• Title/Summary/Keyword: 척추 골절

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A Case of Upper Thoracic Spinal Tuberculosis(T2-8) with T5,6 Compression Fracture in Pulmonary Tuberculosis Patient (폐결핵과 T5,6압박골절을 동반한 상부흉추(T2-8)결핵환자 1예)

  • Kim, Chong Kyung;Song, Ha Do;Cho, Dong Il;Yoo, Nam Soo
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.4
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    • pp.372-377
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    • 2007
  • Tuberculous spondylitis is the most common manifestation of musculoskeletal tuberculosis (TB). The progression of the disease is usually slow and insidious. The main symptom, back pain, is not specific, which frequently results in a delayed diagnosis resulting in neurologic deficits and more advanced vertebral destruction. It is more difficult to diagnose the disease if the involved area is an uncommon sites, such as the upper thoracic, cervical or sacral region. It is important to make an early diagnosis and treatment to achieve a better treatment outcome. We reported a 29 year old female with upper thoracic TB spondylitis(T2-8) and pulmonary TB complaining of back pain that persisted for 5 months and fever. TB spondylitis was not suspected to be due to upper thoracic involvement despite her pulmonary tuberculosis. Chest CT for the evaluation of pulmonary TB found T5 destruction and the paravertebral abscess that was consistent with TB spondylitis. Her spine was examined by MRI, which made an early diagnosis before the neurologic deficit had developed. She was treated with surgical intervention due to the spinal instability and anti-TB medication for 1 year with excellent results.

A Study of Radiographic Methods to X-ray Study of Patients with Spinal Scoliosis and Vertebrae Bone Fracture of Lumbar Spine (척주측만증과 허리뼈 골절 수술 환자의 엑스선 촬영법 연구)

  • Ahn, Byung-Ju;Lee, Jun-Haeng
    • Journal of the Korean Society of Radiology
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    • v.13 no.3
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    • pp.425-431
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    • 2019
  • The Study In order to obtain images of overlap of the two iron cores in the spinal cord simple x-ray scan after surgery of patients with ulcer lateral sclerosis and a fractured backbone, the researcher conducted a subjective evaluation on five radiographers of the university hospital's imaging department for more than 10 years. The results of the experiment showed that the lateral shot of lateral scoliosis of the spinal cord was taken with the middle face of the IR plane, and then the X-ray tube angle was taken vertically with the vertical spinal column fan-tom position, resulting in two overlapping images and high scores in the subjective evaluation. In addition, lateral shots of the lumbar dislocation fractured lumbar vertebrae were taken with the forehead aligned with the center of the IR plane and then with the X-ray angle perpendicular to the fourth waistline and the angle of the spinal cord perpendicular to the fourth waistline, the image of the two iron cores could be obtained from the radiographer.

A Micro Finite Element Analysis on Effects of Altering Monomer-to-Powder ]Ratio of Bone Cement During Vertebroplasty (골 시멘트 중합 비율 변경이 척추성형술 치료에 미치는 영향에 대한 비교 분석)

  • 김형도;탁계래;김한성
    • Journal of Biomedical Engineering Research
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    • v.23 no.6
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    • pp.451-458
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    • 2002
  • Osteoporosis is a systemic skeletal disease caused by low bone mass and the decrease of bone density in the microstructure of trabecular bone. Drug therapy(PTH Parathyroid hormone) may increase the trabecular thickness and thus bone strength. Vertebroplasty is a minimally invasive surgery foy the treatment of osteoporotic vertebral compression fracture. This Procedure includes Puncturing vertebrae and filling with Polymethylmethacrylate(PMMA). Although altering recommended monomer-to-Powder ratio affects material properties of bone cement, clinicians commonly alter the mixture ratio to decrease viscosity and increase the working time. The Purposes of this study were to analyze the effect of 4he monomer-to-powder ratio on the mechanical characteristics of trabecular. In this paper, the finite element model of human vertebral trabecualr bone was developed by modified Voronoi diagram, to analyze the relative effect of hormone therapy and vertebroplasty at the treatment of osteoporotic vertebrae. Trabeuclar bone models for vertebroplasty with varied monomer-to-Powder ratio(0.40∼1.07 ㎖/g) were analyzed. Effective modulus and strength of bone cement-treated models were approximately 60% of those of intact models and these are almost twice the values of hormone-treated models. The bone cement models with the ratio of 0.53㎖/g have the maximum modulus and strength. For the ratio of 1.07㎖/g, the modulus and strength were minimum(42% and 49% respectively) but these were greater than those for drug therapy. This study shows that bone cement treatment is more effective than drug therapy. It is found that in vertebroplasty, using a monomer-to-powder ratio different from that recommended by manufacturer nay significantly not only reduce the cement's material Properties but also deteriorate the mechanical characteristics of osteoporotic vertebrae.

A Clinical Study of Intercostal Neuropathy after Rib Fracture (늑골 골절 후 발생한 늑간 신경병증의 임상적 연구)

  • Kang, Jung-Hun;Lee, Seog-Ki;Seo, Min-Bum;Na, Jeong-Yeop;Jang, Jae-Hyouk;Kim, Kweon-Young
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.53-57
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    • 2010
  • Background: The purpose of this study is to evaluate intercostal neuropathy after rib fracture and to determine the severity of intercostal neuropathy with using a numerical rating scale and according to the duration of pain and the body mass index. Material and Method: We measured the positive sharp wave and fibrillation on the intercostal and paraspinal muscles in the thoracic region by performing needle electromyography in 47 patients who had intercostal neuralgia after rib fracture and who had needed daily analgesic for more than three months. Result: We diagnosed 11 cases as intercostal neuropathy among the 47 cases. Of the total 11 cases, 8 were male and 3 were female and they were most often of an active generation in the community. The common location of intercostal neuropathy was the intercostal space below the rib fracture and from the 7th to the 12th intercostal rib area. The incidence of intercostal neuropathy was significantly related with multiple rib fracture rather than single rib fracture. The symptoms observed were chest pain (90.9%), sensory change (81.8%), paresthesia and numbness (63.6%), back pain (27.2%) and muscle atrophy (18.2%). The numerical rating scale, the duration of pain and the body mass index showed no significant correlation with the severity of intercostal neuropathy. Conclusion: We concluded that the electrodiagnostic approach with considering the affecting factors and the clinical findings will be helpful for diagnosing and treating persistent intercostal neuralgic pain (more than 3 months) after rib fracture.

Usefulness Evaluation of Artifacts by Bone Cement of Percutaneous Vertebroplasty Performed Patients and CT Correction Method in Spine SPECT/CT Examinations (척추 뼈 SPECT/CT검사에서 경피적 척추성형술 시행 환자의 골 시멘트로 인한 인공물과 CT보정방법의 유용성 평가)

  • Kim, Ji-Hyeon;Park, Hoon-Hee;Lee, Juyoung;Nam-Kung, Sik;Son, Hyeon-Soo;Park, Sang-Ryoon
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.49-61
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    • 2014
  • Purpose: With the aging of the population, the attack rate of osteoporotic vertebral compression fracture is in the increasing trend, and percutaneous vertebroplasty (PVP) is the most commonly performed standardized treatment. Although there is a research report of the excellence of usefulness of the SPECT/CT examination in terns of the exact diagnosis before and after the procedure, the bone cement material used in the procedure influences the image quality by forming an artifact in the CT image. Therefore, the objective of the research lies on evaluating the effect the bone cement gives to a SPECT/CT image. Materials and Methods: The images were acquired by inserting a model cement to each cylinder, after setting the background (3.6 kBq/mL), hot cylinder (29.6 kBq/mL) and cold cylinder (water) to the NEMA-1994 phantom. It was reconstructed with Astonish (Iterative: 4 Subset: 16), and non attenuation correction (NAC), attenuation correction (AC+SC-) and attenuation and scatter correction (AC+SC+) were used for the CT correction method. The mean count by each correction method and the count change ratio by the existence of the cement material were compared and the contrast recovery coefficient (CRC) was obtained. Additionally, the bone/soft tissue ratio (B/S ratio) was obtained after measuring the mean count of the 4 places including the soft tissue(spine erector muscle) after dividing the vertebral body into fracture region, normal region and cement by selecting the 20 patients those have performed PVP from the 107 patients diagnosed of compression fracture. Results: The mean count by the existence of a cement material showed the rate of increase of 12.4%, 6.5%, 1.5% at the hot cylinder of the phantom by NAC, AC+SC- and AC+SC+ when cement existed, 75.2%, 85.4%, 102.9% at the cold cylinder, 13.6%, 18.2%, 9.1% at the background, 33.1%, 41.4%, 63.5% at the fracture region of the clinical image, 53.1%, 61.6%, 67.7% at the normal region and 10.0%, 4.7%, 3.6% at the soft tissue. Meanwhile, a relative count reduction could be verified at the cement adjacent part at the inside of the cylinder, and the phantom image on the lesion and the count increase ratio of the clinical image showed a contrary phase. CRC implying the contrast ratio and B/S ratio was improved in the order of NAC, AC+SC-, AC+SC+, and was constant without a big change in the cold cylinder of the phantom. AC+SC- for the quantitative count, and AC+SC+ for the contrast ratio was analyzed to be the highest. Conclusion: It is considered to be useful in a clinical diagnosis if the application of AC+SC+ that improves the contrast ratio is combined, as it increases the noise count of the soft tissue and the scatter region as well along with the effect of the bone cement in contrast to the fact that the use of AC+SC- in the spine SPECT/CT examination of a PVP performed patient drastically increases the image count and enables a high density of image of the lesion(fracture).

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A Clinical Analysis of 101 blunt sternal fractures (둔상에 의한 흉골골절 101례의 임상적 분석)

  • Kim, U-Jong;Lee, Jun-Bok
    • Journal of Chest Surgery
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    • v.30 no.7
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    • pp.713-718
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    • 1997
  • Fracture of the sternum has been considered as a serious injury and also associated with major complications such as myocardial, major thoracic vascular, and spinal injury. Retrospective datas from blunt trauma victims admitted to our hospital were analyzed to determine significance of sternal fractures and possible associated injures. 101 sternal fractures by blunt trauma were admitted from january, 1986 to december, 1995. Frequency was about 3.51 olo of the nonpenetrating chest trauma. The ratio of male to female was 1.82 versus 1. Most common cause in the stemal fracture was high decelerating injury(73 cases). Most common fracture site was sternal body(75 cases). Average days of adm ssion were 26 days. Abnormal ECG findings were sinus bradycardia(Teases), complete or incomplete RBBB(6 cases), sinus tachycardia(4 cases), specific S-T change(3 cases), 1st degree A-V block(2 cases), LVH(1 case), PVC(1 case), and Low voltage(1 case). CPK-MB was increased about 32.Lolo of sternal fractures. Except of expired 2 patients, patients were treated with conservative treatment(94 cases) and open reductions & steel wire fixations(5 cases). Complication after operation was wound infection(1 case). Causes of death were 1 hypovolemia and 1 acute respiratory distress syndrome. In conclusion, although sternal fracture is less frequent, and mostly treats with conservative treatment, it shoed be carefully observed because of critical associated injuries.

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A Clinical Study about Steroid induced Myopathy in patient with latrogenic Cushing Syndrome and Compression Fracture of L-spine. (의인성 쿠싱 증후군과 동란하여 발생한 스테로이드 근병증과 요추 압박 골절 1예)

  • Yang, Dong-Ho;Lim, Chang-Sun;Kim, Sung-Keun;Lee, Kyung-Yun;Sin, Hyun-Sueng;Yim, Jun-Hyok
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.4 no.2
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    • pp.149-161
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    • 2009
  • Objective : The purpose of this study is to report the improvement after the acupuncture therapy and herbal medicine about a patient who has latrogenic Cushing with steroid induced myopathy and compression fracture of L-spine. Methods : We treated the patient with Neutral Blood Stasis herbal acupuncture, acupuncture therapy and herbal medication. Results : We have experienced one case of latrogenic Cushing syndrome with steroid induced myopathy and compression fracture of L-spine. This case improved significantly through acupuncture and herbal medication treatment. Conclusions : This study suggests manual acupuncture therapy and herbal medication is effective for the improvement of latrogenic Cushing syndrome with steroid induced myopathy and compression fracture of L-spine.

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Clinical Case Report on the Gait disturbance Patient with Osteoporosis and Lower Limb Fracture Surgery Treated by Chuna Therapy (골다공증을 동반한 하지부골절 수술 후 보행불리 환자 재활에 단순추나요법을 적용한 치험 1례)

  • Lee, Yun-Jin;Park, Na-Ri;Yang, Doo-Hwa;Ahn, Hee-Duk
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.14 no.2
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    • pp.77-88
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    • 2019
  • Objectives : The purpose of this study was to show the effectiveness of Chuna Manual Therapy applied to a osteoporosis patient with gait disturbance due to lower limb fracture surgery. Method : We focused on Chuna therapy accompanied with acupuncture, herbal medicine, moxibustion, cupping treatment and rehabilitation exercise. This case was assessed using the Visual Analogue Scale (VAS), Pain Free Walking Distance (PFWD), Berg Balance Scale (BBS), and Modified Barthel Index (MBI). Result : This patient showed improvement on the VAS from 6 to 3, PFWD from 0 m to 2000 m using a walker and 50 m by self-walking, BBS from 2 to 28, and MBI from 56 to 89. Moreover the walking state improved from gait disturbance to self-walking. Conclusion : This study suggests that Chuna therapy could be used to improve gait disturbance in patients with osteoporosis and lower limb fracture surgery.

A Case Report of Conservative Treatment of Femoral Neck Stress Fracture Developed in Avascular Necrosis of the Femoral Head (대퇴골두 무혈성 괴사에 속발한 대퇴경부 피로골절 환자에서의 보존적 치료 치험 1례)

  • Ro, Hae-Rin;Park, So-Hyun;Kim, Jeong-Won;Cho, Tae-Young
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.6 no.2
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    • pp.79-85
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    • 2011
  • Objectives : The Purpose of this study is to investigate the clinical application of conservative treatment for femoral neck stress fracture developed in avascular necrosis of the femoral head. Methods : Patient is hospitalized at Dept. of Oriental Rehabilitation Medicine, Bu-Chun Jaseng Oriental Medicine Hospital, diagnosed as femoral neck stress fracture developed in avascular necrosis of the femoral head and treated by herbal medicine, acupuncture and moxibustion. This study was measured by Visual Analogue Scale(VAS) score, range of motion and walking time. Results : After conservative treatment, the patient's pain was controlled and VAS score was decreased. Range of motion and walking time were improved. Conclusions : As seen in this one case, Oriental conservative treatment has a positive effect to control pain with femoral neck stress fracture developed in avascular necrosis of the femoral head.

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A Case Report of Conservative Treatment of the Lumbar Incomplete Burst Fracture (불완전 방출성 요추 골절 환자에 보존적 치료를 시행한 치험 1례)

  • Kim, Su-Young;Min, Kwan-Sik;Kim, Tae-Hun;Jeong, Hae-Chan;Jun, Byung-Chul;Lee, Jin-Hyuk
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.5 no.2
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    • pp.85-94
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    • 2010
  • Objectives : The propose of this study is to find out the clinical application of conservative treatment to the patient who has Lumbar incomplete burst fracture. Methods : We examined 1 patient with lumbar burst fracture who admitted Jaseng Hospital of Oriental Medicine. Results : In this study, the patient showed a certain degree of improvement in gait disturbance. Low back and leg pain were also reduced significantly after conservative oriental medical treatment. Conclusions : Conservative oriental medical treatment can be effective for improving symptoms of Lumbar incomplete burst fracture, decreasing pain.

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