• Title/Summary/Keyword: Vertebral column

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Clinical Efficacy and Safety of Controlled Distraction-Compression Technique Using Expandable Titanium Cage in Correction of Posttraumatic Kyphosis

  • Kang, Dongho;Lewis, Stephen J;Kim, Dong-Hwan
    • Journal of Korean Neurosurgical Society
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    • v.65 no.1
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    • pp.84-95
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    • 2022
  • Objective : To investigate the clinical efficacy and safety of the controlled distraction-compression technique using an expandable titanium cage (ETC) in posttraumatic kyphosis (PTK). Methods : We retrospectively studied and collected data on 20 patients with PTK. From January 2014 to December 2017, the controlled distraction-compression technique using ETC was consecutively performed in 20 patients with PTK of the thoracolumbar zone (range, 36-82 years). Among them, nine were males and 11 were females and the mean age was 61.5 years. The patients were followed regularly at 1, 3, 6, and 12 months, and the last follow-up was more than 2 years after surgery. Results : The mean follow-up period was 27.3±7.3 months (range, 14-48). The average operation time was 286.8±33.1 minutes (range, 225-365). The preoperative regional kyphotic angle (RKA) ranged from 35.6° to 70.6° with an average of 47.5°±8.1°. The immediate postoperative mean RKA was 5.9°±3.8° (86.2% correction rate, p=0.000), and at the last follow-up more than 2 years later, the mean RKA was 9.2°±4.9° (80.2% correction rate, p=0.000). The preoperative mean thoracolumbar kyphosis was 49.1°±9.2° and was corrected to an average of 8.8°±5.3° immediately after surgery (p=0.000). At the last follow-up, a correction of 11.9°±6.3° was obtained (p=0.000). The preoperative mean back visual analog scale (VAS) score was 7.9±0.8 and at the last follow-up, the VAS score was improved to a mean of 2.3±1.0 with a 70.9% correction rate (p=0.000). The preoperative mean Oswestry disability index (ODI) score was 32.3±6.9 (64.6%) and the last follow-up ODI score was improved to a mean of 6.85±2.9 (3.7%) with a 78.8% correction rate (p=0.000). The overall complication was 15%, with two of distal junctional fractures and one of proximal junctional kyphosis and screw loosening. However, there were no complications directly related to the operation. Conclusion : Posterior vertebral column resection through the controlled distraction-compression technique using ETC showed safe and good results in terms of complications, and clinical and radiologic outcomes in PTK. However, to further evaluate the efficacy of this surgical procedure, more patients need long-term follow-up and there is a need to apply it to other diseases.

Expandable Cage for Cervical Spine Reconstruction

  • Zhang, Ho-Yeol;Thongtrangan, Issada;Le, Hoang;Park, Jon;Kim, Daniel H.
    • Journal of Korean Neurosurgical Society
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    • v.38 no.6
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    • pp.435-441
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    • 2005
  • Objective : Expandable cage used for spinal reconstruction after corpectomy has several advantages over nonexpendable cages. Here we present our clinical experience with the use of this cage after anterior column corpectomy with an average of one year follow up. Methods : Ten patients underwent expandable cage reconstruction of the anterior column after single-level or multilevel corpectomy for various cervical spinal disorders. Anterior plating with or without additional posterior instrumentation were performed in all patients. Functional outcomes, complications, and radiographic outcomes were determined. Results : There was no cage-related complication. Functionally, neurological examination revealed improvement in 7 of 10 patients and no patient had neurological deterioration after the surgery. Immediate stability was achieved and maintained throughout the period of follow-up. There was minimal subsidence [<2mm] noticeable in three of the cases that underwent a two-level corpectomy. Subsidence was noted in osteoporotic patients and patients undergoing multi-level corpectomies. Average pre-operative kyphotic angle was 9 degrees. This was corrected to an average of 5.4 degrees in lordosis postoperatively. Conclusion : In conclusion, expandable cages are safe and effective devices for vertebral body replacement after cervical corpectomy when used in combination with anterior plating with or without additional posterior stabilization. The advantages of using expandable cages include its ability to easily accommodate itself into the corpectomy defect, its ability to tightly purchase into the end plates after expansion and thus minimizing the potential for migration, and finally, its ability to correct kyphosis deformity via its in vivo expansion properties.

Spinal Cord Injury without Radiographic Abnormalities in Children (소아의 척추 외상)

  • Yang, Hong-Ki;Doo, Jung-Hee
    • Physical Therapy Korea
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    • v.3 no.1
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    • pp.57-64
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    • 1996
  • Spinal cord injury in child often occurs without evidence of fracture or dislocation. The mechanisms of neural damage in this syndrome of spinal cord injury without radiographic abnormality(SCIWORA) include flexion, hyperextension, longitudinal distraction, and ischemia. Inherent elasticity of the vertebral column in infants and young children, among other age-related anatomical peculiarities, render the pediatric spine exceedingly vulnerable to deforming forces. The neurological lesions encountered in this syndrome include a high incidence of complete and severe partial cord lesions. Children younger than 8years old sustain more serious neurological damage and suffer a larger number of upper cervical cord lesions than children aged over 8 years. Of the children with SCIWORA. 52% have delayed onset of paralysis up to 4 days after injury, and most of these children recall transient paresthesia, numbness, or subjective paralysis. The long-term prognosis in cases of SCIWORA is grim. Most children with complete and severe lesions do not recover; only those with initially mild neural injuries make satisfactory neurological recovery.

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Effect of Spinal Cord Removal before or after Splitting and Washing on CNST Decontamination of Beef Carcasses

  • Lim, D.G.;Kim, D.H.;Lee, M.
    • Asian-Australasian Journal of Animal Sciences
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    • v.20 no.11
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    • pp.1770-1776
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    • 2007
  • Beef carcasses were examined to explore the effects of spinal cord removal and washing on central nervous system tissue (CNST) decontamination of the surface during the slaughtering process. A total of 15 carcasses were split by sawing centrally down the vertebral column and left sides of split carcasses were used for analysis. Samples were collected by swabbing the surface from 4 defined parts on the interior and 4 on the exterior of carcasses from the abattoir and analyzed using an ELISA-based test. The results showed that automatic and manual spray washing decreased CNST contamination, especially on the interior ventral parts of carcass surfaces (p<0.01), but did not decrease CNST on the interior dorsal parts. Increasing washing time to 60 s did not affect the reduction of CNST contamination. Samples following spinal cord removal prior to splitting showed lower calculated levels of "risk material" than the stated limit of detection (0.1%) of the ELISA kit on interior and exterior carcass parts (p<0.01). Therefore, spinal cord removal prior to splitting could be a very effective way to minimize CNST contamination of beef carcasses.

Newborn English Bulldogs with Multiple Malformation Syndrome and Lethal Characters

  • Jang, Si-Jung;Kim, Minkyung;Lee, Hyeon-Jeong;You, Young-Sung;Lee, Jaehoon;Lee, Sung-Lim
    • Journal of Animal Reproduction and Biotechnology
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    • v.34 no.3
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    • pp.253-258
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    • 2019
  • A female English bulldog was gave birth two neonates by cesarean section on the sixty one days after mating, but both neonates were died soon after birth. The bodies of neonates were diagnosed using radiography, ultrasonography, computed tomography and necropsy immediately after death. Both neonates had caudal regression syndrome, butterfly vertebra, hydrocephalus, umbilical hernia, cleft palate and bow-legged hind-limb. At necropsy, neonates had mild fetal anasarca, cleft lip and the skull was remained non-union. At thoracic cavity, only three ribs and thoracic spines were existed and patent ductus arteriosus was found. At abnormal cavity, the renal ectopia was found with abnormal morphology. In the present case, those English bulldog neonates with multiple congenital malformation syndromes seriously suffered vertebral column anomalies and that may induced by neural tube defects in during embryonic period. To prevent congenital malformation occurring in English bulldog, further in depth studies are needed for the breed specific genetic diversity and for the reason of behind genetic abnormality in these breed.

Schistosomus reflexus in Korean native calf (한우 송아지의 반전성열체)

  • Kim, Chong-sup;Huh, Chan-kwen;Lee, Jong-hwan;Lee, Jong-han
    • Korean Journal of Veterinary Research
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    • v.36 no.2
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    • pp.289-296
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    • 1996
  • A case of schistosomus reflexes in Korean native female calf was observed macroscopically and radiographically. The results were summarized as follows. 1. The abdominal visceral organs were exposed. 2. The vertebral column bent laterally to the left, and the sacrum approached to the cranium by reflected caudal lumber vertebrae, presenting S-shaped lateral twisting of the vertebrae. 3. The right ribs reflected laterally and dorso-cranially from the 7th rib to 13th rib. The left ribs bent caudally from 8th rib to 13th rib. 4. The length of rudimentary 6th right rib was one half of normal size and the 7th right rib was one third. 5. The sternum was bifid split from the fourth sternebra through the xyphoid cartilage. 6. The diaphragm was intact and thoracic cavity was reduced in size. The lung and heart severely deformed in shape and size. 7. The liver markedly deformed in shape and thickness. 8. The pelvic cavity was reduced in size by compression laterally to the left. 9. The uterus horn, ovary, urinary bladder, and urethra were severely deformed in the shape and position.

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Influence of the Midsole Hardness on Shock Absorption along the Human Body during Running (달리기 중 신발 중저의 경도가 인체를 따라 흡수되는 충격에 미치는 영향)

  • Lee, Yong-Ku;Kim, Yoon-Hyuk
    • Journal of Biomedical Engineering Research
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    • v.31 no.1
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    • pp.33-39
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    • 2010
  • During running, the human body experiences repeated impact force between the foot and the ground. The impact force is highly associated with injury of the lower extremity, comfort and running performance. Therefore, shoemakers have developed shoes with various midsole properties to prevent the injury of lower extremity, improve the comfort and enhance the running performance. The purpose of this study is to investigate influence of midsole hardness on shock absorption along the human body during running. Thirty two expert runners consented to participate in the study and ran at a constant speed with three different pairs of shoes with soft, medium and hard midsole respectively. Using accelerometers we measured the shock absorption from shoe heel to cervical vertebral column. In conclusion, at the shoe heel, shock was the greatest with the hard midsole. However because most shock was absorbed between shoe heel and the knee, notable influence of midsole was not detected upper knee. At shoe heel, regardless of midsole hardness, the shock of younger female was the greatest. The authors expect to apply this result for providing a guideline for utilizing proper midsole hardness for manufacturing age and gender-specific shoe.

An Image-guided Radiosurgery for the Treatment of Metastatic Bone Tumors using the CyberKnife Robotic System

  • Cho, Chul-Koo
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.1
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    • pp.14-21
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    • 2007
  • Bone is a common site for metastatic spread from many kinds of malignancies. The morbidity associated with this metastatic spread can be significant, including severe pain. When it comes to spinal metastasis, occupying nearly 40% of skeletal metastases, the risks of complications, such as vertebral body collapse, nerve root impingement, or spinal cord compression, are also significant. Because of the necessity of preserving the integrity of the spinal column and the proximity of critical structures, surgical treatment has limitations when durable local control is desired. Radiotherapy, therefore, is often used as an adjunct treatment or as a sole treatment. A considerable limitation of standard radiotherapy is the reported recurrence rate or ineffective palliation of pain, either clinically or symptomatically. This may be due to limited radiation doses to tumor itself because of the proximity of critical structures. CyberKnife is an image-guided robotic radiosurgical system. The image guidance system includes a kilovoltage X-ray imaging source and amorphous silica detectors. The radiation delivery device is a mobile X-band linear accelerator (6 MV) mounted on a robotic arm. Highly conformal fields and hypofractionated radiotherapy schedules are increasingly being used as a means to achieve biologic dose escalation for body tumors. Therefore, we can give much higher doses to the targeted tumor volume with minimizing doses to the surrounding critical structures, resulting in more effective local control and less severe side effects, compared to conventional fractionated radiotherapy. A description of this technology and a review of clinical applications to bone metastases are detailed herein.

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Osteochondroma of the 3rd Lumbar Spine Causing Spinal Compression - A Case Report - (척수 압박을 동반한 제 3 요추의 골연골종 - 1례 보고 -)

  • Kim, Hyung-Seok;Hong, Ki-Do;Ha, Sung-Sik;Lee, Sun-Woo
    • The Journal of the Korean bone and joint tumor society
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    • v.3 no.1
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    • pp.26-31
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    • 1997
  • One of the most common benign tumors of bone is the osteochondroma which is a cartilage-capped bony projection on the surface of a bone. It may occur in any bone that has been performed from cartilage, but the most common locations are the long bone at the metaphyseal region of the most active growth cartilage, that is, the lower end of femur, the upper end of the tibia, and the upper end of the humerus. Other bones often involved are the ilium, scapula, fibula, and phalanges of hands and feet. But, the vertebral column is very rare location for osteochondroma. Only one case of osteochondroma involving the lumbar spine has been previously reported in Korea. We report an unusual case of osteochondroma arising from the left lamina and inferior articular process of the 3rd lumbar spine causing spinal cord compression.

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Intraosseous hemangioma of the orbit

  • Choi, June Seok;Bae, Yong Chan;Kang, Gyu Bin;Choi, Kyung-Un
    • Archives of Craniofacial Surgery
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    • v.19 no.1
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    • pp.68-71
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    • 2018
  • Intraosseous hemangioma is an extremely rare tumor that accounts for 1% or fewer of all osseous tumors. The most common sites of its occurrence are the vertebral column and calvaria. Occurrence in a facial bone is very rare. The authors aim to report a case of the surgical treatment of intraosseous hemangioma occurring in the periorbital region, which is a very rare site of occurrence and to introduce our own experiences with the diagnosis and treatment of this condition along with a literature review. A 73-year-old male patient visited our hospital with the chief complaint of a mass touching the left orbital rim. A biopsy was performed by applying a direct incision after local anesthesia. Eventually, intraosseous hemangioma was diagnosed histologically. To fully resect the mass, the orbital floor and zygoma were exposed through a subciliary incision under general anesthesia, and then the tumor was completely eliminated. Bony defect was reconstructed by performing a seventh rib bone graft. Follow-up observation has so far been conducted for 10 months after surgery without recurrence or symptoms.