• 제목/요약/키워드: Disc Disease

검색결과 283건 처리시간 0.039초

두경부 위치에 따른 측두하악장애환자의 하악 torque 회전운동 분석 (Effects of Head Posture on the Rotational Torque Movement of Mandible in Patients with Temporomandibular Disorders)

  • 박혜숙;최종훈;김종열
    • Journal of Oral Medicine and Pain
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    • 제25권2호
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    • pp.173-189
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    • 2000
  • The purpose of this study was to evaluate the effect of specific head positions on the mandibular rotational torque movements in maximum mouth opening, protrusion and lateral excursion. Thirty dental students without any sign or symptom of temporomandibular disorders(TMDs) were included as a control group and 90 patients with TMDs were selected and examined by routine diagnostic procedure for TMDs including radiographs and were classified into 3 subgroups : disc displacement with reduction, disc displacement without reduction, and degenerative joint disease. Mandibular rotational torque movements were observed in four head postures: upright head posture(NHP), upward head posture(UHP), downward head posture(DHP), and forward head posture(FHP). For UHP, the head was inclined 30 degrees upward: for DHP, the head was inclined 30 degrees downward: for FHP, the head was positioned 4cm forward. These positions were adjusted with the use of cervical range-of-motion instrumentation(CROM, Performance Attainment Inc., St. Paul, U.S.A.). Mandibular rotational torque movements were monitored with the Rotate program of BioPAK system (Bioresearch Inc., WI, U.S.A.). The rotational torque movements in frontal and horizontal plane during mandibular border movement were recorded with two parameters: frontal rotational torque angle and horizontal rotational torque angle. The data obtained was analyzed by the SAS/Stat program. The obtained results were as follows : 1. The control group showed significantly larger mandibular rotational angles in UHP than those in DHP and FHP during maximum mouth opening in both frontal and horizontal planes. Disc displacement with reduction group showed significantly larger mandibular rotational angles in DHP and FHP than those in NHP during lateral excursion to the affected and non-affected sides in both frontal and horizontal planes(p<0.05). 2. Disc displacement without reduction group showed significantly larger mandibular rotational angles in FHP than those in any other head postures during maximum mouth opening as well as lateral excursion to the affected and non-affected sides in both frontal and horizontal planes. Degenerative joint disease group showed significantly larger mandibular rotational angles in FHP than those in any other head postures during maximum mouth opening, protrusion and lateral excursion in both frontal and horizontal planes(p<0.05). 3. In NHP, mandibular rotational angle of the control group was significantly larger than that of any other patient subgroups. Mandibular rotational angle of disc displacement with reduction group was significantly larger than that of disc displacement without reduction group during maximum mouth opening in the frontal plane. Mandibular rotational angle of disc displacement without reduction group was significantly larger than that of disc displacement with reduction group or degenerative joint disease group during maximum mouth opening in the horizontal plane(p<0.05). 4. In NHP, mandibular rotational angles of disc displacement without reduction group were significantly larger than those of the control group or disc displacement with reduction group during lateral excursion to the affected side in both frontal and horizontal planes. Mandibular rotational angle of disc displacement without reduction group was significantly smaller than that of the control group during lateral excursion to the non-affected side in frontal plane. Mandibular rotational angle of disc displacement without reduction group was significantly larger than that of disc displacement with reduction group during lateral excursion to the non-affected side in the horizontal plane(p<0.05). 5. In NHP, mandibular rotational angle of the control group was significantly smaller than that of disc displacement with reduction group or disc displacement without reduction group during protrusion in the frontal plane. Mandibular rotational angle of disc displacement without reduction group was significantly larger than that of the disc displacement with reduction group or degenerative joint disease group during protrusion in the horizontal plane. Mandibular rotational angle of the control group was significantly smaller than that of disc displacement without reduction group or degenerative joint disease group during protrusion in the horizontal plane(p<0.05). 6. In NHP, disc displacement without reduction group and degenerative joint disease group showed significantly larger mandibular rotational angles during lateral excursion to the affected side than during lateral excursion to the non-affected side in both frontal and horizontal planes(p<0.05). The findings indicate that changes in head posture can influence mandibular rotational torque movements. The more advanced state is a progressive stage of TMDs, the more influenced by FHP are mandibular rotational torque movements of the patients with TMDs.

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Cost-Effectiveness Analysis of Cervical Anterior Fusion and Cervical Artificial Disc Replacement in the Korean Medical System

  • Lee, Hyosang;Kim, Ui Chul;Oh, Jae Keun;Kim, Taehyun;Park, Sohee;Ha, Yoon
    • Journal of Korean Neurosurgical Society
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    • 제62권1호
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    • pp.83-89
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    • 2019
  • Objective : This study is a retrospective cost-benefit analysis of cervical anterior interbody fusion and cervical artificial disc replacement, which are the main surgical methods to treat degenerative cervical disc disease. Methods : We analyzed 156 patients who underwent anterior cervical disc fusion and cervical artificial disc replacement from January 1, 2008 to December 31, 2009, diagnosed with degenerative cervical disc disorder. In this study, the costs and benefits were analyzed by using quality adjusted life year (QALY) as the outcome index for patients undergoing surgery, and a Markov model was used for the analysis. Only direct medical costs were included in the analysis; indirect medical costs were excluded. Data were analyzed with TreeAge Pro $2015^{TM}$ (TreeAge Software, Inc, Williamstown, MA, USA). Results : Patients who underwent cervical anterior fusion had a total cost of KRW 2501807/USD 2357 over 5 years and obtained a utility of 3.72 QALY. Patients who underwent cervical artificial disc replacement received 4.18 QALY for a total of KRW 3685949/USD 3473 over 5 years. The cumulative cost-effectiveness ratio of cervical spine replacement surgery was KRW 2549511/QALY (USD 2402/QALY), which was lower than the general Korean payment standard. Conclusion : Both cervical anterior fusion and cervical artificial disc replacement are cost-effective treatments for patients with degenerative cervical disc disease. Cervical artificial disc replacement may be an effective alternative to obtain more benefits.

허리디스크 환자를 위한 허리보호용 이너웨어 개발 연구(제2보) -여성 이너웨어 개발과 착의평가- (A Study on the Development of Protective Inner Wear for Lumbar Disc Disease Patients (Part II) -Development of Female Inner Wear and Wearing Test-)

  • 강혜진;정명숙
    • 한국의류학회지
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    • 제41권1호
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    • pp.141-152
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    • 2017
  • The lumbar disc is one of the first parts of the human body to age. Female discs start to age at twenty and completely age between fifty and sixty. The number of lumbar herniated intervertebral disc patients is increasing rapidly; however, studies on protective inner wear are insufficient. This study develops protective inner wear equipment for bodies. The following were the study methods and procedures. First, the protective design, pattern and making of the inner wear were based on the analysis of collected data. Second, one subject was selected, then human body parts were measured to create the inner protective pattern. The inner pattern was made by the basic size of the subject. The inner protective equipment was made for lumbar disc disease patients after a wearing test and after correcting the pattern. Third, inner protective equipment was thoroughly tested to verify the compatibility of lumbar pads. The following were the study results and observations. First, lumbar pads who had inner protection were easily worn and the design was very ladyish in contrast to other lumbar pads on the market. Second, the pattern was completed by referring to, Lee Hyoung Sook's, torso and her lumbar pad shape. The fabric was mesh (for good ventilation) and poly spandex (for elasticity). Third, lumbar inner protective equipment was verified through a subject assessment and a major assessment. This study showed high scores on appearance and functional satisfaction versus existing disc lumbar pads in the market. This study predicts that new waist protective inner wear can help the female patient's health and social life because it has great functionality and can maintain outer line patterns.

The Option of Motion Preservation in Cervical Spondylosis: Cervical Disc Arthroplasty Update

  • Chang, Chih-Chang;Huang, Wen-Cheng;Wu, Jau-Ching;Mummaneni, Praveen V.
    • Neurospine
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    • 제15권4호
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    • pp.296-305
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    • 2018
  • Cervical disc arthroplasty (CDA), or total disc replacement, has emerged as an option in the past two decades for the management of 1- and 2-level cervical disc herniation and spondylosis causing radiculopathy, myelopathy, or both. Multiple prospective randomized controlled trials have demonstrated CDA to be as safe and effective as anterior cervical discectomy and fusion, which has been the standard of care for decades. Moreover, CDA successfully preserved segmental mobility in the majority of surgical levels for 5-10 years. Although CDA has been suggested to have long-term efficacy for the reduction of adjacent segment disease in some studies, more data are needed on this topic. Surgery for CDA is more demanding for decompression, because indirect decompression by placement of a tall bone graft is not possible in CDA. The artificial discs should be properly sized, centered, and installed to allow movement of the vertebrae, and are commonly 6 mm high or less in most patients. The key to successful CDA surgery includes strict patient selection, generous decompression of the neural elements, accurate sizing of the device, and appropriately centered implant placement.

개에서 추간판 질환에 대한 침술치료 증례 (Application of Traditional Acupuncture on Canine Intervertebral Disc Disease)

  • 정성목;박수원
    • 한국임상수의학회지
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    • 제21권1호
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    • pp.49-51
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    • 2004
  • A four-year-old female Pekingese dog was presented with intermittent ambulatory hindlimb lameness and severe back pain. The course of the disease was acute and static and 5 days passed by until presentation. In neurological examination, severe back pain and slightly decreased proprioception in right hindlimb were shown. In radiographic examination, radiopacity was increased at T10-11 intervertebral disc space. According to the history taking, neurological examination and radiographic examination, it was tentatively diagnosed as intervertebral disc disease (IVDD). Conservative treatment was performed including cage rest, medication with prednisolone and traditional acupuncture. Acupoints were GV-6, GV-7, BL-18, BL-19. BL-40 and GB-34. Dry needlings rested for 20 minutes. Just after the first acupuncture treatment back pain was significantly decreased. With additional acupuncture treatment, all the clinical signs were not observed. It is considered that conservative therapy including traditional acupuncture, medication and cage rest might be the first choice of therapeutic method for Grade I or II IVDD in dogs.

Narrative Review of Pathophysiology and Endoscopic Management of Basivertebral and Sinuvertebral Neuropathy for Chronic Back Pain

  • Hyeun Sung Kim;Pang Hung Wu;Il-Tae Jang
    • Journal of Korean Neurosurgical Society
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    • 제66권4호
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    • pp.344-355
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    • 2023
  • Chronic lower back pain is a leading cause of disability in musculoskeletal system. Degenerative disc disease is one of the main contributing factor of chronic back pain in the aging population in the world. It is postulated that sinuvertebral nerve and basivertebral nerve main mediator of the nociceptive response in degenerative disc disease as a result of neurotization of sinuvertebral and basivertebral nerve. A review in literature is done on the pathoanatomy, pathophysiology and pain generation pathway in degenerative disc disease and chronic back pain and management strategy is discussed in this review to aid understanding of sinuvertebral and basivertebral neuropathy treatment strategies.

Immediate Effect of Flexion-Distraction Spinal Manipulation on Intervertebral Height, Pain, and Spine Mobility in Patients with Lumbar Degenerative Disc Disease

  • Pi, Taejin;Chung, Yijung
    • Physical Therapy Rehabilitation Science
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    • 제10권2호
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    • pp.235-243
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    • 2021
  • Objective: This study aimed to investigate the short-term effects of flexion-distraction spinal manipulation on intervertebral height, pain, spine mobility in patients with lumbar degenerative disc disease. Design: Randomized controlled trial with a pretest-posttest control group design Methods: A total of 96 participants with degenerative disc disease participated in the study and were randomly divided into two groups. Both groups received intervention for 3-5 minutes a day. The experimental group (n=48) underwent flexion-distraction spinal manipulation for 3-5 minutes, and the control group (n=48) was maintained in the same position as the experimental group for 5 minutes without any intervention. The intervertebral height was measured by computed tomography, pain was assessed using visual analog scale, and the spine in flexion mobility was measured using the finger-to-floor distance test and passive straight leg raise test. Pre-test and post-test measurements were obtained. Results: The experimental group showed significant improvement in intervertebral height, degree of pain, and spinal mobility (p<0.05). The intervertebral height increased from 6.32±1.90 to 6.93±1.85 mm (p<0.05), lower back pain decreased from 69.17±13.35 mm to 48.48±12.20 mm (p<0.05), lumbar spine mobility changed from 17.37±4.49 to 12.69±4.34 cm (p<0.05), and passive straight leg raise test range increased from 46.94±13.05° to 56.01±12.20° (p<0.05). Conclusions: This study suggests that flexion-distraction spinal manipulation could be an effective treatment for decreasing pain and improving function in patients with degenerative disc disease.

Standardized Body Size Indexes of 10 Canine Breeds Vulnerable to Intervertebral Disc Disease

  • Seong-Min Kang;Eun-Jik Kim;Seong-won An;Young-Sam Kwon
    • 한국임상수의학회지
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    • 제41권1호
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    • pp.1-7
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    • 2024
  • The intervertebral disc is a crucial structure located between each vertebral body, except C1 and C2 and the fused sacral vertebrae, which provides cushioning and stability. However, sometimes these discs may bulge or extrude, causing painful conditions and various neurological problems such as ataxia, paresis, motor or sensorimotor paralysis. As a result, dogs affected by intervertebral disc disease (IVDD) can suffer a significant decrease in their quality of life. The main objective of this study was to provide comprehensive data on the body size of several IVDD-susceptible dog breeds commonly bred in South Korea, which could help develop supportive devices for IVDD patients. Using standardized measurements, the study aimed to design appropriate support tools, taking into account the mobility challenges faced by IVDD patients. The findings provide valuable data to improve the quality of life of patients with IVDD. In addition, it may lay the foundation for research to establish the correlation between body size and IVDD through future research.

Discogenic Abdominal Pain

  • Choi, Seok-Min;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • 제38권5호
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    • pp.384-386
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    • 2005
  • There have been several reports about abdominal pain due to discitis in children or thoracic disc herniation. However, none of them could verify causal relationship between disc disease and abdominal pain clearly. The authors report a patient with discogenic abdominal pain who had disc degeneration at lower lumbar level without definite protrusion or any evidence of inflammation. We could reproduce the abdominal pain by using discography. The patient was treated by percutaneous disc decompression successfully.

요추 추간판 간격 좁아짐 진단 환자에서 요추 추간판 간격과 요추 추간판 탈출증 정도와의 상관성 (The relationship between Width of Lumbar Disc Space and Severity of Herniated Intervertebral Disc in Patients Diagnosis Disc space narrowing)

  • 이갑수;김원우;성익현;조창영
    • 척추신경추나의학회지
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    • 제8권2호
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    • pp.79-86
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    • 2013
  • Objective : The purpose of this study was to suggest (diagnostic) criteria for lumbar disc space and see the correlation between lumbar disc space narrowing and the level of HIVD. Methods : We looked at the 113 patients diagnosed disc space narrowing with lumbar x-ray and MRI films who have visited Jaseng Hospital of Oriental Medicine with low back pain in October,2013. The width of lumbar disc space and the severity of Herniated Intervertebral Disc(HIVD) on MRI films were collected and stastically analyzed using one-way ANOVA. Results : In this study, measured value(%) for lumbar disc space of the group diagnosed serious HIVD, such as protrusion, extrusion and migration was significantly decresed compared to the normal group and the bulging group. Conclusion : There was a significant correlation between lumbar disc space narrowing and the level of HIVD.

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