자가 이식 골-슬개건-골을 이용한 관절경하 전방 십자 인대 재건술후 경골 터널 형태의 변화

전득수,조현철,이상훈,이동연,성상철,이명철 대한슬관절학회 2002 대한슬관절학회지 Vol.14 No.1

PEEK Cage와 국소 조각골을 이용한 후방 추체간 유합술에서 한 개 Cage와 두 개 Cage 사용 후 방사선학적 및 임상적 결과 비교

전득수,신원주,이경찬 대한척추외과학회 2009 대한척추외과학회지 Vol.16 No.2

Study Design: This is a retrospective study. Objectives: We wanted to compare and evaluate the results of using one cage and two cages with local bone grafting for each segment when performing posterior lumbar interbody fusion (PLIF). Summary of Literature Review: Some authors have reported that unilateral one-caged PLIF with local bone grafting and posterior instrumentation was no difference from bilateral two-caged PLIF regard to the fusion rates and the radiologic or clinical results. Materials and Methods: From March 2005 to February 2006, PLIF was performed on 36 patients who had lumbar degenerative disease. They were categorized as the cases for which one cage was used for a segment and the cases for which 2 cages were used for a segment. The clinical and radiological results in each group were compared. Results: There was complete union in 11 segments with using one cage (55%), complete union in 12 segments using two cages (77%) and incomplete unions in 9 segments with using one cage (45%) and incomplete union in 4 segments with using 2 cages (25%), and there wasn't any case of nonunion (p>0.05). The postoperative changes of the intervertebral disc space were a 2.0 mm increase with using one cage and a 2.2 mm increase with using two cages, yet these values decreased by 0.4 mm and 0.3 mm, respectively, on the last follow-up. The mean operation time was 89 minutes for one segment with one cage and 105 minutes for one segment with two cages. The blood loss was a mean of 602 ml with one cage and 802 ml with two cages (p>0.05). There was no significant difference between the one cage group and the two cages group for the Kirkadly-Willis criteria. Conclusion: Posterior decompression and PLIF with one PEEK cage for treating degenerative lumbar disease was more effective for the operation time and the amount of blood loss than that with two cages, but the fusion rate, the alteration of the intervertebral disc space, the improvement of pain and the clinical results were no different. However, these results are from short term follow up, so continuous follow up will be necessary in the future for assessing the long term prognosis. 연구계획: 후향적 연구 연구목적: 후방 추체간 유합술에서 각 분절당 한 개의 PEEK cage를 사용한 경우와 두 개의 PEEK cage를 사용한 경우 의 방사선학적 결과 및 임상적 결과를 비교 분석하고자 하였다. 대상 및 방법: 2005년 3월부터 2006년 2월까지 퇴행성 요추 질환으로 진단받고 후방 감압술과 PEEK cage를 이용한 후방 추체 간 유합술을 시행 받은 후, 1년 이상 추시가 가능했던 36명을 후향적 방법으로 비교 분석 하였다. 1분절 수 술시 한 개의 cage를 사용한 경우 20명, 두 개의 cage를 사용한 경우 16명이었다. 최종 추시 시 단순 방사선 사진에서 유합의 정도, 수술 전후 및 최종 추시 시의 추간판 간격 변화, 수술 시간, 출혈량 및 수술 전후 요통과 방사통의 호전 을 visual analogue scale(VAS)로 평가하였고, 임상적 결과는 Kirkaldy-Willis방법으로 평가하였다. 결과: 단순 방사선 사진 상 완전 유합은 한 개의 cage를 사용한 경우 11분절(55%), 두 개의 cage는 12분절(77%), 불완 전 유합은 한 개의 cage 9분절(45%), 두 개의 cage 4분절(25%)이었고 불유합을 보이는 경우는 없었다. 두 군 간의 유 의한 차이는 없었다(p>0.05). 추간판 간격의 변화는 시술 직후 한 개의 cage 평균 2.0 mm 증가, 두 개의 cage 2.2 mm 증 가하였고, 최종 추시 시 한 개의 cage 평균 0.4 mm, 두 개의 cage 0.3 mm 침강하여 두 군 간의 유의한 차이는 없었다 (p>0.05). 수술 시간은 한 개의 cage 평균 89분, 두 개의cage 평균 105분으로 두 군 간의 유의한 차이가 있었다(p<0.05). 수술 중 출혈량은 한 개의 cage 평균 602 ml, 두 개의 cage 평균 802 ml로 두 군 간의 유의한 차이가 있었다(p<0.05). 임 상적 평가 결과에 의하면 한 개의 cage의 경우 85.0%에서, 두 개의 cage의 경우 81.3%에서 양호 이상의 결과를 보여 두 군 간의 유의한 차이는 없었다(p>0.05). 결론: 퇴행성 요추 질환으로 PEEK cage를 이용한 후방 감압 및 후방 추체간 유합술을 시행시, 한 개의 cage를 이용한 경우가 두 개의 cage를 이용한 경우 보다 수술 시간 및 출혈량은 줄일 수 있으면서, 추체간 유합율 및 추간판 간격 변 화에서는 차이가 없었고, 통증 감소의 정도와 임상적 결과에서도 차이가 없다는 결론을 얻었다. 그러나 본 연구는 단 기 추시 결과로서 향후 장기적 예후는 지속적인 추시 관찰이 요구된다.

Evaluation of a Cloverleaf Screw Head to Minimize the Slippage of Medical Screws

전득수,고흥,김영철,전차수,이상철 한국정밀공학회 2011 International Journal of Precision Engineering and Vol. No.

Slippage occurs when a screw cannot be driven because the user’s power or torque is not transmitted due to plastic deformation of the screw head socket or driver tip. In this study, we evaluated a new cloverleaf-shaped screw head to minimize the slippage of medical screws. L-clover and S-clover heads were selected as new candidates and compared with triangular, Torx®, and hexagonal screw heads. For each head, the polar moment of inertia was calculated, the stress distribution was analyzed using a finite element method, and torsion tests of physical specimens were performed to analyze their slippage characteristics. The hexagonal head, which is used most commonly in medical screws, had the lowest resistance to slippage. However, the L-clover head had the best features for minimizing the slippage of medical screws.

Practical Use of Bone Scan in Patients with an Osteoporotic Vertebral Compression Fracture

전득수,안병근,유창훈,황경훈,백제원 대한의학회 2015 Journal of Korean medical science Vol.30 No.2

Rib fractures are one of main causes of chest or flank pain when related to an osteoporoticvertebral compression fracture (OVCF). The authors investigated the incidence and riskfactors of rib fracture in 284 patients with OVCF using bone scans and evaluated thefeasibility as to whether bone scans could be utilized as a useful screening tool. Hot uptakelesions on ribs were found in 122 cases (43.0%). The factors analyzed were age, sex,number and locations of fractured vertebrae, BMD, and compression rates as determinedusing initial radiography. However, no statistical significances were found. In 16 cases(5.6%), there were concurrent multiple fractures of both the thoracic and lumbar spinesnot detected by single site MRI. Sixty cases (21.1%) of OVCF with the a compression rateof less than 15% could not be identified definitely by initial plain radiography, but wereconfirmed by bone scans. It is concluded that a bone scan has outstanding ability for thescreening of rib fractures associated with OVCF. Non-adjacent multiple fractures in boththoracic and lumbar spines and fractures not identified definitely by plain radiographywere detected on bone scans, which provided a means for determining managementstrategies and predicting prognosis.

The Relationship between the Progression of Kyphosis in Stable Thoracolumbar Fractures and Magnetic Resonance Imaging Findings

전득수,신원주,안병근,백제원,박민호 대한척추외과학회 2015 Asian Spine Journal Vol.9 No.2

Study Design: Retrospective study. Purpose: To investigate the relation between the progression of kyphotic deformity and magnetic resonance imaging (MRI) findings in conservatively treated stable thoracolumbar fractures. Overview of Literature: When treated conservatively, excessive progression of kyphotic deformity and vertebral compression can emerge during follow-up. We sought to identify predictors of vertebral body deformation using MR images. Methods: The presence in MR images of anterior longitudinal ligament (AL) or posterior longitudinal ligament (PL) injury, superior or inferior endplate disruption, superior or inferior disc injury in fractured vertebral bodies, the existence of low signal intensity on T2 weighted images, and bone edema of intravertebral bodies were assessed. Results: The presence of superior endplate disruption and a higher level of bone edema were found to cause the progressions of kyphotic angle (KA), wedge angle (WA), and anterior vertebral compression (AVC) rate. When AL or superior disc injury was observed, only KA increased meaningfully. When low signal intensity was present on T2 weighted images WA and AVC increased significantly, but PL injury, inferior endplate disruption, and inferior disc injury showed no notable correlation with kyphotic deformity progression. The risk factors found to be associated with an increase of KA to >5° were AL injury, superior endplate disruption, superior disc injury, and a bone edema level of over 1/3, and their associated risks versus no injury cases were 14.1, 3.7, 6.8, and 10.4-fold, respectively. Conclusions: AL injury, superior endplate and disc injury, or a high level of bone edema, were critical factors that determine kyphotic deformity progression.

S상-결장의 선종성 종양의 초음파검사의 접근방법

전득수,황희자 대한방사선사협회 2003 대한방사선사협회지 Vol.29 No.1

풍선 척추 성형술을 시행받은 골다공증성 척추 압박 골절 환자에서 골주사 검사의 유용성

전득수,신원주,김광희 대한척추외과학회 2008 대한척추외과학회지 Vol.15 No.1

Study Design: Retrospective study. Objectives: To compare the clinical results of kyphoplasty between osteoporotic patients with compression fractures and rib hot uptake on bone scan and patients without rib hot uptake. Summary of Literature Review: The incidence of osteoporotic rib fractures is 0.3% in postmenopausal women. Materials and Methods: Between July 2005 and July 2006, 72 kyphoplasties for osteoporotic vertebral compression fractures were performed, and all patients had a bone scan study. On bone scan study, 41 patients (57.7%) had hot uptake in their ribs. Results were assessed by visual analog scale (VAS). Results: The incidence of hot uptake was 67.8% in thoracic fractures, 40.0% in lumbar fractures, and 72.7% in thoracolumbar fractures. Hot uptake was significantly more common with thoracic and thoracolumbar fractures than with lumbar fractures (p<0.05). The incidence of hot uptake was 49.1% in one- and two-level fractures and 84.6% in over three-level fractures. This finding demonstrated significant difference between the two groups (p<0.05). The mean VAS scores for all cases were 8.2/3.4/3.2 at preoperative/immediate postoperative/after 3 months, respectively. In thoracic fractures, they were 8.2/3.9/3.1; lumbar fractures 8.0/3.2/3.1; and thoracolumbar fractures 8.3/3.7/3.0, respectively. The immediate postoperative VAS score in lumbar fractures was better than in thoracic fractures (p<0.05). The VAS scores in thoracic fractures with hot uptake were 8.3/4.1/3, and those without hot uptake were 7.8/2.8/3.0. The immediate VAS score in thoracic fractures without hot uptake was better than in those with hot uptake (p<0.05). Conclusions: Thoracic and multiple osteoporotic compression fractures are often accompanied by rib fractures. Bone scan is a useful tool to detect rib fractures and predict the prognosis of kyphoplasty.

상부 위장관 경복부 초음파검사의 유용성

전득수,Soo Jeon Deuk 대한방사선사협회 2002 대한방사선사협회지 Vol.28 No.1

PURPOSE : The purpose of this study is to evaluate the value of the transabdominal sonography of the upper GI tract together with the abdominal examination in screening test. MATERIALS & METHODS : The transabdominal sonography of the upper GI tract togeth

Asymptomatic Colon Cancer-초음파 검사에 의한 접근방법 및 유용성

전득수 대한방사선과학회(구 대한방사선기술학회) 2004 방사선기술과학 Vol.27 No.1

췌장의 초음파 검사를 위한 scanning method의 제안

전득수,황희자 대한방사선사협회 2003 대한방사선사협회지 Vol.29 No.1