• Journal of Korean Neurosurgical Society
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• v.46 no.4
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• pp.322-327
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• 2009

Objective : Posterior lumbar interbody fusion (PLIF) is considered to have the best theoretical potential in promoting bony fusion of unstable vertebral segments by way of a load sharing effect of the anterior column. This study was undertaken to investigate the efficacy of PLIF with cages in chronic degenerative disc disease with Modic degeneration (changes of vertebral end plate). Methods : A total of 597 patients underwent a PLIF with threaded fusion cages (TFC) from 1993 to 2000. Three-hundred-fifty-one patients, who could be followed for more than 3 years, were enrolled in this study. Patients were grouped into 4 categories according to Modic classification (no degeneration : 259, type 1 : 26, type 2 : 55, type 3 : 11). Clinical and radiographic data were evaluated retrospectively. Results : The clinical success rate according to the Prolo's functional and economic outcome scale was 86% in patients without degeneration and 83% in patients with Modic degeneration. The clinical outcomes in each group were 88% in type 1, 84% in type 2, and 73% in type 3. The bony fusion rate was 97% in patients without degeneration and 83% in patients with Modic degeneration. The bony fusion rate in each group was 81% in type 1, 84% in type 2, and 55% in type 3. The clinical success and fusion rates were significantly lower in patients with type 3 degeneration. Conclusion : The PLIF with TFC has been found to be an effective procedure for lumbar spine fusion. But, the clinical outcome and bony fusion rates were significantly low in the patients with Modic type 3. The authors suggest that PLIF combined with pedicle screw fixation would be the better for them.

• Journal of the Korean Orthopaedic Association
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• v.54 no.3
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• pp.203-210
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• 2019

The aim of this review was to evaluate minimally invasive lateral lumbar interbody fusion on the latest update. Lumbar interbody fusion was introduced recently. This study performed, a literature review of the indications, clinical outcomes, fusion rate, and complications regarding recently highlighted minimally invasive lateral lumbar interbody fusion. The indications of lateral lumbar interbody fusion are similar to the conventional anterior and posterior interbody fusion in degenerative lumbar diseases. In particular, lateral lumbar interbody fusion is an effective minimally invasive surgery in spinal stenosis, degenerative spondylolisthesis, degenerative adult deformity, degenerative disc disease and adjacent segment disease. In addition, the clinical outcomes and fusion rates of lateral lumbar interbody fusion are similar compared to conventional lumbar fusion. On the other hand, non-specific complications including hip flexor weakness, nerve injury, vascular injury, visceral injury, cage subsidence and pseudohernia have been reported. Lateral lumbar interbody fusion is a very useful minimally invasive surgery because it has advantages over conventional anterior and posterior interbody fusion without many of the disadvantages. Nevertheless, nonspecific complications during lateral lumbar interbody fusion procedure remain a challenge to be improved.

• Journal of Applied Reliability
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• v.14 no.4
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• pp.243-247
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• 2014

The Spinal cage is the cage-shaped implantable medical device used to treat structural abnormalities caused by degenerative intervertebral disks. In order to secure enough space to provide the mechanical stability and the intervertebral fusion, after removing the intervertebral disc, the Spinal cage is transplanted between the intervertebral space. A hammer is used to push the spinal cage into a narrow space during the spinal cage transplant surgery. Due to the impact and pressure, damage occurs frequently on the spinal cage. In this study, a test model is constructed to measure the value of impulse generally applied on the Spinal cage. The figures of internal impulse before and after the improvement of the Spinal cage are then compared to suggest direction to improve the reliability of the spinal cage.

• Journal of Korean Neurosurgical Society
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• v.41 no.2
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• pp.88-94
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• 2007

Objective : The aim of this study is to investigate predictable risk factors for radiologic degeneration of adjacent segment after lumbar fusion and preoperative radiologic features of patients who underwent additional surgery with adjacent segment degeneration. Methods : Between January 1995 and December 2002, 201 patients who underwent lumbar fusion for degenerative conditions of lumbar spine were evaluated. We studied radiologic features, the method of operation, the length of fusion, age, sex, osteoporosis, and body mass index. Special attention was focused on, preoperative radiologic features of patients who required additional surgery were studied to detect risk factors for clinical deterioration. Results : Follow-up period ranged from 3 to 11 years. In our study, 61 [30%] patients developed adjacent segment degeneration, and 15 [7%] patients required additional surgery for neurologic deterioration. Age, the postoperative delay, facet volume, motion range, laminar inclination, facet tropism, and preexisting disc degeneration of adjacent segment considered as possible risk factors. Among these, laminar inclination and preexisting disc degeneration of adjacent segment were significantly correlated with clinical deterioration. Conclusion : The radiologic degeneration of adjacent segment after lumbar fusion can be predicted in terms of each preoperative radiologic factor, age and the postoperative delay. Laminar inclination and preexisting disc degeneration of adjacent segment have shown as strong risk factors for neurologic deterioration. Thus, careful consideration is warranted when these risk factors are present.

• The korean journal of orthodontics
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• v.22 no.2 s.37
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• pp.345-372
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• 1992

The purpose of this experiment was to study the effects of changes of mandibular position on temporomandibular joint in internal derangement patients Twenty-four female New Zealand White Rabbits, weighing over 3.5kg, were utilized in this study . Bilateral temporomandibular joint surgery was performed in twenty-one of the rabbits to displace disc anteriorly through incising the retrodiscal tissue 1-2mm posterior to the disc, thus inducing internal derangement. They were divided into three groups nine were left untreated after surgery, six were fitted with functional protrusive appliances 4 weeks after surgery, and six wore collar appliances to apply 4 ounces of mandibular refractive force per side 4 weeks after surgery. The remaining three served as the control group. Histologic examinations were performed after sacrificing them by threes at 4-week intervals. The results were as follows. 1. Histologic findings similar to internal derangement were observed in the rabbits whose retrodiscal tissues had been incised. 2. In the rabbits untreated after surgery, articular surface on condylar process and articular eminence showed severe erosion and deformation, and displaced disc manifested changes in both shape and internal architecture. 3. Functional protrusion after surgery resulted in progressive remodeling on postero-superior portion of condyle and glenoid fossa, while it also brought about erosion on articular eminence and anterior portion of condyle. 4. Mandibular retraction after surgery resulted in compression of retrodiscal tissue and regressive remodeling of posterior portion of condyle.

• Journal of Korean Neurosurgical Society
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• v.49 no.4
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• pp.212-216
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• 2011

Objective : It is well known that plate-to-disc distance (POD) is closely related to adjacent-level ossification following anterior cervical plate placement. The study was undertaken to compare the outcomes of two different anterior cervical plating methods for degenerative cervical condition. Specifically, the new method involves making holes for plate screws first with an air drill and then choosing a plate size. The other method was standard, that is, decide on the plate size first, locate the plate on the anterior vertebral body, and then drilling the screw holes. Our hypothesis was that the new technical tip may increase POD as compared with the standard anterior cervical plating procedure. Methods : We retrospectively reviewed 49 patients who had a solid fusion after anterior cervical arthrodesis with a plate for the treatment of cervical disc degeneration. Twenty-three patients underwent the new anterior cervical plating technique (Group A) and 26 patients underwent the standard technique (Group B). POD and ratios between POD to anterior body heights (ABH) were measured using postoperative lateral radiographs. In addition, operating times and clinical results were reviewed in all cases. Results : The mean durations of follow-up were $16.42{\pm}5.99$ (Group A) and $19.83{\pm}6.71$ (Group B) months, range 12 to 35 months. Of these parameters mentioned above, cephalad POD (5.43 versus 3.46 mm, p=0.005) and cephalad POD/ABH (0.36 versus 0.23, p=0.004) were significantly greater in the Group A, whereas operation time for two segment arthrodesis (141.9 versus 170.6 minutes, p=0.047) was significantly lower in the Group A. There were no significant difference between the two groups in caudal POD (5.92 versus 5.06 mm), caudal POO/ABH (0.37 versus 0.32) and clinical results. Conclusion : The new anterior cervical plating method represents an improvement over the standard method in terms of cephalad plate-to-disc distance and operating time.

• Journal of Korean Neurosurgical Society
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• v.61 no.1
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• pp.66-74
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• 2018

Objective : The aim of this study was to identify the susceptibility genes responsible for lumbar spondylosis (LS) in Korean patients. Methods : Data from 1427 subjects were made available for radiographic grading and genome wide association studies (GWAS) analysis. Lateral lumbar spine radiographs were obtained and the various degrees of degenerative change were semi-quantitatively scored. A pilot GWAS was performed using the AffymetrixGenome-Wide Human single-nucleotide polymorphisms (SNPs), 500K array. A total of 352228 SNPs were analyzed and the association between the SNPs and case-control status was analyzed by stepwise logistic regression analyses. Results : The top 100 SNPs with a cutoff p-value of less than $3.7{\times}10^{-4}$ were selected for joint space narrowing, while a cutoff p-value of $6.0{\times}10^{-4}$ was applied to osteophytes and the Kellgren-Lawrence (K-L) osteoarthritis grade. The SNPs with the strongest effect on disc space narrowing, osteophytes, and K-L grade were serine incorporator 1 (rs155467, odds ratio [OR]=17.58, $p=1.6{\times}10^{-4}$), stromal interaction molecule 2 (STIM1, rs210781, OR=5.53, $p=5{\times}10^{-4}$), and transient receptor potential cation channel, subfamily C (rs11224760, OR=3.99, $p=4.8{\times}10^{-4}$), respectively. Leucine-rich repeat-containing G protein-coupled receptor 4 was significantly associated with both disc space narrowing and osteophytes (rs1979400, OR=2.01, $p=1.1{\times}10^{-4}$ for disc space narrowing, OR=1.79, $p=3{\times}10^{-4}$ for osteophytes), while zinc finger and BTB domain containing 7C was significantly and negatively associated with both osteophytes and a K-L grade >2 (rs12457004,OR=0.25, $p=5.8{\times}10^{-4}$ and OR=0.27, $p=5.3{\times}10^{-4}$, respectively). Conclusion : We identified SNPs that potentially contribute to the pathogenesis of LS. This is the first report of a GWAS in an Asian population.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.6
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• pp.412-420
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• 2013

The literature on alloplastic total temporomandibular joint (TMJ) replacement is encouraging, with acceptable improvement of treatment outcomes in terms of both pain level and jaw function. This is a case report on patients who suffered from degenerative joint disease and ankylosis after mandibular condyle fracture or prior TMJ surgery and were treated by TMJ replacement with condyle prosthesis. We obtained good results from the procedures, including total TMJ replacement.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.18 no.1
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• pp.1-10
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• 2012

Thoracic kyphosis is occasionally used to describe someone with accentuated thoracic curvature, hyperkyphosis is preferred since kyphosis itself refers to the normal sagittal angle of thoracic curvature. The angle of thoracic kyphosis tends to increase with age resulting in hyperkyphosis in some individuals. The persons who suffer from hyperkyphosis are at increased risk for a variety of adverse health outcomes that include musculoskeletal alteration, physical functional limitations, poor quality of life, falls, and even earlier mortality. Hyperkyphosis may develop from vertebral fractures, degenerative disc disease, either muscle weakness, decreased mobility and sensory deficits. The gold-standard orthopaedic technique for assessment of thoracic kyphosis is standing lateral spine radiographs. Other clinical measures are Debrunner kyphometer, inclinometer, flexicurve ruler, arcometer, flexible electrogoniometer and spinal mouse.

• The Journal of Korean Physical Therapy
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• v.6 no.1
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• pp.163-170
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• 1994

Low back pain is one of the moot common human diseases, striking $70\~80$ percent of the population. Many of the causes of low back pain are unknown. Yet, degenerative and mechanical changes are regarded by some as the most common cause of low back pain is physical therapy using various types of modalities and exercise. Therefore physical therapist must understand not only structure of intervertebral disk but also biomechanics of the lumbar intervertebral disk for prevent accourance of low back pain and treat patients with low back pain. The purpose of this article was to study biomechanices of the lumbar intervertebral disk and its intradiscal pressure in various position.