• Title/Summary/Keyword: pedicle

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The Change of Biomechanical Milieu after Removal of mstnnnentation in lrunbar Arthrodesis Stiffness of fusion Mass: Finite Element Analysis (척추 유합술 후, 인접 분절의 스트레스에 대한 척추경 나사못에 대한 영향)

  • Kang, Kyoung-Tak;Chun, Heoung-Jae;Son, Ju-Hyun;Kim, Ho-Joong
    • Proceedings of the KSME Conference
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    • 2008.11a
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    • pp.664-667
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    • 2008
  • Since the advent of pedicle screw fixation system, posterior spinal fusion has markedly increased This intemal fixation system has been reported to enhance the fusion rates, thereby becoming very popular procedure in posterior spinal arthrodesis. Although some previous studies have shown the complications of spinal instruments removal, i.e. loss of correction and spinal collapse in scoliosis or long spine fusion patients, there has been no study describing the benefit or complications in lumbar spinal fusion surgery of one or two level. In order to clarify the effect of removal of instruments on mechanical motion profile, we simulated a finite element model of instrumented posterolateral fused lumbar spine model, and investigated the change of mechanical motion profiles after the removal of instrumentation.

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A Case of Pedunculated Localized Nodular Synovitis of the Knee: MR Imaging Findings (유경성 국소성 소결절성 활막염: 자기공명영상소견의 증례 보고)

  • Lee, Jae-Hwan;Lee, Jee-Young;Suh, Kyung-Jin
    • Investigative Magnetic Resonance Imaging
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    • v.11 no.1
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    • pp.54-57
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    • 2007
  • Localized nodular synovitis of the knee joint is a rare benign tumorous condition, and should be differentially diagnosed with pigmented villonodular synovitis. We report a case of localized nodular synovitis in the knee that was noted to have a pedicle and characteristic findings on MR image.

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"DUMBBELL" Neurilemmoma -1 case Report- (DUMBBELL 신경종양 -1례 보고-)

  • 박영환
    • Journal of Chest Surgery
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    • v.23 no.3
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    • pp.556-560
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    • 1990
  • A 22 year old soldier was discovered on routine study for discharge to have a mass in the posterior mediastinum He was admitted due to high fever and improved by antibiotic treatment for 2 weeks. Chest PA, apicogram, myelogram and CT scan demonstrated enlargement of the neural foramen at the T1 level with erosion of the posterior aspect of the vertebral body and the pedicle contiguous with the intrathoracic mass, A myelogram showed a large extradural defect at the T1 level on the left. There were no clinical signs of cord compression. A standard posterolateral thoracotomy incision was made with extension to high thoracic vertebra. The 3rd rib was resected and the angles of the posterior portion of 1st and 2nd ribs were cut and rib heads were removed. Extrapleural neurilemmoma 6x6 cm was resected intrathoracically. And after removal of the pedicle and the lamina, intraspinal extradural mass 3 X 2 cm was resected carefully with trivial tearing of the dura which was sealed with gel-foam and pleura. There was ma postoperative neurological complication.

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Primary thrombolysis for free flap surgery in head and neck reconstruction: a case report and review

  • Zhang, Steven Liben;Ng, Hui Wen
    • Archives of Plastic Surgery
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    • v.48 no.5
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    • pp.511-517
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    • 2021
  • The use of free flaps is an essential and reliable method of reconstruction in complex head and neck defects. Flap failure remains the most feared complication, the most common cause being pedicle thrombosis. Among other measures, thrombolysis is useful when manual thrombectomy has failed to restore flap perfusion, in the setting of late or established thrombosis, or in arterial thrombosis with distal clot propagation. We report a case of pedicle arterial thrombosis with distal clot propagation which occurred during reconstruction of a maxillectomy defect, and was successfully treated with thrombolysis using recombinant tissue plasminogen activator. We also review the literature regarding the use of thrombolysis in free flap surgery, and propose an algorithm for the salvage of free flaps in head and neck reconstruction.

Review of Photoacoustic Imaging for Imaging-Guided Spinal Surgery

  • Han, Seung Hee
    • Neurospine
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    • v.15 no.4
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    • pp.306-322
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    • 2018
  • This review introduces the current technique of photoacoustic imaging as it is applied in imaging-guided surgery (IGS), which provides the surgeon with image visualization and analysis capabilities during surgery. Numerous imaging techniques have been developed to help surgeons perform complex operations more safely and quickly. Although surgeons typically use these kinds of images to visualize targets hidden by bone and other tissues, it is nonetheless more difficult to perform surgery with static reference images (e.g., computed tomography scans and magnetic resonance images) of internal structures. Photoacoustic imaging could enable real-time visualization of regions of interest during surgery. Several researchers have shown that photoacoustic imaging has potential for the noninvasive diagnosis of various types of tissues, including bone. Previous studies of the surgical application of photoacoustic imaging have focused on cancer surgery, but photoacoustic imaging has also recently attracted interest for spinal surgery, because it could be useful for avoiding pedicle breaches and for choosing an appropriate starting point before drilling or pedicle probe insertion. This review describes the current instruments and clinical applications of photoacoustic imaging. Its primary objective is to provide a comprehensive overview of photoacoustic IGS in spinal surgery.

Thorax masculinization in a transsexual patient: Inferior pedicle mastectomy without an inverted T scar

  • Cely, Adriana Marcela Gonzalez;Triana, Carlos Enrique;Triana, Lina Maria
    • Archives of Plastic Surgery
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    • v.46 no.3
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    • pp.262-266
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    • 2019
  • Transsexual individuals with gender dysphoria or gender identity disorder are rare, with a prevalence reported to range from 0.002% to 0.014%. Studies have shown that mastectomy yields significant improvements in body image and self-esteem in female-to-male transsexual patients. In patients with grade III breast ptosis, mastectomy with a nipple-areolar complex (NAC) graft is the most commonly used technique, although it has several disadvantages. In the case described herein, a bilateral mastectomy preserving the NAC in an inferior pedicle was performed. Additionally, a thin superior thoracic dermal-fat flap was preserved and eventually sutured at the previous inframammary fold, preventing an inverted T scar. This case shows the advantage of this technique for preserving the blood supply and innervation of the NAC, with a low hypopigmentation risk. Furthermore, in this technique, the patch effect does not impair the results of the NAC graft, and there is no need to use an inverted T scar that may result in thoracic feminization.

Socket sealing using pedicle subepithelial connective tissue graft with tunneling in maxillary esthetic zone: Case reports

  • Bae, Ju-Eun;Kim, Yong-Gun;Park, Jin-Woo;Lee, Jae-Mok;Suh, Jo-Young
    • Oral Biology Research
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    • v.42 no.4
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    • pp.254-261
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    • 2018
  • Reports have it that horizontal and vertical loss of the ridge happens during 6 months after tooth extraction. So valuable ridge preservation techniques are often necessary in the maxillary anterior areas. Maintaining and/or increasing blood supply and stability is essential to graft survival. The objective of this study was to determine the effect on extraction socket seal of pedicle subepithelial connective tissue graft with tunneling on maxillary esthetic zone through healing state for 8 weeks.

Fibular flap for mandible reconstruction in osteoradionecrosis of the jaw: selection criteria of fibula flap

  • Kim, Ji-Wan;Hwang, Jong-Hyun;Ahn, Kang-Min
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.38
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    • pp.46.1-46.7
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    • 2016
  • Background: Osteoradionecrosis is the most dreadful complication after head and neck irradiation. Orocutaneous fistula makes patients difficult to eat food. Fibular free flap is the choice of the flap for mandibular reconstruction. Osteocutaneous flap can reconstruct both hard and soft tissues simultaneously. This study was to investigate the success rate and results of the free fibular flap for osteoradionecrosis of the mandible and which side of the flap should be harvested for better reconstruction. Methods: A total of eight consecutive patients who underwent fibula reconstruction due to jaw necrosis from March 2008 to December 2015 were included in this study. Patients were classified according to stages, primary sites, radiation dose, survival, and quality of life. Results: Five male and three female patients underwent operation. The mean age of the patients was 60.1 years old. Two male patients died of recurred disease of oral squamous cell carcinoma. The mean dose of radiation was 70.5 Gy. All fibular free flaps were survived. Five patients could eat normal diet after operation; however, three patients could eat only soft diet due to loss of teeth. Five patients reported no change of speech after operation, two reported worse speech ability, and one patient reported improved speech after operation. The ipsilateral side of the fibular flap was used when intraoral soft tissue defect with proximal side of the vascular pedicle is required. The contralateral side of the fibular flap was used when extraoral skin defect with proximal side of the vascular pedicle is required. Conclusions: Osteonecrosis of the jaw is hard to treat because of poor healing process and lack of vascularity. Free fibular flap is the choice of the surgery for jaw bone reconstruction and soft tissue fistula repair. The design and selection of the right or left fibular is dependent on the available vascular pedicle and soft tissue defect sites.