• Title/Summary/Keyword: Spinal Disease

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Deep Learning-based Spine Segmentation Technique Using the Center Point of the Spine and Modified U-Net (척추의 중심점과 Modified U-Net을 활용한 딥러닝 기반 척추 자동 분할)

  • Sungjoo Lim;Hwiyoung Kim
    • Journal of Biomedical Engineering Research
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    • v.44 no.2
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    • pp.139-146
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    • 2023
  • Osteoporosis is a disease in which the risk of bone fractures increases due to a decrease in bone density caused by aging. Osteoporosis is diagnosed by measuring bone density in the total hip, femoral neck, and lumbar spine. To accurately measure bone density in the lumbar spine, the vertebral region must be segmented from the lumbar X-ray image. Deep learning-based automatic spinal segmentation methods can provide fast and precise information about the vertebral region. In this study, we used 695 lumbar spine images as training and test datasets for a deep learning segmentation model. We proposed a lumbar automatic segmentation model, CM-Net, which combines the center point of the spine and the modified U-Net network. As a result, the average Dice Similarity Coefficient(DSC) was 0.974, precision was 0.916, recall was 0.906, accuracy was 0.998, and Area under the Precision-Recall Curve (AUPRC) was 0.912. This study demonstrates a high-performance automatic segmentation model for lumbar X-ray images, which overcomes noise such as spinal fractures and implants. Furthermore, we can perform accurate measurement of bone density on lumbar X-ray images using an automatic segmentation methodology for the spine, which can prevent the risk of compression fractures at an early stage and improve the accuracy and efficiency of osteoporosis diagnosis.

The Effects of Joint and Muscle Mobilization on Pain and Flexibility of the Patients with Degenerative Disc Disease (근관절가동기법이 퇴행성 디스크 질환을 가진 환자의 통증과 유연성에 미치는 영향)

  • Jeon, Jae-Guk;Kim, Myung-Jun
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.16 no.2
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    • pp.28-33
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    • 2010
  • Purpose : The purpose of this study is to find out the effects of Joint and Muscle Mobilization applied to the patients with Degenerative Disc Disease by measuring, assessing and analyzing the changes on pain and in flexibility before and after Joint and Muscle Mobilization. Method: Surveyed from June. 2008 to July. 2009 were 10 patients suffering from DDD. Joint and muscle Mobilization were applied for 15 minutes in total. After Joint Mobilization, the Oswestry Disability Index(ODI), Visual Analogue Scale (VAS) were used to measure the degree of the pain on the patients. After Joint and Muscle Mobilization, Spinal-$Mouse^{(R)}$ were used to measure the degree of the flexibility on the patients. Result: 1. There was significant decrease in the numerical values of the VAS & ODI after Joint and Muscle Mobilization (p<0.01). 2. There was significant decrease in the degree of the pain on the patients after Joint and Muscle Mobilization (p<0.01). 3. From the analysis into DDD in the degree the pain before and after Joint and Muscle Mobilization with Paired Sample T-test, It became evident that the longer the period of treatment was, the higher the pains decreases drastically, while significant difference was shown in the flexibility and the degree of the pain (p<0.01). Conclusion: Summed up, it can be generally concluded that Joint and Muscle Mobilization is an effective treatment to rid the patients with DDD of pains safely and promptly. It is, therefore, suggested to continue and expand the study on the cure of DDD and to motivate patients. Joint and Muscle Mobilization is considered as safest and most efficient pain remedy.

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Effects of Treatment of Oriental Medicine and Sling Exercise Therapy on Herniated Lumbar Intervertebral Disc (요추 추간판 탈출증의 한의학적 치료와 슬링운동 병행 치료 효과)

  • Yang, Mi-Sung;Kang, Dae-Hee;Ki, Young-Bum;Park, Su-Gon;Cho, Hee-Geun;Choi, Jin-Bong;Sul, Jae-Uk;Kim, Sun-Jong
    • Korean Journal of Acupuncture
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    • v.27 no.4
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    • pp.5-13
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    • 2010
  • Objectives : Herniated lumbar intervertebral disc is common reason causing back pain. Lumbar stabilization exercise prevent back pain recurrence by strengthening lumbar muscles. Sling Exercise Therapy(SET) is a system for spinal muscle stabilization and strengthening using fixed string and mobile band. The purpose of this study is to investigate and measure the effectiveness of SET and oriental medicine for Herniated lumbar intervertebral disc. Methods : The subjects for this study are 40 patients suffering from Herniated lumbar intervertebral disc in our clinic. They were measured and compared by Visual Analogue Scale(VAS), 4 grades of recovery degree and sex, age, period of disease, disc herniation type, times of exercise. Results : In the above index, the score(VAS, 4 grades of recovery degree) improved after treatments. But they make no difference between sex, age, period of disease, disc herniation type and times of exercise. Conclusions : These results suggest that SET may be used for Herniated lumbar intervertebral disc for pain management and muscle strengthening as an essential treatment regardless of sex, age, period of disease and disc herniation type.

Outbreaks of Akabane Diseasc of Cattle in Korea (한국(韓國)에서의 소의 Akabane병(病)의 발생(發生))

  • Bak, Ung-Bok;Lim, Chang Hyeong;Cheong, Chang Kook;Hwang, Woo Suk;Cho, Myung Rae
    • Korean Journal of Veterinary Research
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    • v.20 no.1
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    • pp.65-78
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    • 1980
  • From November 1978 to April 1979, there occurred among cows many cases of abortion, premature birth, stillbirth and congenital arthrogryposis or hydranencephaly in Kyongki-do province in Korea. Epizootics recurred between February and May, 1980 in the same area. Six calves born at 8 or 10 months of gestation were examined by means of pathology and one of the calves was examined by serological test. And a survey on local occurrence of the disease in other than Kyongki-do province, was conducted. 1. At necropsy, some calves showed distinct lesions such deformities of the limbs and the vertebrae as arthrogryposis or scoliosis. Other calves revealed arthrogryposis and partial or total deficience of the cerebral hemispheres with hydranencephaly. 2. In the calves with deformities the skeletal muscle showed histologically severe hypoplasia of the muscle fibers with cellular infiltration. In the central nervous system of the calves with hydranencephaly there were minute cystic cavitation and the decrease of ventral horn cells of the spinal cord in the number. 3. Similar epizootics were also observed in the same season in the other several provinces such as Chungoheongnam-do, Kangwon-do and Jeonrabuk-do. 4. Anti-Akabane virus antibody was detected in precolostral blood from the calf with arthroglposis and hydranencephaly syndrome. 5. On these findings of the disease it was diagnosed as Akabane disease presenting the first report on the epizootics in Korea.

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Pathological observation on the piglets experimentally infected with Aujeszky′s disease virus isolated in Korea (국내 분리 오제스키병 바이러스 접종자돈의 병리학적 관찰)

  • Park, Nam-Yong;Chung, Chi-Young;Kim, JIn-Ho;Yoon, Jin-Gyu;Park, Young-Seok
    • Korean Journal of Veterinary Pathology
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    • v.2 no.2
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    • pp.117-125
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    • 1998
  • Pathological studies were performed on the five piglets experimentally infected with Aujeszky's disease virus(pseudorabies), NYJ isolate, isolated from the naturally infected pigs in Korea: two piglets were inoculated intramuscularly, two piglets intranasally, and one piglet subcutaneously at the dose of 1$m\ell$ per animal with the 105.5 $TCID_50$/0.1ml titer. Clinical signs included dyspnea, high fever(>$41^{\circ}C$), anorexia, vomiting, diarrhea or constipation, ataxia, circling movement, posterior paralysis, intermittent convulsion, and coma followed by death although some variations by age and inoculated routes were observed. Gross features included multiple necrotic foci in the liver, congestion and hemorrhage in the lymph nodes and spleen, petechial hemorrhage in the kidney, hemorrhagic pneumonia, marked meningeal congestion, severe sub meningeal hemorrhage in the spinal cord, excessive cerebrospinal fluid retention, and muscular necrosis at the inoculated area. Microscopically, non suppurative meningoencephalitis with gliosis and perivascular cuffing in CNS, ganglioneuritis, necrohemorrhagic splenitis, necrotic hepatitis, tonsillitis and rhinitis, hemorrhagic or interstitial pneumonia, and non-suppurative myositis in the injected area were observed. Eosinophilic intranuclear inclusion bodies were found in a variety of tissues the including the liver, kidney, adrenal gland, spleen, lymph nodes, tonsil, and lung. Ultrastructurally, virus particles were confirmed in nucleus and cytoplasms of pneumocytes around the necrotic areas.

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The Analysis on Research in the Korean Journal of Rehabilitation Nursing (재활간호학회지 논문 분석 - 창간호부터 2004년까지 -)

  • Lim, Nan-Young;Kim, Jeong-Hwa;Cho, Bok-Hee;So, Hee-Young;Park, Song-Ja;Cho, Nam-Ok;Yoo, Kyung-Hee
    • The Korean Journal of Rehabilitation Nursing
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    • v.8 no.2
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    • pp.119-128
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    • 2005
  • Purpose: The purpose of this study was to analyze research in the Korean Journal of Rehabilitation Nursing and to suggest further perspective for rehabilitation nursing research. Method: In this study we reviewed the contents of 134 articles published in this journal from its beginning year 1998 to 2004. Results: The majority of subjects were adult patients. The type of disease were Cerebrovascular Accident, Neuromuscular disease, Cancer patients, Urogenital disease such as Chronic Renal Failure, Spinal cord injury. Domain of research almost was client, type of research were survey(34.3%), quasi experimental study(20.9%), correlation study(19.4%). Nursing intervention of experimental study was exercise(39.0%), education(17.1%). Place of data collection was hospital (58.2%), position of researcher was professor(67.2%), method of data collection was questionnaire(50.7%). Conclusion: There has been a lack of written consent, child rehabilitation, measurement tool development, qualitative research. More studies about rehabilitation nursing are needed to extend the role and fields for professional nursing.

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Hemilaminectomy for Herniated Discs at the Cervicothoracic Junction in a Beagle Dog (편측추궁절제술을 이용한 비글견의 경흉연접부 추간판 탈출증의 치료)

  • Kang, Byung-Jae;Kweon, Oh-Kyeong
    • Journal of Veterinary Clinics
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    • v.31 no.6
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    • pp.511-514
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    • 2014
  • A 7-year-old, female Beagle dog presented with a primary complaint of severe neck pain and paretic gait. A lesion was suspected between C6 and T2 on the basis of neurological examinations. Magnetic resonance imaging of the cervicothoracic spine revealed herniation of disc material from the C7-T1 intervertebral space resulting in marked spinal cord compression. Hemilaminectomy was performed to treat the intervertebral disc disease at C7-T1. Treatment was effective and the clinical condition of the dog was remarkably improved. This result suggests that hemilaminectomy is an effective option for surgical treatment of intervertebral disc disease at the cervicothoracic junction in dogs.

Is Adjacent Segment Disease More Frequent in Proximal Levels in Comparison with Distal Levels? Based on Radiological Data of at Least 2 Years Follow Up with More than 2 Level Thoracolumbar Fusions

  • Kim, Jung-Ho;Ryu, Dal-Sung;Yoon, Seung-Hwan
    • Journal of Korean Neurosurgical Society
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    • v.62 no.5
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    • pp.603-609
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    • 2019
  • Objective : The purpose of this retrospective study was to determine which of the proximal adjacent segment disease (ASD) and distal ASD was more prevalent and what parameters is more related to ASD in proximal levels and distal levels after more than 2 levels fusions. Methods : The medical records were reviewed retrospectively for 856 cases. A total of 66 cases of ASD were enrolled. On preop magnetic resonance imaging, disc degeneration was measured at the upper and lower parts of surgically treated levels and confirmed by the commonly used Pfirrmann grade. Segmental flexibility in sagittal plane was embodied in segment range of motion (ROM) obtained through flexion and extension X-ray before surgery. Coronal angle was recorded as methods Cobb's angle including fusion levels preoperatively. For the comparison of categorical variables between two independent groups, the chi-square test and Fisher exact test were performed. Results : Proximal ASD and distal ASD were 37/856 (4.32%) and 29/856 (3.39%), respectively. The incidence of proximal ASD was relatively high but insignificant differences. In comparison between ASD group and non ASD group, proximal Pfirmman was higher in proximal ASD and distal Pfirmman was higher in distal ASD group (p=0.005, p<0.008, respectively). However, in the ROM, proximal ROM was higher in proximal ASD, but distal ROM was not different between the two groups (p<0.0001, p=0.995, respectively). Coronal angle was not quite different in both groups (p=0.846). Conclusion : In spite of higher frequency in ASD in proximal level in spinal fusion, it is not clear that incidence of ASD in proximal level is not higher than that of distal ASD group in more than 2 level thoracolumbar fusions. Not only Pfirrmann grade but also proximal segmental ROM is risk factor for predicting the occurrence of ASD in patients more than 2 level of thoracolumbar spine fusion operation excluding L5S1.

Is the Agricultural Work a Risk Factor for Koreans Elderly Spinal Sagittal Imbalance?

  • Hong, Jong-Hwan;Han, Moon-Soo;Lee, Seul-Kee;Lee, Jung-Kil;Moon, Bong Ju
    • Journal of Korean Neurosurgical Society
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    • v.63 no.5
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    • pp.623-630
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    • 2020
  • Objective : A primary degenerative sagittal imbalance has been considered because of unique lifestyles such as the prolonged crouched posture during agricultural work and performing activities of daily living on the floor. Previous papers have reported that sagittal imbalance disease is often seen distinctly in the farming districts of "oriental" countries such as Korea and Japan. However, this finding was only evaluated with the use of X-ray, and other factors such as magnetic resonance imaging (MRI), muscle volume, compression fracture, and laboratory results were not considered. Thus, using these, we evaluate the agricultural work-associated factors for Korean elderly spinal sagittal imbalance. Methods : We recruited 103 Korean participants who had a sagittal vertical axis (SVA) of >5 cm in this Korean Elderly Sagittal Imbalance Cohort Study. The following were evaluated : radiological parameters, MRI, compression fracture, vitamin D, parathyroid hormone, C-terminal telopeptide, osteocalcin, bone mineral density and muscle fatty change, muscle volume, and health-related quality of life from patients' survey. Moreover, in this survey, the farmers' annual working hours were investigated. Subsequently, we analyzed the associated factors for spinal sagittal imbalance depending on occupation. Results : A total of 46 participants were farmers, and the others were housewives, sellers, and office workers. The farmer group had more SVA (141 vs. 99 mm, p=0.001) and pelvic tilt (31° vs. 24°, p=0.004) and lesser lumbar lordosis (20° vs. 30°, p=0.009) and thoracic kyphosis (24° vs. 33°, p=0.03) than non-farmer group. A significantly positive correlation was noted between the working hour and SVA in the farmer group (p=0.014). The visual analogue scale score for back pain (8.26 vs. 6.96, p=0.008) and Oswestry Disability Index (23.5 vs. 19.1, p=0.003) in the farmer group were higher than that in the non-farmer group, but the Short Form-36 score was not significantly different between the two groups. The Mini-Mental State Exam score was significantly lower in the farmer group than in the non-farmer group (24.85 vs. 26.98, p=0.002). Conclusion : The farmer group had more sagittal imbalance and back pain in proportion to the working hours even though the muscle and bone factors and general laboratory condition were not significantly different between the two groups. These results supported that the long hours spent in the crouched posture while performing agricultural work were a risk factor for severe sagittal imbalance.

Clinical Experience of Currarino Syndrome (큐라리노 증후군의 임상 경험)

  • Kim, Tae-Hoon;Cho, Min-Jeong;Kim, Dae-Yeon;Kim, Seong-Chul;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.17 no.1
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    • pp.65-71
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    • 2011
  • Currarino syndrome is a hereditary syndrome characterized by the triad of a sacral bony defect, presacral mass and anorectal malformation. We retrospectively reviewed 13 Currarino syndrome patients who were treated in our center between 1997 and 2010. Demographic data, initial symptoms, initial diagnosis. pathologic diagnosis of presacral mass, associated anomalies and managements were analyzed. There were 8 boys and 5 girls. Four patients were diagnosed as Currarino syndrome immediately after birth with failure of passage of meconium and abdominal distension. Four patients underwent surgery for imperforate anus immediately after birth and W8re diagnosed as Currarino syndrome later and underwent reoperation. Three patients were diagnosed during work-up and management with of the tentative diagnosis of Hirschsprung's disease. Diagnosis of the remaining two patients was at the age of 26 months and 9 years and anorectal malformation was not associated. Twelve patients showed hemi-sacrum and one patient showed bilateral sacral subtotal agenesis. Two patients without anorectal malformation underwent presacral mass excision, untethering of spinal cord and repair of myelomeningocele. Six out of 8 patients, excluding 3 that expired or were lost to follow up, with anorectal malformation underwent colostomy, presacral mass excision, untethering of spinal cord, repair of myelomeningocele, posterior sagittal anorectoplasty and colostomy repair. One patient underwent only posterior sagittal anorectoplasty after colostomy. One waits the scheduled operation only with Hegar dilatation. Pathologic examation of presacral masses showed myelomeningoceles in 4 patients, lipomyelomeningoceles in 3 patients and dermoid Cyst in one patient. Teratoma was combined in 2 patients. Eight patients needed neurosurgical operation for spinal cord problems. Seven patients had urologic anomalies and two of them underwent operation. Currarino syndrome should be considered as a differential diagnosis in pediatric patients with abdominal distension, constipation and anorectal malforlnation. For proper evaluation and treatment, a multi-disciplinary approach is recommended.

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