• Journal of Veterinary Clinics
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• v.40 no.2
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• pp.135-138
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• 2023

A one-month-old Thoroughbred colt presented with left hindlimb lameness grade 5/5, according to the American Association of Equine Practitioners' lameness scale. The colt started showing signs of lameness two weeks earlier without being involved in an accident. A local veterinarian examined the foal; radiography revealed no significant findings under the hip joint. No improvement was noted after 15 days of non-steroidal anti-inflammatory drugs (NSAIDs) medication. On presentation at our hospital, ultrasonography was performed, which revealed no significant findings in the iliac wings. The foal underwent a computed tomography (CT) scan under general anesthesia. CT revealed bone cysts in the following that could have caused the lameness: the left transverse process of the 5th, 6th lumbar, and the 1st sacrum vertebrae; osteophytes in the auricular surface of the ilium, suggestive of sacroiliac arthritis. The foal recovered smoothly from anesthesia with assistance. The foal was treated with NSAIDs and rested for more than six months. The owner reported that the foal showed no lameness one year later. CT revealed bony changes in the lumbosacral region that were not detected by radiography and ultrasonography, suggesting that CT could be useful for detecting abnormalities in the pelvic region of horses.

• Anatomy and Cell Biology
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• v.56 no.2
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• pp.252-258
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• 2023

The human fetal sacroiliac joint (SIJ) is characterized by unequal development of the paired bones and delayed cavitation. Thus, during the long in utero period, the bony ilium becomes adjacent to the cartilaginous sacrum. This morphology may be analogous to that of the temporomandibular joint (TMJ). We examined horizontal histological sections of 24 fetuses at 10-30 weeks and compared the timing and sequences of joint cartilage development, cavitation, and ossification of the ilium. We also examined histological sections of the TMJ and humeroradial joint, because these also contain a disk or disk-like structure. In the ilium, endochondral ossification started in the anterior side of the SIJ, extended posteriorly and reached the joint at 12 weeks GA, and then extended over the joint at 15 weeks GA. Likewise, the joint cartilage appeared at the anterior end of the future SIJ at 12 weeks GA, and extended along the bony ilium posteriorly to cover the entire SIJ at 26 weeks GA. The cavitation started at 15 weeks GA. Therefore, joint cartilage development seemed to follow the ossification of the ilium by extending along the SIJ, and cavitation then occurred. This sequence "ossification, followed by joint cartilage formation, and then cavitation" did not occur in the TMJ or humeroradial joint. The TMJ had a periosteum-like membrane that covered the joint surface, but the humeroradial joint did not. After muscle contraction starts, it is likely that the mechanical stress from the bony ilium induces development of joint cartilage.

• Journal of Digital Policy
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• v.3 no.1
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• pp.21-25
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• 2024

This is a case study that sought to consider whether taping, which focuses on instability of the sacroiliac joint, is a potential intervention method that may be helpful for low back pain. In the case of a 58-year-old participant, we summarized the notable results from a taping training session that a man with a history of back surgery due to disc herniation and stenosis participated in to reduce ongoing pain. As an intervention method, tape was applied between the 2nd and 4th sacrum on both sides from the spinous tuberosity. It was stretched to a tension of 80% and attached past the sacroiliac joint, and then the ends were raised at about 45° on both sides and attached toward the gluteus medius muscle. Then, along the erector spinae muscle from the iliac crest. Bilateral taping up to the level of the 10th rib was applied. Through this intervention, positive case results were observed from both VAS and ODI test tools, with VAS recorded as 5 to 0 and disability index recorded as 13 to 0, respectively.

• The Journal of the Korean bone and joint tumor society
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• v.15 no.2
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• pp.138-145
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• 2009

Purpose: Giant cell tumor of the spine is very rare, and the treatment is very difficult. However, surgical techniques and diagnostic modalities are developed, and postoperative functional results are improved. To evaluate the efficacy of total spondylectomy for giant cell tumor of the spine, the clinical results of the surgical treatments for the giant cell tumor of the spine with intralesional curettage or total spondylectomy were evaluated. Materials and Methods: From April 1987 to March 2006, 10 patients who were underwent surgical treatments using total spondylectomy or intralesional curettage were studied. There were 3 men and 7 women. The mean age of the patients was 32 years (range, 25~44 years). The mean duration of follow-up was 8 years (range, 3~15 years). Locations of the tumor were 2 cervical spines, 4 thoracic spines, 2 lumbar spines and 2 sacrum. Initial main symptom of 10 patients was pain, and 7 patients had neurologic impairments too. Four patients were treated with total spodylectomy using anterior and posterior combined approach, 1 patient was treated with total sacrectomy using posterior approach only, and 5 patients were treated with intralesional curettage using anterior approach. Results: Nine patients improved pain and neurologic impairments. Local recurrences developed in 4(40%) patients (2 cervical spines, 1 thoracic spine, 1 sacrum). While a local recurrence developed from 5 total spondylectomy, 3 local recurrences developed from 5 intralesional curettage. Conclusion: Local recurrence rate after surgical treatment with intralesional curettage for the giant cell tumor of the spine was very high. Total spondylectomy using anterior and posterior approach is advisable to prevent the local recurrence after surgical treatment.

• The Journal of the Korean bone and joint tumor society
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• v.11 no.2
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• pp.148-154
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• 2005

Purpose: To evaluate the long term results of surgical treatment for sacral chordoma. Material and Method: We reviewed the records of 4 patients with sacral tumor treated surgical resection. Mean follow-up duration was 8.3 year(3~11). All cases were performed complete resection of tumor mass through posterior approach in 3 cases and anterior-posterior approach in one. The most caudad nerve-roots spared were the second sacral roots in one and the third sacral roots in 3 cases. Functions of voiding and defecation including neurological symptoms of lower extremities, other complications of surgical treatment, and local recurrence or distant metastasis of tumor were evaluated. Result: There was no motor deficit in all cases, but radiating pain was developed in one and wound infection in one. Bladder function was preserved in 2 cases, intermittent incontinence in one, and doing intermittent catheterization in one. Bowel function was preserved in one and 2 cases were suffered from constipation. At the last follow-up, disease-free was in one, local recurrence in one, and local recurrence with distant metastasis in one. Conclusion: The result of surgical resection for sacral chordoma is satisfactory showing average 8 years survival. Early detection and aggressive surgical treatment is the best to prolong survival and to minimize functional deficit with preservation of upper sacral nerves.

• Archives of Plastic Surgery
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• v.37 no.5
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• pp.712-716
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• 2010

Purpose: Extensive lumbosacral defects after removal of spinal tumors have a high risk of wound healing problems. Therefore it is an effective reconstructive strategy to provide preemptive soft tissue coverage at the time of initial spinal surgery, especially when there is an instrument exposure. For soft tissue reconstruction of a lumbosacral defect, a variation of the gluteal flap is the first-line choice. However, the musculocutaneous flap or muscle flap that is conventionally used, has many disadvantages. It damages gluteus muscle and causes functional disturbance in ambulation, has a short pedicle which limits areas of coverage, and can damage perforators, limiting further surgery that is usually necessary in spinal tumor patients. In this article, we present the superior gluteal artery perforator turn-over flap that reconstructs complex lumbosacral defects successfully, especially one that has instrument exposure, without damaging the ambulatory function of the patient. Methods: A 67 year old man presented with sacral sarcoma. Sacralectomy with L5 corpectomy was performed and resulted in a $15{\times}8\;cm$ sized complex soft tissue defect in the lumbosacral area. There was no defect in the skin. Sacral stabilization with alloplastic fibular bone graft and reconstruction plate was done and the instruments were exposed through the wound. A $18{\times}8\;cm$ sized superior gluteal artery perforator flap was designed based on the superior gluteal artery perforator and deepithelized. It was turned over 180 degrees into the lumbosacral dead space. Soft tissue from both sides of the wound was approximated over the flap and this provided in double padding over the instrument. Results: No complications such as hematoma, flap necrosis, or infection occurred. Until three months after the resection, functional disturbances in walking were not observed. The postoperative magnetic resonance imaging scan shows the flap volume was well maintained over the instrument. Conclusion: This superior gluteal artery perforator turn-over flap, a modification of the conventional superior gluteal artery perforator flap, is a simple method that enabled the successful reconstruction of a lumbosacral defect with instrument exposure without affecting ambulatory function.

• The Journal of the Korean bone and joint tumor society
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• v.19 no.2
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• pp.50-55
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• 2013

Purpose: The purpose of this study is to determine the usefulness of arterial embolization on sacral and pelvic giant cell tumor (GCT). Materials and Methods: We retrospectively reviewed the medical records of 9 patients who had undergone serial arterial embolization between December 1996 and May 2008. We analyzed the clinical outcomes and therapeutic responsiveness of arterial embolization on sacral and pelvic GCT. Results: Six of 9 cases showed progression of disease (PD) status, even if 5 cases showed PD status despite of additional treatments including surgery and radiation, implying that serial arterial embolization on sacral and pelvic GCT is not effective. Three of 9 cases showed stable disease (SD) or continuous disease free (CDF) status and we analyzed associated factors with these good responses for embolization by ${\chi}^2$ test. The number of feeding vessels under six (p=0.048) and the number of collateral arterial supply under three (p=0.048) in the first angiogram showed significant relationships with good response for embolization, while remaining tumor staining by contrast after the first embolization and repeated embolization times were not significant. Conclusion: Although serial arterial embolization is not an effective modality on sacral and pelvic giant cell tumors, it may be a pilot modality under narrow indication of tumors with poor vascularity at first angiogram.

• Journal of Trauma and Injury
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• v.29 no.3
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• pp.93-97
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• 2016

Hepatic duct confluence injury, which is developed by blunt abdominal trauma, is rare. Conventionally, bile duct injury was treated by surgical intervention. In recent decades, however, there had been an increase in radiologic or endoscopic intervention to treat bile duct injury. In a hemodynamically stable patient, endoscopic intervention is considered as the first-line treatment for bile duct injury. A 40 year-old man was transferred to the emergency department of ${\bigcirc}{\bigcirc}$ trauma center after multiple blunt injuries. Contrast-enhanced abdominal computed tomography performed in another hospital showed a liver laceration with active arterial bleeding, fracture of the sacrum and left inferior pubic ramus, and intraperitoneal bladder rupture. The patient presented with hemorrhagic shock because of intra-peritoneal hemorrhage. After resuscitation, angiographic intervention was performed. After angiographic embolization of the liver laceration, emergency laparotomy was performed to repair the bladder injury. However, there was no evidence of bile duct injury on initial laparotomy. On post-trauma day (PTD) 4, the color of intra-abdominal drainage of the patient changed to a greenish hue; bile leakage was revealed on magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography (ERCP). Bile leakage was detected near the hepatic duct confluence; therefore, a biliary stent was placed into the left hepatic duct. On PTD 37, contrast leakage was still detected but both hepatic ducts were delineated on the second ERCP. Stents were placed into the right and left hepatic ducts. On PTD 71, a third ERCP revealed no contrast leakage; therefore, all stents were removed after 2 weeks (PTD 85). ERCP and biliary stenting could be effective treatment options for hemodynamically stable patients after blunt trauma.

• Journal of Biomedical Engineering Research
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• v.28 no.3
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• pp.397-409
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• 2007

Owing to needs of biomechanical comprehension and analysis to obtain various medical treatment designs which are related with the spine in order to cure and diagnose LBP patients, the FE modeling and nonlinear analysis of lumbosacrum including a partial ilium and iliolumbar ligaments, were carried out. First, we investigated whether the geometrical configuration of vertebrae displayed by DICOM slice files is regular and normal condition. After constructing spinal vertebrae including a partial ilium, a sacrum and five lumbars (from L1 to L5)with anatomical shape reconstructed using softwares such as image modeler and CAD modeler, we added iliolumbar ligaments, lumbar ligaments, discs and facet joints, etc.. And also, we assigned material property and discretized the model using proper finite element types, thus it was completely modeled through the above procedure. For the verification of each segment, average sagittal ROM, average coronal ROM and average transversal ROM under various loading conditions(${\pm}10Nm$), average vertical displacement under compression(400N), ALL(Anterior Longitudinal Ligament) and PLL(Posterior Longitudinal Ligament) force at L12 level, strains of seven ligaments on sagittal plane at L45 level and maximal strain of disc fibers according to various loading conditions at L45 level, etc., they were compared with experimental results. For the verification of multilevel-lumbosacrum spine including partial ilium and iliolumbar ligaments, the cases with and without iliolumbar ligaments were compared with ROM of experiment. The results were obtained from analysis of the verified FE model as follows: I) Iliolumbar ligaments played a stabilizing role as mainly posterior iliolumbar ligaments under flexion and as both posterior and anterior iliolumbar ligaments of one side under lateral bending. 2) The iliolumbar ligaments decreased total ROM of 1-8% in total model according to various motion conditions, which changed facet contact forces of L5S level by approximately 0.8-1.4 times and disc forces of L5S level by approximately 0.8-1.5 times more than casewithout ilioligaments, under various loading conditions. 3) The force of lower discs such as L45 and L5S was bigger than upper discs under flexion, left and right bending and left and right twisting, except extension. 4) It was predicted that strains of posterior ligaments among iliolumbar ligaments would produce the maximum 16% under flexion and the maximum 10% under twisting. 5) It's expected that this present model applies to the development and design of artificial disc, since it was comparatively in agreement with the experimental datum.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.1
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• pp.431-440
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• 2017

The purpose of this study was to investigate the effects of Iyengar yoga practice on the lower body imbalance in middle-aged women. The subjects (n=24), who had not performed yoga training prior to this study (and) were not attending any other training programs, participated after undergoing an X-RAY examination with the Gonstead Technique and then their lower body imbalance (was reevaluated). The subjects completed the yoga program for 12 weeks (3 times per week, 90 minutes per session). The data were analyzed with the paired t-test and alpha was set at 0.05. It was found that 1) the height differences between the right and left iliac crests (p < 0.001), width (p < 0.001) and length (p < 0.001) differences between the right and left iliac fossa, and width differences between the right and left sacrum (p < 0.001) were significantly reduced after the training program. In addition, 2) the lower limb length discrepancy was significantly reduced (p < 0.001). Our data suggest that Iyengar yoga training for 12 weeks reduces the pelvic imbalance and length differences between the right and left lower limbs in middle-aged females.