• Title/Summary/Keyword: Spinal Fractures

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A Study of Radiographic Methods to X-ray Study of Patients with Spinal Scoliosis and Vertebrae Bone Fracture of Lumbar Spine (척주측만증과 허리뼈 골절 수술 환자의 엑스선 촬영법 연구)

  • Ahn, Byung-Ju;Lee, Jun-Haeng
    • Journal of the Korean Society of Radiology
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    • v.13 no.3
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    • pp.425-431
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    • 2019
  • The Study In order to obtain images of overlap of the two iron cores in the spinal cord simple x-ray scan after surgery of patients with ulcer lateral sclerosis and a fractured backbone, the researcher conducted a subjective evaluation on five radiographers of the university hospital's imaging department for more than 10 years. The results of the experiment showed that the lateral shot of lateral scoliosis of the spinal cord was taken with the middle face of the IR plane, and then the X-ray tube angle was taken vertically with the vertical spinal column fan-tom position, resulting in two overlapping images and high scores in the subjective evaluation. In addition, lateral shots of the lumbar dislocation fractured lumbar vertebrae were taken with the forehead aligned with the center of the IR plane and then with the X-ray angle perpendicular to the fourth waistline and the angle of the spinal cord perpendicular to the fourth waistline, the image of the two iron cores could be obtained from the radiographer.

Bone Cement Dislodgement : One of Complications Following Bone Cement Augmentation Procedures for Osteoporotic Spinal Fracture

  • Ha, Kee-Yong;Kim, Young-Hoon;Yoo, Sung-Rim;Molon, Jan Noel
    • Journal of Korean Neurosurgical Society
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    • v.57 no.5
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    • pp.367-370
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    • 2015
  • Bone cement augmentation procedures have been getting more position as a minimally invasive surgical option for osteoporotic spinal fractures. However, complications related to these procedures have been increasingly reported. We describe a case of bone cement dislodgement following cement augmentation procedure for osteoporotic spinal fracture by reviewing the patient's medical records, imaging results and related literatures. A 73-year-old woman suffering back and buttock pain following a fall from level ground was diagnosed as an osteoporotic fracture of the 11th thoracic spine. Percutaneous kyphoplasty was performed for this lesion. Six weeks later, the patient complained of a recurrence of back and buttock pain. Radiologic images revealed superior dislodgement of bone cement through the 11th thoracic superior endplate with destruction of the lower part of the 10th thoracic spine. Staged anterior and posterior fusion was performed. Two years postoperatively, the patient carries on with her daily living without any significant disability. Delayed bone cement dislodgement can occur as one of complications following bone cement augmentation procedure for osteoporotic spinal fracture. It might be related to the presence of intravertebral cleft, lack of interdigitation of bone cement with the surrounding trabeculae, and possible damage of endplate during ballooning procedure.

The Renewal of Cognizance Criteria for Work Compensated Disease in Spondylolisthesis (척추전방전위증의 업무상질병 인정기준 개선)

  • Cho, Joon;Yoon, Do Heum;Park, Young Gou
    • Journal of Korean Neurosurgical Society
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    • v.29 no.12
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    • pp.1600-1605
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    • 2000
  • Objective : World Health Organization and International Labour Organization, in June 8, 1999, requested that working conditions should be reformed ethically right and economically solid for 2.7 billion world labour force. The purpose of this study is to request compensable surgical therapeutic options and to suggest the renewal in cognizance criteria for worker's compensation, especially in spondylolisthesis. Methods : Regarding spondylolisthesis, we obtained data from Korea Labor Welfare Corporation(KLWC). Spinal disease occurrence incidences and medical fees of National Federation of Medical Insurance(NFMI) were analysed. The compensated 122 spinal instrumented cases included 117 male and 5 female patients, aged from 23 to 72 years old(mean : $45{\pm}9.85$). We compared Korean and Foreign Workers Compensation Law. Results : Numbers of herniated nucleus pulpus(78 cases), spinal fractures(34 cases) and dislocations(4 cases) were claimed after spinal interbody fusion operation and were compensated. These compensated degenerative diseases, work related illness, occurred in the course of work. A case of 52-year old spondylolisthesis patient with Disability Grade 8 was compensated by KLWC, according to its occurrence at work by accident. With exception of trauma at work by accident, current cognizance criteria were too narrow to be compensable, especially in surgical therapeutic option, for worker's spondylolisthesis. Conclusion : Considering both worker's compensation law and clinical pathologic progress, we believe that spondylolisthesis should be regarded as a compensable occupation related disease if and when aggravates rapidly in the course of work. We suggest a new cognizance standard to KLWC for labour welfare and proper worker's compensation.

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Lumbar Facet Joint Injection: A Review of Efficacy and Safety (요추 후관절 주사: 임상적 유용성과 안전성에 대한 고찰)

  • Yoonah Do;Eugene Lee;Choong Guen Chee;Joon Woo Lee
    • Journal of the Korean Society of Radiology
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    • v.85 no.1
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    • pp.54-76
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    • 2024
  • Facet joint arthrosis is a progressive degenerative disease that is frequently associated with other spinal degenerative disorders such as degenerative disc disease or spinal stenosis. Lumbar facet joint arthrosis can induce pain in the proximal lower extremities. However, symptoms and imaging findings of "facet joint syndrome" are not specific as they mimic the pain from herniated discs or nerve root compression. Currently, evidence for therapeutic intra-articular lumbar facet joint injections is still considered low, with a weak recommendation strength. Nevertheless, some studies have reported therapeutic effectiveness of facet joint injections. Moreover, the use of therapeutic facet joint injections in clinical practice has increased. This review article includes opinions based on the authors' experience with facet joint injections. This review primarily aimed to investigate the efficacy of lumbar facet joint injections and consider their associated safety aspects.

Effect of Complex Korean Medicine Treatment on Sacral Insufficiency Fracture: A Case Report

  • Jung, Ga Hyeon;Lee, Hyun;Ryu, Hwa Yeon;Kang, Jae Hui
    • Journal of Acupuncture Research
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    • v.37 no.3
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    • pp.187-192
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    • 2020
  • Sacral insufficiency fractures (SIF) are a common, but often underdiagnosed source of lower back pain without apparent trauma. This report presents the clinical outcome of a 75-year-old female with SIF, and an underlying medical history of osteoporosis and rheumatoid arthritis. She was treated non-operatively, in-hospital, with Korean medicine. Patient progress was assessed using the numerical rating scale and self-reported symptoms. Post-treatment, the numerical rating scale score for pain in her hip decreased from 7 to 2. At admission, the patient was unable to sit, and could only walk 3 m with assistance. At discharge, she could sit for longer than 1 hour and walk further than 200 m unassisted. On the follow-up visit, the patient was asymptomatic, and x-ray scans showed ossification of the sacral and pubic fractures. These results suggest that, Korean medicine can effectively reduce pain and aid rehabilitation in patients with SIF, without the need for surgery.

Pin and Bone Cement Fixation of Fifth-Sixth Lumbar Vertebral Fracture-Luxation in a Korean Goral (Nemorhaedus caudatus)

  • Choi, Seong-jae;Kim, Jong-taek;Oh, Yeon-su;Kang, Byung-Jae
    • Journal of Veterinary Clinics
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    • v.34 no.2
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    • pp.115-118
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    • 2017
  • A Korean goral (immature, female) was presented with paraplegia following motor vehicle trauma. The patient was diagnosed with an L5-6 vertebral fracture-luxation based on digital radiographs. Surgical reduction and stabilization of the fracture-luxation were performed via a dorsal approach to the lumbar spine. It was confirmed in surgery that the patient had L5-7 spinous process fractures, L6 bilateral articular process fractures, and an L5-6 luxation. Free fragments were removed and the luxation was reduced. During reduction, caudodorsal dislocation of the L5 caudal vertebral end plate was discovered and the displaced end plate was removed. The L5-6 vertebral luxation was stabilized using pins and bone cement. However, the presence of an intact spinal cord was not confirmed. Two weeks postoperatively the patient became dyspneic and arrested. A necropsy was performed, which revealed that the surgical stabilization was intact. Pulmonary edema was identified and the immediate cause of death was determined to be systemic inflammatory response syndrome.

Diagnostic Imaging for Physical Abuse in Children (신체적 학대를 받은 아동의 진단적 영상)

  • Tae Yeon Jeon;So-Young Yoo;Hong Eo;Ji Hye Kim
    • Journal of the Korean Society of Radiology
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    • v.81 no.4
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    • pp.832-851
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    • 2020
  • Physical abuse is a significant cause of morbidity and mortality in the pediatric population. Young children, particularly in the first year of life, are most vulnerable to physical abuse. To evaluate suspected physical abuse, radiologists play a vital role by detecting radiological findings suggestive of physical abuse and differentiating them from other pathologies. This review focuses on radiologic findings, including those for fractures, abusive head trauma, spinal injury, and thoracoabdominal injury, commonly discovered in physically abused children, with special emphasis on biomechanical forces that produce injuries.

Anterolateral Surgical Decompression and Instrumentation in Thoracolumbar Bursting Fracture (외상성 흉요추접합부 파열골절의 전측방경유법에 의한 신경감압 및 기구고정술)

  • Bae, Jang-Ho
    • Journal of Yeungnam Medical Science
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    • v.13 no.2
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    • pp.234-242
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    • 1996
  • Ten patients with a thoracolumbar spine fractures were treated with Kaneda internal fixation device through anterolateral approach during last 1 year. In all cases, spinal decompression, internal instrument fixation and hone fusion with rib were performed. No patient showed neurological deterioration after surgery and 6(60%) patients improved postoperatively with entering the next Frankel subgroup. Follwo-up patient evaluation showed the correction of the fracture deformity with good bony fusion, but 3 patient arc remained back pain. According to above results we concluded that anterolateral internal fixation combined with hone fusion using rib was good mechanical stability and decompression of protruding ventral bone fragments above conus medullaris level.

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Extensive Tension Pneumocephalus Caused by Spinal Tapping in a Patient with Basal Skull Fracture and Pneumothorax

  • Lee, Seung-Hwan;Koh, Jun-Seok;Bang, Jae-Seung;Kim, Myung-Chun
    • Journal of Korean Neurosurgical Society
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    • v.45 no.5
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    • pp.318-321
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    • 2009
  • Tension pneumocephalus may follow a cerebrospinal fluid(CSF) leak communicating with extensive extradural air. However, it rarely occurs after diagnostic lumbar puncture, and its treatment and pathophysiology are uncertain. Tension pneumocephalus can develop even after diagnostic lumbar puncture in a special condition. This extremely rare condition and underlying pathophysiology will be presented and discussed. The authors report the case of a 44-year-old man with a basal skull fracture accompanied by pneumothorax necessitating chest tube suction drainage, who underwent an uneventful lumbar tapping that was complicated by postprocedural tension pneumocephalus resulting in an altered mental status. The patient was managed by burr hole trephination and saline infusion following chest tube disengagement. He recovered well with no neurologic deficits after the operation, and a follow-up computed tomography (CT) scan demonstrated that the pneumocephalus had completely resolved. Tension pneumocephalus is a rare but serious complication of lumbar puncture in patients with basal skull fractures accompanied by pneumothorax, which requires continuous chest tube drainage. Thus, when there is a need for lumbar tapping in these patients, it should be performed after the negative pressure is disengaged.

Percutaneous osteoplasty for painful bony lesions: a technical survey

  • Kim, Won-Sung;Kim, Kyung-Hoon
    • The Korean Journal of Pain
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    • v.34 no.4
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    • pp.375-393
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    • 2021
  • Percutaneous osteoplasty (POP) is defined as the injection of bone cement into various painful bony lesions, refractory to conventional therapy, as an extended technique of percutaneous vertebroplasty (PVP). POP can be applied to benign osteochondral lesions and malignant metastatic lesions throughout the whole skeleton, whereas PVP is restricted to the vertebral body. Common spinal metastases occur in the thoracic (70%), lumbosacral (20%), and cervical (10%) vertebrae, in order of frequency. Extraspinal metastases into the ribs, scapulae, sternum, and humeral head commonly originate from lung and breast cancers; extraspinal metastases into the pelvis and femoral head come from prostate, urinary bladder, colon, and uterine cervical cancers. Pain is aggravated in the dependent (or weight bearing) position, or during movement (or respiration). The tenderness and imaging diagnosis should match. The supposed mechanism of pain relief in POP is the augmentation of damaged bones, thermal and chemical ablation of the nociceptive nerves, and local inhibition of tumor invasion. Adjacent (facet) joint injections may be needed prior to POP (PVP). The length and thickness of the applied needle should be chosen according to the targeted bone. Bone cement is also selected by its osteoconduction, osteoinduction, and osteogenesis. Needle route should be chosen as a shortcut to reach the target bony lesions, without damage to the nerves and vessels. POP is a promising minimally invasive procedure for immediate pain relief. This review provides a technical survey for POPs in painful bony lesions.