• 제목/요약/키워드: Segmental Group

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The Predictable Factors of the Postoperative Kyphotic Change of Sagittal Alignment of the Cervical Spine after the Laminoplasty

  • Lee, Jun Seok;Son, Dong Wuk;Lee, Su Hun;Kim, Dong Ha;Lee, Sang Weon;Song, Geun Sung
    • Journal of Korean Neurosurgical Society
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    • 제60권5호
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    • pp.577-583
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    • 2017
  • Objective : Laminoplasty is an effective surgical method for treating cervical degenerative disease. However, postoperative complications such as kyphosis, restriction of neck motion, and instability are often reported. Despite sufficient preoperative lordosis, this procedure often aggravates the lordotic curve of the cervical spine and straightens cervical alignment. Hence, it is important to examine preoperative risk factors associated with postoperative kyphotic alignment changes. Our study aimed to investigate preoperative radiologic parameters associated with kyphotic deformity post laminoplasty. Methods : We retrospectively reviewed the medical records of 49 patients who underwent open door laminoplasty for cervical spondylotic myelopathy (CSM) or ossification of the posterior longitudinal ligament (OPLL) at Pusan National University Yangsan Hospital between January 2011 and December 2015. Inclusion criteria were as follows : 1) preoperative diagnosis of OPLL or CSM, 2) no previous history of cervical spinal surgery, cervical trauma, tumor, or infection, 3) minimum of one-year follow-up post laminoplasty with proper radiologic examinations performed in outpatient clinics, and 4) cases showing C7 and T1 vertebral body in the preoperative cervical sagittal plane. The radiologic parameters examined included C2-C7 Cobb angles, T1 slope, C2-C7 sagittal vertical axis (SVA), range of motion (ROM) from C2-C7, segmental instability, and T2 signal change observed on magnetic resonance imaging (MRI). Clinical factors examined included preoperative modified Japanese Orthopedic Association scores, disease classification, duration of symptoms, and the range of operation levels. Results : Mean preoperative sagittal alignment was $13.01^{\circ}$ lordotic; $6.94^{\circ}$ lordotic postoperatively. Percentage of postoperative kyphosis was 80%. Patients were subdivided into two groups according to postoperative Cobb angle change; a control group (n=22) and kyphotic group (n=27). The kyphotic group consisted of patients with more than $5^{\circ}$ kyphotic angle change postoperatively. There were no differences in age, sex, C2-C7 Cobb angle, T1 slope, C2-C7 SVA, ROM from C2-C7, segmental instability, or T2 signal change. Multiple regression analysis revealed T1 slope had a strong relationship with postoperative cervical kyphosis. Likewise, correlation analysis revealed there was a statistical significance between T1 slope and postoperative Cobb angle change (p=0.035), and that there was a statistically significant relationship between T1 slope and C2-C7 SVA (p=0.001). Patients with higher preoperative T1 slope demonstrated loss of lordotic curvature postoperatively. Conclusion : Laminoplasty has a high probability of aggravating sagittal balance of the cervical spine. T1 slope is a good predictor of postoperative kyphotic changes of the cervical spine. Similarly, T1 slope is strongly correlated with C2-C7 SVA.

Circuit training과 마황(麻黃) 복용이 태음인 여성의 심폐기능향상과 체지방감소에 미치는 상관성 연구 (Correlation between Cardiopulmonary System Function and Body Fat by Circuit Training and Ephedra Herba in Taeumin Women)

  • 박상호;조현철;최승범;송윤경;임형호
    • 한방재활의학과학회지
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    • 제15권1호
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    • pp.39-65
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    • 2005
  • Objectives : This study was aimed to find out correlation of relation between cardiopulmonary function and body fat. Methods : We studied tendency of change of cardiopulmonary function and body fat for medication of Ephedrae Herba capsule by ergogenic aids with circuit training. We got the results for Exercise stress test and Segmental Bioelectrical Impedence Analysis. Results : 1. Sample Group of Ephedrae Herba medication and Circuit training generally showed the insignificant improvement of Body composition, but Control Group of Placebo and Circuit training significantly(p<.05) showed significant improvement of Body composition. 2. Sample Group of Ephedrae Herba medication and Circuit training generally showed the significant improvement of cardio-pulmonary function. Control Group of Placebo and Circuit training showed insignificant elevation of Cardiopulmonary function. 3. In the case of Sample Group, there wasn't closely correlation relationship of improvement of cardiopulmonary function and body composition, but in the case of Control Group, there was closely correlation relationship of improvement of cardiopulmonary function and body composition. Conclusions : It might be recognized that cardiopulmonary function has the correlation of body composition, and Ephedrae Herba might help the reduction of Body Fat by elevation of Cardiopulmonary function for ergogenic aids and it might be needed further study In various viewpoints.

Anterior Cervical Discectomy and Fusion Using a Double Cylindrical Cage versus an Anterior Cervical Plating System with Iliac Crest Autografts for the Treatment of Cervical Degenerative Disc Disease

  • Kim, Seong Joon;Kim, Sang Don
    • Journal of Korean Neurosurgical Society
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    • 제55권1호
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    • pp.12-17
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    • 2014
  • Objective : Anterior cervical discectomy and fusion (ACDF) is often complicated by subsidence, pseudoarthrosis, kyphosis, and graft donor site morbidities. To decrease the occurrence of these complications, various types of cages have been developed. We designed this retrospective study to analyze and compare the efficacy and outcomes of ACDF using double cylindrical cages (DCC) (BK Medical, Seoul, Korea) versus an anterior cervical plating system with autogenous iliac crest grafts. Methods : Forty-eight patients were treated with autograft and plating (plate group), and 48 with DCC group from October 2007 to October 2011. We analyzed construct length, cervical lordotic curvarture, the thickness of the prevertebral soft tissue, segmental instability, and clinical outcomes. Results : There were no significant differences between the two groups with regard to the decrease in construct length or cervical lodortic curvature at the 3-, 6-, and 12-month follow-ups. The prevertebral soft tissue was thinner in the DCC group than the plate group immediately after surgery and at the 3-, 6-, and 12-month follow-ups. The difference in interspinous distance on flexion-extension was shorter in the plate group than the DCC group at the 3- and 6-month follow-ups. However, there was no significant difference in this distance between the two groups at the 12-month follow-up. Conclusion : A double cylindrical cage is a good alternative for fusion in patients with cervical degenerative diseases; the surgical method is relatively simple, allows good synostosis, has less associated prevertebral soft tissue swelling, and complications associated with autografting can be avoided.

Clinical and Radiological Comparison of Femur and Fibular Allografts for the Treatment of Cervical Degenerative Disc Diseases

  • Oh, Hyeong-Seok;Shim, Chan Shik;Kim, Jin-Sung;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • 제53권1호
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    • pp.6-12
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    • 2013
  • Objective : This consecutive retrospective study was designed to analyze and to compare the efficacy and outcomes of anterior cervical discectomy and fusion (ACDF) using a fibular and femur allograft with anterior cervical plating. Methods : A total of 88 consecutive patients suffering from cervical degenerative disc disease (DDD) who were treated with ACDF from September 2007 to August 2010 were enrolled in this study. Thirty-seven patients (58 segments) underwent anterior interbody fusion with a femur allograft, and 51 patients (64 segments) were treated with a fibular allograft. The mean follow-up period was 16.0 (range, 12-25) months in the femur group and 19.5 (range, 14-39) months in the fibular group. Cage fracture and breakage, subsidence rate, fusion rate, segmental angle and height and disc height were assessed by using radiography. Clinical outcomes were assessed using a visual analog scale and neck disability index. Results : At 12 months postoperatively, cage fracture and breakage had occurred in 3.4% (2/58) and 7.4% (4/58) of the patients in the femur group, respectively, and 21.9% (14/64) and 31.3% (20/64) of the patients in the fibular group, respectively (p<0.05). Subsidence was noted in 43.1% (25/58) of the femur group and in 50.5% (32/64) of the fibular group. No difference in improvements in the clinical outcome between the two groups was observed. Conclusion : The femur allograft showed good results in subsidence and radiologic parameters, and sustained the original cage shape more effectively than the fibular allograft. The present study suggests that the femur allograft may be a good choice as a fusion substitute for the treatment of cervical DDD.

Comparative Analysis between Total Disc Replacement and Posterior Foraminotomy for Posterolateral Soft Disc Herniation with Unilateral Radiculopathy : Clinical and Biomechanical Results of a Minimum 5 Years Follow-up

  • Kim, Kyoung-Tae;Cho, Dae-Chul;Sung, Joo-Kyung;Kim, Young-Baeg;Kim, Du Hwan
    • Journal of Korean Neurosurgical Society
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    • 제60권1호
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    • pp.30-39
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    • 2017
  • Objective : To compare the clinical outcomes and biomechanical effects of total disc replacement (TDR) and posterior cervical foraminotomy (PCF) and to propose relative inclusion criteria. Methods : Thirty-five patients who underwent surgery between 2006 and 2008 were included. All patients had single-level disease and only radiculopathy. The overall sagittal balance and angle and height of a functional segmental unit (FSU; upper and lower vertebral body of the operative lesion) were assessed by preoperative and follow-up radiographs. C2-7 range of motion (ROM), FSU, and the adjacent segment were also checked. Results : The clinical outcome of TDR (group A) was tended to be superior to that of PCF (group B) without statistical significance. In the group A, preoperative and postoperative upper adjacent segment level motion values were $8.6{\pm}2.3$ and $8.4{\pm}2.0$, and lower level motion values were $8.4{\pm}2.2$ and $8.3{\pm}1.9$. Preoperative and postoperative FSU heights were $37.0{\pm}2.1$ and $37.1{\pm}1.8$. In the group B, upper level adjacent segment motion values were $8.1{\pm}2.6$ and $8.2{\pm}2.8$, and lower level motion values were $6.5{\pm}3.3$ and $6.3{\pm}3.1$. FSU heights were $37.1{\pm}2.0$ and $36.2{\pm}1.8$. The postoperative FSU motion and height changes were significant (p<0.05). The patient's satisfaction rates for surgery were 88.2% in group A and 88.8% in group B. Conclusion : TDR and PCF have favorable outcomes in patients with unilateral soft disc herniation. However, patients have different biomechanical backgrounds, so the patient's biomechanical characteristics and economic status should be understood and treated using the optimal procedure.

Clinical Efficacy of Intra-Operative Cell Salvage System in Major Spinal Deformity Surgery

  • Choi, Ho Yong;Hyun, Seung-Jae;Kim, Ki-Jeong;Jahng, Tae-Ahn;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • 제62권1호
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    • pp.53-60
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    • 2019
  • Objective : The purpose of this study was to determine the efficacy of intra-operative cell salvage system (ICS) to decrease the need for allogeneic transfusions in patients undergoing major spinal deformity surgeries. Methods : A total of 113 consecutive patients undergoing long level posterior spinal segmental instrumented fusion (${\geq}5$ levels) for spinal deformity correction were enrolled. Data including the osteotomy status, the number of fused segments, estimated blood loss, intra-operative transfusion amount by ICS (Cell $Saver^{(R)}$, $Haemonetics^{(C)}$, Baltimore, MA, USA) or allogeneic blood, postoperative transfusion amount, and operative time were collected and analyzed. Results : The number of patients was 81 in ICS group and 32 in non-ICS group. There were no significant differences in demographic data and comorbidities between the groups. Autotransfusion by ICS system was performed in 53 patients out of 81 in the ICS group (65.4%) and the amount of transfused blood by ICS was 226.7 mL in ICS group. The mean intra-operative allogeneic blood transfusion requirement was significantly lower in the ICS group than non-ICS group (2.0 vs. 2.9 units, p=0.033). The regression coefficient of ICS use was -1.036. Conclusion : ICS use could decrease the need for intra-operative allogeneic blood transfusion. Specifically, the use of ICS may reduce about one unit amount of allogeneic transfusion in major spinal deformity surgery.

A Comparative Study on Internal Fixation Using Long Proximal Intramedullary Nail for the Treatment of Humeral Shaft Fracture according to Fracture Types

  • Choi, Chang-Hyuk;Jun, Chung-Mu;Kim, Jun-Young
    • Clinics in Shoulder and Elbow
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    • 제22권2호
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    • pp.87-92
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    • 2019
  • Background: This study was conducted to compare the radiological and clinical outcomes of internal fixation using a Polarus humeral nail for treatment of a humeral shaft fracture according to fracture types. Methods: From 43 patients, 13 were excluded and 30 patients were included. The 30 patients were divided into 2 groups: 15 in group I (Orthopaedic Trauma Association/Arbeitsgemeinschaft $f{\ddot{u}}r$ Osteosynthesefragen classification type A and B) and 15 in group II (type C). The mean age was 63.1 years (range, 20-87 years), and mean follow-up period was 2.3 years (range, 1.0-6.1 years). The causes of injuries were as follows: 12, traffic accidents; 14, simple slips; 2, simple falls; 2, contusions after lower energy trauma. Radiological and clinical evaluations were performed. Results: Radiological union was confirmed by plain anteroposterior and lateral radiographs on average of 5.0 months in group I, and 8.4 months in group II, respectively. Differences between the two groups were statistically significant (p<0.01). The clinical union value was 1.6 in group I, and 2.0 months in group II, but these values did not differ significantly (p=0.441). The mean Korean shoulder scoring system scores were 89.7 and 90.6, which did not differ significantly (p=0.352). Conclusions: Intramedullary nailing using the Polarus humeral nail is considered to be a good treatment modality for all types of humeral shaft fractures. Additionally, the Polarus humeral nail can be an optimal choice for the treatment of complex type fractures such as segmental or comminuted humeral shaft fractures.

6FDA-2, 4TDA;BAAF Polyimide Membrane의 기체투과특성

  • 이종규;남세종
    • 한국막학회:학술대회논문집
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    • 한국막학회 1994년도 춘계 총회 및 학술발표회
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    • pp.53-54
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    • 1994
  • Polyimide는 열, 화학적으로 안정하고 기계적성질이 우수하고, 기체분리특성이 비교적 좋다. Polyimide의 화학구조와 기체투과도와의 관계는 화학구조를 체계적으로 변화시키면서 많이 검토되어왔다.[1-2] Polyimide는 강직한 직쇄구조, bulky group에 의한 분자쇄운동성을 제어함과 동시, 약한 분자간 상호작용이 polymer chain의 유효층진을 억제하여 기체투과도를 높여준다. 국부분절운동(local segmental mobility)이 감소된 구조는 기체투과선택도를 향상시켜주는 경향을 보여주었다. [3] kim et al. 과 Stern et al은 6FDA나 fluorine-containing diamines으로 만든 polyimde가 매우높은 투과도를 보여준다고 보고했다. 본 연구에서는 6FDA-2, 4TDA hobopolymer에 BAAF를 가하여 copolyimide Membrane을 제막하여 BAAF 조성에 따라 투과선택도를 측정하는 homopolymer와 copolymer에 따른 변화를 관찰하였다.

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Teaching Pronunciation Using Sound Visualization Technology to EFL Learners

  • Min, Su-Jung;Pak, Hubert H.
    • 영어어문교육
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    • 제13권2호
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    • pp.129-153
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    • 2007
  • When English language teachers are deciding on their priorities for teaching pronunciation, it is imperative to know what kind of differences and errors are most likely to interfere with communication, and what special problems particular first-language speakers will have with English pronunciation. In other words, phoneme discrimination skill is an integral part of speech processing for the EFL learners' learning to converse in English. Training using sound visualization technique can be effective in improving second language learners' perceptions and productions of segmental and suprasegmental speech contrasts. This study assessed the efficacy of a pronunciation training that provided visual feedback for EFL learners acquiring pitch and durational contrasts to produce and perceive English phonemic distinctions. The subjects' ability to produce and to perceive novel English words was tested in two contexts before and after training; words in isolation and words in sentences. In comparison with an untrained control group, trainees showed improved perceptual and productive performance, transferred their knowledge to new contexts, and maintained their improvement three months after training. These findings support the feasibility of learner-centered programs using sound visualization technique for English language pronunciation instruction.

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운율 및 분절음의 독립적 발음 평가 연구: 평가자 집단의 언어별 차이를 중심으로 (A Study of an Independent Evaluation of Prosody and Segmentals: With Reference to the Difference in the Evaluation of English Pronunciation across Subject Groups)

  • 박한상
    • 말소리와 음성과학
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    • 제5권4호
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    • pp.91-98
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    • 2013
  • This study investigates the difference in the evaluation of foreign-accentedness of English pronunciation across subject groups, evaluated accents, and compared components. This study independently evaluates the prosody and segmentals of the foreign-accented English sentences by pairwise difference rating. Using the prosody swapping technique, segmentals and prosody of the English sentences read by native speakers of American English (one male and one female) were combined with the corresponding segmentals and prosody of the English sentences read by male and female native speakers of Chinese, Japanese or Korean (one male and one female from each native language). These stimuli were evaluated by 4 different subject groups: native speakers of American English, Korean, Chinese, and Japanese. The results showed that the Japanese subject group scored higher in prosody difference than in segmental difference while the other groups scored the other way around. This study is significant in that the attitude toward the difference in segmentals and prosody of the foreign accents of English varies with the native language of the subject group. In other words, for native speakers of some languages, the difference in prosody could have a greater influence on the foreign-accentedness than the difference in segmentals, while for native speakers of other languages the other way around.