• Journal of Korean Neurosurgical Society
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• 제62권4호
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• pp.450-457
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• 2019

Objective : Anterior cervical discectomy and fusion (ACDF) is commonly used surgical procedure for cervical degenerative disease. Among the various intervertebral spacers, the use of allografts is increasing due to its advantages such as no harvest site complications and low rate of subsidence. Although subsidence is a rare complication, graft collapse is often observed in the follow-up period. Graft collapse is defined as a significant graft height loss without subsidence, which can lead to clinical deterioration due to foraminal re-stenosis or segmental kyphosis. However, studies about the collapse of allografts are very limited. In this study, we evaluated risk factors associated with graft collapse. Methods : We retrospectively reviewed 33 patients who underwent two level ACDF with anterior plating using allogenous bone graft from January 2013 to June 2017. Various factors related to cervical sagittal alignment were measured preoperatively (PRE), postoperatively (POST), and last follow-up. The collapse was defined as the ratio of decrement from POST disc height to follow-up disc height. We also defined significant collapses as disc heights that were decreased by 30% or more after surgery. The intraoperative distraction was defined as the ratio of increment from PRE disc height to POST disc height. Results : The subsidence rate was 4.5% and graft collapse rate was 28.8%. The pseudarthrosis rate was 16.7% and there was no association between pseudarthrosis and graft collapse. Among the collapse-related risk factors, pre-operative segmental angle (p=0.047) and intra-operative distraction (p=0.003) were significantly related to allograft collapse. The cut-off value of intraoperative distraction ${\geq}37.3%$ was significantly associated with collapse (p=0.009; odds ratio, 4.622; 95% confidence interval, 1.470-14.531). The average time of events were as follows: collapse, $5.8{\pm}5.7months$; subsidence, $0.99{\pm}0.50months$; and instrument failure, $9.13{\pm}0.50months$. Conclusion : We experienced a higher frequency rate of collapse than subsidence in ACDF using an allograft. Of the various preoperative factors, intra-operative distraction was the most predictable factor of the allograft collapse. This was especially true when the intraoperative distraction was more than 37%, in which case the occurrence of graft collapse increased 4.6 times. We also found that instrument failure occurs only after the allograft collapse.

• 대한의료기공학회지
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• 제20권1호
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• pp.118-147
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• 2020

Objective : The purpose of this study is to understand trends of pelvic correction therapy in Korea and to assist research activities on pelvic correction therapy. Also, this study selected and presented indicators for measuring pelvic slope to help ensure consistent studies with uniform indicators in future studies related to pelvic correction. Methods : The following keywords "골반", "골반 교정", "골반 변위" "Pelvic correction" were searched on three specialized search sites (RISS, NAI, DBpia). Trends in pelvic correction therapy were analyzed through the selected researches suitable among these searched researches in an overview format. Results : 1. A total of 7,806 studies were searched and a total of 268 studies were finally selected. 2. Studies began in 1977 and have been actively studied until recently, with 35 studies in 2017 being the most recent trend since 2000. 3. In the results according to the Main Field of Research, the 'Arts and Kinesiology'(113, 42.16%) and 'Medicine and Pharmacy'(103, 38.43%) were the most in order. To the Middle Field, the 'Kinesiology was the largest with 96(35.82%) studies. 4. In the results according to the study design, 'Pre-Post Test(PPT)' was the largest with 107 studies. 5. In the results according to the Intervention, 'Exercise' was the largest with 165 studies, of which 'Pilates' and 'Yoga' in 'Training' was the largest. 6. Among the evaluation method, the 'Pelvic Index' was used 146 times, followed by 'Spinal Alignment (99)', 'Other Joints (93)', and 'Kinetic Specialized Measurement Test (56)'. 7. Among the evaluation methods, the pelvic slope measurement indicators were PT (58), PH (48), Pelvic Torsion (40), Iliac Crest (38), ASIS-PSIS distance/angle (27), and Pelvic Width (I.W., I.L., S.W) (25) in order. 8. The journals that published the most researches were KJSS(Korean Alliance For Health, Physical Education, Recreation, And Dance;9), and JKPT(Korean Physical Therapy;9). Among the University, the Graduate School of Silla University published the most papers (12). 9. The author who published the most studies were Seungjin Park(3), the co-authors were Hoseong Lee, Gideok Park, Seongsu Bae(3), and the Thesis-Director Gyeongok Lee(7). Conclusions : 1. Studies on pelvic correction treatment continue to increase every year. 2. The main academic field of pelvic correction is 'Sports', 'Physical Therapy', and 'Medical Science'. 3. The most chosen research design method in the study on pelvic correction treatment was 'Pre-Post Test(PPT)', primarily as an intermediary, Pilates and yoga during exercise therapy, and then Chiropractic during handcraft were used as multiple frequencies. 4. Among the various measurement method indicators of pelvic correction previously used, multiple frequency was taken up in the order of PT, PH, Pelvic Torsion, iliac crest, ASIS-PSIS distance/angle, and pelvic width (I.W.,I.L.,S.W). Typically, measurements through "ASIS-PSIS angle" are recommended and are considered as the most rational in clinical trials.