• 제목/요약/키워드: Posterior instability

검색결과 154건 처리시간 0.031초

슬관절 후외측 불안정성 치료의 새 기법: 동종 후경골건을 이용한 후외측 재건술 (New Technique for Posterolateral Instability of The Knee: Posterolateral Reconstruction Using The Tibialis Posterior Tendon Allograft)

  • 김성재;류상욱;천용민;용석원;김보람
    • 대한정형외과스포츠의학회지
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    • 제2권2호
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    • pp.136-141
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    • 2003
  • 슬관절의 후외측 불안정성은 많은 연구가 필요한 손상 중의 하나이다 치료에 있어서도 여러 술기들이 고안되어 왔지만 아직 까지 만족할 만한 치료법은 없는 상황이다. 이에 저자들은 동종 후경골건을 이 용하여 외측측부인대와 슬와건을 동시에 재건하는 새로운 술식을 소개하고자 한다.

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Posterior Atlantoaxial Transarticular Screw Fixation

  • Ko, Byung-Su;Lee, Jung-Kil;Kim, Yeon-Seong;Moon, Sung-Jun;Kim, Jae-Hyoo;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • 제42권3호
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    • pp.179-183
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    • 2007
  • Objective : Posterior arthrodesis in atlantoaxial instability has been performed using various posterior C1-2 wiring techniques. Recently, transarticular screw fixation (TASF) technique was introduced to achieve significant immediate stability of the C1-2 joint complex. The purpose of this study is to assess the clinical outcomes associated with posterior C1-2 TASF for the patient of atlantoaxial instability. Methods : We retrospectively reviewed data obtained from 17 patients who underwent C1-2 TASF and supplemented Posterior wiring technique (PWT) with graft between 1994 and 2005. There were 8 men and 9 women with a mean age of 43.5 years (range, 12-65 years). An average follow-up was 26 months (range, 15-108 months). Results : Successful fusions were achieved in 16 of 17 (94%). The pain was improved markedly (3 patients) or resolved completely (14 patients). There was no case of neurological deterioration, hypoglossal nerve injury, or vertebral artery injury. Progression of spinal deformity, screw pullout or breakage, and neurological or vascular complications did not occur. Conclusion : The C1-2 TASF with supplemental wiring provided a high fusion rate. Our result demonstrates that C1-2 TASF supplemented by PWT is a safe and effective procedure for atlantoaxial instability. Preoperative evaluation and planning is mandatory for optimal safety.

Bone Microarchitecture at the Femoral Attachment of the Posterior Cruciate Ligament (PCL) by Texture Analysis of Magnetic Resonance Imaging (MRI) in Patients with PCL Injury: an Indirect Reflection of Ligament Integrity

  • Kim, Hwan;Shin, YiRang;Kim, Sung-Hwan;Lee, Young Han
    • Investigative Magnetic Resonance Imaging
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    • 제25권2호
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    • pp.93-100
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    • 2021
  • Purpose: (1) To evaluate the trabecular pattern at the femoral attachment of the posterior cruciate ligament (PCL) in patients with a PCL injury; (2) to analyze bone microarchitecture by applying gray level co-occurrence matrix (GLCM)-based texture analysis; and (3) to determine if there is a significant relationship between bone microarchitecture and posterior instability. Materials and Methods: The study included 96 patients with PCL tears. Trabecular patterns were evaluated on T2-weighted MRI qualitatively, and were evaluated by GLCM texture analysis quantitatively. The grades of posterior drawer test (PDT) and the degrees of posterior displacement on stress radiographs were recorded. The 96 patients were classified into two groups: acute and chronic injury. And 27 patients with no PCL injury were enrolled for control. Pearson's correlation coefficient and one-way ANOVA with Bonferroni test were conducted for statistical analyses. This protocol was approved by the Institutional Review Board. Results: A thick and anisotropic trabecular bone pattern was apparent in normal or acute injury (n = 57/61;93.4%), but was not prominent in chronic injury and posterior instability (n = 31/35;88.6%). Grades of PDT and degrees of posterior displacement on stress radiograph were not correlated with texture parameters. However, the texture analysis parameters of chronic injury were significantly different from those of acute injury and control groups (P < 0.05). Conclusion: The trabecular pattern and texture analysis parameters are useful in predicting posterior instability in patients with PCL injury. Evaluation of the bone microarchitecture resulting from altered biomechanics could advance the understanding of PCL function and improve the detection of PCL injury.

슬관절 후내측 혹은 후외측 관절막 파열의 관절경적 봉합술 - 수술 수기 - (Arthroscopic Repair of the Postero-medial or Postero-lateral Capsule Tear in the Knee Joint - Technical Note -)

  • 안진환;조양범;이용석
    • 대한관절경학회지
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    • 제5권2호
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    • pp.135-139
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    • 2001
  • 목적 : 진구성 후방, 후외측 또는 후내측 회전 불안정성에 대한 수술시 후방 관절막 파열을 발견할 수는 있으나 이에 관한 관절경적 치료 방법에 대한 보고는 아직 없다. 저자들은 후내측 또는 후외측 관절막 파열을 후방 경격막 도달법을 이용한 새로운 관절경적 봉합술을 소개하고자 한다. 대상 및 방법 : 슬관절의 관절경적 기본검사 후, 후내측 도달법과 후외측 도달법을 개설하여 후방 경격막 도달법을 확보한 후 관절경적 시야 하에서 봉합용 갈고리를 이용하여 파열된 후내측 또는 후외 측 관절막을 봉합한다. 결론 : 후방 십자인대 재건술 또는 후외측 회전 불안정성에 대한 재건술시, 후내측 또는 후외측 관절막 파열을 후방 경격막 도달법을 이용한 관절경적 봉합술은, 충분한 시야 확보로 파열된 관절막을 정확히 봉합할 수 있었으며 불안정성을 현저히 감소시킬 수 있어 보다 우수한 수기로 판단된다.

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만성 허리통증 환자의 엉덩허리근 단축과 허리 불안정성 검사 간에 관련성 연구 (A Study on the Relationship Between the Results of Shortening of the Iliopsoas Muscles and the Lumbar Instability Tests in Patients with Chronic Low Back Pain)

  • 유창현;김선엽
    • 대한물리의학회지
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    • 제18권2호
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    • pp.49-59
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    • 2023
  • PURPOSE: This study examined the relationship between lumbar instability and shortening of the iliopsoas muscles in patients with chronic low back pain. METHODS: Forty-nine patients with chronic low back pain participated in this study. The modified Thomas test was used to examine the shortening state of the iliopsoas muscle. The length of the iliopsoas muscle was measured using the hip flexion angle, and those with a flexion angle of 10° or more were classified as positive. Five subtests were used for the lumbar instability test: testing for prone lumbar instability, passive lumbar extension, anterior-posterior mobility, passive straight leg raise, and age. Those who tested positive for at least three of these tests were classified as positive for the lumbar segment instability test. RESULTS: There was a significant association between the results of the lumbar instability test and the shortening of the iliopsoas test (p < .05). After analyzing the association between the iliopsoas length test and the five lumbar instability subtests, the results of the prone lumbar instability test (p < .001) and the anterior-posterior mobility test (p < .05) showed a significant association with the iliopsoas length test. CONCLUSION: The association between lumbar instability and shortening of the iliopsoas muscles was examined in 49 patients with chronic low back pain. Patients with shortened iliopsoas muscles tested positive in the lumbar instability tests more often. Hence, the length test of the iliopsoas muscle can be used to determine lumbar instability in patients with chronic low back pain.

후방불안정성을 동반한 요추 추간판 탈출증에서 Graf 고정술후 발생한 합병증 분석 (The Complications of the Graf Stabilization for Lumbar Disc Herniation with Posterior Instability)

  • 박주태;신영식;양정호;민강우
    • Journal of Yeungnam Medical Science
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    • 제15권1호
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    • pp.164-172
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    • 1998
  • 본 포항성모병원 정형외과에서는 1991년 5월부터 1995년 12월까지 척추불안정성과 관련된 요추부질환 중 연성고정술을 시행한 145례 중 문제점이 발생된 22례를 분석하여 다음과 같은 결론을 얻었다. 1. 총 145례 중 22례(15.1%)에서 연성고정술로 유발되는 문제점을 발견하였다. 2. 문제점으로 주위분절의 불안정성 증가 10례, 추간판 간격의 감소 8례, 척추경 나사못의 해리 3례, Graf band의 파열이 1례였다. 3. 추간판 간격의 감소 8례 중 초기 질환의 원 인으로 추간판이 파열된 경우가 6례로 의의있는 소견을 보였다. 이상과 같은 문제점이 관찰되었으나 주위분절의 불안정성 증가 및 척추경 나사못의 해리는 견고한 고정술에 비해 그 빈도가 낮은 것으로 보이며, 추간판 간격의 감소의 경우 역시 단순 수핵 제거술후 발생된 추간판 간격의 감소 보다 빈도가 적었으나, 보다 장기간의 추시 및 계속적인 관찰과 연구가 필요할 것으로 사료된다.

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환추-축추 불안정성에 있어서 후방 경관절 나사못 고정술에 대한 수술적 경험 (Surgical Experience with Posterior Atlantoaxial Transarticular Screw Fixation in Atlantoaxial Instability)

  • 차승규;유찬종
    • Journal of Korean Neurosurgical Society
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    • 제29권1호
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    • pp.95-100
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    • 2000
  • Objective : Posterior transarticular screw fixation is known to be one of the best surgical method for the atlantoaxial instability. We assessed the complication and operative risk in 15 patients. Patients and Methods : Between January 1997 and April 1998, 15 patients suffering from this condition were admitted to our institution. Atlantoaxial instability was caused by C1 or C2 fractures in 11, rheumatoid arthritis in 2, and os odontoideum in 2. This technique was used in the treatment of 13 patients and 2 patients was used in sublaminar wire fixation only. Bilateral C1-C2 screws were placed in 11 patients ; 2 patients had only one screw placed becauce of an anomalous vertebral artery and axial destruction. Follow-up period ranged from 5 to 20 months. Results : Most screws were positioned satisfactorily. One screw was malpositioned. No patients had neurological complications. Conclusion : Rigidly fixating C1-C2 instability with transarticular screws showed a significantly higher fusion rate than that achieved using wired grafts alone. The risk of screw malpositioning and catastrophic vascular or neural injury is small and can be minimized by assessing the position of the transverse foramen on preoperative computed tomographic scans and by correctly using intraoperative fluoroscopy and surgeon's precaution.

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키네시오 테이핑이 허리뼈 불안정성을 가진 대상자의 통증감소 및 기능장애 개선에 미치는 효과 (Effect of Kinesio Taping on Pain Decrease and Functional Disability Improvement of Subjects with Lumbar Instability)

  • 조효신;원종혁;이권호;차현규
    • 대한통합의학회지
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    • 제8권3호
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    • pp.71-81
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    • 2020
  • Purpose : The purpose of this study is to investigate the instant effect of Kinesio taping on pain decrease and improvement of functional disorder of the subjects who have lumbar instability. Methods : A total of 20 patients (13 men and 7 women) who have lumbar instability were chosen as the subjects. The experiment was conducted by assigning the subjects into Kinesio taping group and placebo taping group. A visual analog scale (VAS) was used to measure back pain and Biering-Sorensen test was applied to measure the muscle endurance of back extensor muscles. A digital dynamometer was used to test the isomeric contraction strength of lumbar extensor muscle. The subject performed single-leg stance and double-leg stance task and their static balancing ability was measured by a testing device that captures the static balancing ability. Results : In a within-group comparison, Kinesio taping group showed a significant decrease of VAS (p<.05) and a significant increase of endurance and strength of lumbar extensor muscle (p<.05). In Kinesio taping group, the shift distance in anterior-posterior sway and medial-lateral sway during the double-leg stance significantly decrease (p<.05). The shift distance in anterior-posterior sway and medial-lateral sway also significantly decreased during the single-leg stance (p<.05). Placebo taping group showed a significant decrease of visual analog scale (p<.05). In a between-group comparison, Kinesio taping group showed a significantly larger decrease of VAS (p<.05), significant larger increase of muscle endurance and muscle strength (p<.05), and significant larger decrease of anterior-posterior sway in the double-leg stance (p<.05), compared to placebo taping group. Conclusion : Application of Kinesio taping to the subjects with lumbar instability produced positive effect of reducing pain, increasing muscle strength and endurance, and improving static balancing ability.