• Clinical Pain
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• 제20권2호
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• pp.93-98
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• 2021

The use of ultrasonography has recently been increasing in musculoskeletal diagnosis or intervention treatment. Ultrasound guided procedure offers a reliable alternative to fluoroscopy or computed tomography for lumbar medial branch block, facet joint block and peripheral nerves of lower extremity. Further, there is no exposure to radiation and additional equipment necessary for the protection against radiation is required. And ultrasound guided procedure needs smaller space than fluoroscopy guided procedure with real time images in the outpatient department. This article reviews ultrasound guided procedure at lumbar vertebra and peripheral nerves of lower extremity.

• 대한족부족관절학회지
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• 제27권1호
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• pp.1-6
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• 2023

Displaced intra-articular calcaneal fractures are difficult to treat because of complex anatomy and high soft tissue complications. Various surgical approaches have been introduced to solve these problems, but the treatment remains complex. Recently, clinically and radiographically superior results were reported using a subtalar arthroscopy in reducing the posterior facet in both percutaneous and open approaches. In the percutaneous approach, the arthroscopically assistant percutaneous approach must be selected carefully for mild-to-moderately displaced fractures because of the limited view. In the open approach, there is little evidence of the utility of subtalar arthroscopy. Therefore, intraoperative arthroscopy should always be used in conjunction with fluoroscopy to achieve reduction and assess the internal fixation placement.

• 한국전산구조공학회논문집
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• 제33권3호
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• pp.145-152
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• 2020

본 논문에서는 유한요소해석을 이용하여 흉요추 후방 고정술의 고정분절 변화에 따른 척추 안정성을 평가하였다. 이를 위해 추간판, 인대, 추간관절(Facet joint) 등을 포함한 정상 흉요추(T10-L4)의 유한요소모델을 구축하였으며, 문헌으로 보고된 재료물성치를 부여하였다. 한편, L1을 병변 부위로 가정하였으며, L1-L2, T12-L2, T12-L1-L2 총 3가지 종류의 후방 고정술을 흉요추 유한요소모델에 구현하고 전방 굽힘, 후방 굽힘, 측면 굽힘, 축 회전의 하중 조건을 부여하였다. 시리즈 유한요소해석을 통해 고정분절에 따른 척추경 나사못, 척추골, 추간판의 변형량, 등가 응력, 운동 범위, 모멘트를 계산하였으며, 그 결과를 바탕으로 척추 안정성을 평가하였다.

• 대한기계학회논문집B
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• 제37권10호
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• pp.953-959
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• 2013

본 연구에서는 가상 생체외 사체실험을 수행할 수 있는 경추 다관절 동역학 모델을 개발하였다. 평균크기 한국인 의료영상과 관절 및 연부조직의 물성 정보를 기반으로 하여 경추 동역학 모델을 개발하였다. 개발된 모델의 검증을 위하여 경추 단분절 및 다분절 모멘트-각도 관계, 인대 하중 및 후관절 접촉력 등을 문헌의 사체실험 결과와 비교한 결과 매우 유사한 경향을 확인하였다. 본 연구에서 개발된 경추 동역학 모델은 앞으로 경추 사체실험 연구 뿐만 아니라 자동차 충돌시 경추 상해 분석 등의 다양한 경추 생체역학 연구 연구에 활용될 수 있을 것이다.

• 척추신경추나의학회지
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• 제17권2호
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• pp.91-100
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• 2022

Objectives The purpose of this study was to report a case of a woman diagnosed with post hysterectomy syndrome treated with combined Korean medical treatment. Methods A combination of treatment including chuna manual therapy, pharmacopuncture at the lumbar facet joints, acupuncture, cupping, and herbal medicine was provided for 1 month. Progress was assessed using the Numeric Rating Scale, Oswestry Disability Index, EuroQol-5Dimension, and Hot Flush Score before and after treatment. Results After treatment, the symptoms were reduced and the quality of life was enhanced, although there was no improvement in the abnormal sensation in the anterior part of the thigh. No adverse events were observed. Conclusions The findings indicate that a combination of Korean medical treatment can be a safe and effective alternative treatment in reducing LBP and hot flushes after hysterectomy.

• 대한족부족관절학회지
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• 제8권2호
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• pp.157-160
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• 2004

Purpose: This study aimed to investigate and compare the micro-structural profiles of trabecular bone from different facets at the ankle joint. Materials and Methods: In a fresh cadaver ankle, four cored 10 mm of diameter cylindrical specimens of trabecular bone were harvested from the distal tibia, the talar dome, the medial malleolus, and the lateral malleolus. Using a micro-computed tomography, two-dimensional and three-dimensional micro-structural indices of the trabecular bone were analyzed. Results: Each specimen from the tibia, talus, medial malleolus, and the lateral malleolus showed unique micro-structural pattern. Tibia versus talus, the talus was seen a higher bone volume fraction and a wider supporting zone subchondrally whereas the tibia was seen a relatively lower bone volume fraction and a much narrower supporting zone subchondrally. Lateral malleolus versus medial malleolus, the lateral malleolus was seen the thicker but sparse trabeculae pattern whereas the medial malleolus was seen the thinner but more compact trabecular pattern. Conclusion: Each four locations from the different facet at the ankle joint have distinct own micro-structural patterns of the trabecular bone, suggesting different mechanical properties.

• 국제물리치료학회지
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• 제12권1호
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• pp.2279-2285
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• 2021

Background: The spinal nerves, which start at the lumbar level, are connected to the nerve innervation in the knees. Currently, there is a lack of research on the treatment of knee pain through lumbar mobilization. Objectives: To investigate the effects of lumbar joint mobilization (LJM) and transcutaneous electronic nerve stimulation (TENS) on proprioception and muscular strength in volleyball players with chronic knee pain. Design: Two group pre-posttest. Methods: A total of 26 professional volleyball players with chronic knee pain were allocated to the LJM (n=13) and TENS (n=13) groups. In the LJM group, grade III - IV amplitude was applied 3 times for 1 minute (80 times per minute) at the affected lumbar (L2-3) facet joint in the prone position. In the TENS group, the TENS treatment device was used to directly apply or 15 minutes to the area of chronic knee pain (100 Hz, 150 ㎲). Proprioception was measured by knee flexion and extension angles, and muscle strength was evaluated using an isokinetic test. Measurements were taken before and after interventions. Results: In the eye opened conditiond, proprioception significantly increased during both knee extension and flexion after LJM, while only knee extension was significantly increased in the TENS group. There was also a significant difference in knee extension between the two groups. In the eye close conditiond, proprioception was significantly improved only during knee extension in the LJM group, and the difference in knee extension between the groups was also significant (P<.05). The maximum torque of the affected knee joint was significantly improved at 60°/sec in both groups (P<.05); however, there was no difference between the two groups. There was no significant difference in the maximum flexion torque within or between the groups. Conclusion: This study suggests that LJM improved proprioception and muscular strength in volleyball players with chronic knee pain.

• 대한족부족관절학회지
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• 제21권4호
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• pp.144-150
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• 2017

Purpose: To assess the clinical and radiographic results and complications of arthroscopy-assisted reduction and percutaneous fixation for patients with tongue-type Sanders type II calcaneal fractures. Materials and Methods: Between August 2014 and December 2015, 10 patients who underwent surgery using subtalar arthroscopic assisted reduction and percutaneous fixation for tongue-type Sanders type II calcaneal fractures were reviewed. The mean age was 50.8 years (36~62 years), and the mean follow-up period was 24 months (12~40 months). The clinical results were evaluated using the visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score at the regular follow-ups, and the foot function index (FFI) at the last follow-up. The subtalar range of motion (ROM) was evaluated and compared with the uninjured limb at the last follow-up. The radiographic results were assessed using the Bohler's angle from the plain radiographs and the reduction of the posterior calcaneal facet using computed tomography (CT). The postoperative complications were assessed by a chart review. Results: The VAS and AOFAS ankle-hindfoot score improved until 12 months after surgery. The FFI was 15 (1.8~25.9) and subtalar ROM was 75.5% (60%~100%) compared to the uninjured limb at the last follow-up. The $B{\ddot{o}}hler^{\prime}s$ angle was increased significantly from $2^{\circ}$ ($-14^{\circ}{\sim}18^{\circ}$) preoperatively to $21.8^{\circ}$ ($20^{\circ}{\sim}28^{\circ}$) at the last follow-up. The reduction of the posterior facet was graded as excellent in five feet (50.0%) and good in five (50.0%) on CT obtained at 12 months after surgery. One foot (10.0%) had subfibular pain due to a prominent screw head. One foot (10.0%) had pain due to a longitudinal tear of the peroneal tendon that occurred during screw insertion. Conclusion: Subtalar arthroscopic-assisted reduction of the posterior calcaneal facet of the subtalar joint and percutaneous fixation is a useful surgical method for tongue-type Sanders type II calcaneal fractures.

• Clinics in Shoulder and Elbow
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• 제16권2호
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• pp.100-106
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• 2013

목적: 외상력이 없는 주관절에서 척골 근위부 활차 내측 관절면 골극의 크기가 주관절 굴곡에 미치는 영향을 분석하고자 한다. 대상 및 방법: 주관절부 컴퓨터 단층촬영을 시행한 외상력이 없는 환자 25예를 대상으로 연구를 시행하였다. 컴퓨터 단층촬영상 구상돌기 및 구상와, 주두 돌기 및 주두와 골극의 유무와 크기를 측정하였고, 그리고 활차 내측 관절면의 골극의 높이와 길이를 측정하였다. 결과: 주관절 굴곡 구축은 평균 $18.6^{\circ}$, 후속 굴곡은 평균 $112.1^{\circ}$ 였다. 활차 내측 관절면 골극의 높이는 평균 2.2 mm, 길이는 평균 4.7 mm이었다. 후속 굴곡 각도는 구상 돌기나 구상와에 골극 또는 유리체가 있었던 경우(n=14)가 $105.1^{\circ}$, 없었던 경우(n=11)가 $119.1^{\circ}$ (p=0.011)로 통계적으로 유의한 차이가 있었다. 후속 굴곡 각도와 활차 내측 관절면 골극의 평균 길이와의 편상관계수는 0.687 (p<0.000)이었다. 결론: 활차 내측 관절면 골극의 길이가 긴 주관절에서 후속 굴곡 각도가 줄어들었다.

• 대한핵의학회지
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• 제35권6호
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• pp.371-377
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• 2001

목적: 요통을 호소하는 암환자에서 골스캔을 시행하여 척추골의 섭취증가를 보이는 경우, 골전이와 양성 골질환의 구분이 모호한 경우가 많다. 이에 척추골 SPECT를 추가로 시행하는 것이 악성과 양성 골질환을 감별하는데 도움이 되는지 알아보고자 섭취양상을 분석하였다. 대상 및 방법: 3년간 척추골 SPECT를 시행한 108명의 환자중 SPECT에서 이상 섭취 병변을 보이고 임상적으로 추적이 가능하였던 45명의 환자의 67개의 병변의 척추골 SPECT소견을 다음과 같이 구분하고 임상소견 및 방사선학적 소견과 비교하였다. 1. 척추체: A. 전반적인 섭취증가, B. 추간판에 연한 선상의 섭취증가, C. 냉소의 동반, D. 분절상 섭취증가, 2. 척추후면체 A. 척추체 후면(lamina, pedicle 등), B. 추간판후면(후관절 등), C 극돌기 결과: 골전이 병변(18)은 척추체의 냉소동반(6), 분절상 섭취증가(5)가 특징적이었으며, 퇴행성변화(28)는 추체연의 선상 섭취증가(12), 추간판후면의 후면체 섭취증가(15), 압박골절(21)은 전반적인 척추체 섭취증가(9) 및 추체연의 섭취증가(9), 냉소동반(1), 분절상 섭취증가(1)와 극돌기의 섭취증가(3)을 보였다. 결론: 척추골 SPECT의 섭취증가 양상은 냉소동반, 분절상 섭취증가를 보이는 경우에 골전이 병변의 가능성이 크지만 압박골절에서도 같은 소견을 보일 수 있으므로 주의하여야 할 것이며, 퇴행성 질환은 특징적인 소견을 보이므로 감별이 가능하였다. 그러므로 골스캔 후 척추골 섭취 이상이 있는 암환자에서 추가 SPECT검사가 도움이 될 것으로 생각된다.