• 제목/요약/키워드: Spinal injuries

검색결과 171건 처리시간 0.02초

Minimally Invasive Removal of an Intradural Cervical Tumor : Assessment of a Combined Split-Spinous Laminectomy and Quadrant Tube Retractor System Technique

  • Kwak, Young-Seok;Kim, Kyoung-Tae;Cho, Dae-Chul;Kim, Young-Baeg
    • Journal of Korean Neurosurgical Society
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    • 제52권4호
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    • pp.427-431
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    • 2012
  • Conventional laminectomy is the most popular technique for the complete removal of intradural spinal tumors. In particular, the central portion intramedullary tumor and large intradural extramedullary tumor often require a total laminectomy for the midline myelotomy, sufficient decompression, and adequate visualization. However, this technique has the disadvantages of a wide incision, extensive periosteal muscle dissection, and bony structural injury. Recently, split-spinous laminectomy and tubular retractor systems were found to decrease postoperative muscle injuries, skin incision size and discomfort. The combined technique of split-spinous laminectomy, using a quadrant tube retractor system allows for an excellent exposure of the tumor with minimal trauma of the surrounding tissue. We propose that this technique offers possible advantages over the traditional open tumor removal of the intradural spinal cord tumors, which covers one or two cervical levels and requires a total laminectomy.

Pulsed Electromagnetic Fields to Influence Pain and Muscle Healing Following Muscle Injury in Rats

  • Koo, Hyun-Mo;Na, Sang-Su;Yong, Min-Sik
    • Journal of Magnetics
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    • 제20권4호
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    • pp.377-380
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    • 2015
  • Muscle contusion has a negative effect on muscle function. Although several studies showed that pain control and muscle recovery is facilitated by pulsed electromagnetic fields (PEMF), there has not been much research regarding the specific effects of PEMF on them. The aim of the present study is to investigate effects of PEMF on pain and muscle recovery following extensor digitorum longus (EDL) contusion injury through measuring the expression of the c-fos proto-oncogene and nerve growth factor (NGF). Significantly reduced c-fos expression in the spinal cord was shown in PEMF groups compared with control (CON) groups. There was no significant difference between PEMF1 and CON1, but significantly increased NGF expression was shown in PEMF3 and PEMF5 compared with in CON groups, where the numbers in the group names are the days from contusion. In conclusion, PEMF could be used to not only reduce pain in muscle injuries by down-regulating c-fos expression in the spinal cord, but it could also influence muscle healing through increasing NGF expression in the injured muscle.

인체진동을 고려한 재활훈련용 이족보행 RGO 보조기의 생체역학적 해석 <인체진동 응력해석과 FEM을 중심으로> (Design and Control of a Dynamic PLS of the Biped Walking RGO for a Trainning of Rehabilitation considering Human Vibration)

  • 장대진;김명회;양현석;백윤수;박영필;박창일
    • 한국소음진동공학회:학술대회논문집
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    • 한국소음진동공학회 2002년도 춘계학술대회논문집
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    • pp.752-759
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    • 2002
  • This paper presented a design and a control of a biped walking RGO and walking simulation by this system. The biped walking RGO was distinguished from the other one by which had a very light-weight and a new RGO type with 12-servo motors. The vibration evaluation of the dynamic PLS on the biped walking RGO was used to access by the 3-axis accelerometer with a low frequency vibration for the spinal cord injuries. The gait of a biped walking RGO depended on the constrains of mechanical kinematics and the initial posture. The stability of dynamic walking was investigated by a ZMP (Zero Moment Point) of the biped walking RGO. It was designed according to a human wear type and was able to accomodate itself to a human environments. The joints of each leg were adopted with a good kinematic characteristics. To test of the analysis of joint kinematic properties, we did the strain stress analysis of the dynamic PLS and the analysis study of FEM with a dynamic PLS. It will be expect that the spinal cord injury patients are able to recover effectively with a biped walking RGO.

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침 시술 이후 발생한 경추 척수 손상 (Cervical Spinal Cord Injury Caused by Acupuncture)

  • 우영하;이지민;심대무;배혁
    • 대한정형외과학회지
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    • 제55권6호
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    • pp.550-553
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    • 2020
  • 침술은 치료적 목적으로 신체의 특정부위에 바늘을 삽입하는 시술로 근골격계 질환의 증상 완화 목적으로 대중적으로 행해지는 술기이다. 침술 이후 심각한 합병증은 20만 예 중 1예 가량으로 발생률이 낮고 대부분의 경우 증상이 가볍고 일시적이므로 비교적 안전하다. 하지만 신경계 손상, 감염, 혈종, 폐기종 등 심각한 합병증이 발생할 수 있다. 저자들은 침술 이후 발생한 경추 척수 손상을 유발한 1예를 경험하였기에 이를 문헌 고찰과 함께 보고하는 바이다.

Delayed Brain Infarction due to Bilateral Vertebral Artery Occlusion Which Occurred 5 Days after Cervical Trauma

  • Jang, Donghwan;Kim, Choonghyo;Lee, Seung Jin;Kim, Jiha
    • Journal of Korean Neurosurgical Society
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    • 제56권2호
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    • pp.141-145
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    • 2014
  • Vertebral artery (VA) injuries usually accompany cervical trauma. Although these injuries are commonly asymptomatic, some result in vertebrobasilar infarction. The symptoms of VA occlusion have been reported to usually manifest within 24 hours after trauma. The symptoms of bilateral VA occlusions seem to be more severe and seem to occur with shorter latencies than those of unilateral occlusions. A 48-year-old man had a C3-4 fracture-dislocation with spinal cord compression that resulted from a traffic accident. After surgery, his initial quadriparesis gradually improved. However, he complained of sudden headache and dizziness on the 5th postoperative day. His motor weakness was abruptly aggravated. Radiologic evaluation revealed an infarction in the occipital lobe and cerebellum. Cerebral angiography revealed complete bilateral VA occlusion. We administered anticoagulation therapy. After 6 months, his weakness had only partially improved. This case demonstrates that delayed infarction due to bilateral VA occlusion can occur at latencies as long as 5 days. Thus, we recommend that patients with cervical traumas that may be accompanied by bilateral VA occlusion should be closely observed for longer than 5 days.

흉·요추 불안정성 척추 손상 환자에서 전방 감압술과 전방기기 및 Surgical Titanium Mesh를 이용한 내고정술 (장기적 추적 검사 결과) (Anterior Decompression and Internal Fixation with Anterior Instrument and Surgical Titanium Mesh in Thoracolumbar Unstable Spine Injuries (Long-term Follow-up Results))

  • 박환민;이승명;조하영;신호;정성헌;송진규;장석정
    • Journal of Korean Neurosurgical Society
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    • 제29권1호
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    • pp.58-65
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    • 2000
  • Objective : Thoracolumbar junction is second most common level of injury next to cervical spine. The object of this study is to study the usefulness of surgical titanium mesh instead of bone graft, as well as to evaluate the correction of spinal deformity and safety of early ambulation in patients with injury at thoracolumbar junction. Patients and Methods : This review included 51 patients who were operated from July 1994 to December 1997. The injured spine is considered to be unstable, if it shows involvement of two or more columns, translatory displacement more than 3.5mm, decrease more than 35% in height of vertebral body and progression of malalignment in serial X-ray. The decision to operate was determined by (1) compression of spinal cord or cauda eguina, (2) unstable fracture, (3) malalignment and (4) fracture dislocation. The procedure consisted of anterior decompression through corpectomy and internal fixation with anterior instrument and surgical titanium mesh which was impacted with gathered bone chip from corpectomy. Results : Fifty-one patients were followed up for at least 12 months. The main causes of injury were fall and vehicle accident. The twelfth thoracic and the first and the second lumbar vertebrae were frequently involved. Complete neural decompression was possible under direct vision in all cases. Kyphotic angulation occurred in a patient. Radiologic evaluation showed correction of deformity and no distortion or loosening of surgical titanium mesh with satisfactory fixation postoperatively. Conclusions : We could obtain neurological improvement, relief of pain, immediate stabilization and early return to normal activities postoperatively. Based on these results, authors recommend anterior decompression and internal fixation with surgical titanium mesh in thoracolumbar unstable spine injuries.

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남성 척수손상 장애인의 성실태 및 성적응에 미치는 요인 (Sexual Activity and Factors Influencing the Sexual Adjustment in Men with Spinal Cord Injury)

  • 김선홍;이범석;한숙정
    • 임상간호연구
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    • 제20권3호
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    • pp.290-302
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    • 2014
  • Purpose: The purpose of this study was to identify sexual activities of males with spinal cord injury (SCI) and influential factors of sexual adjustment. Methods: A correlational survey was conducted among a total of 135 males with SCI. Results: After SCI, patients maintained low levels of sexual adjustment, and a main obstacle of sexual rehabilitation was decreased erectile function (65.2%). Sexual desires recovered in 84.4%, with 62.4% patients reporting more than once intercourse experiences. The erectile function of participants with normal, decreased or no erectile function were 13.0%, 62.6% and 24.4%, respectively. 8.1% of the participants reported no problem with ejaculation. Patients with incomplete SCI had better preserved erectile function than those with complete SCI (t=-4.627, p<.001). Patients with upper motor neuron injury had better preserved erectile function than those with lower motor neuron injury (t=2.446, p =.016). Sexual adjustment was relevant to age, job, degree of injury, post-injury period, sexual desire, intercourse experience, erection therapy, erectile function, and sexual health. Sexual adjustment was a factor of sexual health with a power of 24.2%. Conclusion: The main obstacle of sexual rehabilitation for males with SCI decreased erectile function. Erection and ejaculation are dependent on the severity and level of SCI. The major influence on sexual adjustment is sexual health.

일상 생활 중의 나쁜 자세에 따른 흉·요추 관절의 기구학 해석 (Kinematic Analysis of Thoraco-Lumbar Spine in Bad Postures During Daily Life)

  • 한아름;정지인;풍균;김윤혁
    • 대한기계학회논문집B
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    • 제36권11호
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    • pp.1105-1110
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    • 2012
  • 척추는 인간의 근골격계 건강에 큰 영향을 미치는 신체 부위 중 하나이다. 최근에 고령화 사회에 진입하게 되면서 요통과 같은 척추 질환이 급속하게 증가하고 있다. 이러한 척추 질환의 요인에는 선천적인 척추 장애나 스포츠 및 교통사고의 부상뿐만 아니라 일상생활에서 반복적으로 취하는 나쁜 자세도 포함된다. 잘못된 척추 자세는 척추 디스크에 압력을 주어 퇴행성 변화를 가져옴으로써 척추를 변형시키고 척추질환을 일으킨다. 따라서 본 연구에서는 여러 나쁜 자세를 취했을 때 흉추와 요추 관절의 3 차원 관절 각도를 분석하였다. 그 결과로부터 일상생활에서의 나쁜 자세가 굽힘/신전, 측면 굽힘, 축 회전 방향으로 척추 관절에 각도 변형을 일으키고 정상범위에서 벗어날 수 있음을 알 수 있었다. 향후 연구로써 척추관절의 각도변화가 디스크와 인대 및 근육 등에 미치는 영향에 대한 연구가 필요하다 생각된다.

한국표준건강분류(KCF)로 평가한 척수경색 환자의 한의 치료 전후 변화 증례 보고 (A case report of a patient with spinal cord infarction treated by Korean medicine combined with conventional medicine: An evaluation using Korean Standard Classification of Functioning, Disability and Health (KCF))

  • 김미경
    • 대한한의학회지
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    • 제39권3호
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    • pp.89-100
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    • 2018
  • Objectives: Korean Standard Classification of Functioning, Disability and Health (KCF), a useful tool for a comprehensive consideration of the health-related overall implications, might be also promising way to validate the effectiveness of Korean medicine. This study reports the change of pre- and post-hospitalization using the KCF in a patient with spinal cord infarction who underwent rehabilitation plus Korean medicine treatment. This study aims to apply the KCF to this case, evaluate its applicability, and review its expected benefits and obstacles in the clinical practice of Korean medicine. Methods: The changes in the overall health status of the patient were assessed by the KCF as well as the chief complaints, diagnosis, neurological deficits, and activities of daily living (ADL), impairment scale etc. before and after admission to a Korean medicine hospital were investigated. Results: Most of the chief complaints of the patient were improved enough to perform her daily routine activities independently. These improvements were reflected in the neurological function and ADL scores, but could not change the diagnosis according to the Korean Standard Classification of Diseases nor the impairment scale. The KCF, on the other hand, was able to grasp the changes of the patient in various aspects in terms of body function, body structure, activity and participation, and environmental factors. Conclusions: Through this case, we found the applicability of the KCF in clinical practice of Korean medicine and the possibility that the KCF can be a promising tool to show the effectiveness and benefits of Korean medicine.

Review of the UBC Porcine Model of Traumatic Spinal Cord Injury

  • Kim, Kyoung-Tae;Streijger, Femke;Manouchehri, Neda;So, Kitty;Shortt, Katelyn;Okon, Elena B.;Tigchelaar, Seth;Cripton, Peter;Kwon, Brian K.
    • Journal of Korean Neurosurgical Society
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    • 제61권5호
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    • pp.539-547
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    • 2018
  • Traumatic spinal cord injury (SCI) research has recently focused on the use of rat and mouse models for in vivo SCI experiments. Such small rodent SCI models are invaluable for the field, and much has been discovered about the biologic and physiologic aspects of SCI from these models. It has been difficult, however, to reproduce the efficacy of treatments found to produce neurologic benefits in rodent SCI models when these treatments are tested in human clinical trials. A large animal model may have advantages for translational research where anatomical, physiological, or genetic similarities to humans may be more relevant for pre-clinically evaluating novel therapies. Here, we review the work carried out at the University of British Columbia (UBC) on a large animal model of SCI that utilizes Yucatan miniature pigs. The UBC porcine model of SCI may be a useful intermediary in the pre-clinical testing of novel pharmacological treatments, cell-based therapies, and the "bedside back to bench" translation of human clinical observations, which require preclinical testing in an applicable animal model.