• Title/Summary/Keyword: Spine Column

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Follow-up Comparison of Two Different Types of Anterior Thoracolumbar Instrumentations in Trauma Cases : Z-plate vs. Kaneda Device

  • Park, Jung-Keun;Kim, Keun-Su
    • Journal of Korean Neurosurgical Society
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    • v.41 no.2
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    • pp.77-81
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    • 2007
  • Objective : In a variety of thoracolumbar diseases, corpectomy followed by interbody bone graft and anterior instrumentation has allowed direct neural decompression and reconstruction of the weight-bearing column by short segments fusion. In this study, we compared spinal stability of the two different anterior thoracolumbar instruments : Z-plate and Kaneda device representing plate and two-rods type, respectively. Methods : A retrospective review was performed for all the patients with thoracolumbar diseases or traumas treated with anterior corpectomy, autologous iliac bone graft, and fixation with instruments from 1996 to 2000. For the anterior instrumentation, Z-plate or Kaneda device was used for 24 [M:F=5:9, average age=37] and 12 [M:F=9:3, average age=41] patients, respectively. The plain AP and lateral flexion-extension films were taken immediately after surgery and at each follow-up. The sagittal and coronal Cobb's angles at the operation segments were used to observe the change of initial fixation status. The surgical time length and bleeding amount of the two groups were compared. Intra-operative and post-operative instrument associated complications were evaluated. Student t-test was used for statistical analysis and p-value less than 0.05 was considered to be significant. Results : Mean follow-up durations for Z-plate and Kaneda device were 24 and 21 months, respectively. The fusion rate was 91% for Z-plate and 100% for Kaneda device. Two cases of Z-plate group showed instrumentation failure during the follow up period, in which additional surgery was necessary. The mean differences of sagittal Cobb's angles among the AP images immediate after surgery and at follow-up were 7 and 2 degrees for Z-plate and Kaneda device, respectively [p<0.05]. The mean differences of coronal Cobb's angles were 5 and 2 degrees for Z-plate and Kaneda device, respectively [p<0.05]. No Intra-operative complication has occurred in both groups. There was no difference in surgery time and bleeding amount between two groups. Conclusion : We think that Kaneda device [rod type] is stronger than Z-plate [plate type] to keep the spinal stability after anterior thoracolumbar surgery.

A Case of Forestier's Disease with Dyspnea (호흡 곤란을 동반한 Forestier병 1례)

  • Park, Yong-Hyun;Park, Yoong-In;Jeon, Doo-Soo;Hong, Jin-Hee;Ryu, Ki-Chan;Lee, Min-Ki;Park, Soon-Kew
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.5
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    • pp.1094-1097
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    • 1998
  • Forestier's disease, also known as diffuse idiopathic skeletal hyperostosis(DISH), is a peculiar type of senile ankylosing hyperostosis of the spine characterized by flowing ossification of the anterior and right lateral aspect of the vertebral column, particularly in the thoracic region. Although these patients are typically asymptomatic, there is documentation of a number of extraspinal manifestations including dysphagia, respiratory distress, dysphonia and cervial myelopathy. We report a case of Forestier's disease presenting with dyspnea in a 57-year old man, who have chronic cervical pain and bronchiectasis. Forestier's disease was diagnosed by cervical spine X-ray, neck CT. The patient was treated with oral steroid and then improved.

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Osteochondroma at the Cervicothoracic Junction (경흉추 이행부에 발생한 골연골종)

  • Park, Yung;Ha, Joong Won;Kie, Jeong Hae;Hong, Seung-Pyo
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.562-566
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    • 2019
  • Osteochondroma is a common benign bone tumor, but relatively rare in the spine. Spinal osteochondroma originates mainly from the posterior column and sometimes invades the spinal canal causing cord compression and myelopathy. A 36-year-old man was admitted to the authors' institution with a two-year history of neck pain. A radiology examination revealed osteochondroma, arising from the left superior articular process of the T1 vertebra with significant central canal narrowing. Most cases of the spinal osteochondroma originate in the cervical vertebra, but there are few reports of an origin of the cervicothoracic junction. This paper reports a case of osteochondroma at the cervicothoracic junction with a review of the relevant literature.

Osteological Development of Korean Striped Bitterling, Acheilognathus yamatsutae (Cyprinidae) (줄납자루, Acheilognathus yamatsutae (잉어과)의 골격 발달)

  • Song, Ho-Bok;Son, Yeong-Mok
    • Korean Journal of Ichthyology
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    • v.17 no.1
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    • pp.19-28
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    • 2005
  • Osteolgical development of Korean striped bitterling, Acheilognathus yamatsutae (Cyprinidae), were investigated using cartilage and bone staining. The parasphenoid, dentary, pterygoid, ceratohyal, branchial arch and parts of the caudal skeleton were formed first as cartilaginous elements at $6.82{\pm}0.08mm$ total length (TL). Formation of frontal, parietal, and maxillary were notable at $7.76{\pm}0.09mm$ TL, and the proximal radial, scapula,and coracoid in the pectoral girdle were developed at this stage. At the same time, the neural and hemal spine were present in the caudal vertebra. The opercle and branchiostegals were observed at $9.68{\pm}0,14mm$, and the posttemporal was formed at $12.9{\pm}40.64mm$ TL, respectively. Ossification in the parasphenoid, pharyngeal bone, dentary, premaxillary, maxillary, and opercle began at about $9.68{\pm}0.14mm$ TL. The cleithrum, supracleithrum, urostyle, and caudal fin were calcified at this stage. The vertebral column was formed and ossified at $11.52{\pm}0.13mm$ TL, and the frontal, preopercle, subopercle, and hyomandibular were ossified at $15.30{\pm}0.68mm$ TL. This fish was late in developing the skeletal formation and ossification as compared with other fishes.

Effects of EMS Compression Belts with Different Muscular Patterns on Lumbar Stabilization (근육모양의 패턴을 달리한 EMS 복압벨트가 요추 안정화에 미치는 영향에 관한 연구)

  • Kim, Dae-Yeon;Park, Jin-hee;Kim, Joo-Yong
    • Science of Emotion and Sensibility
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    • v.24 no.2
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    • pp.81-92
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    • 2021
  • In this study, we investigated the effects of five EMS lumbar back pressure belts produced on an anatomical basis on lumbar spine stabilization. Five core muscles were selected, including the urinal, vertebral column, endotracheal, external abdominal, and large back muscles, and patterns were designed using a conductive fabric considering the appropriate muscle shape and pain-causing points. We experimented with four motions to examine the effects of different EMS abdominal compression belts on lumbar spine stabilization. Five healthy men in their 20s were selected. The selection conditions include no back pain history for the past three months, no restricted movements through pre-inspection, and the muscular strength of the body should belong to the normal grade. Using SLR, the sequence of experimental actions was chosen from the following but not limited to left-hand, body-hand, and back-line forces. Resting between movements lasted for 2 min, and the experiments were conducted after wearing the EMS abdominal pressure belt. Electrical stimulation was applied for 10 min to increase blood flow and muscle activation. The statistics of the experimental results were analyzed for specific differences by conducting the Wilcoxon and Friedman tests with nonparametric tests. The ranking results of each pattern were successfully assessed in the order of 5, 4, 3, 1, 2 for the five patterns, and we could identify slightly more significant results for experimental behavior associated with each muscle movement. Patterns produced based on anatomy showed differentiated effects when electric stimulation was applied to each muscle in different shapes, which could improve the stabilization of the lumbar spine in everyday life or training to the public. Based on these results, subsequent research would focus on developing smart healthcare clothing that is practical in daily life by employing different anatomical mechanisms, depending on the back pain, to utilize trunk-type tights.

Conservative treatment of Osteoporotic Compression Fractures in Thoracolumbar spine (골다공증성 흉요추부 압박 골절에서의 보존적 치료)

  • Kang, Kyu-Bok;Koh, Young-Do
    • Journal of Trauma and Injury
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    • v.18 no.2
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    • pp.107-111
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    • 2005
  • Backgrounds: To evaluate the effectiveness of conservative treatment in osteoporotic thoraco-lumbar compression fractures and to identify the factors influencing the progression of compression. Materials and Methods: From January 2003 to October 2004, Patients who were admitted to our hospital for osteoporotic thoraco-lumbar compression fractures were reviewed retrospectively with follow-up more than 12 months (ave. 14.6 months). With simple x-ray lateral view, we evaluate wedge compression ratio (WCR) and kyphotic angle (KA) at initial and final follow-up. We separate the patients into two groups baesed on the amount of progression of vertebral compression and evaluate a relation with BMD, vertebral fracture level, initial WCR, initial KA. All datas were statistically analyzed. Results: An average of T-score was -3.5 and the changes of KA between initial and final follow-up were average $3.5^{\circ}$. Compression of anterior column were progressed to 8.5%. The changes between initial and final WCR in Group I (N=24) was 17.8%, and Group II (N=18) was 3.3%. T-score in group I was -3.4 and group II was -3.8 (p=0.228). vertebral fracture level were 10 T12, 12 L1, 2 L2 in group I; 6 T12, 6 L1, 6 L2 in group II (p=0.156). Initail WCR was 0.74 in group I, 0.63 in group II, and there was statistical difference between two groups(p=0002). Initial kyphotic angle was $13.9^{\circ}$in group I, $16.2^{\circ}$in group II repectively (p=0.392). Conclusion: The conservative treatment with short-term bed rest and early embulation is effective and valuable method to patients who have osteoporotic thoraco-lumbar compression fractures. There was no statistical difference between two groups according to BMD, vertebral fracture level, KA. But in comparison with initail WCR between two groups, there was statistical difference. That means, in the case of small initial compression of anterior column, the progression of compression was bigger than else. In these patients, more strict use of appropriate brace and careful follow-up should be needed.

Expandable Cage for Cervical Spine Reconstruction

  • Zhang, Ho-Yeol;Thongtrangan, Issada;Le, Hoang;Park, Jon;Kim, Daniel H.
    • Journal of Korean Neurosurgical Society
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    • v.38 no.6
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    • pp.435-441
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    • 2005
  • Objective : Expandable cage used for spinal reconstruction after corpectomy has several advantages over nonexpendable cages. Here we present our clinical experience with the use of this cage after anterior column corpectomy with an average of one year follow up. Methods : Ten patients underwent expandable cage reconstruction of the anterior column after single-level or multilevel corpectomy for various cervical spinal disorders. Anterior plating with or without additional posterior instrumentation were performed in all patients. Functional outcomes, complications, and radiographic outcomes were determined. Results : There was no cage-related complication. Functionally, neurological examination revealed improvement in 7 of 10 patients and no patient had neurological deterioration after the surgery. Immediate stability was achieved and maintained throughout the period of follow-up. There was minimal subsidence [<2mm] noticeable in three of the cases that underwent a two-level corpectomy. Subsidence was noted in osteoporotic patients and patients undergoing multi-level corpectomies. Average pre-operative kyphotic angle was 9 degrees. This was corrected to an average of 5.4 degrees in lordosis postoperatively. Conclusion : In conclusion, expandable cages are safe and effective devices for vertebral body replacement after cervical corpectomy when used in combination with anterior plating with or without additional posterior stabilization. The advantages of using expandable cages include its ability to easily accommodate itself into the corpectomy defect, its ability to tightly purchase into the end plates after expansion and thus minimizing the potential for migration, and finally, its ability to correct kyphosis deformity via its in vivo expansion properties.

Study of Vertebral Column and Pterygiophores in Gobiidae (Pisces, Perciformes) from Korea (한국산 망둥어 과 어류의 척주와 담기골에 관한 연구)

  • Lee, yong-Joo
    • Animal Systematics, Evolution and Diversity
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    • v.9 no.1
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    • pp.25-34
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    • 1993
  • Several osteological characters of 45 species belonging to 26 genera and 4 subfamilies in th family Gobiidae were surveyed based on 348 specimens collected from April, 1984 to September, 1992 in the southern part of Korea. The characters include the following: first dorsal-fin pterygiophore formula, vertebral number, epural number, and number of anal-fin pterygiophores anterior to the first haemal spine. The first dorsal-fin pterygiophore formula and epural number showed considerable stability at the generic level, and the apeared useful characters at the species level. Among them, the epural number used formerly to distinguish gobiid subfamilies was considered to be unimpotant taxonomic character in the classification of the subfamily Gobiinae.

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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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Integrated Biomechanics in the Lumbo-Pelvic-Hip Complex : Focus on Sacroiliac Joint Dysfunction (요부-골반-고관절 복합체의 생체역학 -천장관절 기능부전과 관련하여-)

  • Yoon, Hong-Il;Sim, Hyun-Po;Lee, Jun-Yong
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.19 no.1
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    • pp.69-77
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    • 2013
  • The pelvic girdle function as an integrated unit with all three bones moving at all three joints, are influenced by the lower extremities below and vertebral column and trunk above sacroiliac movements are caused by spinal motion, whereas iliosacral movements are caused by movements of the lower limbs. Concept of normal functional integration among the lumbar spine, pelvic and hip joint is basic to the understanding of dysfunction in this region and also functional movement of the lumbo-pelvic-hip region are part of the clinical examination, consequently the integrated biomechanics of these region need to be understood. The purpose of this review is to ascertain the integrated biomechanics among the lumbo-pelvic-hip complex by consideration of literature and to give sufficient information to be able to render accurate assessment and treatment for the syndromes described.

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