• Journal of Korean Neurosurgical Society
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• 제40권6호
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• pp.471-475
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• 2006

Complete vertebral tumor resection is important in order to prevent local recurrence. Among the available techniques for total spondylectomy, the total en bloc spondylectomy has been accepted as the most sophisticated one. After a total en bloc spondylectomy, anterior and posterior column reconstruction is mandatory in order to achieve stability. We experienced the usefulness of an expandable cage for anterior column reconstruction especially in this surgery. The chance of cutting the nerve root and damaging the spinal cord is minimized because the size of the expandable cage is initially small enough to be inserted into the anterior column. The technical details of total vertebral body replacement with an expandable cage after an en bloc lumbar spondylectomy are described herein.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2005년도 춘계학술대회 논문집
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• pp.907-910
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• 2005

Although several artificial disc designs have been developed for the treatment of discogenic low back pain, biomechanical change with its implantation was rarely studied. To evaluate the effect of artificial disc implantation on the biomechanics of functional spinal unit, nonlinear three-dimensional finite element model of L4-L5 was developed with 1-mm CT scan data. Two models implanted with artificial discs, SB $Charit\acute{e}$ or Prodisc, via anterior approach were also developed. The implanted model predictions were compared with that of intact model. Angular motion of vertebral body, force on spinal ligaments and facet joint, and the stress distribution of vertebral endplate for flexion-extension, lateral bending, and axial rotation with a compressive preload of 400 N were compared. The implanted model showed increased flexion-extension range of motion and increased force in the vertically oriented ligaments, such as ligamentum flavum, supraspinous ligament and interspinous ligament. The increase of facet contact force on extension were greater in implanted models. The incresed stress distribution on vertebral endplate for implanted cases indicated that additinal bone growth around vertebral body and this is matched well with clinical observation. With axial rotation moment, relatively less axial rotation were observed in SB $Charit\acute{e}$ model than in ProDisc model.

• 한국정밀공학회지
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• 제23권3호
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• pp.187-194
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• 2006

Unexpected postoperative changes, such as growth in rib hump and shoulder unbalance, have been occasionally reported after corrective surgery for scoliosis. However there has been neither experimental data fer explanation of these changes, nor the suggestion of optimal correction method. Therefore, the numerical study was designed to investigate the post-operative changes of vertebral rotation and rib cage deformation after the corrective surgery of scoliosis. A mathematical finite element model of normal spine including rib cage, sternum, both clavicles, and pelvis was developed with anatomical details. In this study, we also developed a special program which could convert a normal spine model to a desired scoliotic spine model automatically. A personalized skeletal deformity of scoliosis model was reconstructed with X-ray images of a scoliosis patient from the normal spine structures and rib cage model. The geometric mapping was performed by translating and rotating the spinal column with an amount analyzed from the digitized 12 built-in coordinate axes in each vertebral image. By utilizing this program, problems generated in mapping procedure such as facet joint overlapping, vertebral body deformity could be automatically resolved.

• The Journal of Korean Physical Therapy
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• 제10권2호
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• pp.149-159
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• 1998

요추가 제기능을 다하려면 추체와 디스크 및 후관절을 구성하고 있는 주위 연부조직이 정상적 위치에 있어야한다. 또한 체중을 지탱하는 역학적 관계로 볼 때 척주(vertebral column)의 운동범위가 가장 큰 부위가 요천추관절이므로 항상 구조적 변화가 잘 일어난다. 이러한 사실로 볼 때 요통 발생은 요추부의 해부학적 구조 중 후관절, 추체, 추간판의 역학적 관계를 고찰을 통해서 본 결과 어느 특정한 한 부위에서 발생한 것 보다는 추체, 추간판, 후관절의 변화에 따른 주위 연부조직의 변화도 함께 동반 손상이 된다는 결론을 얻을 수 있다. 요통이란 용어는 포괄적인 개념에서 다양한 원인과 증상을 동반하는 매우 광범위한 질병 중 대표적이라 할 수 있다. 요통의 해부학적 고찰을 통해서 미비하나마, 요통은 디스크의 문제라는 일반적인 개념에서 탈피해서 여러 가지 복잡 다양한 원인과 증상을 알아보았다. 요통의 치료는 그 원인에 따라 치료가 이루어져야 하기 때문에 좀더 정확한 원인을 규명하는 것이 필수적이라 생각된다.

• 대한정형외과학회지
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• 제55권4호
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• pp.348-353
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• 2020

68세 남자 환자가 허리의 피부에서 고름을 동반한 욕창으로 내원하였다. 초진시 일반 방사선상 제4요추체의 광범위한 파괴 소견과 자기공명영상 촬영에서 제4요추 척추체의 결손 부위에 고인 조영 증강된 많은 양의 액체가 양측 요근 및 후관절까지 확장된 소견을 보였다. 신경병성 척추병증으로 일차 진단하였으나 농양을 동반한 감염성 척추염을 배제할 수 없어 정맥 항생제를 2주 투여하였다. 자기공명영상을 재촬영한 결과 농양의 크기는 줄어 들지 않아 수술적 치료로 진행하였다. 샤르코 척추 관절병증은 광범위한 척추체 파괴를 일으켜 감염성 척추염과 유사한 소견을 보일 수 있으며 특히 척추체 불안정으로 인한 경막 파열로 뇌척수액이 축적되면 감별이 어려울 수 있어 이 증례를 보고하는 바이다.

• 대한의용생체공학회:의공학회지
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• 제24권5호
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• pp.447-451
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• 2003

준분자 동력학 기법을 적용한 새로운 골-재형성 해석 방법을 제안 하였다. 본 연구에서는 기존의 연구에서 고려하지 못 하였던 해변골 내의 유체 압력이 골-재형성에 미치는 영향 까지를 고려한 해석 모델이 제안 되었다. 골-재형성의 대상 모델로 추체 시상면상의 2-D 모델을 개발 하였으며, 약 2kN의 수직 압축력에 해당되는 1.8564mm의 일정 변위 조건에 따른 모델내의 준분자들의 재배치 과정을 해석 하였다. 수렴된 피질골 및 해면골 모델의 준 분자의 형상은 실제 추체의 모양과 일치된 형태를 보이고 있었으며 계산된 수핵 압력 변화도 기존의 in-Vitro 실험 결과와 비교적 일치 하여 본 모델의 타당성을 입증 할 수 있었다.

• 대한의용생체공학회:의공학회지
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• 제25권1호
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• pp.27-32
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• 2004

본 논문에서는 골다공증성 척추압박골절에 대한 척추성형술시 골강화제인 PMMA 주입방법을 제안하였다. 척추성형술의 정량적 분석을 위해서는 유한요소해석을 사용하였으며 1m간격의 척추체 CT를 바탕으로 보다 정교한 척추체 모델을 제시함으로써, 단순화된 척추의 기하학적 형상과 간단한 재료 물성치를 사용하는 기존의 연구의 한계를 극복하고자 하였다. 본 연구 결과를 토대로 추체내 망상골에 주입되는 PMMA의 주입형태, 주입위치를 정량적으로 평가하여 이상적인 수술방법을 제시하였다. PMMA의 구입위치는 망상골의 앞쪽-위쪽에 많은 양이 집중하여 주입되었을 때, 가장 효율적으로 추체를 보완해 주는 것으로 나타났다.

• Journal of Korean Neurosurgical Society
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• 제30권2호
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• pp.231-238
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• 2001

Vertebral artery injury is a rare complication of anterior cervical approach. We report two patients who suffered injury to vertebral artery during anterior cervical spine surgery. The mechanism of injury, their operative management, and the subsequent outcome were assessed and relevant literatures reviewed. The awareness of the possibility of vertebral artery injury is most important to prevent and it's occurrence is best avoided by a thorough understanding of the anatomical relationships of the artery, the spinal canal, and the vertebral body and careful use of surgical instruments.

• Asian Spine Journal
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• 제12권6호
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• pp.1123-1126
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• 2018

Study Design: Observational study. Purpose: To assess the correlational accuracy between the traditional anatomic landmarks of the neck and their corresponding vertebral levels in Southern Chinese patients. Overview of Literature: Recent studies have demonstrated discrepancies between traditional anatomic landmarks of the neck and their corresponding cervical vertebra. Methods: The center of the body of the hyoid bone, the upper limit of the lamina of the thyroid cartilage, and the lower limit of the cricoid cartilage were selected as representative surface landmarks for this investigation. The corresponding vertebral levels in 78 patients were assessed using computed tomography. Results: In both male and female patients, almost none of the anatomical landmarks demonstrated greater than 50% correlation with any vertebral level. The most commonly corresponding vertebra of the hyoid bone, the lamina of the thyroid cartilage, and the cricoid cartilage were the C4 (47.5%), C5 (35.9%), and C7 (42.3%), respectively, which were all different from the classic descriptions in textbooks. The vertebral levels corresponding with the thyroid and cricoid cartilage were significantly different between genders. Conclusions: The surface landmarks of the neck were not accurate enough to be used as the sole determinant of vertebral levels or incision sites. Intra-operative fluoroscopy is necessary to accurately locate each of the cervical vertebral levels.

• Journal of Korean Neurosurgical Society
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• 제30권7호
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• pp.907-915
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• 2001

Objective : Percutaneous vertebroplasty is often complicated by the presence of multiple fractures or non-localizing pain in the patients with osteoporotic vertebral fractures. The purpose of this study is to estimate the value of preoperative radiologic studies in the localization of symptomatic vertebrae and to determine the factors which can influence on the clinical results. Materials and Methods : We retrospectively reviewed the clinical and radiologic data of 57 vertebrae in 30 patients underwent percutaneous vertebroplasty for osteoporotic vertebral compression fractures. Inclusion criteria was severe pain(McGill-Melzack score 3, 4 or 5) associated with the acute vertebral fractures and absence of spinal nerve root or cord compression sign. Acute symptomatic vertebral fracture was determined by the presence of signal change on MR images or increased uptake on whole body bone scan. Results : Pain improvement was obtained immediately in all patients and favorable result was sustained in 26 patients(86.7%) during the mean follow-up duration of 4.7 months(5 complete pain relief, 21 marked pain relief). Those who underwent vertebroplasty for all acute symptomatic vertebrae had significantly better clinical result than those who did not. Further vertebral collapse and eventual bursting fracture occurred in 1 vertebra which showed intradiskal leakage of bone cement and disruption of cortical endplate on postoperative CT scan. Conclusion : Preoperative MR imaging and whole body bone scan are very useful in determining the symptomatic vertebrae, especially in the patients with multiple osteoporotic vertebral fractures. To obtain favorable clinical result, the careful radiologic evaluation as well as clinical assessment is required. Control of PMMA volume seems to be the most critical point for avoiding complications.