• Title/Summary/Keyword: Vertebral

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Epidural Administration of Morphine for Cancer Pain via Portal System (경막외 Port 및 주입기를 이용한 지속적 모르핀 투여에 의한 암성 통증 조절)

  • Yoon, Duck-Mi;Chung, So-Young;Oh, Hung-Kun;Kim, Ju-Yeon
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.69-74
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    • 1996
  • Background: Efficacy of spinal opioids for the treatment of intractable cancer pain has been reported by several authors. The epidural route seems to be a more reliable and effective method of pain control as compared to the intrathecal route which can lead to opioids by portal system. Methods: Medical records were reviewed of 18 patients who had been treated with epidural morphine via an implanted port-A-Cath from Mar. 1991 to Sep. 1994. Results: Patients were treated for a mean of 92 days. There were wide variation of dose requirements. The minimum daily dose ranged from 2 to 10mg, and maximum daily dose from 3 to 30 mg. Verbal rating scale were below moderate until 100th days after posrtal implantation. When 3 patients suffered from aggravated pain associated with vertebral metastasis. Five of 11 patients who were administered medication longer than 50 days reguired increased doses ranging from 3 mg to 25 mg which were higher as compared to initial doses. These patients also experienced pain due to vertebral metastasis. There were no report of epidural scarring, respiratory depression, epidural infections, meningitis, or catheter blockade. Conclusion: Continuous epidural morphine administration via Port-A-Cath is an effective method with minimal complication.

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Conservative treatment of lumbar compression fracture with illeus and urinary disorder -A case of study - (대소변불리(大小便不利)를 동반한 척추 압박골절 환자 치험 1례)

  • Park, Sung-Ho;Park, Jun-Sik;Song, Yun-Kyung;Eom, Yu-Sik
    • The Journal of Korea CHUNA Manual Medicine
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    • v.6 no.1
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    • pp.169-176
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    • 2005
  • In recent years, according to the increase of the osteoporosis and traffic accidents, the vertebral compression fracture patients are increased, This Study is clinical observation to the patients who be taken compression fracture of the $L1^{\sim}L2$ vertebra bodies with the symptoms of urinary disorder and ileus. She was treated by bed rest, acupuncture and moxibustion, herb medicine, physical therapy. In the observation of this case, I think that conservative treatment which involved acupuncture, moxibustion therapy and herb medicinal treatment is more effective than common nonoperative therapy.

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Diagnostic Imaging and Treatment of Lumbar Vertebral Fracture in a Dog (개에서 발생한 요추골절의 영상진단과 치료 1례)

  • Kwon, Young-Hang;Lim, Soo-Ji;An, Ji-Young;Choi, Soo-Young;Lee, In;Ahn, Se-Joon;Choi, Ho-Jung;Lee, Young-Won
    • Journal of Veterinary Clinics
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    • v.26 no.5
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    • pp.495-498
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    • 2009
  • A female, nine-month-old Rottweiler was presented with bilateral hind limbs lameness. Physical examination, survey radiography, computed tomography (CT) and magnetic resonance imaging (MRI) were performed. Oblique fracture of L6 vertebral body and abnormal alignment was observed in survey radiographs, CT, and MRI. No significant lesion was found in the intervertebral disc adjacent to fracture site. The patient was applied by bandage and medical management including corticosteroid administration was performed. The patient was able to walk after 4 weeks and prognosis was good.

Postoperative Evaluation of Funnel Chest - The role of radiologic indices -

  • 윤태진
    • Journal of Chest Surgery
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    • v.25 no.12
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    • pp.1416-1421
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    • 1992
  • There are many objective indices of operative outcome of funnel chest, but there has been only a few report about the postoperative change of these indices and which is best correlated with subjective outcome. From January 1989 to December 1991, 74 patients with funnel chest underwent Ravitch operation and radiologic evaluation was performed on the twenty patients whose operative outcome were satisfactory by Humphreys` criteria and postoperative chest X-ray were available. Variable radiologic chest idices such as deformity grade [DG], lower vertebral index [LVI], upper vertebral index [UVI] and configuration index [CI] were measured preoperatively and 1, 6, 12 and 18 months pos-toperatively. The mean value of preoperative DG, LVI, UVI and CI were 5.32, 0.3, 0.26 and 1.01 respectively, and postoperative chages were as follows; DG; 3.13, 3.66, 3, 72, 4.0, LVI: 0.22, 0, 24, 0.25, 0.25 UVI; 0.27, 0.27, 0.27, 0.27 CI; 0.69, 0.77, 0.76, 0.79. The increments of CI were within the 90 percent confidence limit of normogram in most cases, but it was not true for LVI and UVI. And the differences between the observed and expected values of CI did not change significantly through the postoperative periods, which was not the case in LVI. We concluded from these results that 1] DG, LVI and CI were increased slowly during the postoperative follow up periods but the increments of CI were usually within the normal limits and so 2] CI can be used as a objective index of satisfactory outcome.

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Comparison of access window created by cervical ventral slot and modified slanted ventral slot in canine cadaver

  • Kang, Ho Young;Kang, Jinsu;Lee, Haebeom;Kim, Namsoo;Heo, Suyoung
    • Korean Journal of Veterinary Research
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    • v.60 no.3
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    • pp.139-144
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    • 2020
  • Ten cadavers were studied to compare the accessibility of cervical vertebral canal with conventional standard ventral slot and modified slanted ventral slot. One group performed standard ventral slot procedures at the C3-4, C5-6. The other group performed modified slanted ventral slot with inverted cone technique procedures at the C3-4, C5-6 computed tomography was performed before and after surgery. The accessibility of cervical vertebral canal with conventional standard ventral slot and modified slanted ventral slot using computed tomography in C3-4 and C5-6 intervertebral space was compared. Although smaller ostectomy was performed in the modified slanted ventral slot, some lesions were more accessible but limitations were obvious in C3-4 and C5-6 intervertebral disk space. After the disc material has been identified through accurate preoperative diagnostic imaging, less morbidity and complications can be expected if the appropriate surgical method is selected based on the lesion of compression.

Posterior Cervical Fixation with a Nitinol Shape Memory Loop for Primary Surgical Stabilization of Atlantoaxial Instability : A Preliminary Report

  • Kim, Duk-Gyu;Eun, Jong-Pil;Park, Jung-Soo
    • Journal of Korean Neurosurgical Society
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    • v.52 no.1
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    • pp.21-26
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    • 2012
  • Objective : To evaluate a new posterior atlantoaxial fixation technique using a nitinol shape memory loop as a simple method that avoids the risk of vertebral artery or nerve injury. Methods : We retrospectively evaluated 14 patients with atlantoaxial instability who had undergone posterior C1-2 fusion using a nitinol shape memory loop. The success of fusion was determined clinically and radiologically. We reviewed patients' neurologic outcomes, neck disability index (NDI), solid bone fusion on cervical spine films, changes in posterior atlantodental interval (PADI), and surgical complications. Results : Solid bone fusion was documented radiologically in all cases, and PADI increased after surgery (p<0.05). All patients remained neurologically intact and showed improvement in NDI score (p<0.05). There were no surgical complications such as neural tissue or vertebral artery injury or instrument failure in the follow-up period. Conclusion : Posterior C1-2 fixation with a nitinol shape memory loop is a simple, less technically demanding method compared to the conventional technique and may avoid the instrument-related complications of posterior C1-2 screw and rod fixation. We introduce this technique as one of the treatment options for atlantoaxial instability.

Fusiform Aneurysm Presenting with Cervical Radiculopathy in Ehlers-Danlos Syndrome

  • Kim, Ho-Sang;Choi, Chang-Hwa;Lee, Tae-Hong;Kim, Sang-Phil
    • Journal of Korean Neurosurgical Society
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    • v.48 no.6
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    • pp.528-531
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    • 2010
  • Ehlers-Danlos syndrome (EDS) type IV is characterized by its clinical manifestations, which are easy bruising, thin skin with visible veins, and rupture of arteries, uterus, or intestines. Arterial complications are the leading cause of death in vascular EDS because they are unpredictable and surgical repair is difficult due to tissue fragility. The authors report a case presented with cervical radiculopathy due to a segmental fusiform aneurysm of the cervical vertebral artery. Transfemoral cerebral angiography (TFCA) was done to verify the aneurysmal dilatation. However, during TFCA, bleeding at the puncture site was not controlled, skin and underlying muscle was disrupted and profound bleeding occurred during manual compression after femoral catheter removal. Accordingly, surgical repair of the injured femoral artery was performed. At this time it was possible to diagnose it as an EDS with fusiform aneurysm on cervical vertebral artery. Particularly, cervical fusiform aneurysm is rare condition, and therefore, connective tissue disorder must be considered in such cases. If connective tissue disorder is suspected, the authors suggest that a noninvasive imaging modality, such as, high quality computed tomography angiography, be used to evaluate the vascular lesion to avoid potential arterial complications.

Diagnostic Imaging of Intervertebral Disk Disease in 3 Dogs (추간판 질환 3례에서의 진단영상)

  • 엄기동;장동우;서민호;정주현;최호정;이기창;이희천;이영원;최민철
    • Journal of Veterinary Clinics
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    • v.18 no.3
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    • pp.284-287
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    • 2001
  • Three dogs referred to Veterinary Medical Teaching Hospital, Seoul National University were diagnosed as intervertebral disc disease. Physical examination, neurologic examination, survey radiograph, and myelography were performed in patients. Case 1 showed narrowing intervertebral space and calcified intervertebral disc material in survey radiograph. Case 2 showed increased opacity in the intervertebral opacity in survey radiograph. All of 3 cases showed extradural pattern during myelography. In survey radiography, radiographic signs consistent with intervertebral disc herniations include narrowing of the disc space and the dorsal intervertebral articular process joint space, small intervertebral foramen, increase opacity in the intervertebral foramen and extruded, mineralized disc material within the vertebral canal. Myelography is useful for evaluating the spinal cord and the cauda equina. Indication for myelography includes confirming a spinal lesion seen or suspected on survey radiograph, defining the extent of a survey lesion, finding a lesion not observed on survey radiograph, and distinguishing between surgical and nonsurgical lesion. In presentcases, two of three cases show radiographic signs of IVDD with survey radiograph and all of three case show extradural pattern during myelography. It is observed that intervertebral disc disease is one of the most important indication for radiographic examination and myelography of the vertebral column of small animals.

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Dysphagia Caused by Osteochondroma of the Cervical Vertebral Body: A Case Report (경추체 전방에 발생한 골연골종으로 인한 연하곤란: 증례 보고)

  • Min, Hak-Jin;Kim, Jin-Soo;Kim, Jong-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.18 no.1
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    • pp.32-36
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    • 2012
  • A 56 year-old female presented with dysphagia 8 weeks ago and newly developed dysphonia 2 weeks ago. The radiology study and swallowing difficulty evaluation study revealed the esophagus and the posterior wall of the laryngopharynx to be severely compressed by the mass of the anterior $4^{th}$ and $5^{th}$ vertebral body of cervical spine. En bloc excisional biopsy of the bony mass was performed, which completely resolved the clinical symptoms. We report a rare case of osteochondroma occurring at the anterior portion of cervical spine leading to dysphasia and dysphonia with a review of relevant literature.

Comparison of Cervical Musculoskeletal Kinematics in Two Different Postures of Primate During Voluntary Head Tracking

  • Park, Hyeonki;Emily Keshner;Barry W. Peterson
    • Journal of Mechanical Science and Technology
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    • v.17 no.8
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    • pp.1140-1147
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    • 2003
  • We have examined the effect on neck-muscle activation of altering whole body posture. A Rhesus monkey (Macaca mulatta) was trained to produce sinusoidal (0.25 Hz) head tracking movements in the sagittal plane when seated with trunk and head vertical or while standing in the quadrupedal position. Video-fluoroscopic images of cervical vertebral motion, and electromyographic (EMG) responses were recorded simultaneously. Results demonstrated that vertebral motion varied with body posture, occurring synchronously between all joints in the upright position and primarily at skull-$C_1$ when in the quadrupedal position. Muscle EMG activation was significantly greater (P<0.001) in the quadrupedal position than when upright for all muscles except semispinalis cervicis. Peak activation of all the muscles occurred prior to peak head extension in the quadrupedal position, suggesting synchronous activity between muscles. Data suggest that, when upright, muscles were activated in functional groupings defined by their anatomical arrangement. In the quadrupedal position, gravity acting on the horizontally oriented head produced greater activation and a collective response of the muscles.