• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.3 no.2
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• pp.53-60
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• 2008

Objectives : The aim of this study is to compare the improvement of Low back pain (LBP) depending on female inpatient's Bone mineral density (BMD) after menopause. Method : We evaluated 10 cases of normal and 25 cases of osteopenia and osteoporosis based on Bone mineral density test among the female inpatients with LBP who were after menopause, admitted at Jaseng Hospital of Oriental Medicine from January 2008 to August 2008. Result : Depending on the analysis of pathogenic cause, most were without specific reason and except that, overwork and lifting heavy weight were the most common reason. Using improvement-analysis based on treating period, the normal group showed higher decrease of Numerical Rating Scale (NRS) than osteopenia and osteoporosis group. Conclusion : Statically, among the female inpatients with LBP, who were after menopause, had no significant differences between the normal group and osteopenia and osteoporosis group's improvement rate, depending on treating period.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.1 no.1
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• pp.105-111
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• 2006

Objective : The aim of this study was to evaluate association between lumbar spinal stenosis, one of degenerative diseases, and bone mineral density. Methods : We monitored 9 lumbar spinal stenosis patients in women above 50 years, visiting outpatient clinic of the Jaseng Oriental Medicine Hospital between January 5 2006 and March 31, 2006. They were diagnosed by radiologist ist after taking Magnetic Resonance Imaging(MRI). The cases were Investigated the bone mineral density using Dual Energy X-ray Absorptiomerty(DEXA). and then Picture Archiving Communication System(PACS) were used to assess correlation between lumbar spinal stenosis and bone mineral density. Results : 1. In comparison of the spinal canal area and lumbar spine 2 level bone mineral density, the data showed a significant result 2. The data, between spinal canal area and lumbar spine 1-2 level bone mineral density, indicated a significant result. 3. Also, the result of comparison between spinal canal area and the lowest value of bone mineral density showed significance. Conclusions : It showed that there is a statistically significant correlation between lumbar spinal stenosis and bone mineral density.

• Journal of Nutrition and Health
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• v.35 no.4
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• pp.473-479
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• 2002

This study investigated associations between calcium intake, exercise behaviors, lumbar bona mineral density (BMD), and bone mineral content (BMC) among 79 premenopausal women (mean age = 41yr). The BMD and BMC of the lumbar spine (L$_2$-L$_4$) were measured by dual energy x-ray absorptiometry. Nutrient intake was estimated by the convenient method and a quantitative food frequency questionnaire was designed for this study that included the most commonly consumed floods sources of Ca. Participants were asked to identify all activities of exercise they had participated in including estimation of number of years of participation, number of weeks per year, number of times per week, and the number of hours per session. Participants were then categorized into the exercise group or nonexercise group (control). To meet the criteria for inclusion in the exercise group, the subjects participated more than 3 sessions per week and more than 30 minutes per session and the length of the exercise participation was at least more then 6 months. The participants were also grouped by calcium intake. The total calcium intake of all participants was estimated by dietary calcium intake and then the subjects were divided into quartiles to assess the lumbar BMD and BMC of the upper 25% (average calcium intake = 910 mg) and the lower 25% (average calcium intake = 414 mg). Results indicated that there were no significant differences in energy and calcium intake, and that there were no significant differences in lumbar BMD and BMC between participants in exercise group and the nonexercising control group. However, the exercise group had significantly lower ALP concentration than the nonexercise group. The upper 25% calcium intake group had significantly greater lumbar bone mineral density and bone mineral content than the lower 25% calcium intake group. Also the upper 25% calcium intake group had significantly lower ALP concentration than the lower 25% calcium intake group. Correlation analysis revealed that the spinal BMB was positively associated with body weight, while calcium intake was negatively associated with ALP concentration in nonexercising women. However, neither body weight nor dietary calcium intake were associated with both spinal BMD or ALP concentration in exercising women. These results suggest that calcium intake positively influence bone mineral density and bone mineral content in nonexercisulg premenopausal women. Exercise group did not affected by body weight and dietary calcium, but decreased ALP concentration than nonexercising group. Both exercise and calcium intake positively influence bone mineral density and bone mineral content in premenopausal women.

• Journal of the Korean Orthopaedic Association
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• v.54 no.4
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• pp.336-342
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• 2019

Purpose: To examine the relationship between the progression of a kyphotic deformity and the magnetic resonance imaging (MRI) findings in conservatively treated osteoporotic thoracolumbar compression fracture patients. Materials and Methods: This study categorized the patients who underwent conservative treatment among those patients who underwent treatment under the suspicion of a thoracolumbar compression fracture from January 2007 to March 2016. Among them, this retrospective study included eighty-nine patients with osteoporosis and osteopenia with a bone density of less than -2.0 and single vertebral body fracture. This study examined the MRI of anterior longitudinal ligament or posterior longitudinal ligament injury, superior or inferior endplate disruption, superior of inferior intravertebral disc injury, the presence of low signal intensity on T2-weighted images, and bone edema of intravertebral bodies in fractured intravertebral bodies. Results: In cases where the superior endplate was disrupted or the level of bone edema of the intravertebral bodies was high, the kyphotic angle, wedge angle, and anterior vertebral compression showed remarkably progression. In the case of damage to the anterior longitudinal ligament or the superior disc, only the kyphotic angle was markedly prominent. On the T2-weighted images, low signal intensity lesions showed a high wedge angle and high anterior vertebral compression. On the other hand, there were no significant correlations among the posterior longitudinal ligament injury, inferior endplate disruption, inferior disc injury, and the progression of kyphotic deformity and vertebral compression. The risk factors that increase the kyphotic angle by more than 5° include the presence of injuries to the anterior longitudinal ligament, superior endplate disruption, and superior disc injury, and the risk factors were 21.3, 5.1, and 8.5 times higher than those of the uninjured case, and the risk differed according to the level of bone edema. Conclusion: An osteoporotic thoracolumbar compression fracture in osteoporotic or osteopenic patients, anterior longitudinal ligament injury, superior endplate and intravertebral disc injury, and high level of edema in the MRI were critical factors that increases the risk of kyphotic deformity.

• Journal of radiological science and technology
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• v.29 no.4
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• pp.229-236
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• 2006

Purpose: This study was conducted to search for the type of technical error in DEXA(dual-energy X-ray absorptiometry) and the effect of error to measurement of BMD. Materials and Methods: The changes of BMD($g/cm^2$, T-score) by patients information(Age, Weight, Height, Manopause age) input error and Confirming ROI error were investigated. Using spine phantom, we canned 10 times by age(5, 10), weight(10, 20 kg), height(5, 10 cm), manopause age(5, 10) increase & decrease respectively. Scanning region(L-spine, femur, Forearm) of 10 patients was calculated by changing ROI respectively. Analysis of difference for mean(precision 1%) were carried out. Results: The error of patient information(Age, Weight, Height, Manopause age) was not changed differently. In confirming ROI, the BMD and T-score of L-spine involving T-12 was decreased to $0.063\;g/cm^2$, 0.3 and involving L-5 increased to $0.077\;g/cm^2$, 0.5. In narrowing 1 cm of vertical line of ROI, the BMD and T-score decreased to $0.006\;g/cm^2$, 0.1 and in 2 cm, $0.021\;g/cm^2$, 0.15, each. In hip ROI, Upper and left shift(0.5 cm) of line was not influenced BMD and T-score. In 0.5 cm lower shift(lesser trochanter below), the BMD and T-score increased $0.031\;g/cm^2$, 0.3 and in 1 cm $0.094\;g/cm^2$, 0.65, each. In forearm ROI, the BMD and T-score decreased $0.042\;g/cm^2$, 0.9 involving 1 cm lower wrist. And expanding 1 cm of vertical line, the BMD and T-score decreased $0.008\;g/cm^2$, 0.1 and in 2 cm, $0.021\;g/cm^2$, 0.3, each. The L-spine, hip, forearm ROI error was changed differently. Conclusion: There are so many kinds of technical error in BMD processing. Errors according to age, weight, height, manopause age did not influent to $BMD(g/cm^2)$ and T-score. There are mean differences BMD and T-score in confirming ROI. For the precision exam, in L-spine processing, L1-4 have to confirmed without shift of ROI vertical line. In hip processing, the ROI have to included greater trochanter, femur head and lesser trochanter. In forearm processing, the ROI have to included wrist, radius and ulnar.

• Journal of the Korean Orthopaedic Association
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• v.52 no.1
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• pp.83-91
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• 2017

Purpose: To investigate the clinical outcomes of distal hook augmentation using a pedicle screw in thoracolumbar fusion in elderly patients. Materials and Methods: This retrospective multicenter study recruited 20 patients aged 65 years or older, who underwent anterior support and long level posterior fusion in the thoracolumbar junction with a follow-up of one year. To assess the effect of distal hook augmentation, the patients were divided into two groups; the pedicle screw with hook group (PH group, n=10) and the pedicle screw alone group (PA group, n=10). Results: The average age was 72.4 years (65-83 years). The average fusion segment was 4.6 segments (3-6 segments). There were no significant differences in age, sex, causative diseases, bone mineral density of lumbar and proximal femur, number of patients with osteoporosis, and number of fused segments between the two groups (p≥0.05). At 1 year follow-up after surgery, parameters related with distal screw pullout were significantly worse in the PA group. No patients in the PH group had distal screw pullout. However, six patients (60%, 6/10) in the PA group had distal screw pullout. There were no significant differences in the progression of distal junctional kyphosis between the two groups. Conclusion: Distal hook augmentation is an effective procedure in protecting distal pedicle screws against the pullout when long level thoracolumbar fusion was performed in elderly patients aged 65 years or older.

• Journal of the Korean Society for Precision Engineering
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• v.27 no.4
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• pp.95-101
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• 2010

The aim of this study was to detect longitudinal alterations on lumbar vertebral trabecular bone quality (microarchitecture and degree of mineralization) and bone mineral density (BMD) during pregnancy Virginal eighteen mice were used. Then, twelve mice were mated. Mice lumbar vertebrae were scanned before mate, at 7 days of pregnancy (early pregnancy, 6 mice) and immediately after delivery (late pregnancy, 6 mice) by using in-vivo micro-computed tomography Structural parameters, degree of mineralization and BMD were measured. During early pregnancy, there were no significant alterations on structural parameters, degree of mineralization and BMD. At late pregnancy, Tb.Th (11.8%) and BMD (12.7%) were significantly decreased and Tb.N (6.3%), Tb.Pf (43.0%) and BS/BV (15.1%) were significantly increased (p<0.05). Additionally, the lower degree of mineralization was increased, although, the higher degree of mineralization was decreased. These results indicated that the quality and BMD might be not affected during early pregnancy. At late pregnancy, however the bone quality and BMD were likely to be negatively affected.

• Proceedings of the KOSOMBE Conference
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• v.1998 no.11
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• pp.155-156
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• 1998

Screw loosening and subsequent pullout can be attributed to the reduction in bone mineral density in the vertebrae manifested by osteoporosis in which the decrease in fixation strength between the cancellous bone and screw threads are accelerated by repeated loads exerted by patients own weight and activities following the surgery. In this study, the change in pullout strength of the pedicle screws was investigated before and after repeated loads were imparted. For this purpose. Diapason pedicle screws $(6.7\times40mm)$ were inserted onto fresh porcine spine specimens (T1-L5) after bone mineral density was measured using a DEXA. With an MTS, an axial load was applied at a loading rate of 0.33mm/sec until failure to measure the maximum pullout strength. Flexion moment of 7.5N-m was then imparted at 0.5Hz for 2000 cycles. It was found that the maximum pullout strength was exponentially related to BMD regardless of load types ($107.71\;\times\;\exp^{(1.43{\times}BMD)}r^2=0.93$, P<0.0001 without repeated load; ($107.71\;\times\;\exp^{(2.19{\times}BMD)}r^2=0.78$, P<0.0001 with repeated load). The results suggest that the reduction in pullout strength for pedicle screws is far more prominent in osteoporotic spine than in normal spine especially as number of repeated load was increased. More importantly, it was demonstrated that the level of bone mineral density and the activity level of the patient should be evaluated in more detail for successful implementation of pedicle screw systems in spinal surgery.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.12 no.1
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• pp.14-22
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• 2012

Objectives: This study was performed to review clinical manifestations of hyperphenylalaninemia patients in Korean. Methods: 178 cases of hyperphenyalaninemia were diagnosed at department of pediatrics, Soonchunhyang University Hospital from January, 1983 to August. We reviewed DNA analysis, MR imaging, EEG, radiography of the left hand and wrist, bone densitometry (BMD), IQ test of hyperphenyalaninemia patients. Results: Out of 178 cases, 161 cases were diagnosed classic phenylketonuria and 17 cases were diagnosed BH4 deficiency. 122 cases performed DNA analysis. R243Q (10.3%), Y204C (9.9%), and IVS4-1G>A (8.1%) mutations were predominant. 22 cases underwent MR imaging. Varying degrees of symmetrical high signal intensity were noted on T2-weighted sequences in the periventricular deep white matter of 15 cases. 23 cases were performed EEG. 12 cases (52.3%) showed abnormal pattern. EEG abnormalities showed in 11 cases. On lumbar BMD four of 11 cases (36%) showed reduced bone density of more than 1 S.D. in four of 11 cases, bone age was less than chronological age by at least one year. 18 cases were performed IQ test. Mean IQ scores was $84{\pm}21.6$. Among older than 15 years (9 cases), Mean IQ scores was $72{\pm}21.2$. PTPS deficiency was 14 cases, DHPR deficiency was 2 cases, and GTPCH deficiency was 1 case. Conclusion: We confirmed there were varieties of DNA mutations. And MR imaging and EEG were nonspecific in PKU patients. Older children showed lower IQ score. Low phenylalanine diet prevents brain damage in PKU patient. Not only first few years of life but also lifetime, Keeping low phenylalanine diet is important.

• Journal of Acupuncture Research
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• v.26 no.4
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• pp.1-9
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• 2009

목적 : 한양방 협진을 통한 보존적 입원 치료를 받은 급성 흉요추 압박골절 환자군에서의 압박골절 compression ratio의 급성기 내의 변화를 기록 분석하여 차후 환자군의 예후를 예측하고자 하였다. 방법 : 한양방 협진병원 척추센터에 입원하여 보존치료를 시행한 발병 2주 내의 압박골절 환자 중 2회 이상의 시점에서 압박골절 부위의 측면 X-ray 영상이 있는 환자 16명의 기록을 수집하였다. X-ray상 급성 압박골절이 발생한 추체(n=19)의 anterior wall과 posterior wall의 높이를 입원 1주차, 입원 2주차, 입원 3주차와 최종 영상 확보 시점의 X-ray에서 측정해 wedge fracture에 해당하는 anterior column fracture가 있는 추체(n=14)에 한해 anterior height/posterior height의 공식을 통해 compression ratio를 산출하였다. 2차적 지표로 입원 1주차에서 입원 3주차까지 환자의 VAS(visual analog scale) 통증 척도 점수를 분석하였다. 그 외 연령, 성별, 입원 기간, 총 치료기간, 당뇨, 골다공증, 골밀도, 압박골절 기왕력, 압박골절의 형태의 빈도와 비율을 분석하였다. 결과 : 1. 전방 골주 단독 골절에서의 compression ratio는 입원 1주차에서 3주차, 그리고 최종 영상 확보시점까지 각각 20.92${\pm}$10.42, 25.22${\pm}$10.90, 25.57${\pm}$11.04, 25.07${\pm}$11.94로 기록되었다. 시점간에는 통계적으로 유의한 compression ratio의 차이가 나타나지 않았다. 2. 통증 VAS 점수 평균은 입원 1주차부터 3주차까지 각각 7.44${\pm}$2.07, 4.67${\pm}$1.63, 3.00${\pm}$1.80으로 기록되었다. 시점간 모두 통계적으로 유의한 감소가 있었다(1주차-2주차 p=.003, 1주차-3주차 p<.000 2주차-3주차 p=0.021). 결론 : 본 연구의 협진 입원치료 압박골절의 compression ratio는 입원 1주차 시점에서 최종 follow-up 시점까지 유의한 차이를 보일 만큼의 추가적인 추체 높이 감소를 보이지 않아 향후 좋은 예후를 예상할 수 있다. 통증 VAS 점수는 모든 주별 시점간에서 유의하게 감소되었다.