http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
장재칠,조성진 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2
The most important complications encountered by achondroplastic dwarfs are neurological problems related to a narrowed spinal canal. The author report a rare case of cervico-thoraco-lumbar stenosis in achondroplasia. A 44-year-old woman was presented with paraparesis and hypesthesia below T5 bermatone. Only decompressive laminectomy was performed without fusion at thoracic and lumbar area. Neurological symptoms improved after surgery.
요추간판탈출증에서 현미경 수술과 경피적 자동수핵제거술에 대한 비교연구
신원한,장재칠,주교성,김범태,최순관,변박장 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.1
A retrospective study of operative results were carried out in a series of 164 patients who were performed microdiscectomy and 57 patients performed automated percutaneous lumbar discectomy (APLD) for herniated lumbar discs between January 1, 1990 and June 30, 1996 at the Department of Neurosurgery, Soonchunhyang University Hospital. The operative results were analysed, and the correlation between preoperative clinicoradiological factors and postoperative clinical results were statistically assessed. The major results were as follows : 1. Of 164 microdiscectomy cases, 102 were males and 62 were females, mean age was 42.4 years and incidence was the highest in the 5th decade, and of 57 APLD cases, 43 were male and 14 female, mean age was 32.2 years and incidence was the highest in the 3rd decade. 2. The preoperative symptoms and signs were lumbago(98.2%), radiating pain(96.3%), positive straight leg raising test(77.4%), motor weakness(27.4%), claudication(13.4%) & voiding difficulty(2.4%) in microdiscectomy cases, and lumbago(98.2%), radiating pain(98.2%), positive straight leg raising test(70.2%) & motor weakness(17.5%) in APLD cases. 3. Number of operated levels were performed 226 in microdiscectomy and 74 in APLD. The most commonly operated levels of two groups were L4-5 level. 4. Operative results 1) The overall success rates by Prolo's scale were 87.1% in microdiscectomy and 80.7% in APLD, respectively. 2) In younger age group (below 30 years) and in non-compensatory group, success rates were significantly higher in microdiscectomy. 3) As to protrusion and degeneration on MRI, clinical results of moderate protrusion and degeneration of discs in microdiscectomy were statistically significant, and those of mild protrusion and degeneration of discs in APLD were also statistically significant. 4) The most common cause of failure was inappropriate removal of disc material in microdiscectomy and sequestered discs in APLD. According to the above results, there were no differance in overall success rates between microdiscectomy and APLD. But clinical results seem to be influenced by the age, existence of compensation, and by the degree of protrusion and degeneration of discs as prognostic factors. If the selection of operative procedure between microdiscectomy and APLD for herniated lumbar disc is carefully done with clinical and radiologic findings of patients, good outcome might be achieved.
Morphometric Measurement of the Anatomical Landmark in Anterior Cervical Microforaminotomy
Chang, Jae-Chil,Park, Hyung-Ki,Bae, Hack-Gun,Cho, Sung-Jin,Choi, Soon-Kwan,Byun, Park-Jang The Korean Neurosurgical Society 2006 Journal of Korean neurosurgical society Vol.39 No.5
Objective : The lack of anatomical knowledge for the anterior cervical microforaminotomy is liable to injure the neurovascular structures. The surgical anatomy is examined with special attention to the ventral aspect exposed in anterior cervical microforaminotomy. Methods : In 16adult formalin fixed cadaveric cervical spine, the author measured the distances from the medical margin of the longus colli to the medical wall of the ipsilateral vertebral artery and the angle for the ipsilateral vertebral artery. The distances from the lateral margin of the posterior longitudinal ligament to the medial margin of the ipsilateral medial wall of the vertebral artery, to the ipsilateral dorsal root ganglion was measured too. Results : The distance from the medial margin of the longus colli to the ipsilateral vertebral artery was $13.3{\sim}14.7mm$ and the angle for the ipsilateral vertebral artery was $41{\sim}42.5\;degrees$. The range of distance from the lateral margin of the posterior longitudinal ligament to the ipsilateral vertebral artery was $11.9{\sim}16.1mm$, to the ipsilateral dorsal root ganglion was $11.6{\sim}12.9mm$. Conclusion : These data will aid in reducing neurovascular injury during anterior cervical approaches.
Posterior Cervical Inclinatory Foraminotomy for Spondylotic Radiculopathy Preliminary
Chang, Jae-Chil,Park, Hyung-Ki,Choi, Soon-Kwan The Korean Neurosurgical Society 2011 Journal of Korean neurosurgical society Vol.49 No.5
Posterior cervical foraminotomy is an attractive therapeutic option in selected cases of cervical radiculopathy that maintains cervical range of motion and minimize adjacent-segment degeneration. The focus of this procedure is to preserve as much of the facet as possible with decompression. Posterior cervical inclinatory foraminotomy (PCIF) is a new technique developed to offer excellent results by inclinatory decompression with minimal facet resection. The highlight of our PCIF technique is the use of inclinatory drilling out for preserving more of facet joint. The operative indications are radiculopathy from cervical foraminal stenosis (single or multilevel) with persistent or recurrent root symptoms. The PCIFs were performed between April 2007 and December 2009 on 26 male and 8 female patients with a total of 55 spinal levels. Complete and partial improvement in radiculopathic pain were seen in 26 patients (76%), and 8 patients (24%), respectively, with preserving more of facet joint. We believe that PCIF allows for preserving more of the facet joint and capsule when decompressing cervical foraminal stenosis due to spondylosis. We suggest that our PCIF technique can be an effective alternative surgical approach in the management of cervical spondylotic radiculopathy.
Kim, Se-Hoon,Chang, Ung-Kyu,Chang, Jae-Chil,Chun, Kwon-Soo,Lim, T. Jesse,Kim, Daniel H. The Korean Neurosurgical Society 2009 Journal of Korean neurosurgical society Vol.46 No.2
Objective: To compare two testing protocols for evaluating range of motion (ROM) changes in the preloaded cadaveric spines implanted with a mobile core type Charite$^{TM}$ lumbar artificial disc. Methods: Using five human cadaveric lumbosacral spines (L2-S2), baseline ROMs were measured with a bending moment of 8 Nm for all motion modes (flexion/extension, lateral bending, and axial rotation) in intact spine. The ROM was tracked using a video-based motion-capturing system. After the Charite$^{TM}$ disc was implanted at the L4-L5 level, the measurement was repeated using two different methods: 1) loading up to 8 Nm with the compressive follower preload as in testing the intact spine (Load control protocol), 2) loading in displacement control until the total ROM of L2-S2 matches that when the intact spine was loaded under load control (Hybrid protocol). The comparison between the data of each protocol was performed. Results: The ROMs of the L4-L5 arthroplasty level were increased in all test modalities (p < 0.05 in bending and rotation) under both load and hybrid protocols. At the adjacent segments, the ROMs were increased in all modes except flexion under load control protocol. Under hybrid protocol, the adjacent segments demonstrated decreased ROMs in all modalities except extension at the inferior segment. Statistical significance between load and hybrid protocols was observed during bending and rotation at the operative and adjacent levels (p< 0.05). Conclusion: In hybrid protocol, the Charite$^{TM}$ disc provided a relatively better restoration of ROM, than in the load control protocol, reproducing clinical observations in terms of motion following surgery.
장재칠,신원한,배학근,김범태,최순관,변박장 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.11
A retrospective study of predictors determining outcome was carried out in a consecutive series of 104 patients, who had suffered from diffuse brain injury between December 1989 and April 1995, at the Department of Neurosurgery. Soonchunhyang University Hospital. The clinical, laboratory and radiological factors affecting the outcome in patients were analyzed and correlation between the factors and Glasgow outcome scale were statistically assessed. The major results were as follows : 1) Significant predictors of poor outcome were old age, time interval within 5 hours from onset to admission, full dilated pupils or anisocoria, lower Glasgow coma scale, seizure, body temperature above 38℃, Pa02 below 70㎜Hg, blood sugar above 160㎎/㎗, platelet count less than 100,000/㎣. prothrombin time less than 80%, lesions in more than 2 locations on CT & MRI and operative cases. Glasgow coma scale, age and temperature were demonstrated as the most significant predictors among the above factors by discriminant analysis. 2) Sex, kind of accidents, associated injuries, systolic blood pressure, pulse rate, respiration rate, PaCO_(2), base excess, serum sodium, bleeding time, coagulation time, and skull fracture were not significant influences on the outcome. According to the above results, the predictors of poor outcome should be considered as factors in assessing prognosis for treatment of diffuse brain injury.