• Journal of Korean Neurosurgical Society
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• 제30권7호
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• pp.883-890
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• 2001

Objectives : An in vitro biomechanical study of posterior lumbar interbody fusion(PLIF) with threaded cage using two different approaches was performed on eighteen functional spinal units of bovine lumbar spines. The purpose of this study was to compare the segmental stiffnesses among PLIF with one long posterolateral cage, PLIF with one long posterolateral cage and simultaneous facet joint fixation, and PLIF with two posterior cages. Methods : Eighteen bovine lumbar functional spinal units were divided into three groups. All specimens were tested intact and with cage insertion. Group 1(n=12) had a long threaded cage($15{\times}36mm$) inserted posterolaterally and oriented counter anterolaterally on the left side by posterior approach with left unilateral facetectomy. Group 2(n=6) had two regular length cages($15{\times}24mm$) inserted posteriorly with bilateral facetectomy. Six specimens from group 1 were then retested after unilateral facet joint screw fixation in neutral(group 3). Likewise, the other six specimens from group 1 were retested after fixation with a facet joint screw in an extended position(group 4). Nondestructive tests were performed in pure compression, flexion, extension, lateral bending, and torsion. Results : PLIF with a single cage, group 1, had a significantly higher stiffnesses than PLIF with two cages, group 2, in left and right torsion(p<0.05). Group 1 showed higher stiffness values than group 2 in pure compression, flexion, left and right bending but were not significantly different. Group 3 showed a significant increase in stiffness in comparison to group 1 for pure compression, extension, left bending and right torsion(p<0.05). For group 4, the stiffness significantly increased in comparison to group 1 for extension, flexion and right torsion(p<0.05). Although there was no significant difference between groups 3 and 4, group 4 had increased stiffness in extension, flexion, right bending and torsion. Conclusion : Posterior lumbar interbody fusion with a single long threaded cage inserted posterolaterally with unilateral facetectomy enables sufficient decompression while maintaining a majority of the posterior elements. In combination with a facet joint screw fixation, adequate postoperative stability can be achieved. We suggest that posterolateral insertion of a long threaded cage is biomechanically an ideal alternative to PLIF.

• 대한정형외과학회지
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• 제55권3호
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• pp.261-265
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• 2020

요추 후관절 주위 낭종은 신경근을 누름으로써 요통과 방사통, 신경성 파행을 일으킬 수 있는 드문 질환이다. 34세 남자가 심한 요통 및 우측 하지 방사통을 호소하였다. 자기공명영상에서 척추관 내에서 제3-4번 요추 추간판과 제4번 요추체 후면까지 우측으로 위치한 낭종이 보였다. 영상증폭기 감시하에서 주사 바늘 흡인을 시행하여 1.5 ml의 장액성의 노란 액체가 흡인되었다. 흡인 치료 후, 증상들이 즉각적으로 소실되었다. 자기공명영상 추시 촬영에서 낭종의 재발소견이 보이지 않았다. 저자들이 아는 한 국내에서는 요추 후관절 주위 낭종에 대한 직접적 바늘 흡인 치료에 대한 보고가 전혀 없기에 이 증례를 문헌 고찰과 함께 보고하는 바이다.