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박원욱(Weon Wook Park),남태욱(Tae Wook Nam),김정태(Jeong Tae Kim),박종호(Jong Ho Park),박동욱(Dong Wook Park),이정섭(Jung Sub Lee),강동준(Dong Joon Kang) 대한정형외과학회 2004 대한정형외과학회지 Vol.39 No.1
목적: 전방 유리술 및 후방교정술이 필요한 척추측만증에 대하여 전방 유리술의 방법 중,개흉술과 흉강경술의 결과를 후향적으로 비교하였다. 대상 및 방법: 전방 유리술과 후방 교정술이 필요한 22예의 척추측만증에서 개흉술을 통한 전방 유리술을 시행한 1군(10예)과 흉강경을 이용한 전방 유리술을 시행한 2군(12예)을 대상으로 출혈량, 수술시간, 전방 유리술 후 1주일째와 최종 추 시시에 확인되는 흉통의 시각적 상사 척도, 주만곡의 교정률 및 합병증 등을 비교 분석하였다. 후방 교정술은 전방 유리술 2주 후에 시행되었다. 사용된 통계학적 검증 방법은 t-검증 또는 Mann-Whitney 검증이었다. 결과: 평균 출혈량은 1군이 268.0 mL (200-530), 2군이 195.0 mL (100-280)로 1군에서 많았다(p=0.047). 평균 수술시간은 1군이 108.0분(90-180), 2군이 175.0분(120-240)이었다(p=0.001). 시각적 상사 척도를 이용한 전방 유리술 후 1주일째와 최종 추시시에 확인된 평균 흉통은 1군에서 각각 5.8 (4-8), 3.1 (1-5)이었고(p=0.005), 2군에서 3.9 (3-6), 1.6 (0-3)이었다(p=0.013). 후방 교정술 후 교정률은 두 군에서 비슷하였으며, 미용상으로는 2군이 우수하였다. 수술후 합병증으로 두 군에서 1예씩의 기흉이 생겼으며, 1군 중 3예에서 만성 흉통을 호소하였다. 결론: 흉강경을 이용한 전방 유리술이 개흉술을 이용한 전방 유리술에 비하여 수술 시간은 길었으나 수술 후 출혈량이 적었고, 수술 후 및 최종 추시시의 흉통이 작았으며, 미용상으로 우수하였다. Purpose: To compare the results of the thoracoscopic approach and open thoracotomy retrospectively for scoliosis requiring anterior release and fusion followed by posterior correction. Materials and Methods: Of 22 rigid scoliosis patients, 10 open thoracotomy cases (group Ⅰ) were compared with 12 thoracoscopic cases (group Ⅱ) in terms of blood loss, operation time, and chest pain (visual analogue scale, VAS), as checked 1 week after operation and final follow-up, correction ratio of major curve and complications. Posterior correction was performed 2 weeks after anterior release. Statistical analysis of group differences was performed using the t-test or the Mann-Whitney. Results: Blood loss was higher in group Ⅰ, 268.0 mL (200-530) than in group Ⅱ, 195.0 mL (100-280) (p=0.047). The operation time was shorter in group Ⅰ, 108.0 minutes (90-180) than in group Ⅱ, 175.0 minutes (120-240) (p=0.001), and chest pain (visual analogue scale, VAS) which was checked at 1 week after operation and at final follow-up was milder in group Ⅱ, 3.9 (3-6), 1.6 (0-3) than in group Ⅰ, 5.8 (4-8), 3.1 (1-5) (p=0.005, p=0.013, respectively). The correction ratios of the major curve between two groups were similar. The cosmetic aspects of the thoracoscopic approach were favorable. The postoperative complications were 1 pneumothorax in each group and 3 chronic chest pain in group Ⅰ. Conclusion: The results of thoracoscopic approach for anterior release were compared favorably with standard open thoracotomy in terms of blood loss, chest pain both postoperatively and at final follow-up, and cosmetics, but unfavorably for operation time.
10년간 10, 11세 청소년에서의 특발성 척추 측만증 유병률 연구
안기찬(Ki Chan An),박대현(Dae Hyun Park),공규민(Gyu Min Kong),김주용(Joo Yong Kim),진성엽(Sung Yub Jin),이운성(Woon Seong Lee),김대유(Dae You Kim),하은정(Eun-Jung Ha),이규열(Kyu Yeol Lee),박원욱(Weon Wook Park),이정섭(Jung Sub Lee) 대한정형외과학회 2015 대한정형외과학회지 Vol.50 No.1
목적: 10년간 10, 11세 청소년을 대상으로 특발성 척추 측만증에 대한 학교 검진을 실시하여 유병률, 만곡의 크기, 유형 등에 대해 조사하였다. 대상 및 방법: 2002-2011년 동안 10, 11세 청소년 총 413,351명에 대해 선별검사로 모아레 검진법을 실시하였고, 선별된 피검자에 대해 단순 기립 척추 전장 방사선 사진을 촬영하였다. Cobb 각도 10o 이상을 측만증으로 판정하였으며 만곡의 크기, 위치 및 유형 등을 기록하였다. 결과: 10년간 전체 유병률은 평균 0.4% (0.3%-0.5%)였으며, 연도별 유병률은 큰 변화 추이가 없었다. 10년간 남녀의 유병률은 1.0:3.8이었으며 만곡의 크기는 10o-19o가 71%, 20o-29o가 24%, 30o-39o가 4%였다. Type III가 45%로 가장 많았고 type IV가 35%, type II가 11%, type I이 7% 및 type V가 5%로 조사되었다. 결론: 10, 11세 척추 측만증 유병률은 10년 동안 유사하였지만, 이전의 연구와는 차이를 보였다. 만곡의 크기, 위치 및 유형은 기존연구와 유사하였다. 기존 연구들과의 유병률의 차이는 선별검사가 원인으로 생각되며, 효과적인 선별검사에 대한 추가적인 연구가 필요하다. Purpose: School screening for adolescent idiopathic scoliosis (AIS) was conducted for 10 years and the prevalence of scoliosis as well as the size and types of curvature were investigated. The outcomes and existing research results were comparatively analyzed and the usefulness of the moire topography as a screening tool was evaluated. Materials and Methods: Moire topography was used in screening of 413,351 10- and 11-year-old from 2002 to 2011; simple standing entire spine x-rays of selected examinees were taken. When the Cobb angle was 10° or higher, the condition was deemed to be scoliosis, and the size, location, and types of curvature were recorded. Results: The average prevalence over the 10 years was 0.4% (0.3%-0.5%) and the trends in yearly prevalence did not change significantly. The ratio of boys-to-girls prevalence rates for the 10 years was 1.0:3.8. The rate of those with scoliosis whose curvature was 10°-19°, 20°-29°, and 30°-39° was 71%, 24%, and 4%, respectively. King-Moe type III accounted for the largest portion at 45%, followed by type IV at 35%, type II at 11%, type I at 7%, and type V at 5%. Conclusion: The prevalence of scoliosis in the subjects was similar for the 10 years but differed from previous research results. The size, location, and types of curvature were similar to those reported in previous research. The differences in prevalence from existing research are considered to be due to the screening method used. Therefore, conduction of additional research on effective screening tests is necessary.
무시멘트 인공고관절 전치환술에서 술전 templating과 술후 측정치의 비교
서근택 ( Kuen Tak Suh ),천상진 ( Sang Jin Cheon ),박원욱 ( Weon Wook Park ) 대한고관절학회 1996 Hip and Pelvis Vol.8 No.2
Preoperative templating has become more valuable and important recently that the limb length discrepancy that can happen after total hip arthroplasty not only causes the adverse effects such as increased energy expenditure in gait, cosmetically disturbing gait, scoliosis, low back problems, and late degenerative arthritis of the opposite hip but also can evoke legal problems. In order to find out whether we can minimize the severity and the frequency of postoperative limb length discrepancy by using preoperative templating, we studied the differences between preoperative templating done before total hip arthroplasty and postoperative assessment. Preoperative predictive value of corrective change of leg length was +4.9 mm, postoperative assessed value of corrective change of leg length was +4.7 mm on an average, showing that the difference between them is only 0.2 mm. Preoperatively planned sizes of acetabular cup and femoral stem templating showed high coincidence rate with those sizes used intraoperatively. Therefore, an accurate and careful preoperative templating can lead to reconstructing balanced hips by the intended correction of leg length differences.
양측 도약성 흉추 관절돌기 탈구 : 1례 보고 A Case Report
박원욱,이창범,김영호 대한척추외과학회 1998 대한척추외과학회지 Vol.5 No.1
Bilateral jumped facets dislocation in upper thoracic spine is rare injury because the thoracic spine is relatively immobile structure. We experienced a case of T2-3 dislocation without fracture and successfully reduced the dislocation after partial resection of the superior articular process of the third thoracic spine and performed fixation and fusion from T1 to T4 with pedicle screw system.