• Anatomy & Biological Anthropology
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• v.31 no.4
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• pp.151-158
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• 2018

The intervertebral foramen is formed by two adjacent vertebrae and an intervertebral disc. Previous studies examining the foramen have been performed using various methods. The author obtained characteristics of the intervertebral foramen based on silicon mold. The author used 18 cadavers and dissected the lumbar intervertebral foramen. First, positional levels of the spinal nerve in the intervertebral foramen were measured. Second, after being removed all tissues covering the intervertebral, bony foramen was filled with melted silicon to mold the cross section. Subsequently, the solidified silicon mold was removed and stamped on a paper. The paper was scanned and analyzed area, perimeter, height and width of the intervertebral foramen on a computer. Area (average, $9.43mm^2$) and perimeter (average, 48.02 mm) did not show any statistical significant pattern for any lumbar vertebral levels. However, the height and width significantly differed at the fifth lumbar vertebra, which had the shortest height (the fifth, 13.00 mm; average, 15.78 mm) and longest width (the fifth, 8.61 mm; average, 7.87 mm), although there were similar patterns in case of area and perimeter of the first to fourth lumbar vertebra. Height had a decrease tendency while width had an increase tendency both from the second to fifth lumbar vertebra. Spinal nerves went through near the intervertebral disc level from the first to fourth lumbar vertebra, although they passed below the disc at the fifth level. This study provides a different view of methodology for the 3-dimensional aspect for the intervertebral foramen. Results of this study may indicate that height and width of the intervertebral foramen changed along all lumbar vertebral levels; nevertheless, area and perimeter of the intervertebral foramen remained constant.

• Journal of Korean Society of Spine Surgery
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• v.25 no.4
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• pp.169-174
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• 2018

Study Design: Case report. Objectives: We report a case of pure epidural cavernous hemangioma located at the thoracolumbar spine in a 53-year-old woman that mimicked a neurogenic tumor on magnetic resonance imaging (MRI). Summary of Literature Review: A pure spinal epidural cavernous hemangioma without bony involvement is a very rare lesion about which limited information is available in the literature. Materials and Methods: A 53-year-old woman visited our clinic for hypoesthesia with a tingling sensation in the left anterolateral thigh that had begun a month ago. No other neurologic symptoms or signs were present upon a neurologic examination. MRI from an outside hospital showed a $2.0{\times}0.5cm$ elongated mass at the T11-12 left neural foramen. The tumor was completely removed in piecemeal fashion. Results: The histopathologic examination revealed a cavernous hemangioma, which was the final diagnosis. The outcome was favorable in that only operation-related mild back pain remained, without any neurologic deficits, after a postoperative follow-up of 2 years and 3 months. No recurrence was observed on MRI at 2 years postoperatively. Conclusion: Pure epidural spinal cavernous hemangioma is very rare, and it is very difficult to differentiate from other epidural lesions. However, we believe that it should be included in the differential diagnosis of spinal epidural tumors due to its favorable prognosis.

• Korean Journal of Ichthyology
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• v.30 no.4
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• pp.205-216
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• 2018

Taxonomic review of the genus Saurida, belonging to the family Synodontidae, was conducted based on three species (S. macrolepis, S. microlepis and S. wanieso) collected from Korea between 1994 and 2017, and one species (S. elongata) loaned from Japan. S. wanieso can be readily distinguished from S. tumbil by following characteristics: outer palatine teeth (2 rows in S. wanieso vs. 3~4 rows in S. tumbil) and pectoral fin length (reaching to pelvic - dorsal line in S. wanieso vs. not reaching to pelvic - dorsal line in S. tumbil). In counts, the four Saurida spp. are well distinguished: number of lateral line scales (48~50 in S. macrolepis vs. 54~58 in S. wanieso vs. 61~62 in S. elongata vs. 63~70 in S. microlepis), vertebrae (47~49 in S. macrolepis vs. 51~53 in S. wanieso vs. 57~59 in S. elongata vs. 62~64 in S. microlepis). The present study suggests S. undosquamis and S. tumbil must be absent in Korean waters, and also S. elongata may be rare or absent in Korean waters. Here we use the Korean name, "tum-bil-mae-tung-i" for S. wanieso, following Yamada et al. (1995) who treated Korean S. tumbil as S. wanieso.

• Journal of Korean Neurosurgical Society
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• v.62 no.4
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• pp.450-457
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• 2019

Objective : Anterior cervical discectomy and fusion (ACDF) is commonly used surgical procedure for cervical degenerative disease. Among the various intervertebral spacers, the use of allografts is increasing due to its advantages such as no harvest site complications and low rate of subsidence. Although subsidence is a rare complication, graft collapse is often observed in the follow-up period. Graft collapse is defined as a significant graft height loss without subsidence, which can lead to clinical deterioration due to foraminal re-stenosis or segmental kyphosis. However, studies about the collapse of allografts are very limited. In this study, we evaluated risk factors associated with graft collapse. Methods : We retrospectively reviewed 33 patients who underwent two level ACDF with anterior plating using allogenous bone graft from January 2013 to June 2017. Various factors related to cervical sagittal alignment were measured preoperatively (PRE), postoperatively (POST), and last follow-up. The collapse was defined as the ratio of decrement from POST disc height to follow-up disc height. We also defined significant collapses as disc heights that were decreased by 30% or more after surgery. The intraoperative distraction was defined as the ratio of increment from PRE disc height to POST disc height. Results : The subsidence rate was 4.5% and graft collapse rate was 28.8%. The pseudarthrosis rate was 16.7% and there was no association between pseudarthrosis and graft collapse. Among the collapse-related risk factors, pre-operative segmental angle (p=0.047) and intra-operative distraction (p=0.003) were significantly related to allograft collapse. The cut-off value of intraoperative distraction ${\geq}37.3%$ was significantly associated with collapse (p=0.009; odds ratio, 4.622; 95% confidence interval, 1.470-14.531). The average time of events were as follows: collapse, $5.8{\pm}5.7months$; subsidence, $0.99{\pm}0.50months$; and instrument failure, $9.13{\pm}0.50months$. Conclusion : We experienced a higher frequency rate of collapse than subsidence in ACDF using an allograft. Of the various preoperative factors, intra-operative distraction was the most predictable factor of the allograft collapse. This was especially true when the intraoperative distraction was more than 37%, in which case the occurrence of graft collapse increased 4.6 times. We also found that instrument failure occurs only after the allograft collapse.

• Journal of Korean Neurosurgical Society
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• v.62 no.4
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• pp.432-441
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• 2019

Objective : Few studies have reported direct comparative data of lumbar spine angles between direct lateral interbody fusion (DLIF) and oblique lateral interbody fusion (OLIF). The purpose of this study was to investigate the clinical and radiological outcomes of DLIF and OLIF, and determine influential factors. Methods : The same surgeon performed DLIF from May 2011 to August 2014 (n=201) and OLIF from September 2014 to September 2016 (n=142). Radiological parameters, cage height, cage angle (CA), cage width (CW), and cage location were assessed. We checked the cage location as the distance (mm) from the anterior margin of the disc space to the anterior metallic indicator of the cage in lateral images. Results : There were significant differences in intervertebral foramen height (FH; $22.0{\pm}2.4$ vs. $21.0{\pm}2.1mm$, p<0.001) and sagittal disc angle (SDA; $8.7{\pm}3.3$ vs. $11.3{\pm}3.2^{\circ}$, p<0.001) between the DLIF and OLIF groups at 7 days postoperatively. CA ($9.6{\pm}3.0$ vs. $8.1{\pm}2.9^{\circ}$, p<0.001) and CW ($21.2{\pm}1.6$ vs. $19.2{\pm}1.9mm$, p<0.001) were significantly larger in the OLIF group compared to the DLIF group. The cage location of the OLIF group was significantly more anterior than the DLIF group ($6.7{\pm}3.0$ vs. $9.1{\pm}3.6mm$, p<0.001). Cage subsidence at 1 year postoperatively was significantly worse in the DLIF group compared to the OLIF group ($1.0{\pm}1.5$ vs. $0.4{\pm}1.1mm$, p=0.001). Cage location was significantly correlated with postoperative FH (${\beta}=0.273$, p<0.001) and postoperative SDA (${\beta}=-0.358$, p<0.001). CA was significantly correlated with postoperative FH (${\beta}=-0.139$, p=0.044) and postoperative SDA (${\beta}=0.236$, p=0.001). Cage location (${\beta}=0.293$, p<0.001) and CW (${\beta}=-0.225$, p<0.001) were significantly correlated with cage subsidence. Conclusion : The cage location, CA, and CW seem to be important factors which result in the different-radiological outcomes between DLIF and OLIF.

• Journal of Korean Neurosurgical Society
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• v.62 no.1
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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.

• Journal of Yeungnam Medical Science
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• v.35 no.2
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• pp.199-204
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• 2018

Background: The authors have performed ultrasound-guided stellate ganglion block (SGB) in our clinic using a lateral paracarotid approach at the level of the 6th cervical vertebra (C6). Although SGB at C6 is a convenient and safe method, there are ongoing concerns about the weak effect of sympathetic blockade in the ipsilateral upper extremity. Therefore, ultrasound-guided SGB was attempted using a lateral paracarotid approach at the level of the 7th cervical vertebra (C7). This prospective study aimed to compare changes in skin temperature after SGB was performed at C6 and C7, and to introduce a lateral paracarotid approach for SGB. Methods: Thirty patients underwent SGB twice: once at C6 and once at C7. For every SGB, the skin temperature of the patient's hypothenar area was measured for 15 min at 1-min intervals. Skin temperatures before and after SGB and side effects were compared between C6 and C7 groups. Results: The temperature of the upper extremity increased after SGB was performed at C6 and C7. There were significant differences between mean pre-SGB and the largest increases in post-SGB temperatures ($0.50{\pm}0.38^{\circ}C$ and $1.41{\pm}0.68^{\circ}C$ at C6 and C7, respectively; p<0.05). Significantly increased post-SGB temperatures (difference > $1^{\circ}C$) were found in 5/30 (16.7%) and 24/30 (80%) cases for C6 and C7, respectively (p<0.05). There were no significant differences in side effects between SGB performed at C6 or C7 (p>0.05). Conclusion: The lateral paracarotid approach using out-of-plane needle insertion for ultrasound-guided SGB performed at C7 was feasible and more effective at elevating skin temperature in the upper extremity than SGB at C6.

• Journal of Korean Medicine Rehabilitation
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• v.31 no.4
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• pp.203-210
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• 2021

Bertolotti's syndrome is a rare spinal disease and it is known to cause low back pain due to a lumbosacral transitional vertebra. There has been rare study of Bertolotti's syndrome. This study reports the effects of Korean medicine treatment on the patient who was diagnosed on Bertolotti's syndrome. The patient was treated with Korean medicine treatment including acupuncture, pharmacopuncture, herbal medicine, and Chuna manual therapy during 40 days. Numerical rating scale (NRS), Euroqol five dimension (EQ-5D) index, Oswestry disability index (ODI), lumbar range of motion were used for assessment. After treatment, low back pain NRS decreased from 3 to 2, and low limb pain NRS decreased from 5 to 2. EQ-5D index, ODI and lumbar range of motion also were improved. This study shows Korean medicine treatment can be an effective care for Bertolotti's syndrome.

• Korean Journal of Ichthyology
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• v.33 no.3
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• pp.184-190
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• 2021

Since the original description of new species, Eumicrotremus jindoensis, we confirmed the first occurrence of E. jindoensis based on a single specimen (22.3 mm SL) caught by inshore stow net at the coastal waters of Boryeong of Korea. However, our specimen slightly differed from type specimens in having more vertebrae (26 vs. 21~24), longer snout (17.4% vs. 8.1~9.1%), longer preanus length (67.5% vs. 58.0~58.3%) and shorter second dorsal fin base (15.3% vs. 20.2~20.8%). Comparing with mtDNA COI and Cytb sequences, we could not find any differences in mtDNA Cytb sequences between our specimen and type specimens, which suggest that those morphological differences may belong to local variation by habitat and environmental condition between off Jindo Island and off Boryeong in Korea. Eumicrotremus uenoi is known from the southern sea of Korea narrowly (Busan, Tongyeong, and Jeju Island), the other congeneric species (E. asperrimus, E. pacificus, and E. taranetzi) from only the eastern sea of Korea, but E. jindoensis from the central coast to southern coast of western Korea.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.4
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• pp.271-281
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• 2021

Purpose : This study aimed to apply muscle relaxation exercise and ultrasound therapy as an effective treatment method for tension headache patients by comparatively analyzing the muscle mechanical properties, neck disorder index, and headache impact test. Method : The subjects were classified into three groups based on the intervention received: the therapeutic ultrasound (n=15, group I), placebo therapeutic ultrasound combined with the suboccipital release (n=15, group II), and therapeutic ultrasound combined with suboccipital release (n=15, group III) groups. The intragroup and intergroup differences in muscle mechanical properties, neck disability index, and headache impact test were compared and analyzed. Result : The comparison and analyses of the changes in muscle tone and post hoc analysis revealed statistically significant intragroup decreases in the suboccipitalis and upper trapezius in groups I and III. Furthermore, statistically significant intergroup differences in the upper trapezius with a greater change in group III than in group II and suboccipitalis with greater changes in group III than in groups I and II were observed. The comparison and analyses of the changes in muscle stiffness and post hoc analysis revealed statistically significant intragroup decreases in the upper trapezius in group I and suboccipitalis in group III. Moreover, statistically significant intergroup differences in both muscles with greater changes in group III than in group II for both cases were observed. The comparison and analyses of the changes in the neck disability index and post hoc analysis revealed statistically significant intragroup decreases in all three groups and statistically significant intergroup differences with greater changes in group III than in groups I and II. The comparison and analyses of the changes in the headache impact test and post hoc analysis revealed statistically significant intragroup decreases in all three groups and a statistically significant intergroup difference with greater changes in group III than in groups I and II. Conclusion : The therapeutic ultrasound and suboccipital muscle release exercise effectively increased the flexibility of the muscles around the cervical vertebrae and reduced muscle tension and stiffness in tension-type headache patients.