• 제목/요약/키워드: Cervical plate

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Molar-incisor malformation에 이환된 제2유구치의 미세 형태학적 분석 : 증례 보고 (Micromorphological Analysis of Primary Second Molar with Molar-incisor Malformation : A Case Report)

  • 김명환;박호원;이주현;서현우
    • 대한소아치과학회지
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    • 제48권3호
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    • pp.352-358
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    • 2021
  • Molar-incisor malformation (MIM)은 치관은 정상이나 치근의 비정상적인 형태를 보이는 것이 특징적이다. 제1대구치에 가장 많이 발생하며, 제2유구치나 상악 중절치도 때때로 이환된다. 이 증례 보고에서는 제1대구치를 포함해, 제2유구치에 MIM이 나타난 환자의 증례를 보고하고, 치근이 건전하게 발거된 제2유구치의 micro computed tomography (CT)를 이용한 형태학적 분석을 시행하였다. 발거된 치아에서는 MIM의 외형적 특징인 치관 - 치근 이행부의 cervical constriction을 육안상으로 확인할 수 있었으며, micro CT 분석에서 백악법랑경계부의 광화된 부위 (Cervical Minelarized Diaphragm), 많은 부근관과 막힌 근관 등의 복잡한 근관 형태, 근관 내 석회화 물질, 영구치에 비해 상대적으로 협착된 치관부 치수강이 관찰되었다.

골밀도에 따른 전방 내고정 장치 시술 후 경추부의 생체역학적 거동에 대한 분석 (Analysis of Biomechanical Responses for the Anterior Cervical Plate Fixation in relation to Bone Mineral Density)

  • 신태진;이성재;신정욱;장한
    • 대한의용생체공학회:의공학회지
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    • 제22권1호
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    • pp.69-80
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    • 2001
  • 본 연구에서는 환자의 골다공증 유무에 따른 내고정 장치 시술 직후 및 융합 후의 안정성을 평가하기 위해 다양한 하중 모드에서 C5-C6 운동분절의 생체역학적 거동을 분석하였다. 이러한 목적으로 먼저, C5-C6 경추부의 유한요소 모델을 구현하여 검증하였다. 모델의 결과는 기존 실험치와 유사하여 신뢰성이 부여되었다. 검증된 모델은 Smith-Robinson 방식으로 골이식물을 삽입한 후 전방 내고정 장치를 적용한 시술 상황을 재현하기 위해 수정되었다. 수정된 모델은 두 종류로 구현되었다. (1) 첫 번째 모델에서는, 시술 직후의 상황을 재현하기 위해 골이식물과 종판의 경계면에 접촉요소를 사용하였다. (2)두 번째 모델에서는 완전히 융합된 상황을 나타내기 위해 골이식물을 종판에 고정하였다. 골다공증의 효과를 예측하기 위하여 두 모델의 해면골에 대한 탄성계수를 변화시켰다(정상: 100MPa, 골다공증: 40MPa). 각 모델의 C5 주체의 상위면에 73.6N의 압축 하중을 가한 후에 108Nm의 굴곡/신전, 굽힘, 비틀림 하중을 가하였으며, C6 추체의 하단면은 모든 방향에 대하여 구속하였다. 전체적인 결과에 있어서 상대적 회전운동, 미끄럼운동, 골이식물 내에서의 von Mises 응력의 경우 정상 모델에 비해 골다공증 모델에서 증가함을 보였으며, 특히 시술 직후의 모델에서 비틀림 하중이 가해진 경우, 상대적 회전운동 및 미끄럼 운동이 가장 높게 예측되었다. 이는 골다공증환자에게 전방 내고정 장치를 시술한 경우 골이식물의 파단 및 유합의 실패가 비틀림 하중에서 발생할 수 있음을 나타낸다. 해면골의 von Mises 응력은 시술 직후에 골다공증 모델의 모든 하중 모드에서, 유합 후에는 굽힘 하중 외의 모든 하중에서 ultimate strength를 초과하는 것으로 나타나 골다공증 환자에게 screw의 해리가 발생할 가능성이 높은 것으로 예측되었다. 따라서 골다공증 환자에게 과도한 운동이 발생하지 않도록 하기 위해서 시술 후 세심한 주의와 halo 같은 견고한 정형술이 필요할 것으로 사료된다.

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Load Sharing Mechanism Across Graft-Bone Interface in Static Cervical Locking Plate Fixation

  • Han, In-Ho;Kuh, Sung-Uk;Chin, Dong-Kyu;Jin, Byung-Ho;Cho, Yang-Eun;Kim, Keun-Su
    • Journal of Korean Neurosurgical Society
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    • 제45권4호
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    • pp.213-218
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    • 2009
  • Objective : This study is a retrospective clinical study over more than 4 years of follow up to understand the mechanism of load sharing across the graft-bone interface in the static locking plate (SLP) fixation compared with non-locking plate (NLP). Methods : Orion locking plates and Top non-locking plates were used for SLP fixation in 29 patients and NLP fixation in 24 patients, respectively. Successful interbody fusion was estimated by dynamic X-ray films. The checking parameters were as follows : screw angle (SA) between upper and lower screw, anterior and posterior height of fusion segment between upper and lower endplate (AH & PH), and upper and lower distance from vertebral endplate to the end of plate (UD & LD). Each follow-up value of AH and PH were compared to initial values. Contributions of upper and lower collapse to whole segment collapse were estimated. Results : Successful intervertebral bone fusion rate was 100% in the SLP group and 92% in the NLP group. The follow-up mean value of SA in SLP group was not significantly changed compared with initial value, but follow-up mean value of SA in NLP group decreased more than those in SLP group (p=0.0067). Statistical analysis did not show a significant difference in the change in AH and PH between SLP and NLP groups (p>0.05). Follow-up AH of NLP group showed more collapse than PH of same group (p=0.04). The upper portion of the vertebral body collapsed more than the lower portion in the SLP fixation (p=0.00058). Conclusion : The fused segments with SLP had successful bone fusion without change in initial screw angle, which was not observed in NLP fixation. It suggests that there was enough load sharing across bone-graft interface in SLP fixation.

Management of Traumatic C6-7 Spondyloptosis with Cord Compression

  • Choi, Man-Kyu;Jo, Dae-Jean;Kim, Min-Ki;Kim, Tae-Sung
    • Journal of Korean Neurosurgical Society
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    • 제55권5호
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    • pp.289-292
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    • 2014
  • A case of total spondyloptosis of the cervical spine at C6-7 level with cord compression is described in a 51-year-old male. Because the bodies of C6 and 7 were tightly locked together, cervical traction failed. Then the patient was operated on by a posterior approach. Posterior stabilization and fusion were performed by C4-5 lateral mass and C7-T1 pedicle screw fixation and rod instrumentation with bridging both C4-5's rods to the C7-T1's extended ones. After C6 total laminectomy and foraminotomy, the C6 body was returned to its proper position. Secondly, anterior stabilization and fusion were performed by C6-7 discectomy with a screw-plate system. A postoperative lateral plain radiograph showed good realignment. In this case, we report the clinical presentation and discuss the surgical modalities of C6-7 total spondyloptosis and the failed close reduction.

제주산 망아지의 Streptococcus equi subsp. zooepidemicus 감염에 의한 뇌막염 증례 (A case of meningitis caused by Streptococcus equi subsp. zooepidemicus infection in a foal in Jeju)

  • 문성환;양형석;정수교;김재훈
    • 한국동물위생학회지
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    • 제37권1호
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    • pp.67-71
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    • 2014
  • In November 2012, a 4-month-old foal with anorexia, neurologic signs with ataxia and death was submitted for necropsy to the diagnostic laboratory of Jeju Self-Governing Provincial Veterinary Research Institute. Grossly, yellowish-white fibrinous materials were seen on the ventral cerebrum, cerebellum, medulla oblongata and cervical spinal cord of the foal. Histologically, severe fibrino-purulent meningitis characterized by the infiltration of neutrophils and fibrionous exudates with bacterial colonies were presented in cerebrum, cerebellum, brain stem and cervical spinal cord. In the bacterial isolation using meningeal exudate, the small white colonies on blood agar plate with ${\beta}$-hemolysis were observed. Isolated bacteria were Gram-positive cocci and confirmed as Streptococcus (S.) equi subsp. zooepidemicus by VITEK 2 system. Based on the histopathological features and the bacterial test, this case was diagnosed as meningitis associated with S. equi subsp. zooepidemicus infection in a foal. In our best knowledge, this is the first report for fibrino-purulent meningitis caused by S. equi subsp. zooepidemicus infection in Jeju.

경부고정(頸部固定) headgear 사용시(使用時) 안면두개골(顔面頭蓋骨)의 변위(變位)에 관(關)한 장력계측법(張力計測法) 및 유한요소법적(有限要素法的) 연구(硏究) (A FINITE ELEMENT AND STRAIN GAUGE ANALYSIS ON THE DISPLACEMENT OF CRANIOFACIAL COMPLEX WITH CERVICAL HEADGEAR)

  • 김현순;남동석
    • 대한치과교정학회지
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    • 제17권2호
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    • pp.185-200
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    • 1987
  • This paper was undertaken to observe the displacement of craniofacial complex with cervical headgear and to compare narrowing or widening effect of palate by use of contraction or expansion face-bow, respectively. The 3-dimensional finite element method(FEM) was used for a mathematical model composed of 597 nodes and 790 elements and an electrical resistance strain gauge investigation was performed to validate the finite element model. The outer bow of cervical headgear was adjusted to be placed below the occlusal plane by $25^{\circ}$ and met the midsagittal plane by $40^{\circ}$, and was loaded 1kg on each right and left hook toward posterior direction. The results were as follows 1. Generally, the maxillary teeth and facial bone were displaced in posterior, medial and downward direction. 2. It was the maxillary 2nd bicuspid that moved bodily. 3. The craniofacial complex rotated in a clockwise direction around the rotating axis which lay from the most posterior and lowest point connecting nasal crest of maxillary bone and vomer, progressively toward a more posterior, lateral and upward direction, anterior and upper area of pterygomaxillary fissure, base of medial pterygoid plate and laterally to the contact area of zygomatic arch with squamous part of temporal bone. 4. No contraction effect was observed by contraction face-bow when compared to the standard face-bow. 5. In case of expansion face-bow, the areas of maxillary 2nd bicuspid, molars and palate were expanded remarkably.

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Radiologic Findings and Risk Factors of Adjacent Segment Degeneration after Anterior Cervical Discectomy and Fusion : A Retrospective Matched Cohort Study with 3-Year Follow-Up Using MRI

  • Ahn, Sang-Soak;So, Wan-Soo;Ku, Min-Geun;Kim, Sang-Hyeon;Kim, Dong-Won;Lee, Byung-Hun
    • Journal of Korean Neurosurgical Society
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    • 제59권2호
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    • pp.129-136
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    • 2016
  • Objective : The purpose of this study was to figure out the radiologic findings and risk factors related to adjacent segment degeneration (ASD) after anterior cervical discectomy and fusion (ACDF) using 3-year follow-up radiography, computed tomography (CT), and magnetic resonance image (MRI). Methods : A retrospective matched comparative study was performed for 64 patients who underwent single-level ACDF with a cage and plate. Radiologic parameters, including upper segment range of motion (USROM), lower segment range of motion (LSROM), upper segment disc height (UDH), and lower segment disc height (LDH), clinical outcomes assessed with neck and arm visual analogue scale (VAS), and risk factors were analyzed. Results : Patients were categorized into the ASD (32 patients) and non-ASD (32 patients) group. The decrease of UDH was significantly greater in the ASD group at each follow-up visit. At 36 months postoperatively, the difference for USROM value from the preoperative one significantly increased in the ASD group than non-ASD group. Preoperative other segment degeneration was significantly associated with the increased incidence of ASD at 36 months. However, pain intensity for the neck and arm was not significantly different between groups at any post-operative follow-up visit. Conclusion : The main factor affecting ASD is preoperative other segment degeneration out of the adjacent segment. In addition, patients over the age of 50 are at higher risk of developing ASD. Although there was definite radiologic degeneration in the ASD group, no significant difference was observed between the ASD and non-ASD groups in terms of the incidence of symptomatic disease.

Comparative Study of Clinical and Radiological Outcomes of a Zero-Profile Device Concerning Reduced Postoperative Dysphagia after Single Level Anterior Cervical Discectomy and Fusion

  • Son, Doo Kyung;Son, Dong Wuk;Kim, Ho Sang;Sung, Soon Ki;Lee, Sang Weon;Song, Geun Sung
    • Journal of Korean Neurosurgical Society
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    • 제56권2호
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    • pp.103-107
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    • 2014
  • Objective : This study analyzed clinical and radiological outcomes of a zero-profile anchored spacer (Zero-P) and conventional cage-plate (CCP) for single level anterior cervical discectomy and fusion (ACDF) to compare the incidence and difference of postoperative dysphagia with both devices. Methods : We retrospectively reviewed our experiences of single level ACDF with the CCP and Zero-P. From January 2011 to December 2013, 48 patients who had single level herniated intervertebral disc were operated on using ACDF, with CCP in 27 patients and Zero-P in 21 patients. Patients who received more than double-level ACDF or combined circumferential fusion were excluded. Age, operation time, estimated blood loss (EBL), pre-operative modified Japanese Orthopaedic Association (mJOA) scores, post-operative mJOA scores, achieved mJOA scores and recovery rate of mJOA scores were assessed. Prevertebral soft tissue thickness and postoperative dysphagia were analyzed on the day of surgery, and 2 weeks and 6 months postoperatively. Results : The Zero-P group showed same or favorable clinical and radiological outcomes compared with the CCP group. Postoperative dysphagia was significantly low in the Zero-P group. Conclusions : Application of Zero-P may achieve favorable outcomes and reduce postoperative dysphagia in single level ACDF.

The Impact of Menopause on Bone Fusion after the Single-Level Anterior Cervical Discectomy and Fusion

  • Park, Sung Bae;Chung, Chun Kee;Lee, Sang Hyung;Yang, Hee-Jin;Son, Young-Je;Chung, Young Seob
    • Journal of Korean Neurosurgical Society
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    • 제54권6호
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    • pp.496-500
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    • 2013
  • Objective : To evaluate the successful fusion rate in postmenopausal women with single-level anterior cervical discectomy and successful fusion (ACDF) and identify the significant factors related to bone successful fusion in pre- and postmenopausal women. Methods : From July 2004 to December 2010, 108 consecutive patients who underwent single-level ACDF were prospectively selected as candidates. Among these, the charts and radiological data of 39 women were reviewed retrospectively. These 39 women were divided into two groups : a premenopausal group (n=11) and a postmenopausal group (n=28). To evaluate the significant factors affecting the successful fusion rate, the following were analyzed : the presence of successful fusion, successful fusion type, age, operated level, bone mineral density, graft materials, stand-alone cage or plating with autologous iliac bone, subsidence, adjacent segment degeneration, smoking, diabetes mellitus, and renal disease. Results : The successful fusion rates of the pre- and postmenopausal groups were 90.9% and 89.2%, respectively. There was no significant difference in the successful fusion rate or successful fusion type between the two groups. In the postmenopausal group, three patients (10.8%) had successful fusion failure. In the postmenopausal group, age and subsidence significantly affected the successful fusion rate (p=0.016 and 0.011, respectively), and the incidence of subsidence in patients with a cage was higher than that in patients with a plate (p=0.030). Conclusion : Menopausal status did not significantly affect bone successful fusion in patients with single-level ACDF. However, in older women with single-level ACDF, the combination of use of a cage and subsidence may unfavorably affect successful fusion.

솔잎 열수 증류액의 생리활성 효과 (Biological Activities of the Vaporized Liquid of Water-boiled Pine Needle)

  • 이효진;최승필;최형택;김수현;함영안;이득식;함승시
    • 한국식품저장유통학회지
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    • 제12권2호
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    • pp.179-183
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    • 2005
  • 솔잎 열수 증류액에 대한 항산화 활성은 $RC_{50}$ 값이 $18.4\;{\mu}L$로서 매우 강한 항산화 활성을 나타내었다. 솔잎 열수 증류액에 대한 항돌연변이 활성은 S. typhimurium TA98과 TA100 균주를 이용한 돌연변이성 실험 결과 솔잎 열수 증류액 자체로서는 변이원성이 없었으며 항돌연변이원성 실험에서는 직접변이원인 WNNG $(0.4\;{\mu}L/plate)$의 경우 S. typhimurium TA100 균주에서 시료농도 $200\;{\mu}L/plate$에서 $45.9\%$의 억제활성을 나타내었으며 4NQO $(0.15\;{\mu}g/plate)$에 대해서는 동일 농도에서 $85.5\%$의 높은 억제활성을 나타내었다. 그리고 간접변이원인 $B(\alpha)P\;(10\;{\mu}g/plate)$에 대해서는 시료농도 $200\;{\mu}g/plate$의 시료농도에서 $88\%$의 높은 억제 활성을 나타내었다. 한편 Trp-P-1 $0.15\;{\mu}g/plate$에 대해서는 $50\;{\mu}g/plate$의 낮은 시료농도에서도 $85\%$의 높은 억제활성을 나타내었으며 모두 농도 의존적으로 억제하는 것으로 나타났다. 솔잎 열수 증류액의 암세포 성장억제효과를 검토한 결과, 폐암세포, 유방암세포에 대해서 각각 $78.7\%$, $62.3\%$의 비교적 높은 억제효과를 보였으며, 특히 위암세포, 자궁암세포, 간암세포에서 각각 $90.8\%,\;93.7\%,\;90.0\%$의 높은 억제효과를 나타내었다.