• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.15 no.1
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• pp.61-70
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• 2005

This study investigated the spinal loads(L5/S1 disc compression and shear forces) predicted from four biomechanical models: one EMG model and three optimization models. Three objective functions used in the optimization models were to miminize 1) the cubed muscle forces : MF3, 2) the cubed muscle stress : MS3, 3) maximum muscle intensity : MI. Twelve healthy male subjects participated in the isometric voluntary exertion tests to six directions : flexion/extension, left/right lateral bending, clockwise/ counterclockwise twist. EMG signals were measured from ten trunk muscles and spinal loads were assessed at 10, 20, 30, 40, 50, 60, 70, 80, 90%MVE(maximum voluntary exertion) in each direction. Three optimization models predicted lower L5/S1 disc compression forces than the EMG model, on average, by 31%(MF3), 27%(MS3), 8%(MI). Especially, in twist and extension, the differences were relatively large. Anterior-posterior shear forces predicted from optimization models were lower, on average, by 27%(MF3), 21%(MS3), 9%(MI) than by the EMG model, especially in flexion(MF3 : 45%, MS3 : 40%, MI : 35%). Lateral shear forces were predicted far less than anterior-posterior shear forces(total average = 124 N), and the optimization models predicted larger values than the EMG model on average. These results indicated that the optimization models could underestimate compression forces during twisting and extension, and anterior-posterior shear forces during flexion. Thus, future research should address the antagonistic coactivation, one major reason of the difference between optimization models and the EMG model, in the optimization models.

• The Korean Journal of Food And Nutrition
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• v.11 no.2
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• pp.165-170
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• 1998

Diagnostic radiology and conservative management for S75 patient with L1 lumbar fracture by traffic accidents were discussed with references, and then the obtained results were as follows ; 1. Wedging compression fractures with 10% deformity was confirmed at anterior vertebral body of L1 lumbar spine through lateral plain X-ray film. 2. Irregular bony fractures were observed at anterior vertebral body of L1 lumbar spine by CT scans, anatomically T12-L1 sites showed highly frequency of injuries, Denis's fracture type was classified as multiple compression fracture at anterior column without abnormal middle and posterior column, also no Cobb's angle, and then Frankel's neurological classification was E grade. 3. Orthopaedic treatments were performed with conservative methods. With rest on the bed, anti-in-flammatory medication, electrolyte and nutritional solution, the pain diminished. 4. After 3 weeks, rehabilitation was worked with putting on polyethylene back corset, although pains remained slightly until after 8 weeks, thereafter the spine showed gradually stability.

• The Journal of Internal Korean Medicine
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• v.42 no.5
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• pp.1027-1034
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• 2021

Objectives: This study aimed to determine the effects of Korean medical treatment on a patient with compression fractures. Methods: The patient was treated with herbal medicine and acupuncture for 51 days. Symptom changes were measured using the Numerical Rating Scale (NRS), Range of Motion (ROM), Oswestry Disability Index (ODI), and European Quality of Life Five Dimensions (EQ-5D) Scale. Results: The NRS score for lower back pain decreased from 7 to 3, and the ODI score decreased from 51.11 to 22.22. Range of motion (ROM) increased meaningfully in flexion(from 30 to 60), Left/Right lateral bending(from 10/30 to 30/45), Left/Right rotation (from 10/30 to 30/45), and the EQ-5D score also increased from 0.506 to 0.677. Conclusion: The results indicate that Korean medical treatment may be effective for managing patients' acute compression fractures.

• Radiation Oncology Journal
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• v.33 no.3
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• pp.217-225
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• 2015

Purpose: To investigate the outcomes of patients with spinal metastases from hepatocellular carcinoma (HCC), who were treated by stereotactic body radiotherapy (SBRT). Materials and Methods: This retrospective study evaluated 23 patients who underwent SBRT from October 2008 to August 2012 for 36 spinal metastases from HCC. SBRT consisted of approximately 2 fractionation schedules, which were 18 to 40 Gy in 1 to 4 fractions for group A lesions (n = 15) and 50 Gy in 10 fractions for group B lesions (n = 21). Results: The median follow-up period was 7 months (range, 2 to 16 months). Seven patients developed grade 1 or 2 gastrointestinal toxicity, and one developed grade 2 leucopenia. Compression fractures occurred in association with 25% of the lesions, with a median time to fracture of 2 months. Pain relief occurred in 92.3% and 68.4% of group A and B lesions, respectively. Radiologic response (complete and partial response) occurred in 80.0% and 61.9% of group A and B lesions, respectively. The estimated 1-year spinal-tumor progression-free survival rate was 78.5%. The median overall survival period and 1-year overall survival rate were 9 months (range, 2 to 16 months) and 25.7%, respectively. Conclusion: SBRT for spinal metastases from HCC is well tolerated and effective at providing pain relief and radiologic response. Because compression fractures develop at a high rate following SBRT for spinal metastases from primary HCC, careful follow up of the patient is required.

• The Journal of Internal Korean Medicine
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• v.11 no.2
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• pp.128-136
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• 1990

I Studied some important medical literatures inorder to examine the cause & syndrome of diffuse fluid-retention syndrome and found out some facts as follows ; 1. cause of diffuse fluid-retention syndrome is Hwang Je Nae Kyong(黃帝內經) and so forth six kinds of medicine books are reffered sudden thirst of intestin and stomark cause of disease Golden chamber(金?要略) and so forth fifteen kinds of medicine books are reffered fluid water promote obscesses atributide at four extrenities and unable hidrosis cause of disease Elementary cause for medicine(醫學入門) and so forth kinds of book medicine books are reffered water in four extrenities cause of disease. The classified Medical Records of Famous physicians(名醫類安) reffered rest at wetness earthly cause of disease. 2. syndrome of diffuse fluid-retention syndrome is Golden chamber and so forth nineteen kinds of medicine books are reffered compression and pain of body syndrome of disease. Hwang Je Nae Kyong(黃帝內經) and so forth seven kinds of medicine books are reffered pulse ; the liver-pulse is soft and powder syndrome of disease. The classified Medical Records of Famous physicians(名醫類安) and so forth two kinds at medicine book are reffered general syndrome of disease. Today is reffered edema of four extremites syndrome of disease. The cause & syndrome of diffuse fluid-retention syndrome obtained was as follows ; cause of diffuse fluid-retention syndrome is fluid water promote abscess attributide at four extremities and unable hidrosis and compression and pain body is main syndrome and hyperhidrosis, vertigo, edema of four extremities alternating episodes of chills and fever can guan pulse is sunken and slippery and both chi wiry are represented syndrome of diffuse fluid-retention syndrome.

• Journal of Korean Neurosurgical Society
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• v.40 no.4
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• pp.249-255
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• 2006

Objective : This study is to evaluate the efficacy of dorsal short-segment fixation in unstable thoracolumbar junction fractures. Methods : The cases of 20 patients who underwent dorsal short-segment fixation were reviewed retrospectively. Clinical outcomes were analysed using Sonntag's pain level, work status, and neurological scale according to the modified Frankel classification. Radiological outcomes were analysed using Mumford's anterior body compression[%], canal compromise ratio, and Cobb's kyphotic angle. Results : At the latest clinical follow-up [average=14.6 months]. there were 19 [95.0%] in group I and 1 patient [5.0%] in II in pain level. The postoperative work status were 17 [85.0%] in group I, 2 patients [10.0%] in II, and 1 patient [5.0%] in V. Surgery brought to improve the neurologic status. In success group [19 cases, 95%], the average canal compromise ratio was reduced from 0.57 [${\pm}0.07$] to 0.05 [${\pm}0.08$] [P<005], the average anterior body compression [%] was reduced from 41% [${\pm}17$] to 18% [${\pm}14$] [P<0.05], and the average preoperative kyphotic angle was $20.0^{\circ}$ [${\pm}9.0$], and corrected to $5.7^{\circ}$ [${\pm}7.1$] postoperatively, and progressed to $7.8^{\circ}$ [${\pm}6.2$] at the latest follow-up. There was a case of implantation failure in an elderly osteoporotic patient. Conclusion : Although there are limitations in the patient number and follow-up period, the present study favors dorsal short-segment fixation for selective cases in unstable thoracolumbar junction fractures.

• Journal of Korean Neurosurgical Society
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• v.39 no.5
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• pp.366-369
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• 2006

Objective : There are various surgical approaches to far-lateral lesions in the L5-S1 intervertebral space. Of these is the validity of a paramedian tangential approach is being investigated in this study. Methods : A retrospective study was conducted on 25 patients who had been diagnosed as having a far-lateral L5-S1 disc herniations, osteophyte, costal process hypertrophy, and had undergone a paramedian tangential approach from November 1999 through December 2003. The degree of symptoms and improvement were compared via the visual analog pain scale, before and after surgery. Results : This study included 4 males and 21 females with a mean age of $62{\pm}11.8$ years old. The average follow-up period after surgery was $8.2{\pm}2.7$ months. The visual analog pain scale taken before surgery was $6.7{\pm}1.1$ points, while the post-surgical scale was $2.4{\pm}0.9$ points showing a significant degrease [p < 005]. There were no complications that developed during surgery. Conclusion : A paramedian tangential approach is less invasive in the soft tissue than that of the median approach. This approach may effectively reduce nerve root compression and expand intervertebral foramens, and is devoid of the risk of spinal instability after surgery. The authors suppose that a paramedian tangential approach is quite an effective technique to relive compression in the far-lateral L5-S1 intervertebral space.

• Journal of Korean Neurosurgical Society
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• v.41 no.5
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• pp.291-294
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• 2007

Objective : The purpose of this retrospective clinical study was to describe a treatment for osteoporotic burst fracture in the setting of severe fractures involving fragmentation of the posterior wall and neural compromise with symptoms of cord compression. Methods : Indication for microscopic decompression and open kyphoplasty were intractable pain at the level of a known osteoporotic burst fractures involving neural compression or posterior wall fragmentation. A total of 18 patients [mean age, 74.6 years] with osteoporotic thoracolumbar burst fractures [3 males, 15 females] were included in this study. In all cases, microscopic decompressive laminectomy was followed by open kyphoplasty. Clinical outcome using VAS score and modified MacNab's grade was assessed on last clinical follow up [mean 6.7 months]. Radiological analysis of sagittal alignment was assessed preoperatively, immediately postoperatively, and at final follow up. Results : One level augmentation and 1.8 level microscopic decompression were performed. Mean blood loss was less than 100 ml and there were no major complications. The mean pain score before operation and at final follow up was 7.2 and 1.9, respectively. Fourteen of 18 patients were graded as excellent and good according to the modified MacNab's criteria. Overall, 6.0 degrees of sagittal correction was obtained at final follow-up. Conclusion : The combined thoracolumbar microscopic decompression and open kyphoplasty for severe osteoporotic fractures involving fragmentation of posterior wall and neural compromise provide direct visualization of neural elements, allowing safe cement augmentation of burst fractures. Decompressive surgery is possible and risk of epidural cement leakage is controlled intraoperatively.

• Journal of Korean Neurosurgical Society
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• v.49 no.5
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• pp.273-277
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• 2011

Objective : A single balloon extrapedicular kyphoplasty has been introduced as one of the unilateral approaches for thoracic compression fractures; however, the unilateral extrapedicular technique in the lumbar area needs a further understanding of structures in the lumbar area. The purpose of the present study is to describe methods and pitfalls of this procedure based on the anatomy of the lumbar area and to analyze clinical outcome and complications. Methods : Anatomical evaluation was performed with 2 human cadavers. A retrospective review of unilateral extrapedicular approaches yielded 74 vertebral levels in 55 patients that were treated with unilateral extrapedicular vertebroplasty and kyphoplasty. Radiographic assessment included the restoration rate of vertebral height and correction of kyphosis. Results : Anatomical evaluation indicates that the safe needle entry zone of bone for the extrapedicular approach was located in the supero-lateral aspect of the junction between the pedicle and vertebral body. The unilateral extrapedicular procedure achieved adequate pain relief with a mean decreases in pain severity of $7.25{\pm}1.5$ and $2.0{\pm}1.4$, respectively. Complications were 1 retroperitoneal hematoma, 6 unilateral fillings and 3 epidural leak of the polymethylmethacrylate. Conclusion : The method of a unilateral extrapedicular approach in kyphoplasty and vertebroplasty in the lumbar area might be similar to that in thoracic approach using a route via the extrapedicular space. However, different anatomical characteristics of the lumbar area should be considered.

• Journal of Acupuncture Research
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• v.18 no.2
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• pp.91-100
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• 2001

Objective : The purpose of this study is to investigate the role of the osteoporosis in low back pain(LBP). Methods : We use method of projection with Quantitative computed tomography(QCT) to estimate Bone mineral density(BMD) of lumbar spine more precisely. From January 1999 to August 2000 we studied lumbar BMD of 46 women with LBP and 53 women with non-LBP, musculoskeletal symptoms who visited Dong-Guk University Bundang Hospital by QCT. Results : 1. Lumbar BMDs in women with LBP and women with non-LBP, musculoskeletal symptom were lower than in normal women and BMDs in women with LBP was higher than in women with non-LBP, musculoskeletal symptom but the significant difference was not revealed between two group in statistics(p<0.05).. 2. Radiological study shows that the number of degenerative spondylosis was 19, compression fracture was 11, non-radiological study was 10, normal was 5 in women with LBP. 3. Radiological study shows that the number of degenerative change was 7, compression fracture was zero, non-radiological study was 33, normal was 5 in women with non-LBP, musculoskeletal symptom. Conclusion : BMDs in women with LBP was higher than in women with non-LBP, musculoskeletat symptom but the significant difference was not revealed between two group in statistics(p<0.05).