• Title/Summary/Keyword: Adult deformity

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Decision Making Algorithm for Adult Spinal Deformity Surgery

  • Kim, Yongjung J.;Hyun, Seung-Jae;Cheh, Gene;Cho, Samuel K.;Rhim, Seung-Chul
    • Journal of Korean Neurosurgical Society
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    • v.59 no.4
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    • pp.327-333
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    • 2016
  • Adult spinal deformity (ASD) is one of the most challenging spinal disorders associated with broad range of clinical and radiological presentation. Correct selection of fusion levels in surgical planning for the management of adult spinal deformity is a complex task. Several classification systems and algorithms exist to assist surgeons in determining the appropriate levels to be instrumented. In this study, we describe our new simple decision making algorithm and selection of fusion level for ASD surgery in terms of adult idiopathic idiopathic scoliosis vs. degenerative scoliosis.

Acquired Adult Flatfoot: Pathophysiology, Diagnosis, and Nonoperative Treatment (후천적 성인 편평족: 병태생리, 진단과 비수술적 치료)

  • Sung, Ki-Sun;Yu, In-Sang
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.3
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    • pp.87-92
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    • 2014
  • Acquired adult flatfoot is a deformity characterized by a decreased medial longitudinal arch and a hindfoot valgus with or without forefoot abduction. The etiologies of this deformity include posterior tibial tendon dysfunction, rheumatoid arthritis, trauma, Charcot's joint, neurologic deficit, and damage to the medial spring ligament complex or plantar fascia. Among these, posterior tibial tendon dysfunction is the most well-known cause. Although posterior tibial tendon dysfunction has been regarded as a synonym of acquired adult acquired flatfoot, failure of the ligaments supporting the arch can also result in progressive deformity even without a posterior tibial tendon problem. The authors describe the pathophysiology, diagnosis, and nonoperative treatment of acquired adult flatfoot, focusing on posterior tibial tendon dysfunction.

Comprehensive Orthodontic Treatment in a Middle-Aged Patient with Missing Maxillary Left First Premolar: A Case Report

  • Kwon, Sun-Mi;Baik, Hyoung-Seon;Choi, Sung-Hwan
    • Journal of Korean Dental Science
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    • v.11 no.1
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    • pp.32-41
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    • 2018
  • As the adult population continues to increase, orthodontic treatment for adult patients is becoming more common. This case report describes comprehensive orthodontic treatment of a middle-aged patient with closure of the extraction space without prosthetic restoration. A 55-year-old woman with her maxillary left first premolar extracted because of a periodontal problem, wanted to close the space with orthodontic treatment. Since she had generalized crowding and mild skeletal discrepancy, we planned comprehensive orthodontic treatment, including closure of the extraction space by protraction of the left maxillary molars using miniscrews and aesthetic alignment of anterior teeth. The total treatment period was 28 months. As a result of these treatments, the extraction space was successfully closed, good tooth alignment and satisfactory occlusion were achieved.

Autotransplantation of a Third Molar as a Lower Second Molar Combined with Orthognathic Surgery (대구치의 자가이식을 동반한 골격성 II급 부정교합의 악교정수술 치험례)

  • Choi, Yoon Jeong;Kim, Kyung-Ho;Chung, Chooryung J.
    • Korean Journal of Cleft Lip And Palate
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    • v.16 no.1
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    • pp.25-35
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    • 2013
  • We report the treatment of an adult Class II malocclusion with severe crowding and a hopeless lower second molar. According to the treatment plan, 4 premolars and 4 third molars were to be extracted for 2-jaw surgery. To replace the hopeless lower second molar, one upper third molar was successfully autotransplanted during the pre-surgical orthodontic treatment. Multiple teeth are frequently extracted for treatment purposes in adult surgical cases. Under precise diagnosis, the reuse of extracted teeth to replace missing teeth can be a successful alternative even in adult surgical patients.

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Operative Treatment of Acquired Adult Flatfoot (후천적 성인 편평족 변형의 수술적 치료)

  • Ahn, Chi-Young;Ahn, Jae Hoon;Kim, Man-Soo
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.3
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    • pp.93-99
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    • 2014
  • Acquired adult flatfoot deformity is characterized by flattening of the medial longitudinal arch and dysfunction of the posteromedial soft tissues, including the posterior tibial tendon. When the non-operative treatment fails to result in improvement of symptoms, surgery should be considered. Operative techniques include flexor digitorum longus tendon transfer, calcaneal medial slide osteotomy, lateral column lengthening, and arthrodesis of the hindfoot. The principle of correcting the deformity while avoiding overcorrection and excessive stiffness is important in achievement of good outcomes in these patients.

Stability of bimaxillary surgery involving intraoral vertical ramus osteotomy with or without presurgical miniscrew-assisted rapid palatal expansion in adult patients with skeletal Class III malocclusion

  • Ahn, Yoon-Soo;Choi, Sung-Hwan;Lee, Kee-Joon;Jung, Young-Soo;Baik, Hyoung-Seon;Yu, Hyung-Seog
    • The korean journal of orthodontics
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    • v.50 no.5
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    • pp.304-313
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    • 2020
  • Objective: The aim of this study was to evaluate the stability of bimaxillary surgery involving bilateral intraoral vertical ramus osteotomy performed with or without presurgical miniscrew-assisted rapid palatal expansion (MARPE) in adult patients with skeletal Class III malocclusion. Methods: A total of 40 adult patients with skeletal Class III malocclusion were retrospectively divided into two groups (n = 20 each) according to the use of MARPE for the correction of transverse maxillomandibular discrepancy during presurgical orthodontic treatment. Serial lateral cephalograms and dental casts were analyzed until 6 months after surgery. Results: Before presurgical orthodontic treatment, there was no significant differences in terms of sex and age between groups. However, the difference of approximately 3.1 mm in the maxillomandibular intermolar width was statistically significant (p < 0.001). Two days after surgery, the mandible had moved backward and upward without any significant intergroup difference. Six months after surgery, the maxillary intercanine (2.7 ± 2.1 mm), interpremolar (3.6 ± 2.4 mm), and intermolar (2.0 ± 1.3 mm) arch widths were significantly increased (p < 0.001) relative to the values before presurgical orthodontic treatment in the MARPE group; these widths were maintained or decreased in the control group. However, there was no significant difference in surgical changes and the postsurgical stability between the two groups. No significant correlations existed between the amount of maxillary expansion and postsurgical mandibular movement. Conclusions: MARPE is useful for stable and nonsurgical expansion of the maxilla in adult patients with skeletal Class III malocclusion who are scheduled for bimaxillary surgery.

Narrative Review of Clinical Impact of Head-Hip Offset Following Adult Spinal Deformity Surgery

  • Sunho Kim;Seung-Jae Hyun;Jae-Koo Lee;Ki-Jeong Kim
    • Journal of Korean Neurosurgical Society
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    • v.67 no.2
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    • pp.137-145
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    • 2024
  • In adult spinal deformity (ASD) surgery, mechanical failure (MF) has been a significant concern for spine surgeons as well as patients. Despite earnest endeavors to prevent MF, the absence of a definitive consensus persists, owing to the intricate interplay of multifarious factors associated with this complication. Previous approaches centered around global spinal alignment have yielded limited success in entirely forestalling MF. These methodologies, albeit valuable, exhibited limitations by neglecting to encompass global balance and compensatory mechanisms within their purview. In response to this concern, an in-depth comprehension of global balance and compensatory mechanisms emerges as imperative. In this discourse, the center of gravity and the gravity line are gaining attention in recent investigations pertaining to global balance. This narrative review aims to provide an overview of the global balance and a comprehensive understanding of related concepts and knowledge. Moreover, it delves into the clinical ramifications of the contemporary optimal correction paradigm to furnish an encompassing understanding of global balance and the current optimal correction strategies within the context of ASD surgery. By doing so, it endeavors to furnish spine surgeons with a guiding compass, enriching their decision-making process as they navigate the intricate terrain of ASD surgical interventions.

New Fixation Method Using Two Crossing Screws and Locking Plate for Cubitus Varus Deformity in Young Adult Elbow: Case Report

  • Kim, Byoung Jin;Seol, Jong Hwan;Kim, Myung Sun
    • Clinics in Shoulder and Elbow
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    • v.19 no.1
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    • pp.43-47
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    • 2016
  • Many types of osteotomy have been proposed for the treatment of cubitus varus deformity of the elbow, and various methods for fixation of the osteotomy site have also been described. However, no method has been perfect. We treated two cases of cubitus varus elbow deformity with step-cut osteotomy using a new fixation method with two crossing screws and an anatomically designed locking plate. Active assisted elbow range of motion (ROM) exercise was permitted at postoperative 3 days, after removal of the drainage. Preoperative and postoperative humerus-elbow-wrist angles and ranges of motion of the two patients were compared. At 3 months followup, each patient had recovered the preoperative elbow ROM, and achieved the complete bony union of the osteotomy site and proper correction of the cubitus varus deformity. In addition, the appropriate remodeling of the lateral bony protrusion was observed. Therefore, we introduce a new fixation method for achievement of stable fixation allowing immediate postoperative elbow motion after corrective osteotomy for cubitus varus deformity in young adults.

Restoration of Sagittal Balance in Spinal Deformity Surgery

  • Makhni, Melvin C.;Shillingford, Jamal N.;Laratta, Joseph L.;Hyun, Seung-Jae;Kim, Yongjung J.
    • Journal of Korean Neurosurgical Society
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    • v.61 no.2
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    • pp.167-179
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    • 2018
  • The prevalence of patients with adult spinal deformity (ASD) has been reported as high as 68%. ASD often leads to significant pain and disability. Recent emphasis has been placed on sagittal plane balance and restoring normal sagittal alignment with regards to the three dimensional deformity of ASD. Optimal sagittal alignment has been known to increase spinal biomechanical efficiency, reduce energy expenditure by maintaining a stable posture with improved load absorption, influence better bony union, and help to decelerate adjacent segment deterioration. Increasingly positive sagittal imbalance has been shown to correlate with poor functional outcome and poor self-image along with poor psychological function. Compensatory mechanisms attempt to maintain sagittal balance through pelvic rotation, alterations in lumbar lordosis as well as knee and ankle flexion at the cost of increased energy expenditure. Restoring normal spinopelvic alignment is paramount to the treatment of complex spinal deformity with sagittal imbalance. Posterior osteotomies including posterior column osteotomies, pedicle subtraction osteotomies, and posterior vertebral column resection, as well anterior column support are well known to improve sagittal alignment. Understanding of whole spinal alignment and dynamics of spinopelvic alignment is essential to restore sagittal balance while minimizing the risk of developing sagittal decompensation after surgical intervention.

Ecotoxicological Responses and Morphological Abnormalities in Chironomus plumosus Larvae Exposed to 4-tert-octylphenol (4-tert-octylphenol에 노출된 장수깔따구 Chironomus plumosus의 생태독성 반응과 기형)

  • Bang, Hyun-Woo;Lee, Chang-Hoon;Jung, Kyung-Suk;Kwak, Inn-Sil
    • Environmental Analysis Health and Toxicology
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    • v.23 no.4
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    • pp.277-284
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    • 2008
  • The ecotoxicological effects of 4-tert-octylphenol were observed on non-biting midge, Chironomus plumosus collected from Anyang stream in Seoul. The survival rate and adult emergence rate on C. plumosus exposed to octylphenol were not significantly affected. However, 4-tert-octylphenol induced developmental delay and disrupted sex ratio in high concentration of octylphenol. The mouth deformity such as tooth deletion or fusion in mentum, and tooth deletion in mandible were observed exposure to 4-tert-octylphenol. The deformity type of the mentum showed deletion (LT, 6.7%), and fusion (LT, 6.3%). Moreover, tooth deletion of mandible was observed in 4-tert-octylphenol treated groups (6.7%, 3 ppm).