• 제목/요약/키워드: Vertebral column

검색결과 79건 처리시간 0.025초

Retrograde Analysis of Clinical Characteristics of Bone Metastasis in 1,031 Cases of Preliminarily Diagnosed Nasopharyngeal Carcinoma

  • Zhao, Chang-Lin;Qian, Guo-Qiang;Chen, Xiao-Yin;Chen, Chao
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권8호
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    • pp.3785-3788
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    • 2014
  • Purpose: To explore the clinical characteristics of bone metastasis (BM) in a large sample of preliminarily diagnosed nasopharyngeal carcinomas (NPCs). Methods: The sample consisted of 1,031 patients diagnosed with NPC at first visitg clinics between October 1989 and June 2012. Several parameters including metastasis locus, T/N staging, diagnosis, therapy and prognosis of BM were analyzed retrospectively. Results: In 70 patients who had been preliminarily diagnosed with BM, the incidence of BM in N0, N1, N2 and N3 stage was 5.7%, 17.2%, 50.2%, and 25.7%, respectively, while the incidence in T0, T1, T2 and T3 stage was 0%, 23.8%, 47.6% and 28.6% respectively. BM occurred in most common in vertebral column, rib, sternum, ilium and femur. Positive rate of Epstein-Barr virus antibody was 77.6%. The median survival time was 12 months. Conclusion: The incidence of BM in NPC preliminarily diagnosed is about 7% and it is related to N classification but not T classification.

요부-골반-고관절 복합체의 생체역학 -천장관절 기능부전과 관련하여- (Integrated Biomechanics in the Lumbo-Pelvic-Hip Complex : Focus on Sacroiliac Joint Dysfunction)

  • 윤홍일;심현보;이준용
    • 대한정형도수물리치료학회지
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    • 제19권1호
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    • pp.69-77
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    • 2013
  • The pelvic girdle function as an integrated unit with all three bones moving at all three joints, are influenced by the lower extremities below and vertebral column and trunk above sacroiliac movements are caused by spinal motion, whereas iliosacral movements are caused by movements of the lower limbs. Concept of normal functional integration among the lumbar spine, pelvic and hip joint is basic to the understanding of dysfunction in this region and also functional movement of the lumbo-pelvic-hip region are part of the clinical examination, consequently the integrated biomechanics of these region need to be understood. The purpose of this review is to ascertain the integrated biomechanics among the lumbo-pelvic-hip complex by consideration of literature and to give sufficient information to be able to render accurate assessment and treatment for the syndromes described.

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독맥경과 임맥경에 대한 해부학적 고찰 (Anatomical Study on the Dogmaek-Gyeong and Immaek-Gyeong of the Oriental Medicine)

  • 김수명
    • 혜화의학회지
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    • 제7권2호
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    • pp.601-607
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    • 1999
  • The human body consists of the twelve main meridians and the eight extra meridians including Dogmaek-Gyeong and Immaek-Gyeong. This study is on twenty-eight acupuncture points Dogmaek-Gyeong and twenty-four acupuncture points Immaek-Gyeong among the eight extra meridians. It is very important to know the accurate acupuncture points, which is the fundamental subject in the Oriental Medicine. From now on they have expressed in Chinese letters and old anatomical terms, acupuncture points are difficult and confused to learn. In order to understand acupuncture points easily, they are translated into Korean anatomical terms focused on osteology in this study. Dogmaek-Gyeong is the meridian of this vessel run along the posterior meridian line of the body. The boundary commences at the coccyx, mounts the length of the vertebral column, contours the skull of the vertex along the philtrum to terminate upon the upper gum. It has twenty-eight acupuncture points. Immaek-Gyeong is the meridian of this vessel run along the anterior meridian line of the body. The boundary commences at the perineum mounts the pubic symphysis along the umbilicus, mandible and the terminates at concave of the lower lip. It has twenty-four acupuncture points.

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Integrative Korean Medicine Treatment for Low Back Pain with Butterfly Vertebra: Two Clinical Cases

  • Dong-Hwan Lee;Oh-Bin Kwon;Jae-Young Lee;Hyo-Rim Kim;Tae-Jun Lee;Sung-Hwan Cho;Kang-Moo Goo;Ja-Yean Son;Seok-Gyu Yang;Yu-Ra Im
    • Journal of Acupuncture Research
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    • 제41권
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    • pp.168-175
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    • 2024
  • The butterfly vertebra is a rare congenital anomaly of the spine, which arises from an asymmetric fusion defect in the embryonic vertebral column. This report delineates an integrative Korean medicine treatment administered to two patients who presented with low back pain associated with asymptomatic butterfly vertebrae. The patients received comprehensive treatment comprising acupuncture, Chuna therapy, pharmacopuncture, herbal medicine, and cupping therapy. The efficacy of the treatments was assessed utilizing diverse parameters, including a numerical rating scale, range of motion of the lumbar spine, Oswestry Disability Index, EuroQoL 5-Dimension 5-Level, and patient global impression of change. After the treatment, a notable improvement was noted in the evaluated indicators. These positive outcomes suggest that integrative Korean medicine treatment is suitable for patients experiencing low back pain associated with asymptomatic butterfly vertebrae.

Long Term Efficacy of Posterior Lumbar Interbody Fusion with Standard Cages alone in Lumbar Disc Diseases Combined with Modic Changes

  • Kwon, Young-Min;Chin, Dong-Kyu;Jin, Byung-Ho;Kim, Keun-Su;Cho, Yong-Eun;Kuh, Sung-Uk
    • Journal of Korean Neurosurgical Society
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    • 제46권4호
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    • pp.322-327
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    • 2009
  • Objective : Posterior lumbar interbody fusion (PLIF) is considered to have the best theoretical potential in promoting bony fusion of unstable vertebral segments by way of a load sharing effect of the anterior column. This study was undertaken to investigate the efficacy of PLIF with cages in chronic degenerative disc disease with Modic degeneration (changes of vertebral end plate). Methods : A total of 597 patients underwent a PLIF with threaded fusion cages (TFC) from 1993 to 2000. Three-hundred-fifty-one patients, who could be followed for more than 3 years, were enrolled in this study. Patients were grouped into 4 categories according to Modic classification (no degeneration : 259, type 1 : 26, type 2 : 55, type 3 : 11). Clinical and radiographic data were evaluated retrospectively. Results : The clinical success rate according to the Prolo's functional and economic outcome scale was 86% in patients without degeneration and 83% in patients with Modic degeneration. The clinical outcomes in each group were 88% in type 1, 84% in type 2, and 73% in type 3. The bony fusion rate was 97% in patients without degeneration and 83% in patients with Modic degeneration. The bony fusion rate in each group was 81% in type 1, 84% in type 2, and 55% in type 3. The clinical success and fusion rates were significantly lower in patients with type 3 degeneration. Conclusion : The PLIF with TFC has been found to be an effective procedure for lumbar spine fusion. But, the clinical outcome and bony fusion rates were significantly low in the patients with Modic type 3. The authors suggest that PLIF combined with pedicle screw fixation would be the better for them.

Estrogen promotes the onset and development of idiopathic scoliosis via disproportionate endochondral ossification of the anterior and posterior column in a bipedal rat model

  • Zheng, Shuhui;Zhou, Hang;Gao, Bo;Li, Yongyong;Liao, Zhiheng;Zhou, Taifeng;Lian, Chengjie;Wu, Zizhao;Su, Deying;Wang, Tingting;Su, Peiqiang;Xu, Caixia
    • Experimental and Molecular Medicine
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    • 제50권11호
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    • pp.3.1-3.11
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    • 2018
  • This study aimed to verify the effects of estrogen on the onset and development of adolescent idiopathic scoliosis and the mechanisms associated with these effects by constructing a pubescent bipedal rat model. Experiments were conducted to investigate whether scoliosis progression was prevented by a Triptorelin treatment. One hundred twenty bipedal rats were divided into female, OVX (ovariectomy), OVX + E2, Triptorelin, sham, and male groups. According to a spinal radiographic analysis, the scoliosis rates and curve severity of the female and OVX + E2 groups were higher than those in the OVX, Triptorelin, and male groups. The measurements obtained from the sagittal plane of thoracic vertebrae CT confirmed a relatively slower growth of the anterior elements and a faster growth of the posterior elements between T11 and T13 in the female and OVX + E2 groups than in the OVX and Triptorelin groups. Histomorphometry and immunohistochemistry revealed a significantly longer hypertrophic zone of the vertebral cartilage growth plates that expressed more type X collagen and less type II collagen in the OVX and Triptorelin groups than in the female and OVX + E2 groups. Ki67 immunostaining confirmed an increase in the proliferation of vertebral growth plate chondrocytes in the OVX group compared with the female and OVX + E2 groups. In conclusion, estrogen obviously increased the incidence of scoliosis and curve severity in pubescent bipedal rats. The underlying mechanism may be a loss of coupling of the endochondral ossification between the anterior and posterior columns. Triptorelin decreased the incidence of scoliosis and curve magnitudes in bipedal female rats.

만성요통의 치료에서 중재적인 치료가 보존적 치료보다 우세한가?: 긍정적인 입장에서 (Is Interventional Therapy Superior to Medical Treatment in Chronic Low Back Pain?: Yes, in Considerable Cases)

  • 장상범
    • Annals of Clinical Neurophysiology
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    • 제12권1호
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    • pp.3-6
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    • 2010
  • The British guideline for early management of persistent low back pain, published in 2009, indicated that physicians should offer exercise or medication, rather than radiological interventions or injections, as first choice of treatment in the patients with chronic low back pain (CLBP). However, there had been great controversies regarding the effectiveness of interventional treatment of patients with CLBP. Both somatic (discogenic, instability, etc) and psychosocial factors contribute to the pathophysiology of chronic low back pain (CLBP). Although it can be difficult in many occasions, thorough interview with the patients and specific diagnostic approaches can help us to identify which is the main etiology in individual patient. With the recent progress in medical radiology and development of new therapeutic modalities, some subgroups of patients of CLBP caused by somatic factors appear to be good candidates of interventional therapy. Interventional therapy can be considered in patients with CLBP caused by annulus rupture, facet joint degeneration, disc degeneration, and vertebral column instability. Among other subgroups of CLBP, carefully selected patients with disc degeneration show the most favorable result by interventional therapy. In this regard, discogenic pain, either as a form of CLBP or acute discogenic radiculopathy, seems to be a good indication of interventional therapy. Because many spine specialists generally consider those with radiculopathy are easier to be treated, patients with CLBP tend to be subjects of conventional conservative therapy. For these reasons, clinicians should make their best effort to identify every possible somatic cause in patients with CLBP before regarding them as hypochondriacs. In this review, some of the recent evidence on the role of interventional treatment in patients with CLBP will be discussed, and some of our cases who showed favorable results by interventional therapy will be presented.

흉부 압박손상에 의한 대동맥궁 파열 - 1예 보고 - (Aortic Arch Rupture due to Compression Injury of the Thorax - A case report -)

  • 이건;임창영;이헌재
    • Journal of Chest Surgery
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    • 제42권1호
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    • pp.100-103
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    • 2009
  • 흉부 대동맥의 외상성 파열은 두부 손상 다음으로 흔한 교통사고의 사망원인으로 약 85%의 환자가 병원 도착 전에 사망한다. 가장 흔한 기전은 고속의 차량이 충돌 등으로 인한 급작스런 감속에 의해 발생되며 대동맥 협부가 전체 대동맥 손상의 95%에 해당된다. 또 다른 기전으로는 흉부 압박 손상에 의해 골절되어 전위된 흉골병과 흉부 척추 사이에 대동맥이 끼이면서 나타날 수 있는데 이로 인해 흔하지 않은 위치의 대동맥벽의 내막이 파열된다. 저자들은 감속사고가 아닌 흉부 압박에 의해 대동맥궁이 파열되어 박리된 증례에 대해 집중적인 내과 치료 후에 지연 수술로 완전 순환정지 하에 뇌보호를 시행하면서 상행 대동맥의 일부와 대동맥궁을 인조혈관으로 치환하였기에 보고하는 바이다.

Clinical Analysis of Video-assisted Thoracoscopic Spinal Surgery in the Thoracic or Thoracolumbar Spinal Pathologies

  • Kim, Sung-Jin;Sohn, Moon-Jun;Ryoo, Ji-Yoon;Kim, Yeon-Soo;Whang, Choong-Jin
    • Journal of Korean Neurosurgical Society
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    • 제42권4호
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    • pp.293-299
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    • 2007
  • Objective : Thoracoscopic spinal surgery provides minimally invasive approaches for effective vertebral decompression and reconstruction of the thoracic and thoracolumbar spine, while surgery related morbidity can be significantly lowered. This study analyzes clinical results of thoracoscopic spinal surgery performed at our institute. Methods : Twenty consecutive patients underwent video-assisted thoracosopic surgery (VATS) to treat various thoracic and thoracolumbar pathologies from April 2000 to July 2006. The lesions consisted of spinal trauma (13 cases), thoracic disc herniation (4 cases), tuberculous spondylitis (1 case), post-operative thoracolumbar kyphosis (1 case) and thoracic tumor (1 case). The level of operation included upper thoracic lesions (3 cases), midthoracic lesions (6 cases) and thoracolumbar lesions (11 cases). We classified the procedure into three groups: stand-alone thoracoscopic discectomy (3 cases), thoracoscopic fusion (11 cases) and video assisted mini-thoracotomy (6 cases). Results : Analysis on the Frankel performance scale in spinal trauma patients (13 cases), showed a total of 7 patients who had neurological impairment preoperatively : Grade D (2 cases), Grade C (2 cases), Grade B (1 case), and Grade A (2 cases). Four patients were neurologically improved postoperatively, two patients were improved from C to E, one improved from grade D to E and one improved from grade B to grade D. The preoperative Cobb's and kyphotic angle were measured in spinal trauma patients and were $18.9{\pm}4.4^{\circ}$ and $18.8{\pm}4.6^{\circ}$, respectively. Postoperatively, the angles showed statistically significant improvement, $15.1{\pm}3.7^{\circ}$ and $11.3{\pm}2.4^{\circ}$, respectively(P<0.001). Conclusion : Although VATS requires a steep learning curve, it is an effective and minimally invasive procedure which provides biomechanical stability in terms of anterior column decompression and reconstruction for anterior load bearing, and preservation of intercostal muscles and diaphragm.

구강악안면재건을 위한 복직근 유리피판의 해부학적 고찰 (Anatomical Review of Rectus Abdominis Muscle Free Flap for the Oral and Maxillofacial Reconstruction)

  • 박정민;서미현;김성민;강지영;명훈;이종호
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제34권5호
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    • pp.367-375
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    • 2012
  • Midfacial reconstruction following resection of extensive malignant oral cavity tumors constitutes a challenging problems for reconstructive surgeons. Rectus abdominis muscle free flap (RAMFF) can be considered as the optimal reconstructive option in this case, because this flap has some advantages including consistent deep inferior epigastric artery anatomy, easy to dissect with well defined skin boundaries, acceptable donor site morbidity and the ability to perform simultaneous flap harvest with oral cancer ablation surgery. The rectus abdominis muscle forms an important part of the anterior abdominal wall and flexes the vertebral column, which is a long strap-like muscle divided transversely by three tendinous intersections, fibrous bands which are adherent to the anterior rectus sheath, which is thickly enclosed by the rectus sheath, except for the posterior part below the arcuate line that is usually located midway between the umbilicus and symphysis pubis. Below the arcuate line, this muscle lies in direct contact with the transversalis fascia and parietal peritoneum. For the better understanding of RAMFF as a routine reconstructive procedure in oral and maxillofacial surgery, the constant anatomical findings muse be learned and memorized by the young doctors in the course of the special curriculum periods for the Korean national board of oral and maxillofacial surgery. This review article will discuss the anatomical basis of RAMFF with Korean language.