• Title/Summary/Keyword: Vertebral Body

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The clinical study on 44 cases of patient with Thoracolumbar Compression Fracture (흉(胸)·요추(腰椎) 압박골절(壓迫骨折) 환자(患者)에 대한 임상적(臨床的) 고찰(考察))

  • Lim, Jeoung-Eun;Kim, Kee-Hyun;Hwang, Hyeon-Seo
    • Journal of Acupuncture Research
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    • v.17 no.2
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    • pp.41-51
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    • 2000
  • Clinical observation was made on 44 cases of stable thoracolumbar compression fracture that were confirmed through simple x-ray and neurological examination. They were hospitalized and treated by acupuncture and moxibustion, bed rest, herb medicine and physical therapy. If necessary, patient was given an enema. The results obtained are as follows. 1. The patient distribution ratio, in regard to sex, was shown to be 1: 13.7 for males to females. In regard to age, it was shown that people in their 60's was the most predominant case, followed by people in their 70's, 80's, 50's and 40's, respectively. 2. In regard to contributing factors, it was observed that accidental falls were most frequent, followed by reasons unknown, repetitive lifting of heavy objects, overlaboring and bruise in that order. 3. In regard to duration of illness before treatment, it was found that treatment within 1 week was most predominant, followed by over 4 weeks, and 1-2 weeks, respectively. 4. With regard to the duration of hospitalization, hospitalization within 2 weeks was found to be most predominant, followed by 2-4 weeks. 5. In regard to the level of the affected vertebral body; The affected vertebral bodies distributed between T3 to L5 except for T7; T12 was found to be most predominant, followed in turn by L1 and L5. 6. In regard to the number of affected vertebral bodies, 2 was the most frequent followed by 1 and 3, in that order. The average of the number of affected vertebral bodies was observed to be 2.8 and single vertebral body compression fracture was shown to have no clinical and statistical difference as compared with multiple vertebral body compression fractures. 7. In regard to the grade of the seriousness of symptoms, it was found that Grade IV was most predominant, followed by Grade III. 8. With regard to signs at the first medical examination, low back pain was seen in the highest number, and followed in order by gait disturbance, flank pain, flexion-extension disturbance, disturbance of rotation to right or left, and bowel dysfunction. 9. Concerning the effect of treatment, good results were most predominantly seen, and 95.5% of total patients showed fair results. 10. The duration of admission treatment due to the grade of clinical symptoms was as follows; In the case of the Grade IV, it was observed that within 2 weeks was most predominant and for Grade III was 2-4 weeks. It was also found that the grade of clinical symptoms was not in proportion to the duration of admission treatment. 11. In regard to the result of treatment due to the grade of clinical symptoms; It was found that in the case of Grade IV, within 2 weeks was most predominant, and for Grade III, it was found to be 2-4 weeks. 12. Intestinal obstruction was shown in 50% of total patients; In the case of duration of constipation, more than 1 week was found to be most predominant, followed by 2 and 4 days respectively. 13. With regard to the treatment of intestinal obstruction, using acupuncture and moxibustion, herb - medicine and enema together were found to be most effective. 14. Intestinal obstruction was mostly seen in the case of Grade IV.

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Mesenchymal Chondrosarcoma of the Cervical Spine - Case Report - (경추부에 발생한 간엽성 연골육종 - 증 례 보 고 -)

  • Kwon, O Hyun;Kim, Jung Deuk;Park, Sang June;Kim, Eui Joong;Yoon, Sung Moon
    • Journal of Korean Neurosurgical Society
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    • v.30 no.11
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    • pp.1336-1339
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    • 2001
  • Mesenchymal chondrosarcoma is a rare tumor occurring in both bone and soft tissues and exhibits characteristic of a malignant nature. The authors experienced a case of mesenchymal chondrosarcoma occurring in a 23-year-old woman which had invaded the cervical spine. The patient presented with severe both shoulder pain, left upper extremity weakness(Grade IV) and paresthesia at admission. Radiologic studies of the cervial spine showed an aggressive osteolysis of C4 vertebral body, pedicle and lamina with compression of the spinal cord posteriorly on C3, C4, C5 levels. The tumor was totally removed by a combined anterior and posterior approach. The removed vertebral body was replaced with autogenous bone and stabilized by Codman locking plate symtem. The pathological examination showed characteristic of mesenchymal chondrosarcoma.previous symptoms well improved postoperatively. The authors present a case of mesenchymal chondrosarcoma with review of literature.

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Splanchnic Nerve Block with Transdiscal Approach -A case report- (경추간판 접근법에 의한 내장 신경 차단 -증례 보고-)

  • Na, Young-Du;Lee, Jung-Koo;Jang, Young-Ho;Chung, Jung-Kil
    • The Korean Journal of Pain
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    • v.10 no.1
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    • pp.89-92
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    • 1997
  • Neurolytic splanchnic nerve block is effective for treatment of intractable upper abdominal cancer pain. Conventional approach for splanchnic nerve block is conducted in the prone position to ensure proper orientation and to allow insertion of needles on each side of the vertebral body. However, the prone position has some technical disadvantages as this position is frequently poorly tolerated by a majority of patients with advanced cancer due to severe abdominal pain, ascites and so on. Male patient, 53-year old with transverse colon cancer, carcinomatosis peritonei and $L_1,\;L_2$ vertebral body metastasis, was admitted for treatment of severe right upper quadrant and right iliac crest pain. We performed neurolytic splanchnic nerve block with transdiscal technique in the lateral decubitus position under fluoroscopic guidance, and well noted the usefulness and the advantage of this technique. The benefits of this technique are safe, simple and effective because the lateral position is better tolerated by patients and makes bony landmarks more accessible during fluoroscopy.

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Metastasis of Intracranial Hemangiopericytoma to Thoracic Spine - Case Report - (두개강내 혈관주위세포종의 흉추로의 전이 - 증례보고 -)

  • Oh, Jun Gyu;Kim, Joo Seung;Moon, Byung Gwan;Kang, Hee In;Lee, Seung Jin
    • Journal of Korean Neurosurgical Society
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    • v.30 no.5
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    • pp.666-669
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    • 2001
  • We report a case of meningeal hemangiopericytoma presenting as metastasis in the vertebral body and pedicle of the thoracic spine. Hemangiopericytoma is a rare vascular neoplasm. Although the tumor has a strong propensity for both local recurrence and extracranial metastasis, metastasis to thoracic spine is very rare and only two cases were found in the literature. A 44-year-old woman with paraparesis and pain in the thoracic and lower legs was examined by plain radiographs and magnetic resonance imaging. The intracranial hemangiopericytoma was operated 3 years ago. Magnetic resonance imaging demonstrated a tumor invading the left vertebral body and pedicle of the 11th thoracic spine, and compressing the dural sac. The patient was gradually improved after surgical removal of the lesions and the histologic findings were characteristics of hemangiopericytoma.

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Intramedullary Spinal Cord Metastasis of Choriocarcinoma

  • Ko, Jun-Kyeung;Cha, Seung-Heon;Lee, Jung-Hwan;Choi, Chang-Hwa
    • Journal of Korean Neurosurgical Society
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    • v.51 no.3
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    • pp.141-143
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    • 2012
  • The authors describe a case of choriocarcinoma that metastasized to the cerebral cortex, vertebral body, and intramedullary spinal cord. A 21-year-old woman presented with sudden headache, vomiting and a visual field defect. Brain computed tomography and magnetic resonance examinations revealed an intracranial hemorrhage in the left temporo-parietal lobe and two enhancing nodules in the left temporal and right frontal lobe. After several days, the size of the hemorrhage increased, and a new hemorrhage was identified in the right frontal lobe. The hematoma and enhancing mass in the left temporo-parietal lobe were surgically removed. Choriocarcinoma was diagnosed after histological examination. At 6 days after the operation, her consciousness had worsened and she was in a state of stupor. The size of the hematoma in the right frontal lobe was enlarged. We performed an emergency operation to remove the hematoma and enhancing mass. Her mental status recovered slowly. Two months thereafter, she complained of paraplegia with sensory loss below the nipples. Whole spine magnetic resonance imaging revealed a well-enhancing mass in the thoracic intramedullary spinal cord and L2 vertebral body. Despite chemotherapy and radiotherapy, the patient died 13 months after the diagnosis.

A Dumbbell-Shaped Meningioma Mimicking a Schwannoma in the Thoracic Spine

  • Kim, Myeong-Soo;Eun, Jong-Pil;Park, Jeong-Soo
    • Journal of Korean Neurosurgical Society
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    • v.50 no.3
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    • pp.264-267
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    • 2011
  • A 50-year-old man presented bilateral hypesthesia on and below the T6 dermatome and paresthesia. Magnetic resonance imaging (MRI) showed an intraspinal extradural tumor, which located from the 6th thoracic vertebral body to the upper margin of the 7th vertebral body, continuing dumbbell-like through the intervertebral foramen into the right middle thorax suggesting a neurogenic tumor (neurofibroma or neurilemmoma). With the patient in a prone position, we exposed and excised the tumor via a one stage posterior approach through a hemi-laminictomy of T6. Histologic examination showed a grade 1 meningothelial meningioma, according to the World Health Organization classification. Initially, we assumed the mass was a schwannoma because of its location and dumbbell shape. However, the tumor was actually a meningioma. Postoperatively, hypesthesia resolved completely and motor power of the leg gradually full recovered. A postoperative MRI revealed no evidence of residual tumor.

Dysphagia Caused by Osteochondroma of the Cervical Vertebral Body: A Case Report (경추체 전방에 발생한 골연골종으로 인한 연하곤란: 증례 보고)

  • Min, Hak-Jin;Kim, Jin-Soo;Kim, Jong-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.18 no.1
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    • pp.32-36
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    • 2012
  • A 56 year-old female presented with dysphagia 8 weeks ago and newly developed dysphonia 2 weeks ago. The radiology study and swallowing difficulty evaluation study revealed the esophagus and the posterior wall of the laryngopharynx to be severely compressed by the mass of the anterior $4^{th}$ and $5^{th}$ vertebral body of cervical spine. En bloc excisional biopsy of the bony mass was performed, which completely resolved the clinical symptoms. We report a rare case of osteochondroma occurring at the anterior portion of cervical spine leading to dysphasia and dysphonia with a review of relevant literature.

Comparison of Cervical Musculoskeletal Kinematics in Two Different Postures of Primate During Voluntary Head Tracking

  • Park, Hyeonki;Emily Keshner;Barry W. Peterson
    • Journal of Mechanical Science and Technology
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    • v.17 no.8
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    • pp.1140-1147
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    • 2003
  • We have examined the effect on neck-muscle activation of altering whole body posture. A Rhesus monkey (Macaca mulatta) was trained to produce sinusoidal (0.25 Hz) head tracking movements in the sagittal plane when seated with trunk and head vertical or while standing in the quadrupedal position. Video-fluoroscopic images of cervical vertebral motion, and electromyographic (EMG) responses were recorded simultaneously. Results demonstrated that vertebral motion varied with body posture, occurring synchronously between all joints in the upright position and primarily at skull-$C_1$ when in the quadrupedal position. Muscle EMG activation was significantly greater (P<0.001) in the quadrupedal position than when upright for all muscles except semispinalis cervicis. Peak activation of all the muscles occurred prior to peak head extension in the quadrupedal position, suggesting synchronous activity between muscles. Data suggest that, when upright, muscles were activated in functional groupings defined by their anatomical arrangement. In the quadrupedal position, gravity acting on the horizontally oriented head produced greater activation and a collective response of the muscles.

Analysis of biomechanical change of adjacent motion segment of the lumbar spine with an implanted artificial disc (인공추간판 적용 시 인접 운동 분절에서의 변화 분석)

  • Kim Y.E.;Yun S.S.
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2005.10a
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    • pp.244-247
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    • 2005
  • Although several artificial disc designs have been developed for the treatment of discogenic low back pain and used clinically, biomechanical change with its implantation seldom studied. To evaluate the effect of artificial disc implantation on the biomechanics of lumbar spinal unit, nonlinear three-dimensional finite element model of L1-L5, S1 was developed and strain and stress of vertebral body and surrounding spinal ligaments were predicted. Intact osteoligamentous L1-L5, S1 model was created with 1-mm CT scan of a volunteer and known material property of each element were applied. This model also includes the effect of local muscles which was modeled with pre-strained spring elements. The intact model was validated with reported biomechanical data. Two models implanted with artificial discs, SB Charite or Prodisc, at L4/5 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, facet joint contact force with $2\sim12$ Nm flexion-extension moment.

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SNR and ADC Changes at Increasing b Values among Patients with Lumbar Vertebral Compression Fracture on 1.5T MR Diffusion Weighted Images (1.5T MR 기기를 이용한 확산강조영상에서 b Value의 증가에 따른 요추압박골절 환자의 신호대 잡음비와 현성 확산 계수의 변화)

  • Cho, Jae-Hwan;Park, Cheol-Soo;Lee, Sun-Yeob;Kim, Bo-Hui
    • Progress in Medical Physics
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    • v.21 no.1
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    • pp.52-59
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    • 2010
  • To examine among patients with vertebral compression fracture the extent to which signal-to-noise ratio (SNR) and Apparent Diffusion Coefficient (ADC) values at the lumbar vertebral compression fracture site vary on diffusion-weighted MR images according to varying b values on the 1.5T MR device. Diffusion-weighted MR images of 30 patients with compression fracture due to chronic osteoporosis who underwent vertebral MRI from Jan. 2008 to Nov. 2009 were respectively obtained using a 1.5-T MR scanner with the b values increased from 400, 600, 800, 1,000 to $1,200\;s/mm^2$. For diffusion-weighted MR images with different b values, the signal-to-noise ratio (SNR) was assessed at three sites: the site of compression fracture of the lumbar vertebral body at L1 to L5, and both the upper and lower discs of the said fracture site, while for ADC map images with different b values, the SNR and ADC were respectively assessed at those three sites. As a quantitative analysis, diffusion-weighted MR images and ADC map images with b value of $400\;s/mm^2$ (the base b values) were respectively compared with the corresponding images with each different b value. As far as qualitative analysis is concerned, for both diffusion-weighted MR and ADC map images with b value of $400\;s/mm^2$, the extent to which signal intensity values obtained at the site of compression fracture of the lumbar vertebral body at L1 to L5 vary according to the increasing b values were examined. The quantitative analysis found that for both diffusion-weighted MR and ADC map images, as the b values increased, the SNR were relatively lowered at all the three sites, compared to the base b value. Also, it was found that as the b values increased, ADC valueswere relatively lowered at all the three sites on ADC map images. On the other hand, the qualitative analysis found that as the b values increased to more than $400\;s/mm^2$, the signal intensity gradually decreased at all the sites, while at the levels of more than $1,000\;s/mm^2$, severe image noises appeared at all of the three sites. In addition, higher signal intensity was found at the site of compression fracture of the lumbar vertebral body than at the discs. Findings showed that with the b value being increased, both the signal-to-noise ratio (SNR) and Apparent Diffusion Coefficient (ADC) values gradually decreased at all the sites of the lumbar vertebral compression fracture and both the upper and lower discs of the fracture site, suggesting that there is a possibility of a wider range of applications to assessment of various vertebral pathologies by utilizing multi b values in the diffusion-weighted MRI examination.