• 제목/요약/키워드: Spinal Disease

검색결과 434건 처리시간 0.024초

노인 퇴행성디스크 환자의 안정화운동이 척추불안정과 피로도에 미치는 영향 (The Effects of Segmental Instability and Muscle Fatigue after Stabilization Exercise Program in Degenerated Disc Disease Patients of Aged)

  • 김희라
    • 대한물리치료과학회지
    • /
    • 제13권4호
    • /
    • pp.7-16
    • /
    • 2006
  • The purpose of this study was designed to find out the effectiveness of vertebral segment instability, muscle fatigue response on lumbar spine after apply lumbosacral stabilization exercise program to 4 patients with chronic low back pain and for 12 weeks. In this study, the lumbar spine motion with blind by MedX test machine and the difference of instability to lumbar vertebra segments in flexion, extension test of standing position and spinal load test(Matthiass Test) by Spinal Mouse. The stabilization exercise program was applied 2 times a week for 12 weeks in hospital and 2 times a day for 20 minutes at home. The results of the present study were as follows: 1. Instability test of lumbar vertebra segment is 2 type differential angle test between vertebrae segment and loading test of spine(matthiass) by Spinal Mouse. It appeared to improve stability of segments in sagittal plane after program. So lumbar spine curve increased lordosis toward anterior and was improved of the lumbar spine flexibility in flexion and extension. Specially, in matthiass test, ( - ) value was increased between lumbar vertebra segment when was the load on spine. And so stability improved after program. 2. Fatigue response test(FRT) results, in male, was raised muscle fatigue rate during increase weight, on the other hand female appeared lower than male. As a results, lumbosacral stabilization exercise was aided to improvement of lumbar spine vertebra segments stabilization. Spine instability patients will have a risk when in lifting a load or working with slight flexion posture during the daily of living life and it is probably to increase recurrence rate. Thus, not only lumbar extension muscle strength but also stability of vertebra segments in lumbar spine may be very important.

  • PDF

수술중 시행한 척수 조영술의 유용성 (The Usefulness of Intraoperative Myelography during Spinal Surgery)

  • 윤성훈;이진석;장하성;이형진;양지호;이일우;강준기
    • Journal of Korean Neurosurgical Society
    • /
    • 제30권sup2호
    • /
    • pp.322-327
    • /
    • 2001
  • Objectives : There are many kinds of method to evaluate neural decompression during operation. They are direct visual and manual inspection, intraoperative ultrasound, endoscope, intraoperative computed tomography and intraoperative myelography. We used intraoperative myelography to evaluate the proper decompression of neural elements during the decompressive surgery. Methods : We injected 10-20cc of nonionic water-soluble contrast materials through direct puncture site of exposed dura during operation or lower lumbar level or lumbar drain inserted preoperatively. 12 patients were included in this study. They were 7 patients of centrally herniated lumbar disc disease, 1 patient of multiple lumbar spinal stenosis, 2 patients of thoracic extradural tumor and 2 cervical fracture & dislocations. Results : 5 of 12 patients showed remained neural compression through intraoperative myelography, so they were operated further through other approach. Myelographic dye is heavier than CSF, so the dependent side of subarachnoid space was visualized only. In one case, CSF leakage through hemovac was detected, but it was treated only bed rest for 5 days after hemovac removal. Conclusion :Intraoperative myelography is an effective method to evaluate neural decompression during spinal surgery. This technique is easy and familiar to us, neurosurgeons.

  • PDF

방사선 투시장치를 이용한 요추 중재술 시 고려점 (Considerations for Fluoroscopic Guided Intervention in Lumbar Spine)

  • 김동현;송광섭
    • 대한정형외과학회지
    • /
    • 제55권3호
    • /
    • pp.210-221
    • /
    • 2020
  • 척추 신경 차단술은 다양한 발전을 거듭하면서 상당부분 수술적 치료의 필요성을 줄일 수 있는 대체 보존적 치료의 한 방법으로 자리매김하고 있다. 이러한 척추 신경 차단술은 통증 완화라는 치료적 측면뿐 아니라, 많은 환자에서 척추 이외의 다른 증상들과 감별을 위한 진단적 목적으로도 유용하게 사용되고 있어 사지 및 척추를 다루는 정형외과의사로서 가장 기본이 되는 술기라 할 수 있다. 하지만 사용하는 기구나 약물이 단순함에도 불구하고 이에 대한 전반적인 이해 및 발생 가능한 부작용 및 합병증에 대한 지식이 없다면 시행 초기에 오히려 환자에게 심각한 해를 끼칠 수 있게 된다. 따라서 척추 신경 차단술에 사용하는 약제들의 종류, 약동학적 특성과 각각 약제의 부작용에 대한 이해가 선행되어야 하며, 요추 전반에 걸친 각 시술의 적응증과 장단점을 파악하고 발생 가능한 합병증을 피하기 위해 노력을 기울여야 한다. 본 종설은 요추 신경 차단술에 필요한 기본적인 지식 및 술기를 접하여 독자 스스로 시행할 수 있게 함을 목적으로 한다.

Usage Status and Regional Variations of Acupotomy in a Korean Medicine Clinic: A Single-Center, Retrospective Analysis of Medical Records

  • Kang, Kyungho;Hwang, Jihyeon;Chu, Hongmin;Lee, Young-ung;Chae, Hyocheong;Lee, Jeong-youn;Lim, Kwanghwan;Jung, Sehun;Park, Seongjun;Choi, Seong-Hun;Mun, Ju hyeon;Kim, Jaehyo;Ryu, Myungseok
    • Journal of Acupuncture Research
    • /
    • 제39권1호
    • /
    • pp.36-39
    • /
    • 2022
  • Background: Acupotomy is a type of acupuncture where a scalpel-shaped needle (miniscalpel needle) is used instead of a normal acupuncture needle to exfoliate adhesion sites or to relax entrapped regions. This study aimed to identify the descriptive characteristics of patients who received acupotomy treatment at a single Korean Medicine Clinic. Methods: This retrospective review analyzed the medical charts of patients who had received acupotomy at least once from August 2017 to December 2019 at a single Korean Medicine Clinic. The demographic characteristics, chief complaints, acupotomy treatment sites, and principal diagnosis codes were analyzed. Results: We identified 551 outpatients; the average age was 52 ± 14.26 years and 49.9% were male. The patients underwent an average of 8.47 sessions of acupotomy. Altogether, 35.91% of the acupotomy treatments were administered to the spinal regions, of which 60.01% were in the lumbar region. The codes related to the lumbar spinal condition/disease which were used most frequently. The chief complaints were dizziness, lumbar spinal stenosis, and Dupuytren's contracture in patients over 60 years of age. Conclusion: This is the 1st analysis of acupotomy treatment patterns in Korea to date. Acupotomy is primarily administered in the treatment of spinal conditions/diseases, especially for those involving the lumbar region. Future studies are necessary to determine the clinical outcomes of patients who receive acupotomy treatment and the safety of this treatment.

추간판 장애 환자의 의료이용 현황 및 특성 -경추질환을 중심으로- (Status and Characteristics of Applying Medical Use Analysis of intervertebral Disc Disorder Patients - Focusing on cervical spinal disease)

  • 서영우;박초열
    • 보건의료생명과학 논문지
    • /
    • 제9권1호
    • /
    • pp.103-115
    • /
    • 2021
  • 본 연구는 건강보험심사평가원 2010~2018년까지 표본자료 DB에서 설정한 의료서비스를 이용대상자 중 경추간판장애를 주상병으로 1회 이상 요양급여를 받은 환자를 대상으로 하였다. 경추간판장애 환자는 9개년 모두 성별로는 여성이, 연령별로는 50~59세에서 가장 많았다. 의료기관 종별 이용행태는 남성과 여성 모두, 모든 연령대에서 의원 이용자가 가장 많았다. 질환별 입원일수는 M50.0(척수병증을 동반한 경추간판장애)은 종합병원과 병원, 의원에서 가장 길었으며, M50.1(신경뿌리병증을 동반한 경추간판장애)은 상급종합병원과 한방의료기관에서 가장 길었다. 외래 진료일수는 M50.0(척수병증을 동반한 경추간판장애)은 상급종합병원과 종합병원, 병원, 의원에서 가장 길었으며, M50.8(기타 경추간판장애)은 보건기관과 한방의료기관에서 가장 길었다. 경추간판장애 환자의 수술은 남성이 많았으며, 40~49세, 50~59세에서 높았다. 2010년 대비 2018년의 수술 추이는 남성, 여성, 전체 환자 모두 감소 추세를 보였다.

Meningeal Supratentorial Hemangioblastoma in a Patient with Von Hippel-Lindau Disease Mimicking Angioblastic Menigioma

  • Kim, Hoon;Park, Ik-Seong;Jo, Kwang-Wook
    • Journal of Korean Neurosurgical Society
    • /
    • 제54권5호
    • /
    • pp.415-419
    • /
    • 2013
  • Hemangioblastomas are sporadic tumors found in the cerebellum or spinal cord. Supratentorial hemangioblastomas are rare, and those with meningeal involvement are extremely rare and have been reported in only approximately 130 patients. Here, we report the case of a 51-year-old female patient with supratentorial meningeal hemangioblastoma detected 5 years after surgical resection of an infratentorial hemangioblastoma associated with von Hippel-Lindau disease. Patients with von Hippel-Lindau syndrome are at risk for developing multiple hemangioblastomas, with new tumor formation and growth and possible meningeal infiltration. Regular lifelong follow-up in at-risk patients is recommended and should include the differential diagnosis of dural-based tumors such as angioblastic meningioma and metastatic renal cell carcinoma.

Human Induced Pluripotent Stem Cells : Clinical Significance and Applications in Neurologic Diseases

  • Chang, Eun-Ah;Jin, Sung-Won;Nam, Myung-Hyun;Kim, Sang-Dae
    • Journal of Korean Neurosurgical Society
    • /
    • 제62권5호
    • /
    • pp.493-501
    • /
    • 2019
  • The generation of human induced pluripotent stem cells (iPSCs) from somatic cells using gene transfer opens new areas for precision medicine with personalized cell therapy and encourages the discovery of essential platforms for targeted drug development. iPSCs retain the genome of the donor, may regenerate indefinitely, and undergo differentiation into virtually any cell type of interest using a range of published protocols. There has been enormous interest among researchers regarding the application of iPSC technology to regenerative medicine and human disease modeling, in particular, modeling of neurologic diseases using patient-specific iPSCs. For instance, Parkinson's disease, Alzheimer's disease, and spinal cord injuries may be treated with iPSC therapy or replacement tissues obtained from iPSCs. In this review, we discuss the work so far on generation and characterization of iPSCs and focus on recent advances in the use of human iPSCs in clinical setting.

Motor dominant polyradiculopathy with Primary Sjögren's syndrome mimicking motor neuron disease

  • Ahn, Suk-Won;Yoon, Byung-Nam
    • Annals of Clinical Neurophysiology
    • /
    • 제21권1호
    • /
    • pp.61-65
    • /
    • 2019
  • $Sj{\ddot{o}}gren^{\prime}s$ syndrome (SS)-associated polyradiculopathy is rarely reported. A 51-year-old woman presented with a history of gradual weakness in all four extremities for several months. Based on electrophysiological studies, spinal magnetic resonance imaging and cerebrospinal fluid examination, inflammatory polyradiculopathy was confirmed. During a search for the aetiology, the patient was ultimately diagnosed with SS. This study introduces SS-associated polyradiculopathy that primarily presented with motor symptoms, thus mimicking motor neuron disease.

노인의 건강상태와 복약실태 (A Study on the Status of Health and Medication in the Elderly)

  • 조원순
    • 한국보건간호학회지
    • /
    • 제14권2호
    • /
    • pp.431-445
    • /
    • 2000
  • In general the prevalence of old people is high and frequently have multiple diseases and symtoms requiring treatment. The nature of illness in the elderly has to be faced, and drugs do have an important part in the treatment of that illness. The purpose of this study were to describe health status and medication, and to provide some basic data for elderly's health education, especially for the right medication. Body mass index, self perceived health status, activities of daily living, disease and experience of past operation were surveyed to recognize the 249 elderly's actual health status. The degree of the elderly's understanding the way of medication, experience of side effects, experience of drug combination and incidence of drug adverse reaction along with drug combination were examined for medication. The aged $women(BMI; 10.7\pm13.3\%)$ overweighed the aged $men(BMI; 4.0\pm10.4\%)$. $69.0\%$ of them recognized their health good. Their activities of daily living were diminished following by the age group(p=0.0068) and relationship with self perceived health status were very significant(p=0.0005). They(192 elderly) suffered from multiple disease such as $osteoarthritis(49.5\%)$, $hypertension(32.0\%)$, gastric $disorder(16.1%)$, $diabetes(14.6\%)$, $osteomalacia(10.9\%)$, cardiovascular $disease(9.9\%)$, senile $cataract(5.7\%)$, skin $rash(5.2\%)$, liver $disease(4.2\%)$, kidney $disease(3.6\%)$, spinal cord $problem(3.6\%)$, respiratory $disease(2.1\%)$ $tuberculosis(1.0\%)\;etc(1.0\%).$ $28.3\%$ of them replied that they had an operation for appendictis senile cataract, peptic ulcer, spinal cord problem, pleurisy, hemorrhoid and the rest. Most of $them(87.4\%)$ knew the way very well how to use drugs, and $21.6\%$ of the replied 171 elderly experienced adverse drug reaction. Drug compliance rate were $high(83.6\%)$. In our study 56.9% of the 167 elderly took several medicine together. And $18.9\%$ of the 95 elderly who did drug combination had an experience of drug interaction. One person kept average 5.5 kinds of drugs at home among 243 elderly. They kept $digestives(79.4\%)$, $ointments(68.7\%)$, $vitamins(59.7\%)$, $analgesics(59.7\%)$, cold $medicines(45.3\%)$ antiarthritic $drugs(33.3\%)$, health $foods(27.7\%)$, antihypertensive $drugs(25.1\%)$, anti peptic ulcer $drugs(24.7\%)$, $laxatives(19.8\%)$, $antacids(16.5\%),\;antibiotics(l6.5\%)$, hypoglycemic $agents(10.3\%)$, cardiac $stimulants(7.0\%)$, $diuretics(4.5\%)$, antiarrhythmic $drugs(4.9\%)$, anti anginal $drugs(4.1\%)$, $hypnotics(3.3\%)$, $etc(38.3\%)$. With this result, we ascertain that polypharmacy in the elderly caused by multiple disease is common, which lead to drug interaction. So our task is to educate elderly how to use drugs in order to maximize their efficiency and to minimize their adverse effects.

  • PDF

척수손상자의 일상생활적응에 관한 연구 (A Study on the Activities of Daily Living Adaptation of Spinal Cord Injured Patients)

  • 손경현;김찬규;방요순
    • 대한물리치료과학회지
    • /
    • 제10권1호
    • /
    • pp.47-57
    • /
    • 2003
  • The purpose of this study was to evaluate the problem on activities of daily living ; the problem which spinal cord injured patients have when they adapt in daily living ; Subjects were 113 members who used the hospital which is located in Kwangju-city from November 20, 2001 to May 20, 2002. The evaluation of the ADL was performed according to MBI and collected data were statistically analysed by SPSS PC for paired Chi-square test T-test, One way ANOVA and Duncan's post-hoc test. The result's were as follows; 1. Modified Barthel Index average mark was $63.77{\pm}33.60$ points and MBI score distribution according to characteristics of injury is as following. 1) A patient who had long duration of injury, small injury region, incomplete paralysis in paralysis degree, paraplegia in paralysis type got high MBI score as statistical and significantly(p<0.05). 2. Society adaptation state by characteristics of spinal cord injured is an following. 1) After lapse of time of disease, a patient who is injured for a long term present surrounding environmental problem, a patient who is injured for a short term shows psychological problem. In society activity, as lapse of time of disease is long, patient did many hobby activity and same private club, on the other hand as lapse of time of diseases is short, the others appeared high and significantly as statistical(p<0.01). 2) In society activity by injury region, cervical injury and thoracic injury did more hobby activity than lumbar injury and in lumbar injury same private club or religion life appeared higher than thoracic injury of cervical injury significantly as statistical(p<0.01). 3) In walk method by paralysis degree Complete paralysis had more wheelchair life than incomplete paralysis(p<0.01). 4) In serious problem by paralysis type psychological problem in quadriplegia and surrounding environmental problem in paraplegia appeared high and significantly as statistical(p<0.01). 3. In society adaptation state by MBI score difference between variables appeared but it wasn't significantly.

  • PDF