기능적 평가 측정을 통하여 전신냉기치료와 척추 감압기 적용이 요추 추간판 탈출증 환자에게 미치는 효과

마상렬,Ma, Sang-Yeol 한국데이터정보과학회 2010 한국데이터정보과학회지 Vol.21 No.6

본 연구는 요추 추간판 탈출증 환자 30명을 대상으로 전신냉기치료와 감압치료를 병행한 그룹과 감압치료를 적용한 그룹으로 나누어 2주간 실시한 후 통증과 요추 굴곡 관절가동범위, 그리고 전반적 인지효과에 미치는 효과에 대해 알아보기 위해 실시하였다. 본 연구의 측정은 시각적 상사 척도 검사와 수정판 쇼버 검사, 그리고 전반적 인지효과척도를 검사하였다. 대응표본 T검사에서 두 그룹 모두 효과적이었다. 그러나 독립표본 T검정과 공분산분석 결과 전신냉기치료와 감압치료를 병행한 그룹에서 더욱 효과적이었다. 요추 추간판 탈출증의 통증과 관절가동범위, 그리고 전반적 인지효과를 개선시키기 위해 전신냉기치료와 감압치료 병용 시 효과적이란 것을 검증하였다. This study was conducted to investigate whether whole body cryotherapy and spinal decompression have effectiveness on the pain, lumbar flexion range of motion, and global perceived effect scale in patients with lumbar disc herniation. Thirty subjects were participated in this study. And they were all randomly divided into whole body cryotherapy and spinal decompression group. To evaluate the effects of whole body cryotherapy and spinal decompression, subjects were evaluated by using visual analogue scale, lumbar flexion range of motion, and global perceived effect scale. The assessment parameters were evaluated before, after 2 weeks treatments. And we received a consent form whole body cryotherapy subjects. The results of paired t-test, independent t-test, and ANCOVA analysis of variance showed that pain, lumbar flexion range of motion, global perceived effect scale were significantly improved after than before therapy in whole body cryotherapy group. So we conclude that whole body cryotherapy has effectiveness on the pain, lumbar flexion range of motion, and global perceived effect scale in patients with lumbar disc herniation.

신경증상을 동반한 Kummell 병의 수술적 치료 : 후외측 감압 및 후방 재건술 Posterolateral Decompression and Posterior Reconstruction

김기택,석경수,김진문 대한척추외과학회 2001 대한척추외과학회지 Vol.8 No.2

연구목적 : 신경증상을 동반한 골 다공증성 척추 골절환자 중 신경 마비 소견이 있어 감압이 필요한 환자에게서 후외측 감압과 척추 재건술로 치료하였던 증례를 통하여 이 치료법을 평가하여 보고자 한다. 대상 및 방법 : 1996년 6월부터 2000년 2월까지 골다공증성 척추 압박골절 환자 중 신경증상을 동반하여 후외측 신경 감압 및 후방 척추 재건술을 시행하였던 8례를 대상으로 하였다. 후향적으로 질료기록을 통한 수술 시간, 수술 중 출혈량을 조사하고, 술 후 방사선학적인 분절 후만각의 교정 및 유지, 이식골의 유합을 관찰하였고, 술전 통증의 변화와 신경증상의 변화 및 합병증을 분석하였다. 결 과 : 수술시간은 평균 217분이었고 출혈량은 평균 682ml이었다. 방사선적인 분절 후만각은 술 전 22.6도에서 술후 4.4도로 교정되었드며 최종 추시 시에는 6.8도였다. 이식골의 유합은 평균 9개월이었다. 신경증상의 변화는 술 전 Frankel등급 C가 4례, D가 4례였으며, 최종 추시 시에는 D가 1례. E가 6례로 평균 1.4등급이 호전되었다. 결 론 : 신경증상을 동반한 골다공증성 척추골절의 치료볍 중 저자들이 이용한 후외측 감압 및 후방 기기 고정술이 유용한 치료방법으로 사료되나, 좀더 많은 환자에게서 장기간의 추시가 필요할 것으로 사료된다. Study design : Retrospective study was performed in eight patients with Kiimmell disease. Objectives : To access the results of posterolateral decompression and posterior reconstruction in Kiimmell disease with neurologic deficits. Summary of Literature Review : Severe osteoporosis is the most frequent cause of spinal compression fracture. Vertebral compression fracture in senile osteoporosis is characterized by the late development and slow progression of paraplegia When conservative treatment for paraplegia proves ineffective, an early operation is recommended. Materials and Methods : From June 1996 to February 2000. eight consecutive Kummell disease patients with neurologic deficits underwent posterolateral decompression and posterior reconstruction. We analyzed operation time, loss of blood through the medical records. Change of segmental kyphotic angle, bone union were assessed by plain radiographs, the clinical results were analyzed according to changes of pain and neurological status. Results : Mean operation time was 217 minutes. mean bleeding loss was 682 ml. The mean preoperative segmental kyphotic angle measured 22.6 degrees. and decreased to 4.4 degrees at postoperative evaluation, and 6.8 degrees at final follow-up. Bony union was obtained in 9 months. At preoperative time, four cases showed Frankel grade C and four cases Frankel grade D. At last follow-up time, one case Frankel grade D and six cases Frankel grade E. Conclusions : We concluded that posterolateral decompression and posterior reconstruction is a useful method for the treatment of K??mmell disease with neurologic deficits.

고압산소치료 사례연구

강보림 한국항공우주의학협회 2015 항공우주의학 학술대회 Vol.2015 No.5

Comparative Analysis of Surgical Decompression and Fusion Methods for the Treatment of Thoracic Myelopathy: Posterior Vertebral Column Resection, Anterior and Posterior Decompression, and Posterior Decompression without Column Resection

김성수,최병완,권유성 대한척추외과학회 2022 대한척추외과학회지 Vol.29 No.2

Study Design: Retrospective case analysis. Objectives: To compare three decompression and fusion methods—posterior vertebral column resection (PVCR), anterior and posterior (AP) decompression, and posterior decompression without column resection (PWCR)—for the surgical treatment of thoracic myelopathy. Summary of Literature Review: The optimal surgical treatment of thoracic myelopathy remains a matter of debate. Materials and Methods: Fifty-two patients with thoracic myelopathy who underwent surgical decompression and fusion (PVCR: 20 cases, AP: 11 cases, PWCR: 21 cases) were included in the analysis. For the radiological analysis, anterior vertebral height (AVH), posterior vertebral height (PVH), and the local kyphotic angle (LKA) were measured. The operation time and intraoperative blood loss were evaluated. A clinical analysis was conducted by comparing the neurological improvement and complication rates. Results: LKA was 17.42° preoperatively, 4.23° postoperatively, and 8.86° at the last follow-up. The PVCR group showed a significantly greater correction of kyphosis (16.94°) than the AP (5.1°) and PWCR (1.52°) groups in postoperative follow-up examinations (p<0.001). No differences were found in the change in AVH. However, PVH decreased postoperatively in the PVCR group (p=0.001). The operation time was longer in the AP group (436 min, p<0.001), and blood loss was greater in the PVCR group (1643 cc, p=0.013). Neurological function improved in all groups postoperatively, and no significant differences were observed between groups either postoperatively or final follow up. Conclusions: All three surgical techniques (PVCR, AP, and PWCR) were effective for the surgical treatment of thoracic myelopathy. PVCR was useful for kyphosis correction, but had greater blood loss. All three techniques led to improvements in neurological status.

한국 고압 의학의 현황 및 발전 방향

이성민,허탁,김기운,김현 대한의사협회 2022 대한의사협회지 Vol.65 No.4

Background: The indications of hyperbaric oxygen therapy (HBOT) covered by the health insurance in Korea increased to 16 in 2019, which includes acute central retinal artery obstruction within 24 hours of vision loss; anemia due to excessive bleeding, since blood transfusion is impractical; chronic refractory osteomyelitis (Wagner grade ≥3); and intracranial abscess. Current Concepts: HBOT affects the treatment in the primary and secondary mechanisms. According to the Boyle’s law, the primary mechanism is important in treating decompression sickness and intravascular air embolism by decreasing the volume of air bubbles when pressure increases, whereas the secondary mechanism involves hyperoxygenation of the primary mechanism and various effects, such as vasoconstriction, angiogenesis, immune function enhancement, reperfusion injury prevention, antimicrobial action, and gas washout effect, occur. In the past 5 years, domestic HBOT has made significant progress. However, there are many non-therapeutic low pressure HBOT facilities that are limited by insurance coverage issues, quality equipment management, and medical personnel in HBOT facilities. Discussion and Conclusion: To solve the problem, the introduction of the definition of therapeutic hyperbaric pressure and certification system of HBOT facilities must be initiated. Moreover, the system should be improved so that insurance can be applied for a more indication of HBOT.