• 제목/요약/키워드: Compression fractures

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Tc-99m 표지 항과립구항체 면역신티그라피(Tc-99m labeled antigranulocyte antibody immunoscintigraphy)를 이용한 척추압박골절의 원인질환 감별 (Vertebral Compression Fractures: Distinction Between Benign and Malignant Causes with Tc-99m Labeled Antigranulocyte Antibody Immunoscintigraphy)

  • 조인호;이형우;안상호;원규장;배장호;조수호
    • Journal of Yeungnam Medical Science
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    • 제15권2호
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    • pp.254-262
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    • 1998
  • 골수의 손상정도률 민감하게 반영하는 Tc-99m 표지 항과립구항체 면역신티그라피를 이용하여 척추압박골절의 원인을 감별할 수 있는지를 알아보기 위하여, 척추압박골절 환자중에서 병리조직학적(수술 혹은 생검) 혹은 3개월 이상의 임상경과를 추적 관찰하여 원인이 밝혀진 16명의 환자를 대상으로 Tc-99m 표지 항과립구항체 면역신티그라피의 결과를 분석하였다. 16명의 환자중 외상이나 골다공증에 의한 압박골절 부위가 16부위 (8명), 전이암에 의한 압박골절이 3부위 (3명), 결핵에 의한 압박골절이 6부위 (5명) 이었다. 외상이나 골다공증과 같은 양성원인에 의한 척추압박골절 16 부위 모두 척추뿌리, 추궁판, 가시돌기의 섭취는 정상이었고, 척추체는 섭취저하가 7례, 섭취결손이 8례, 섭취정상이 2례에서 관찰되었다. 결핵에 의한 압박골절 6례에서 척추체의 섭취결손이 6례 모두, 척추뿌리의 섭취결손이 5례에서 관찰되었고, 가시돌기와 추궁판의 섭취결손은 발견되지 않았다. 전이암에 의한 3례의 경우는 2례에서 척추체, 척추뿌리, 추궁판, 가시돌기의 섭취결손이 보였고, 1례에서는 척추체와 가시돌기에만 섭취결손이 관찰되었다. Tc-99m 표지 항과립구항체 면역신티그라피의 단층영상에서 섭취결손부위를 평가함으로서 양성원인과 병적원인에 의한 척추압박골절의 원인의 감별에 도움이 될 수 있을 것으로 사료된다.

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대상포진후신경통 치료 중 발견된 척추압박골절 - 증례보고 - (Compression Fractures Diagnosed during the Treatment of Postherpetic Neuralgia - A case report -)

  • 최용민;신화용;이강준;구미숙;남상건;서정훈;조지연;김용철;이상철
    • The Korean Journal of Pain
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    • 제20권2호
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    • pp.224-229
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    • 2007
  • Vertebral compression fractures can occur due to trauma, a malignancy, or most commonly, osteoporosis. These fractures are frequently seen in elderly women; 30% of postmenopausal women are affected by vertebral compression fractures. These fragile fractures frequently result in both acute and chronic pain, but more importantly, are a source of increased morbidity and possibly, mortality. These injuries can be treated both conservatively and with surgery. The use of percutaneous vertebral augmentation offers a minimally invasive approach for the treatment of vertebral compression fractures. We experienced two cases of compression fractures diagnosed during the treatment of thoracic postherpetic neuralgia. Two patients suffering from postherpetic neuralgia with a sharp and stabbing pain in the thoracic dermatomes that was unresponsive to conservative treatment were transferred to our clinic. During the management of postherpetic neuralgia, we incidentally found thoracic compression fractures after obtaining fluoroscopic guided images. After a balloon kyphoplasty, the preoperative pain related to the postherpetic neuralgia was successfully relieved soon after the procedure, and there were no complications.

A numerical study on anisotropic strength of a rock containing fractures under uniaxial compression condition

  • Ohk Jin-Wook;Moon Hyun-Koo
    • 한국지구물리탐사학회:학술대회논문집
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    • 한국지구물리탐사학회 2003년도 Proceedings of the international symposium on the fusion technology
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    • pp.150-155
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    • 2003
  • Fractures in the form of micro cracks are commonly found in natural rocks. A rock behaves in a complex way due to fracture; in particular, the anisotropic strength of a rock material is significantly influenced by the presence of these fractures. Therefore, it is essential to understand the failure mechanism of a fractured rock. In this study, a fractured rock is formulated in terms of fabric tensor based on geometric and mechanical simplifications. In this way, position, density and shape of fractures can be determined by the fabric tensor so that rocks containing multi-fractures can successfully be modeled. Also an index to evaluate the degree of anisotropy of a fractured rock is proposed. Hence, anisotropic strength of a rock containing fractures under uniaxial compression condition is estimated through a series of numerical analyses for the multi-fractured model. Numerical investigations are carried out by varying the fracture angle from $0^{\circ}\;to\;90^{\circ}$ and relationship between uniaxial compression strength and the degree of anisotropy is investigated. By comparing anisotropic strength of numerical analysis with analytic solution, this study attempts to understand the failure mechanism of rock containing fractures.

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Percutaneous Vertebroplasty for Pregnancy-Associated Osteoporotic Vertebral Compression Fractures

  • Kim, Han-Woong;Song, Jae-Wook;Kwon, Austin;Kim, In-Hwan
    • Journal of Korean Neurosurgical Society
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    • 제47권5호
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    • pp.399-402
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    • 2010
  • Osteoporosis is a worldwide problem and it mainly affects postmenopausal women. Osteoporosis associated with pregnancy or lactation is a rare condition. The incidence and mechanism of this phenomenon has not been clarified, but it can cause one or more vertebral compression fractures with severe, prolonged back pain in the affected women. We experienced this uncommon case, treated it with percutaneous vertebroplasty. A 35-old-woman visited our hospital with complaints of severe back pain and flank pain 2 months after normal vaginal delivery. She was diagnosed with osteoporotic vertebral compression fractures on the T5, 8, 9 and 11 vertebral bodies and we performed percutaneous vertebroplasty on the T8, 9 and 11 vertebrae with a good result. We present here an unusual case of pregnancy-associated compression fractures treated by percutaneous vertebroplasty.

Spontaneous Height Restoration of Vertebral Compression Fracture - A Case Report-

  • Joo, Young;Lee, Pyung-Bok;Nahm, Francis Sahngun
    • The Korean Journal of Pain
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    • 제24권4호
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    • pp.235-238
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    • 2011
  • Vertebral compression fractures result in vertebral height loss and alter sagittal spinal alignment, which in turn can lead to increased morbidity and mortality. Acute osteoporotic vertebral compression fractures are known to increase mobility and instability of the spine. There are limited published data correlating the degree of dynamic mobility and the efficacy of kyphoplasty on vertebral compression fractures. Here we report a 73-year-old female with a severe acute osteoporotic L2 compression fracture who obtained total vertebral height restoration following kyphoplasty, with resolution of back pain.

The Relationship between the Compression Grade of Vertebrae and Outcome after Percutaneous Vertebroplasty in Patients with Osteoporotic Vertebral Compression Fractures

  • Kim, Jung-Min;Lee, Jong-Won;Hur, Jin-Woo;Kim, Seung-Hyun;Lee, Hyun-Koo;Kim, Myoung-Soo
    • Journal of Korean Neurosurgical Society
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    • 제38권5호
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    • pp.350-354
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    • 2005
  • Objective : The aim of this study is to assess the immediate and long-term efficacy of percutaneous vertebroplasty for treating painful vertebral osteoporotic fractures. Methods : A retrospective review of 149patients who had undergone 167 vertebroplasty procedures for osteoporotic fractures was performed. Clinical, radiologic, and procedural datas were analyzed as parameters of prognostic significance, including age, sex, bone marrow density score, symptom duration, bone cement filling grade, number of fractured vertebrae, compression grade of vertebrae, leakage of bone cement, volume of bone cement injected and complications. Results : In 158 of the 167 procedures assessed, immediate pain relief was obtained [94.6%]. The extent of collapse of the vertebral body was assessed as a parameter for prognostic significance [p=0.015]. Three months postoperatively, no improvement of the pain was observed in four of the 167 procedures that had undergone the vertebroplasty [2%]. At long-term follow-up, the improvement of pain was not correlated with the compression grade of vertebrae [p=0.420]. Conclusion : The immediate outcome of vertebroplasty are less effective in vertebrae more collapsed.

Percutaneous Vertebroplasty versus Conservative Treatment Using a Transdermal Fentanyl Patch for Osteoporotic Vertebral Compression Fractures

  • Oh, Younggyu;Lee, Byungjou;Lee, Subum;Kim, Junghwan;Park, Jinhoon
    • Journal of Korean Neurosurgical Society
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    • 제62권5호
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    • pp.594-602
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    • 2019
  • Objective : Although surgical intervention, such as percutaneous vertebroplasty (PVP), is the standard treatment for osteoporotic vertebral compression fractures (OVCFs), its effectiveness and safety are unclear. Therefore, this study compared the safety and efficacy of conservative treatment with that of PVP for acute OVCFs. Methods : Patients with single-level OVCFs who were treated conservatively with a transdermal fentanyl patch (TFP) or with PVP between March 2013 and December 2017 and followed-up for more than 1 year were retrospectively evaluated. Patients with pathologic fractures, fractures of more than two columns, or a history of PVP were excluded. Clinical outcomes (visual analog scale [VAS] scores) and radiographic factors were evaluated, including changes in the compression rate of the corresponding vertebral body at onset and after 12 months, sagittal Cobb angle at onset and after 6 and 12 months, and the incidence of adjacent compression fractures. Results : Of the 131 patients evaluated, 75 were treated conservatively using TFPs and 56 underwent PVP. We divided the patients into TFP and PVP groups. Their baseline characteristics (including sex, level of fracture, and bone mineral density T-scores) were similar, but the TFP group was significantly younger. The overall VAS score for pain showed a greater decrease during the first month (1 week after PVP) in the PVP group but remained similar in the two groups thereafter. The compression rate after 12 months increased in the TFP group but decreased in the PVP group. Five patients in the PVP group, but none in the TFP group, experienced adjacent compression fractures within 12 months. Conclusion : We compared clinical and radiological outcomes between the TFP and PVP groups. The immediate pain reduction effect was superior in the PVP group, but the final clinical outcome was similar. Although the PVP group had a better-preserved compression rate than the TFP group for 1 year, the development of adjacent fractures was significantly higher. Although TFPs seemed to be beneficial in reducing the failure rate of conservative treatment, the possibility of side effects (22.6%, 17 out of 75 patients, in this study) should be carefully monitored.

골다공증성 흉요추부 압박 골절에서의 보존적 치료 (Conservative treatment of Osteoporotic Compression Fractures in Thoracolumbar spine)

  • 강규복;고영도
    • Journal of Trauma and Injury
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    • 제18권2호
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    • pp.107-111
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    • 2005
  • Backgrounds: To evaluate the effectiveness of conservative treatment in osteoporotic thoraco-lumbar compression fractures and to identify the factors influencing the progression of compression. Materials and Methods: From January 2003 to October 2004, Patients who were admitted to our hospital for osteoporotic thoraco-lumbar compression fractures were reviewed retrospectively with follow-up more than 12 months (ave. 14.6 months). With simple x-ray lateral view, we evaluate wedge compression ratio (WCR) and kyphotic angle (KA) at initial and final follow-up. We separate the patients into two groups baesed on the amount of progression of vertebral compression and evaluate a relation with BMD, vertebral fracture level, initial WCR, initial KA. All datas were statistically analyzed. Results: An average of T-score was -3.5 and the changes of KA between initial and final follow-up were average $3.5^{\circ}$. Compression of anterior column were progressed to 8.5%. The changes between initial and final WCR in Group I (N=24) was 17.8%, and Group II (N=18) was 3.3%. T-score in group I was -3.4 and group II was -3.8 (p=0.228). vertebral fracture level were 10 T12, 12 L1, 2 L2 in group I; 6 T12, 6 L1, 6 L2 in group II (p=0.156). Initail WCR was 0.74 in group I, 0.63 in group II, and there was statistical difference between two groups(p=0002). Initial kyphotic angle was $13.9^{\circ}$in group I, $16.2^{\circ}$in group II repectively (p=0.392). Conclusion: The conservative treatment with short-term bed rest and early embulation is effective and valuable method to patients who have osteoporotic thoraco-lumbar compression fractures. There was no statistical difference between two groups according to BMD, vertebral fracture level, KA. But in comparison with initail WCR between two groups, there was statistical difference. That means, in the case of small initial compression of anterior column, the progression of compression was bigger than else. In these patients, more strict use of appropriate brace and careful follow-up should be needed.

Combination Therapy of Conventional and Korean Medicine for Multiple Vertebral Compression Fractures Associated with Postpartum Osteoporosis: A Case Report

  • Lee, Ki-Beom;Yang, Kyu-Jin;Gi, Yu-Mi;Kim, Tae-Gyu;Jo, Hooin;Choi, Jongho
    • Journal of Acupuncture Research
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    • 제35권4호
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    • pp.244-247
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    • 2018
  • Multiple vertebral compression fractures are a rare condition and are a serious consequence of postpartum osteoporosis. This report describes the case of a 35-year-old woman who had given birth to her first child 2 months before the onset of pain. Magnetic resonance imaging showed compression fractures of 7 vertebrae. The patient was treated with both conventional, and Korean medicine methods including acupuncture and herbal prescriptions. The patient's progress was assessed using self-reported symptoms, scale scores and laboratory test results. Her pain was gradually alleviated and biochemical inflammation marker levels improved, but her functional status remained severely impaired. Clinical practitioners who treat women in the postpartum period must be aware of osteoporosis and potential vertebral fractures and need to consider Korean medicine as an alternative therapy to help such patients.

화침을 이용한 흉요추부 압박골절 치험 1례 (A Case Report on Burning Acupuncture Treatments for Stable Compression Fracture)

  • 이종수;한순현
    • 대한추나의학회지
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    • 제3권1호
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    • pp.167-174
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    • 2002
  • 흉요추 이행부의 안정성 압박골절은 통증의 소실과 후만각 증가 억제에 의한 척추의 안정화이다. 이의 원인을 후방인대의 손상에 의한 손상으로 보고 프로로테라피(Prolotherapy)로 이의 치료를 시행 할 수 있다고 생각되며 한방적인 방법으로 화침을 적용할 수 있었다. 최근 저자는 흉요추 이행부의 안정성 압박골절에 의한 요배통 환자를 발견하고 화침치료를 통해 증세 회복에 도움이 되었기에 치료내용과 경과를 문헌고찰과 함께 보고하는 바이다.

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