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문명상,조정훈,안덕선,Mun, Myeong-Sang,Jo, Jeong-Hun,An, Deok-Seon 한국건강관리협회 2007 건강소식 Vol.31 No.1
사람의 뼈의 총 개수는 206개, 이 중 양손이 차지하는 뼈의 개수는 무려 54개이다. 말 그대로‘손바닥만한’기관에 우리 몸 전체 뼈의 25%가 들어있다는 말이다. 손은 14개의 손가락 뼈, 5개의 손바닥 뼈, 8개의 손목뼈로 구성돼 자유자재로또 정교하게 움직일 수 있다. 손에는 수많은 미세 혈류가 분포되어 있으며 모든 신체 조직과 연결된 신경을 이용해서 움직이며 또한 지식과 정보를 다루고 있는인체의 중요한 부분이기도 하다. 인체의 신비를 보여주는 우리 몸의 기관 그 첫 번째 손에 대해서 대전 선병원 정형외과 문명상 교수, 경희의료원 한방병원 부인과 조정훈 교수, 고려대 성형외과 안덕선 교수의 도움말로 알아본다.
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Radiological Assessment of Morphological Changes of Lumbar Spine: From First to 9th Decade of Life
문명상,Moon Paul S.,Kim Chae-Yeon 대한척추외과학회 2023 Asian Spine Journal Vol.17 No.5
Study Design: Analysis of lumbar spine radiograms of 1,496 Jeju islanders of Korea.Purpose: To look into the age- and gender-matched incidences of morphological changes and their severities.Overview of Literature: There have been several prior research on the prevalence and severity of age-related diseases, both related and unrelated. Those offer some fundamental clinical data for clinicians.Methods: Radiograms of 1,496 patients (555 males and 941 females) from the first to 9th decade were examined for this study. Sagittal and coronal alignment, disc space narrowing, spur formation including diffuse idiopathic spinal hyperostosis (DISH), spondylolisthesis, and ballooned discs associated with biconcave bodies due to osteoporosis were among the parameters of lumbar spine morphologies examined on high-quality radiographs by both human observers and computers.Results: The alignment of the lumbar spine altered after birth and set at growth maturity, and then the curve was maintained till the end of the 5th decade afterward and the curve gradually hypolordotic. There were three types of coronal alignment abnormalities can be seen: idiopathic, osteopathic, and discogenic (degenerative lumbar scoliosis [DLS]). DLS developed after 6th decade. There was no scoliosis associated with spondylolysis or the post-laminofacetectomy period. Disc space narrowing and corporal spur formation were not seen till the end of 3rd decade comparatively speaking, the corporal spurs generated in the non-scoliotic spine were smaller than those in the scoliotic spine. DISH began to appear in the 5th-decade patients and its incidences increased gradually afterward. Porosis-related vertebral body collapse started to happen after 6th decade. There are three different types of spondylolisthesis: anterior, posterior, and lateral. The lateral slip occurred only in the scoliotic spine. All types were related to degenerative discs.Conclusions: It has been shown that the morphology of the lumbar spine changes throughout time.
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Most Reliable Time in Predicting Residual Kyphosis and Stability: Pediatric Spinal Tuberculosis
문명상,김상재,김민수,김동석 대한척추외과학회 2018 Asian Spine Journal Vol.12 No.6
Study Design: A case study. Purpose: To assess the chronological changes of the disease-related kyphosis after chemotherapy alone, secondly to clarify the role of growth cartilage in the healed lesion on kyphosis change, and to define the accurate prediction time in assessing residual kyphosis. Overview of Literature: None of the previous papers up to now dealt with the residual kyphosis, stability and remodeling processes of the affected segments. Methods: One hundred and one spinal tuberculosis children with various stages of disease processes, age 2 to 15 years, were the subject materials, between 1971 to 2010. They were treated with two different chemotherapy formula: before 1975, 18 months of triple chemotherapy (isoniazid [INH], para-aminosalicylic acid, streptomycin); and since 1976, 12 months triple chemotherapy (INH, rifampicin, ethambutol, or pyrazinamide). The first assessment at post-chemotherapy one year and at the final discharge time from the follow-up (36 months at minimum and 20 years at maximum) were analyzed by utilizing the images effect of the remaining growth plate cartilage on chronological changes of kyphosis after initiation of chemotherapy. Results: Complete disc destruction at the initial examination were observed in two (5.0%) out of 40 cervical spine, eight (26.7%) out of 30 dorsal spine, and six (19.4%) out of 31 lumbosacral spine. In all those cases residual kyphosis developed inevitably. In the remainders the discs were partially preserved or remained intact. Among 101 children kyphosis was maintained without change in 20 (19.8%), while kyphosis decreased in 14 children (13.7%), and increased in 67 children (66.3%) with non-recoverably damaged growth plate, respectively. Conclusions: It could tentatively be possible to predict the deformity progress or non-progress and spontaneous correction at the time of initial treatment, but it predictive accuracy was low. Therefore, assessment of the trend of kyphotic change is recommended at the end of chemotherapy. In children with progressive curve change, the deformity assessment should be continued till the maturity.
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Mycobacterium Tuberculosis in Spinal Tuberculosis
문명상,김성심,문한림,김동현 대한척추외과학회 2017 Asian Spine Journal Vol.11 No.1
Even in an era of remarkable medical advances, there is an issue of why tuberculosis remains in the list of disastrous diseases, afflicting humans and causing suffering. There has not been a plausible answer to this, and it has been suggested that clinicians and medical scientists could presently not win the war against the tubercle bacilli. With regards to this issue, based on the authors’ own clinical and research experiences, in this review, the available literature was revisited in order to address the raised questions and to provide recent information on characteristics of tubercle bacilli and possible ways to more effectively treat tuberculosis.
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Effect of Congenital C4–5 Synostosis on Adjacent Mobile Segments: Radiographic Assessment
문명상,Choi Won Rak,Lim Hyuon Gyu,Jeon Seong Man,Yu Chang Geun 대한척추외과학회 2021 Asian Spine Journal Vol.15 No.2
Study Design: Prospective case series.Purpose: To assess the corporal morphology of the fused body and adjacent segment conditions.Overview of Literature: It is known that two fused vertebral bodies take the similar shape of the single body with inwaisting, with or without caudal flaring of the fused body, and that the fused body can cause the fusion disease at the adjacent segment that can be a risk factor for potential neurological compromise.Methods: Radiograms of the 11 study subjects (six men and five women), aged 22–90 years who visited the outpatients’ clinic for various neck complaints without trauma history were examined. C4–5 synostosis was an incidental finding in all the subjects.Results: All the fused bodies were inwaisted and had anterior caudal breaking but no interior corporal flaring. Adjacent segment disease was not found in eight patients aged <40 years. Disk degeneration was found at C3–4 and C5–6 in three patients each and at C6–7 in two patients. Disk degeneration was limited to the adjacent segments.Conclusions: Degenerative disk changes are associated with the natural aging process, and the corporal morphology of the fused vertebral becomes inwaisted similar to that in the single vertebrae.
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