• The Korean Journal of Pain
• /
• 제18권2호
• /
• pp.142-145
• /
• 2005

Background: Vertebroplasty that is performed in the upper and middle thoracic spine presents technical challenges that are different from those in the lower thoracic or lumbar region due to the small pedicle size and angular severity for thoracic kyphosis. We report the results of percutaneous vertebroplasty and review its effectiveness in treating intractable osteoporotic compression fractures in the upper and middle thoracic spine. Methods: Patients who underwent vertebroplasty due to painful osteoporotic compression fractures at T3 T8 were retrospectively analyzed. The compression rate, volume of injected cement, clinical outcome (VAS score) and complications were analyzed. Results: Forty-three vertebral bodies from 41 patients (32 females and 9 males, age from 64 to 78 years old) underwent vertebroplasty. The mean compression rate improved from 35% to 17%. Bipedicular injections of bone cement were performed at 3 levels of 2 patients, and unipedicular injections were performed in 40 levels of 39 patients. The mean VAS score prior to surgery was 7.7, which improved to 2.4 within 48 hours after surgery, and the mean VAS score after 6 months was 1.5, which was significantly lower. All patients recovered uneventfully, and the neurological examination revealed no deficits. Cement leakage to the adjacent disc (9 levels) and paravertebral soft tissues (10 levels) developed. However, there were no significant complications related to the procedure such as a pneumothorax or pulmonary embolism. Conclusions: Transpedicular vertebroplasty is a safe and effective treatment for the upper and middle thoracic regions, and has a low complication rate.

• Journal of Korean Neurosurgical Society
• /
• 제42권5호
• /
• pp.363-366
• /
• 2007

Objective : Kyphoplasty performed in the middle thoracic spine presents technical challenges that differ from those in the lower thoracic or lumbar region due to small pedicle size and angular severity for thoracic kyphosis. The purpose of this study was to evaluate the efficacy of balloon kyphoplasty through extrapedicular approach for the treatment of intractable osteoporotic compression fractures in the middle thoracic spine. Methods : The patients who were performed with one level balloon kyphoplasty through extrapedicular approach due to painful osteoporotic compression fractures at T5-T8 from June 2003 to July 2005 were retrospectively analyzed. Imaging and clinical features were analyzed including involved vertebrae level, vertebral height, Injected cement volume, clinical outcome and complications. Results : Eighteen female patients (age ranged from 60 to 77 years old) were included in this study. The average amount of the implanted cement was $4.2{\pm}1.5\;cc$. The mean cobb angle and compression rate were improved from $12.1{\pm}6.5^{\circ}$ to $8.5{\pm}7.2^{\circ}$ and from 30% to 15%, respectively. The mean pain score (visual analogue scale) prior to kyphoplasty was 7.9 and it decreased to 3.0 after the procedure. Cement leakage to the adjacent disc (2 cases) and paravertebral soft tissues (1 case) were seen but there were no major complications such as pneumothorax, segmental arte 이 Injury, pulmonary embolism, or epidural leakage. Conclusion : Balloon kyphoplasty through extrapedicular approach is considered as a safe and effective in treating the middle thoracic regions with low complication rate.

• 대한물리치료과학회지
• /
• 제11권3호
• /
• pp.38-48
• /
• 2004

The purpose of present study is to examine the relative efficacy of active exercise programs for work-related chronic low back pain and to figure out how much they affect mechanical stability of lumbar. Subjects are 43 employees with work-related chronic low hack pain, and they were randomly divided into two groups with general physiotherapy groups and thoracic exercise groups for increasing thoracic mobility. Active exercise programs were done 3 times a week, for 6 months, and the subjects were tested for Pain intensity(VAS), the Oswestry Disability Index, Maximal stretching with both hands in the overhead direction and the lumbar region angle of inclination. All subjects were reassessed with same measurement with Pre-study and 6 months after study After applying active exercise programs, pain intensity didn't show any significant difference between two groups. The Oswestry Disability Index showed significant difference between two groups and thoracic exercise groups decreased significantly compare to general physiotherapy group(p<0.05). Maximal stretching with both hands in the overhead direction showed significant difference between two groups and thoracic exercise group increased significantly more than general physiotherapy groups(p<0.05). The lumbar region angle of inclination showed significant difference between two groups and thoracic exercise group decreased significantly more than general physiotherapy groups (p<0.05). According to the results above, exercise for increasing thoracic mobility has an effect on lumbar stability. For the work-related chronic lower hack pain workers, it is far more effective for lumbar stabilization than general physiotherapy.

• Journal of Chest Surgery
• /
• 제34권5호
• /
• pp.426-429
• /
• 2001

Superior sulcus or pancoase tumor refers to any primarty lung cancer locating in thoracic inlet and causing pain in the periscapular region or aim. These originate inperipheral, and involve th extrapulmonary structures more than parenchyma of the lung. We experienced l case of superior sulcus tumor radically resected via anterior transcervical approach, which provide more safe exposure of cervical structures of thoracic inlet than classis posterolateral thoracotomy. Therefore were report this case with review of literature.

• Journal of Trauma and Injury
• /
• 제30권4호
• /
• pp.158-165
• /
• 2017

Purpose: The purpose of this study was to evaluate the diagnostic accuracy of X-rays in patients with acute traumatic vertebral fractures visiting the emergency department and to analyze the diagnostic value of X-rays for each spine level. Methods: We retrospectively analyzed basal characteristics by reviewing medical records of 363 patients with adult traumatic vertebral fractures, admitted to the emergency center from March 1, 2014 to February 28, 2017. We analyzed spine X-rays and magnetic resonance imaging (MRI) scans to determine distribution according to the vertebral level, and we evaluated the efficacy of X-rays by comparing discrepancies between X-rays and MRI scans. Results: For a total of 363 patients, the mean age was 56.65 (20-93) and 214 (59%) were males. On the basis of X-rays, 67 cases (15.1%) were of the cervical spine, 133 cases (30.0%) were of the thoracic spine, and 243 cases (54.9%) were of the lumbar spine. In particular, the thoracolumbar region (T11-L2) was the most common, with 260 cases (58.7%). In X-rays, fractures were the least in the upper thoracic region (T1-T3), whereas MRI scans revealed fairly uniform distribution across the thoracic spine. Sensitivity of X-rays was lowest in the upper thoracic spine and specificity was almost always greater than 98%, except for 94.7% in L1. Positive predictive value was lower in the mid-thoracic region (T4-T9) and negative predictive value was slightly lower in C6, T2, and T3 than at other sites. Diagnostic accuracy of X-rays by vertebral body, transverse process, and spinous process according to fractured vertebral structures was significantly different according to vertebral level. Conclusions: Diagnostic accuracy of X-rays was lower in the upper thoracic region than in other parts. Further studies are needed to identify better methods for diagnosis considering cost and neurological prognosis.

• 한국전문물리치료학회지
• /
• 제12권2호
• /
• pp.44-57
• /
• 2005

The objectives of this study were to examine the relative efficacy of three active exercise programs for work-related, chronic low back pain, and to observe to what extent the programs affected the mechanical stability of the lumbar region. The subjects were 64 employees who were randomly divided into three groups to match the three active exercise programs which were performed 3 times a week for 6 months. All subjects were assessed with the same measurements at a pre-study examination, and then were reassessed at 2 weeks, 3months and 6 months after the study. The pain intensity didn't show any significant difference among the three groups. However, the Oswestry Disability Index showed significant differences among the three groups at 6 months and the lumbar and thoracic exercise groups showed significant decreases compared to the general physiotherapy group (p<.05). Maximal stretching with both hands in the overhead direction showed a significant difference among the three groups at 3 months and 6 months, and the thoracic exercise group at 6 months showed a significant increase in overhead stretching compared to the lumbar exercise and general physiotherapy groups (p<.05). The group that performed maximal stretching with both hands in the overhead direction showed the most significant among the 3 months and 6 months. At 6 months, the thoracic exercise group showed a significant increase in overhead stretching compared to the lumbar exercise and general physiotherapy groups (p<.05). The lumbar region angle of inclination showed significant differences among the three groups at 2 weeks 3 months, and 6 months, with the thoracic exercise group being decreased more significantly at 6 months than the lumbar exercise and general physiotherapy groups (p<.05). Exercise aimed at increasing thoracic mobility has an effect on lumbar stability. Furthermore, it is far more effective for lumbar stabilization than general physiotherapy and deep muscle strengthening lumbar exercise.

• 대한정형도수물리치료학회지
• /
• 제9권2호
• /
• pp.5-11
• /
• 2003

Thoracic outlet syndrome is actually a collection of syndromes brought about by abnormal compression of the neurovascular bundle by bony, ligamentous or muscular obstacles between the cervical spine and the lower border of the axilla. First of all a syndrome is defined as a group of signs and symptoms that collectively characterize or indicate a particular disease or abnormal condition. The neurovascular bundle which can suffer compression consists of the brachial plexus plus the C8 and T1 nerve roots and the subclavian artery and vein. The brachial plexus is the network of motor and sensory nerves which innervate the arm, the hand, and the region of the shoulder girdle. The vascular component of the bundle, the subclavian artery and vein transport blood to and from the arm. the hand. the shoulder girdle and the regions of the neck and head. The bony, ligamentous, and muscular obstacles all define the cervicoaxillary canal or the thoracic outlet and its course from the base of the neck to the axilla or arm pit. Look at the scheme of this region and it all becomes more easily understood. Compression occurs when the size and shape of the thoracic outlet is altered. The outlet can be altered by exercise, trauma, pregnancy, a congenital anomaly, an exostosis, postural weakness or changes. Thoracic outlet syndrome has been described as occurring in a diverse population. It is most often the result of poor or strenuous posture but can also result from trauma or constant muscle tension in the shoulder girdle. The first step to beginning any treatment begins with a trip to the doctor. Make a list of all of the symptoms which seem to be present even if the sensations are vague. Make a note of what activities and positions produce or alleviate the symptoms and the time of day when symptoms are worst. Also, note when the symptoms first appeared. This list is important and should also include any questions one may have.

• Journal of Chest Surgery
• /
• 제42권6호
• /
• pp.796-799
• /
• 2009

63세 여자 환자가 좌측 견갑골 하부에 만져지는 흉벽 종괴를 주소로 본원을 내원하여 종양적출술을 시행하였으며, 조직 검사상 탄력 섬유종으로 진단되었다. 탄력섬유종은 탄력섬유를 포함하는 섬유조직의 증식을 특징으로 한다. 비교적 천천히 자라는 양성의 연조직 종양으로 견갑골 하부에 가장 많이 발생한다. 드문 질환으로 알려진 흉벽의 탄력섬유종을 치험하였기에 문헌고찰과 함께 보고하는 바이다.

• The Journal of Korean Physical Therapy
• /
• 제26권3호
• /
• pp.169-174
• /
• 2014

Purpose: This study demonstrated a postural alignment exercise as conservative management strategy for a woman with excessive thoracic kyphosis presenting decreased chest function, and reports its results. Methods: A 21-year-old woman with thoracic kyphosis presenting limited chest function. The exercise program underwent for 30 min in the intervention phase, which consisted of exercises to improve the strength of back extensor and to stretch anterior chest region. Outcome measures comprised the severity of thoracic kyphosis and chest function (vital capacity [VC], forced expiratory volume in a second [FEV1], and chest expansion length). Results: The thoracic kyphotic angle decreased by 23.6% ($9.38^{\circ}$) and 25.4% ($10.58^{\circ}$) in the intervention and follow-up phases respectively. Also, chest function was improved in the intervention (VC: 3.7% [$0.10{\ell}$], FEV1: 17.1% [$0.39{\ell}$], and chest expansion length: 17.1% [0.96 cm]), and the improvement was maintained during the follow-up phase (VC: 4.8% [$0.13{\ell}$], FEV1: 17.1% [$0.39{\ell}$], and chest expansion length: 64.3% [1.81 cm]). Conclusion: These findings suggest that the postural alignment exercise was favorable for improving chest function of a woman with thoracic kyphosis.

• Journal of Chest Surgery
• /
• 제41권4호
• /
• pp.532-535
• /
• 2008

71세 여자 환자로 우측 견갑골 하방의 종물을 주소로 내원하여, 적출술 시행하였으며 탄력섬유종으로 진단되었다. 탄력섬유종은 양성의 연조직 종양으로 견갑골 하방에 가장 많이 발생하며 느린 성장과 탄력소를 포함한 섬유질이 증식하는 특성이 있다. 탄력섬유종은 발생이 드문 질환이며 원인이 아직 잘 밝혀지지 앎은 종양이다. 상기 증례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.