• Title/Summary/Keyword: Vertebral spine

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Sparganosis Presenting as Cauda Equina Syndrome with Molecular Identification of the Parasite in Tissue Sections

  • Boonyasiri, Adhiratha;Cheunsuchon, Pornsuk;Srirabheebhat, Prajak;Yamasaki, Hiroshi;Maleewong, Wanchai;Intapan, Pewpan M.
    • Parasites, Hosts and Diseases
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    • v.51 no.6
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    • pp.739-742
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    • 2013
  • A 52-year-old woman presented with lower back pain, progressive symmetrical paraparesis with sensory impairment, and sphincter disturbance. Magnetic resonance imaging (MRI) of the whole spine revealed multiple intradural extramedullary serpiginous-mass lesions in the subarachnoid space continuously from the prepontine to the anterior part of the medulla oblongata levels, C7, T2-T8, and T12 vertebral levels distally until the end of the theca sac and filling-in the right S1 neural foramen. Sparganosis was diagnosed by demonstration of the sparganum in histopathological sections of surgically resected tissues and also by the presence of serum IgG antibodies by ELISA. DNA was extracted from unstained tissue sections, and a partial fragment of mitochondrial cytochrome c oxidase subunit 1 (cox1) gene was amplified using a primer set specific for Spirometra spp. cox1. After sequencing of the PCR-amplicon and alignment of the nucleotide sequence data, the causative agent was identified as the larva of Spirometra erinaceieuropaei.

Unusual Anterior Arch Fracture of C1 - Case Report - (Unusual Anterior Arch Fracture of C1 - 증 례 보 고 -)

  • Kim, Sang Jin;Son, Chan Young;Kim, Tae Hong;Shin, Hyung Sik;Hwang, Young Soon;Park, Sang Keun
    • Journal of Korean Neurosurgical Society
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    • v.30 no.4
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    • pp.537-540
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    • 2001
  • Fractures of C1 are not uncommon, constituting only 10% of all cervical spine injuries. There is a high prevalence of concomitant fractures of the second and first cervical vertebral complex. Surgical treatment is controversal. Mainstay of treatment is various combination of traction and cervical orthosis according to degree of displacement and location of fracture. We experienced unusual type of fracture, anterior arch fracture of C1 who had a history of total laminectomy of C1,2 due to cervical cord tumor(neurilemmoma arising from C2 root). We performed C1,2 lateral mass screw fixation with posterior fusion with good postoperative outcome.

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Fluoroscopic Radiation Exposure during Percutaneous Kyphoplasty

  • Choi, Hyun-Chul
    • Journal of Korean Neurosurgical Society
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    • v.49 no.1
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    • pp.37-42
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    • 2011
  • Objective: The author measured levels of fluoroscopic radiation exposure to the surgeon's body based on the different beam directions during kyphoplasty. Methods: This is an observational study. A series of 84 patients (96 vertebral bodies) were treated with kyphoplasty over one year. The patients were divided into four groups based on the horizontal and vertical directions of the X-Ray beams. We measured radiation exposure with the seven dosimetry badges which were worn by the surgeon in each group (total of 28 badges). Twenty-four procedures were measured in each group. Cumulative dose and dose rates were compared between groups. Results: Fluoroscopic radiation is received by the operator in real-time for approximately 50% (half) of the operation time. Thyroid protectors and lead aprons can block radiation almost completely. The largest dose was received in the chest irrespective of beam directions. The lowest level of radiation were received when X-ray tube was away from the surgeon and beneath the bed (dose rate of head, neck, chest, abdomen and knee: 0.2986, 0.2828, 0.9711, 0.8977, 0.8168 mSv, respectively). The radiation differences between each group were approximately 2.7-10 folds. Conclusion: When fluoroscopic guided-KP is performed, the X-Ray tube should be positioned on the opposite side of the operator and below the table, otherwise the received radiation to the surgeon's body would be 2.7-10 times higher than such condition.

Syringo-Subarachnoid-Peritoneal Shunt Using T-Tube for Treatment of Post-Traumatic Syringomyelia

  • Kim, Seon-Hwan;Choi, Seung-Won;Youm, Jin-Young;Kwon, Hyon-Jo
    • Journal of Korean Neurosurgical Society
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    • v.52 no.1
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    • pp.58-61
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    • 2012
  • Various surgical procedures for the treatment of post-traumatic syringomyelia have been introduced recently, but most surgical strategies have been unreliable. We introduce the concept and technique of a new shunting procedure, syringo-subarachnoid-peritoneal shunt. A 54-year-old patient presented to our hospital with a progressive impairment of motion and position sense on the right side. Sixteen years before this admission, he had been treated by decompressive laminectomy for a burst fracture of L1. On his recent admission, magnetic resonance (MR) imaging studies of the whole spine revealed the presence of a huge syrinx extending from the medulla to the L1 vertebral level. We performed a syringo-subarachnoid-peritoneal shunt, including insertion of a T-tube into the syrinx, subarachnoid space and peritoneal cavity. Clinical manifestations and radiological findings improved after the operation. The syringo-subarachnoid-peritoneal shunt has several advantages. First, fluid can communicate freely between the syrinx, the subarachnoid space, and the peritoneal cavity. Secondly, we can prevent shunt catheter from migrating because dural anchoring of the T-tube is easy. Finally, we can perform shunt revision easily, because only one arm of the T-tube is inserted into the intraspinal syringx cavity. We think that this procedure is the most beneficial method among the various shunting procedures.

Effects on the Adjacent Motion Segments according to the Artificial Disc Insertion (인공 추간판 적용으로 인한 인접 운동 분절의 영향)

  • Kim, Young-Eun;Yun, Sang-Seok
    • Journal of the Korean Society for Precision Engineering
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    • v.24 no.8 s.197
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    • pp.122-129
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    • 2007
  • To evaluate the effect of artificial disc implantation and fusion on the biomechanics of adjacent motion segment, a nonlinear three-dimensional finite element model of whole lumbar spine (L1-S1) was developed. Biomechanical analysis was performed for two different types of artificial disc, ProDisc and SB $Charit{\acute{e}}$ III model, inserted at L4-L5 level and these results were also compared with fusion case. Angular motion of vertebral body, forces on the spinal ligaments and facet joint under sagittal plane loading with a compressive preload of 150 N at a nonlinear three-dimensional finite element model of Ll-S1 were compared. The implant did not significantly alter the kinematics of the motion segment adjacent to the instrumented level. However, $Charit{\acute{e}}$ III model tend to decrease its motion on the adjacent levels, especially in extension motion. Contrast to motion and ligament force changes, facet contact forces were increased in the adjacent levels as well as implanted level for constrained instantaneous center of rotation model, i.e. ProDisc model.

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

  • Yoon, Hong-Il;Sim, Hyun-Po;Lee, Jun-Yong
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.19 no.1
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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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Lumbar Osteochondroma Arising from Spondylolytic L3 Lamina

  • Choi, Byung-Kwan;Han, In-Ho;Cho, Won-Ho; Cha, Seung-Heon
    • Journal of Korean Neurosurgical Society
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    • v.47 no.4
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    • pp.313-315
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    • 2010
  • Osteochondromas are common, benign tumors in the long bones, but osteochondromas are rare in the vertebrae. Most vertebral osteochondromas arise from the cervical or upper thoracic spine. However, lumbar osteochondromas have rarely been reported. In this report, a rare case of a lumbar osteochondroma arising from the spondylolytic L3 lamina in a 57-year-old woman is presented. She also had a ruptured disc and lumbar canal stenosis at L4-5-S1. The osteochondroma was completely removed and a posterior lumbar interbody fusion and instrumentation were performed. Considering the rarity of osteochondromas in the lumbar vertebrae, especially the L3 vertebra, it is possible that the pre-existing lumbar spondylolysis or spondylolisthesis was one of the factors affecting the occurrence or progression of the osteochondroma.

Effect of asymmetric exercise to soccer player's spinal deformity and weight bearing (편측성 운동이 축구선수의 척추 변형과 체중 지지에 미치는 영향)

  • Uhm, Yo-Han;Park, Seung-Kyu;Yang, Dae-Jung
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.10 no.1
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    • pp.45-52
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    • 2012
  • Purpose : This study is carried out to investigate the effect of asymmetric exercises on soccer players' vertebral abnormality and weight bearing. Methods : A total of 40 soccer players were divided into either a group of 20 players who use a unilateral foot or a group of 20 players who use both feet. 3-dimensional spine structure analyzer was used to analyze body inclination, pelvic inclination, pelvic torsion, turning of spinal segment, spinal curvature, thoracic kyphosis curvature, lumbar lordosis curvature, left/right weight distribution, and front/back weight distribution. Results : The result of the two groups showed that there were significant differences (p<0.05) for every item except turning of spinal segment and lumbar lordosis curvature. Conclusion : From this result, we can find that spinal and pelvic deformity and body weight are unilaterally supported for soccer players with asymmetric exercises.

Meridian Sinews and Sagittal Spinal Balance (경근(經筋)과 인체 시상균형에 관한 소고(小考))

  • Nam, Tong-Hyun;Shin, Sang-Hun
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.13 no.2
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    • pp.129-139
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    • 2009
  • Sagittal spinal balance means standing postural balance at sagittal plane. Postural imbalance with displacement of the patient's center of gravity can cause chronic back pain and ambulatory difficulty. The sagittal spinal balance is determined based on the deviation of the C7 plumb line, originating at the middle of the C7 vertebral body, from the posterior superior endplate of S1. The line is called as sagittal vertical axis (SVA). In the traditional Korean medicine, the meridian sinews, which are the most superficial pathways of the meridian system, associated with movement, muscle balance and defense. They too are separate from the main meridians, though they intersect the main meridians. Some creative and pioneer researchers in Korea thought that the anatomy trains, which suggested by Myers is a concept familiar to the meridian sinews. A reciprocal relationship between the superficial back line and the superficial front line used to be compared to the rigging of a sailboat. Therefore, We suggest that spine may be compared to a mast of the sailboat and that the sagittal spinal balance can be maintained with systemic reciprocal interacts between the front line muscles and the back.

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Can Angular Deformity Due to Sacrococcygeal Fracture Cause Permanent Impairment? : Current State and Problems in Korea

  • Cho, Dosang
    • Journal of Korean Neurosurgical Society
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    • v.65 no.2
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    • pp.173-179
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    • 2022
  • Disabilities can emerge due to traumatic spinal fractures. In terms of sacrococcygeal spine, because of its unique anatomic structure with minimal movement, the possibility for it to have a disability is relatively low. In Korea, unlike most disability criteria, private insurance companies acknowledge angular deformities caused by vertebral fractures as disabilities according to their degree, so there were several cases where patients required compensation, arguing angular deformity caused by sacrococcygeal fracture, which in some cases led to legal conflicts. Except the Act Welfare of Persons with Disabilities which recognizes only severe angular deformity affecting internal organs as disability and the industrial accident disability evaluation which does not recognize coccygeal fracture as disability but rarely recognizes sacral vertebra deformity equivalent to compressive deformation, there is little or no case where angular deformity is recognized as disability. Given the impairment evaluation standards in social insurance, McBride system, American Medical Association (AMA) guides, and newly proposed standards by the Korean Academy of Medical Sciences (KAMS), the most contentious point in the general terms and conditions of private insurance is spinal deformity. To overcome controversy over disability evaluation, the private insurance sector is now applying criteria for axial skeleton to sacrococcygeal vertebrae through revision of standards. Under these circumstances, it is fair to recognize sacrococcygeal fracture as impairment in terms of the pelvis only when the fracture leaves serious deformity and neurological symptoms with clear relevancy. Though it may not be easy to develop accurate disability evaluation standards, improvement is necessary to remove any irrationalities and make the standards as objective as possible.