• Archives of Reconstructive Microsurgery
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• v.6 no.1
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• pp.103-110
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• 1997

Since R.Y. Song(1982) has reported anatomic studies about septocutaneous perforator flap, various experiences especially on thigh flaps pedicled on septocutaneous artery were reported. Baek(1983) reported an anatomic study through the cadavers dissections on medial, lateral thigh area and provided the first new cutaneous free flap of thigh for clinical use. Song, et a1.(1984) reported anterolateral thigh free flap, Koshima, et al.(1989) reported pedicle variations and its versatile clinical usages. According to their reports, accessory branches of lateral femoral circumflex artery are placed in comparatively constant location and proved to be the effective pedicle of this flap. The advantages of anterolateral thigh free flap are 1) comparatively thin 2) can obtain sufficiently large flap 3) can contain cutaneous nerve 4) can be easy to approach anatomically because pedicle is located in comparatively constant position 5) minimal donor site morbidity. We report the experience of 10 cases of anterolateral thigh free flap coverage for soft tissue defects: 4 cases of soft tissue defects on foot area, 2 cases of soft tissue defects on hand, 3 cases of partial tongue defects owing to tongue cancer ablation, and 1 case of soft tissue defect on nasal alar.

• The Journal of the Korean dental association
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• v.49 no.9
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• pp.527-534
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• 2011

Microvascular reconstruction of maxillary composite defect after oncologic resection has improved both esthetic and functional aspect of quality of life of the cancer patients. However, a lot of patients had prior surgery with radiation and/or chemotherapy as a part of comprehensive cancer treatment. Sometimes it is nearly impossible to find out adequate recipient vessel for maxillary reconstruction with microvascular anastomosis. Therefore long pedicle of the flap is needed to use distant neck vessels located far from the reconstruction site such as ipsilateral transverse cervical artery or a branch of contralateral external carotid artery. For this reason, although we know the treatment of the choice is osteocutaneous flap, it is difficult to use this flap when we need long pedicle with complex three dimensional osseous defect. Vascular option for these vessel-depleted neck patients can be managed by a soft tissue reconstruction with long vascular pedicle and additional free non-vascularized flap that is rigidly fixed to remaining skeletal structures. For this reason, maxillofacial reconstruction by vascularized soft tissue flap with or without the secondary restoration of maxillary bone with non-vascularized iliac bone can be regarded as one of options for reconstruction of profound maxillofacial composite defect resulted from previous oncological resection with chemo-radiotherapy.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.3
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• pp.174-177
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• 2013

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a disease characterized by jaw necrosis and delayed wound healing in patients who had received bisphosphonates. Buccal fat pad (BFP) can be used as a pedicled flap in the posterior region of the oral cavity. BFP pedicle flap needs simple surgical technique and it shows less donor site morbidity and aesthetic problem than other vascularized flap. BFP pedicled flap was fed by 3 arteries-facial, internal maxillary, and transverse facial artery. Osteomyelitis was generally related with poor blood supply. Thus, rich blood supply of BFP pedicle flap can have a potential advantage to BRONJ patients. In this case report, we presented 3 BRONJ patients treated by BFP pedicle flap after sequestrectomy.

• Journal of Chest Surgery
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• v.25 no.8
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• pp.819-825
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• 1992

The omental pedicle flap[OFF] has been used for management of complicated problems in various fields of cardiovascular surgery. Its unique properties of enhancing neovascularity, relieving lymphedema, providing fibroblasts to promote healing, providing soft tissue coverage, & functioning in the face of existing infection make it ideal in managing many of the more complicated problems facing the thoracic surgeon. We have used omental pedicle for colosing of the bronchial fistula R esophageal fistula with filling the adjoining cavity after pneumonectomy. The successful closure of the bronchial stump with OFF were obtained in 2 cases, but one case was failed who was suffered from the esophageal fistula. The primary operation in each cases were right pleuropneumonctomy for tuberculous empyema in 2 cases & left pneumonectomy for chronic empyema in 1 case, We believe that the OFF is effective for closing fistula due to postoperative empyema k plombage procedures for dead space of infected thoracic cavity.

• The Korean Journal of Pain
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• v.32 no.4
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• pp.280-285
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• 2019

Background: Pulsed radiofrequency (PRF) is a treatment modality that alleviates radicular pain by intermittently applying high-frequency currents adjacent to the dorsal root ganglion. There has been no comparative study on analgesic effect according to the position of the needle tip in PRF treatment. The objective of this study is to evaluate the clinical outcomes of PRF according to the needle tip position. Methods: Patients were classified into 2 groups (group IP [group inside of pedicle] and group OP [group outside of pedicle]) based on needle tip position in the anteroposterior view of fluoroscopy. In the anteroposterior view, the needle tip was advanced medially further than the lateral aspect of the corresponding pedicle in group IP; however, in group OP, the needle tip was not advanced. The treatment outcomes and pain scores were evaluated at 4, 8, and 12 weeks after applying PRF. Results: At 4, 8, and 12 weeks, there were no significant differences between the successful response rate and numerical rating scale score ratio. Conclusions: The analgesic efficacy of PRF treatment did not differ with the needle tip position.

• The Journal of Korea Robotics Society
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• v.17 no.1
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• pp.8-15
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• 2022

In this paper, we proposed the method of virtual reality-based surgical navigation to reproduce the pre-planned position and angle of the pedicle screw in spinal fusion surgery. The goal of the proposed method is to quantitatively save the surgical plan by applying a virtual guide coordinate system and reproduce it in the surgical process through virtual reality. In the surgical planning step, the insertion position and angle of the pedicle screw are planned and stored based on the virtual guide coordinate system. To implement the virtual reality-based surgical navigation, a vision tracking system is applied to set the patient coordinate system and paired point-based patient-to-image registration is performed. In the surgical navigation step, the surgical plan is reproduced by quantitatively visualizing the pre-planned insertion position and angle of the pedicle screw using a virtual guide coordinate system. We conducted phantom experiment to verify the error between the surgical plan and the surgical navigation, the experimental result showed that target registration error was average 1.47 ± 0.64 mm when using the proposed method. We believe that our method can be used to accurately reproduce a pre-established surgical plan in spinal fusion surgery.

• Journal of Veterinary Clinics
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• v.28 no.6
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• pp.566-570
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• 2011

The objective of this study was to assess the complications of titanium clip application after ovariohysterectomy (OHE) and find the proper surgical technique to minimize the complications by comparing the ligation method of ovarian pedicle. Six female beagle dogs were used for this study and they were divided randomly into two groups by ligation techniques: ligation and non-ligation of the suspensory ligament of ovary including ovarian pedicle. To evaluate the difference between two techniques, the location and embedded pattern of applied clips in the abdominal cavity were identified through radiographic tests and autopsy. Hematology tests were also performed to check the existence of inflammation by applied clips and all tests were carried out monthly for 1 year. There were few changes in location of clips of both groups on X-ray views without any migration. Almost all values in hematology of two groups were within the normal range and there were no inflammatory symptoms. All of applied clips in two groups were found near the kidney, but the embedded forms of them showed slight differences. The clips ligating suspensory ligament and ovarian pedicle were located in deep place and thickly surrounded with thin layers of peritoneum. But the clips ligating only ovarian pedicle were found with ease on surface of layer and located in lower place compared with the clips ligating suspensory ligament. These results indicate that the suspensory ligament holds applied clips and minimizes the movement of them. Therefore, ligation of suspensory ligament would be the preferred technique in titanium clip application for OHE.

• Journal of Animal Science and Technology
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• v.48 no.6
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• pp.943-948
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• 2006

This study carried out to investigate the effect of cutting stimulation on time of cutting, yield and length of antler in Sika deer. There was no significance between surgical stimulation and length of antler, but length was the longest in one side cutting group and the shortest in both side cutting group. Development of point was increased as the number of wounds in the second year (P<0.05). Time of casting was 2 weeks earlier in one side cutting group (P<0.05) than in both sides cutting group. Yields of velvet antler were 148±23g when pedicle was not cut, and 126±61g, 179±63g, 170g, and 48±25g when pedicle was cut by 0.3cm, 0.4cm, 0.5cm and 0.6cm thickness, respectively. In case of 0.6cm, yield was significantly smaller than others (P<0.05). The most desirable thickness of pedicle cut was 0.4～0.5mm. Yield of antler was increased as the size of wound in the first year, and 588, 790 and 657g in control, one-cut and both-cut, respectively. Yields of antler in one-cut is significantly high (P<0.05).

• Journal of Biomedical Engineering Research
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• v.36 no.6
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• pp.276-282
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• 2015

Recently, during the multi-level fusion with pedicle screws, interspinous spacer are sometimes substituted for the most superior level of the fusion in an attempt to reduce the number of fusion level and likelihood of degeneration process at the adjacent level. In this study, a finite element (FE) study was performed to assess biomechanical efficacies of the interspinous spacer combined with posterior lumbar fusion with a previously-validated 3-dimensional FE model of the intact lumbar spine (L1-S1). The post-operative models were made by modifying the intact model to simulate the implantation of interspinous spacer and pedicle screws at the L3-4 and L4-5. Four different configurations of the post-op model were considered: (1) a normal spinal model; (2) Type 1, one-level fusion using posterior pedicle screws at the L4-5; (3) Type 2, two-level (L3-5) fusion; (4) Type 3, Type 1 plus Coflex$^{TM}$ at the L3-4. hybrid protocol (intact: 10 Nm) with a compressive follower load of 400N were used to flex, extend, axially rotate and laterally bend the FE model. As compared to the intact model, Type 2 showed the greatest increase in Range of motion (ROM) at the adjacent level (L2-3), followed Type 3, and Type 1 depending on the loading type. At L3-4, ROM of Type 2 was reduced by 34~56% regardless of loading mode, as compared to decrease of 55% in Type 3 only in extension. In case of normal bone strength model (Type 3_Normal), PVMS at the process and the pedicle remained less than 20% of their yield strengths regardless of loading, except in extension (about 35%). However, for the osteoporotic model (Type 3_Osteoporotic), it reached up to 56% in extension indicating increased susceptibility to fracture. This study suggested that substitution of the superior level fusion with the interspinous spacer in multi-level fusion may be able to offer similar biomechanical outcome and stability while reducing likelihood of adjacent level degeneration.

• Journal of the Korean Orthopaedic Association
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• v.56 no.5
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• pp.419-426
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• 2021

Purpose: In the surgical treatment of pyogenic lumbar spondylodiscitis, screw insertion at the affected vertebra has been avoided because of biofilm formation, and the risk of infection recurrence. The authors analyzed the success rate of infection treatment while minimizing the number of instrumented segments by inserting pedicle screws into the affected vertebrae. Therefore, this study examined the usefulness of this technique. Materials and Methods: From January 2000 to June 2018, among patients with pyogenic lumbar spondylodiscitis treated surgically, group A consisted of patients with pedicle screws inserted directly at the affected vertebrae (28 cases), and group B underwent fusion by inserting screws at the adjacent normal vertebrae due to bone destruction of the affected vertebral pedicle (20 cases). The classified clinical results were analyzed retrospectively. All patients were treated via the posterior-only approach, so the affected disc and sequestrum were removed. Posterior interbody fusion was performed with an autogenous strut bone graft, and the segments were then stabilized with pedicle screw systems. The hospitalization period, operation time, amount of blood loss, EQ-5D index, duration of intravenous antibiotics, and the clinical and radiological results were analyzed. Results: In group A, the number of instrumented segments, operation time, blood loss, and EQ-5D index at one month postoperatively showed significant improvement compared to group B. There were no significant differences in the duration of antibiotic use, hospitalization, radiological bone union time, sagittal angle correction rate, and recurrence rate. Conclusion: Minimal segmental fixation, in which pedicle screws were inserted directly into the affected vertebrae through the posterior approach, reduced the surgery time and blood loss, preserved the lumbar motion by minimizing fixed segments and showed rapid recovery without spreading or recurrence of infection. Therefore, this procedure recommended for the surgical treatment of lumbar pyogenic spondyodiscitis.