• Journal of Korean Neurosurgical Society
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• 제59권3호
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• pp.292-295
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• 2016

Objective : To investigate the variation of pelvic radius and related parameters in low-grade isthmic lumbar spondylolisthesis. Methods : Seventy-four patients with isthmic lumbar spondylolisthesis and 47 controls were included in this study. There were 17 males and 57 females between 30 and 66 years of age, including 30 with grade I slippages and 44 grade II slippages; diseased levels included 34 cases on L4 and 40 cases on L5. Thoracic kyphosis (TK), the pelvic radius (PR), the pelvic angle (PA), pelvic morphology (PR-S1), and total lumbopelvic lordosis (PR-T12) were assessed from radiographs. Results : Statistically significant differences were found for the PA, PR-T12, and PR-S1 ($24.5{\pm}6.6^{\circ}$, $83.7{\pm}9.8^{\circ}$, and $25.4{\pm}11.2^{\circ}$, respectively) of the patients with spondylolisthesis and the healthy volunteers ($13.7{\pm}7.8^{\circ}$, $92.9{\pm}9.2^{\circ}$, and $40.7{\pm}8.9^{\circ}$, respectively). The TK/PR-T12 ratios were between 0.15 and 0.75. However, there were no differences in all the parameters between the L4 and L5 spondylolysis subgroups (p>0.05). The TK and PR-S1 of grade II were less than grade I, but the PA was greater. The PR-T12 of female patients were less than male patients, but the PA was greater (p<0.05). Conclusion : Pelvic morphology differed in patients with low-grade isthmic lumbar spondylolisthesis compared to controls. Gender and the grade of slippage impacted the sagittal configuration of the pelvis, but the segment of the vertebral slip did not. Overall, the spine of those with spondylolisthesis remains able to maintain sagittal balance despite abnormal pelvic morphology.

• Journal of Korean Neurosurgical Society
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• 제45권2호
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• pp.74-80
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• 2009

Objective : To evaluate clinical and radiological results of two different fusion techniques in adult low-grade isthmic spondylolisthesis. Methods : Between November 2003 and December 2004, 46 consecutive patients underwent instrumented mini-transforaminal lumbar interbody fusion (mini-TLIF) (group I) at Wooridul Spine Hospital, Seoul, Korea. Between February 2003 and October 2006, 32 consecutive patients underwent instrumented circumferential fusion (group II) at Leon Wiltse Memorial Hospital, Suwon, Korea. The mean follow-up periods were 29.7 and 26.1 months, respectively. Results : Mean visual analog scale (VAS) scores for back and leg pain decreased, respectively, from 6.98 and 6.33 to 2.3 and 2.2 in group I and from 7.38 and 6.00 to 1.7 and 1.0 in group II. Mean Oswestry disability index (ODI) improved from 51.85% to 14.4% in group I and from 60% to 9.1% in group II. In both groups, VAS and ODI scores significantly changed from pre- to postoperatively (p<0.001), but postoperative outcome between groups was statistically not significant. Radiologic evidence of fusion was noted in 95.7% and 100% of the patients in group I and II, respectively. In both groups, changes in disc height, segmental lordosis, degree of listhesis, and whole lumbar lordosis between the pre- and postoperative periods were significant except whole lumbar lordosis in both groups. Conclusion : Clinical and functional outcomes demonstrate no significant differences between groups in treating back and leg pain of adult patients with low-grade isthmic spondylolisthesis. However, in terms of operative data (i.e. operation time and hospital stay), instrumented mini-TLIF demonstrated better results.

• Journal of Korean Neurosurgical Society
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• 제30권10호
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• pp.1193-1199
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• 2001

Objectives : The goal of operation for degenerative lumbar diseases is to relieve radiculopathy and low back pain and to prevent further degeneration. The authors analyzed the surgical results of posterior lumbar interbody fusion(PLIF) and $0^{\circ}$ fixation to evaluate the proper treatment policy in spinal stenosis, degenerative spondylolisthesis and low grade isthmic spondylolisthesis. Material and Methods : The authors performed PLIF on 92 patients and $0^{\circ}$ fixation on 138 patients with spinal stenosis, degenerative spondylolisthesis and low grade isthmic spondylolisthesis. We retrospectively studied clinical outcomes and subjective satisfaction of these patients by several criteria such as visual analog scale(VAS), Prolo's economic and functional outcome scale, medication usage after operation and questionaire for overall outcome. Result : Pre- and postoperative VAS on back pain and leg pain showed decrease of pain from 6.5, 6.7 to 2.2, 2.4 in PLIF group and from 7.0, 7.2 to 2.5, 2.7 in $0^{\circ}$ fixation group. Excellent and good outcomes on Prolo's scale were 81.5% in PLIF group and 82.6% in $0^{\circ}$ fixation group. Medication usage after operation was reduced in 79.3% of PLIF group and in 78.3% of $0^{\circ}$ fixation group. Patients' self-reported overall success of their procedure showed 82% in PLIF group and 84% in $0^{\circ}$ fixation group. Conclusion : Both PLIF and $0^{\circ}$ fixation showed good outcomes and provided biomechanically stable fusion in spinal stenosis, degenerative spondylolisthesis and low grade isthmic spondylolisthesis. Therefore, only PLIF seems necessary and considered a proper surgical treatment for these disorders.

• Journal of Acupuncture Research
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• 제17권3호
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• pp.106-115
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• 2000

1997년 4월 1일부터 2000년 1월 31일까지 요통 및 하지통을 주소로 원광대학교 부속 광주한방병원에 척추전방전위증을 진단받고 입원 치료한 환자 28례를 분석하여 다음과 같은 결론을 얻었다. 1. 성별은 여성에 호발(82.1%)하였고, 원인에 따른 성별 분포는 협부형은 여성이 16례(76.2%)였고, 퇴행형은 여성이 7례(100%)였다. 2. 병력기간별 분포로는 최급성기가 32.1%로 가장 많았다. 남자는 80%가 최급성기 환자였고, 여자는 각 유형별로 고른 분포를 보였다. 3. 발병동기별 분포는 과로가 35.7%로 가장 많았다. 4. 원인별 분류에 따르면 협부형이 75%였고, 퇴행형이 25%였다. 5. 병변의 발생부위는 협부형의 경우 57.1%가 제5요추, 퇴행형의 경우 57.1%가 제4요추이다. 6. 전위정도는 대부분(96.4%)이 grade I이다. 7. 증상은 요통이 78.6%, 하지방산통이 92.9%이고, grade III 이상의 통증이 심한 환자가 25례(89.3%)로 거의 대부분 이었다. 8. 치료성적은 71.4%에서 good 이상의 만족스런 결과를 보였다. 이상의 결과로 보아 철추전방전위증 역시 요통의 범주로 놓고 볼 때 한방적인 치료만으로도 만족할만한 효과를 거둘 수 있음을 알 수 있으며 앞으로 척추전방전위증의 한방적 치료에 대한 더 깊이 있는 연구가 필요하리라 사료된다.