• 제목/요약/키워드: Vertebral column

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Restoration of Sagittal Balance in Spinal Deformity Surgery

  • Makhni, Melvin C.;Shillingford, Jamal N.;Laratta, Joseph L.;Hyun, Seung-Jae;Kim, Yongjung J.
    • Journal of Korean Neurosurgical Society
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    • 제61권2호
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    • pp.167-179
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    • 2018
  • The prevalence of patients with adult spinal deformity (ASD) has been reported as high as 68%. ASD often leads to significant pain and disability. Recent emphasis has been placed on sagittal plane balance and restoring normal sagittal alignment with regards to the three dimensional deformity of ASD. Optimal sagittal alignment has been known to increase spinal biomechanical efficiency, reduce energy expenditure by maintaining a stable posture with improved load absorption, influence better bony union, and help to decelerate adjacent segment deterioration. Increasingly positive sagittal imbalance has been shown to correlate with poor functional outcome and poor self-image along with poor psychological function. Compensatory mechanisms attempt to maintain sagittal balance through pelvic rotation, alterations in lumbar lordosis as well as knee and ankle flexion at the cost of increased energy expenditure. Restoring normal spinopelvic alignment is paramount to the treatment of complex spinal deformity with sagittal imbalance. Posterior osteotomies including posterior column osteotomies, pedicle subtraction osteotomies, and posterior vertebral column resection, as well anterior column support are well known to improve sagittal alignment. Understanding of whole spinal alignment and dynamics of spinopelvic alignment is essential to restore sagittal balance while minimizing the risk of developing sagittal decompensation after surgical intervention.

한국산 망둥어 과 어류의 척주와 담기골에 관한 연구 (Study of Vertebral Column and Pterygiophores in Gobiidae (Pisces, Perciformes) from Korea)

  • Lee, yong-Joo
    • Animal Systematics, Evolution and Diversity
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    • 제9권1호
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    • pp.25-34
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    • 1993
  • 1984년 4월부터 1992년 10월가지 국내에서 채집된 망둑어과 어류 4아과 26속 45종의 총 348개체를 대상으로 제1등지느러미 담기골의 배열식, 척추골수, 상미축골수 및 제 1혈관극 전방의 뒷지느러미 담기골수를 조사하여 비교하였다. 제1등지느러미 담기골의 배열식과 상미축골수는 속의 특징을 잘 나타내주었으며, 척추골수와 제1혈관극 전방의 뒷지느러미 담기골수는 종에 따라 고유한 특징을 보여주었다. 이중 이전에 망둑어 과의 아과를 구분하는 특징으로 사용되어진 상미축골수는 망둑어 아과의 분류에서는 적합하지 않았다.

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

  • 엄기동;장동우;서민호;정주현;최호정;이기창;이희천;이영원;최민철
    • 한국임상수의학회지
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    • 제18권3호
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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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Variations of azygos vein: a cadaveric study with clinical relevance

  • Ananya Priya;Shalom Elsy Philip;Anjali Jain;Aparajita Sikka
    • Anatomy and Cell Biology
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    • 제56권4호
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    • pp.448-455
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    • 2023
  • The azygos vein can be formed as a single root, two roots, and three roots, namely lateral, intermediate and the medial roots respectively. The hemiazygos vein and the accessory hemiazygos vein are the tributaries of azygos vein rather than its left side equivalents. Its variations, especially in young persons without any relevant risk factors, may result in thromboembolic illness. This study aimed to describe the morphological and morphometric variations of azygos system of veins. The present study was conducted on thirty formalin fixed adult human cadavers by dissecting azygos vein from formation to termination and variations were noted. The azygos vein was formed by a single root in 56.7%, by two roots: the lateral root and intermediate root in 36.7% cases and by the lateral root and medial root in 6.6%. The vertebral level of termination of azygos vein was seen at the level of T4 vertebrae in 70% cases, at the level of T3 vertebrae in 20% of cases and at the level of T5 vertebrae in 10% cases. The course of azygos vein was varying in 13.3%. These morphological variations can be useful while performing mediastinal surgery, mediastinoscopy, surgery of the deformations of the vertebral column, neurovascular surgeries of the retroperitoneal organs, disc herniation and fracture of thoracic vertebrae.

Anatomic Variations of Cervical and High Thoracic Ligamentum Flavum

  • Yoon, Sang Pil;Kim, Hyun Jung;Choi, Yun Suk
    • The Korean Journal of Pain
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    • 제27권4호
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    • pp.321-325
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    • 2014
  • Background: Epidural blocks are widely used for the management of acute and chronic pain. The technique of loss of resistance is frequently adopted to determine the epidural space. A discontinuity of the ligamentum flavum may increase the risk of failure to identify the epidural space. The purpose of this study was to investigate the anatomic variations of the cervical and high thoracic ligamentum flavum in embalmed cadavers. Methods: Vertebral column specimens of 15 human cadavers were obtained. After vertebral arches were detached from pedicles, the dural sac and epidural connective tissue were removed. The ligamentum flavum from C3 to T6 was directly examined anteriorly. Results: The incidence of midline gaps in the ligamentum flavum was 87%-100% between C3 and T2. The incidence decreased below this level and was the lowest at T4-T5 (8%). Among the levels with a gap, the location of a gap in the caudal third of the ligamentum flavum was more frequent than in the middle or cephalic portion of the ligamentum flavum. Conclusions: The cervical and high thoracic ligamentum flavum frequently has midline intervals with various features, especially in the caudal portion of the intervertebral space. Therefore, the ligamentum flavum is not always reliable as a perceptible barrier to identify the epidural space at these vertebral levels. Additionally, it may be more useful to insert the needle into the cephalic portion of the intervertebral space than in the caudal portion.

강아지 고리뼈의 치아돌기 골절 진단과 치료 (Diagnosis and treatment of the odontoid process fracture of the axis in a dog)

  • 박형준;이신호;김충희;원청길;조재현
    • 한국동물위생학회지
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    • 제46권1호
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    • pp.87-92
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    • 2023
  • A 7-year-old dog weighing 3.9 kg visited the hospital with symptoms of inability to stand and quadriparesis. There were seizure symptoms 2 months before admission to the hospital, and the symptoms of stiffness and rigidity appeared. Radiographs showed normal vertebrae in cervical vertebral column. Magnetic resonance imaging (MRI) and computed tomography (CT) were performed immediately to diagnose vertebral lameness. As a result of the CT, it was possible to observe the fracture of the odontoid process of the axis, and the exact location of the damage was identified. The odontoid process was fractured and separated from the body of the 2nd cervical vertebra (axis), and fragment of the process was observed inside the vertebral arch of the first cervical vertebra (atlas), and the body of the axis was lifted to the dorsal side. The MRI examination reflected the CT findings and confirmed severe spinal cord compression due to the fracture of the odontoid process. The patient was applied by neck brace and medical management including Mycophenolate mofetil administration was performed. The patient was able to move legs and tail after 2 weeks, and was able to voluntarily defecate, urinate and stand up after 4 weeks of administration.

골반의 운동학적 고찰 (A Comprehensive Kinematic Approach to Pelvis)

  • 배성수;김태윤;정현애;배주한
    • The Journal of Korean Physical Therapy
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    • 제11권2호
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    • pp.93-102
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    • 1999
  • Alignment of the hip joint and pelvis affects it's weight-bearing capabilities as well as the motion available at the joints. The normal hip joint is well designed to withstand the forces that act through and around it, assisted by the trabecular systems, cartilagious, muscles, and ligaments. Alterations in the direction or magnitude of forces action around the injury and degenerative changes. The integration of motion of the pelvis with motion of the vertebral column not only increases the ROM available to the total column but also reduces the amount of flexibility required of the lumbar lesion. In any instance in which there is normal or abnormal pelvic motion during weight hearing and the head must remain upright, compensatory motions of the lumber spine will occur if available. The motions that occur at the hip, pelvis, and lumbar spine during forward trunk bending with the motions that occur during anterior and posterior tilting of the pelvis in the erect standing postion.

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Quantitative Vertebral Bone Density Seen on Chest CT in Chronic Obstructive Pulmonary Disease Patients: Association with Mortality in the Korean Obstructive Lung Disease Cohort

  • Hye Jeon Hwang;Sang Min Lee;Joon Beom Seo;Ji-Eun Kim;Hye Young Choi;Namkug Kim;Jae Seung Lee;Sei Won Lee;Yeon-Mok Oh
    • Korean Journal of Radiology
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    • 제21권7호
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    • pp.880-890
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    • 2020
  • Objective: Patients with chronic obstructive pulmonary disease (COPD) are known to be at risk of osteoporosis. The purpose of this study was to evaluate the association between thoracic vertebral bone density measured on chest CT (DThorax) and clinical variables, including survival, in patients with COPD. Materials and Methods: A total of 322 patients with COPD were selected from the Korean Obstructive Lung Disease (KOLD) cohort. DThorax was measured by averaging the CT values of three consecutive vertebral bodies at the level of the left main coronary artery with a round region of interest as large as possible within the anterior column of each vertebral body using an in-house software. Associations between DThorax and clinical variables, including survival, pulmonary function test (PFT) results, and CT densitometry, were evaluated. Results: The median follow-up time was 7.3 years (range: 0.1-12.4 years). Fifty-six patients (17.4%) died. DThorax differed significantly between the different Global Initiative for Chronic Obstructive Lung Disease stages. DThorax correlated positively with body mass index (BMI), some PFT results, and the six-minute walk distance, and correlated negatively with the emphysema index (EI) (all p < 0.05). In the univariate Cox analysis, older age (hazard ratio [HR], 3.617; 95% confidence interval [CI], 2.119-6.173, p < 0.001), lower BMI (HR, 3.589; 95% CI, 2.122-6.071, p < 0.001), lower forced expiratory volume in one second (FEV1) (HR, 2.975; 95% CI, 1.682-5.262, p < 0.001), lower diffusing capacity of the lung for carbon monoxide corrected with hemoglobin (DLCO) (HR, 4.595; 95% CI, 2.665-7.924, p < 0.001), higher EI (HR, 3.722; 95% CI, 2.192-6.319, p < 0.001), presence of vertebral fractures (HR, 2.062; 95% CI, 1.154-3.683, p = 0.015), and lower DThorax (HR, 2.773; 95% CI, 1.620-4.746, p < 0.001) were significantly associated with all-cause mortality and lung-related mortality. In the multivariate Cox analysis, lower DThorax (HR, 1.957; 95% CI, 1.075-3.563, p = 0.028) along with older age, lower BMI, lower FEV1, and lower DLCO were independent predictors of all-cause mortality. Conclusion: The thoracic vertebral bone density measured on chest CT demonstrated significant associations with the patients' mortality and clinical variables of disease severity in the COPD patients included in KOLD cohort.

Gelatinous Transformation of Bone Marrow Mimicking Malignant Marrow-Replacing Lesion on Magnetic Resonance Imaging in a Patient without Underlying Devastating Disease

  • Lee, Joohee;Yoo, Yeon Hwa;Lee, Sarah;Kim, Hak Sun;Kim, Sungjun
    • Investigative Magnetic Resonance Imaging
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    • 제22권1호
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    • pp.50-55
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    • 2018
  • Gelatinous transformation of bone marrow is characterized by hypoplasia of fat cells with focal loss of hematopoietic cells and deposition of extracellular gelatinous substances. It is known to be associated with devastating underlying diseases that starve bone marrow. Here, we present a case of a patient whose magnetic resonance (MR) imaging findings of vertebral column were interpreted as metastasis or hematologic malignancy, however, the final diagnosis revealed a gelatinous transformation of bone marrow. This is the first report of gelatinous transformation of bone marrow without evidence of underlying devastating disease.

The Role of the Cricopharyngeus Muscle in Pitch Control - Electromyographic and radiographic studies

  • Hong, Ki-Hwan;Kim, Hyun-Ki;Yang, Yoon-Soo
    • 음성과학
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    • 제11권1호
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    • pp.73-83
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    • 2004
  • Electromyographic studies of the cricopharyngeus muscle using hooked wire electrodes were performed in thyroidectomized patients. The shape of the cricoid cartilage and soft tissue thickness in the postcricoid area were evaluated during pitch elevation and pitch lowering using conventional neck lateral films. The cricopharyngeus muscle simultaneously activated in the initial task of speech and continuously activated. Its activity lessened in the interrogative stress contrast of sentence terminals and increased in the pitch lowered contrast of sentence terminal. On the radiologic findings the cricoid cartilage was tilted backward during high pitched phonation and tilted forward during low pitched phonation. The soft tissue thickness of postcricoid area was thicker at the low pitch than at high pitch. At low pitch the cricoid cartilage paralleled along the vertebral column. This result suggests that the bulging of cricopharyngeus muscle in contraction induce a thickened the postcricoid area thickened, and exert pressure anteriorly exerted on the cricoid cartilage. This contraction of the cricopharyngeus muscle may result in shortening the vocal fold and lowering pitch.

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