• Title/Summary/Keyword: Spine Column

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Total Deformity Angular Ratio as a Risk Factor for Complications after Posterior Vertebral Column Resection Surgery

  • Lee, Byoung Hun;Hyun, Seung-Jae;Han, Sanghyun;Jeon, Se-Il;Kim, Ki-Jeong;Jahng, Tae-Ahn;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.61 no.6
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    • pp.723-730
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    • 2018
  • Objective : The aim of the present study was to identify whether the deformity angular ratio (DAR) influences the occurrence of complications after posterior vertebral column resection (PVCR) and to establish the DAR cut-off value. Methods : Thirty-six consecutive patients undergoing PVCR from December 2010 to October 2016 were reviewed. The relationships between the total, sagittal, and coronal DAR and complications were assessed using receiver operator characteristics curves. The patients were divided into two groups according to a reference value based on the cut-off value of DAR. Demographic, surgical, radiological, and clinical outcomes were compared between the groups. Results : There were no significant differences in the patient demographic and surgical data between the groups. The cut-off values for the total DAR (T-DAR) and the sagittal DAR (S-DAR) were 20.2 and 16.4, respectively (p=0.018 and 0.010). Both values were significantly associated with complications (p=0.016 and 0.005). In the higher T-DAR group, total complications (12 vs. 21, p=0.042) and late-onset complications (3 vs. 9, p=0.036) were significantly correlated with the T-DAR. The number of patients experiencing complications (9 vs. 11, p=0.029) and the total number of complications (13 vs. 20, p=0.015) were significantly correlated with the S-DAR. Worsening intraoperative neurophysiologic monitoring was more frequent in the higher T-DAR group (2 vs. 4) than in the higher S-DAR group (3 vs. 3). There was no difference in neurological deterioration between the groups after surgery. Conclusion : Both the T-DAR and the S-DAR are risk factors for complications after PVCR. Those who had a T-DAR >20.2 or S-DAR >16.4 experienced a higher rate of complications after PVCR.

Notochord opacity in fry ayu, Plecoglossus altivelis

  • Huh, Min Do;Lee, Hyo Eun;Lee, Mu Kun;Kim, Bo Sung
    • Journal of fish pathology
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    • v.34 no.1
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    • pp.117-121
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    • 2021
  • An ayu (Plecoglossus altivelis) farm in Korea recently experienced an epidemic of vertebral column deformities where about 90% of fry displayed a vertebral column that was grossly opaque along either the cranial part of the column or its entire length. Abnormal fish were lordotic, scoliotic and/or kyphotic about midway down the spine. Examination of serial sections of whole fish showed only histological lesions in the vertebral column and suggested some disturbance in the early development of the vertebral centrum. Such abnormalities included a frayed spinal or notochord sheaths with irregular thickening and compression, mal-absorbed notochord cells, thickening of around cell layer and hypercellularity on both facets of the notochord sheath. No parasites, fungi, or bacteria were detected. While this lesion has only been reported once in the past, this is the first report of histopathological findings.

Classification of Vertebral Body Fractures with Two-level Posterior Column Injuries of the Thoracolumbar Spine (두 개의 수준을 침범한 후주손상을 동반한 흉요추부 추체 골절의 분류)

  • Koh, Young-Do;Jeong, Hoon;Yeo, Sung-Gu
    • Journal of Trauma and Injury
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    • v.18 no.1
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    • pp.26-32
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    • 2005
  • Purpose: We evaluate the characteristics of vertebral body fractures in two level flexion-distraction injuries of the thoracolumbar spine Methods: The findings of radiographs, computed tomographs, and MRIs of 43 patients with flexion-distraction injuries combined with vertebral body fractures were retrospectively evaluated. We divided the patients with bursting fractures into two groups, the distractive group (posterior vertebral height ratio >1) and the compressive group (vertebral height ratio <1). Results: There were 23 compression fractures and 20 bursting fractures. In bursting fractures, the distractive group had 5 cases, and the compressive group 15 cases. In 24 cases (55.8%), the interspinous distances were widened. The average of the canal encroachment was 4% in the distractive group and 40% in the compressive group. At last follow-up, the average loss of correction was 2.0 degree in compression fractures and 2.7 degree in bursting fractures. Conclusion: The configurations of vertebral body fractures in flexion-distraction injuries of the thoracolumbar spine were varied as to the location of the axis of flexion. Because bursting fractures in flexion-distraction injuries had distractive or compressive features, one should consider that in establishing operative plan.

Osteochondroma of the 3rd Lumbar Spine Causing Spinal Compression - A Case Report - (척수 압박을 동반한 제 3 요추의 골연골종 - 1례 보고 -)

  • Kim, Hyung-Seok;Hong, Ki-Do;Ha, Sung-Sik;Lee, Sun-Woo
    • The Journal of the Korean bone and joint tumor society
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    • v.3 no.1
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    • pp.26-31
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    • 1997
  • One of the most common benign tumors of bone is the osteochondroma which is a cartilage-capped bony projection on the surface of a bone. It may occur in any bone that has been performed from cartilage, but the most common locations are the long bone at the metaphyseal region of the most active growth cartilage, that is, the lower end of femur, the upper end of the tibia, and the upper end of the humerus. Other bones often involved are the ilium, scapula, fibula, and phalanges of hands and feet. But, the vertebral column is very rare location for osteochondroma. Only one case of osteochondroma involving the lumbar spine has been previously reported in Korea. We report an unusual case of osteochondroma arising from the left lamina and inferior articular process of the 3rd lumbar spine causing spinal cord compression.

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Insight Into the Potential Role of the Spine in Relation to the Immune System (면역체계와 연관된 척추의 잠재적 역할에 대한 통찰)

  • Il-Young, Cho;Hyun-Seok, Choi
    • Journal of Industrial Convergence
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    • v.21 no.2
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    • pp.85-92
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    • 2023
  • Abnormal spinal disease and function, in addition to simple musculoskeletal problems, can disrupt homeostasis and cause direct and indirect physiological side effects. Part or all of the immune function can be compromised, exposing you to more disease, especially if the nerves running through your spine do not deliver the proper signals to the organs that regulate your immune system. This study focuses on basic anatomic and physiological knowledge and seeks to consider potential mechanisms by which spinal function may potentially help maintain or improve immune function. To this end, we examine the roles of the spine in relation to hematopoiesis, stress, respiration, spine-nerve relationships, and the immune system, and confirm that these roles may influence immune function.

Long Term Efficacy of Posterior Lumbar Interbody Fusion with Standard Cages alone in Lumbar Disc Diseases Combined with Modic Changes

  • Kwon, Young-Min;Chin, Dong-Kyu;Jin, Byung-Ho;Kim, Keun-Su;Cho, Yong-Eun;Kuh, Sung-Uk
    • Journal of Korean Neurosurgical Society
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    • v.46 no.4
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    • pp.322-327
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    • 2009
  • Objective : Posterior lumbar interbody fusion (PLIF) is considered to have the best theoretical potential in promoting bony fusion of unstable vertebral segments by way of a load sharing effect of the anterior column. This study was undertaken to investigate the efficacy of PLIF with cages in chronic degenerative disc disease with Modic degeneration (changes of vertebral end plate). Methods : A total of 597 patients underwent a PLIF with threaded fusion cages (TFC) from 1993 to 2000. Three-hundred-fifty-one patients, who could be followed for more than 3 years, were enrolled in this study. Patients were grouped into 4 categories according to Modic classification (no degeneration : 259, type 1 : 26, type 2 : 55, type 3 : 11). Clinical and radiographic data were evaluated retrospectively. Results : The clinical success rate according to the Prolo's functional and economic outcome scale was 86% in patients without degeneration and 83% in patients with Modic degeneration. The clinical outcomes in each group were 88% in type 1, 84% in type 2, and 73% in type 3. The bony fusion rate was 97% in patients without degeneration and 83% in patients with Modic degeneration. The bony fusion rate in each group was 81% in type 1, 84% in type 2, and 55% in type 3. The clinical success and fusion rates were significantly lower in patients with type 3 degeneration. Conclusion : The PLIF with TFC has been found to be an effective procedure for lumbar spine fusion. But, the clinical outcome and bony fusion rates were significantly low in the patients with Modic type 3. The authors suggest that PLIF combined with pedicle screw fixation would be the better for them.

A Comprehensive Kinematic Approach to Pelvis (골반의 운동학적 고찰)

  • Bae Sung-Soo;Kim Tae-Yoon;Chung Hyun-Ae;Bae Ju-Han
    • The Journal of Korean Physical Therapy
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    • v.11 no.2
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    • pp.93-102
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    • 1999
  • Alignment of the hip joint and pelvis affects it's weight-bearing capabilities as well as the motion available at the joints. The normal hip joint is well designed to withstand the forces that act through and around it, assisted by the trabecular systems, cartilagious, muscles, and ligaments. Alterations in the direction or magnitude of forces action around the injury and degenerative changes. The integration of motion of the pelvis with motion of the vertebral column not only increases the ROM available to the total column but also reduces the amount of flexibility required of the lumbar lesion. In any instance in which there is normal or abnormal pelvic motion during weight hearing and the head must remain upright, compensatory motions of the lumber spine will occur if available. The motions that occur at the hip, pelvis, and lumbar spine during forward trunk bending with the motions that occur during anterior and posterior tilting of the pelvis in the erect standing postion.

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Analysis of Posterior Cervical Fixation and Fusion in Subaxial Cervical Spine Injury (중하부 경추손상에서 후방 경추 내고정술 및 골유합술의 분석결과)

  • Lee, Dong Hoon;Song, Geun Sung
    • Journal of Korean Neurosurgical Society
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    • v.30 no.12
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    • pp.1388-1393
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    • 2001
  • Objective : In the retrospective analyzing 19 consecutive patients with subaxial cervical spine(C3~T1) injury treated by posterior cervical fixation and fusion, clinical manifestation, radiologic finding, operative technique, and postoperative results following 6 months were analyzed. Materials and Methods : Most common fracture level was C4-5, mean age 41, and male to female ratio 13 : 6. The most common cause of injury was motor vehicle accident(17 cases). In 19 cervical procedures, interspinous triple wiring was done in 14 cases, lateral mass plating in 5 cases, and additional anterior fusion in 2 cases. Results : Twelve weeks after operation, all cases were reviewed by plain cervical radiogram. In 17 cases that treated by posterior fusion only, 14 cases(81%) had kyphotic angle change less than $5^{\circ}$, 2 cases(12%) $5-20^{\circ}$, and 1 case(6%) more than $20^{\circ}$. Overall fusion rate was 88%, and there was no significant difference of bone fusion rate between autogenous bone graft and allogenous bone graft. Conclusion : In the case of severe posterior column injury or displacement, posterior approach seems superior to anterior approach, but in the case of combined anterior column injury, anterior approach is considered necessary. In this study, posterior fixation and fusion might be acceptable procedure for subaxial cervical fracture and dislocation, owing to its high fusion rate, low kyphotic angulation and low operation related complication rate.

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Diversity in Surgical Decision Strategies for Adult Spine Deformity Treatment: The Effects of Neurosurgery or Orthopedic Training Background and Surgical Experience

  • Kang, Jiin;Hosogane, Naobumi;Ames, Christopher;Schwab, Frank;Hart, Robert;Burton, Douglas;Shaffrey, Christopher;Smith, Justin S.;Bess, Shay;Lafage, Virginie;Cho, Kyu-Jung;Ha, Yoon
    • Neurospine
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    • v.15 no.4
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    • pp.353-361
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    • 2018
  • Objective: This study is aimed to investigate whether surgical strategies for adult spinal deformity (ASD) treatment differed among Korean physicians. Methods: This study is retrospective questionnaire-based study. ASD is challenging to manage, with a broad range of clinical and radiological presentations. To investigate possible nationality- or ethnicity-related differences in the surgical strategies adopted for ASD treatment, the International Spine Study Group surveyed physicians' responses to 16 cases of ASD. We reviewed the answers to this survey from Korean physicians. Korean orthopedic surgeons (OS) and neurosurgeons (NS) received a questionnaire containing 16 cases and response forms via email. After reviewing the cases, physicians were asked to indicate whether they would treat each case with decompression or fusion. If fusion was chosen, physicians were also asked to indicate whether they would perform 3-column osteotomy. Retrospective chi-square analyses were performed to investigate whether the answers to each question differed according to training specialty or amount of surgical experience. Results: Twenty-nine physicians responded to our survey, of whom 12 were OS and 17 were NS. In addition, 18 (62.1%) had more than 10 years of experience in ASD correction and were assigned to the M10 group, while 11 (37.9%) had less than 10 years of experience and were assigned to the L10 group. We found that for all cases, the surgical strategies favored did not significantly differ between OS and NS or between the M10 and L10 groups. However, for both fusion surgery and 3-column osteotomy, opinions were divided regarding the necessity of the procedures in 4 of the 16 cases. Conclusion: The surgical strategies favored by physicians were similar for most cases regardless of their training specialty or experience. This suggests that these factors do not affect the surgical strategies selected for ASD treatment, with patient clinical and radiological characteristics having greater importance.