• 제목/요약/키워드: segmental joint

검색결과 94건 처리시간 0.042초

Comparison between Anterior Cervical Decompression with Fusion and Posterior Cervical Fusion with Wide Facetectomy for Treatment of Severe Bony Foraminal Stenosis

  • Lee, Subum;Cho, Dae-Chul;Chon, Haemin;Roh, Sung Woo;Choi, Il;Park, Jin Hoon
    • Journal of Korean Neurosurgical Society
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    • 제64권4호
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    • pp.552-561
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    • 2021
  • Objective : To compare the anterior cervical discectomy and fusion (ACDF) and posterior cervical fusion (PCF) with wide facetectomy in the treatment of parallel-shaped bony foraminal stenosis (FS). Methods : Thirty-six patients underwent surgery due to one-or-two levels of parallel-shaped cervical FS. ACDF was performed in 16 patients, and PCF using CPS was performed in 20 patients. All patients were followed up at 1, 3, 6, and 12 months postoperatively. Standardized outcome measures such as Numeric rating scale (NRS) score for arm/neck pain and Neck disability index (NDI) were evaluated. Cervical radiographs were used to compare the C2-7 Cobb's angle, segmental angle, and fusion rates. Results : There was an improvement in NRS scores after both approaches for radicular arm pain (mean change -6.78 vs. -8.14, p=0.012), neck pain (mean change -1.67 vs. -4.36, p=0.038), and NDI score (-19.69 vs. -18.15, p=0.794). The segmental angle improvement was greater in the ACDF group than in the posterior group (9.4°±2.7° vs. 3.3°±5.1°, p=0.004). However, there was no significant difference in C2-7 Cobb angle between groups (16.2°±7.9° vs. 14.8°±8.5°, p=0.142). As a complication, dysphagia was observed in one case of the ACDF group. Conclusion : In the treatment of parallel-shaped bony FS up to two surgical levels, segmental angle improvement was more favorable in patients who underwent ACDF. However, PCF with wide facetectomy using CPS should be considered as an alternative treatment option in cases where the anterior approach is burdensome.

당뇨환자에서 하치조신경 전달마취와 턱관절 탈구후 유발된 안면신경 마비 치험 1예 -증례보고- (The Care of Facial Palsy after Inferior Alveolar Nerve Block Anesthesia and Temporomandibular Joint Dislocation in Diabetic Mellitus Patient -A Case Report-)

  • 이천의;유재하;최병호;김종배
    • 대한치과마취과학회지
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    • 제11권1호
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    • pp.45-50
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    • 2011
  • Bell's palsy is an isolated facial paralysis of sudden onset caused by a neuritis of the seventh nerve within the facial canal. It occurs often in the adult man with a history of recent exposure to local cold, such as sleeping next to an open window, or in some cases it occurs after infections of the nasopharynx or masticator spaces. Especially, this neuropathy have linked with the major collagen disorders (diabetes mellitus). A segmental demyelination develops rapidly, with vascultitis in microinfarcts and ischemia to the nerve segment. The authors experienced about the bizarre neurological symptom of Bell's palsy after inferior alveolar nerve block anesthesia and TMJ dislocation in diabetic mellitus. The early and correct consultation with the multiple medical and dental departments was important to prevent the inadequate care & medicolegal problems.

습식접합부를 갖는 프리캐스트 세그먼트 PSC-I형 거더의 2차원 비선형해석 (Two-Demensional Nonlinear Analysis of Precast Segmental PSC-I Girder with Wet Joint)

  • 김광수;홍성남;한경남;박선규
    • 한국구조물진단유지관리공학회 논문집
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    • 제11권6호
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    • pp.103-112
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    • 2007
  • 본 연구의 목적은 건설현장에서 노무비와 공사비를 절감하기 위하여 5개의 프리캐스트 세그먼트로 구성된 프리스트레스트 콘크리트 거더를 제작하여 그 역학적인 거동 특성을 평가하는데 있다. 본 연구를 위하여 총 4개의 25m 실험체를 동일 단면으로 제작하였으며, 모멘트-처짐 곡선으로 텐던변화와 접합부에 대한 분석과 해석을 수행하였다. 또한, 실험결과를 검증하기 위하여 2차원 비선형유한요소해석을 수행하였으며, 해석결과는 실험체의 모멘트-처짐곡선을 비교적 잘 예측하였다.

Research on the cable-driven endoscopic manipulator for fusion reactors

  • Guodong Qin;Yong Cheng;Aihong Ji;Hongtao Pan;Yang Yang;Zhixin Yao;Yuntao Song
    • Nuclear Engineering and Technology
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    • 제56권2호
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    • pp.498-505
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    • 2024
  • In this paper, a cable-driven endoscopic manipulator (CEM) is designed for the Chinese latest compact fusion reactor. The whole CEM arm is more than 3000 mm long and includes end vision tools, an endoscopic manipulator/control system, a feeding system, a drag chain system, support systems, a neutron shield door, etc. It can cover a range of ±45° of the vacuum chamber by working in a wrap-around mode, etc., to meet the need for observation at any position and angle. By placing all drive motors in the end drive box via a cable drive, cooling, and radiation protection of the entire robot can be facilitated. To address the CEM motion control problem, a discrete trajectory tracking method is proposed. By restricting each joint of the CEM to the target curve through segmental fitting, the trajectory tracking control is completed. To avoid the joint rotation angle overrun, a joint limit rotation angle optimization method is proposed based on the equivalent rod length principle. Finally, the CEM simulation system is established. The rationality of the structure design and the effectiveness of the motion control algorithm are verified by the simulation.

요통 환자의 척추골 SPECT에서 골전이 병변과 양성골질환의 섭취 양상 분석을 통한 감별진단이 가능한가 (Differential Diagnosis of Metastatic Bone Disease and Benign Bone Disease on Spine SPECT in Patients with Low Back Pain)

  • 이승훈;최윤영;조석신
    • 대한핵의학회지
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    • 제35권6호
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    • pp.371-377
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    • 2001
  • 목적: 요통을 호소하는 암환자에서 골스캔을 시행하여 척추골의 섭취증가를 보이는 경우, 골전이와 양성 골질환의 구분이 모호한 경우가 많다. 이에 척추골 SPECT를 추가로 시행하는 것이 악성과 양성 골질환을 감별하는데 도움이 되는지 알아보고자 섭취양상을 분석하였다. 대상 및 방법: 3년간 척추골 SPECT를 시행한 108명의 환자중 SPECT에서 이상 섭취 병변을 보이고 임상적으로 추적이 가능하였던 45명의 환자의 67개의 병변의 척추골 SPECT소견을 다음과 같이 구분하고 임상소견 및 방사선학적 소견과 비교하였다. 1. 척추체: A. 전반적인 섭취증가, B. 추간판에 연한 선상의 섭취증가, C. 냉소의 동반, D. 분절상 섭취증가, 2. 척추후면체 A. 척추체 후면(lamina, pedicle 등), B. 추간판후면(후관절 등), C 극돌기 결과: 골전이 병변(18)은 척추체의 냉소동반(6), 분절상 섭취증가(5)가 특징적이었으며, 퇴행성변화(28)는 추체연의 선상 섭취증가(12), 추간판후면의 후면체 섭취증가(15), 압박골절(21)은 전반적인 척추체 섭취증가(9) 및 추체연의 섭취증가(9), 냉소동반(1), 분절상 섭취증가(1)와 극돌기의 섭취증가(3)을 보였다. 결론: 척추골 SPECT의 섭취증가 양상은 냉소동반, 분절상 섭취증가를 보이는 경우에 골전이 병변의 가능성이 크지만 압박골절에서도 같은 소견을 보일 수 있으므로 주의하여야 할 것이며, 퇴행성 질환은 특징적인 소견을 보이므로 감별이 가능하였다. 그러므로 골스캔 후 척추골 섭취 이상이 있는 암환자에서 추가 SPECT검사가 도움이 될 것으로 생각된다.

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슬관절 보존형 광범위 절제를 시행한 골육종 환자에서 발생한 국소 재발 - 증례보고 - (Local Recurrence of Osteosarcoma After Joint Sparing Wide Resection -A Case Report-)

  • 조상현;송원석;원호현;전대근
    • 대한골관절종양학회지
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    • 제14권1호
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    • pp.51-55
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    • 2008
  • 골육종의 치료율이 높아짐에 따라 장기 추시 결과와 기능적인 결과에 대한 관심이 환자나 의료진 모두에게 중요한 문제가 되어가고 있다. 슬관절 주위의 악성 종양을 절제 후 재건 시 종양인공관절 치환술에 비해 정상적인 슬관절 구조물을 보존하는 사지구제 술식이 가능하다면 좋은 방법으로 생각된다. 그러나 장기적으로 바람직한 기능적 결과를 얻기 위해 절제연을 희생하면 안 될 것으로 생각된다. 저자들은 원위 대퇴골 간부 골육종 환자에서 광범위 이상의 절제연 확보가 가능하다고 판단되어 분절 절제 후 저온 열처리한 자가골을 이용하여 재건하였으나 술 후 44개월만에 국소재발 한 례를 경험하여 문헌 고찰과 함께 보고하는 바이다.

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A Position based Kinematic Method for the Analysis of Human Gait

  • Choi Ahn Ryul;Rim Yong Hoon;Kim Youn Soo;Mun Joung Hwan
    • Journal of Mechanical Science and Technology
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    • 제19권10호
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    • pp.1919-1931
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    • 2005
  • Human joint motion can be kinematically described in three planes, typically the frontal, sagittal, and transverse, and related to experimentally measured data. The selection of reference systems is a prerequisite for accurate kinematic analysis and resulting development of the equations of motion. Moreover, the development of analysis techniques for the minimization of errors, due to skin movement or body deformation, during experiments involving human locomotion is a critically important step, without which accurate results in this type of experiment are an impossibility. The traditional kinematic analysis method is the Angular-based method (ABM), which utilizes the Euler angle or the Bryant angle. However, this analysis method tends to increase cumulative errors due to skin movement. Therefore, the objective of this study was to propose a new kinematic analysis method, Position-based method (PBM), which directly applies position displacement data to represent locomotion. The PBM presented here was designed to minimize cumulative errors via considerations of angle changes and translational motion between markers occurring due to skin movements. In order to verify the efficacy and accuracy of the developed PBM, the mean value of joint dislocation at the knee during one gait cycle and the pattern of three dimensional translation motion of the tibiofemoral joint at the knee, in both flexion and extension, were accessed via ABM and via new method, PBM, with a Local Reference system (LRS) and Segmental Reference system (SRS), and then the data were compared between the two techniques. Our results indicate that the proposed PBM resulted in improved accuracy in terms of motion analysis, as compared to ABM, with the LRS and SRS.

Mandibular condyle and infratemporal fossa reconstruction using vascularized costochondral and calvarial bone grafts

  • Jang, Hyo Won;Kim, Nam-Kyoo;Lee, Won-Sang;Kim, Hyung Jun;Cha, In-Ho;Nam, Woong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제40권2호
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    • pp.83-86
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    • 2014
  • There are some difficulties in approaching and removing the lesion in infratemporal fossa because of its anatomical location. After wide excision of tumor lesion, it is also difficult for reconstruction of mandibular condyle and cranium base on infratemporal fossa. Besides, there are some possibilities of cerebrospinal fluid leakage, intracranial infection and bone resorption. It is also challenging for functional reconstruction that allows normal mandibular movement, preventing mandibular condyle from invaginating into the skull. In this report, we present 14-month follow-up results of a patient who had undergone posterior segmental mandibulectomy including condyle and infratemporal calvarial bone and mandible reconstruction with free vascularized costochondral rib and calvarial bone graft to restoration of the temporomandibular joint area.

평지를 걸어갈 때 하지운동과 작용하는 하중에 대한 생체역학적 해석 (A Biomechanical Analysis of Lower Extremity Kinematics and Kinetics During Level Walking)

  • 손권;최기영;정민근
    • 대한기계학회논문집
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    • 제18권8호
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    • pp.2101-2112
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    • 1994
  • A two-dimensional biomechanical model was developed in order to calculated the lower extremity kinematics and kinetics during level walking. This model consists of three segments : the thigh, calf, and foot. Each segment was assumed to be a rigid body ; its motion to be planar in the sagittal plane. Five young males were involved in the gait experiment and their anthropometric data were measured for the calculation of segmental masses and moments of inertial. Six markers were used to obtain the kinematic data of the right lower extremity for at least three trials of walking at 1.0m/s, and simultaneously a Kistler force plate was used to obtain the foot-floor reaction data. Based on the experimental data acquired for the stance phase of the right foot, calculated vertical joint forces reached up to 0.91, 1.05, and 1.11 BW(body weight) at the hip, the knee, the ankle joints, respectively. The flexion-extension moments reached up to 69.7, 52.3, and 98.8 Nm in magnitude at the corresponding three joints. It was found that the calculated joint loadings of a subject were statistically the same for all his three trials, but not the same for all five subjects involved in the gait study.

혈관부착 비골이식술을 이용한 거골 무혈성 괴사의 치료 (Treatment of Avascular Necrosis of the Talus with Vascularized Fibular Graft)

  • 정덕환;고덕환
    • Archives of Reconstructive Microsurgery
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    • 제9권1호
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    • pp.49-55
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    • 2000
  • Nonunion and avascular necrosis are well-recognized complications of severe ankle injury especially aftrer talar neck fracture. The treatment of avascular necrosis is controversial and methods of treatment are limited. Many modalities have been introduced for the treatment of avascular necrosis of talus. The prolonged non-weight bearing for 2~3 years is not practical but also is occasionally complicated by late segmental collapse. Operative treatment includes tibiotalar arthrodesis and talectomy with tibiocalcaneal arthrodesis, but arthrodesis in patients with talar avascular necrosis is technically demanding and cause stiff, immobile foot and relatively high failure rate was reported. It is desirable to preserve their original joint if possible. Vascularized fibular grafting has been reported as a joint preserving treatment option for osteonecrosis of the hip but has not been described for the ankle. The authors applied free vascularized fibular grafts for 3 cases of avascular necrosis of talus. We observed evidences of revascularization of necrotic talar body and progression of fracture healing and obtained satisfactory results at mean 8 months of follow-up. Vascularized fibular grafting is one of the better alternatives for treating avascular necrosis of talus. It is expected that vascularized fibular grafting can prevent the necrotic talar dome from progressing to collapse and promote directly restored vascularization and new bone formation.

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