• Title/Summary/Keyword: Spine fracture

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Bilateral Pedicle Stress Fracture Accompanying Spondylolysis in a Patient with Ankylosing Spondylitis

  • Kim, Hyeun-Sung;Ju, Chang-Il;Kim, Seok-Won
    • Journal of Korean Neurosurgical Society
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    • v.48 no.1
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    • pp.70-72
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    • 2010
  • Bilateral pedicle stress fracture is a rare entity and few cases have been reported in the literature. Furthermore, the majority of these reports concern previous spine surgery or stress-related activities. Here, the authors report ankylosing spondylitis as a new cause of bilateral pedicle stress fractures accompanying spondylolysis. The reported case adds to the literature on bilateral pedicle stress fracture and spondylolysis by documenting that ankylosing spondylitis is another cause of this condition.

Diagnostic Radiology and Conservative Management of L1 Lumbar Spine with Compression Fracture (L1 요추 압박골절에 대한 진단방사선학 및 보존적 치료)

  • 김재웅
    • The Korean Journal of Food And Nutrition
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    • v.11 no.2
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    • pp.165-170
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    • 1998
  • Diagnostic radiology and conservative management for S75 patient with L1 lumbar fracture by traffic accidents were discussed with references, and then the obtained results were as follows ; 1. Wedging compression fractures with 10% deformity was confirmed at anterior vertebral body of L1 lumbar spine through lateral plain X-ray film. 2. Irregular bony fractures were observed at anterior vertebral body of L1 lumbar spine by CT scans, anatomically T12-L1 sites showed highly frequency of injuries, Denis's fracture type was classified as multiple compression fracture at anterior column without abnormal middle and posterior column, also no Cobb's angle, and then Frankel's neurological classification was E grade. 3. Orthopaedic treatments were performed with conservative methods. With rest on the bed, anti-in-flammatory medication, electrolyte and nutritional solution, the pain diminished. 4. After 3 weeks, rehabilitation was worked with putting on polyethylene back corset, although pains remained slightly until after 8 weeks, thereafter the spine showed gradually stability.

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Thoracolumbar Spine Injury (흉요추부 손상)

  • Ahn, Myun-Whan
    • Journal of Yeungnam Medical Science
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    • v.19 no.2
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    • pp.73-91
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    • 2002
  • Method of management of the spine injury should be determined, based on the status of neurological injury as well as on the presence of traumatic instability. At the thoracic and lumbar spine, patterns of neurological injury are different from the cervical spine due to their neuro-anatomical characteristics. Especially, at the thoracolumbar junction, neurological injury patterns with their respective prognosis vary from the complete cord injury or conus medullaris syndrome to the cauda equina syndrome according to the injury level. The concept of Holdsworth's instability based on the posterior ligament complex theory has evolved into the current 3-column theory of Denis. Flexion-rotation injury and fracture-dislocation are well known to be unstable that surgical fixation is frequently needed for these injuries. However, there have been some controversies for the stability of burst fractures and their treatment, such as indirect or direct decompression and anterior or posterior approach. In this article, current concepts and management of traumatic instabilities at the thoracic and lumbar spine have been reviewed and summarized.

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Anterior and Posterior Stabilization by One Stage Posterolateral Approach in the Unstable Fracture of Thoracolumbar and Lumbar Spine

  • Lee, Young-Min;Cho, Yang-Woon;Kim, Joon-Soo;Kim, Kyu-Hong;Lee, In-Chang;Bae, Sang-Do
    • Journal of Korean Neurosurgical Society
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    • v.40 no.1
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    • pp.22-27
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    • 2006
  • Objective : The purpose of this study is to investigate the clinical results of anterior and posterior stabilization by one stage posterolateral approach for the unstable fracture of thoracolumbar and lumbar spine. Methods : By posterolateral approach with curved skin incision, unilateral facet and pedicle were removed. Through this route, corpectomy was performed, and then this space was replaced with mesh cage filled up with autologous bone graft. Both side pedicle screw fixation was followed to upper and lower levels. Results : Six of seven patients of this study showed neurological improvement. The other one patient showed no neurological change. One patient had postoperative infection, another patient had postoperative kyphosis. The other patient had epidural hematoma on operation site after surgery. And all patinets on this study made to have spinal stability except one patient happened postoperative kyphosis. Conclusion : In the unstable fracture of thoracolumbar and lumbar spine, one stage anterior and posterior stabilization and fusion by posterolateral approach seems to be an effective procedure, if we have more care and supplementation.

Multiple Cervical Spinous Process Fractures in a Novice Golf Player

  • Kim, Sei-Yoon;Chung, Sang Ki;Kim, Dong-Yun
    • Journal of Korean Neurosurgical Society
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    • v.52 no.6
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    • pp.570-573
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    • 2012
  • Avulsion of spinous process, also called Clay-shoveler's fracture, is most prevalent among those engaged in hard physical labor. To the best of the author's knowledge, only one case of multiple spinous process fractures of the upper thoracic spine in a novice golfer has been reported. A 45-year-old female presented with intractable posterior neck pain. The patient experienced a sharp, sudden pain on the neck while swinging a golf club, immediately after the club head struck the ground. Dynamic cervical radiographic findings were C6 and C7 spinous process fractures. Magnetic resonance imaging revealed C6 and C7 spinous process fractures without spinal cord pathology. The patient was treated with pain medications and cervical bracing. The patient's pain gradually improved. The injury mechanism was speculated to be similar to Clay-shoveler's fracture. Lower cervical spinous process fractures can be associated with a golf swing. If the patient complains of long lasting neck pain and has a history of golf activity, further study should be conducted to rule out lower cervical spinous fracture.

Finite Element Analysis of Lumbar Spine under Surgical Condition (척추 수술시 요추의 유한요소해석)

  • Kim D. H.;Cho S. H.;Jang D. P.;Hwang W;Chung W. K;Oh S. H.;Kim Y. S.
    • Proceedings of the Korean Society For Composite Materials Conference
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    • 2004.04a
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    • pp.210-213
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    • 2004
  • We study the fracture behavior of the lumbar No.4 and No.5 vertebra subjected to posteroanterior (PA) forces, a three dimensional finite element method (FEM). The lumbar spine was modeled 3-dimensionally using commercial software based on the principle of convert stacked two dimensional CT scan images into three dimensional shapes. Determination of the boundary conditions corresponding to actual surgical conditions was not easy, so that the simplified spine beam analyses were performed. The results were used in three dimensional finite element (FE) analysis. This FE analysis, indicates that the fracture loads of the lumbar No.4 and No.5 vertebra are respectively 1550 N and 1500 N. These fracture loads are for static loading, but in actual conditions the load on the lumbar spine varies dynamically. We found that the fracture load of lumbar No.4 vertebra is larger than that of lumbar No.5 vertebra, as a result of the total stress difference by the moment.

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Combined Korean Medicine Treatment of a Rare Case of Burst Fracture in an Elderly Patient with Kissing Spine

  • Park, Eun-Young;Choi, Jong-Ho;Jo, Hoo-In;Lee, Soo-Kyung;Lee, June-Haeng;Kang, Sun-Woo;Won, Yoon-Jae;Choi, Sung-Ryul;Cho, Yu-Jin
    • Journal of Acupuncture Research
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    • v.38 no.2
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    • pp.165-169
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    • 2021
  • A burst fracture refers to the fracture of the anterior and middle vertebral columns which are moving into the spinal canal causing neurological impairments, generally requiring surgical treatment. We herein report a rare case of burst fracture with kissing spine in a 90-year-old man who had severe lower back pain that worsened during back extension. Considering the surgical treatment risk, he was hospitalized at a Korean medicine hospital for 85 days and underwent combined Korean medicine treatments including pharmacopuncture, herbal medicine, chuna, deep-fascia meridian therapy, walking practice, and abdominal breathing. Based on patient-reported scales, his pain was alleviated, and his physical function improved. Furthermore, his range of motion and walking time increased. This case report suggests that combined Korean medicine treatments could be an effective alternative for patients with burst fracture who have surgery risks.

Surgical Experience of Neglected Lower Cervical Spine Fracture in Patient with Ankylosing Spondylitis

  • Jo, Dae-Jean;Kim, Sung-Min;Kim, Ki-Tack;Sea, Eun-Min
    • Journal of Korean Neurosurgical Society
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    • v.48 no.1
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    • pp.66-69
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    • 2010
  • The management of lower cervical fractures in patients with ankylosing spondylitis (AS) differs from normal cervical fractures. Patients with AS are highly susceptible to extensive neurologic injuries and spinal deformities after cervical fractures from even minor traumatic forces. These injuries are uniquely complex, require careful imaging assessment, and aggressive surgical management to optimize spinal stability and functional outcomes.

Feasibility of Serum Pentosidine Level as a Potential Risk Factor for Osteoporotic Vertebral Compression Fracture

  • Choi, Dong-Hyuk;Lee, Sang-Min;Lim, Sung-An;Choi, Yong-Soo
    • Asian Spine Journal
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    • v.12 no.6
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    • pp.992-997
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    • 2018
  • Study Design: Feasibility study. Purpose: To evaluate the feasibility of using serum pentosidine level as a potential marker for osteoporotic vertebral compression fracture (OVCF). Overview of Literature: A review of previous studies suggests a negative correlation between serum pentosidine concentration and bone strength. However, it is unclear whether serum pentosidine level might be a potential marker of OVCF in Koreans. Methods: Forty patients who underwent bone mineral density examination were included in this study, and their serum pentosidine levels were prospectively analyzed. Serum pentosidine level was evaluated using enzyme-linked immunosorbent assay. Among all the patients, 11 with OVCF were assigned to the vertebral fracture group and 29 who did not have vertebral fracture were included in the non-fracture group. In addition, we used the Fracture Risk Assessment (FRAX) tool Korean version for assessing the 10-year probability of fracture. Results: There was a statistically significant difference in the mean serum pentosidine level (p=0.04) of the vertebral fracture group (110.8 ng/mL) and the non-fracture group (64.3 ng/mL). Logistic regression analyses showed that serum pentosidine was significantly associated with OVCF. The vertebral fracture group had significantly higher 10-year probability of major osteoporotic fracture as per FRAX than the non-fracture group. There was a positive correlation between pentosidine level and FRAX results (r=0.35, p=0.02). Conclusions: These results suggest that increased serum pentosidine level could be a potential marker for OVCF.

Vertebral compression fractures after spine irradiation using conventional fractionation in patients with metastatic colorectal cancer

  • Rhee, Woo Joong;Kim, Kyung Hwan;Chang, Jee Suk;Kim, Hyun Ju;Choi, Seohee;Koom, Woong Sub
    • Radiation Oncology Journal
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    • v.32 no.4
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    • pp.221-230
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    • 2014
  • Purpose: To evaluate the risk of vertebral compression fracture (VCF) after conventional radiotherapy (RT) for colorectal cancer (CRC) with spine metastasis and to identify risk factors for VCF in metastatic and non-metastatic irradiated spines. Materials and Methods: We retrospectively reviewed 68 spinal segments in 16 patients who received conventional RT between 2009 and 2012. Fracture was defined as a newly developed VCF or progression of an existing fracture. The target volume included all metastatic spinal segments and one additional non-metastatic vertebra adjacent to the tumor-involved spines. Results: The median follow-up was 7.8 months. Among all 68 spinal segments, there were six fracture events (8.8%) including three new VCFs and three fracture progressions. Observed VCF rates in vertebral segments with prior irradiation or pre-existing compression fracture were 30.0% and 75.0% respectively, compared with 5.2% and 4.7% for segments without prior irradiation or pre-existing compression fracture, respectively (both p < 0.05). The 1-year fracture-free probability was 87.8% (95% CI, 78.2-97.4). On multivariate analysis, prior irradiation (HR, 7.30; 95% CI, 1.31-40.86) and pre-existing compression fracture (HR, 18.45; 95% CI, 3.42-99.52) were independent risk factors for VCF. Conclusion: The incidence of VCF following conventional RT to the spine is not particularly high, regardless of metastatic tumor involvement. Spines that received irradiation and/or have pre-existing compression fracture before RT have an increased risk of VCF and require close observation.