• 대한의용생체공학회:의공학회지
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• 제23권6호
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• pp.451-458
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• 2002

골다공증이란 골량의 감소에 의해 야기되며. 해면골 미세구조의 골밀도가 감소하는 질병이다. 약물치료(부갑상선 호르몬)법은 골소주의 두께 및 골의 강도를 어느 정도 증가시킬 수 있는 호르몬 치료법이다. 척추성형술은 골다공성 척추 압박 골절의 치료를 위하여 척추 해면골에 주사기를 통하여 골 시멘트를 주입하는 최소 침습적 수술법이다. 임상적으로 골 시멘트의 물성치에 영향을 미치더라도 점성 감소와 주입 시간 확보를 위해 중합비율을 변경하여 사용한다. 본 연구의 목적은 골 시멘트 중합비율 변경에 따른 척추 해면골의 역학적 특성을 알아보고자 한다. 본 논문에서 는 수정된 보로노이 도형을 이용하여 척추 해면골의 유한요소 모델을 생성하고, 골 시멘트의 중합비율(0.40~l.07$m\ell$/g)에 따른 척추 해면골의 강도회복 정도를 비교하였다. 또한 골다공증 치료에서 호르몬 치료와 골 시멘트 치료의 상대적인 영향을 비교 분석하였다. 분석결과 골 시멘트 치료모델의 탄성계수와 강도는 정상 상태의 약 50%로 회복되었으며, 이 값은 호르몬 치료 모델의 약 2배이다. 0.53$m\ell$/g의 중합비율에서 골 시멘트의 탄성계수와 강도가 최고이며 1.07$m\ell$/g의 중합비율에서 최소의 탄성계수와 강도(각각 42%와 49%)이지만 약물 치료보다는 더 효과적임을 알 수 있다. 척추성형술시 제작사에서 추천하는 중합비율과 다른 비율을 사용할 경우 골 시멘트의 물성치 감소뿐만 아니라 환자의 골 밀도에 따라서 해면골의 강도회복에 문제가 발생할 수 있다는 것을 알 수 있었다.

• Tuberculosis and Respiratory Diseases
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• 제63권4호
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• pp.372-377
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• 2007

척추결핵은 경과가 느리고 서서히 진행하며 특이한 증상이 없으므로 임상적으로 의심하지 않으면 병이 상당히 진행된 후에야 진단되기 쉽다. 또한 침범된 부위가 척추결핵이 흔하지 않은 상부흉추, 경추, 천추부라면 진단은 더욱 늦어질 수 있다. 저자들은 국립의료원 결핵과에서 발열과 약 5개월간 지속된 상부 배부 통증으로 입원한 폐결핵환자에서 MRI 촬영으로 T5-6의 압박골절까지 초래한 상부흉추결핵을 진단하고 신경학적 이상이 생기기 전에 수술을 시행하고 항결핵약제의 치료로 좋은 결과를 얻었기에 이에 보고하는 바이다.

• The Korean Journal of Pain
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• 제21권3호
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• pp.202-205
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• 2008

Background: Lumbar radicular pain is a frequent and often debilitating event. Although many treatment methods have been described in several studies, the available evidences regarding efficacy is not sufficient enough to draw definitive conclusions on an optimal therapy regime. Pulsed radiofrequency (RF) treatment was found to exert a beneficial effect on intractable radicular pain in individuals. The purpose of this study was to assess the efficacy of pulsed RF of the dorsal root ganglion for chronic lumbar radicular pain. Methods: Twenty five patients with chronic lumbar radicular pain that was refractory to selective nerve root blockage met the inclusion criteria of our study and received pulsed RF treatment. The average numeric rating scale (NRS) for leg pain during usual activities and the Oswestry disability index (ODI) were measured at 1 and 3 months after the procedure. Results: Of the 25 patients accepted for pulsed RF treatment, one dropped out due to a vertebral compression fracture during this study. ODI and NRS showed a positive trend in favor of the pulsed RF treatment. No significant complications were observed during the study period. Conclusions: It appears that pulsed RF treatment of the lumbar spinal dorsal root ganglion may be an effective treatment method for patients suffering from lumbar radicular pain, and who were not responsive to selective nerve root blockage.

• Journal of Korean Neurosurgical Society
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• 제42권1호
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• pp.6-10
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• 2007

Objective : The purpose of this study was to determine the effect of bone cement augmentation of pedicular screwing in severe osteoporotic spondylolisthetic patients. Methods : Twenty patients with spondylolisthesis (8 : spondylolytic spondylolisthesis 12 : degenerative spondylolisthesis) who had undergone pedicular screwing and interbody fusion for osteoporotic lumbar spine (T-score on bone mineral density<-3.0) from 2002 to 2005 were reviewed. Mean age was 62.3 years with 3 male and 17 female patients. Average follow-up period was 14 months. Average T-score on bone mineral density (BMD) was -3.62. After decompression of neural elements, about 6cc of polymethylmethacrylate (PMMA) was injected into the each vertebral body through transpedicular route. All patients underwent one level interbody fusion and pedicular screw fixation. Clinical outcome was assessed using Oswestry Disability Index (ODI) on the last clinical follow-up. In addition, a modified MacNab's grading criteria was used to objectively assess patient's outcome postoperatively. Radiographic analysis of sagittal contour was assessed preoperatively, immediately postoperatively, and at final follow-up including fusion rate. Results : Eighteen of 20 patients were graded as excellent or good according to the modified MacNab's criteria. An significant improvement of ODI was achieved in both groups. Mean sagittal angle at the preoperative state, postoperative state and at the last follow-up state was $11.0^{\circ},\;20.1^{\circ}$ and $18.3^{\circ}$, respectively, with mean sagittal angle correction gain $7.3^{\circ}$. Firm fusion was achieved in all patients. There were one compression fracture above the fused segment after 6 months follow-up and one case of seroma. But there were no postoperative complications related to bone cement leakage and pedicular screwings such as screw pullout or screw cut-up. Conclusion : Bone cement augmentation of pedicular screwing can be an effective procedure for osteoporotic lumbar spine in spondylolisthetic patients.

• 동의생리병리학회지
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• 제28권2호
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• pp.129-136
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• 2014

The "WuQinXi" exercise, one of the medical Qi-gongs, is an exercise maximizing human's self healing power and has been confirmed to be effective significantly at several modern researches. There are many exercise therapies in western medcine, such as Willams's flexion exercise, Mckenzie's extension exercise, vertebral stabilization exercise and so on. However, there isn't a special exercise therapy which can be applied for medical practice in oriental medicine. So we selected 24 motions which are related with lumbar movements from 3 type "WuQinXi" exercises ; 20 mode, 30 mode, and 40 mode. And then, we classified them according to lumbar movements as flexion, extention, lateral bending and rotation, and also functions as stabilization and rubbing. Next, with these classifications, we assorted them by kinds of lumbar spinal disease as HIVD(herniation of intervertebral disc), spinal stenosis, spondylolysis and spondylolisthesis, facet joint syndrome, compression fracture and spondylosis. We expect that "WuQinXi" exercise be a exercise therapy for lumbar spinal disease at an oriental medical clinic in this way. Oriental medical doctors will be able to teach easily patients "WuQinXi" exercise's motions at clinic, depending on kinds of lumbar spinal disease each patient suffers from. We plan to study the effect of "WuQinXi" exercise by comparing patients who do the "WuQinXi" exercise with the patients who do the western medical exercise therapy.

• 동의생리병리학회지
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• 제18권6호
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• pp.1918-1926
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• 2004

Osteoporosis is defined as a progressive systemic skeletal disorder characterized by low bone mineral density, microarchitectual deteriorations of bone and susceptibility to fracture. numerous methods have been used for quantitative assessment of the skeleton in osteoporosis. QCT has been shown to measure changes in trabecular mineral content in the spine with great sensitivity and precision. To provide the normal reference values and changes of lumbar spinal bone mineral density in korean adult spinal bone mineral density was evaluated in 451 women (229 premenopausal and 222 postmenopausal women) and 206 men, aged 20 to 74 years old in Wonkwang hospital from 2000 to 2004, which was carried out by using QCT. women with oophorectomy, vertebral compression fracture, any history of endocrine disease and use of drugs that alter bone metabolism were excluded. According to the WHO definition, a patient is osteoporotic based on a bone mineral density(BMD) measurement that is 2.5 standard deviations (SDs) below typical peak bone mass of young healthy white women. This measurement of standard deviation from peak mass is called the T score. BMD values of normal women in their 20-24 years, 25-29 years, 30-34 years, 35-39 years, 40-44 years, 45-49 years, 50-54 years, 55-59 years, 60-64 years, 65-69 years, over 70 years were 168.95㎎/㏄ K₂PHO₄, 155.41㎎/㏄ K₂PHO₄, 166.87㎎/㏄ K₂PHO₄, 160.67㎎/㏄ K₂PHO₄, 154.06㎎/㏄ K₂PHO₄, 132.04㎎/㏄ K₂PHO₄, 114.05㎎/㏄ K₂PHO₄, 91.78㎎/㏄ K₂PHO₄, 78.61 ㎎/㏄ K₂PHO₄, 61.35㎎/㏄ K₂PHO₄, 50.53㎎/㏄ K₂PHO₄ Mean bone density of normal women was 115.77K₂PHO₄ K₂PHO₄. BMD values of normal men in their 20-24 years, 25-29 years, 30-34 years, 35-39 years, 40-44 years, 45-49 years, 50-54 years, 55-59 years, 60-64 years, 65-69 years, over 70 years were 171.46㎎/㏄ K₂PHO₄, 162.19㎎/㏄ K₂PHO₄, 155.62㎎/㏄ K₂PHO₄, 147.28㎎/㏄ K₂PHO₄, 137.56㎎/㏄ K₂PHO₄, 137.56㎎/㏄ K₂PHO₄, 101.25㎎/㏄ K₂PHO₄, 109.00㎎/㏄ K₂PHO₄, 103.32㎎/㏄ K₂PHO₄, 91.53㎎/㏄ K₂PHO₄, 88.35㎎/㏄ K₂PHO₄ Mean density of normal men was 115.77㎎/㏄ K₂PHO₄. Peak bone density of women and men was in the age group of 20-24 years and 168.95㎎/㏄ K₂PHO₄, 171.46㎎/㏄ K₂PHO₄, respectively. Bone loss was increased with aging and was accelerated in postmenopausal women than that of premenopausal women. The total loss of BMD for women and men was 70.09% and 48.47%, respectively. Postmenopausal women(mean BMD : 85.83㎎/㏄ K₂PHO₄) had significantly lower BMD than premenopausal women(meand BMD : 144.80㎎/㏄ K₂PHO₄)(p<0.001). The annual loss of BMD of women and men was 2.702㎎/㏄ K₂PHO₄ and 1.795㎎/㏄ K₂PHO₄, respectively. This study provided the BMD reference data for normal korean adult. further studies on BMD in healthy adult and comparison with published data are needed.

• Journal of Korean Neurosurgical Society
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• 제29권1호
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• pp.58-65
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• 2000

Objective : Thoracolumbar junction is second most common level of injury next to cervical spine. The object of this study is to study the usefulness of surgical titanium mesh instead of bone graft, as well as to evaluate the correction of spinal deformity and safety of early ambulation in patients with injury at thoracolumbar junction. Patients and Methods : This review included 51 patients who were operated from July 1994 to December 1997. The injured spine is considered to be unstable, if it shows involvement of two or more columns, translatory displacement more than 3.5mm, decrease more than 35% in height of vertebral body and progression of malalignment in serial X-ray. The decision to operate was determined by (1) compression of spinal cord or cauda eguina, (2) unstable fracture, (3) malalignment and (4) fracture dislocation. The procedure consisted of anterior decompression through corpectomy and internal fixation with anterior instrument and surgical titanium mesh which was impacted with gathered bone chip from corpectomy. Results : Fifty-one patients were followed up for at least 12 months. The main causes of injury were fall and vehicle accident. The twelfth thoracic and the first and the second lumbar vertebrae were frequently involved. Complete neural decompression was possible under direct vision in all cases. Kyphotic angulation occurred in a patient. Radiologic evaluation showed correction of deformity and no distortion or loosening of surgical titanium mesh with satisfactory fixation postoperatively. Conclusions : We could obtain neurological improvement, relief of pain, immediate stabilization and early return to normal activities postoperatively. Based on these results, authors recommend anterior decompression and internal fixation with surgical titanium mesh in thoracolumbar unstable spine injuries.

• Journal of Korean Neurosurgical Society
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• 제29권6호
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• pp.763-771
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• 2000

Objectives : Thoracolumbar burst fractures(TBLF) result in not only compressive deformity of vertebral body but also spinal cord compression by bony fragments. Many thoracolumbar burst fractures demand both anterior decompression and intervertebral fusion. Most of spinal surgeons use anterior instrumentation for anteior intervertebral bony fusion. The use of Z-plate has been increased recently, however there has been only a few reports regarding its clinical long-term strength. We studied nineteen patients with TBLF to find out the long-term stability of Z-plate. Methods : We have operated 19 patients from March 1996 to August 1998. They were treated with anterior decompression through either a transthoracic, retroperitoneal extrapleural or retroperitoneal approach. Retropulsed bony fragments were removed completely by corpectomy. Iliac bone graft was used for interbody fusion in all of the cases. They were evaluated by plain X-ray films including flexion and extention lateral films. Cobbs angle was used to evaluate kyphotic and lateral wedging deformity. Results : Burst fractured sites were T11 in two, three T12, nine L1, and five L2. Mean follow-up duration was fifteen months. Preoperative average kyphotic angle was 23.7 degree. Immediate postoperative kyphotic angle was 10.2 degree. Follow-up resluts of average kyphotic angles revealed 14 degrees. Four patients(21%), including two spinal 3-column injury, showed increasement of kyphotic angle more than 5 degree or breakage of intrumentation. Two patients showed the difference of kyphotic angle more than 3 degree. Five patients(26%) revealed lateral wedging deformity more than 3 degrees. Postoperative complications were two meralgia parestheticas, one pulmonary atelectasis and two donor site infections. Four of the eight patients, who initially showed incomplete spinal cord deficits, were nerologically improved by Frankel's grade. Conclusion : Z-plate fixation and iliac bone graft after anterior decompression in thoracolumbar burst fractures is a safe and easy method. Immediate postoperative results revealed excellent correction of posttraumatic kyphosis, but long-term follow-up evalution showed insufficient strength. Therefore we believe that use of Z-plate should be carefully decided, especially in the case of large lumbar fracture or 3-column injury.

• 동의생리병리학회지
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• 제27권3호
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• pp.280-288
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• 2013

Hua-Tuo(145-208) created five "WuQinXi" exercise by imitating the movements of a tiger, a deer, a bear, a monkey and a bird. The "WuQinXi" exercise, one of the medical Qi-gongs, is an exercise maximizing human's self healing power and has been effective significantly at several modern researches. There are many exercise therapies in western medcine, such as Willamss flexion exercise, Mckenzie's extension exercise, vertebral stabilization exercise and so on. However, there isn't a special exercise therapy which can be applied for medical practice in oriental medicine. So We selected some motions from "WuQinXi" exercise, which are suitable for lumbar spinal disease, and analyzed them. After that, We assorted them by kinds of lumbar spinal disease. First, We selected 22 motions which are related with lumbar movements from 3 type "WuQinXi" exercises ; 10 mode, 15 mode, 18 mode. And then, We classified them according to lumbar movements as flexion, extention, lateral bending and rotation, and also functions as stabilization and rubbing. Next, with these classifications, We assorted those motions by kinds of lumbar spinal disease as HIVD(herniation of intervertebral disc), spinal stenosis, spondylolysis and spondylolisthesis, facet joint syndrome, compression fracture and spondylosis. We expect that trying "WuQinXi" exercise at clinic in this way, the particular exercise therapy of oriental medicine, "WuQinXi" exercise will become more popular. And Oriental medical doctors will be able to teach patients "WuQinXi" exercise's motions easily at clinic, depending on kinds of lumbar spinal disease each patient suffers from. We plan to study more about 20 mode, 30 mode, 40 mode and the effect of "WuQinXi" exercise by comparing patients who do the "WuQinXi" exercise with the patients who do the western medical exercise therapy.