• Title/Summary/Keyword: Compression pain

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Usefulness of Intraoperative Monitoring during Microsurgical Decompression of Cervicomedullary Compression Caused by an Anomalous Vertebral Artery

  • Kim, Sung Tae;Paeng, Sung Hwa;Jeong, Dong Mun;Lee, Kun Soo
    • Journal of Korean Neurosurgical Society
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    • v.56 no.6
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    • pp.513-516
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    • 2014
  • We report a case of cervicomedullary compression by an anomalous vertebral artery treated using microsurgical decompression with intraoperative monitoring. A 68-year-old woman presented with posterior neck pain and gait disturbance. MRI revealed multiple abnormalities, including an anomalous vertebral artery that compressed the spinal cord at the cervicomedullary junction. Suboccipital craniectomy with C1 laminectomy was performed. The spinal cord was found to be compressed by the vertebral arteries, which were retracted dorsolaterally. At that time, the somatosensory evoked potential (SSEP) changed. After release of the vertebral artery, the SSEP signal normalized instantly. The vertebral artery was then lifted gently and anchored to the dura. There was no other procedural complication. The patient's symptoms improved. This case demonstrates that intraoperative monitoring may be useful for preventing procedural complications during spinal cord microsurgical decompression.

Two Case Reports and an Updated Review of Spinal Intraosseous Schwannoma

  • Zhang, Fan;Lu, Feizhou;Jiang, Jianyuan;Wang, Hongli
    • Journal of Korean Neurosurgical Society
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    • v.57 no.6
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    • pp.478-483
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    • 2015
  • We report two rare cases of spinal intraosseous schwannoma (SIS) with sustained myelopathy symptoms and provide an updated review regarding SIS in the literature. A 71-year-old man experienced right lumbocrural pain and gait disturbance accompanied with paresthesia and right leg weakness. Imaging examinations revealed a mass with lesions in L4 vertebral body causing bone destruction and spinal cord compression. Complete resection of the well-demarcated tumor and posterior fusion were performed. A 54-year-old female reported bilateral gait disturbance, paresthesia, and numbness without weakness, and imaging revealed a posterior mass from T9 causing spinal cord compression and bone erosion. The tumor was completely separated from the spinal nerve root. The tumors from both patients were confirmed as schwannomas. Tumor recurrence was not observed at the 2-4 year follow-up. Although rare, SIS should be considered during differential diagnosis and can affect treatment planning. SIS symptoms vary depending on tumor location, and fusion is frequently necessary for spinal reconstruction after complete tumor resection.

May-Thurner Syndrome with Deep Vein Trombosis after Total Knee Arthroplasty (인공 슬관절 전치환술 후 발생한 메이-터너 증후군 및 심부정맥 혈전증)

  • Lee, Hwa-Sung;Kim, Yong-Woo;Jung, Se-Hoon;Lee, Se-Won
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.4
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    • pp.343-347
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    • 2020
  • May-Thurner syndrome (MTS), also known as iliac vein compression syndrome, is a condition, in which compression of the common venous outflow tract of the left lower extremity can cause discomfort, swelling, pain or blood clots in the iliofemoral veins. The problem is due to left common iliac vein compression by the overlying right common iliac artery. This paper describes the case of a 75-year-old female with MTS after performing right total knee replacement arthroplasty. The authors diagnosed MTS through intravenous angiography and angiographic computed tomography on swelling and pain of the left lower extremities after performing right total knee replacement arthroplasty. The thrombus was removed using a thrombolytic agent and mechanical thrombectomy, and an intravenous stent then inserted after angioplasty. No case of MTS after performing total knee replacement arthroplasty has been reported in Korea. Therefore, this case is reported along with review of the relevant literature.

Design of the Interspinous Process Fixator Using Biomechanical Analysis for the Treament of Degenerative Lumbar Spinal Stenosis (퇴행성 요추부 척추관 협착증 치료를 위한 극돌기간 고정기구의 설계 및 생체역학적 분석)

  • Heo S.;Son K.;Lee S.J.;Moon B.Y.
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2005.06a
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    • pp.1963-1966
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    • 2005
  • Degenerative lumbar spinal stenosis(DLSS) is a disease inducing low back pain, leg pain, convulsion, numbness, and neurogenic claudication from compression of nerve root. Intervertebra fixation was reported to increase the degenerative of neighbor region after treatment. Recently, a new surgical technique of inserting a fixator between interspinous processes has been introduced. The purpose of this study is to design of the interspinous process fixator with flexibility to complement the trouble of using fixator in DLSS. This study evaluated the existing fixator through the mechanical test and modified fixators using the finite element analysis(FEA). Displacement, stiffness and Von-Mises stress were found to have similar values to those obtained from the mechanical test and the FEA in the biomechanical loading condition. Effects of variation in length and thickness were investigated to design an optimal fixator.

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Biomechanical Analysis of Lumbar Interspinous Process Fixators (요추부 극돌기간 고정기구의 생체역학적 해석)

  • Heo Soon;Park Jung-Hong;Lee Sung-Jae;Son Kwon
    • Journal of the Korean Society for Precision Engineering
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    • v.23 no.3 s.180
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    • pp.195-202
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    • 2006
  • The degenerative lumbar spinal stenosis (DLSS) is a disease inducing low back pain, leg pain, convulsion. numbness, and neurogenic claudication from compression of nerve root. Intervertebra fixation was reported to increase the degeneration of neighbor lesion after treatment. Recently, a new surgical technique of inserting a fixator between interspinous processes has been introduced. The purpose of this study is to design the interspinous process fixator with flexibility to complement the trouble of using fixator in DLSS. This study evaluated the existing fixator through the mechanical test and modified it using the finite element analysis (FEA). The evaluation was based on the displacement, stiffness and von-Mises stress obtained from the mechanical test and calculated from the FEA in the biomechanical loading condition. Effects of variation in length and thickness were investigated to design an optimal fixator. Three prototypes were manufactured using FEA results. Mechanical tests under the biomechanical loading condition were performed to select the best one from these three. The selected fixator increased flexiblity by 32.9%.

The Clinical Effects of Acupotomy for Ossification of the Posterior Longitudinal Ligament (침도치료를 통한 후종인대 골화증에 대한 치험 1례)

  • Park, Se-Woon;Kim, Sung-Soo;Yang, Seung-Bum;Lee, Geon-Mok
    • Journal of Acupuncture Research
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    • v.28 no.4
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    • pp.127-135
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    • 2011
  • Objectives : Ossification of the posterior longitudinal ligament (OPLL) is a cause of the progressive compression myelopahty or radiculopathy. More and more cases being reported in the field of western medicine, but very few cases have been reported in the field of oriental medicine. This study can make prove the effectiveness of oriental medicine about OPLL by acupotomy therpapy. Methods : A patient who is diagnosed to OPLL was participated in this study. The patient was treated by acupotomy therapy. After the treatment, patient was measured by VAS (visual analogue scale), questionnaires (NDI, J-OA score) and 5 Likert scale. Results : The results in the questionnaires (NDI, J-OA score) and VAS, ROM shows that the improving of OPLL pain and function. Conclusions : Acuptomy on OPLL was showed the effectiveness in pain and function of the patient.

Atlantoaxial Rotatory Fixation in Adults Patient

  • Jeon, Sei-Woong;Jeong, Je-Hoon;Moon, Seung-Myung;Choi, Sun-Kil
    • Journal of Korean Neurosurgical Society
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    • v.45 no.4
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    • pp.246-248
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    • 2009
  • Atlantoaxial rotatory fixation (AARF) in adult is a rare disorder that occurs followed by a trauma. The patients were presented with painful torticollis and a typical 'cock robin' position of the head. The clinical diagnosis is generally difficult and often made in the late stage. In some cases, an irreducible or chronic fixation develops. We reported a case of AARF in adult patient which was treated by immobilization with conservative treatment. A 25-year-old female was presented with a posterior neck pain and limitation of motion of cervical spine after a traffic accident. She had no neurological deficit but suffered from severe defect on the scalp and multiple thoracic compression fractures. Plain radiographs demonstrated torticollis, lateral shift of odontoid process to one side and widening of one side of C1-C2 joint space. Immobilization with a Holter traction were performed and analgesics and muscle relaxants were given. Posterior neck pain and limitation of the cervical spine' motion were resolved. Plain cervical radiographs taken at one month after the injury showed that torticollis disappeared and the dens were in the midline position. The authors reported a case of type I post-traumatic AARF that was successfully treated by immobilization alone.

Malignant Solitary Fibrous Tumor of Tandem Lesions in the Skull and Spine

  • Son, Seong;Lee, Sang-Gu;Jeong, Dong-Hae;Yoo, Chan Jong
    • Journal of Korean Neurosurgical Society
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    • v.54 no.3
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    • pp.246-249
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    • 2013
  • A solitary fibrous tumor (SFT) is a rare neoplasm originated from the pleura, but they can occur in a variety of extrathoracic regions. Although many cases of primary SFT have been reported, there are extremely rare repots to date of a malignant SFT in the spine or skull. A 54-year-woman visited our hospital due to low back pain and both leg radiating pain. Several imaging studies including magnetic resonance imaging and computed tomography revealed expansive enhanced lesions in the occipital bone, T8, S1-2, and ilium, with neural tissue compression. We performed surgical resection of the tumor in each site, and postoperative radiosurgery and chemotherapy were performed. However, after six months, tumors were recurred and metastasized in multiple regions including whole spine and lung. The authors report here the first case of patient with malignant SFT of tandem lesions in the various bony structures, including skull, thoracic spine, and sacral spine, with a rapid recurrence and metastasis. Although malignant SFT is extremely rare, it should be considered in the differential diagnosis and carful follow-up is needed.

Anatomy and Biomechanics of the Patellofemoral Joint (슬개대퇴관절의 해부학과 생체역학에 관한 문헌적 고찰)

  • Choi, Byung-Ok
    • Journal of Korean Physical Therapy Science
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    • v.8 no.2
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    • pp.935-944
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    • 2001
  • The patellofemoral pint is formed by the articulation of the patella and femoral condyles in the trochlear groove. The complexity of the patellofemoral pint is magnified by the fact that the tibiofemoral pint works in conjunction with the patellofemoral pint. Additionally, other pints such as the subtalar pint., hip and sacroiliac pints indirectly contribute to the function of the patellofemoral pint. This pint has little bony stability, Soft tissue surrounds the pint to increase stability. The patellofemoral pint increases the mechanical advantage of the quadriceps muscles and resists mechanical loading. In patellofemoral dysfunction, patellofemoral contact pattern is disrupted. leading to excessive compression at the pint. When you treat the patellofemoral dysfunction, you should evaluate anatomic and biomechanic components and find factors of patellofemoral dysfunction. Hamstring tightness. weakness of VMO and tightness of lateral retinaculum lead to flexed knee and abnormal patella tracking and patellofemoral pint reaction force and patellofemoral dysfunction. A through understanding of the anatomy and biomechanics may assist the clinician in the recognition and treatment of patients with patellofemoral pain. Therefore physical therapists should apply modality as well as therapeutic exercise, stretching and strengthening. In this paper, I will discuss the germane anatomical structures and biomechanics of the patellofemoral pint.

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A Study on the Evaluations of Compression Force for the Prevention of Low Back Pain : Nine-step Stretching Exercises (요통 예방을 위한 요추부하 평가에 관한 연구)

  • Yang, S.H.;Kim, D.S.;Park, P.;Kal, W.M.;Kang, Y.S.
    • Journal of the Korean Society of Safety
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    • v.13 no.4
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    • pp.248-255
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    • 1998
  • The objective of this study is to conduct the prevention method using electromyography that is to resist the strain on L5/S1 disc and to measure the heart rate for the prevention of low back pain during lifting. EMG signals and heart rate were analyzed under the condition of fixed vertical factor (20∼80cm), two horizontal factors (35cm, 55cm), and two weight factors (10kg, 25kg) 2 times per minute for each lifting task. Eight healthy male workers performed nine-step stretching exercises which were intensified back power at the L5/S1 disc for six months. After completion of the two trials, the results were compared. The results of this analysis show that EMG signals have more an effect on the weight than the horizontal factors similar to those analyzed previous study, and are decreased. Therefore, those exercises presented very efficient. Also, there are not statistically significant differences on the analysis result of heart rate between weight factors.

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