• Title/Summary/Keyword: Posterior fusion

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A Clinical Analysis of Surgically Managed Primary Spondylitis (수술 치료를 받은 원발성 척추염 환자의 임상적 고찰)

  • Park, Jong Hoon;Kim, Kyu Hong
    • Journal of Korean Neurosurgical Society
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    • v.30 no.10
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    • pp.1163-1169
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    • 2001
  • Objective : To assess the surgical outcome for patients with primary spondylitis who were treated surgically. Materials and Methods : We retrospectively analyzed the clinical characteristics of 19 patients who underwent surgical treatment from september 1997 to October 1999 in our department. Results : The 19 patients presented 13 tuberculous spondylitis and 6 pyogenic spondylitis. The male to female ratio was 1.4 : 1 and average age 48.4 years(range 15-68 years). The most prevalent location was thoracic region(47%) and paraparesis was frequently seen in patients with middle and lower spinal lesions. Operative approaches were either anterior(13) or posterior(6). All patients with neurologic deficits improved after surgery. Autogenous rib and/or iliac strut bone grafting was performed, followed by spinal instrumentation. Solid bone fusion was obtained in all patients. There was no need for prolongation of duration of antituberculous drug therapy and no increased incidence of secondary infection due to spinal instrumentation. Conclusion : From the results, it may be advised that patients of primary spondylitis who had neurologic deficit should receive an aggressive opeation in their early stage.

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Lumbar Osteochondroma Arising from Spondylolytic L3 Lamina

  • Choi, Byung-Kwan;Han, In-Ho;Cho, Won-Ho; Cha, Seung-Heon
    • Journal of Korean Neurosurgical Society
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    • v.47 no.4
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    • pp.313-315
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    • 2010
  • Osteochondromas are common, benign tumors in the long bones, but osteochondromas are rare in the vertebrae. Most vertebral osteochondromas arise from the cervical or upper thoracic spine. However, lumbar osteochondromas have rarely been reported. In this report, a rare case of a lumbar osteochondroma arising from the spondylolytic L3 lamina in a 57-year-old woman is presented. She also had a ruptured disc and lumbar canal stenosis at L4-5-S1. The osteochondroma was completely removed and a posterior lumbar interbody fusion and instrumentation were performed. Considering the rarity of osteochondromas in the lumbar vertebrae, especially the L3 vertebra, it is possible that the pre-existing lumbar spondylolysis or spondylolisthesis was one of the factors affecting the occurrence or progression of the osteochondroma.

Welding Characteristics of Rapid Palatal Expander for Teeth Calibration using a Continuous Wave Nd:YAG Laser (연속파 Nd:YAG 레이저를 이용한 치아교정 급속 구개확장장치 용접특성)

  • Yoo, Young-Tae;Yang, Yun-Seok;Shin, Ho-Jun
    • Journal of the Korean Society for Precision Engineering
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    • v.27 no.2
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    • pp.40-49
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    • 2010
  • The Purpose of this paper is to weld a rapid palatal expander using a continuous wave Nd:YAG laser. The rapid palatal expander has become a useful treatment method for severe maxillary transverse deficiencies and posterior crossbites. Rapid maxillary expansion is a well-established method to correct transverse maxillary deficiency and arch length discrepancy. The major process parameters studied in the present laser welding experiment were the positions of focus, laser power and travel speed of laser beam. We measured the fusion zone size and its shape using an optical microscope for the observation of cross-sectional area and tension stress of a rapid palatal expander welded. Through the experimental investigation, the optimum speeds and power of laser without deficiencies of weld cross-sectional area were obtained.

Fine structure of the silk spinning system in the caddisworm, Hydatophylax nigrovittatus (Trichoptera: Limnephilidae)

  • Hyo-Jeong Kim;Yan Sun;Myung-Jin Moon
    • Applied Microscopy
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    • v.50
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    • pp.16.1-16.11
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    • 2020
  • Silk is produced by a variety of insects, but only silk made by terrestrial arthropods has been examined in detail. To fill the gap, this study was designed to understand the silk spinning system of aquatic insect. The larvae of caddis flies, Hydatophylax nigrovittatus produce silk through a pair of labial silk glands and use raw silk to protect themselves in the aquatic environment. The result of this study clearly shows that although silk fibers are made under aquatic conditions, the cellular silk production system is quite similar to that of terrestrial arthropods. Typically, silk production in caddisworm has been achieved by two independent processes in the silk glands. This includes the synthesis of silk fibroin in the posterior region, the production of adhesive glycoproteins in the anterior region, which are ultimately accumulated into functional silk dope and converted to a silk ribbon coated with gluey substances. At the cellular level, each substance of fibroin and glycoprotein is specifically synthesized at different locations, and then transported from the rough ER to the Golgi apparatus as transport vesicles, respectively. Thereafter, the secretory vesicles gradually increase in size by vesicular fusion, forming larger secretory granules containing specific proteins. It was found that these granules eventually migrate to the apical membrane and are exocytosed into the lumen by a mechanism of merocrine secretion.

Efficacy of Ilizarov External Fixation and Autologous Bone Grafting for Performing Arthrodesis on the Ankle Arthropathy with Risk Factors (불유합의 위험 인자를 가진 족관절 병변에 시행한 족관절 유합술로서 Ilizarov 외고정 기구 장착술 및 자가골 이식술의 유용성)

  • Lee, Yong-Sik;Nam, Il-Hyun;Lee, Tae-Hun;Ahn, Gil-Yeong;Lee, Yeong-Hyeon;Lee, Hee-Hyung;Hwang, Sung-Hyun
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.4
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    • pp.189-195
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    • 2019
  • Purpose: The aim of this study is to evaluate if the Ilizarov external fixation procedure with axial compression can help to obtain fusion across the ankle joint in patients with a high risk of nonunion. Materials and Methods: From January 2006 to December 2015, the study reviewed 17 patients who underwent ankle arthropathy with a high risk of nonunion and who underwent ankle fusion using the Ilizarov external fixator with axial compression and auto bone grafting. After the lateral surface of the ankle joint was exposed through a lateral trans-fibular approach, massive removal of the articular cartilage and excision of any loose or avascular bone were done. With the cortical bone harvested from the pelvis as corticocancellous bone blocks, we inserted the two cortical blocks longitudinally into the anterior and posterior part of the free ankle space from lateral to medial to make the rectangular chamber to fill the cancellous bones. After the Ilizarov external fixator was equipped, we tightened the frame by 5 mm to compress the bone graft space. We accessed the American Orthopaedic Foot and Ankle Society (AOFAS) AnkleHindfoot score both preoperatively and postoperatively. Results: The average age at the time of operation was 63.4 years (range, 47~78 years). The mean frame time was 17.4 weeks (range, 15~23 weeks). The average follow-up period was 3.7 years (range, 2~6 years). Osseous fusion was obtained in 15 patients (88.2%). There were two stable pseudarthroses among the rheumatoid arthritis patients, and we continued their follow-up. The mean AOFAS AnkleHindfoot score improved from 48.5 to 73.7 points. Conclusion: Ankle arthrodesis using the Ilizarov external fixation with axial compression and auto bone grafting on the ankle arthropathy that had difficult conditions to achieve union is considered one of the useful methods with a correspondingly low incidence of complications.

Production of the yellow fluorescent silk using the fibroin heavy chain protein expression system in transgenic silkworm (피브로인 H-chain 재조합 단백질 발현시스템을 이용한 황색형광실크의 제작)

  • Kim, Seong Wan;Choi, Kwang-Ho;Kim, Seong Ryul;Yun, Eun Young;Park, Seung Won;Kang, Seok Woo;Goo, Tae Won
    • Journal of Sericultural and Entomological Science
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    • v.52 no.2
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    • pp.102-109
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    • 2014
  • We constructed the fibroin H-chain expression system to produce enhanced yellow fluorescent proteins (EYFP) in the silk of transgenic silkworm. Fluorescent silk could be made by fusing EYFP cDNA to the heavy chain gene and injecting it into a silkworm. The EYFP fusion protein, each with N- and C-terminal sequences of the fibroin H-chain, was designed to be secreted into the lumen of the posterior silk glands. The expression of the EYFP/H-chain fusion gene was regulated by the fibroin H-chain promoter. The yellow fluorescence proving that the fusion protein was present in the silk. Accordingly, we suggest that the EYFP fluorescence silk will enable the production of novel biomaterial based on the transgenic silk.

Construction of fluorescent red silk using fibroin H-chain expression system (누에 형질전환에 의한 견사선에서의 적색형광단백질 발현)

  • Kim, Sung Wan;Yun, Eun Young;Choi, Kwang-Ho;Kim, Seong Ryul;Park, Seung Won;Kang, Seok Woo;Kwon, O-Yu;Goo, Tae Won
    • Journal of Sericultural and Entomological Science
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    • v.50 no.2
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    • pp.87-92
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    • 2012
  • We constructed the fibroin H-chain expression system to produce Discosoma sp. red fluorescent protein variant2 (DsRed2) in transgenic silkworm cocoon. Fluorescent cocoon could be made by fusing DsRed2 cDNA to the heavy chain gene and injecting it into a silkworm. The DsRed2 fusion protein, each with N- and C-terminal sequences of the fibroin H-chain, was designed to be secreted into the lumen of the posterior silk glands. The expression of the DsRed2/H-chain fusion gene was regulated by the fibroin H-chain promoter. The use of the 3xP3-driven EGFP cDNA as a marker allowed us to rapidly distinguish transgenic silkworms. The EGFP fluorescence became visible in the ocelli and in the central and peripheral nervous system on the seventh day of embryonic development. A mixture of the donor and helper vector was micro-injected into 1,020 Kumokjam, bivoltin silkworm eggs. We obtained 6 broods. The cocoon was displayed strong red fluorescence, proving that the fusion protein was present in the cocoon. Accordingly, we suggest that the DsRed2 fluorescence silk will enable the production of novel biomaterial based on the transgenic silk.

The Effect of Distal Hooks in Thoracolumbar Fusion Using a Pedicle Screw in Elderly Patients (척추경 나사못을 이용한 고령 환자의 흉요추부 유합에서 원위부 갈고리의 효과)

  • Lee, Dong-Hyun;Kim, Sung-Soo;Kim, Jung-Hoon;Lim, Dong-Ju;Choi, Byung-Wan;Kim, Jin-Hwan;Kim, Jin-Hyok;Park, Byung-Ook
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.83-91
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    • 2017
  • Purpose: To investigate the clinical outcomes of distal hook augmentation using a pedicle screw in thoracolumbar fusion in elderly patients. Materials and Methods: This retrospective multicenter study recruited 20 patients aged 65 years or older, who underwent anterior support and long level posterior fusion in the thoracolumbar junction with a follow-up of one year. To assess the effect of distal hook augmentation, the patients were divided into two groups; the pedicle screw with hook group (PH group, n=10) and the pedicle screw alone group (PA group, n=10). Results: The average age was 72.4 years (65-83 years). The average fusion segment was 4.6 segments (3-6 segments). There were no significant differences in age, sex, causative diseases, bone mineral density of lumbar and proximal femur, number of patients with osteoporosis, and number of fused segments between the two groups (p≥0.05). At 1 year follow-up after surgery, parameters related with distal screw pullout were significantly worse in the PA group. No patients in the PH group had distal screw pullout. However, six patients (60%, 6/10) in the PA group had distal screw pullout. There were no significant differences in the progression of distal junctional kyphosis between the two groups. Conclusion: Distal hook augmentation is an effective procedure in protecting distal pedicle screws against the pullout when long level thoracolumbar fusion was performed in elderly patients aged 65 years or older.

Treatment of Atlantoaxial Fractures (제1,2경추골절의 치료)

  • Jin, Sung-Chul;Kim, Sang-Jin
    • Journal of Trauma and Injury
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    • v.19 no.2
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    • pp.164-172
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    • 2006
  • Background: The authors conducted a retrospective study to evaluate the mechanism of injury, the surgical techniques, the clinical features, the combined injuries, the treatment results, and the surgical complications in patients with atlantoaxial fracture/subluxations. Methods: The authors reviewed 71 cervical fracture/dislocations during a four-year period from September 2002 to August 2006. Among them, there were twenty one C1,2 fracture/subluxations. There were thirteen men (mean age : 43.5 years) and eight women (mean age : 50 years). Their follow-up period was at least 6 months, and the mean follow-up period was 9.6 months. Gardner-Wells tongs traction was used in all patients immediately on presentation. Surgical treatment was performed, depending on the pathologic conditions. Results: Of all 21 cases, 14 cases were injured in motor vehicle accidents, 5 were falls, and 2 were miscellaneous. There were four C1 fracture (5.6%), fourteen C2 fracture (66.7%), one C1 and 2 combined fracture (4.8%), and one C1-2 subluxation (4.8%). The C1 fractures in our series were classified as two Jefferson's fractures and two C1 lateral mass fracture. The C2 fractures were classified as one odontoid type I fracture, two odontoid type II fractures, five odontoid type III fractures, one hangman's fracture, and four C2 body tear-drop fractures. Atlantoaxial fractures were associated with six (28.6%) head injuries, four (19.0%) other spinal injuries, two (9.5%) chest injuries, and three (14.3%) spinal cord injuries. Surgical treatment was performed in nine cases, which included anterior odontoid screw fixation in two cases, transarticular screw fixation with iliac bone graft in one case, posterior fixation by using C2 pedicle screw and C3 lateral mass screw in three cases, lateral mass screw fixation C1-2 with iliac bone graft in one case, O(occipito)-C1-3-4 screw fixation in one case, posterior C2-3 wiring with allograft in one case, and halo vest in six cases. Conservative management was used in the rest of the patients in our trials. Bone fusion was complete in all cases. There were no operation-related complication, except one pin site infection in the case of halo vest. Conclusion: In this study, the choice of appropriate treatment according to the fracture types resulted in safe and effective management of unique atlantoaxial fracture/subluxations.

Analysis of Complications after Treatment of Calcaneal Fracture (종골 골절 일차 치료 후 발생한 합병증에 대한 분석)

  • Suh, Dong-Hyun;Park, Yong-Wook;Kim, Do-Young;Lee, Sang-Soo;Yoon, Tae-Kyung;Park, Hyun-Chul;Kang, Seung-Wan
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.1
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    • pp.46-51
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    • 2004
  • Purpose: Problematic late sequelae are common following a calcaneal fracture regardless of the initial treatment. We retrospectively evaluated the painful conditions and reviewed the results of the operative treatment in patients with previously treated calcaneal fractures. Materials and Methods: Between October 1996 and September 2001, forty-three patients who underwent subsequent surgical treatment for late sequelae of calcaneal fracture were reviewed. The initial treatment consisted of only immobilization in a cast in 7 patients, closed reduction with pin fixation (Essex-Lopresti technique) in 22 and open reduction and internal fixation in 14. Painful conditions in the hind foot included subtalar arthritis in 31 patients, calcaneofibular impingement in 13, peroneal tendinitis in 6, displaced posterior bony fragment in 3, sural neuritis in 2, subtalar and midtarsal arthritis in 1 and displaced plantar bony fragment in 1. The surgical procedures for the late complications were performed at a mean of 19 months (range, 6 to 35 months) after the injury and consisted of lateral wall ostectomy and in situ subtalar fusion in 28 patients, only lateral wall ostectomy in 5 patients, lateral wall ostectomy and subtalar distraction arthrodesis in 3, removal of displaced posterior bony fragment in 3, sural nerve transposition in the peroneus brevis in 2, triple arthrodesis in 1 and removal of displaced plantar bony fragment in 1. Mean postoperative follow up period was 57 months (range, 33 to 82 months). The results of treatment were evaluated on the basis of pain, improvement in the ability to perform activities of daily living, to return to work or to a pre-injury level of activity. Results: Pain was partially relieved in 38 patients (88%), but not relieved in 5. Function improved in 34 patients (79%), and 32 (74%) returned to work or to a pre-injury level of activity. There was a trend that the longer the interval between the injury and the operation, the longer the subsequent interval until the patient returned to full activities or work. Conclusion: Meticulous physical examination and intensive prompt treatment for remaining pain after initial treatment of calcaneal fractures are recommended for patient's satisfaction and returning to work.

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