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요추 협착증에 대한 일측성 추궁절개술을 통한 미세 수술적 감압술
심용진,하호균,이종선,김용석,박문선,김주승,Shim, Yong-Jin,Ha, Ho-Gyun,Lee, Jong-Sun,Kim, Yong-Seog,Park, Moon-Sun,Kim, Joo-Seung 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.11
Objectives : Many surgical procedures have been introduced to a symptomatic lumbar stenosis. Most of these procedures still have been regarded as an extensive surgical intervention with respect to normal aging process of the lumbar spine. We adopted a microsurgical decompression procedure via unilateral exposure as a minimally invasive intervention for symptomatic lumbar stenosis without instability. Materials and Methods : Fifty-seven patients with symptomatic lumbar stenosis underwent microsurgical decompression via unilateral laminotomy between March 1998 and December 1999. The conceptual modification and technical refinements were added to the previously reported microsurgical decompression procedure. Bilateral decompression through a unilateral laminotomy hole was performed in 11 patients. These patients profile also included 9 cases of degenerative spondylolisthesis(Grade I) without instability. Results : Preoperative neurogenic intermittent claudication(NIC) was more notably improved than low back pain, 60% to 82% during the follow-up period. Overall clinical results were excellent in 20(35%), good in 29(51%), fair in 6(11%) and poor in 2(3%). Conclusions : Microsurgical decompression for lumbar stenosis with stable spine provided a satisfactory symptomatic improvement without extensive destruction of the weight-bearing structures and functional mobile segments, even bilateral symptoms existed.
성인 수도관 폐쇄증에 대한 내시경적 제3뇌실 누공술 : 이중개창술 - 증례보고 및 수술수기 -
심용진,하호균,정호,김용석,박문선,Shim, Yong-Jin,Ha, Ho-Gyun,Jung, Ho,Kim, Yong-Seog,Park, Moon-Sun 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.8
Objective : Endoscopic third ventriculostomy is gaining popularity as a minimally invasive surgical option for certain types of hydrocephalus as an alternative to shunting. The authors have tried to fenestrate down to the subdural space passing through the prepontine cistern to lessen or avoid the chance of redoing due to healing. Materials and Method : A 48-year-old male patient with several years of intractable headache was presented. Magnetic Resonance Image(MRI) of the brain revealed marked ventricular dilatation with stenotic cerebral aqueduct. A 2.3mm flexible steerable endoscope($Neuroview^{(R)}$) was introduced via precoronal route and accessed to the third ventricular floor. Using 3-French Fogarty balloon catheter, thin third ventricular floor and the arachnoid membrane of the prepontine cistern were fenestrated, so called "double fenestration". To confirm the fenestration, subdural compa-rtment of the left abducens nerve was identified during the procedure. Forceful pulsating flow through the orifice convinced the patency of the opening. Results : The patient was discharged on the third postoperative day without any postoperative complications. The postoperative follow-up MRI of the brain, at second and sixth months, clearly demonstrated the flow void through the third ventricular floor. Conclusions : Endoscopic third ventriculostomy was successfully performed on an adult hydrocephalus patient with aqueduct stenosis. The third ventricular floor and arachnoid membrane of the prepontine cistern were fenestrated to achieve double fenestration to minimize the chance for failure. The details of this procedure and results are described.
화강풍화토 지반에 설치된 압력재주입 그라우팅 보강재의 인발특성
심용진(Shim, Yong-Jin),이종규(Lee, Jong-Kyu),이봉직(Lee, Bong-Jik) 한국지반환경공학회 2012 한국지반환경공학회논문집 Vol.13 No.11
지반보강을 위해 국내에서 널리 사용되고 있는 공법으로 앵커공법, 소일네일 공법 및 소구경말뚝 공법 등을 들 수 있다. 상기 공법의 경우 보강재의 시공은 용도에 따라 구분되지만 공통적으로 보강재를 삽입한 후에 그라우팅 작업을 실시하는 공정이 포함되어 있다. 지금까지는 국내 대부분의 경우 중력식 그라우팅으로 시공되고 있지만 중력에 의해 그라우팅을 실시하기 때문에 천공 시 발생하는 지반이완영역에 대한 복원이 명확지 않아 보강재의 구조적 결함을 유발할 우려가 있다. 반면에 압력재주입 그라우팅은 먼저 그라우트를 채운 후 소정의 시간이 지나고 미리 설치한 튜브를 통하여 추가적으로 재주입하는 방식으로 기존의 그라우팅 방식에서 발생할 수 있는 문제를 상당부분 해결할 수 있어 그라우팅의 품질을 향상할 수 있다. 본 연구에서는 그라우팅 방식에 따른 인발특성을 평가하기 위하여 화강풍화토 지반을 대상으로 모형실험을 실시하였으며, 그라우팅방법에 따른 인발력 변화와 압력 재주입그라우팅의 재주입시기와 재주입압에 따른 보강재 지지력 증대 특성을 평가하고자 하였다. 연구결과 압력재주입식 그라우팅 이 중력식그라우팅에 비해 최소 1.1배에서 1.3배까지 인발력이 크게 발휘되는 것을 확인하였으며, 압력재주입식 그라우팅의 적정물시멘트비, 주입압력 및 재주입시기에 대한 고찰결과를 제시하였다. Most widely methods for reinforcement of soil utilized in Korea are anchor method, soil nail method and micro pile method. These methods are classified by the intended use of the structure to be constructed, but the reinforcement of the ground is accomplished contains in common the process of grouting work after inserting the reinforcements. Domestically, gravity grouting has been used mostly so far, but there has always been the risk of insufficient restoration of the loose ground area from the drill holes because the grouting is conducted only by gravity. On the other hand, pressure reinjection grouting may enhance the grouting quality by solving the problem of the existing grouting method considerably since it additionally reinjects grouting through pre-installed tube a certain time after the first grouting. Accordingly, this study evaluated the pullout characteristics by the grouting methods by performing model test on decomposed granite soil, and investigated the support increasing characteristics of reinforcements depending on the curing time, reinjection pressure, and uplift force variation of the pressure reinjection grouting. The result of this research shows that the pressure reinjection grouting demonstrated 1.1~1.3 times of performance of the gravity grouting, and suggests some analysis on optimal water content, reinjection pressure and curing time of the pressure reinjection grouting.