• 제목/요약/키워드: Cervical instability

검색결과 53건 처리시간 0.019초

Surgical Outcomes after Traumatic Vertebral Fractures in Patients with Ankylosing Spondylitis

  • An, Seong-Bae;Kim, Keung-Nyun;Chin, Dong-Kyu;Kim, Keun-Su;Cho, Yong-Eun;Kuh, Sung-Uk
    • Journal of Korean Neurosurgical Society
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    • 제56권2호
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    • pp.108-113
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    • 2014
  • Objective : Ankylosing spondylitis is an inflammatory rheumatic disease mainly affecting the axial skeleton. The rigid spine may secondarily develop osteoporosis, further increasing the risk of spinal fracture. In this study, we reviewed fractures in patients with ankylosing spondylitis that had been clinically diagnosed to better define the mechanism of injury, associated neurological deficit, predisposing factors, and management strategies. Methods : Between January 2003 and December 2013, 12 patients with 13 fractures with neurological complications were treated. Neuroimaging evaluation was obtained in all patients by using plain radiography, CT scan, and MR imaging. The ASIA Impairment Scale was used in order to evaluate the neurologic status of the patients. Management was based on the presence or absence of spinal instability. Results : A total of 9 cervical and 4 thoracolumbar fractures were identified in a review of patients in whom ankylosing spondylitis had been diagnosed. Of these, 7 fractures were associated with a hyperextension mechanism. 10 cases resulted in a fracture by minor trauma. Posttraumatic neurological deficits were demonstrated in 11 cases and neurological improvement after surgery was observed in 5 of these cases. Conclusions : Patients with ankylosing spondylitis are highly susceptible to spinal fracture and spinal cord injury even after only mild trauma. Initial CT or MR imaging of the whole spine is recommended even if the patient's symptoms are mild. The patient should also have early surgical stabilization to correct spinal deformity and avoid worsening of the patient's neurological status.

두경부 편평상피세포암에서 종양억제유전자들의 변이 (Alteration of Multiple Tumor Suppressor Genes in Head and Neck Squamous Cell Carcinoma)

  • 송시연;박강식;배창훈
    • 대한두경부종양학회지
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    • 제20권2호
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    • pp.147-155
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    • 2004
  • Objectives: Head and neck squamous cell carcinoma (HNSCC) is the most common head and neck malignant tumor. The molecular genetic changes involving both oncogenes and tumor suppressor genes are known to be involved in head and neck squamous cell carcinogenesis, but the roles of the known tumor suppressor genes in carcinogenesis are not fully elucidated. The objectives of this study are to demonstrate the genetic alterations including the loss of heterozygosity (LOH) , amplification, and microsatellite instability of known tumor suppressor genes in HNSCC and to evaluate the relationship between genetic alterations of tumor suppressor genes and clinicopathologic features. Materials and Methods: Genetic alterations of 10 micro satellite markers of the 6 known tumor suppressor genes (APC, EXT1, DPC4, p16, FHIT, and PTEN) were analysed by DNA-PCR in paraffin-embedded histologically confirmed HNSCC specimens. Results: The genetic alterations of tumor suppressor genes were found frequently. Among the genetic alterations, LOH was most frequently found one. LOH was found frequently in APC (45.4%), EXT1 (36.4%), DPC4 (54.5%), and p16 (50%), but not found in FHIT. Also, the author found that abnormalities of APC gene was related to cervical lymph node metastasis and recurrence and that abnormalities of EXT1 gene were coexisted with those of APC gene or DPC4 gene. But these coexistences had no correlation with clinical features. Conclusion: These results suggested that APC, EXT1, p16, and DPC4 genes might play important roles and multiple tumor suppressor genes may participate dependently or independently in the carcinogenesis of HNSCC. These results also suggested that APC gene might relate to prognosis.

중쇠뼈 찢김골절로 인한 고리중쇠 관절 불안정의 교정 (Correction of Atlanto-axial Instability by Avulsion Fracture of the Axis in a Dog)

  • 황용현;김민경;박정현;진소영;박기태;이희천;이재훈
    • 한국임상수의학회지
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    • 제30권6호
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    • pp.499-502
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    • 2013
  • 목 부위에 교상을 입은 8살의 중성화된 수컷 푸들이 내원하였다. 신체 검사에서, 보행이 불가능하였고 심부통증이 있는 사지의 불완전 마비로 UML 증상을 보였다. 방사선과 CT 검사에서 경추 1번의 횡돌기의 골절, 경추 2번의 가시돌기의 골절이 관찰 되었다. 보존적 처지를 1주일 실시 하였으나 증상이 완화 되지 않아 수술적 교정이 선택되었다. 수술적 안정은, 배쪽으로 접근하여 나사, K-wires 와 bone cement를 이용하여 내원 7일차에 실시 되었다. 수술 후 4주 이후 혼자 설 수 있었으며, 6주 이후 보행이 가능하였다. 본 증례에서는 등쪽과 배쪽 부위 중쇠뼈 골절을 교정하기 위하여 배쪽 복합 고정을 실시하였으며, 좋은 예후를 보였다.