• 제목/요약/키워드: Radiologic placement

검색결과 14건 처리시간 0.024초

Radiologic Evaluation of Proper Pedicle Screw Placement after Pedicle Screw Fixation in Degenerative Lumbar Disc Disease

  • Ju, Sun-Min;Kim, Young-Soo;Kim, Sung-Bum;Ko, Yong;Oh, Seong-Hoon
    • Journal of Korean Neurosurgical Society
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    • 제38권4호
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    • pp.265-268
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    • 2005
  • Objective : With the increasing popularity of pedicle screw fixation devices for several indications, the safety and reliability of screw insertion in the small pedicle has become a major issue. Many studies have investigated the accuracy of screw placement after pedicle screw fixation using various method. The reported displacement rates have been very different. The purpose of the study is to investigate the proper placement of pedicle screw insertion in the lumbar spine on 26 consecutive patients. Methods : Between September and December 2003, 26 consecutive patients [16women and 10men] were analyzed after transpedicular screw fixation of the lumbar and lumbosacral spine. After pedicle screw fixation in this study, 2-mm slices of CT scan were performed in all patients to detect caudal and cranial deviation of screw and medial and lateral deviation. Pedcile screw placement related complication was evaluated clinically. Results : A total of 144 inserted pedicle were analyzed in 26patients, and 58pedicle screws [40.3%] were detected to be improper placement. There were 14level [9.0%] of caudal or cranial deviation and 44level [30.6%] of medial or lateral deviation to the pedicle. Extra-pedicle placement was found on 4levels [2.7%] with only lease of neurologic injury. Conclusion : Proper screw placement, though complication rate is low, is important not only for clinical symptom but also for biomechanics. Further study for screw placement related biomechanical changes is needed.

Extraoral periapical radiography: an alternative approach to intraoral periapical radiography

  • Kumar, Rahul;Khambete, Neha;Priya, Ekta
    • Imaging Science in Dentistry
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    • 제41권4호
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    • pp.161-165
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    • 2011
  • It is difficult to take intraoral radiographs in some patients who are intolerable to place the film in their mouth. For these patients, Newman and Friedman recommended a new technique of extraoral film placement. Here we report various cases that diagnostic imaging was performed in patients using the extraoral periapical technique. This technique was used to obtain the radiographs for the patients with severe gag reflex, pediatric dental patients, and patients with restricted mouth opening. This technique can be recommended as an alternative to conventional intraoral periapical technique in cases where intraoral film placement is difficult to achieve.

췌십이지장절제술 후 발생한 후기 출혈에서 스텐트-그라프트를 이용한 치료의 장기적 임상, 영상의학적 결과 (Long-Term Clinical and Radiologic Outcomes after Stent-Graft Placement for the Treatment of Late-Onset Post-Pancreaticoduodenectomy Arterial Hemorrhage)

  • 김우진;전창호;권훈;김진혁;전웅배;김석;서형일;김창원
    • 대한영상의학회지
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    • 제82권3호
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    • pp.600-612
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    • 2021
  • 목적 간 기능 검사와 영상 소견을 기반으로 하여 췌십이지장절제술 후 발생한 후기 출혈에서 스텐트-그라프트를 이용한 치료의 장기적 영상의학적, 임상적 경과를 보고자 한다. 대상과 방법 2012년 6월부터 2017년 5월까지 췌십이지장절제술 후 발생한 후기 출혈로 스텐트-그라프트 삽입술을 받은 9명의 환자를 후향적으로 분석하였다. 저자들은 시술 직후 술기적, 임상적 결과와 간 기능 검사를 검토하였다. 스텐트-그라프트의 개통성은 CT angiography를 이용하여 평가하였다. 결과 모든 스텐트-그라프트는 즉각적인 동맥 출혈을 멈추면서 간동맥 혈류를 유지할 수 있도록 의도했던 위치에 배치되었다. 기술적 성공은 모든 9명의 환자에게서 이루어졌다. 8명의 환자는 시술 후 생존하여 퇴원하였으며 한 명의 환자는 시술 28일 후 사망하였다. 평균 추적 관찰 기간은 781일이었다(범위: 28~1766일). 추적관찰 CT angiography에서 모든 환자의 스텐트-그라프트는 폐쇄되었다. 그러나 모든 환자들에서 간 경색을 시사할 만한 혈중 아스파르테이트아미노전달효소나 알라닌아미노전달효소 수치의 증가를 보이지 않았다. 결론 스텐트-그라프트 삽입술은 췌십이지장절제술 후 발생한 생명을 위협하는 후기 출혈의 안전하고 효과적인 치료이다. 간 기능과 간 말단부 동맥혈 공급은 추적관찰 CT상 스텐트-그라프트가 높은 확률로 막힘에도 불구하고 유지된다.

자가치아 뼈 이식재의 발치와내 이식 후 골 치유 양상에 관한 연구 (Study of bone healing pattern in extraction socket after application of demineralized dentin matrix material)

  • 정재호;이재훈
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제37권5호
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    • pp.365-374
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    • 2011
  • Introduction: Research on dental bone graft material has been actively conducted. Recently, demineralized dentin matrix material has been developed and introduced. This study examined the effect of demineralized dentin matrix material on bone healing. Subjects and Methods: The patients who received no treatment after extraction were used as the control group and patients who underwent demineralized dentin matrix material application in the extraction socket after extraction were used as the experimental group. Panorama radiography was performed at the baseline and at 3.5 months after graft material placement and CT was taken at 3.5 months after graft material placement for a radiologic evaluation. Bony tissue specimens were collected from the alveolar crest in the middle of the extraction socket using a 2 mm trephine bur after 3.5 months for the histology and hostomorphometric study. Results: 1. On the panoramic view, a higher bone density was observed in the subject group. 2. On the panoramic view, the bone density increased significantly in the extraction socket, from the baseline to 3.5 months: a 7 and 10 gray-level scale was observed in the control and experimental group, respectively (P<0.05). 3. The CT view evaluation at 3.5 months revealed significantly higher bone density in the subject group than the control group (P<0.05). 4. The histological findings showed more active new bone and lamellar bone formation in the subject group. Dentin with osteoinduction ability and enamel with osteoconduction ability appeared. 5. On histomorphometric analysis, the subject group showed significantly more new bone, lamellar bone area and lower soft tissue area (P<0.05). The difference between the groups was significant (P<0.05). Conclusion: Bone healing was improved after the application of demineralized dentin matrix material and there was active new bone and lamellar bone formation.

이식된 자가골의 종류와 형태에 따른 임플란트 변연골 흡수량에 관한 후향적 연구 (The retrospective study of marginal bone loss around dental implants according to different autogenous bone grafts)

  • 김태이;김예미;김지연;김명래;김선종
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제37권6호
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    • pp.483-489
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    • 2011
  • Introduction: This study examined the cumulative resorption of implants placed in a severely atrophic mandible and analyzed the radiologic bone resorption in the marginal bone, after an autogenous bone graft including both block and particulates that had been harvested from the ramus and iliac crest. Materials and Methods: A retrospective study was performed on patients who had bone grafts for augmentation followed by implant installation in the mandible area from 2003 to 2008. Twelve patients (6 men and 6 women) who received 34 implants in the augmented sites were evaluated. Cumulative radiologic resorption around the implants was measured immediately, 3 months, 6 months and 12 months after implant installation surgery. Results: The installed implant in grafted bone showed 0.84 mm marginal bone resorption after 3 months and 50% total cumulative resorption after 1 year. The mean marginal bone resorption around the implant installed in the grafted bone was 0.44 mm after 3 months, 0.52 mm after 1 year, after which it stabilized. The implant survival rate was 97% (failed implant was 1/34). Marginal bone resorption of the installed implant in the autogenous onlay block bone grafts was 0.98 mm after 3 months, which was significantly higher than that of a particulated bone graft (0.74 mm) (P <0.05). Conclusion: An autogenous graft including block type and particulate type is a predictable procedure for the use of dental implants in a severely atrophic mandible. Implant placement in augmented areas show a relatively high survival and minimal bone loss, as revealed by a radiologic evaluation.

쥐 대장에서 스텐트 삽입 후 발생하는 조직 과증식 모델 형성을 위한 연구 (A Mouse Colon Model to Investigate Stent-Induced Tissue Hyperplasia)

  • 김민태
    • 한국방사선학회논문지
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    • 제14권4호
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    • pp.439-445
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    • 2020
  • 본 연구는 쥐 대장 모델에서 자가팽창형 금속형 스텐트 삽입을 통한 삽입술의 유용성과 조직 과증식을 평가하고자 한다. 먼저 C57BL/6 쥐 대장의 직경을 확인하기 위해 1마리의 대장 투시조영 사전 실험을 실행하였다. 평균 직경은 4.05 mm였다. C57BL/6 쥐들은 두 군으로 나누어 각각 다른 스텐트의 직경을 비교 평가하였다. A 군은 직경이 5 mm, B군은 4mm 였다. 추적관찰 검사는 매주 투시를 통해 스텐트 삽입의 이상 유무를 평가하였다. 4주 후 내시경적 검사를 시행하고 희생하여 육안적 관찰 및 H&E 염색을 통해 조직 과증식을 평가하였다. 스텐트 삽입술은 시술 중 천공이 일어난 1마리를 제외하고 모든 쥐에서는 성공적으로 삽입되었다. 해당 데이터는 본 실험에서 제외하였다. 추적관찰 실험 기간에 A군에 속한 5마리의 쥐는 스텐트 삽입 후 7일 이내에 천공에 의해 사망하였다. B군의 1마리의 쥐는 곧창자로 스텐트의 이동이 발생하였다. A, B 군에서의 합병증은 각각 60%, 10%로 나타났다. 육안적 내시경적 결과에서는 모든 군에서 스텐트 와이어사이로 전체적인 조직 과증식이 일어남을 확인하였다. 조직병리에서의 결과 또한 두 군 사이의 통계적 차이는 유의하지 않게 조직 과증식이 일어났음을 확인할 수 있었다. 대장 스텐트의 삽입술은 기술적으로 유용하게 삽입이 가능했으며, 스텐트에 의한 조직 과증식이 쥐 모델에서 나타남을 확인하였다. 또한 스텐트 사이즈의 증가에 따라 쥐 대장내 천공이 많이 발생함을 확인할 수 있었다.

방사선 구개상을 이용한 제3 후두 신경 고주파신경절개술의 시행 -증례보고- (Third Occipital Nerve Radiofrequency Neurotomy with Radiologic Open Mouth View -A case report-)

  • 박정주;정미애;심재철
    • The Korean Journal of Pain
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    • 제19권2호
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    • pp.244-248
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    • 2006
  • Radiofrequency lesioning is a valuable tool for third occipital headache. Relative to most neural targets, a radiofrequency lesion is very small. Reliable pre-operative diagnosis of the nociceptive source is critical, as inappropriately placed lesions will not modulate pain. Knowledge of the anatomical courses of nerves and extremely precise electrode placement are required for accurate lesioning. This report describes our experience with RF lesioning in the treatment of chronic pain in two patients who suffered from third occipital headaches. In one patient, satisfactory improvement of the pain was observed after 10 months of follow up.

Mobile Computed Tomography : Three Year Clinical Experience in Korea

  • Jeon, Jin Sue;Lee, Sang Hyung;Son, Young-Je;Yang, Hee-Jin;Chung, Young Seob;Jung, Hee-Won
    • Journal of Korean Neurosurgical Society
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    • 제53권1호
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    • pp.39-42
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    • 2013
  • Objective : Obtaining real-time image is essential for neurosurgeons to minimize invasion of normal brain tissue and to prompt diagnosis of intracranial event. The aim of this study was to report our three-year experience with a mobile computed tomography (mCT) for intraoperative and bedside scanning. Methods : A total of 357 mCT (297 patients) scans from January 2009 to December 2011 in single institution were reviewed. After excluding postoperative routine follow-up, 202 mCT were included for analysis. Their medical records such as diagnosis, clinical application, impact on decision making, times, image quality and radiologic findings were assessed. Results : Two-hundred-two mCT scans were performed in the operation room (n=192, 95%) or intensive care unit (ICU) (n=10, 5%). Regarding intraoperative images, extent of resection of tumor (n=55, 27.2%), degree of hematoma removal (n=42, 20.8%), confirmation of catheter placement (n=91, 45.0%) and monitoring unexpected complications (n=4, 2.0%) were evaluated. A total of 14 additional procedures were introduced after confirmation of residual tumor (n=7, 50%), hematoma (n=2, 14.3%), malpositioned catheter (n=3, 21.4%) and newly developed intracranial events (n=2, 14.3%). Every image was obtained within 15 minutes and image quality was sufficient for interpretation. Conclusion : mCT is feasible for prompt intraoperative and ICU monitoring with enhanced diagnostic certainty, safety and efficiency.

Fusion Criteria for Posterior Lumbar Interbody Fusion with Intervertebral Cages : The Significance of Traction Spur

  • Kim, Kyung-Hoon;Park, Jeong-Yoon;Chin, Dong-Kyu
    • Journal of Korean Neurosurgical Society
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    • 제46권4호
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    • pp.328-332
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    • 2009
  • Objective : The purpose of this study was to establish new fusion criteria to complement existing Brantigan-Steffee fusion criteria. The primary purpose of intervertebral cage placement is to create a proper biomechanical environment through successful fusion. The existence of a traction spur is an essential predictable radiologic factor which shows that there is instability of a fusion segment. We studied the relationship between the existence of a traction spur and fusion after a posterior lumbar interbody fusion (PLIF) procedure. Methods : This study was conducted using retrospective radiological findings from patients who underwent a PLIF procedure with the use of a cage without posterior fixation between 1993 and 1997 at a single institution. We enrolled 183 patients who were followed for a minimum of five years after the procedure, and used the Brantigan-Steffee classification to confirm the fusion. These criteria include a denser and more mature bone fusion area than originally achieved during surgery, no interspace between the cage and the vertebral body, and mature bony trabeculae bridging the fusion area. We also confirmed the existence of traction spurs on fusion segments and non-fusion segments. Results : The PLIF procedure was done on a total of 251 segments in 183 patients (71 men and 112 women). The average follow-up period was $80.4{\pm}12.7$ months. The mean age at the time of surgery was $48.3{\pm}11.3$ years (range, 25 to 84 years). Among the 251 segments, 213 segments (84.9%) were fused after five years. The remaining 38 segments (15.1%) were not fused. An analysis of the 38 segments that were not fused found traction spur formation in 20 of those segments (52.6%). No segments had traction spur formation with fusion. Conclusion : A new parameter should be added to the fusion criteria. These criteria should be referred to as 'no traction spur formation' and should be used to confirm fusion after a PLIF procedure.