• Journal of Korean Neurosurgical Society
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• 제46권4호
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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.

• Pediatric Infection and Vaccine
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• 제24권1호
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• pp.54-59
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• 2017

목적: 생후 3개월 이하 어린 영아에서 심각한 세균 감염 가운데 요로 감염이 가장 흔하다. 요추 천자는 발열의 평가 시 기본 검사에 포함되어 시행되는 경우가 많지만, 요로 감염 환자에서 수막염을 진단하기 위해 통상적으로 시행해야 하는 뚜렷한 지침은 없다. 이에 저자들은 어린 영아의 요로 감염에서 동반되는 세균성 수막염 및 무균성 뇌척수액 백혈구증가증의 유병률을 알아보기 위해 연구를 시행하였다. 방법: 2013년 1월부터 2016년 5월 사이 대구가톨릭병원 소아청소년과에서 요로 감염으로 입원하여 요추 천자를 시행한 생후 29일부터 99일 미만 영아 80명의 의무기록을 후향적으로 조사하였다. 분석 변수로는 대상 환자들의 인구학적 특징, 임상 증상, 검사 결과 및 치료를 조사하였고, 뇌척수액 백혈구 증가증을 보이는 군과 그렇지 않은 군을 비교하였다. 결과: 총 80명의 환자 가운데 34명(43%)에서 뇌척수액 백혈구증가증이 관찰되었다. 뇌척수액에서 세균이 배양된 경우는 없었다. 뇌척수액 장바이러스 중합효소연쇄반응은 56명(70%)에서 시행하였고, 뇌척수액 백혈구증가증이 나타나지 않은 환자들 중 2명에서 양성이었다. 뇌척수액 백혈구증가증을 보이는 군과 그렇지 않는 군 간에 인구학적 특징, 검사실 소견, 영상검사, 치료 및 경과에 있어 양 군 간에 유의한 차이가 없었다. 결론: 신생아기 이후 어린 영아의 요로 감염에서 동반되는 뇌척수액 백혈구증가증은 흔하지만, 이의 원인으로 세균이나 바이러스 감염에 의한 가능성은 아주 낮다. 전신 상태나 검사실 소견을 종합하여 요추 천자의 적응증을 개별적으로 평가하여 적용하는 것이 필요하다.

• 한국식품영양과학회지
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• 제30권1호
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• pp.159-167
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• 2001

The objective of this study is to examine the factors affecting bone mineral density in pre- and postmenopausal women. The subject were 30 Korean premenopausal women with mean ages of 33.6 years, and 30 Korean post menopausal women with mean ages of 63.3 years without diagnosed diseases. Data for food and nutrient intake were obtained by the24-hour recall method. BMD of lumbar spine and femoral neck were measured by the dual-energy X-ray absorptiometry (DEXA). Anthropometric measurement were made, and a blood sample was taken for assay osteocalcin. The results are summarized as follows: 16.67% of the subjects in the premenopausal women and 87.33% of the subjects in the postmenopausal women was less than the korean RDA level exceping phosphorus and vitamin C. In the premenopausal women, BMD of lumbar spine is correlated significantly with anthropometric measurement such as weight, waist circumference, BMI, and body fat mass BMD of femoral neck for the premenopausal women is correlated significantly with weight, BMI, waist circumference, body fat mass, hip circumference, and BMDs of both site are negatively correlated with lean body mass, total body water, but they are not related with intake of nutrients in this study. In the postmenopausal women group, BMDs of both site are not significantly correlated with anthropometric measurement, but BMD of lumbar spine showed positive relation with intake of energy, protein, and carbohydrate. In conclusion, adequate nutrient intake, especially energy, protein have been suggested to prevent the loss of bone mineral density in the postmenopausal women. Also, adequate body weight and BMI have been suggested in the premenopausal women.

• Journal of Korean Neurosurgical Society
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• 제51권1호
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• pp.8-13
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• 2012

Objective : This is prospective study of clinical outcomes of percutaneous plasma disc coagulation Therapy (PDCT) in patients with herniated lumbar disc disease (HLD) to evaluate the safety and efficacy in its clinical application and usefulness as a reliable alternative to microscopic discectomy. Methods : Forty-six patients were enrolled in this study from April 2006 to June 2010. All patients had one-level HLD. Disc degeneration was graded on routine T2-weighted magnetic resonance Image (MRI) using the Pfirrmann's grading system and all index levels were grade 3 and grade 4. Indications for surgery were radiculopathy caused by disc protrusion with soft consistency. MRI was done at one month after the procedure in all patients to check post-PDCT change. The clinical outcomes were evaluated using Visual Analog Scales (VAS) score and MacNab's criteria. Results : This study was approved by the Institutional Review Board of our institution. The age of the study population ranged from 16 to 59 years with a mean age of 37.2 years. There were 29 males and 17 females in this study. The mean period of clinical follow-up was 21 months. The average preoperative VAS score for radiculopathy was $7.4{\pm}1.4$, while the final follow-up VAS score was $1.4{\pm}0.7$ (p<0.001). In MacNab's criteria, 41 patients (89.1%) had achieved favorable improvement (excellent and good) until later follow-up. There were one patient from infection and two patients who needed to convert to open discectomy. Conclusion : PDCT is a safe and efficient treatment modality in a selective patient with HLD.

• Journal of Korean Neurosurgical Society
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• 제54권5호
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• pp.384-389
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• 2013

Objective : Use of quantitative computed tomography (CT) to evaluate bone mineral density was suggested in the 1970s. Despite its reliability and accuracy, technical shortcomings restricted its usage, and dual-energy X-ray absorptiometry (DXA) became the gold standard evaluation method. Advances in CT technology have reduced its previous limitations, and CT evaluation of bone quality may now be applicable in clinical practice. The aim of this study was to determine if the Hounsfield unit (HU) values obtained from CT correlate with patient age and bone mineral density. Methods : A total of 128 female patients who underwent lumbar CT for back pain were enrolled in the study. Their mean age was 66.4 years. Among them, 70 patients also underwent DXA. The patients were stratified by decade of life, forming five age groups. Lumbar vertebrae L1-4 were analyzed. The HU value of each vertebra was determined by averaging three measurements of the vertebra's trabecular portion, as shown in consecutive axial CT images. The HU values were compared between age groups, and correlations of HU value with bone mineral density and T-scores were determined. Results : The HU values consistently decreased with increasing age with significant differences between age groups (p<0.001). There were significant positive correlations (p<0.001) of HU value with bone mineral density and T-score. Conclusion : The trabecular area HU value consistently decreases with age. Based on the strong positive correlation between HU value and bone mineral density, CT-based HU values might be useful in detecting bone mineral diseases, such as osteoporosis.

• Journal of Korean Neurosurgical Society
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• 제63권6호
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• pp.730-737
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• 2020

Objective : Spinal degeneration is a progressive disease, worsening over time. Lumbar degenerative disease (LDD) is a major spinal disease in elderly patients. Surgical treatment is considered for medically intractable patients with LDD and reoperation after primary surgery is not uncommon. The surgical outcome is occasionally unpredictable because of comorbidities. In the present study, the relationship between comorbidities and the incidence of reoperation for LDD over time was determined. Methods : The claims data of the health insurance national database were used to identify a cohort of patients who underwent spinal surgery for LDD in 2009. The patients were followed up until 2016. Medical comorbidity was assessed according to the Charlson comorbidity index (CCI). Cox proportional hazard regression modeling was used to identify significant differences in sex, surgery, age, causative disease, and comorbidity. Results : The study cohort included 78241 patients; 10328 patients (13.2%) underwent reoperation during the observation period. The reoperation rate was statistically higher (p<0.01) in males, patients 55-74 years and 65-74 years of age, and patients with decompression or discectomy. Significant association was found between increasing reoperation rate and CCI score (p<0.01). Based on multivariate analysis of comorbidities, the significantly higher reoperation rates were observed in patients with peripheral vascular disease, pulmonary lung disease, peptic ulcer, diabetes, and diabetes complications (p<0.01). Conclusion : The study results indicate the reoperation rate for LDD is associated with patient comorbidities. The comorbidities identified in this study could be helpful in future LDD studies.

• 한국방사선학회논문지
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• 제15권7호
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• pp.1015-1020
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• 2021

본 연구는 2020년 1월부터 2021년 6월까지 부산지역 일개 의료기관을 방문하여 골다공증 검사를 시행한 환자 중 특별한 질환이 없는 건강한 폐경 후 여성 113명의 검사 결과지를 후향적으로 분석하였다. 연구 목적은 폐경 여성의 BMI(신체질량지수)가 골밀도에 미치는 영향을 알아보고자 하였으며 저체중(BMI<18.5) 환자의 요추부와 대퇴부의 분석결과 유의확률(p-value) 0.000으로 나타났으며 정상체중(18.5≦BMI<23.0) 환자의 요추부에서 유의확률(p-value)은 0.025, 대퇴부의 유의확률(p-value)은 0.012로 나타났다. 과체중(23.0≦BMI<25.0) 환자의 요추부의 유의확률(p-value)은 0.021, 대퇴부의 유의확률(p-value)은 0.034로 나타나 상관 관계가 확인되었다. 그러나 고도비만(30.0≦BMI<40.0) 환자의 요추부 유의확률(p-value)은 0.127, 대퇴부의 유의확률(p-value)은 0.093으로 요추부와 대퇴부 모두에서 유의확률 p>0.05로 나타나 BMI와 골밀도의 상관 관계가 없음을 알 수 있다.

• PNF and Movement
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• 제17권1호
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• pp.41-46
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• 2019

Purpose: Continuous use of a smartphone increases the angle of forward bending of the user's cervical vertebrae, causing pain in the shoulders and back, including the thorax, lumbar region, and vertebrae. Although there are many studies on changes in the cervical spine due to smartphone usage, the changes in the shoulders, thoracolumbar spine, and pelvic have rarely been compared. The purpose of this study is to investigate the change in the spinal segments, shoulders, and pelvic when using a smartphone with both hands while in the standing position. Methods: This study was conducted on 35 adults in their twenties. The selection criteria for the subjects were limited to those in a similar age group, thus excluding posture differences according to age, and to those who did not have specific diseases or pain in the spinal and musculoskeletal system for 12 months prior to the study. In this study, we used a 3D spinal diagnostic imaging system (Back Mapper, Frickenhausen) to compare the changing conditions in each vertebral segment before and during smartphone usage with both hands while in the standing position. Posture differences according to smartphone usage were compared using the paired t-test for the motion of each spinal segment. Results: This study showed that the thoracic and lumbar angle increased posteriorly during smartphone usage (p<0.05). In addition, the anterior rotation angle of the shoulder bone significantly increased, but no significant difference occurred in the pelvic region. Conclusion: Based on the results of this study, smartphone usage with both hands while in the standing position showed that the spine, as a whole, forms a kyphotic curve. Therefore, we propose to present a postural guideline for correct smartphone usage, considering the change in each vertebral segment.

• 대한정형외과학회지
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• 제55권3호
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• pp.210-221
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• 2020

척추 신경 차단술은 다양한 발전을 거듭하면서 상당부분 수술적 치료의 필요성을 줄일 수 있는 대체 보존적 치료의 한 방법으로 자리매김하고 있다. 이러한 척추 신경 차단술은 통증 완화라는 치료적 측면뿐 아니라, 많은 환자에서 척추 이외의 다른 증상들과 감별을 위한 진단적 목적으로도 유용하게 사용되고 있어 사지 및 척추를 다루는 정형외과의사로서 가장 기본이 되는 술기라 할 수 있다. 하지만 사용하는 기구나 약물이 단순함에도 불구하고 이에 대한 전반적인 이해 및 발생 가능한 부작용 및 합병증에 대한 지식이 없다면 시행 초기에 오히려 환자에게 심각한 해를 끼칠 수 있게 된다. 따라서 척추 신경 차단술에 사용하는 약제들의 종류, 약동학적 특성과 각각 약제의 부작용에 대한 이해가 선행되어야 하며, 요추 전반에 걸친 각 시술의 적응증과 장단점을 파악하고 발생 가능한 합병증을 피하기 위해 노력을 기울여야 한다. 본 종설은 요추 신경 차단술에 필요한 기본적인 지식 및 술기를 접하여 독자 스스로 시행할 수 있게 함을 목적으로 한다.

• 대한의료기공학회지
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• 제21권1호
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• pp.1-12
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• 2022

Objective : The purpose of this study is to report the results of treating patients with acute low back pain syndrome who are difficult to walk with Whidam's Vibrator Pelvic Sugi Therapy. Methods : We used combinations of korean medicine such as herbal medicine, acupuncture, cupping therapy, and thermal therapy. At the same time, the patient was treated with Whidam's Vibrator Pelvic Sugi Therapy. The first period of hospitalization was 14 days and the second period was 54 days. At the second hospitalization, back pain recurred and was unable to walk. At the first hospitalization, L5-S1 HIVD and L4-5 Mild HIVD were diagnosed on lumbar MRI, and there was no abnormality in blood tests. Results : By relieving muscle tension and restoring the weakened muscle elasticity with herbal treatment and Whidam's Vibrator Pelvic Sugi Therapy, back pain decreased and the inability to walk gradually improved, making it possible to walk on its own. Conclusions : The results of standing and walking on one's own were obtained by relieving muscle tension and restoring weakened muscle elasticity in acute back pain syndrome with gait disturbance diagnosed with lumbar herniated intervertebral disc through korean medicine treatment and Whidam's Vibrator Pelvic Sugi Therapy. Whidam's Vibrator Pelvic Sugi Therapy is thought to help acute back pain by restoring muscle elasticity and strengthening muscle strength. In the future, it is expected that additional clinical studies will be conducted on various pain diseases with Whidam's Vibrator Pelvic Sugi Therapy.