• Title/Summary/Keyword: radiologic department

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Long-Term Follow-Up Radiologic and Clinical Evaluation of Cylindrical Cage for Anterior Interbody Fusion in Degenerative Cervical Disc Disease

  • Kim, Su-Hyeong;Chun, Hyoung-Joon;Yi, Hyeon-Joong;Bak, Koang-Hum;Kim, Dong-Won;Lee, Yoon-Kyoung
    • Journal of Korean Neurosurgical Society
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    • 제52권2호
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    • pp.107-113
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    • 2012
  • Objective : Various procedures have been introduced for anterior interbody fusion in degenerative cervical disc disease including plate systems with autologous iliac bone, carbon cages, and cylindrical cages. However, except for plate systems, the long-term results of other methods have not been established. In the present study, we evaluated radiologic findings for cylindrical cervical cages over long-term follow up periods. Methods : During 4 year period, radiologic findings of 138 patients who underwent anterior cervical fusion with cylindrical cage were evaluated at 6, 12, 24, and 36 postoperative months using plain radiographs. We investigated subsidence, osteophyte formation (anterior and posterior margin), cage direction change, kyphotic angle, and bone fusion on each radiograph. Results : Among the 138 patients, a minimum of 36 month follow-up was achieved in 99 patients (mean follow-up : 38.61 months) with 115 levels. Mean disc height was 7.32 mm for preoperative evaluations, 9.00 for immediate postoperative evaluations, and 4.87 more than 36 months after surgery. Osteophytes were observed in 107 levels (93%) of the anterior portion and 48 levels (41%) of the posterior margin. The mean kyphotic angle was $9.87^{\circ}$ in 35 levels showing cage directional change. There were several significant findings : 1) related subsidence [T-score (p=0.039) and anterior osteophyte (p=0.009)], 2) accompanying posterior osteophyte and outcome (p=0.05). Conclusion : Cage subsidence and osteophyte formation were radiologically observed in most cases. Low T-scores may have led to subsidence and kyphosis during bone fusion although severe neurologic aggravation was not found, and therefore cylindrical cages should be used in selected cases.

연골하 낭종을 동반한 거골의 골연골 병변의 관절경적 치료 후 임상적 결과 및 방사선학적 변화 (Clinical and Radiologic Results of Arthroscopic Treatment for Osteochondral Lesion with Subchondral Cyst on Talus)

  • 이진우;박관규;;한수봉;강응식
    • 대한족부족관절학회지
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    • 제7권1호
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    • pp.21-29
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    • 2003
  • Purpose: The purpose of this study is to review clinical and radiologic changes after arthroscopic operation without bone graft for osteochondral lesion with subchondral cyst on the talus. And we compared the results with those without cyst. Radiologic changes were also observed. Materials and Methods: Arthroscopic microfrature or abrasion arthroplasty was performed on 10 caeses of osteochondral lesions with subchondral cyst and 20 cases without cysts. Preoperative and postoperative symptoms were evaluated by Ankle-Hind foot scale of AOFAS and the score of two groups were compared(t-Test : Paired Two Test for Means). Radiologic evaluation was performed after operation on patients with osteochondral lesion with cyst. Results: On patients of osteochondral lesion with subchondral cyst on talus, there was clinical improvement compared to the preoperative status and compared to patients without cysts(P=0.01) after arthroscopic operation. We could get increase of density and decrease of size of cystic lesion on plain film with time passage. Conclusion: We report 10 cases with osteochondral lesion with subchondral cyst on talus which resulted in clinical and radiological improvement after arthroscopic microfracture or abrasion arthroplasty without bone graft.

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경추간판 탈출 환자의 전방 고정술에 따른 경제적 분석 - 골 이식법과 금속판 고정 병행술의 비교 - (Economical Analysis of Cervical Disc Disease by Anterior Inter-body Fusion Methods - Comparing of Bone Graft vs Plating -)

  • 길승배;이상열;허승호;장연규
    • Journal of Korean Neurosurgical Society
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    • 제30권2호
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    • pp.201-206
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    • 2001
  • Objective : The purpose of this study was to assess the complications, duration of admission, cost effectiveness, radiologic stabilization of the anterior cervical bone fusion in the treatment of cervical disc disease with and without plating. Materials and Methods : Fifty-two surgically treated patients for cervical disc disease were reviewed. Group I consisted of consecutive treated patients with iliac auto-bone graft without instrumentation after anterior cervical discectomy. Group II consisted of consecutive treated patients with iliac autologous-bone graft with CASPER cervical plate fixations. Radiologic fusion was decided when loss of end plate boundary between graft bone and vertebral body and immobile, maintenance of the disc space were evident on simple dynamic plain films. The patients were discharged after the stabilization of cervical motion by films was of tained. These groups were analysed multiple variably with Mann-Whitney U-test. Results : Group I consisted of 18 patients, group II consisted of 34 patients. Mean age was $49.0{\pm}8.1years$, mean duration of admission was $17.27{\pm}10.51days$, mean costs for treatment was $1,970,000{\pm}475,000won$. In group I, mean age was 47.7(34-60) years, 16 patients had undergo on one-level operation, 2-patients had undergo on two-level operation, mean duration of admission was $28.7{\pm}10.4days$, mean costs for treatment was $2,194,473{\pm}561,639won$. The periods of stabilization was $6.6{\pm}3.36weeks$ on radiologic study. Mean periods of out patient follow up was 16.8(6-64) weeks after discharge. Mean period of radiologic follow up was 17.3(4-6) weeks after surgical operation. In group II, mean age was 49.7(37-62) years and 18 patients one-level operation, 14- patients had undergo on two-level operation and 2-patients three-level operation. Mean duration of admission was $11.24{\pm}3.29days$, mean costs for treatment was $1,850,823{\pm}389,372won$. The periods of stabilization was $5.88{\pm}7.07weeks$ on radiologic study. Mean period of out patients follow up was 16.7(4-60) weeks after discharge. Mean period of radiologic follow up was 12.4(3-52) weeks after surgical operation. The duration of admission showed statistical significance in Group II but other items showed no significant difference between two groups. Conclusions : The more economic, early life return and effective method of cervical disc disease in our series were evident in patients who had undergone, iliac bone graft and plate fixations after anterior discectomy.

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Analysis of the Risk Factors for Unfavorable Radiologic Outcomes after Fusion Surgery in Thoracolumbar Burst Fracture : What Amount of Postoperative Thoracolumbar Kyphosis Correction is Reasonable?

  • Seo, Dong Kwang;Kim, Chung Hwan;Jung, Sang Ku;Kim, Moon Kyu;Choi, Soo Jung;Park, Jin Hoon
    • Journal of Korean Neurosurgical Society
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    • 제62권1호
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    • pp.96-105
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    • 2019
  • Objective : The aims in the management of thoracolumbar spinal fractures are not only to restore vertebral column stability, but also to obtain acceptable alignment of the thoracolumbar junction (T-L junction) to prevent complications. However, insufficient surgical correction of the thoracolumbar spine would be likely to cause late progression of abnormal kyphosis. Therefore, we identified the surgical factors that affected unfavorable radiologic outcomes of the thoracolumbar spine after surgery. Methods : This study was conducted in a single institution from January 2007 to December 2013. A total of 98 patients with unstable thoracolumbar spine fracture were included. In these patients, fixation was done through transpedicular screws with rods by three surgical patterns. We reviewed digital radiographs and analyzed the images preoperatively and postoperatively during follow-up visits to compare the change of the thoracolumbar Cobb angle with radiologic parameters and clinical outcomes. The unfavorable radiologic group was defined as the patients who were measured as having greater than 20 degrees of thoracolumbar Cobb angle on the last follow-up, or who underwent kyphotic progression of thoracolumbar Cobb angle greater than 10 degrees from the immediate postoperative state to final follow-up, or who had overt instrument failure with/without additional surgery. We assessed the risk factors that affected the unfavorable radiologic outcomes. Results : We had 43 patients with unfavorable radiologic outcomes, including 35 abnormal thoracolumbar alignments and 14 instrumental failures with/without additional surgery. The multivariate logistic regression test showed that immediate postoperative T-L junction Cobb angle less than 10.5 degrees was a statistically significant risk factor, as well as the presence of osteoporosis (p=0.017 and 0.049, respectively). Conclusion : Insufficient correction of thoracolumbar kyphosis was considered to be a major factor of an unfavorable radiological outcome. The spinal surgeon should consider that having a T-L junction Cobb angle larger than 10.5 degrees immediately after surgery could result in an unfavorable radiological outcome, which is related to a poor clinical outcome.

Destructive Radiologic Development of Intravascular Papillary Endothelial Hyperplasia on Skull Bone

  • Lee, Seul-Kee;Jung, Tae-Young;Baek, Hee-Jo;Kim, Seul-Kee
    • Journal of Korean Neurosurgical Society
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    • 제52권1호
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    • pp.48-51
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    • 2012
  • Intravascular papillary endothelial hyperplasia (IPEH) is a rare vascular benign lesion that rarely involves the central nervous system with or without skull invasion. We report a rare case of IPEH on the skull bone, which displayed destructive radiologic development associated with hemorrhage. A 14-year-old male presented with an incidentally detected a small enhancing, left frontal osteolytic lesion. Previously, he underwent operation and received adjuvant chemoradiation therapy for cerebellar medulloblastoma. Follow-up magnetic resonance imaging revealed a left frontal bone lesion, which expanded to an approximately 2 cm-sized well-circumscribed osteolytic lesion associated with hemorrhage for 20 months. Frontal craniectomy and cranioplasty were performed. Destructive change was detected on the inner table and diploic space of the skull. The mass had a cystic feature with hemorrhagic content without dural attachment. Pathologic examination showed the capsule consisted of parallel collagen lamellae representing a vascular wall, vascular lumen, which was pathognomonic for IPEH. Immunohistochemical staining revealed that the capsule was positive for CD34 and factor VIII, which favor the final diagnosis of IPEH. This was the first case of intracalvarial IPEH.

치성각화낭과 법랑모세포종의 임상 및 방사선학적 감별진단 (Clinicoradiologic Differential Diagnosis of Odontogenic Keratocyst and Ameloblastoma)

  • 정호걸;이장렬;김기덕;박창서
    • Imaging Science in Dentistry
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    • 제30권4호
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    • pp.249-254
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    • 2000
  • Purpose: To clarify the clinical and radiologic parameters that can be used to differentiate odontogenic keratocyst and ameloblastoma Materials and Methods: The records of 46 patients of ameloblastoma and 48 patients of odontogenic keratocyst at the Yonsei University Dental Hospital during the period of 1979 to 1995 were retrospectively reviewed. As a possible means for differentiating between the odontogenic keratocyst and ameloblastoma, the clinical parameters and the radiologic parameters were evaluated. Results: In the clinical parameters, there was no significant difference in age, sex, and sign and symptoms (p>0.05). In the radiologic parameters, there was significant difference in site, shape of the lesion, and external root resorption of adjacent teeth (p<0.05). Conclusion: The site, shape of the lesion, and external root resorption of adjacent teeth can be the parameters to differentiate odontogenic keratocyst and ameloblastoma, but a definite differentiation of these two lesions needs a more specialized imaging modality.

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모래무지(Teleostei, Cyprinidae) 정자변형과정과 정자의 미세구조 (Ultrastructure of Pseudogobio esocinus (Teleostei, Cyprinidae) Spermiogenesis and Spermatozoa)

  • 김구환;권덕문;이준일;정성배
    • 한국수산과학회지
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    • 제40권3호
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    • pp.147-152
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    • 2007
  • Spermiogenesis and mature spermatozoa of the Korean false minnow Pseudogobio esocinus (Cyprinidae) are described by means of scanning and transmission electron microscopy. Spermiogenesis is characterized by lateral development of the flagellum, absence of nuclear rotation, and eccentric nuclear fossa formation. The spermatozoa have a spherical head containing a nucleus with highly condensed chromatin and no acrosome. The nuclear fossa contains the proximal centriole and anterior part of the distal centriole. The midpiece is type A II and contains semi-fused mitochondria around the axoneme. However, the symmetrical distribution of 4 or more the mitochondria does not follow a general pattern of the cyprinid spermatozoa. Cytoplasmic vesicles in the midpiece are common in Cypriniformes and some of Siluriformes and Characiformes spermatozoa.

양방사선 골밀도 측정 장치의 공간산란선량분포측정 (Bone Density Spatial Distribution of Radiation Dose Measurement)

  • 김선칠;원도연;박창희;동경래
    • 대한디지털의료영상학회논문지
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    • 제13권2호
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    • pp.59-62
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    • 2011
  • In this experiment, how DEXA(Dual-energy X-ray Absorptiometry) bone mineral density was measured using the equipment. In order to maintain the same measurement conditions, bone mineral density measurements of 10 cm thick phantom, with an actual patient at a point when examining the same conditions(100 kVp, 1 mA) and then out to the five doses of radiation and its average was calculated by dividing measured. X-ray dose rate measured at the Research Institute, Sword of the gamma survey meters calibrated MEDCOM Ltd. (Inspector GM counter tube) was used, calibration factor is 1.15. On a horizontal plane around the patient, depending on the distance was significantly reduced dose rate. In addition, orientation $0^{\circ}$ head end was higher in the direction of the highest dose rate, $0^{\circ}$ $180^{\circ}$ direction from the direction towards the higher dose rate reduced to some extent in the direction of all the $120^{\circ}$ were able to identify.

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법랑모세포종과 치성각화낭의 방사선학적 진단의 정확도 및 판독자간과 판독자내 일치 (ACCURACY AND INTEROBSERVER- INTRAOBSERVER AGREEMENT IN THE RADIOLOGIC DIAGNOSIS OF AMELOBLASTOMA AND ODONTOGENIC KERATOCYST)

  • 최순철;이진;박인우;이영호
    • 치과방사선
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    • 제26권2호
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    • pp.147-152
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    • 1996
  • Six observers with different amount of experience in the field of Oral and Maxillofacial Radiology interpreted the radiographs of 13 cases of ameloblastoma and 8 cases of odontogenic keratocyct which were confirmed histopathologically and showed pseudo-multilocular appearance and scalloped border radiographically. The authors examined the accuracy of radiologic diagnoses, interobserver agrement and intraobserver agreement. The obtained results were as follows; 1. The accuracy of radiologic diagnosis ranged from 0.48 to 0.81. The average value was 0.61. 2. The accuracy of radiologic diagnosis for ameloblastoma(0.55) was lower than that for odontogenic keratocyst(0.70) (P<0.05). 3. The overall agreement among the 6 observers was 14.3% at the first interpretation and 19.0% at the second interpretation. 4. The intraobserver agreement of each observer expressed in kappa index ranged from -0.14 to 0.64. The overall intraobserver agreement was 0.29. 5. The intraobserver agreement of each observer for ameloblastoma and odontogenic keratocyst ranged from -0.07 to 0.65 and from -0.25 to 1.00, respectively. The overall intraobserver agreement for ameloblatoma and odontogenic keratocyst were 0.27 and 0.26, respectively. 6. The diagnostic accuracy highly correlated to the intraobserver agreement(r=0.6370).

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The Radiologic Comparison of Operative Treatment Using a Hook Plate versus a Distal Clavicle Locking Plate of Distal Clavicle Fracture

  • Yoon, Byungil;Kim, Jae Yoon;Lee, Jae-Sung;Jung, Hyoung Seok
    • Clinics in Shoulder and Elbow
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    • 제21권4호
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    • pp.227-233
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    • 2018
  • Background: The purpose of this study was to compare the radiologic results of patients who underwent surgery with a hook plate and a locking plate in distal clavicle fractures. Methods: Sixty patients underwent surgical treatment for Neer type IIa, IIb, III, and V distal clavicle fracture. Twenty-eight patients underwent fracture fixation with a hook plate and 32 with a locking plate. Coracoclavicular distance was measured on standard anteroposterior radiographs before and after the surgery, and union was confirmed by radiograph or computed tomography taken at 6 months postoperatively. Other radiologic complications like osteolysis was also checked. Results: Bony union was confirmed in 59 patients out of 60 patients, and 1 patient in the hook plate group showed delayed union. Coracoclavicular distance was decreased more in the hook plate group after surgery (p<0.01). After 6 weeks of the hook plate removal, the coracoclavicular distance was increased a little compared to before metal removal, but there was no difference compared to the contralateral shoulder. Eleven out of 28 patients (39.3%) showed osteolysis on the acromial undersurface in the hook plate group. Conclusions: Both the hook plate group and the locking plate group showed satisfactory radiologic results in distal clavicle fractures. Both hook plate and locking plate could be a good treatment option if it is used in proper indication in distal clavicle fracture with acromioclavicular subluxation or dislocation.