The Evaluation of the Treatment Modality in Low Back Pain / 대한척추외과학회지

OBJECT: The Authors compaired the treatment interval, the motive of admission and costs of episodes of back pain care between different provide type in a population representation of the Korea. MATERIAL AND METHOD: We reviewed 100 different patients undergone back pain care from October 1997 to March 1998 in Wonkwang Medical Center. This study was a prospective, nurse community based and observational design. Male were 42 and female were 58, mean age was 51(18-81)years. Patients with back pain had been treated with 62 patients operation and 38 patients conservative treatment. RESULTS: The results were as follows 1. The from preadmmision treatment to admission treatment time is consume over 6 months, that makes chronic phase of back pain until 72%, more than 80% of the patients were admitted after the herb medical treatment. 2. The cost of preadmission treatment is average 1,000,000 won. In the cases of herb medicine are average 1,300,000won. The medical fee in the herb medicine is seven times as much as in the medical clinics for a visit. 3. The motive of admission is recommended by neighbour that major to 89%, 62 patients were operated that showed 12 excel-lent, 35 good, 13 fair and 2 poor results. CONCLUSION: There were correlations of three factors, that is high cost, patients chronicity and preference of the herb medicine.

Characteristics of Motor Evoked Potentials by Pyramidal and Extrapyramidal Systems in Rats / 대한정형외과연구학회지

PURPOSE: Electrophysiologically assess conduction pathways of the pyramidal and extrapyramidal systems in rats and predict the pathways involved in spinal cord injuries. METHOD: The motor area of the cerebral cortex, medullary reticular nucleus, lateral vestibular nucleus, and red nucleus of adult Sprague-Dawley rats were stimulated with microelectrodes. Laminectomies were performed at the C6, T10 and L2 cord level. Field potentials evoked by stimulation of the cerebral cortex and the three motor nuclei were recorded with a glass microelectrode of 1.5~2.5 Mohm filled with 0.2M NaCl. To construct a cross-sectional map of field potentials, recording was made in 7 tracks equally spaced across the spinal cord. In each track, field potentials were recorded at seven equally spaced points from the ventral to dorsal cord. RESULT: Stimulation of the cerebral motor cortex evoked 5 wanes, such as P1, P2, P3, P4, P5. P1 was monitored mainly in the bilateral dorsal half of the spinal cord and other wades mainly in the ventral half of the spinal cord. With lateral vestibular nucleus stimulation, 1 or 2 short duration biphasic waves followed by a longer duration positive wave were monitored mainly in the ipsilateral ventrolateral funiculus of the cord. Field potentials produced by stimulating the medullary reticular nucleus were shown mainly in the ventromedial funiculus, and their latencies were longer than those from the vestibular nucleus stimulation. Field potentials generated by the stimulation of the red nucleus were monitored mainly in the dorsolateral funiculus. CONCLUSION: motor evoked potential is clinically useful to evaluate the descending pathways of the spinal cord.

Immunohistochemical Study of the Ligamentum Flavum in the Lumbar Spinal Stenosis / 대한정형외과학회잡지

Lumbar ligimentum flava obtained from 21 patients of spinal stenosis and 10 patients who underwent surgery for vertebral fracture(control group) were studied with hematoxylin-eosin stain, Verhoff s elastic stain, and immunohistochemical stains for S-100 protein ad fibronectin. The chondroid metaplasia of ligamentum flavum found more frequently and widely in the group of spinal stenosis compared with control group. The elastic fibers were decreased in number and irregu- larly arranged at the bone attached area in the group of spinal stenosis. There was tendency to increase the amount of fibronectin in the stroma of the ligamentum flavum in the group of spinal stenosis. Above findings suggest that chondroid metaplasia and changes of the elastic fiber in the peripheral area of the ligamentum flavum are able to contribute the pathogenesis of spinal stenosis.