• Korean Journal of Acupuncture
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• v.35 no.4
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• pp.247-247
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• 2018

• Journal of Korean Neurosurgical Society
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• v.52 no.4
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• pp.359-364
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• 2012

Objective : Transpedicular screw fixation has some disadvantages such as postoperative back pain through wide muscle dissection, long operative time, and cephalad adjacent segmental degeneration (ASD). The purposes of this study are investigation and comparison of radiological and clinical results between interspinous fusion device (IFD) and pedicle screw. Methods : From Jan. 2008 to Aug. 2009, 40 patients underwent spinal fusion with IFD combined with posterior lumbar interbody fusion (PLIF). In same study period, 36 patients underwent spinal fusion with pedicle screw fixation as control group. Dynamic lateral radiographs, visual analogue scale (VAS), and Korean version of the Oswestry disability index (K-ODI) scores were evaluated in both groups. Results : The lumbar spine diseases in the IFD group were as followings; spinal stenosis in 26, degenerative spondylolisthesis in 12, and intervertebral disc herniation in 2. The mean follow up period was 14.24 months (range; 12 to 22 months) in the IFD group and 18.3 months (range; 12 to 28 months) in pedicle screw group. The mean VAS scores was preoperatively $7.16{\pm}2.1$ and $8.03{\pm}2.3$ in the IFD and pedicle screw groups, respectively, and improved postoperatively to $1.3{\pm}2.9$ and $1.2{\pm}3.2$ in 1-year follow ups (p<0.05). The K-ODI was decreased significantly in an equal amount in both groups one year postoperatively (p<0.05). The statistics revealed a higher incidence of ASD in pedicle screw group than the IFD group (p=0.029) Conclusion : Posterior IFD has several advantages over the pedicle screw fixation in terms of skin incision, muscle dissection and short operative time and less intraoperative estimated blood loss. The IFD with PLIF may be a favorable technique to replace the pedicle screw fixation in selective case.

• Journal of Korean Neurosurgical Society
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• v.50 no.5
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• pp.415-419
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• 2011

Objective : The purpose of this study was to investigate the possible association of estrogen receptor alpha ($ER{\alpha}$) gene polymorphisms in a cohort of degenerative spondylolisthesis (DS) patients. Methods : Accordingly, the authors examined the association between DS and $ER{\alpha}$ gene polymorphisms in 174 patients diagnosed with DS. The $Pvu$ $II$ and $Xba$ $I$ polymorphisms, bone mineral density at the lumbar spine and femoral neck, and biochemical markers were analyzed and compared in the 174 patients with DS and 214 patients with spinal stenosis (SS). Results : A comparison of genotype frequencies in DS and SS patients revealed a significant difference for the $Pvu$ $II$ polymorphism only ($p$=0.0452). No significant difference was found between these two groups with respect to the $Xba$ $I$ polymorphism, BMD or biochemical markers. No significant association was found between the$Pvu$ $II$ polymorphism of $ER{\alpha}$ and BMD, vertebral slip or biochemical markers in patients with DS. Conclusion : These results suggest that the $ER{\alpha}$ gene polymorphism using $Pvu$ $II$ restriction enzyme influences the prevalence of DS.

• Journal of Korean Neurosurgical Society
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• v.46 no.4
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• pp.305-311
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• 2009

Objective : The purpose of this study was to determine the efficacy, radiological findings, clinical outcomes and complications in patients with lumbar stenosis and osteoporosis after the use of polymethylmethacrylate (PMMA) augmentation of a cannulated pedicle screw. Methods : Thirty-seven patients with degenerative spinal stenosis and osteoporosis (T-score < -2.5) underwent lumbar fusion using the Dream Technology Pedicle Screw ($DTPS^{TM}$, Dream Spine Total Solutions, Dream STS, Seoul. Korea) between 2005 and 2007. The clinical outcomes were evaluated by using the visual analog scale (VAS) and the Prolo scale. Radiologic findings were documented through computed tomography (CT) and plain films. Results : Thirty-seven patients were evaluated and included, 2 males and 35 females with an average bone mineral density (BMD) of $0.47g/cm^2$. The average age of the patients was 68.7 (range, 57-88). The preoperative VAS for low back and leg pain ($7.87{\pm}0.95$ and $8.82{\pm}0.83$) were higher as compared with postoperative VAS ($2.30{\pm}1.61$ and $1.42{\pm}0.73$) with statistical significance (p = 0.006, p = 0.003). According to the Prolo scale, 11, 22, one and three patients were in excellent, good, fair and poor conditions, respectively. The average amount of the injected cement per one cannulated screw was $1.83{\pm}0.11\;mL$. Conclusion : The results show favorable outcome both clinically and radiographically for 37 patients who underwent lumbar fusion using $DTPS^{TM}$ and PMMA. Based on the results, the use of this surgical method can be a safe and effective option for the operation on the osteoporotic spine.

• Journal of the Korean Orthopaedic Association
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• v.54 no.3
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• pp.203-210
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• 2019

The aim of this review was to evaluate minimally invasive lateral lumbar interbody fusion on the latest update. Lumbar interbody fusion was introduced recently. This study performed, a literature review of the indications, clinical outcomes, fusion rate, and complications regarding recently highlighted minimally invasive lateral lumbar interbody fusion. The indications of lateral lumbar interbody fusion are similar to the conventional anterior and posterior interbody fusion in degenerative lumbar diseases. In particular, lateral lumbar interbody fusion is an effective minimally invasive surgery in spinal stenosis, degenerative spondylolisthesis, degenerative adult deformity, degenerative disc disease and adjacent segment disease. In addition, the clinical outcomes and fusion rates of lateral lumbar interbody fusion are similar compared to conventional lumbar fusion. On the other hand, non-specific complications including hip flexor weakness, nerve injury, vascular injury, visceral injury, cage subsidence and pseudohernia have been reported. Lateral lumbar interbody fusion is a very useful minimally invasive surgery because it has advantages over conventional anterior and posterior interbody fusion without many of the disadvantages. Nevertheless, nonspecific complications during lateral lumbar interbody fusion procedure remain a challenge to be improved.

• Journal of the Korean Orthopaedic Association
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• v.55 no.5
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• pp.405-410
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• 2020

Purpose: Pedicle screw insertion has been traditionally used as a surgical treatment for degenerative lumbar spine disease. As an alternative, the cortical-bone trajectory screw allows less invasive posterior lumbar fixation and excellent mechanical stability, as reported in several biomechanical studies. This study evaluated the clinical and radiological results of a case of early failure of cortical-bone screw fixation in posterior fixation and union after posterior decompression. Materials and Methods: This study examined 311 patients who underwent surgical treatment from 2013 to 2018 using cortical orbital screws as an alternative to traditional pedicle screw fixation for degenerative spinal stenosis and anterior spine dislocation of the lumbar spine. Early fixation failure after surgery was defined as fixation failure, such as loosening, pull-out, and breakage of the screw on computed tomography (CT) and radiographs at a follow-up of six months. Results: Early fixation failure occurred in 46 out of 311 cases (14.8%), screw loosening in 46 cases (14.8%), pull-out in 12 cases (3.9%), and breakage in four cases (1.3%). An analysis of the site where the fixation failure occurred revealed the following, L1 in seven cases (15.2%), L2 in three cases (6.5%), L3 in four cases (8.7%), L4 in four cases (8.7%), L5 in four cases (8.7%), and S1 in 24 cases (52.2%). Among the distal cortical bone screws, fixation failures such as loosening, pull-out, and breakage occurred mainly in the S1 screws. Conclusion: Cortical-bone trajectory screw fixation may be an alternative with comparable clinical outcomes or fewer complications compared to conventional pedicle screw fixation. On the other hand, in case with osteoporosis and no anterior support structure particularly at L5-S1 fusion sites were observed to have result of premature fixation failures such as relaxation, pull-out, and breakage.

• The Korean Journal of Pain
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• v.22 no.3
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• pp.245-248
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• 2009

Ossification of the yellow ligament (OYL) is a pathologic condition that causes spinal stenosis, which is a form of ectopic ossification. OYL causes compressive myelopathy and radiculopathy. Although the pathogenesis of OYL is still unclear, diffuse mechanical stresses and degenerative changes caused by extreme ranges of motion may be related to the development of OYL in young sportsmen. Here we report an interesting case of thoracic radiculopathy due to OYL in a 35-year-old male amateur judo player who was successfully treated with continuous thoracic patient controlled epidural analgesia and epidural adhesiolysis.

• Journal of Acupuncture Research
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• v.17 no.2
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• pp.11-18
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• 2000

Bee-venom Acupucture has good effect on pain control but We may be anxious about the problem of Liver and Kidneys on many times treated patients. Therefore, In order to analysis the clinical form, We have observed the LFT, RFT of 37 patients who visited Won-Kwang University Kunpo Oriental Medical Hospital and treated Bee Venom therapy over 20 times from March 1999 to February 2000. The results were summarized as follows 1. The distribution of sex was 25 females, 12 males, and the average of patients age was 42.3 years 2. The distribution of disease was degenerative arthritis, HIVD of L-spine, HIVD of C-spine, spinal stenosis, RA, etc. 3. The total treated times is 1464 and the average of treated times is 39.6 times 4. The results of the LFT(AST, ALT) of 37 patients showed that normal impression is occupied 91.9% and abnormal impression is occupied 8.1%. 5. The results of the RFT(BLTN, Creatinine) of 37 patients showed that normal impression is occupied 100%. 6. The results of treatment using BV-acupunture showed that 81.1% achieved above excelent recovery 13.5% achieved above good recovery, 5.4% achieved fair recovery.

• Journal of Korean Neurosurgical Society
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• v.59 no.6
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• pp.647-649
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• 2016

The device for intervertebral assisted motion (DIAM) is a dynamic implant that consists of a silicone bumper enveloped by a polyethylene terephthalate (PET) fiber sack. Silicone and PET were used because of their biological inertness, but repetitive motion of the spine can cause wear on the implant nonetheless. The purpose of this study is to report a case of foreign body reaction (FBR) against a DIAM. A 72-year-old female patient presented with lower back pain and both legs radiating pain. She had undergone DIAM implantation at L4-5 for spinal stenosis 5 years previously. The intervertebral disc space of L4-5, where the DIAM was inserted, had collapsed and degenerative scoliosis had developed due to left-side collapse. MRI showed L3-4 thecal sac compression and left L4-5 foraminal stenosis. The patient underwent removal of the DIAM and instrumented fusion from L3 to L5. During surgery, fluid and granulation tissue were evident around the DIAM. Histopathology showed scattered wear debris from the DIAM causing chronic inflammation due to the resulting FBR. A FBR due to wear debris of a DIAM can induce a hypersensitivity reaction and bone resorption around the implant, causing it to loosen.

• Journal of Korean Neurosurgical Society
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• v.58 no.1
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• pp.43-49
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• 2015

Objective : $Dynesys^{(R)}$ is one of the pedicle-based dynamic lumbar stabilization systems and good clinical outcome has been reported. However, the cylindrical spacer between the heads of the screws undergoes deformation during assembly of the system. The pre-strain probably change the angle of instrumented spine with time and oblique-shaped spacer may reduce the pre-strain. We analyzed patients with single-level stabilization with $Dynesys^{(R)}$ and simulated oblique-shaped spacer with finite element (FE) model analysis. Methods : Consecutive 14 patients, who underwent surgery for single-level lumbar spinal stenosis and were followed-up more than 24 months (M : F=6 : 8; age, $58.7{\pm}8.0$ years), were analyzed. Lumbar lordosis and segmental angle at the index level were compared between preoperation and postoperative month 24. The von Mises stresses on the obliquely-cut spacer ($5^{\circ}$, $10^{\circ}$, $15^{\circ}$, $20^{\circ}$, $25^{\circ}$, and $30^{\circ}$) were calculated under the compressive force of 400 N and 10 Nm of moment with validated FE model of the L4-5 spinal motion segment with segmental angle of $16^{\circ}$. Results : Lumbar lordosis was not changed, while segmental angle was changed significantly from $-8.1{\pm}7.2^{\circ}$ to $-5.9{\pm}6.7^{\circ}$ (p<0.01) at postoperative month 24. The maximum von Mises stresses were markedly decreased with increased angle of the spacer up to $20^{\circ}$. The stress on the spacer was uneven with cylindrical spacer but it became even with the $15^{\circ}$ oblique spacer. Conclusion : The decreased segmental lordosis may be partially related to the pre-strain of Dynesys. Further clinical and biomechanical studies are required for relevant use of the system.