• Title/Summary/Keyword: Spine fracture

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The Patterns of Intraosseous Venography before Percutaneous Vertebroplasty for Osteoporotic Compression Fractures

  • Kim, Dong-Sung;Doh, Jae-Won;Lee, Kyeong-Seok;Yoon, Seok-Mann;Shim, Jai-Joon;Kim, Seong-Ho
    • Journal of Korean Neurosurgical Society
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    • v.43 no.6
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    • pp.288-293
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    • 2008
  • Objective : Bone cement leakage is a well-known potential complication of percutaneous vertebroplasty (PVP) in patients with osteoporotic compression fracture. Even though there has been a controversy in the efficacy of antecedent venography to prevent this complication, many authors have performed intra osseous venography before bone cement injection. The goal of this study was to classify the venous drainage patterns of spine before PVP, and compare their patterns at different vertebral levels. Methods : The authors retrospectively reviewed 1,042 intraosseous venographic patterns in 321 patients with 574 osteoporotic compression fractures during six-year period in one institution. To classify venogram patterns, we selected simple lateral X-ray of spine taken immediately after injection of the contrast dye. We classified the venography patterns according to contrast leakage pattern and leakage direction as follows; trabecular (TR), trabecular anterior (TA), trabecular posterior (TP), trabecular anterior-posterior (TAP), trabecular lateral (TL), venous anterior(VA), venous posterior (VP), venous anterior-posterior (VAP), soft tissue (ST). Also, we compared venogram patterns according to different spinal levels. Results : In overall, the most common pattern was TP type accounting for 37.4% (390/1042) of all intraosseous venograms. This is followed by TAP in 21.5%, TR 17.4%, TA 116%, TL 5.8%, ST 4.1%, VA 1.2%, VP 0.6%, and VAP 0.4% in descending order of frequency. According to the spinal level, TR and TAP types were most common in thoracic spine (T6-T10), TP type was most common in thoraco-Iumbar spine (T11-L2), and TP and TAP types were most common in lumbo-sacral spine (L3-S1). Contrast dye leakage to soft tissue such as psoas muscle or disc were detected in 43 (4.1%) venograms. Direct venous drainage without staining of vertebral body was found in 23 (2.2%) venograms. The 8.3% of thoracic venogram showed direct venous drainage. Thoracic level showed a more tendency of direct venous drainage than other spine levels (p<001). Conclusion : The authors propose a new classification system of intra osseous venography during PVP. The trabecular-posterior (TP) type is most common through all spine, and venous-filling (V) type was most frequent in thoracic spine. Further study would be necessary to elucidate the efficacy of this classification system to prevent bone cement leakage during PVP.

Open Intramedullary Nail with Tension Band Sutures on Proximal Humeral Fracture (상완골 근위부 골절에 시행한 긴장 대 봉합을 동반한 관혈적 골수강내 고정술)

  • Park, Jin-Young;An, Jin-Woo;Lee, Sung-Churl
    • Clinics in Shoulder and Elbow
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    • v.6 no.2
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    • pp.149-160
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    • 2003
  • Purpose: to determine the results after open intramedullary nailing and tension band suture technique in proximal humerus fracture for improving the stability and decreasing the complications. Materials and Method: Authors reviewed 27 patients treated by open intramedullary nailing and tension band suture technique. Mean follow-up period was 39 months (24-59months). Surgical neck fracture were 6 cases, surgical neck fracture with shaft fracture were 3 cases, three part fracture with greater tuberosity fracture were 17 cases, four part fracture was 1 case and fracture and dislocation were 2 cases Results: We got the bony union in 26 cases. Average pain scale was 1 point (0-6), Neer score was 86 point(45-99) and ASES score was 85 point(40-100). We separate all cases in two groups based on age (65 years), L-spine t-score (-2.5) and Neer classification (2 and 3 part). There is no significance in pain scale, Neer score and ASES score between each group. Conclusion: As a method of surgical treatment on severe proximal humeral fractures, we recommend intramedullary nailing and tension band suture technique and it may have particular advantages in early exercise and satisfactory functional outcome.

Indirect Reduction and Spinal Canal Remodeling through Ligamentotaxis for Lumbar Burst Fracture

  • Kang, Wu Seong;Kim, Jung Chul;Choi, Ik Sun;Kim, Sung Kyu
    • Journal of Trauma and Injury
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    • v.30 no.4
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    • pp.212-215
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    • 2017
  • The choice of the most appropriate treatment for thoracolumbar or lumbar spine burst fracture remains controversial from conservative treatment to fusion through a posterior or anterior approach. There are many cases where ligamentotaxis is used to reduce the burst fracture. However, indirect reduction using ligamentotaxis is often limited in the magnitude of the reduction that it can achieve. In our patient with severe burst fracture, we were able to restore an almost normal level of vertebral height and secure spinal canal widening by using only ligamentotaxis by posterior instrumentation. Before the operation, the patient had more than 95% encroachment of the spinal canal. This was reduced to less than 10% after treatment.

Radiological assessment and follow-up of a nonsurgically treated odontoid process fracture after a motor vehicle accident in Egypt: a case report

  • Ahmad Mokhtar Abodahab
    • Journal of Trauma and Injury
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    • v.36 no.4
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    • pp.411-415
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    • 2023
  • An odontoid process fracture is a serious type of cervical spine injury. This injury is categorized into three types based on the location of the fracture. Severe or even fatal neurological deficits can occur due to associated cord injury, which can result in complete quadriplegia. Computed tomography is the primary diagnostic tool, while magnetic resonance imaging is used to evaluate any associated cord injuries. These injuries can occur either directly from the injury or during transportation to the hospital if mishandled. There are two main treatment approaches: surgical fixation or external nonsurgical fixation, with various types and models of fixation devices available. In this case study, computed tomography follow-up confirmed that external fixation can yield successful results in terms of complete healing, even in cases complicated by other factors that may impede healing, such as pregnancy.

4 Cases of Patients That Improved from Traffic Accident Which Caused Lumbar Spine Compression Fracture by Complex Korean Medical Admission Treatment: Retrospective Case Study (교통 사고 이후 발생한 요추부 압박골절에 한방복합입원치료로 호전된 환자 4례: 후향적 증례 연구)

  • Hong, Je-Rak;Kim, Yu-Jong;Kim, Ji-Su;Lee, Jeong-Ryol;Kim, Tae-Gyu;Yoo, Do-Hyun;Choi, In-Seok;Lee, Sang-Won
    • Journal of Korean Medicine Rehabilitation
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    • v.27 no.4
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    • pp.163-170
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    • 2017
  • Objectives The objective of this study is to report 4 patients who had vertebral compression fracture after traffic accident, that had a complex korean medical admission treatment. Methods In this study we collected the data of traffic accident patients that came to receive intense Korean medical treatment, and had compression fracture of the lumbar spine. A total of 4 patients were studied and we compared the Visual Analogue Scale (VAS) score and the Pain-Free Walking Distance (PFWD) at addmission date and 19th day of hospitalization. Results After receiving an average of 22.25 days of admission treatment, all patients showed a significant decrease in VAS scores and increase in PFWD. The median VAS score at date of admission was 6.5 (VAS 6~9) and decreased to 3.5 (VAS 3~5), median PFWD was 37.5 (30~45) m and increased to 435 (420~450) m. Conclusions After complex korean medicine admission treatment, 4 patients with vertebral compression fracture caused by traffic accident showed decrease of pain and increase of walking distance. But there is a need for further studys to be done on treatment methods and evaluation methods.

Clinical Effects of Combination of Korean Medicine Admission Treatment in Patients with Sternum Fracture after Traffic Accidents : 5 Case Series Report (교통 사고로 발생한 흉골 골절 환자에 대한 한방복합입원치료 효과: 증례 보고 5례)

  • Park, Joon;Kim, Hyo-Jun;Kim, Gook-Beom;Kwon, Yong-Su;Lee, Hee-Won;Yu, Jae-Eun;Choi, Gyu-Cheol
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.14 no.2
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    • pp.101-111
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    • 2019
  • Objectives : The purpose of this study was to report five patients with a sternum fracture after a traffic accident who improved with a combination of Korean medicine treatments. Methods : We collected data of traffic accident patients with a sternum fracture who were admitted to Dae-Jeon Jaseng Korean Medicine Hospital from March 2019 to September 2019. We observed five cases of patients treated with acupuncture, pharmacoacupuncture, herbal medicine, and Korean physical therapy. We measured the validity of the treatments using the Numeric Rating Scale (NRS) and European Quality of Life-5 Dimension (EQ-5D) at admission, at two weeks, and on the discharge date of hospitalization. Results : Following treatment using a combination of the above mentioned methods, the general overall condition of the patients had significantly improved. Furthermore, the NRS and EQ-5D scores were numerically better. Conclusions : After the combination of Korean medicine treatments, results from five patients with a sternum fracture after a traffic accident suggested that the treatments were effective. However, the number of subjects was insufficient and individual efficacy was not measured in this study. Therefore, further studies are needed on this topic.

A Case Report of Prescribing Tong shun-san for Three Patients with Compression Fracture (통순산(通順散)을 투여한 압박골절(壓迫骨折)환자 치험 3례)

  • Han, Sang-Wook;Jung, Young-Hun;Kim, Jeong-Won;Kim, Choo-Young;Uhm, Bong-Kun;Lee, Cha-Ro;Lee, Jae-Young
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.6 no.2
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    • pp.145-154
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    • 2011
  • Objectives : The purpose of this study is to investigate the clinical application of Tong shun-san to three patients with compression fracture. Methods : Three patients were hospitalized at Dept. of Oriental Rehabilitation, Bu-Chun Jaseng Oriental Medicine Hospital, diagnosed as compression fracture and treated mainly with herbal medicine ; Tong shun-san. Their conditions were measured by VAS(Visual Analogue Scale) score. Results : After taking Tong shun-san, their pain was reduced. And VAS score was decreased. Conclusions : During three patients with compression fracture were taking Tong shun-san, their conditions were improved.

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Arthroscopic Treatment of Tibial Spine Fracture using Suture Hook and pull-out PDS (Suture Hook과 pull-out PDS를 이용한 경골극 골절의 관절경적 치료)

  • Lee, Young Kuk;Kim, Joon Seok;Sohn, Sung Won
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.2
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    • pp.132-137
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    • 1999
  • Displaced tibial spine fractures need the anatomical reduction of the displaced bone fragment to achieve normal range of motion and anterior stability of the knee joint. The purpose of this paper is to describe details of arthroscopic technique using suture hook and pull-out PDS and to evaluate the clinical results. We report 7 cases who underwent arthroscopic reduction and internal fixation using suture hook and pull-out PDS. All cases had fresh fractures generated within 3 weeks. The follow up period was at average 16.6 months. The fracture union was achieved at average 7.4 weeks. Knee exercise was started 2 weeks after the operation. One of the patients, who had combined injury of posterior cruciate ligament and lateral meniscus, showed limitation of knee movement. But he was underwent the arthroscopic fibrolysis at one year later, he returned to normal range of motion. Arthroscopic treatment of displaced tibial spine fracture using suture hook and pull-out PDS showed good results including rigid fixation and early mobilization. Therefore it is thought to be one of the effective operative techniques in treatment of the tibial spine fractures.

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Characteristics of 601 Low Back Pain Patients: A Korean Medicine Hospital Experience, Retrospective Chart Review (요통으로 한방병원에 입원한 환자 601명에 대한 후향적 연구)

  • Nam, Dae-Jin;Oh, Min-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.25 no.2
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    • pp.135-153
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    • 2015
  • Objectives The purpose of this study was to investigate the characteristics of inpatients who were admitted to Korean medicine hospital due to low back pain. Methods The current study was designed as a retrospective chart review to investigate descriptive characteristics of LBP patients. The clinical records of 601 patients who were hospitalized for treatment of LBP in Cheonan Korean Medicine Hospital, Daejeon University from 1st, January, 2013 to 31th, December, 2013 were analyzed. Results 1. Most frequently given diagnosis was sprain and strain of lumbar (45.93%). 2. Female outnumbered male patients in all disease groups except fracture of lumbar spine. 3. In distribution according to age, sprain and strain of lumbar, HNP of L-spine and lumbago with sciatica were most frequent at 30s, fracture of lumbar spine was most frequent at 50s and spinal stenosis was most frequent at 70s. 4. The most frequently motive for low back pain was traffic accident (35.4%) 5. Patients with no related medical history were 76.95% 6. 0~1week interval between onset and visit to Korean Medicine Hospital was most frequent in all disease groups. 7. 50.85% of patients went through treatment at medical institutions before the admitting to Korean Medicine Hospital. 8. The average admission days of female was higher than male's. And age goes up, average duration of admission was longer. 9. In most (74.59%) of the patients, symptoms were more than improved. 10. Most frequently prescribed examination was X-ray (65.13%). 11. Most frequently prescribed herb medicine was whal-lak-tang (Huoluo-tang). Conclusions In most (74.59%) of the patients, symptoms were more than improved, especially in sprain and strain of lumbar and lumbago with sciatica. But Patients with a local hospital statistic is not be representative of the incidence of the population. In order to obtain more accurate statistics, it is necessary to compare analysis collect statistics from other medical hospitals.

Clinical and Radiological Comparison of Femur and Fibular Allografts for the Treatment of Cervical Degenerative Disc Diseases

  • Oh, Hyeong-Seok;Shim, Chan Shik;Kim, Jin-Sung;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • v.53 no.1
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    • pp.6-12
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    • 2013
  • Objective : This consecutive retrospective study was designed to analyze and to compare the efficacy and outcomes of anterior cervical discectomy and fusion (ACDF) using a fibular and femur allograft with anterior cervical plating. Methods : A total of 88 consecutive patients suffering from cervical degenerative disc disease (DDD) who were treated with ACDF from September 2007 to August 2010 were enrolled in this study. Thirty-seven patients (58 segments) underwent anterior interbody fusion with a femur allograft, and 51 patients (64 segments) were treated with a fibular allograft. The mean follow-up period was 16.0 (range, 12-25) months in the femur group and 19.5 (range, 14-39) months in the fibular group. Cage fracture and breakage, subsidence rate, fusion rate, segmental angle and height and disc height were assessed by using radiography. Clinical outcomes were assessed using a visual analog scale and neck disability index. Results : At 12 months postoperatively, cage fracture and breakage had occurred in 3.4% (2/58) and 7.4% (4/58) of the patients in the femur group, respectively, and 21.9% (14/64) and 31.3% (20/64) of the patients in the fibular group, respectively (p<0.05). Subsidence was noted in 43.1% (25/58) of the femur group and in 50.5% (32/64) of the fibular group. No difference in improvements in the clinical outcome between the two groups was observed. Conclusion : The femur allograft showed good results in subsidence and radiologic parameters, and sustained the original cage shape more effectively than the fibular allograft. The present study suggests that the femur allograft may be a good choice as a fusion substitute for the treatment of cervical DDD.