• Title/Summary/Keyword: 척추 골절

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Treatment Effect with Weekly Teriparatide in the Vertebral Compression Fractures in Patients with Severe Osteoporosis (심한 골다공증 환자에서 발생한 척추체 압박골절에 대한 주 단위 테리파라타이드(Teriparatide)의 투여 효과)

  • Hwang, Seok-Ha;Woo, Young-Kyun;Jeon, Ho-Seung;Suh, Seung-Pyo;Kim, Joo-Young;Kim, Jae-Nam
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.528-536
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    • 2019
  • Purpose: This study examined the effects of a weekly teriparatide on the change in vertebral compression ratio, back pain, and vertebral fracture healing in osteoporosis patients with vertebral compression fractured induced by low energy trauma. Materials and Methods: From January 2016 to December 2017, 57 patients with severe osteoporotic vertebral fractures with a T score of -3.5 or less were included in this study. The changes in the vertebral compression ratio, visual analogue scale (VAS), Oswestry disability index (ODI) for at least 6 months were examined. The morphology of bone marrow edema and the presence of intervertebral cleft, osteocalcin, and N-terminal telopeptide (NTx) were also investigated. Results: The mean compression ratio was 20% in the experimental group (teripratide group) at 3 months, and 38% in the control group. A significant difference in the compression ratio of the vertebral body over time was observed (p<0.05; t-test). A comparison of the compression ratio of the vertebral body with the follow-up duration in each group showed no significant increase in the, compression (p=0.063) in the experimental group and a significant increase in the control group (p<0.05). The mean time to reach the plateau of the compression rate was one month in the experimental group and three months in the control group. The VAS score in the experimental and control group was 0.39 and 1.07 points, respectively. The ODI score in the experimental and control group was 33.72 and 39.52, respectively. At the last follow-up radiographs, there were no cases with an intervertebral cleft (0%) in the experimental group and 1 case (2.2%) in the control group. A significant difference in the osteocalcin level was observed between the injury and 6 months after the injury (p=0.003). In addition, there was no significant difference in the NTx level between the injury and 6 months after injury (p=0.960). Conclusion: In vertebral compression fractures patients with severe osteoporosis, a weekly teriparatide can promote the union of fractures, prevent further collapse of the vertebral body, and reduce the back pain faster.

Conservative treatment of lumbar compression fracture with illeus and urinary disorder -A case of study - (대소변불리(大小便不利)를 동반한 척추 압박골절 환자 치험 1례)

  • Park, Sung-Ho;Park, Jun-Sik;Song, Yun-Kyung;Eom, Yu-Sik
    • The Journal of Korea CHUNA Manual Medicine
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    • v.6 no.1
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    • pp.169-176
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    • 2005
  • In recent years, according to the increase of the osteoporosis and traffic accidents, the vertebral compression fracture patients are increased, This Study is clinical observation to the patients who be taken compression fracture of the $L1^{\sim}L2$ vertebra bodies with the symptoms of urinary disorder and ileus. She was treated by bed rest, acupuncture and moxibustion, herb medicine, physical therapy. In the observation of this case, I think that conservative treatment which involved acupuncture, moxibustion therapy and herb medicinal treatment is more effective than common nonoperative therapy.

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지혜 깊어지는 건강 - 활기찬 실버 세대 - 골절 예방하면 빙판길도 두렵지 않다

  • Son, Ju-Seok
    • 건강소식
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    • v.35 no.12
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    • pp.24-25
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    • 2011
  • 겨울철에는 낙상사고가 다른 계절보다 3배 이상 높게 나타난다. 추운 날씨 주머니에 손을 넣고 걷다 빙판길에서 미끄러지는 일이 빈번하다. 문제는 노인들의 골절이다. 손목, 척추, 고관절(엉덩이뼈) 골절을 입은 환자는 독립적 보행이 불가능해지며 일상생활에 큰 어려움을 겪게 된다. 특히 고관절(엉덩이뼈) 골절의 경우 1년 내에 사망할 확률이 무려 20%다. 고령 환자의 경우 고관절 골절을 입고 병상에 누워 지내는 기간이 길어지면 심폐 및 방광기능이 저하될 수 있으며, 욕창이나 혈전증 등이 발생할 수 있다. 골절이 노인에게 치명적인 이유다.

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Biomechanical Stability Evaluation of Anterior/posterior Spinal Fusion for Burst Fracture (척추 파열 골절 치료를 위한 전.후방 척추고정술의 생체역학적 안정성 평가)

  • Park W.M.;Kim Y.H.;Park Y.S.;Oh T.Y.
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2006.05a
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    • pp.187-188
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    • 2006
  • A 3-D finite element model of human thoracolumbar spine (T12-L2) was reconstructed from CT images. Various anterior and posterior instrumentation techniques were performed with long cage after corpectomy. Six loading cases were applied up to 10 Nm, espectively. The rotations of T12 with respect to L2 were measured and the stiffnesses were calculated as the applied forces divided by the segmental rotations. The posterior fixation technique increased the stiffness of the spine the most. The addition of anterior rod from 1 to 2 increased the stiffness significantly without posterior fixation, but no effect was found with posterior fixation. We found that different fixation techniques changed the stiffness of the spine.

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Correlation Analysis between the Factors Associated with Osteoporosis and the Fat Infiltration Rate of the Multifidus and Erector Spinae Muscles in Osteoporotic Vertebral Compression Fracture Patients (골다공증성 척추 압박 골절 환자에서 다열근과 척추기립근의 지방 침투율과 골다공증 관련 인자의 상관 관계 분석)

  • Jun, Deuk Soo;Baik, Jong-Min;Choi, Ji Uk
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.4
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    • pp.318-323
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    • 2020
  • Purpose: To examine the relationship between total fat infiltration (TFI) rate, which quantifies the reduction of muscles around the spine and is an important factor for sarcopenia, and the factors affecting osteoporotic vertebral compression fracture. Materials and Methods: Patients treated for osteoporotic compression fractures of the lumber spine from January 2012 to December 2016 were analyzed retrospectively. Among them, this study included ninety-eight patients who were 1) diagnosed with osteoporosis with a bone mineral density (BMD) T score of less than 2.5 g/cm2, 2) received vertebroplasty or kyphoplasty for lumbar fractures, 3) involved one segment of the lumbar spine, and 4) were followed-up for more than one year. The TFI rate confirmed by analyzing magnetic resonance imagings with the Image J program was studied. Based on this, the relationship between the TFI of the multifidus and erector spinae muscles and the factors of osteoporosis were analyzed. Results: The mean TFI of the multifidus and erector spinae was 14.66±10.16. The spine BMD showed a positive correlation with the hip BMD, but a negative correlation with the TFI. A positive correlation was observed between the hip BMD and body mass index. In addition, vitamin D was positively correlated with both the hip and spine BMD but negatively correlated with the TFI rate. Conclusion: Muscle growth helps treat osteoporosis, and can prevent fractures that occur frequently in osteoporosis patients. Increasing the vitamin intake can also slow the progression of muscle atrophy.

웃음 꽃피우는 협회 - 그래픽 건강 뉴스 - 2010년 한국건강관리협회 골다공증 검사결과 골다공증 작은 충격에도 골절 부른다

  • 한국건강관리협회
    • 건강소식
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    • v.36 no.1
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    • pp.40-41
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    • 2012
  • 골다공증은 뼈의 화학적 조성에는 변화가 없고 단위 용적 내의 물량 감소를 초래해 경미한 충격에도 쉽게 골절을 일으키는 질환으로 뼛속에 구멍이 많아져 골밀도가 저하된 상태를 말한다. 우리 몸의 뼈는 소아기와 청소년기를 거쳐서 점차 단단해지고 20~30대에 생애 중 최대골량을 형성하며, 나이가 들수록 골량이 서서히 줄어들다가 폐경기 이후 여성에서 매우 빠른 속도로 골량이 감소한다. 이러한 골다공증은 대부분 증상 없이 조용히 진행되다가 골절이 나타난 후에야 발견된다. 골다공증이 진행된 후에는 허리가 구부러지고 경미한 충격에도 골절을 일으키는데 주로 척추, 대퇴골 늑글 등의 골절이 흔히 발생한다.

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The Study of Changes in Compressive Strength of Trabecular Bone with PMMA Injection in Vertebroplasty (척추성형술에서 PMMA 주입에 의한 망상골의 압축강도 변화 연구)

  • 문희옥;이문규;김정규;이태수;최귀원
    • Journal of Biomedical Engineering Research
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    • v.24 no.4
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    • pp.369-373
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    • 2003
  • The compressed fracture of spine caused by osteoporosis is one of the most frequent diseases in bone fracture. Recently the vertebroplasty has drawn much attention as a medical treatment for the compressed fracture of spine, which strengthens the vertebral body and corrects deformity, and relieves pain in patients by injecting bone cement. But because there were no research about strengthening of mechanical properties of verbral body in bone cement injection, in this study, based on the properties of PMMA, we had measured the Young's modulus for different apparent densities of intact trabecular bone and PMMA injected one from a porcine and a cadaver. Young's modulus to apparent density had a form of a power series in intact trabecular bone and had a linear relation in PMMA injected bone.

Surgical Treatment of Osteoporotic Vertebral Compression Fractures at Thoraco-Lumbar Levels: Only Pedicle Screw Constructs with Polymethylmethacrylate Augmentation (흉요추부 골다공증성 척추 압박 골절의 수술적 치료: 골시멘트 보강술을 이용한 척추경 나사 고정)

  • Jun, Deuk Soo;Baik, Jong-Min;Park, Ji Hyeon
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.4
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    • pp.327-335
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    • 2019
  • Purpose: To investigate the radiological efficacy of polymethylmethacrylate (PMMA) augmentation of pedicle screw operation in osteoporotic vertebral compression fractures (OVCF) patients. Materials and Methods: Twenty OVCF patients, who underwent only posterior fusion using pedicle screws with PMMA augmentation, were included in the study. The mean follow-up period was 15.6 months. The demographic data, bone mineral density (BMD), fusion segments, number of pedicle screws, and amount of PMMA were reviewed as medical records. To analyze the radiological outcomes, the radiologic parameters were measured as the time serial follow-up (preoperation, immediately postoperation, postoperation 6 weeks, 3, 6 months, and 1 year follow-up). Results: A total of 20 patients were examined (16 females [80.0%]; mean age, 69.1±8.9 years). The average BMD was -2.5±0.9 g/cm2. The average cement volume per vertebral body was 6.3 ml. The mean preoperative Cobb angle of focal kyphosis was 32.7°±7.0° and was improved significantly to 8.7°±6.9° postoperatively (p<0.001), with maintenance of the correction at the serial follow-up, postoperatively. The Cobb angle of instrumented kyphosis, wedge angle, and sagittal index showed similar patterns. In addition, the anterior part of fractured vertebral body height averaged 11.0±5.0 mm and was improved to 18.5±5.7 mm postoperatively (p=0.006), with maintenance of the improvement at the 3-month, 6-month, and 1-year follow-up. Conclusion: The reinforcement of pedicle screws using PMMA augmentation may be a feasible surgical technique for OVCF. Moreover, it appears to be appropriate for improving the focal thoracolumbar/lumbar kyphosis and is maintained well after surgery.

Osteoporotic Vertebral Compression Fracture Associated with Pregnancy and Lactation in Young Women (젊은 여성에서 임신 및 수유와 연관된 골다공증성 척추 압박골절)

  • Shin, Woo-Jin;Suh, Seung-Pyo;Yeom, Ji-Ung;Kim, Yun-Seong
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.3
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    • pp.266-271
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    • 2021
  • Osteoporosis associated with pregnancy and lactation is a rare disease that can cause osteoporotic vertebral compression fracture (OVCF). Patients usually complain of severe back pain, which is easily mistaken for pain due to pregnancy, childbirth, and lactation, making a rapid diagnosis and treatment difficult. The authors diagnosed OVCF related to pregnancy and lactation through a physical examination, simple radiography, whole-body bone scan, magnetic resonance image, bone marrow density, and blood tests in a 29-year-old female patient and a 31-year-old female patient who presented with low back pain. This paper reports two cases of symptom improvement through a teriparatide injection, wearing thoracic lumbar sacral orthosis and taking calcium and vitamin D with a review of the literature.

Diagnostic Radiology and Conservative Management of L1 Lumbar Spine with Compression Fracture (L1 요추 압박골절에 대한 진단방사선학 및 보존적 치료)

  • 김재웅
    • The Korean Journal of Food And Nutrition
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    • v.11 no.2
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    • pp.165-170
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    • 1998
  • Diagnostic radiology and conservative management for S75 patient with L1 lumbar fracture by traffic accidents were discussed with references, and then the obtained results were as follows ; 1. Wedging compression fractures with 10% deformity was confirmed at anterior vertebral body of L1 lumbar spine through lateral plain X-ray film. 2. Irregular bony fractures were observed at anterior vertebral body of L1 lumbar spine by CT scans, anatomically T12-L1 sites showed highly frequency of injuries, Denis's fracture type was classified as multiple compression fracture at anterior column without abnormal middle and posterior column, also no Cobb's angle, and then Frankel's neurological classification was E grade. 3. Orthopaedic treatments were performed with conservative methods. With rest on the bed, anti-in-flammatory medication, electrolyte and nutritional solution, the pain diminished. 4. After 3 weeks, rehabilitation was worked with putting on polyethylene back corset, although pains remained slightly until after 8 weeks, thereafter the spine showed gradually stability.

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