity of various factors as prognotic indicators in patients with multisegmental spondylotic myelopathy and ossification of posterior longitudinal ligament[OPLL]. Methods : The authors reviewed 43 cases in whom laminoplasty were performed for cervical myelopathy between January 2000 and December 2002. Clinical symptoms and results were evaluated using the Japanese Orthopaedic Association[JOA] scale. The recovery rate was calculated and then assessed for prognostic factors such as preoperative JOA scores, ages, history of previous trauma, duration of symptoms and signal change in cord on T2-weighted magnetic resonance Image. Results : In cervical stenosis, canal widening of antero-posterior diameter and dimension after laminoplasty is 4.16mm, $87.43mm^2$ and in OPLL is 6.20mm, $117.61mm^2$. In all cases there wasn't neurologic deterioration, mild postoperative complications developed in seven cases. Four patient had a limitation of range of neck motion and the other one showed kyphotic change and another two showed C5 radiculopathy. The recovery rate of JOA score in cervical stenosis and OPLL was 62% and 68% respectively. Duration of symptoms, the severity[preoperative JOA score], and signal change in cord on T2-weighted magnetic resonance image had close relationship to the clinical outcomes. Conclusion : Unilateral en bloc laminoplasty is simultaneous expansile and decompressive method. And preoperative JOA score, symptom duration and high signal intensity on T2-weighted magnetic resonance image can be used to predict prognosis.

• 대한골관절종양학회지
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• 제12권2호
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• pp.171-175
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• 2006

척추에서의 호산구 육아종은 흔하지 않으며, 특히 경추 및 후방 신경궁에서의 발생은 드물다. 또한 호산구 육아종은 자기 공명 영상을 포함한 방사선학적 검사상 추체의 붕괴, 척추경의 소실 및 척추 주변 연부 조직의 종물 형성 등의 소견을 보이므로 다른 악성 골종양이나 전이성 종양 또는 결핵성 척추염 등과 감별을 요한다. 저자들은 각각 제 4 경추, 제 7 경추의 후방 신경궁, 그리고 제 4 경추체에서 발생한 호산구 육아종에 대하여 수술적 치료 후 완치를 보인 3례를 경험하였기에 문헌 고찰과 함께 보고하고자 한다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권5호
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• pp.401-406
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• 2011

Purpose: The purpose of this study was to investigate changes in the position of the hyoid bone and soft palate and the amount of airway space after bilateral sagittal split ramus osteotomy (B-SSRO). Methods: This study is a review of lateral cephalometric tracings of 30 patients who underwent B-SSRO with setbacks at Kyunghee Dental Hospital from 2005 to 2009. Lateral cephalograms were taken before (T0), within one month (T1), and more than six months after the surgery (T2). Results: The hyoid bone at T1 changed significantly towards the inferoposterior position. At T2, it had significantly moved superiorly, but not anteriorly. At T1, the nasopharyngeal space, extending from the posterior nasal spine to the posterior pharyngeal space, decreased significantly, but did not show a significant increase at T2. The nasopharyngeal space, extending from the middle of soft palate to the posterior pharyngeal space, decreased significantly at T1, but did not show a significant decrease at T2. The oropharyngeal airway space decreased significantly at T1 and did not return to its original position at T2. The hypopharyngeal space, extending from the anterior to the posterior pharyngeal space at the level of the most anterior point of the third cervical vertebrae, slightly decreased at T1, but the amount was insignificant; however, the amount of decrease at T2 was significant. The hypopharyngeal space extending from the anterior to the posterior pharyngeal space at the level of the lowest point of the third cervical vertebrae, decreased significantly at T1 but returned to its original position at T2. Conclusion: B-SSRO changes the position of the hyoid bone and muscles inferoposteriorly. These change allows enough space for the tongue and prevent airway obstruction. Airway changes may be related to post-operative edema, posterior movement of the soft palate, anteroposterior movement of the hyoid bone, or compensation for decreased oral cavity volume. The position of the pogonion which measures anterior relapse after surgery did not show significant differences during the follow-up period.

• Annals of Clinical Neurophysiology
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• 제6권1호
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• pp.20-25
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• 2004

Background and Objectives: The proximal and distal nerve segments are preferentially involved in acquired demyelinating polyneuropathies (ADP). This study was undertaken in order to assess the usefulness of motor evoked potential (MEP) and somatosensory evoked potential (SSEP) in the detection of the proximal nerve lesion in ADP. Methods: MEP, SSEP and conventional NCS were performed in 6 consecutive patients with ADP (3 AIDP, 3 CIDP). MEP was recorded from abductor pollicis brevis and abductor hallucis using magnetic stimulation of the cortex and the cervical/lumbar spinal roots. SSEP were elicited by stimulating the median and posterior tibial nerves. Latency from cortex and cervical/lumbar roots, central motor conduction time (CMCT), EN1-CN2 interpeak latency were measured for comparison. Results: MEP was recorded in 24 limbs (12 upper and 12 lower limbs) and SSEP in 24 limbs (12 median nerve, 12 posterior tibial nerve). F-wave latency was prolonged in 25 motor nerves (25/34, 73.5%). Prolonged CML and PML were found in 41.7% (10/24) and 45.8% (11/24), respectively. Interside difference (ISD) of CMCT was abnormally increased in the upper extremity, 66.7% (4/6 pairs) in case of CML-PML. EN1-CN2 interpeak latency was abnormally prolonged in one median nerve (1/10) and LN1-P1 interpeak latency was normal in all posterior tibial nerves. Conclusions: MEP and SSEP may provide useful information for the proximal nerve and root lesion in ADP. MEP and SSEP is supplemental examination as well as complementary to conventional NCS.

• 치과방사선
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• 제14권1호
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• pp.81-87
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• 1984

This study was performed to observe the secondary images and to analyse the relationships between the primary and secondary images in panoramic radiograph. Using the Moritta's Panex-EC panoramic x-ray machine and the human dry skull, the author analysed 17 radiographs which were selected from 65 radiographs of the dry skull that attached the radiopaque materials, and the attached regions of the radiopaque materials were the normal anatomical structures which were important and selected as a regions for the evaluation of the secondary images effectively. The results were as follows; 1. The cervical vertebrae showed three images. The midline image was the most distorted and less clear, and bilateral images were slightly superimposed over the posterior border of the mandibular ramus. 2. In mandible, the secondary image of the posterior border of the ramus was superimposed on the opposite ramus region, and this image was elongated from the anterior border of the ramus to the lateral side of the posterior border of the ramus. The secondary image of the condyle was observed on the upper area of the coronoid process, the sigmoid notch and the condyle in opposite side. 3. In maxilla, the posterior region of the hard palate showed the secondary image on the lower part of the nasal cavity and the medial wall of the maxillary sinus. 4. The primary images of the occipital condyle and the mastoid process appeared on the same region, and only the secondary image of the occipital condyle was observed symmetrically on the opposite side with similar shape to the primary one. 5. In the cranial base, the anatomical structures of the midsagittal portions like a inferior border of the frontal sinus, sella turcica, inferior borderr of the sphenoid sinus and inferior border of the posterior part of the occipital bone showed the simillar shape between the primary and secondary images symmetrically. 6. The petrous portion of the temporal bone showed the secondary image on the lateral side of the sella-turcica, and the secondary images of the posterior border of lesser wing, superior border of greater wing of the sphenoid bone and posterior border were observed on the anterior-superior and inferior region of the sella-turcica.