• Title/Summary/Keyword: Spinal disorders

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Morphological Patterns of the Anterior Median Fissure in the Cervical Spinal Cord Evaluated by Computed Tomography After Myelography

  • Oichi, Yuki;Hanakita, Junya;Takahashi, Toshiyuki;Minami, Manabu;Kawaoka, Taigo;Funakoshi, Yusuke;Kawauchi, Takeshi;Ohtake, Yasufumi
    • Neurospine
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    • v.15 no.4
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    • pp.388-393
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    • 2018
  • Objective: Computed tomography following myelography (CTM) revealed an unusual flow of contrast dye into the anterior median fissure (AMF) in a patient with cervical spondylotic myelopathy. Since then, several AMF configurations have been observed on CTM. Therefore, we evaluated morphological patterns of the AMF on CTM and investigated the significance and mechanisms of contrast dye flow into the AMF. Methods: Morphological patterns of the AMF on CTM were examined in 79 patients. Group A (24 patients) underwent surgery because of symptomatic cervical myelopathy. Group B (43 patients) had no clinical symptoms but showed spinal cord compression on CTM. Group C (12 patients), who showed neither clinical symptoms nor cord changes, underwent CTM for lumbar lesion evaluation. AMF patterns were classified into 4 types according to their configurations on CTM (reversed T, Y, V, and O types). Results: In group B, the reversed T type and Y type appeared significantly more often near the compressed portion (p<0.001). A similar tendency was seen in group A. The V and O types were most frequently observed in group C (p<0.001). Conclusion: On CTM, contrast dye tends to flow into the AMF of the cervical cord when the spinal cord is compressed. We speculate that there may be 3 possible mechanisms for this phenomenon: deformation of the epipial layer of the AMF due to cervical cord compression, AMF dilatation due to atrophy of the anterior funiculus or anterior horn, and temporary AMF dilatation when it becomes an alternative route for cerebrospinal fluid circulation.

Academic trend of traditional Chinese orthopedics association and the guideline of diagnosis and treatment of common spinal disorders by treating Chinese spinal manipulation technique (중화중의약학회 정척분회 학술동향과 "척추 상견병의 중의 정척 진료 가이드(中醫整脊科常見病診療指南), 2011" 소개)

  • Shin, Byung-Cheul;Hwang, Eui-Hyoung;Cho, Hyun-Woo;Yang, Hui-Chun;Chun, Jong-Yul;Sul, Jae-Uk;Hoe, Kwang-Ho
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.7 no.1
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    • pp.15-20
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    • 2012
  • Objectives : The aims of this study were to introduce the theory of traditional Chinese orthopedic theory(整脊理論) and to analyze the guideline of diagnosis and treatment of common spinal disorders by treating Chinese spinal manipulation technique(常見病中醫整脊指南). Methods : We have searched the web sites of traditional Chinese orthopedics association (整脊學會), a branch of the China academy of traditional Chinese medicine (TCM), and related articles. Additionally, we analyzed the guideline of diagnosis and treatment of common spinal disorders by treating Chinese spinal manipulation technique which was introduced by that association at 7th academic conference in China in 2011. Results : The guideline was prepared by 2 year project leaded by professor Yi-zhong Wei who was a person in charge of the spinal manipulation guideline of national standardization committee of TCM in China. It was a summary of the whole theory of China spinal manipulation therapy in TCM and contained 22 common spinal disorders by the treatment of traditional Chinese Tuina methods. Spinal manipulation theory was summarized by one doctrine, two theories, and two important view points. The treatment method was abstracted as 8 major Tuina techniques. Conclusions : The guideline will be a way of advance of Chinese spinal manipulation technique. This will be a good reference to Korea Chuna manipulation for improving their techniques.

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Delayed Diagnosis of Probable Radiation Induced Spinal Cord Vascular Disorders

  • Won, Young Il;Kim, Chi Heon;Chung, Chun Kee;Yun, Tae Jin
    • Journal of Korean Neurosurgical Society
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    • v.57 no.3
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    • pp.215-218
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    • 2015
  • Occasionally, unexpected neurological deficits occur after lumbar spinal surgery. We report a case of monoparesis after lumbar decompressive surgery. A 63-year-old man, who had undergone decompression of L4-5 for spinal stenosis 4 days previously in the other hospital, visted the emergency department with progressive weakness in the left leg and hypoesthesia below sensory level T7 on the right side. He had been cured of lung cancer with chemotherapy and radiation therapy 10 years previously, but detailed information of radiotherapy was not available. Whole spine magnetic resonance (MR) imaging showed fatty marrow change from T1 to T8, most likely due to previous irradiation. The T2-weighted MR image showed a high-signal T4-5 spinal cord lesion surrounded by a low signal rim, and the T1-weighted MR image showed focal high signal intensity with focal enhancement. The radiological diagnosis was vascular disorders with suspicious bleeding. Surgical removal was refused by the patient. With rehabilitation, the patient could walk independently without assistance 2 months later. Considering radiation induced change at thoracic vertebrae, vascular disorders may be induced by irradiation. If the spinal cord was previously irradiated, radiation induced vascular disorders needs to be considered.

The Domestic Trend of Chuna Manual Therapy on Cervical Spinal Disorders (경추부 질환에 적용하는 추나 치료에 대한 국내 연구 동향)

  • Jeong, Yun-Gyu;Kim, Min-Young;Kim, Jin-Soo;Ro, Hae-Rin;Choi, Young-Il;Choi, Hee-Seung;Shin, Dong-Jae
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.8 no.1
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    • pp.1-13
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    • 2013
  • Objectives: The present study examines the domestic trend of Chuna manual therapy on cervical spinal disorders in Korea. Methods: We investigated the studies on Chuna manual therapy for cervical spinal disorders via searching 6 Korean web databases. As a result, 51 research papers were found to be analyzed according to their published year, published institution, the titles of journals, the types of study, the techniques of Chuna, the instruments for assessment, the Chuna technique and the number of the treatment trials by the cases of cervical spinal disorders and ethical approvals. Results: The number of the research papers published tended to increase every year. The studies on Chuna manual therapy for cervical spinal disorders were mainly published in The Journal of Korea CHUNA Manual Medicine for Spine & Nerves. The most frequently adopted technique of Chuna in the examined studies was Chuna spine manipulation therapy - cervical spine technique. Visual analogue scale (VAS), neck disability index(NDI) were used as primary means of assessments. The ethical problems of the examined studies needed to be improved. Conclusions: Reviewing the domestic trend of studies on Chuna manual therapy for cervical spinal disorders and examining the strong and weak points of those treatments are essential for the future studies. It is anticipated that this review benefits the future in-depth study on the treatments for Chuna in Korean medicine.

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Clinical Applications of the Tubular Retractor on Spinal Disorders

  • Kim, Young-Baeg;Hyun, Seung-Jae
    • Journal of Korean Neurosurgical Society
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    • v.42 no.4
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    • pp.245-250
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    • 2007
  • Tubular retractor system as a minimally invasive surgery (MIS) technique has many advantages over other conventional MIS techniques. It offers direct visualization of the operative field, anatomical familiarity to spine surgeons, and minimizing tissue trauma. With technical advancement, many spinal pathologies are being treated using this system. Namely, herniated discs, lumbar and cervical stenosis, synovial cysts, lumbar instability, trauma, and even some intraspinal tumors have all been treated through tubular retractor system. Flexible arm and easy change of the tube direction are particularly useful in contralateral spinal decompression from an ipsilateral approach. Careful attention to surgical technique through narrow space will ensure that complications are minimized and will provide improved outcomes. However, understanding detailed anatomies and keeping precise surgical orientation are essential for this technique. Authors present the technical feasibility and initial results of use a tubular retractor system as a minimally invasive technique for variaties of spinal disorders with a review of literature.

Application Design and Implementation for Spinal Disorder Prevention using Kotlin (코틀린을 사용한 척추 질환 예방을 위한 Application 설계 및 구현)

  • Kyoung-Ju Minn
    • The Journal of the Institute of Internet, Broadcasting and Communication
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    • v.24 no.2
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    • pp.71-77
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    • 2024
  • The increasing use of smart devices in South Korea has led to a rise in patients with spinal disorders. This study aims to develop an Android application with exercise prompts to prevent spinal disorders, enhance the usability of healthcare applications, and utilize Android's overlay technology to encourage physical activity. Considering South Korea's total population, it is estimated that around one million individuals may suffer from spinal disorders due to smart device usage. Emphasizing the importance of maintaining proper posture and regular exercise habits, this research highlights the need for innovative application development to assist users in preventing musculoskeletal disorders caused by smart device usage.

Spinal Deformity Surgery : It Becomes an Essential Part of Neurosurgery

  • Hyun, Seung-Jae;Jung, Jong-myung
    • Journal of Korean Neurosurgical Society
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    • v.61 no.6
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    • pp.661-668
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    • 2018
  • Among the spinal disorders, the treatment approach for spinal deformities has been discussed least among department of neurosurgery. But nowadays, more and more neurosurgeons are interested in spinal deformities as well as complex spinal disorders and are doing not a few surgeries for these kinds of disease. Nevertheless, it is mandatory to understand the course of spinal deformity, principles of treatment, and surgical outcomes and complications. Understanding of the biology, biomechanics and metallurgy of the spine and instrumentation are also required for successful spinal deformity surgery. We need senior mentors and good surgical and neurophysiologic monitoring team. Knowledge of spinal deformity may be augmented with spine fellowships and surgical experience. Step by step training such as basic knowledge, orthopedic as well as neurosurgical disciplines and surgical skills would be mandatory. Neurosurgeons can have several advantages for spinal deformity surgeries. By high-level technical ability of the spinal cord handling to preserve neurological function and familiarity with microscopic surgery, better synergistic effect could be expected. A fundamental understanding of pediatric spinal deformity and growing spine should be needed for spinal deformity surgery.

Analysis of Clinical Tendency of Spinal Disorder in Primary, Middle and High School Students in Korea (국내 초.중.고등학생들의 척추질환 진료경향 분석)

  • Kim, Min-Jung;Son, Chang-Gue;Heo, Dong-Seok;Hong, Kwon-Eui
    • Journal of Acupuncture Research
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    • v.27 no.2
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    • pp.43-49
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    • 2010
  • Objectives : Among young generation, the prevalence of spinal disorders is known to be increasing. This study aimed to analyze the clinical data of spinal disorder in young ages in Korea. Methods : Number of patient, kinds of disorder, and medical cost were analyzed for patients(7~18 years) underwent spinal disorders using computerized database of Health Insurance Review and Assessment Service(HIRAS) from 2004 to 2008. We included dorsopathies as spinal disorder according to Korean Classification of Diseases(KCD) and excluded spinal disorder caused by trauma. We compared the data of traditional Korean medicine treatment with that of western medical care. Results : 4.8% of the children and adolescents had medical treatment with spinal disorder in 2008. The claim number and medical cost for both traditional Korean medicine and western medicine treatment are increasing 1.8 and 1.3 times respectively over 5 years. Total medical spent of western clinic was 2.1 times than those of traditional Korean clinic. The most common spinal disorder was dorsalgia(31.8%) and scoliosis(13.5%) in western clinics while back pain(29.0%) and neck pain(10.8%) in oriental clinic. Conclusions : We first reported the clinical tendency of spinal disorder in Korean children adolescents from 2004 to 2008. This study will support the development of a strategy for traditional Korean medicine-based prevention or treatment of spinal disorders in young generation.

Spontaneous Resolution of Nontraumatic Acute Spinal Subdural Hematoma

  • Yang, Na-Rae;Kim, Sang-Jin;Cho, Yong-Jae;Cho, Do-Sang
    • Journal of Korean Neurosurgical Society
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    • v.50 no.3
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    • pp.268-270
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    • 2011
  • Spinal subdural hematoma (SSDH) is an extremely uncommon condition. Causative factors include trauma, anticoagulant drug administration, hemostatic disorders, and vascular disorders such as arteriovenous malformations and lumbar punctures. Of SSDH cases, those that do not have any traumatic event can be considered cases of nontraumatic acute spinal subdural hematoma, which is known to have diverse clinical progress. Treatment typically consists of surgical decompression and cases in which the condition is relieved with conservative treatment are rarely reported. We report two nontraumatic acute spinal subdural hematoma patients who were successfully treated without surgery.

Facet joint disorders: from diagnosis to treatment

  • Yeong-Min Yoo;Kyung-Hoon Kim
    • The Korean Journal of Pain
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    • v.37 no.1
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    • pp.3-12
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    • 2024
  • One of the most common sources of spinal pain syndromes is the facet joints. Cervical, thoracic, and lumbar facet joint pain syndromes comprise 55%, 42%, and 31% of chronic spinal pain syndromes, respectively. Common facet joint disorders are degenerative disorders, such as osteoarthritis, hypertrophied superior articular process, and facet joint cysts; septic arthritis; systemic and metabolic disorders, such as ankylosing spondylitis or gout; and traumatic dislocations. The facet pain syndrome from osteoarthritis is suspected from a patient's history (referred pain pattern) and physical examination (tenderness). Other facet joint disorders may cause radicular pain if mass effect from a facet joint cyst, hypertrophied superior articular process, or tumors compress the dorsal root ganglion. However, a high degree of morphological change does not always provoke pain. The superiority of innervating nerve block or direct joint injection for diagnosis and treatment is still a controversy. Treatment includes facet joint injection in facet joint osteoarthritis or whiplash injury provoking referred pain or decompression in mass effect in cases of hypertrophied superior articular process or facet joint cyst eliciting radicular pain. In addition, septic arthritis is treated using a proper antibiotic, based on infected tissue or blood culture. This review describes the diagnosis and treatment of common facet joint disorders.