• Title/Summary/Keyword: Disc Height

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Anterior Cervical Interbody Fusion with the Carbon Composite Osta-Pek Frame Cage in Degenerative Cervical Diseases

  • Han, Kwang-Wook;Kim, Joon-Soo;Kim, Kyu-Hong;Cho, Yong-Woon;Lee, In-Chang;Bae, Sang-Do
    • Journal of Korean Neurosurgical Society
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    • v.37 no.6
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    • pp.422-426
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    • 2005
  • Objective: Different types of interbody fusion cages are available for use in the surgical treatment of degenerative cervical diseases. The purpose of this study is to assess the technical feasibility, clinical efficacy and radiological results of intervertebral fusion with a carbon composite Osta-Pek frame cage (Co-Ligne AG, Switzerland) following anterior cervical discectomy. Methods: 41 patients (25males and 16females) with minimum 6months follow-up were included in the study. Disc height, cervical lordotic angle, segmental angle, and fusion rate were assessed by lateral radiographs. In this retrospective analysis, clinical outcome was assessed as evaluated according to Odom's criteria. Results: Fifty-four cages were implanted in 30 single-level, 9 two-level, and 2 three-level procedures. The mean disc height, cervical lordosis angle, segmental angle were $4.2{\pm}1.8mm,\;23.5{\pm}7.2^{\circ},\;2.3{\pm}3.3^{\circ}$ pre-operatively and $5.3{\pm}2.1mm,\;24.2{\pm}8.3^{\circ},\;3.8{\pm}3.5^{\circ}$ at 6months after the surgery. Six months after surgery, there was radiographic evidence of fusion in 92.7% (38/41) of the patients. According to Odom's criteria, 37 of 41 (90.2%) patients experienced good to excellent functional recovery. Conclusion: These clinical and radiological results suggest that the carbon composite Osta-Pek frame cages are safe and effective alternative to autologous bone graft after anterior cervical discectomy for treatment of degenerative cervical disease.

Usefulness of Oblique Lateral Interbody Fusion at L5-S1 Level Compared to Transforaminal Lumbar Interbody Fusion

  • Mun, Hah Yong;Ko, Myeong Jin;Kim, Young Baeg;Park, Seung Won
    • Journal of Korean Neurosurgical Society
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    • v.63 no.6
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    • pp.723-729
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    • 2020
  • Objective : The use of oblique lateral interbody fusion at the L5-S1 level (OLIF51) is increasing, but no study has directly compared OLIF51 and transforaminal lumbar interbody fusion (TLIF) at the L5-S1 level. We evaluated the usefulness of OLIF51 by comparing clinical and radiologic outcomes with those of TLIF at the same L5-S1 level. Methods : We retrospectively reviewed and compared 74 patients who underwent OLIF51 (OLIF51 group) and 74 who underwent TLIF at the L5-S1 level (TLIF51 group). Clinical outcomes were assessed with the visual analogue scale for back pain and leg pain and the Oswestry Disability Index. Mean disc height (MDH), foraminal height (FH), disc angle (DA), fusion rate, and subsidence rate were measured for radiologic outcomes. Results : The OLIF51 group used significantly higher, wider, and larger-angled cages than the TLIF51 group (p<0.001). The postoperative MDH and FH were significantly greater in the OLIF51 group than in the TLIF51 group (p<0.001). The postoperative DA was significantly larger in the OLIF51 group than in the TLIF51 group by more than 10º (p<0.001). The fusion rate was 81.1% and 87.8% at postoperative 6 months in the OLIF51 and TLIF51 groups, respectively, and the TLIF51 group showed a higher fusion rate (p<0.05). The subsidence rate was 16.2% and 25.3% in the OLIF51 and TLIF51 groups, respectively, and the OLIF51 group showed a lower subsidence rate (p<0.05). Conclusion : OLIF51 was more effective for the indirect decompression of foraminal stenosis, providing strong mechanical support with a larger cage, and making a greater lordotic angle with a high-angle cage than with TLIF.

Minimally Invasive Posterior Lumbar Interbody Fusion with Threaded Fusion Cage(TFC) (Threaded Fusion Cage(TFC)를 이용한 최소 침습적 요추체 후방융합술)

  • Kim, Hyeok Joon;Cho, Ki Hong;Shin, Yong Sam;Yoon, Soo Han;Cho, Kyung Gi
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup2
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    • pp.247-253
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    • 2001
  • Objective : In general, to perform posterior lumbar interbody fusion(PLIF), it has been used more invasive procedure than simple discectomy. However we try to perform PLIF with TFC with smaller invasion almost same as in simple discectomy. This study is about its procedure and clinical results. Materials and Methods : The authors retrospectively analyzed 43 cases of minimally invasive PLIF with TFC from July 1998 to May 2000. Operative procedure, operative complication, change of disc height, blood loss, ambulation time, hospitalization period, clinical success rate, and bony fusion rate were analyzed. Results : 40 patients were capable to walk on the 2nd day of the post-operation. The average hospitalization period is 5.6 days. The average blood loss was 0.19L/level with no transfusion or wound drainage. The height of disc changed from 8.84mm to 13.54mm. Clinical success rate is 95% when evaluated by the Prolo's scale. The complication was delayed wound infection(2) and transient paresthesis(1). The bony fusion was shown in 17 patients (94.4%) out of 18 patients who passed one year. Conclusion : As a result of minimally invasive PLIF, pain was decreased and early ambulation and short hospitalization was possible. Complication was similar or lower than other studies, and the bony fusion rate and clinical success rate were also similar during follow-up.

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Percutaneous Vertebroplasty Following Postural Reduction in Unstable Vertebra Plana; Is it a Contraindication?

  • Kim, Seok-Won;Lee, Seung-Meung;Shin, Ho;Kim, Hyun-Sung
    • Journal of Korean Neurosurgical Society
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    • v.39 no.2
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    • pp.92-95
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    • 2006
  • Objective : Severe vertebral body collapse [vertebra plana] is considered a contraindication to vertebroplasty by most authors. The purpose of this study is to determine the efficacy of vertebroplasty in treating severe compression fracture patients with osteoporosis. Methods : 16 patients underwent 18 vertebroplasties following postural reduction for vertebra plana. The fractures were defined vertebrae that have collapsed to more than 75% of their original height. Imaging and clinical features were analyzed, including involved vertebrae level, vertebral height after postural reduction for 2 days, injected cement volume, clinical outcome and complications. Results : Involved veretebra were located from level T7 to L4. Vertebral body collapse averaged 79% [range $12{\sim}25%$] of the original height. After pillow reduction for 2 days, vertebral body height increased 35% of the original height [range $15{\sim}45%$]. The kyphotic wedge was $12^{\circ}$ before procedure and was decreased $7.0^{\circ}$ after vertebroplasty. The mean injected cement volume was 3.8ml [range $2.0{\sim}4.9ml$]. After the procedure, surgical outcome was excellent in 8 [50%] of 16 patients, good in 7 [42%] and unchanged in one [8%]. The mean pain score [VAS score] prior to vertebroplasty was 8.3 and it changed 3.2 after the procure. Cement leakage to the adjacent disc [5 cases] and paravertebral soft tissues [4 cases] developed but there were no major complications. Conclusion : We propose that vertebra plana due to osteoporosis is not a contraindication to vertebroplasty. Vertebroplasty following postural reduction for severe compression fracture is safe and effective treatment.

Two-body wear behavior of human enamel versus monolithic zirconia, lithium disilicate, ceramometal and composite resin

  • Habib, Syed Rashid;Alotaibi, Abdulaziz;Al Hazza, Nawaf;Allam, Yasser;AlGhazi, Mohammad
    • The Journal of Advanced Prosthodontics
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    • v.11 no.1
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    • pp.23-31
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    • 2019
  • PURPOSE. To investigate and compare the surface roughness (SR), weight and height of monolithic zirconia (MZ), ceramometal (CM), lithium disilicate glass ceramic (LD), composite resin (CR), and their antagonistic human teeth enamel. MATERIALS AND METHODS. 32 disc shaped specimens for the four test materials (n=8) and 32 premolars were prepared and randomly divided. SR, weight and height of the materials and the antagonist enamel were recorded before and after subjecting the specimens to 240,000 wear-cycles ($49N/0.8Hz/5^{\circ}C/50^{\circ}C$). SR, height, weight, and digital microscopic qualitative evaluation were measured. RESULTS. CM ($0.23+0.08{\mu}m$) and LD ($0.68+0.16{\mu}m$) exhibited the least and highest mean difference in the SR, respectively. ANOVA revealed significance (P=.001) between the materials for the SR. Paired T-Test showed significance (P<.05) for the pre- and post- SR for all the materials. For the antagonistic enamel, no significance (P=.987) was found between the groups. However, the pre- and post- SR values of all the enamel groups were significant (P<.05). Wear cycles had significant effect on enamel weight loss against all the materials (P<.05). CR and MZ showed the lowest and highest height loss of 0.14 mm and 0.46 mm, respectively. CONCLUSION. MZ and CM are more resistant to SR against the enamel than LD and CR. Enamel worn against test materials showed similar SR. Significant variations in SR values for the tested materials (MZ, LD, CM, and CR) against the enamel were found. Wear simulation significantly affected the enamel weight loss against all the materials, and enamel antagonist against MZ and CM showed more height loss.

Hinge Mechanism Design of Smooth-Lift-Unit for Flat Panel Display (평판디스플레이용 유연승강유니트의 힌지기구 설계)

  • Cheong, Seon-Hwan;Choi, Seong-Dae;Cho, Gyu-Yeol
    • Journal of the Korean Society of Manufacturing Process Engineers
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    • v.6 no.3
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    • pp.85-91
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    • 2007
  • This study was carried out to minimize the lifting force of a two hinge type stand mechanism. This unit is designed for the display devices in order to enhance the ergonomics for effective height adjustment and maintenance at any preferred position. The unit will be very useful for the mechanism fabricated with a coil spring and disc springs as a torque generator. The maximum and the minimum torque value should be calculated initially for the smooth lift. And the reasonable torque distribution is necessary to prevent any auto lift and auto dropping at any position because the torque generated by coil spring is more sensitive than disc spring in tilting the position. Therefore, the analysis of the coil spring is requisite to issue the specific torque value depending on the distorted angle with securing reliability of a long time storage condition. After the theoretical torque value was calculated, the evaluation was carried out by making a proto-type sample, then distorted angle was updated by experiment. The result of this study can readily be applied to various units for the optimization of the smooth lift.

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A Study on Adaptive Design of Mechanical Part for Smooth Lift (유연 승강기용 부품의 적용 설계에 관한 연구)

  • 최성대;정선환;조규열
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2003.06a
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    • pp.1454-1457
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    • 2003
  • This study was carried out to minimize the lifting force of a two hinge type stand mechanism. This unit is designed for the display devices in order to enhance the ergonomics for effective height adjustment and maintenance at any preferred position. The unit will be very useful for the mechanism fabricated with a coil spring and disc springs as a torque generator. The maximum and the minimum torque value should be calculated initially for the smooth lift. And the reasonable torque distribution is necessary to prevent any AUTO LIFT and AUTO Drooping at any position because the torque generated by coil spring is more sensitive than disc spring in tilting the position. Therefore, the analysis of the coil spring is requisite to issue the specific torque value depending on the distorted angle with securing reliability of a long time storage condition. After the theoretical torque value was calculated, the evaluation was carried out by making a proto-type sample, then distorted angle was updated by experiment. The result of this study can readily be applied to various units for the optimization of the smooth lift.

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Long-Term Follow-Up Radiologic and Clinical Evaluation of Cylindrical Cage for Anterior Interbody Fusion in Degenerative Cervical Disc Disease

  • Kim, Su-Hyeong;Chun, Hyoung-Joon;Yi, Hyeon-Joong;Bak, Koang-Hum;Kim, Dong-Won;Lee, Yoon-Kyoung
    • Journal of Korean Neurosurgical Society
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    • v.52 no.2
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    • pp.107-113
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    • 2012
  • Objective : Various procedures have been introduced for anterior interbody fusion in degenerative cervical disc disease including plate systems with autologous iliac bone, carbon cages, and cylindrical cages. However, except for plate systems, the long-term results of other methods have not been established. In the present study, we evaluated radiologic findings for cylindrical cervical cages over long-term follow up periods. Methods : During 4 year period, radiologic findings of 138 patients who underwent anterior cervical fusion with cylindrical cage were evaluated at 6, 12, 24, and 36 postoperative months using plain radiographs. We investigated subsidence, osteophyte formation (anterior and posterior margin), cage direction change, kyphotic angle, and bone fusion on each radiograph. Results : Among the 138 patients, a minimum of 36 month follow-up was achieved in 99 patients (mean follow-up : 38.61 months) with 115 levels. Mean disc height was 7.32 mm for preoperative evaluations, 9.00 for immediate postoperative evaluations, and 4.87 more than 36 months after surgery. Osteophytes were observed in 107 levels (93%) of the anterior portion and 48 levels (41%) of the posterior margin. The mean kyphotic angle was $9.87^{\circ}$ in 35 levels showing cage directional change. There were several significant findings : 1) related subsidence [T-score (p=0.039) and anterior osteophyte (p=0.009)], 2) accompanying posterior osteophyte and outcome (p=0.05). Conclusion : Cage subsidence and osteophyte formation were radiologically observed in most cases. Low T-scores may have led to subsidence and kyphosis during bone fusion although severe neurologic aggravation was not found, and therefore cylindrical cages should be used in selected cases.

A STUDY ON SURFACE ROUGHNESS OF COMPOSITE RESINS AFTER FINISHING AND POLISHING -an Atomic Force Microscope study (연마방법에 따른 복합레진의 활택도에 관한 연군 -Atomic Force Microscope를 이용한 연구)

  • Kim, Hyeong-Seob;Woo, Yi-Hyung
    • The Journal of Korean Academy of Prosthodontics
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    • v.35 no.4
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    • pp.719-741
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    • 1997
  • This study was undertaken to compare by Atomic Force Microscope the effects of various finishing and polishing instruments on surface roughness of filling and veneering composite resins. Seven composite resins were studied : Silux Plus (3M Dental Products, U.S.A.), Charisma (Heraeus Kulzer, Germany), Prisma THP (L.D.Caulk, Dentsply, U.S.A.), Photoclearfil (Kuraray, Japan), Cesead (Kuraray, Japan), Thermoresin LC (GC, Japan), Artglass (Heraeus Kulzer, Germany). Samples were placed and polymerized in holes (2mm thick and 8.5mm in diameter) machined in Teflon mold under glass plate, ensuring excess of material and moulded to shape with polyester matrix strip. Except control group (Polyester matrix strip), all experimental groups were finished and polishied under manufacturer's instructions. The finishing and polishing procedure were : carbide bur (E.T carbide set 4159, Komet, Germany), diamond bur (composite resin polishing bur set, GC, Japan), aluminum-oxide disc (Sof-Lex Pop-On, 3M Dental Products, U.S.A.), diamond-particle disc (Dia-Finish, Renfert Germany), white stone bur & rubber point( composite finishing kit, EDENTA, Swiss), respectively. Each specimens were evaluated for the surface roughness with Atomic Force Microscope (AutoProbe CP, Park Scientific Instruments, U.S.A.) under contact mode and constant height mode. The results as follows : 1. Except Thermoresin LC, all experimental composite resin groups showed more rougher than control group after finishing and polishing(p<0.1). 2. A surface as smooth as control group was obtained by $Al_{2}O_{3}$ disc all filling composite resin groups except Charisma and all veneering composite resin groups except Thermoresin LC(p<0.05). 3. In case of Thermoresin LC, there were no statistically significant differences before and after finishing and polishing(p>0.1). 4. Carbide bur, diamond bur showed rough surfaces in all composite resin groups, so these were inappropriate for the final polishing instruments.

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Fabrication of Tissue Engineered Intervertebral Disc Using Enable 3D bio-printing and Scaffod-Free technologies (3D 바이오프린팅과 무지지체 조직공학 기술 기반 추간판 복합 조직 제작)

  • Kim, Byeong Kook;Park, Jinho;Park, Sang-Hyug
    • Journal of Biomedical Engineering Research
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    • v.39 no.1
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    • pp.22-29
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    • 2018
  • Intervertebral disc(IVD) mainly consists of Annulus fibrosus(AF) and Nucleus pulposus(NP), playing a role of distributing a mechanical load on vertebral body. IVD tissue engineering has been developed the methods to achieve anatomic morphology and restoration of biological function. The goal of present study is to identify the possibilities for creating a substitute of IVD the morphology and biological functions are the same as undamaged complete IVD. To fabricate the AF and NP combine biphasic IVD tissue, AF tissue scaffolds have been printed by 3D bio-printing system with natural biomaterials and NP tissues have been prepared by scaffold-free culture system. We evaluated whether the combined structure of 3D printed AF scaffold and scaffold-free NP tissue construct could support the architecture and cell functions as IVD tissue. 3D printed AF scaffolds were printed with 60 degree angle stripe patterned lamella structure(the inner-diameter is 5mm, outer-diameter is 10 mm and height is 3 mm). In the cytotoxicity test, the 3D printed AF scaffold showed good cell compatibility. The results of histological and immunohistochemical staining also showed the newly synthesized collagens and glycosaminoglycans, which are specific makers of AF tissue. And scaffold-free NP tissue actively synthesized glycosaminoglycans and type 2 collagen, which are the major components of NP tissue. When we combined two engineered tissues to realize the IVD, combined biphasic tissues showed a good integration between the two tissues. In conclusion, this study describes the fabrication of Engineered biphasic IVD tissue by using enable techniques of tissue engineering. This fabricated biphasic tissue would be used as a model system for the study of the native IVD tissue. In the future, it may have the potential to replace the damaged IVD in the future.