• The Korean Journal of Pain
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• 제18권2호
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• pp.142-145
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• 2005

Background: Vertebroplasty that is performed in the upper and middle thoracic spine presents technical challenges that are different from those in the lower thoracic or lumbar region due to the small pedicle size and angular severity for thoracic kyphosis. We report the results of percutaneous vertebroplasty and review its effectiveness in treating intractable osteoporotic compression fractures in the upper and middle thoracic spine. Methods: Patients who underwent vertebroplasty due to painful osteoporotic compression fractures at T3 T8 were retrospectively analyzed. The compression rate, volume of injected cement, clinical outcome (VAS score) and complications were analyzed. Results: Forty-three vertebral bodies from 41 patients (32 females and 9 males, age from 64 to 78 years old) underwent vertebroplasty. The mean compression rate improved from 35% to 17%. Bipedicular injections of bone cement were performed at 3 levels of 2 patients, and unipedicular injections were performed in 40 levels of 39 patients. The mean VAS score prior to surgery was 7.7, which improved to 2.4 within 48 hours after surgery, and the mean VAS score after 6 months was 1.5, which was significantly lower. All patients recovered uneventfully, and the neurological examination revealed no deficits. Cement leakage to the adjacent disc (9 levels) and paravertebral soft tissues (10 levels) developed. However, there were no significant complications related to the procedure such as a pneumothorax or pulmonary embolism. Conclusions: Transpedicular vertebroplasty is a safe and effective treatment for the upper and middle thoracic regions, and has a low complication rate.

• 한방재활의학과학회지
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• 제30권2호
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• pp.125-137
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• 2020

Objectives The purpose of this study was to examine how changes in the cervical spine correlate with body posture changes in the whole body, and to find out the significance of complementary clinical application X-ray and Chuna posture analysis. Methods From January 1, 2019 to October 31, 2019, the results of 27 patients with pain in the vertebral region were analysed in accordance with the results of cervical X-ray and Chuna posture analysis. In order to confirm the significance of Chuna posture analysis results, the survey of 187 Chuna standard curriculum instruction qualification certifiers was conducted and the responses of 47 of them were analyzed. Results The occiput-atlas cline angle increases in both hypolordosis/hyperlordosis groups based on cervical lordosis angle, and increases further than in the hyperlordosis group. There were significant correlations between the changes in the cervical spine and the body posture changes in the whole body. There were no significant differences between cervical X-ray sagittal parameters and the body posture analysis parameters based on the patient's major disease codes. Conclusions As a result of conducting a survey on the clinical importance of the body posture analysis parameters, the importance of cervical parameters was verified. Changes in the cervical spine may not only cause other changes in the cervical region, but also affect the body posture changes in the whole body. The complementary application of X-ray and Chuna posture analysis results is helpful in clinical diagnosis and treatment of musculoskeletal disorders.

• Journal of Korean Neurosurgical Society
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• 제53권6호
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• pp.331-336
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• 2013

Objective : The offset connector can allow medial and lateral variability and facilitate intralaminar screw incorporation into the construct. The aim of this study was to compare the biomechanical characteristics of C7 intralaminar screw constructs with and without offset connector using a three dimensional finite element model of a C6-7 cervical spine segment. Methods : Finite element models representing C7 intralaminar screw constructs with and without the offset connector were developed. Range of motion (ROM) and maximum von Mises stresses in the vertebra for the two techniques were compared under pure moments in flexion, extension, lateral bending and axial rotation. Results : ROM for intralaminar screw construct with offset connector was less than the construct without the offset connector in the three principal directions. The maximum von Misses stress was observed in the C7 vertebra around the pedicle in both constructs. Maximum von Mises stress in the construct without offset connector was found to be 12-30% higher than the corresponding stresses in the construct with offset connector in the three principal directions. Conclusion : This study demonstrated that the intralaminar screw fixation with offset connector is better than the construct without offset connector in terms of biomechanical stability. Construct with the offset connector reduces the ROM of C6-7 segment more significantly compared to the construct without the offset connector and causes lower stresses around the C7 pedicle-vertebral body complex.

• 대한정형도수물리치료학회지
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• 제18권1호
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• pp.1-10
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• 2012

Thoracic kyphosis is occasionally used to describe someone with accentuated thoracic curvature, hyperkyphosis is preferred since kyphosis itself refers to the normal sagittal angle of thoracic curvature. The angle of thoracic kyphosis tends to increase with age resulting in hyperkyphosis in some individuals. The persons who suffer from hyperkyphosis are at increased risk for a variety of adverse health outcomes that include musculoskeletal alteration, physical functional limitations, poor quality of life, falls, and even earlier mortality. Hyperkyphosis may develop from vertebral fractures, degenerative disc disease, either muscle weakness, decreased mobility and sensory deficits. The gold-standard orthopaedic technique for assessment of thoracic kyphosis is standing lateral spine radiographs. Other clinical measures are Debrunner kyphometer, inclinometer, flexicurve ruler, arcometer, flexible electrogoniometer and spinal mouse.

• 한국정밀공학회지
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• 제21권8호
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• pp.157-163
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• 2004

Scoliosis is a complex musculoskeletal dieses requiring 3-D treatment with surgical instrumentation. To investigate the effects of correction surgery, a finite element model of personalized model of the scoliotic spine that will allow the design of clinical test providing optimal estimation of the post-operation results was developed. Three dimensional skeletal parts, such as vertebrae, clavicle and scapular were modeled as rigid bodies with keeping their morphologies. Kinematical joints and spring elements were adapted to represent the inter-vertebral disc and ligaments respectively. With this model, two types of surgery procedure, distraction procedure with Harrington device and rod derotation procedure with pedicle screw and rod system had been carried out. The obtained simulation results were comparatively corresponding to the post operational outcomes and successfully demonstrated qualitative analysis of surgical effectiveness. From this analysis, it has been found that the preparing of appropriate rod curvature and its insertion was more important than just performing the excessive derotation for scoliosis correction.

• Journal of Korean Neurosurgical Society
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• 제49권4호
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• pp.231-233
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• 2011

Chronic spinal epidural hematoma related to Kummell's disease is extremely rare. An 82-year-old woman who had been managed conservatively for seven weeks with the diagnosis of a multi-level osteoporotic compression fracture was transferred to our institute. Lumbar spine magnetic resonance images revealed vertebral body collapse with the formation of a cavitary lesion at L1, and a chronic spinal epidural hematoma extending from L1 to L3. Because of intractable back pain, a percutaneous vertebroplasty was performed. The pain improved dramatically and follow-up magnetic resonance imaging obtained three days after the procedure showed a nearly complete resolution of the hematoma. Here, we present the rare case of a chronic spinal epidural hematoma associated with Kummell's disease and discuss the possible mechanism.

• Journal of Korean Neurosurgical Society
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• 제51권2호
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• pp.105-108
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• 2012

Giant spinal schwannoma of the cauda equine involving many nerve roots is rare, and ossification is usually not observed in the schwannoma. A 21-year-old man presented with a 12-month history of urinary dysfunction and numbness below the buttocks. Plain radiography showed scalloping of the posterior surface of the vertebral bodies from L4 to the sacrum, and magnetic resonance imaging and computed tomography revealed a giant cauda equina tumor with dystrophic calcification. The tumor was completely removed, with intraoperative neurophysiologic monitoring. Histopathologic examination showed that the tumor was a schwannoma. The patient's postoperative course was uneventful, with urinary function and numbness gradually improving. Although a giant schwannoma accompanied by dystrophic calcification is extremely rare, such a tumor can be removed safely and completely by meticulous dissection and careful neuromonitoring of the cauda equina spinal nerves involved in the tumor.

• Journal of Trauma and Injury
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• 제30권4호
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• pp.212-215
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• 2017

The choice of the most appropriate treatment for thoracolumbar or lumbar spine burst fracture remains controversial from conservative treatment to fusion through a posterior or anterior approach. There are many cases where ligamentotaxis is used to reduce the burst fracture. However, indirect reduction using ligamentotaxis is often limited in the magnitude of the reduction that it can achieve. In our patient with severe burst fracture, we were able to restore an almost normal level of vertebral height and secure spinal canal widening by using only ligamentotaxis by posterior instrumentation. Before the operation, the patient had more than 95% encroachment of the spinal canal. This was reduced to less than 10% after treatment.

• 한국자동차공학회논문집
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• 제10권2호
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• pp.193-200
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• 2002

Simple spring-damper-mass models have been widely used to investigate whole-body vortical biodynamic response characteristics of the seated vehicle driver. Most previous models have not considered the effect of wobbling masses; i.e. heart, lungs, liver, intestine, etc. In this study, 4 -DOF seated driver model including one non-rigid mass representing wobbling visceral mass, 5-DOF model including intestine, and 10-DOF model including five lumbar vertebral masses were proposed. The model parameters were identified by a combinatorial optimization technique. simulated annealing method. The objective function was chosen as the sum of error between model response of seat-to-head transmissibility and driving point mechanical impedance and those of experimental data for subjects seated erect without backrest support. The model response showed a good agreement with the experimental response characteristics. Using a 10-DOF model, calculated resonance frequency of lumbar spine at 4Hz was matched well with experimental results of Panjabi et al.

• Journal of Korean Neurosurgical Society
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• 제47권2호
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• pp.134-136
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• 2010

Bow hunter's stroke is a rare symptomatic vertebrobasilar insufficiency in which vertebral artery (VA) is mechanically occluded during head rotation. Various pathologic conditions have been reported as causes of bow hunter's stroke. However, bow hunter's stroke caused by facet hypertrophy of C1-2 has not been reported. A 71-year-old woman presented with symptoms of vertebrobasilar insufficiency. Spine computed tomography showed massive facet hypertrophy on the left side of C1-2 level. A VA angiogram with her head rotated to the right revealed significant stenosis of left VA. C1-2 posterior fixation and fusion was performed to prevent serious neurologic deficit from vertebrobasilar stroke.