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요추부 척추전위증에 대한 횡돌기간골유합술과 추체간골유합술의 비교
김영백,민병국,황성남,석종식,최덕영 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.7
Thirty patients of symptomatic unstable, medically intractable, degenerative spondylolisthesis were treated by pedicle screw with intertransverse fusion(ITF) or pedicle screw with unilateral posterior lumbar interbody fusion(UPLIF). In the ITF, multiple corticocancellous bone chips harvested from posterior iliac bone grafted on the decorticated transverse processes and lateral facet joints after adequate decompression. The UPLIF was performed through unilateral route by using two bicortical bone dowels from anterior iliac bone and chip bones from resected lamina. These two treatment modes compared in terms of symptomatic improvement, fusion rate, and other various parameters related with operation. The follow up period was ranged from 8 months to 44 months. Both procedures showed good result in symptomatic improvement(79% in ITF. 88% in UPLIF) and in fusion rate(93% in ITF. 86% in UPLIF). The UPLIF showed shorter hospital stay(16days vs. 25days). shorter operation running time(329min vs. 459min), and need less transfusion(1. 1pint vs. 3.7pints) compared with the ITF. The complication rates of both procedures were similar(36% in ITF vs. 38% in UPLIF) and all complications resolved within 2 months. The major complication of the ITF was persistent back pain, and nerve injury in the UPLIF.
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김영백,이상구,박찬우,김동준,박윤관,성낙정,안상호,안재성,신희석,이범석,김진혁,전창훈 대한의학회 2009 Journal of Korean medical science Vol.24 No.-
The criteria for the evaluation of spinal impairment are diverse, complex, and have no standardized form. This makes it difficult and somewhat troublesome to accurately evaluate spinal impairment patients. A standardized guideline was studied for the evaluation of spinal impairment, based on the American Medical Association (AMA) Guides and the McBride method. This guideline proposal was developed by specialty medical societies under the Korean Academy of Medical Sciences. In this study, the grades of impairment were assessed by dividing patients into three different categories: spinal cord impairment, spinal injury impairment and spinal disorder impairment. The affected regions of the spine are divided into three: the cervical region, the thoracic region, and the lumbosacral region. The grade of impairment was differentially evaluated according to the affected region. The restricted range of motion was excluded in the evaluation spinal impairment because of low objectivity. Even though the new Korean guideline for the evaluation of spinal impairment has been proposed, it should be continuously supplemented and revised.
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