• Title/Summary/Keyword: 요추부

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Is It Appropriate to Insert Pedicle Screws at an Infected Vertebral Body in the Treatment of Lumbar Pyogenic Spondylodiscitis? (요추부 화농성 척추염의 수술적 치료: 이환된 추체에 척추경 나사 고정이 타당한가?)

  • Na, Hwa-Yeop;Jung, Yu-Hun;Lee, Joo-Young;Kim, Hyung-Do
    • 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.

Spinal Ganglion Cyst of Lumbar Posterior Longitudinal Ligament (요추부 후종인대에서 발생한 결절종)

  • Roh, Sung Woo;Rhim, Seung Chul;Lee, Ho Kyu;Kang, Sin Kwang
    • Journal of Korean Neurosurgical Society
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    • v.29 no.4
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    • pp.543-549
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    • 2000
  • Objective : In contrary to ganglion cyst that commonly develops in connective tissue of peripheral joint or tendon, spinal ganglion cysts have been rarely reported. The authors report five cases of spinal ganglion cysts which originated from posterior longitudinal ligament of the lumbar spine. Methods : The authors retrospectively analyzed clinical, radiological, and surgical findings of five cases of spinal ganglion cysts and speculated the pathogenesis of spinal ganglion cyst. Result : Cysts were excised totally and symptoms improved without complications in all cases. Intraoperative findings revealed cysts that were tightly adherent to posterior longitudinal ligament. Conclusion : Five cases of ganglion cyst which caused similar symptoms and signs those of lumbar disc herniations were excised successfully. MRI and operative findings suggested spinal ganglion cyst of posterior longitudinal ligament were closely associated with disc degeneration which imply disc degeneration or herniation may play an important role in the pathogenesis of ganglion cyst.

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Design of the Interspinous Process Fixator Using Biomechanical Analysis for the Treament of Degenerative Lumbar Spinal Stenosis (퇴행성 요추부 척추관 협착증 치료를 위한 극돌기간 고정기구의 설계 및 생체역학적 분석)

  • Heo S.;Son K.;Lee S.J.;Moon B.Y.
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2005.06a
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    • pp.1963-1966
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    • 2005
  • Degenerative lumbar spinal stenosis(DLSS) is a disease inducing low back pain, leg pain, convulsion, numbness, and neurogenic claudication from compression of nerve root. Intervertebra fixation was reported to increase the degenerative of neighbor region after treatment. Recently, a new surgical technique of inserting a fixator between interspinous processes has been introduced. The purpose of this study is to design of the interspinous process fixator with flexibility to complement the trouble of using fixator in DLSS. This study evaluated the existing fixator through the mechanical test and modified fixators using the finite element analysis(FEA). Displacement, stiffness and Von-Mises stress were found to have similar values to those obtained from the mechanical test and the FEA in the biomechanical loading condition. Effects of variation in length and thickness were investigated to design an optimal fixator.

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Biomechanical Analysis of Lumbar Interspinous Process Fixators (요추부 극돌기간 고정기구의 생체역학적 해석)

  • Heo Soon;Park Jung-Hong;Lee Sung-Jae;Son Kwon
    • Journal of the Korean Society for Precision Engineering
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    • v.23 no.3 s.180
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    • pp.195-202
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    • 2006
  • The degenerative lumbar spinal stenosis (DLSS) is a disease inducing low back pain, leg pain, convulsion. numbness, and neurogenic claudication from compression of nerve root. Intervertebra fixation was reported to increase the degeneration of neighbor lesion after treatment. Recently, a new surgical technique of inserting a fixator between interspinous processes has been introduced. The purpose of this study is to design the interspinous process fixator with flexibility to complement the trouble of using fixator in DLSS. This study evaluated the existing fixator through the mechanical test and modified it using the finite element analysis (FEA). The evaluation was based on the displacement, stiffness and von-Mises stress obtained from the mechanical test and calculated from the FEA in the biomechanical loading condition. Effects of variation in length and thickness were investigated to design an optimal fixator. Three prototypes were manufactured using FEA results. Mechanical tests under the biomechanical loading condition were performed to select the best one from these three. The selected fixator increased flexiblity by 32.9%.

Biomechanical Analysis of Lumbar Interspinous Process Fixators and Design of Miniaturization and Advanced Flexibility (요추부 극돌기간 고정기구의 생체역학적 해석과 소형화 및 유연성 향상 설계)

  • Park, Jung-Hong;Heo, Soon;Lee, Sung-Jae;Son, Kwon
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.30 no.12 s.255
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    • pp.1509-1517
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    • 2006
  • The intervertebral fusion was reported to increase the degeneration of the neighboring region. Recently, a new technique of inserting an interspinous process fixator has been introduced to minimize the degenerative change in the lumbar spine. This study analyzed biomechanical effects of the fixator in the lumbar spine, and designed a new prototype to improve flexibility of the fixator with a reduced size. The evaluation was based on the displacement, stiffness and von-Mises stress obtained from the mechanical test and finite element analysis. A finite element lumbar model of L1 to L5 was constructed. The finite element model was used to analyze intervertebral fusion, insertion of a commercial fixator and a new prototype. The range of motion of intervertebral segments and pressures at vertebral discs were calculated from FEA. The results showed that the stiffness of the prototype was reduced by 32.9% than that of the commercial one.

Postural Aberrations in Female Patients With Chronic Low Back Pain (만성요통 여성 환자들에서 발생되는 자세의 변화)

  • Oh, Duck-Won
    • Physical Therapy Korea
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    • v.7 no.4
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    • pp.1-7
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    • 2000
  • 이 연구의 목적은 만성요통 여성 환자들에서 나타나는 자세 이상을 평가하고 방사선적 변수들과 임상적인 변수들과의 상관성을 알아보는 것이다. 이 연구의 대상자는 만성요통 여성 환자 38명과 대조군 32명이었다. 변수의 측정은 모든 대상자들이 이완된 자세로 기립한 상태에서 방사선 검사를 실시한 후 경추전만각, 흉추후만각, 요추전만각, 그리고 요추경사각을 측정하였다. 대상자들의 연령과 통증기간은 의무기록지를 참고하였다. 자료분석은 요통군과 대조군의 방사선적 변수들 간의 유의한 차이가 있는지를 알아보기 위해 독립된 t-검정을 시행하였고, 방사선적 변수들과 임상적 변수들과의 상관성을 알아보기 위해 피어슨 상관분석을 시행하였다. 연구결과 만성요통 환자군과 대조군사이의 경추전만각(p<.05), 요추전만각(p<.001), 그리고 천추경사각(p<.01)에서 통계학적으로 유의한 차이가 보였다. 통증기간은 요추전만각과 통계적학으로 유의한 상관관계가 있었으며(p<.05), 경추전만각은 흉추후만각과 통계학적으로 유의한 상관관계가 있었다(p<.05). 또한 흉추후만각, 요추전만각, 그리고 천추경사각은 각각 상호간에 상관관계가 있었다(p<.05). 만성요통은 요추만곡의 변화를 초래하여 흉추부 및 경추부의 자세이상을 유발할 수 있다. 그러므로 요통으로 인하여 올 수 있는 신체 전반적인 자세이상을 미리 예측하고 이를 교정하여야만 장기적으로 올 수 있는 합병증들을 예방할 수 있을 것이다.

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The Correlation Analysis of BMD in Proximal Femur and Spine with Dual Energy X-ray Absorptiometry (이중에너지 X-ray 흡수법을 적용한 근위 대퇴골 및 요추부 골밀도 검사의 상관관계 분석)

  • Han, Man-Seok;Cho, Dong-Heon
    • Journal of the Korea Society of Computer and Information
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    • v.17 no.9
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    • pp.165-169
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    • 2012
  • To analogize the result of the test through explaining the correlation of bone mineral density (BMD) test value between proximal femur and lumbar spine at age. It is based on 62 cases who visited the out-patient department. They were classified into three groups by age, group I (30~40 yr) and II (40~60 yr) and III (60~80 yr). Then we evaluated the average and the degree of correlation between the three groups and analyzed the correlation of the three sites according to the BMD result and T & Z-score through the t-test analysis. The results are listed below, first, if rise in age T-score is lower and over 60age occurred osteopenia, second, compared three groups, the correlation of BMD results was some of the highest between Lumbar spine and Proximal femur of T-score & Z-score. the correlation of BMD results is very high. It is regarded that there will be a clinical availability which can analogize the result of a part by using the result of the other part.

The Influences of Bowel Condition with Lumbar Spine BMD Measurement (요추부 골밀도 측정 시 장내 변화가 골밀도에 미치는 영향)

  • Yoon, Joon;Kim, Yun-Min;Lee, Hoo-Min;Lee, Jung Min;Kwon, Soon-Mu;Cho, Hyung-Wook;Kang, Yeong-Han;Kim, Boo-Soon;Kim, Jung-Soo
    • Journal of radiological science and technology
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    • v.37 no.4
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    • pp.273-278
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    • 2014
  • Bone density measurement use of diagnosis of osteoporosis and it is an important indicator for treatment as well as prevention. But errors in degree of precision of BMD can be occurred by status of patient, bone densitometer and radiological technologist. Therefore the author evaluated that how BMD changes according to the condition of the patient. As Lumbar region, which could lead to substantial effects on bone density by diverse factors such as the water, food, intentional bowels. We recognized a change of bone mineral density in accordance with the height of the water tank and in the presence or absence of the gas using the Aluminum Spine Phantom. We also figured out the influence of bone mineral density by increasing the water and food into a target on the volunteers. Measured bone mineral density through Aluminum Spine Phantom had statistically significant difference accordance with increasing the height of water tank(p=0.026). There was no significant difference in BMD according to the existence of the bowl gas(p=0.587). There was no significant difference in a study of six people targeted volunteers in the presence or absence of the food(p=0.812). And also there was no significant difference according to the existence of water(p=0.618). If it is not difficult to recognize the surround of bone in measuring BMD of lumbar bone, it is not the factor which has the great effect on bone mineral density whether the test is after endoscopic examination of large intestine and patient's fast or not.

Effects of Taping Therapy by Methods on Back Pain and Muscle Flexibility of Bus Drivers's (테이핑 적용방법에 따른 버스 운전기사의 요통과 근 유연성에 미치는 효과)

  • Park, Min-Chull;Kim, Eun-Young;Ha, Mi-Sook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.11
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    • pp.4367-4373
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    • 2010
  • The purpose of this study was to compared the effectiveness of erector spine taping and lumbar taping maintained in bus driver's back pain. The research subjects were some bus drivers working in Changwon, Masan, and Busan terminal. And we concluded this research; By selecting a group of 15 people taping erector spine, a group of lumbar taping, and a control group of 15 people randomly. Because we measured them before treatment and two weeks after treatment by the time, we could get the results which were as follows. The experiment group applied of taping therapy would be reduced in back pain when compared to the control group. The experiment group applied of taping therapy would be improved in muscle flexibility when compared to the control group. After treatment, the experiment group compared to control group showed decrease pain and an increase of flexibility. In conclusion, we could know that taping reduces back pain of bus drivers and gives a positive impact to muscle flexibility improvement, we finded out a distinct difference between the erector spine taping and the lumbar taping. Thus, the taping treatment can be applied easily to the bus driver and used as a way of therapeutic approach.

A study on compression force at L5/Sl in MMH -Erector Spinae Muscle Electromyography about Lifting Distance- (중량물 인양작업에 있어서의 요추부하 평가에 관한 연구 -수평거리에 따른 척추기립근의 근전도 변화-)

  • Choi, Jeong-Hwa;Yang, Seong-Hwan;Park, Beom
    • Proceedings of the Safety Management and Science Conference
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    • 1999.11a
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    • pp.303-310
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    • 1999
  • MMH(Manual Material Handling)와 관련되어 최근 요통질환으로 인한 요양신청이 크게 증가하는 추세에 있다. 본 연구에서는 Lifting 작업시 적용되는 중요 요소들 중 수평거리가 변함에 따른 IEMG 값을 이용하여 EMG 변화를 살펴보았다. 좌ㆍ우 EMG 값간에는 유의한 차이가 없었으며, 수평거리 35cm와 55cm간에는 유의한 차이를 보였다. 이는 수평거리가 길어질 경우 척추기립근의 동원량이 증가한다는 것을 의미한다. 따라서 요추부의 부담도를 줄이기 위해 수평거리를 줄이는 것이 요통예방을 위해 무엇보다 중요한 것이라 하겠다. 인체측정치와 EMG 값 사이의 상관관계에서는 35cm일 때 키, 가슴둘레, 허리둘레 등이, 55cm일 때 체중, 몸통너비, 허리두께, 손바닥폭 등이 상관관계가 있는 것으로 나타나고 있다.

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