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1.
Article | WPRIM | ID: wpr-836047

ABSTRACT

Objectives@#The purpose of our study was to investigate medical care utilization behavior and the conceptions of disease treatment among spine disease patients.Summary of Literature Review: Analyzing the medical care utilization behavior and conceptions of disease treatment among spine disease patients is important. @*Materials and Methods@#A survey was administered to 500 first-time patients who visited the spine center of a tertiary educational hospital from May 2017 to August 2019. @*Results@#A total of 479 valid responses were analyzed. A minority of patients (16.1%) visited the tertiary educational hospital without having previously visited a private hospital. Spinal procedures and surgery were considered negatively by 52.6% of respondents, and 14.8% of patients reported negative perceptions of orthopedic drugs. @*Conclusions@#Extensive efforts will be required to improve unreasonable medical utilization behavior by changing patients’ incorrect knowledge and beliefs about hospitals, diseases, and treatments.

2.
Article | WPRIM | ID: wpr-836044

ABSTRACT

Objectives@#This study was conducted to analyze associations between the volume of the fusion mass and clinical outcomes 1 year after posterior lumbar interbody fusion (PLIF).Summary of Literature Review: No study has investigated associations between the size of the fusion mass and clinical outcomes after PLIF. @*Materials and Methods@#The volume of the fusion mass and its clinical correlations after PLIF were analyzed in all patients and in subgroups. When a sufficient amount of local bone was available for grafting, only local bone without a graft extender was used (LbG group, n=20). If an inadequate amount of local bone was present for grafting, a local bone graft with porous hydroxyapatite bone chips was used (LbHa group, n=20). The same amount of demineralized bone matrix was used in both groups. The primary outcome was the relationship between the size of the fusion mass and clinical outcomes in all patients 1 year after surgery. The secondary outcome was a comparison of the size of the fusion mass and clinical outcomes by group. @*Results@#The volume of the fusion mass was not correlated with any clinical outcomes 1 year after surgery, either in the overall group of patients or in the subgroup analysis. @*Conclusions@#The volume of the interbody fusion mass was not related to any clinical outcomes 1 year after surgery. Furthermore, in cases with an insufficient amount of local bone for grafting, porous hydroxyapatite could be a relatively good alternative as a graft extender.

3.
Asian Spine Journal ; : 694-701, 2020.
Article | WPRIM | ID: wpr-830898

ABSTRACT

Over the past few decades, interest in minimally invasive spine surgery (MISS) has increased tremendously due to its core principle of minimizing approach-related injury while providing outcomes similar to traditional open spine procedures. With technical and technological advancements, MISS has expanded its utility not only to simple spinal stenosis, but also to complex spinal pathologies such as metastasis, trauma, or adult spinal deformity. In this article, we review the techniques and technology in MISS and discuss the indications, benefits, and limitations of MISS.

4.
Article in Korean | WPRIM | ID: wpr-765622

ABSTRACT

STUDY DESIGN: Review article. OBJECTIVES: To present the latest knowledge on spine surgery using augmented reality (AR). SUMMARY OF LITERATURE REVIEW: AR is a new technology that simulates interactions with real-world surroundings using computer graphics, and it is a field that has recently been highlighted as part of the fourth industrial revolution. MATERIALS AND METHODS: Review of related literature and introduction of latest research. RESULTS: Spine surgery using AR is currently in its early stages. If industry, academia, and research institutes cooperate and develop, spine surgery using AR is highly likely to develop to the next level. CONCLUSIONS: Spine surgeons should strive to develop relevant technology.


Subject(s)
Academies and Institutes , Computer Graphics , Spine , Surgeons
5.
Yonsei Medical Journal ; : 317-324, 2018.
Article in English | WPRIM | ID: wpr-713192

ABSTRACT

PURPOSE: To assess the association between frailty and osteoporotic vertebral compression fracture (OVCF) and to evaluate the relationship between numbers of OVCFs and frailty. MATERIALS AND METHODS: We enrolled 760 subjects, including 59 patients (with OVCF) and 701 controls (without OVCF). Successful matching provided 56 patient-control pairs. We analyzed principal clinical and demographic information, which included sex, age, height, weight, body mass index (BMI), variable frailty phenotypes, and Oswestry Disability Index (ODI) and EuroQol 5-dimension questionnaire (EQ-5D) scores. The association between frailty and OVCF was ascertained. In addition, the degrees of disability and quality of life attributable to frailty were determined. RESULTS: The prevalence of frailty was significantly higher in the OVCF group than in the control group (p < 0.001). Most of the frailty phenotypes, such as exhaustion, physical inactivity, slowness, and handgrip strength, were also significantly observed in the OVCF group. Within the OVCF group, the participants with frailty had significantly higher disability and lower quality of life than those in a robust state (p < 0.001 for ODI and EQ-5D). In addition, the multivariate logistic regression analysis demonstrated that the patients with low BMI [odds ratio (OR)=0.704; 95% confidence interval (CI), 0.543–0.913] and ≥3 fractures (OR=9.213; 95% CI, 1.529–55.501) within the OVCF group were associated with higher odds of frailty. CONCLUSION: The present study showed significant relationships between frailty and OVCF, severity of symptoms, and disability induced by OVCF. Furthermore, frailty could be a causal and/or resulting factor of OVCFs.


Subject(s)
Aged , Aged, 80 and over , Case-Control Studies , Female , Fractures, Compression/complications , Frailty/complications , Humans , Male , Middle Aged , Osteoporotic Fractures/complications , Prevalence , Propensity Score , Quality of Life , Spinal Fractures/complications , Treatment Outcome
6.
Article in English | WPRIM | ID: wpr-765602

ABSTRACT

STUDY DESIGN: Retrospective cohort study. OBJECTIVES: To investigate the potential clinical use of the spinal instability neoplastic score (SINS) for determining the surgical strategy, especially regarding the need for anterior support. SUMMARY OF LITERATURE REVIEW: The SINS seems to enable an improved qualitative and quantitative assessment of spinal instability in patients with spinal metastasis. MATERIALS AND METHODS: We retrospectively reviewed 69 consecutive patients who underwent surgical treatment for spinal metastasis. We assessed the patients' preoperative status with respect to each component of the SINS. Multiple logistic regression was performed to calculate odds ratios (ORs) representing the associations among SINS, age, Eastern Cooperative Oncology Group performance status, modified Tokuhashi score, as well as the preoperative Nurick grade variables and reconstruction of the anterior spinal column. RESULTS: Among the 6 items in the SINS, those indicating the degree of collapse and alignment had significantly higher scores in those who underwent corpectomy and anterior support (p<0.001). Multiple logistic regression revealed that the total SINS was the only factor significantly associated with predicting whether anterior support should be performed (adjusted OR=1.595). Receiver operating characteristic (ROC) curve analysis suggested that a cut-off value of 10 points on the SINS scale could be used to decide whether anterior support following corpectomy should be performed (AUC=0.706). CONCLUSIONS: The SINS, insofar as it assesses the degree of collapse and alignment, is a potentially useful tool for determining the surgical strategy in patients with spinal metastasis, especially for deciding upon the necessity of additional anterior support procedures.


Subject(s)
Cohort Studies , Humans , Logistic Models , Neoplasm Metastasis , Odds Ratio , Retrospective Studies , ROC Curve , Spine
7.
Yonsei Medical Journal ; : 438-444, 2018.
Article in English | WPRIM | ID: wpr-714665

ABSTRACT

PURPOSE: We prospectively assessed the early radiographic and clinical outcomes (minimum follow-up of 2 years) of robot-assisted pedicle screw fixation (Robot-PSF) and conventional freehand pedicle screw fixation (Conv-PSF). MATERIALS AND METHODS: Patients were randomly assigned to Robot-PSF (37 patients) or Conv-PSF (41 patients) for posterior interbody fusion surgery. The Robot-PSF group underwent minimally invasive pedicle screw fixation using a pre-planned robot-guided screw trajectory. The Conv-PSF underwent screw fixation using the freehand technique. Radiographic adjacent segment degeneration (ASD) was measured on plain radiographs, and clinical outcomes were measured using visual analogue scale (VAS) and Oswestry disability index (ODI) scores regularly after surgery. RESULTS: The two groups had similar values for radiographic ASD, including University California at Los Angeles grade, vertebral translation, angular motion, and loss of disc height (p=0.320). At final follow-up, both groups had experienced significant improvements in back VAS, leg VAS, and ODI scores after surgery (p < 0.001), although inter-group differences were not significant for back VAS (p=0.876), leg VAS (p=0.429), and ODI scores (p=0.952). In the Conv-PSF group, revision surgery was required for two of the 25 patients (8%), compared to no patients in the Robot-PSF group. CONCLUSION: There were no significant differences in radiographic ASD and clinical outcomes between Robot-PSF and Conv-PSF. Thus, the advantages of robot-assisted surgery (accurate pedicle screw insertion and minimal facet joint violation) do not appear to be clinically significant.


Subject(s)
California , Follow-Up Studies , Humans , Leg , Pedicle Screws , Prospective Studies , Zygapophyseal Joint
8.
Article in English | WPRIM | ID: wpr-179531

ABSTRACT

BACKGROUND AND OBJECTIVES: This study examined whether the prognosis of sudden deafness was dependent on the time of onset and evaluated the factors affecting prognosis during each period. SUBJECTS AND METHODS: Patients who developed sudden hearing loss from January 2005 to December 2015 were evaluated retrospectively. Meteorological data were obtained from the official website of the Korea Meteorological Administration. Factors prognostic of hearing recovery rate were analyzed. RESULTS: The hearing recovery rate of the 318 patients who developed sudden deafness did not differ significantly by month. Mean temperature and daily temperature range at onset of sudden deafness were not associated with recovery rate. CONCLUSIONS: The recovery rate in patients with sudden deafness did not differ markedly by season.


Subject(s)
Hearing , Hearing Loss, Sensorineural , Hearing Loss, Sudden , Humans , Korea , Observational Study , Prognosis , Retrospective Studies , Seasons
9.
Asian Spine Journal ; : 256-263, 2017.
Article in English | WPRIM | ID: wpr-10345

ABSTRACT

STUDY DESIGN: A cross-sectional, case-control study. PURPOSE: To investigate associations between physical fitness measures and disabilities related to back pain and quality of life (QOL) by the presence of symptomatic lumbar spinal stenosis (LSS) in elderly Korean women. OVERVIEW OF LITERATURE: LSS leads to decreased functioning and reduced QOL. However, correlations among physical fitness, disability, and QOL have not been investigated in elderly women with LSS. METHODS: Participants included women aged 65 years and older (n=192), divided into a study group (n=38) and a control group (n=154) based on the presence/absence of LSS. All participants underwent physical function and fitness tests. Oswestry disability index (ODI) scores and EuroQol five-dimensional questionnaire (EQ-5D-5L) scores were used to assess disability and health-related QOL. RESULTS: The results for the handgrip strength, sit-and-reach, functional reach, and timed up and go (TUG) tests were significantly higher in the control group than the LSS group. ODI scores were significantly higher and EQ-5D-5L scores significantly lower in the LSS group. TUG and functional reach test scores were significantly correlated with ODI scores, and handgrip strength was strongly interrelated with ODI and EQ-5D-5L scores in the LSS group. No other physical fitness measures showed statistically significant relationships with ODI or EQ-5D-5L scores. CONCLUSIONS: In elderly Korean women with LSS, back pain-related disability and QOL are significantly associated with some physical fitness parameters such as handgrip strength. Handgrip strength reflects general muscle strength, which is significantly interrelated with the level of disability and QOL. Our results suggest that enhancing generalized muscle strength helps to reduce disability due to back pain and improve QOL in patients with LSS.


Subject(s)
Aged , Back Pain , Case-Control Studies , Female , Humans , Lumbar Vertebrae , Muscle Strength , Physical Fitness , Quality of Life , Spinal Stenosis
10.
Article in English | WPRIM | ID: wpr-195558

ABSTRACT

BACKGROUND AND OBJECTIVES: This study was designed to assess the characteristics of patients according to the degree and audiogram shape of hearing loss and the association of these characteristics with hearing aids (HA) choice, return rate, and cause of return. SUBJECTS AND METHODS: This study included 460 individuals who received HAs from 2011 to 2015. The relationships between type of HA and age, primary and accompanying symptoms, HA choice and return and cause of return were evaluated according to the degree and pattern of hearing loss. RESULTS: HA type did not differ significantly according to the degree and pattern of hearing loss. Intensity of hearing loss was greater in male than in female (p<0.05). Open and completely-in-canal types of HA decreased with age (p<0.05). As degree of hearing loss intensified, behind-the-ear and in-the-ear types increased and Open type decreased (p<0.05). The HA return rate was 9.7%, but was not associated with degree or pattern of hearing loss. The main causes of HA return were costs, psychological fears and adaptive failure. CONCLUSIONS: Choice of HA is affected by age, sex, and degree and pattern of hearing loss. HA for hearing rehabilitation in patients with hearing loss can be personalized according to each patient's characteristics and tendencies.


Subject(s)
Female , Hearing Aids , Hearing Loss , Hearing , Humans , Male , Rehabilitation
11.
Asian Spine Journal ; : 38-45, 2016.
Article in English | WPRIM | ID: wpr-157495

ABSTRACT

STUDY DESIGN: Retrospective interventional study. PURPOSE: To introduce a free-hand pedicle screw (PS) insertion technique without fluoroscopic guidance in the C7 vertebra and evaluate the procedure's feasibility and radiologic outcomes. OVERVIEW OF LITERATURE: Although PS insertion at C7 has been recognized as a critical procedure in posterior cervical fusion surgery, conventional techniques for C7 PS have several limitations. METHODS: Thirty two patients (64 screws) who underwent PS insertion in C7 with the novel technique were included in this study. Postoperative clinical and radiological outcomes were evaluated. Special attention was paid to the presence of any problems in the screw position including cortical breaches of the PS and encroachment of the PS into the spinal canal or the vertebral foramen. This novel technique for PS insertion in C7 without fluoroscopy guidance had three key elements. First, the ideal PS entry point was chosen near the C6-7 facet joint using preoperative images. Second, the convergent angle distance was measured at axial computed tomography (CT) imaging, which defined the distance between the tip of C7 spinous process and the extended line passing through the pedicle axis from the ideal entry point. Third, the cranial-caudal angle distance was measured in sagittal CT images, which defined the distance between the tip of the C7 spinous process and the extended line passing through the pedicle axis. RESULTS: Cortical breach on postoperative CT images was observed in three screws. All violated only the lateral wall of the affected pedicle. The breached screws occurred in the initial five cases. Postoperative neurologic deterioration was not observed in any patient, regardless of cortical breaching. CONCLUSIONS: The novel technique successfully allows for C7 PS to be placed and is associated with a low rate of cortical breach.


Subject(s)
Axis, Cervical Vertebra , Feasibility Studies , Fluoroscopy , Humans , Retrospective Studies , Spinal Canal , Spine , Zygapophyseal Joint
12.
Yonsei Medical Journal ; : 449-454, 2016.
Article in English | WPRIM | ID: wpr-21010

ABSTRACT

PURPOSE: To evaluate the diagnostic value of the Korean version of the Douleur Neuropathique 4 (DN4) questionnaire and to validate this questionnaire in terms of psychometric properties in patients with chronic pain due to degenerative spinal disease. MATERIALS AND METHODS: The Korean version of the DN4 questionnaire, which was translated and linguistically validated by the MAPI Research Group, was tested on 83 patients with lumbar or lumbar-radicular pain. Test-retest reliability was evaluated in a subsample of 40 patients who completed two assessments with an interval of 2 weeks. Nociceptive pain and neuropathic component pain were diagnosed in 40 and 43 patients, respectively. RESULTS: The Cronbach's alpha coefficient of internal consistency was 0.819, and the test-retest intraclass correlation coefficient (3, 1) (95% confidence interval) was 0.813 (0.776-0.847) (n=40). The area under the receiver-operator characteristics curve was 0.953 (p<0.001), with 95% confidence interval between 0.869 and 0.990. The Korean version of the DN4 questionnaire showed a sensitivity of 100% and 87.1%, and a specificity of 88.2% and 94.1% at the cutoff value of 3/10 and 4/10, respectively, for discriminating neuropathic component pain. CONCLUSION: The present study demonstrated the good discriminatory power of DN4 between nociceptive pain and neuropathic component pain in patients with lumbar or lumbar-radicular pain.


Subject(s)
Adult , Aged , Aged, 80 and over , Chronic Pain/diagnosis , Female , Humans , Male , Middle Aged , Neuralgia/diagnosis , Pain Measurement/methods , Psychometrics , Reproducibility of Results , Sensitivity and Specificity , Surveys and Questionnaires/standards , Translating
13.
Yonsei Medical Journal ; : 146-153, 2015.
Article in English | WPRIM | ID: wpr-174640

ABSTRACT

PURPOSE: The purpose of this study was to evaluate and compare the biomechanical behavior of the lumbar spine after posterior decompression with the spinous process osteotomy (SPiO) technique or the conventional laminectomy (CL) technique using a finite element (FE) model. MATERIALS AND METHODS: Three validated lumbar FE models (L2-5) which represented intact spine and two decompression models using SPiO and CL techniques at the L3-4 segment were developed. In each model, the ranges of motion, the maximal von Mises stress of the annulus fibrosus, and the intradiscal pressures at the index segment (L3-4) and adjacent segments (L2-3 and L4-5) under 7.5 Nm moments were analyzed. Facet contact forces were also compared among three models under the extension and torsion moments. RESULTS: Compared to the intact model, the CL and SPiO models had increased range of motion and annulus stress at both the index segment (L3-4) and the adjacent segments under flexion and torsion. However, the SPiO model demonstrated a reduced range of motion and annulus stress than the CL model. Both CL and SPiO models had an increase of facet contact force at the L3-4 segment under the torsion moment compared to that of the intact model. Under the extension moment, however, three models demonstrated a similar facet contact force even at the L3-4 model. CONCLUSION: Both decompression methods lead to postoperative segmental instability compared to the intact model. However, SPiO technique leads to better segmental stability compared to the CL technique.


Subject(s)
Biomechanical Phenomena , Decompression, Surgical/methods , Finite Element Analysis , Humans , Intervertebral Disc/physiopathology , Laminectomy/methods , Lumbar Vertebrae/pathology , Male , Middle Aged , Models, Anatomic , Osteotomy/methods , Range of Motion, Articular , Stress, Mechanical , Zygapophyseal Joint/pathology
14.
Article in Korean | WPRIM | ID: wpr-67732

ABSTRACT

In patient with renal failure, hypoglycemia may develop because of decreased caloric intake, diminished renal insulin degradation and clearance, reduced renal gluconeogenesis and hepatic glucose production, impaired release of counter-regulatory hormone such as glucagon and epinephrine. We report here on a 80-year-old female patient with hypoglycemia due to endogenous hyperinsulinemia with acute kidney injury. She had chronic kidney disease and had no history of diabetes mellitus or insulin use. She had experienced recurrent hypoglycemia despite of intravenous dextrose injection and eventually generalized tonic clonic seizure occurred as a result of hypoglycemia. As serum creatinine level decreases, serum insulin and C-peptide level decreased and hypoglycemia was not occurred. We present this case along with a review of the literature.


Subject(s)
Acute Kidney Injury , Aged, 80 and over , C-Peptide , Creatinine , Diabetes Mellitus , Energy Intake , Epinephrine , Female , Glucagon , Gluconeogenesis , Glucose , Humans , Hyperinsulinism , Hypoglycemia , Insulin , Renal Insufficiency , Renal Insufficiency, Chronic , Seizures
15.
Asian Spine Journal ; : 909-915, 2015.
Article in English | WPRIM | ID: wpr-126909

ABSTRACT

STUDY DESIGN: Retrospective fusion level(s)-, age-, and gender-matched analysis. PURPOSE: To determine whether the application of a topical gelatin-thrombin matrix sealant (Floseal) at the end of anterior cervical discectomy and fusion (ACDF) can reduce the amount of postoperative hemorrhage. OVERVIEW OF LITERATURE: The effect of the matrix sealant in decreasing postoperative hemorrhage following ACDF has not been reported. METHODS: Matrix sealant was (n=116, study group) or was not applied (n=58, control group) at the end of ACDF. Patients were selected by 1:2 matching criteria of fusion level(s), age, and gender. Seven parameters described below were compared between the two groups. RESULTS: The total drain amount for the first 24 hours (8+/-9 versus 27+/-22 mL), total drain amount until the 8-hour drainage decreased to < or =10 mL (8+/-10 versus 33+/-26 mL), and the total drain amount until 6 AM on the first postoperative day (7+/-8 versus 24+/-20 mL) were significantly lower in the study group than the control group (all p<0.001). The time for the 8-hour drainage to decrease to < or =10 mL was significantly lower in the study group (10+/-5 versus 26+/-14 hours, p<0.001). The 8-hour drainage decreased to < or =10 mL on the operation day in most patients (88%) in the study group versus mostly on the first (48%) or second (33%) postoperative day in the control group (p<0.001). The total drain amount until 6 AM on the first postoperative day was 0 mL in 43% of patients in the study group and in 7% in the control group (p<0.001). No patient in either group required hematoma evacuation. CONCLUSIONS: Application of the topical matrix sealant at the end of ACDF can significantly reduce the amount of postoperative hemorrhage.


Subject(s)
Cervical Vertebrae , Diskectomy , Drainage , Female , Hematoma , Hemostasis , Humans , Postoperative Hemorrhage , Retrospective Studies , Spinal Fusion
16.
Article in Korean | WPRIM | ID: wpr-653574

ABSTRACT

Trichofolliculoma is an uncommon follicular hamartoma of hair follicle tissue, typically occurring on the face and skin of the head and neck and appearing as papules or nodules. Dents in the central portion and immature white hair may be observed. Asymptomatically, trichofolliculoma occurs at any age but rather frequently in adults in many cases. A 47-year-old man presented a right ear canal mass, which had not been treated for 12 years. The tumor began to increase its size 4 years ago. A little red bump blocked the entrance of the right external auditory canal and there was a little dinge at the center of bump with growing black hair. This case was first reported in our country. Thus, we report this rare case with a review of the literature.


Subject(s)
Adult , Ear Canal , Hair , Hair Follicle , Hamartoma , Head , Humans , Middle Aged , Neck , Skin
17.
Article in Korean | WPRIM | ID: wpr-644534

ABSTRACT

The orbital apex syndrome is a very rare complication of fungal sinusitis, as well as of other conditions, and is characterized by blindness, diplopia, proptosis of the eye and ophthalmoplegia. We present a case of diplopia caused by a fungal ball in the Onodi cell. A 62-year-old woman, diagnosed with orbital apex syndrome and suffering from ophthalmalgia and diplopia in the right eye, was presented to our outpatient clinic. Computed tomography showed a soft tissue lesion occupying the right Onodi cell with chronic inflammation. Patients who have an Onodi cell carry a high risk for optic nerve injury, so endoscopic sinus surgery using navigation was performed. Histopathology examination confirmed the diagnosis of a fungal ball. We experienced a rare case of a fungal ball in the Onodi cell, which caused damage to the adjacent cavernous sinus structure and led to diplopia and orbital pain. We present this case with a brief review of these disease entities.


Subject(s)
Ambulatory Care Facilities , Blindness , Cavernous Sinus , Diagnosis , Diplopia , Exophthalmos , Female , Humans , Inflammation , Middle Aged , Ophthalmoplegia , Optic Nerve Injuries , Orbit , Sinusitis
18.
Article in Korean | WPRIM | ID: wpr-646191

ABSTRACT

We report on a case involving total en bloc uncinatectomy of C7 without removal of the previously inserted cage, performed on a patient with a history of previous anterior cervical discectomy and fusion without uncoforaminotomy at C5-6-7 who had persistent pain radiating to the upper extremity along with progressive weakness. Satisfactory results were achieved. This procedure should be regarded as an effective option for surgical treatment of persistent or recurrent radiculopathy caused by remaining foraminal stenosis following anterior cervical fusion, and we suggest it as a new indication for this procedure.


Subject(s)
Constriction, Pathologic , Diskectomy , Humans , Radiculopathy , Upper Extremity
19.
Yonsei Medical Journal ; : 1386-1394, 2014.
Article in English | WPRIM | ID: wpr-44325

ABSTRACT

PURPOSE: The purpose of this study was to investigate the effects of unilateral pedicle screw fixation on the fusion segment and the superior adjacent segment after one segment lumbar fusion using validated finite element models. MATERIALS AND METHODS: Four L3-4 fusion models were simulated according to the extent of decompression and the method of pedicle screws fixation in L3-4 lumbar fusion. These models included hemi-laminectomy with bilateral pedicle screw fixation in the L3-4 segment (BF-HL model), total laminectomy with bilateral pedicle screw fixation (BF-TL model), hemi-laminectomy with unilateral pedicle screw fixation (UF-HL model), and total laminectomy with unilateral pedicle screw fixation (UF-TL model). In each scenario, intradiscal pressures, annulus stress, and range of motion at the L2-3 and L3-4 segments were analyzed under flexion, extension, lateral bending, and torsional moments. RESULTS: Under four pure moments, the unilateral fixation leads to a reduction in increment of range of motion at the adjacent segment, but larger motions were noted at the fusion segment (L3-4) in the unilateral fixation (UF-HL and UF-TL) models when compared to bilateral fixation. The maximal von Mises stress showed similar patterns to range of motion at both superior adjacent L2-3 segments and fusion segment. CONCLUSION: The current study suggests that unilateral pedicle screw fixation seems to be unable to afford sufficient biomechanical stability in case of bilateral total laminectomy. Conversely, in the case of hemi-laminectomy, unilateral fixation could be an alternative option, which also has potential benefit to reduce the stress of the adjacent segment.


Subject(s)
Biomechanical Phenomena , Computer Simulation , Humans , Lumbar Vertebrae/surgery , Male , Middle Aged , Models, Anatomic , Pedicle Screws , Range of Motion, Articular , Software , Spinal Fusion , Stress, Mechanical
20.
Korean Journal of Medicine ; : 608-612, 2013.
Article in Korean | WPRIM | ID: wpr-80225

ABSTRACT

Prompt antibiotic treatment reduces the incidence of complications such as liver abscesses, pyelonephritis, and osteomyelitis in patients with typhoid fever. Renal or liver abscesses are especially rare in patients without underlying disease or predisposing factors. The occurrence of both renal and liver abscesses in a patient with typhoid fever has not been reported. Although the prevalence of typhoid fever in Korea has decreased, it is still an important disease owing to increased opportunities for the occurrence of waterborne diseases with climate warming and group feeding, and the increased numbers of tourists and foreigners visiting Korea. We present a patient with no underlying disease or predisposing factors who developed both renal and liver abscesses caused by nalidixic acid-resistant Salmonella typhi after a trip to Nepal. He was treated successfully with percutaneous drainage of the renal abscess and high-dose ciprofloxacin.


Subject(s)
Abscess , Ciprofloxacin , Climate , Drainage , Drug Resistance , Emigrants and Immigrants , Humans , Incidence , Korea , Liver , Liver Abscess , Nalidixic Acid , Nepal , Osteomyelitis , Prevalence , Pyelonephritis , Salmonella , Salmonella typhi , Typhoid Fever
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