복와위 척추 고정술시 중심정맥압이 출혈량에 미치는 영향

정성삼,진동규,윤영설,조용은,윤도흠,김영수 대한신경외과학회 2003 Journal of Korean neurosurgical society Vol.33 No.2

Objective:The central venous pressure(CVP) could affect the vertebral venous pressure, which in turn may influence blood loss during lumbar spinal surgery. The authors perform prospective clinical study to investigate the influence of the CVP on the amount of intra-operative blood loss and operating time. Methods:Total 134 patients having various degenerative lumbar spinal pathology were treated by laminectomy and spinal fusion using posterior lumbar interbody fusion with cages and pedicle screws. The CVP was measured after prone positioning in all the patients. The correlation between the CVP and intra-operative blood loss and operating time were analyzed. Results:The mean CVP after prone positioning was 10 cmH2O(5-18). The mean amount of intra-operative blood loss and operating time were 1884 cc and 213 minutes, respectively. The amount of blood loss and operating time significantly increased with the extent of spinal fusion. The CVP was significantly correlated with intra-operative blood loss and operating time(p<0.05). Conclusion:With increased CVP on prone position, there is a tendency of increasing amount of blood loss and operating time. The measurement of CVP is useful in determining the position providing a bloodless field during spinal fusion. Key words:CVP;Blood Loss;Operating Time.

뇌동맥류내 코일색전술 실패 후 수술을 통한 코일 제거 및 뇌동맥류 결찰

정성삼,이재환,이규창,허승곤,김동익 대한신경외과학회 2002 Journal of Korean neurosurgical society Vol.32 No.5

전방 경추 미세 추간공 확대술의 장기 추적 결과

정성삼,정종철,박기석,정승영,박문선,하호균 대한척추신경외과학회 2010 Neurospine Vol.7 No.2

Objective: We previously reported excellent early and midterm clinical results of anterior cervical microforaminotomy (ACMF) for patients with cervical radiculopathy caused by disc herniation or foraminal stenosis. ACMF is accepted as a minimally invasive functional spinal surgery, but its long-term outcomes are unknown. The purpose of this study is to evaluate the long-term clinical and radiographic results of ACMF. Methods: We performed a questionnaire survey and retrospective analysis of 13 patients with cervical radiculopathy who underwent ACMF from 1998 to 2002. Clinical and radiographic data from these 13 patients(one-level operations in seven patients, and two-level operations in six patients) were analysed. We measured disc height, sagittal plane displacement and sagittal plane angulation to evaluate instability. Results: Thirteen patients answered the questionnaires. Mean follow-up was 77.3 months(ranged from 498 to 110 months). The surgical outcome was excellent in three patients(23%) and good in nine patients(69%). One patient had only a fair outcome, but there were no cases of recurrence, reoperation or additional surgery.Twelve of 13 patients were satisfied with the results of their surgery. On the average, the loss of disc height was 0.84mm(16.6% of preoperative disc height), increase of displacement was 0.47mm and increase of sagittal plane angulation was 0.65°. All patients maintained stability during the follow-up period. Although the patient sample included in this study is a different sample from that surveyed in our previous study of mid-term results, the long-term radiographic outcomes showed that the parameters of instability tended to decrease in comparison to those midterm results. Three-dimensional computed tomography scans showed signs indicative of bone remodeling, including regrowth of the resected bone and gradual fusion around the uncovertebral joint (UVJ) where ACMF was performed. In spite of bone regeneration around the UVJ, the neural foramen appeared to be well maintained in all patients. Conclusion: In the long-term, ACMF is clinically effective method for the treatment of cervical radiculopathy, although disc height was decreased and sagittal angulation was increased. UVJ with mild hypermobility that was apparent at midterm appears to be restored during long-term follow-up. The efficacy of this procedure should be evaluated in additional studies involving large patient series.

국내 해양에너지 시장잠재량 분석

정성삼(Sungsam Chung),김창기(Changki kim) 한국신재생에너지학회 2017 한국신재생에너지학회 학술대회논문집 Vol.2017 No.9

A Case of Ulcerative Colitis Patient with Colonic Stenosis and Enterocutaneous Fistula

정성연,김유선,옥경삼,권선옥,김진남,문정섭,강윤경,홍성우 대한장연구학회 2012 Intestinal Research Vol.10 No.4

Ulcerative colitis (UC) is one of the chronic inflammatory bowel diseases (IBD), characterized by a diffuse mucosal inflammation limited to the colon. Complications of UC include stricture, colorectal cancer, and toxic colitis. UC patients rarely present with a stenosis or fistula, and strictures develop in less than 5% of patients with UC. We present a patient with UC, accompanied by unusual complications that involved not only a stricture but also a fistula and abscess. A 49-year-old female was presented with a left flank pain and fever that had begun two weeks before admission. She had received a diagnosis of UC 20 years ago and had it treated for 2 years in a local hospital. However, she arbitrarily stopped visiting the hospital and relied on home remedies. An abdominopelvic CT scan revealed luminal narrowing and extra-peritoneal fistula formation in the descending colon. Fistula was connected with a subcutaneous abscess in the left flank. She had undergone total colectomy and ileo-anal anastomosis. On the pathologic exam, the long standing UC with severe stenosis was observed without malignant change. It cannot be emphasized enough that a correct therapeutic approach and an appropriate follow-up schedule are very important for patients with UC.

시간에 따라 변화하는 CGH의 공간 재구현

김상혁,정성락,조재철,최상삼,조규만,고성재 한국광학회 1997 한국광학회지 Vol.8 No.3

We realized CGH display of moving objects with an optical addressed spatial light modulator. CGH was calculated by the horizontal parallex method for saving a calculating time, and calculation speed was improved by making a lookup table of trigonometric function and root calculation. This lookup table was applied to a low resolution SLM, and succeeded in a simultaneous display of the three hologram images by the scanning method. 본 연구는 움직이는 물체의 컴퓨터 합성 홀로그래피(CGH)의 동영상 디스프레이를 액정형 공간광변조기(OASLM)에 의하여 시도하였다. CGH는 계산하는 시간을 줄이기 위해서 horizontal parallex 방법을 사용하였고, 또한 계산하는데 시간이 오래 걸리는 삼각함수 계산과 자승근 계산부분을 미리 lookup table로 만들어 놓음으로써 계산속도를 향상시키고 저해상도 SLM에 맞춰 lookup table을 적용시키는 방법을 개발하였다. 그리고 이미 성공한 정지영상을 연속 디스프레이하여 동영상으로 표현하였고 스캐너를 이용하여 3개의 동영상을 분리하여 동시에 디스프레이하는 데 성공하였다.

Spontaneous Cervical Epidural Hematoma Causing Brown-Sequard Syndrome

윤별희,박기석,정성삼,박문선,김승민,정승영,정종철,김한규 대한척추신경외과학회 2012 Neurospine Vol.9 No.3

Spontaneous cervical epidural hematoma (SCEH) is a rare clinical entity and has a varied etiology. Urgent surgical decompression should be done to prevent serious permanent neurologic deficits. We describe a 59-year-old female who presented with Brown-Sequard syndrome due to spontaneous cervical epidural hematoma. Initially, she was misdiagnosed as cerebrovascular accident. Cervical magnetic resonance imaging revealed epidural hematoma to the right of the spinal cord extending from C3 to C6. She later underwent surgical evacuation and had complete restoration of neurologic function. The outcome in SCEH is essentially determined by the time taken from onset of the symptom to operation. Therefore, early and precise diagnosis such as careful history taking and MRI evaluation is mandatory.

Surgical Results and Risk Factors for Recurrence of Lumbar Disc Herniation

오정태,박기석,정성삼,정승영,김승민,박문선,김한규 대한척추신경외과학회 2012 Neurospine Vol.9 No.3

Objective: Recurrent lumbar disc herniation has been defined as disc herniation at the same level, regardless of ipsilateral or contralateral herniation, with a pain-free interval greater than 6 months. The aim of this study is to analyze outcomes and identify the potential risk factors for recurrent lumbar disc herniation. Methods: The authors retrospectively reviewed the cases of 178 patients who underwent open discectomy for single-level lumbar disc herniation. Visual analogue scales and modified Macnab criteria were used to compare the clinical outcomes between the recurrent group and the non-recurrent group. Sex, age, discectomy level, degree of disc degeneration, type of disc herniation, pain-free interval after first-operation, smoking status, and trauma were investigated as potential recurrence risk factors. Results: Of the 178 patients for whom the authors were able to definitely assess symptomatic recurrence status, 18 patients(10.1%) underwent revision surgery for recurrent disc herniation. The most common level involved was L4-L5(61%) and the mean period of time to recurrence was 18.7 months (6-61 months). There were 17 cases of ipsilateral herniation and 1 case of contralateral herniation. The types of herniation for which revision surgery was done were protrusion(3 cases), and transligamentous extrusion (14 cases). There were five excellent, eight good, and two fair results. Conclusion: Repeated discectomy for recurrent disc herniation produced unsatisfactory outcomes. Factors such as sex, type of disc herniation and traumatic events were found to be significant risk factors. Objective: Recurrent lumbar disc herniation has been defined as disc herniation at the same level, regardless of ipsilateral or contralateral herniation, with a pain-free interval greater than 6 months. The aim of this study is to analyze outcomes and identify the potential risk factors for recurrent lumbar disc herniation. Methods: The authors retrospectively reviewed the cases of 178 patients who underwent open discectomy for single-level lumbar disc herniation. Visual analogue scales and modified Macnab criteria were used to compare the clinical outcomes between the recurrent group and the non-recurrent group. Sex, age, discectomy level, degree of disc degeneration, type of disc herniation, pain-free interval after first-operation, smoking status, and trauma were investigated as potential recurrence risk factors. Results: Of the 178 patients for whom the authors were able to definitely assess symptomatic recurrence status, 18 patients(10.1%) underwent revision surgery for recurrent disc herniation. The most common level involved was L4-L5(61%) and the mean period of time to recurrence was 18.7 months (6-61 months). There were 17 cases of ipsilateral herniation and 1 case of contralateral herniation. The types of herniation for which revision surgery was done were protrusion(3 cases), and transligamentous extrusion (14 cases). There were five excellent, eight good, and two fair results. Conclusion: Repeated discectomy for recurrent disc herniation produced unsatisfactory outcomes. Factors such as sex, type of disc herniation and traumatic events were found to be significant risk factors.

An Early Comparative Analysis of the Use of Autograft Versus Allograft in Anterior Cervical Discectomy and Fusion

김상용,박기석,정성삼,정승영,김승민,박문선,김한규 대한척추신경외과학회 2012 Neurospine Vol.9 No.3

Objective: The purpose of this study is to verify the usefulness of autograft versus allograft in the radiographic and clinical outcome in early period after the surgery. Methods: We performed a retrospective review of 38 patients who had undergone one- or two-level anterior cervical discectomy and fusion (ACDF) with rigid anterior plate fixation from March 2006 to May 2009. Interbody graft materials were iliac autograft (n=17) or with allograft (n=21). Fusion rate and graft collapse rate were assessed by radiographic analysis and clinical outcome was based on Odom's criteria. Results: In autograft group, 13 patients achieved successful bone fusion (65%), whereas 7 patients (31.8%) in allograft group. There was statistically significant between two groups (p<0.05). Comparing immediate postoperative radiograph with last followup, the mean graft collapse was noted 1.3mm(15.5% change) in autograft group, whereas 2.0mm(24.7% change) in allograft group. There was no statistically significant collapse rate in autograft group (p>0.05), but statistically significant in allograft group (p<0.05). Clinical outcome was excellent or good in 94.1% in autograft group, and 90.5% in allograft group. Conclusion: In study, anterior cervical interbody fusion with an allograft got a result of lower fusion rate and higher collapse rate compared with autograft in early period after surgery, and clinical outcome showed similar results in both groups. Objective: The purpose of this study is to verify the usefulness of autograft versus allograft in the radiographic and clinical outcome in early period after the surgery. Methods: We performed a retrospective review of 38 patients who had undergone one- or two-level anterior cervical discectomy and fusion (ACDF) with rigid anterior plate fixation from March 2006 to May 2009. Interbody graft materials were iliac autograft (n=17) or with allograft (n=21). Fusion rate and graft collapse rate were assessed by radiographic analysis and clinical outcome was based on Odom's criteria. Results: In autograft group, 13 patients achieved successful bone fusion (65%), whereas 7 patients (31.8%) in allograft group. There was statistically significant between two groups (p<0.05). Comparing immediate postoperative radiograph with last followup, the mean graft collapse was noted 1.3mm(15.5% change) in autograft group, whereas 2.0mm(24.7% change) in allograft group. There was no statistically significant collapse rate in autograft group (p>0.05), but statistically significant in allograft group (p<0.05). Clinical outcome was excellent or good in 94.1% in autograft group, and 90.5% in allograft group. Conclusion: In study, anterior cervical interbody fusion with an allograft got a result of lower fusion rate and higher collapse rate compared with autograft in early period after surgery, and clinical outcome showed similar results in both groups.

Long Term Clinical and Radiographic Results of Lumbar Spinal Stenosis with Grade I Degenerative Spondylolisthesis after Microsurgical Bilateral Decompression via Unilateral Laminotomy

정종철,김승민,박문선,하호균,정성삼,박기석 대한척추신경외과학회 2009 Neurospine Vol.6 No.3

Objective: The purpose of this study was to assess long-term clinical outcomes and radiographic changes in patients with lumbar spinal stenosis with grade I degenerative spondylolisthesis who underwent microsurgical bilateral decompression via unilateral laminotomy, as a minimally invasive surgery. Method: Medical records of twenty-five patients who underwent the surgery between 1999 and 2005 were retrospectively evaluated. Clinical outcomes were evaluated through interviews over telephone with standardized questionnaires. Preoperative and postoperative radiographs were taken from all patients in neutral and dynamic lateral views. The mean follow-up period after surgery was 38.5 months (range 9-57 months). Results: Seventy-two percent of patients were either pain free (48%) or doing well with occasional acetaminophens (24 %), and satisfied with the treatment. The most improved preoperative symptom was neurogenic intermittent claudication, which was ameliorated in 94.7% of patients (excellent 84.2%, good 10.5%, fair 5.3%). Postoperative vertebral slippage was also measured and appeared to be slightly increased but this was not statistically significant. Postoperative dynamic angulation did not change significantly compared to the preoperative value. Conclusion: Microsurgical bilateral decompression via unilateral laminotomy achieved a satisfactory decompression and symptomatic relief without extensive destruction of the weight-bearing structures and functional mobile segments. This treatment can be an effective modality for patients with lumbar spinal stenosis associated with mild degenerative spondylolisthesis. Objective: The purpose of this study was to assess long-term clinical outcomes and radiographic changes in patients with lumbar spinal stenosis with grade I degenerative spondylolisthesis who underwent microsurgical bilateral decompression via unilateral laminotomy, as a minimally invasive surgery. Method: Medical records of twenty-five patients who underwent the surgery between 1999 and 2005 were retrospectively evaluated. Clinical outcomes were evaluated through interviews over telephone with standardized questionnaires. Preoperative and postoperative radiographs were taken from all patients in neutral and dynamic lateral views. The mean follow-up period after surgery was 38.5 months (range 9-57 months). Results: Seventy-two percent of patients were either pain free (48%) or doing well with occasional acetaminophens (24 %), and satisfied with the treatment. The most improved preoperative symptom was neurogenic intermittent claudication, which was ameliorated in 94.7% of patients (excellent 84.2%, good 10.5%, fair 5.3%). Postoperative vertebral slippage was also measured and appeared to be slightly increased but this was not statistically significant. Postoperative dynamic angulation did not change significantly compared to the preoperative value. Conclusion: Microsurgical bilateral decompression via unilateral laminotomy achieved a satisfactory decompression and symptomatic relief without extensive destruction of the weight-bearing structures and functional mobile segments. This treatment can be an effective modality for patients with lumbar spinal stenosis associated with mild degenerative spondylolisthesis.