• Journal of Korean Neurosurgical Society
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• 제62권1호
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• pp.96-105
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• 2019

Objective : The aims in the management of thoracolumbar spinal fractures are not only to restore vertebral column stability, but also to obtain acceptable alignment of the thoracolumbar junction (T-L junction) to prevent complications. However, insufficient surgical correction of the thoracolumbar spine would be likely to cause late progression of abnormal kyphosis. Therefore, we identified the surgical factors that affected unfavorable radiologic outcomes of the thoracolumbar spine after surgery. Methods : This study was conducted in a single institution from January 2007 to December 2013. A total of 98 patients with unstable thoracolumbar spine fracture were included. In these patients, fixation was done through transpedicular screws with rods by three surgical patterns. We reviewed digital radiographs and analyzed the images preoperatively and postoperatively during follow-up visits to compare the change of the thoracolumbar Cobb angle with radiologic parameters and clinical outcomes. The unfavorable radiologic group was defined as the patients who were measured as having greater than 20 degrees of thoracolumbar Cobb angle on the last follow-up, or who underwent kyphotic progression of thoracolumbar Cobb angle greater than 10 degrees from the immediate postoperative state to final follow-up, or who had overt instrument failure with/without additional surgery. We assessed the risk factors that affected the unfavorable radiologic outcomes. Results : We had 43 patients with unfavorable radiologic outcomes, including 35 abnormal thoracolumbar alignments and 14 instrumental failures with/without additional surgery. The multivariate logistic regression test showed that immediate postoperative T-L junction Cobb angle less than 10.5 degrees was a statistically significant risk factor, as well as the presence of osteoporosis (p=0.017 and 0.049, respectively). Conclusion : Insufficient correction of thoracolumbar kyphosis was considered to be a major factor of an unfavorable radiological outcome. The spinal surgeon should consider that having a T-L junction Cobb angle larger than 10.5 degrees immediately after surgery could result in an unfavorable radiological outcome, which is related to a poor clinical outcome.

• 자동차안전학회지
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• 제10권3호
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• pp.20-26
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• 2018

It was a pilot study for developing an algorithm to determine the presence or absence of cervical spine injury by analyzing the severity factor of the patients in motor vehicle occupant accidents. From August 2012 to October 2016, we used the KIDAS database, called as Korean In-Depth Accident Study database, collected from three regional emergency centers. We analyzed the general characteristics with several factors. Moreover, cervical spine injury patients were divided into two groups: Group 1 for from Quebec Task Force (hereinafter 'QTF') grade 0 to 1, and group 2 for from QTF grade 2 to 4. The score was assigned according to the distribution ratio of cervical spine injured patients compared to the total injured patients, and the cut-off value was derived from the total score by summation of the assigned score of each factors. 987 patients (53.0%) had no cervical spine injuries and 874 patients (47.0%) had cervical spine injuries. QTF grade 2 was found in 171 patients (9.2%) with musculoskeletal pain, QTF grade 3 was found in 38 patients (2.0%) with spinal cord injuries, and QTF grade 4 was found in 119 patients (6.4%) with dislocation or fracture, respectively. We selected the statistically significant factors, which could be affected the cervical spine injury, like the collision direction, the seating position, the deformation extent, the vehicle type and the frontal airbag deployment. Total score, summation of the assigned each factors, 10 was presented as a cut-off value to determine the cervical spine injury. In this study, it was meaningful as a pilot study to develop algorithms by selecting limited influence factors and proposing cut-off value to determine cervical spine injury. However, since the number of data samples was too small, additional data collection and influencing factor analysis should be performed to develop a more delicate algorithm.

• The Korean Journal of Pain
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• 제31권1호
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• pp.54-57
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• 2018

Burner or stinger syndrome is a rare sports injury caused by direct or indirect trauma during high-speed or contact sports mainly in young athletes. It affects peripheral nerves, plexus trunks or spinal nerve roots, causing paralysis, paresthesia and pain. We report the case of a 57-year-old male athlete suffering from burner syndrome related to a lumbar nerve root. He presented with prolonged pain and partial paralysis of the right leg after a skewed landing during the long jump. He was initially misdiagnosed since the first magnet resonance imaging was normal whereas electromyography showed denervation. The insurance company refused to pay damage claims. Partial recovery was achieved by pain medication and physiotherapy. Burner syndrome is an injury of physically active individuals of any age and may appear in the cervical and lumbar area. MRI may be normal due to the lack of complete nerve transection, but electromyography typically shows pathologic results.

• The Korean Journal of Pain
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• 제25권4호
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• pp.258-261
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• 2012

Posterior neck pain is a common complaint of patients in the pain clinic. The atlas (C1) burst fracture is known to be a cause of posterior neck pain and instability. Although the atlas burst fracture and instability can be discovered by plain X-rays which show lateral mass displacement or widening of the atlantodental interval, assessment of an atlas burst fracture can be difficult if there is no instability in the imaging study. Here we report a case of a 46-year-old female patient who had complained of sustained posterior neck pain for 6 months. Plain X-rays showed only disc space narrowing at C4/5 and C5/6, without any cervical instability. However, an unrecognized C1 lateral mass fracture was detected by CT and MRI. The patient's pain was then successfully treated after atlantoaxial joint injection with a C2 DRG block.

• 한국전문물리치료학회지
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• 제10권2호
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• pp.1-10
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• 2003

This study was carried out to help the comprehensive rehabilitation of spinal cord injuries by measuring propulsion force and endurance exerted on wheelchair handrims, and predicting the differences among three different rear axle positions. The BTE (Baltimore Therapeutic Exerciser) work simulator was used on 9 paraplegia to test the force and endurance during wheelchair propulsion. The 141 large wheel of the BTE work simulator and a standard wheelchair with removed handrims were used for simulating wheelchair propulsion. The neurological and demographical characteristics of the patients were collected by personal interviews and direct examinations. The Kruskal-Wallis test was used to compare force and endurance among the groups. The strongest maximum isometric strength was produced when the rear axle of the wheelchair and the acromion process were on the same coronal plane. Although there were no significant differences statistically, moving the rear axle forward did result in greater isotonic strength. The research suggests that better functional activity of persons with paraplegia is possible when the rear axle of the wheelchair is appropriately adjusted.

• 대한기계학회논문집A
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• 제34권2호
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• pp.139-143
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• 2010

자동차 충돌에 의하여 편타성 손상이 일어나게 되는데, 대부분 경추부분에서 발생한다. 이러한 편타성손상의 메카니즘은 아직까지 명확히 밝혀지지 않고 있다. 본 논문에서는 다물체 경추에 근육을 부착한 모델을 만들고, 부착된 근육에 follower load 개념에 근거한 최적화방법을 이용하여 계산된 초기힘(preloads)를 가하였다. 경추모델에서 추체, 추간판 및 근육은 인간의 해부학적 정보와 일치시켜 제작되었다. 이번 연구의 목적은 경추모델에 부착된 근육에 초기힘이 존재할 때 초기힘의 편타성 손상에의 영향을 조사하는 것이다. 결론적으로, 초기힘이 존재하는 근육-경추모델의 경우가 초기힘이 존재하지 않는 모델에 비하여 좀더 실제와 일치하는 경향성을 보여주었다.

• The Journal of Korean Physical Therapy
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• 제12권2호
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• pp.229-238
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• 2000

A properly prescribed wheelchair may be able to normalize tone. decrease pathologic reflex activity, improve postural symmetry, enhance range of movement, maintain and/or improve skin conduit)n. increase comfort and sitting tolerance, decrease fatigue, and improve function of the autonomic nervous system. Whereas a poorly prescribed one can actually exacerbate the problems associated with a disability. Maintained for longer without relief, pressure concentrations may also lead to tissue breakdown. Pressure sores continue to be a major problem for many disabled individuals. Many groups of disabled individuals have a very high incidence of pressure sores, including those individuals with spinal cord injuries. hemiplegia, multiple sclerosis. cancer. and the disabled geriatric population. It is important to understand the factors which predispose an individuals to the development of a pressure sores. Those factors can divided into extrinsic factors, related to the individual's immediate environment and intrinsic factors. related to their medical or physical condition. Pressure sores are generally preventable through sensible pressure management based on an understanding of the causes of pressure sores, risk factors and methods of redistributing pressure.

• Journal of Chest Surgery
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• 제15권4호
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• pp.414-421
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• 1982

200 patients admitted to the Chest Surgery Department of Jeonbug National University Hospital from January, 1974 to December, 1981 were analyzed clinically. The ratio of male to female was 7: 1, which showed male predominance. Distribution of patients according to age disclosed that over half [62%] of the patients was social age between 20 and 49 years. The most common cause of chest trauma was traffic accident [39%], and the next were stab wound, fall down [17.5%], and hit [8.5%] in decreasing order. Common lesions due to chest trauma were as follows; rib fracture [51%], hemopneumothorax, hemothorax, and pneumothorax in decreasing number. The most common cause of rib fracture was traffic accident [50%] and the associated organ injuries were long bone fracture, head injury, spine and pelvic bone fracture, spleen rupture, and liver laceration. Hemothorax, pneumothorax, and hemopneumothorax were treated with insertion of thoracic catheter in 90 cases, pure thoracentesis in 11 cases, and emergency thoracotomy in 11 cases. In flail chest, 6 patients were treated by intramedullary insertion of Kirschner`s wire and the results were good. The incidence of complication was 17%, including atelectasis [11 cases], pyothorax, fibrothorax, pneumonia, and acute respiratory failure. Four patients were died [2%], and the causes were acute respiratory failure in 2 cases, spinal cord injury in one case and head injury in one case.

• 대한물리치료과학회지
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• 제18권4호
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• pp.65-72
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• 2011

The purpose of this study was to investigate the responses of the trunk muscle during expected and unexpected sudden loadings of the hands on the sagittal plane. Twenty, young healthy adults(male 10, female 10) were participated to two different loading conditions : expected and unexpected sudden loadings. Different weights were dropped in hand : 5lb, 6lb, 7lb for male, and 3lb, 4lb, 5lb for female. EMG activity of rectus abdominalis and erector spine muscle were collected. Rectus abdominalis and lumbar erector spine muscle activity significantly increased in unexpected sudden loadings than expected sudden loadings(p<.05). This results indicate that co-contraction of abdominal and back muscle contribute for dynamic spinal stability during expected or unexpected activities of daily living. Preparatory adjustments can be made which reduce the postural perturbation to sudden load and prevent low back injuries.

• 대한인간공학회지
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• 제32권4호
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• pp.297-301
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• 2013

Objective: The purpose of this study is to review the hazards of whole body vibration(WBV) and prevent human injuries due to WBV. Background: Vibrations that shake the whole body in vehicles and vessels is WBV. Vibration at a specific frequency, and intensity in the human body can act as a hazard. But, it has not yet done enough research about effects of WBV. Method: We analyzed and reviewed occupational or ergonomic papers published past 30 years. Results: Exposure to whole body vibration can cause permanent physical injury or damage of the nervous system. In addition, it may cause problem in the cardiovascular system, digestive system, musculoskeletal system, endocrine system, reproductive system, and psychological system. The effect of vibration depends on its acceleration, duration, frequency, and direction. Conclusion: WBV-exposed human body experience a high risk of some illnesses such as lumbar spinal disorders. Some workers(bus drivers, truck drivers and heavy equipment operators) are the high risk population exposed to WBV. Application: The results of this study might help to judge and prevent occupational disease caused by WBV.