• Title/Summary/Keyword: Thoracic Spine

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Surgical Treatment of Giant Cell Tumor of the Spine (척추 거대세포종의 수술적 치료)

  • Kang, Yong-Koo;Rhyu, Kee-Won;Rhee, Seung-Koo;Bahk, Won-Jong;Chung, Yang-Guk;Park, Chang-Goo
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.2
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    • pp.138-145
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    • 2009
  • Purpose: Giant cell tumor of the spine is very rare, and the treatment is very difficult. However, surgical techniques and diagnostic modalities are developed, and postoperative functional results are improved. To evaluate the efficacy of total spondylectomy for giant cell tumor of the spine, the clinical results of the surgical treatments for the giant cell tumor of the spine with intralesional curettage or total spondylectomy were evaluated. Materials and Methods: From April 1987 to March 2006, 10 patients who were underwent surgical treatments using total spondylectomy or intralesional curettage were studied. There were 3 men and 7 women. The mean age of the patients was 32 years (range, 25~44 years). The mean duration of follow-up was 8 years (range, 3~15 years). Locations of the tumor were 2 cervical spines, 4 thoracic spines, 2 lumbar spines and 2 sacrum. Initial main symptom of 10 patients was pain, and 7 patients had neurologic impairments too. Four patients were treated with total spodylectomy using anterior and posterior combined approach, 1 patient was treated with total sacrectomy using posterior approach only, and 5 patients were treated with intralesional curettage using anterior approach. Results: Nine patients improved pain and neurologic impairments. Local recurrences developed in 4(40%) patients (2 cervical spines, 1 thoracic spine, 1 sacrum). While a local recurrence developed from 5 total spondylectomy, 3 local recurrences developed from 5 intralesional curettage. Conclusion: Local recurrence rate after surgical treatment with intralesional curettage for the giant cell tumor of the spine was very high. Total spondylectomy using anterior and posterior approach is advisable to prevent the local recurrence after surgical treatment.

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Clinical and Radiological Outcomes of Posterior Vertebral Column Resection for Severe Spinal Deformities

  • Lee, Byoung Hun;Hyun, Seung-Jae;Kim, Ki-Jeong;Jahng, Tae-Ahn;Kim, Yongjung J.;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.61 no.2
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    • pp.251-257
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    • 2018
  • Objective : The aim of this study was to investigate clinical and radiological outcomes of patients who underwent posterior vertebral column resection (PVCR) by a single neurosurgeon in a single institution. Methods : Thirty-four consecutive patients with severe spinal deformities who underwent PVCR between 2010 and 2016 were enrolled. The radiographic measurements included a kyphotic angle of PVCR levels (VCR angle), sagittal vertical axis (SVA), thoracic kyphosis, lumbar lordosis (LL), and spinopelvic parameters. The data of surgical time, estimated blood loss, duration of hospital stay, complications, intraoperative neurophysiologic monitoring, and the Scoliosis Research Society (SRS)-22 questionnaire were collected using a retrospective review of medical records. Results : The VCR angle, LL, and SVA values were significantly corrected after surgery. The VCR and LL angle were changed from the average of $38.4{\pm}32.1^{\circ}$ and $-22.1{\pm}39.1^{\circ}$ to $-1.7{\pm}29.4^{\circ}$ (p<0.001) and $-46.3{\pm}23.8^{\circ}$ (p=0.001), respectively. The SVA was significantly reduced from $103.6{\pm}88.5mm$ to $22.0{\pm}46.3mm$ (p=0.001). The clinical results using SRS-22 survey improved from $2.6{\pm}0.9$ to $3.4{\pm}0.8$ (p=0.033). There were no death and permanent neurological deficits after PVCR. However, complications occurred in 19 (55.9%) patients. Those patients experienced a total of 31 complications during- and after surgery. Sixteen reoperations were performed in twelve (35.3%) patients. The incidence of transient neurological deterioration was 5.9% (two out of 34 patients). Conclusion : Severe spinal deformities can be effectively corrected by PVCR. However, the PVCR technique should be utilized limitedly because surgery-related serious complications are relatively common.

The Effects of Changes In Body Composition Through High Intensity Circuit Training On Spine Curvature And Low Back Pain Among Middle-Aged Men With Abdominal Obesity (고강도서키트트레이닝에 의한 신체조성의 변화가 복부비만 중년남성의 척추만곡도와 요부통증에 미치는 영향)

  • Kim, Chae-Won;Kim, Jung-Hoon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.5
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    • pp.346-356
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    • 2018
  • Overweight and abdominal obesity caused by sedentary lifestyle may induce deconditioned and atrophied extensor musculature of the lumbar spine and be a potential risk factor for low back pain (LBP). Therefore, this study was conducted to evaluate the validity of high intensity circuit training (HICT) on weight loss and subsequent alleviation of spine curvature (SC) and visual analog scale (VAS) among middle aged men with abdominal obesity. The training program (1 exercise session for 30 minutes, three times a week for 12 weeks) consisted of 12 different functional exercises based on core strengthening multiple joint circuit training. Portions of the obesity index related to body composition were positively changed, which improved the angles of thoracic kyposis and lumbar lordosis, which appeared to effectively reduce lower back pain. Taken together, HICT specifically designed for LBP effectively decreased obesity related body composition and was superior to other treatments for decreasing aggravation of the spine curvature and LBP caused by abdominal obesity; however, weight loss should be the primary treatment target for LBP patients.

Altered Thoracic Cage Dimensions in Patients with Chronic Obstructive Pulmonary Disease

  • Lim, Su Jin;Kim, Ju-Young;Lee, Seung Jun;Lee, Gi Dong;Cho, Yu Ji;Jeong, Yi Yeong;Jeon, Kyung Nyeo;Lee, Jong Deog;Kim, Jang Rak;Kim, Ho Cheol
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.2
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    • pp.123-131
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    • 2018
  • Background: Chronic obstructive pulmonary disease (COPD) may cause changes in the shape of the thoracic cage by increasing lung volume and hyperinflation. This study investigated changes in thoracic cage dimensions and related factors in patients with COPD. Methods: We enrolled 85 patients with COPD (76 males, 9 females; mean age, $70.6{\pm}7.1years$) and 30 normal controls. Thoracic cage dimensions were measured using chest computed tomography at levels 3, 6, and 9 of the thoracic spine. We measured the maximal transverse diameter, mid-sagittal anteroposterior (AP) diameter, and maximal AP diameter of the right and left hemithorax. Results: The average AP diameter was significantly greater in patients with COPD compared with normal controls ($13.1{\pm}2.8cm$ vs. $12.2{\pm}1.13cm$, respectively; p=0.001). The ratio of AP/transverse diameter of the thoracic cage was also significantly greater in patients with COPD compared with normal controls ($0.66{\pm}0.061$ vs. $0.61{\pm}0.86$; p=0.002). In COPD patients, the AP diameter of the thoracic cage was positively correlated with body mass index (BMI) and 6-minute walk test distance (r=0.395, p<0.001 and r=0.238, p=0.028) and negatively correlated with increasing age (r=-0.231, p=0.034). Multiple regression analysis revealed independent correlation only between BMI and increased ratio of AP/transverse diameter of the thoracic cage (p<0.001). Conclusion: Patients with COPD exhibited an increased AP diameter of the thoracic cage compared with normal controls. BMI was associated with increased AP diameter in these patients.

A Study of the Correlation between Spinal Curvatures, Plantar Pressure and Foot Angles (척추의 만곡과 족저부 압력 분포 및 발각도의 상관성 연구 - 족부 진단기의 임상적 활용 가능성 검토를 위한 예비연구 -)

  • Eun, Young-Joon;Song, Yun-Kyung;Lim, Hyung-Ho
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.2 no.2
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    • pp.1-16
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    • 2007
  • Objectives : The purpose of this study was to identify spinal curvatures, plantar pressure and foot angles in a walking. Methods : 19 outpatients under 19 years old were included. Plantar pressure and foot angle in a walking were measured by using Gaitview AFA-50. Spinal curvatures were measured by using radiograph. Results : The cervical lordotic angle is significantly difference with left and right plantar pressure(p=0.027). The thoracic kyphotic angle is significantly difference with left and right plantar pressure(p=0.026). Cobb's angle is significantly difference with left and right plantar pressure(p=0.027). The other plantar pressure were no difference from spinal curvatures and foot angle in a walking. Conclusion : There were no correlation between plantar pressure, spinal curvatures and foot angle. We consider that needed more additional study.

The Analysis of EMG According to Surface Type and Elastic Band Usage During the Pilates Superman Movement (필라테스 슈퍼맨 동작 시 탄성밴드 사용유무와 지면의 종류에 따른 근활성도 분석)

  • Son, Nam-Jeong;Yi, Kyung-Ock
    • Korean Journal of Applied Biomechanics
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    • v.25 no.2
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    • pp.219-229
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    • 2015
  • Objective : The purpose of this study was to analyze EMG according to surface type and elastic band usage during the pilates Superman movement. Method : The subjects were 10 female university students with a mean age of 27. The independent variables were surface type (yoga mat, air filled equipment, elastic mat) and elastic band usage. In order to measure muscle activity, the Noraxon(USA) was used. Eight muscles (upper trapezius, lower trapezius, thoracic spine, lumbar spine, gluteus maximus, gluteus medius, biceps femoris, semitendinosus) activation were analyzed. For the statistical analysis, MANOVA, independent t-test and Scheffe test for the post-hoc via SPSS 20.0 was used. Results : The left and right upper trapezius muscle activities were significantly reduced when using the elastic bands. In addition gluteus medius muscle activities significantly increased with the elastic band as well. Conclusion : According to the usage of the elastic band and the different types of surfaces, different muscle groups were recruited. Elastic bands were found to have more activation on the gluteus medius muscle meanwhile there was less activation on the upper trapezius during the pilates Superman movement.

Brown Tumor of the Thoracic Spine : First Manifestation of Primary Hyperparathyroidism

  • Sonmez, Erkin;Tezcaner, Tugan;Coven, Ilker;Terzi, Aysen
    • Journal of Korean Neurosurgical Society
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    • v.58 no.4
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    • pp.389-392
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    • 2015
  • Brown tumors also called as osteoclastomas, are rare nonneoplastic lesions that arise in the setting of primary or secondary hyperparathyroidism. Parathyroid adenomas or hyperplasia constitute the major Brown tumor source in primary hyperparathyroidism while chronic renal failure is the leading cause in secondary hyperparathyroidism. Most of the patients with the diagnosis of primary hyperparathyroidism present with kidney stones or isolated hypercalcemia. However, nearly one third of patients are asymptomatic and hypercalcemia is found incidentally. Skeletal involvement such as generalized osteopenia, bone resorption, bone cysts and Brown tumors are seen on the late phase of hyperparathyroidism. The symptoms include axial pain, radiculopathy, myelopathy and myeloradiculopathy according to their locations. Plasmocytoma, lymphoma, giant cell tumors and metastates should be ruled out in the differential diagnosis of Brown tumors. Treatment of Brown tumors involve both the management of hyperparathyroidism and neural decompression. The authors report a very rare spinal Brown tumor case, arisen as the initial manifestation of primary hyperparathyroidism that leads to acute paraparesis.

Atlantoaxial Rotatory Fixation in Adults Patient

  • Jeon, Sei-Woong;Jeong, Je-Hoon;Moon, Seung-Myung;Choi, Sun-Kil
    • Journal of Korean Neurosurgical Society
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    • v.45 no.4
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    • pp.246-248
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    • 2009
  • Atlantoaxial rotatory fixation (AARF) in adult is a rare disorder that occurs followed by a trauma. The patients were presented with painful torticollis and a typical 'cock robin' position of the head. The clinical diagnosis is generally difficult and often made in the late stage. In some cases, an irreducible or chronic fixation develops. We reported a case of AARF in adult patient which was treated by immobilization with conservative treatment. A 25-year-old female was presented with a posterior neck pain and limitation of motion of cervical spine after a traffic accident. She had no neurological deficit but suffered from severe defect on the scalp and multiple thoracic compression fractures. Plain radiographs demonstrated torticollis, lateral shift of odontoid process to one side and widening of one side of C1-C2 joint space. Immobilization with a Holter traction were performed and analgesics and muscle relaxants were given. Posterior neck pain and limitation of the cervical spine' motion were resolved. Plain cervical radiographs taken at one month after the injury showed that torticollis disappeared and the dens were in the midline position. The authors reported a case of type I post-traumatic AARF that was successfully treated by immobilization alone.

A Study on Asymmetric Lifting Capacity Due to Spine Deformity

  • Oh, Hyunsoo;Chang, Seong Rok
    • International Journal of Safety
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    • v.11 no.1
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    • pp.22-25
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    • 2012
  • Scoliosis can be biomechanically described as a three dimensional deformity of the spine, with deviations from the physiologic curves in the sagittal and frontal planes, usually combined with intervertebral rotation. Various factors are suspected such as genetic defects, uneven growth of the vertebrae, hormonal effects, abnormal muscular activity, postural problems, or a mix of some of these elements, but its initial cause is known in only 15-20% cases. The screening test for diagnosing scoliosis is called the Adams Forward Bend Test. During the experiment, the subjects were asked to bend over, with arms dangling, until a curve could be observed. The Scoliometer was placed on the back of the subjects and used to measure the difference between the left and right apex of the curve in the thoracic, thoracolumbar and lumbar area. Then, the subjects were asked to perform Maximum Voluntary Contractions (MVCs) using the digital back muscle dynamometer in three different postures: (1) 0o (sagittally symmetric); (2) 30o from the mid-sagittal plane (clockwise); and (3) 30o from the mid-sagittal plane (counterclockwise). In addition to the experimental data, subject-dependent variables including Body Mass Index (BMI), percentage of body fat and muscle mass of left/right arms and legs were employed to reveal the cause of difference among three MVC conditions. All those variables were tested using statistical methods.

Ankylosing Spondylitis Associated with Bilateral TMJ Ankylosis (강직성 척추염에 수반된 양측성 측두하악관절 강직)

  • Song Ju-Seop;Koh Kwang-Joon
    • Imaging Science in Dentistry
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    • v.30 no.3
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    • pp.217-222
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    • 2000
  • A 31-year-old male with the complaint of severe limitation of mouth opening was referred to our department of Chonbuk National University Hospital. The physical status of the patient was hyposthenic. Extraoral examination showed no condylar movement of the both temporomandibular joints, no pain, no facial swelling or paresthesia. Intraoral examination showed several cervical caries on the upper anterior teeth, and gingival swelling on the whole dentition. Transcranial view showed no condylar movement, and narrowing of joint spaces. Chest P-A view showed straightening of thoracic, lumbar spine, and squaring of vertebrae of the same spines. Conventional lateral radiograph of cervical spine showed calcification of the intervertebral ligament. Computed tomograph showed extensive bone formation between temporal bone and the condylar head at both sides. Laboratory findings showed positive reaction on HLA-B27 histocompatibility antigen and increased level of IgA, IgG, ESR. Based on the clinical, radiographic, and the laboratary findings, final diagnosis was made as bony ankylosis of the both temporomandibular joints secondary to ankylosing spondylitis.

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