제1-2 경추 관절 관통 나사못 고정술을 위한 제 1-2 경추부의 자기공명영상을 이용한 측정

석경수,김기택,이영호,류경남 대한척추외과학회 2003 대한척추외과학회지 Vol.10 No.2

배양된 골수 간엽 간세포에서 연골형성의 유도 및 그 포식 인자의 발현

석경수,김현우,강응식 대한정형외과학회 골.연부조직이식학회 2003 대한골.연부 조직이식학회지 Vol.3 No.1

요추부 척추분리형 척추전방전위증에서 척추경 나사못을 이용한 후외방 유합술과 전방 추체간 유합술 후 척추경 나사못 고정술의 비교

석경수,전창훈,이환모,김남현,김형찬 대한척추외과학회 1999 대한척추외과학회지 Vol.6 No.3

연구계획 : 척추경 나사못을 이용한 후외방유합술과 전방 추체간 유합술후 척추경 나사못 고정술을 시행한 요추부 척추분리형 척추전방전위증 환자에서 후향적 연구를 시행하였다. 연구목적 : 상기한 두가지 술식의 결과를 비교, 분석하여 척추분리형 척추전방전위증의 치료 방법의 선택에 도움을 주고자하는 것이다. 대상 및 방법 : 척추경 나사못을 이용한 요추 후외방유합술( 1군, 35명)과 요추 전방유합술후 척추경 나사못 고정술 ( 2군, 21명)을 시행한 척추분리형 척추전방전위증 환자중 최소 2년이상 추시가 가능하였던 5 6명을 대상으로 하였다. 두 군간에 나이, 성별, 병변 부위, 유합 분절수, 사용한 척추경 나사못 기기의 종류, 전위의 정도, 흡연력 등에는 의 의 있는 차이가 없었다. 병력과 방사선 검사를 검토하여 수술시간, 출혈량, 입원기간, 임상결과, 합병증, 유합율, 유합기간, 방사선 측정치를 비교하였다. 통계 분석은 Independent sample t-test, Paired sample t-test, Chi-square test, Fisher’sexact test로 시행하였다. 결과 : 수술 시간은 1군 202.1분, 2군 247.0분, 유합기간은 1군 4.8개월 , 2군 6.6개월로 두 군간의 수술시간, 유합기간 에는 통계적으로 의의 있는 차이가 있었으나 실혈량, 입원기간, 요통, 방사통, 유합율, 합병율에는 통계적으로 의의 있는 차이가 없었다. 두군 모두 수술후 의의 있는 정복이 되었으나 1군에서는 술후 6개월에 정복의 소실이 있었다. 2군에서는 추시 기간중 정복의 소실이 없었다. 결론 : 척추분리형 척추전방전위증에서 척추경 나사못을 이용한 요추 후외방 유합술과 요추 전방 유합술후 척추경 나사못 고정술은 임상적 결과에 있어서는 유사한 결과를 보였으나 척추경 나사못을 이용한 요추 후외방 유합술은 정복의 소실이 있었다. 따라서 정복의 소실을 방지하기 위하여 추체간 유합술을 추가하는 것이 필요할 것으로 사료되었다. Study Design : A retrospective study was performed in spondylolytic spondylolisthesis patients who had undergone posterolateral fusion with pedicle screw fixation or anterior lumbar interbody fusion with pedicle screw fixation. Objectives : To compare the clinical outcomes of posterolateral fusion with pedicle screw fixation and anterior lumbar interbody fusion with pedicle screw fixation, and to help in the selection of treatment options. Summary of Literature Review : There have been many reports regarding 360。fusion, anterior lumbar interbody fusion, posterolateral fusion, and posterior lumbar interbody fusion with or without instrumentation in spondylolytic spondylolisthesis. However, there has been no reports regarding the comparison between posterolateral fusion with pedicle screw fixation and anterior lumbar interbody fusion with pedicle screw fixation. Materials and Methods : Fifty-six patients with spondylolytic spondylolisthesis who underwent posterolateral fusion with pedicle screw fixation(group 1, 35 patients) or who underwent anterior lumbar interbody fusion with pedicle screw fixation(group 2, 21 patients) were studied. Minimum follow-up was 2 years. Demographic variables and disease state were similar between the two groups. We reviewed medical records and radiological films. We studied operating time, amount of blood loss, duration of hospital stay, clinical outcomes, complications, time at which fusion was complete, fusion rate, and radiological measurements. Results : There were no significant differences between the two groups in terms of amount of blood loss, duration of hospital stay, back pain, radiating pain, fusion rate, and complication rate. However, in the group of anterior interbody fusion with pedicle screw fixation, the operation time and the time at which fusion was complete was longer. There was significant radiological reduction loss in group 1. Conclusions : Posterolateral fusion with pedicle screw fixation was just as effective as anterior interbody fusion with pedicle screw fixation in terms of clinical outcomes, but anterior lumbar interbody fusion with pedicle screw fixation was superior to posterolateral fusion with pedicle screw fixation in terms of prevention of reduction loss. Anterior support would be helpful for the prevention of reduction loss in spondylolytic spondylolisthesis of the lumbar spine.

비만이 요추부 수술결과에 미치는 영향

석경수,김남현,이환모,강용호 대한척추외과학회 1998 대한척추외과학회지 Vol.5 No.2

Study design : A retrospective study was performed in obese and nonobese patients undergoing lumbar spine surgery. Objectives : To report perioperative complications and surgical outcomes in obese patients who underwent lumbar surgery compared with a similar consecutive control group to determine whether obesity is a predictor of poor outcome as well as a factor associated with perioperative complications in lumbar spine surgery. Summary of Literature Review : Perioperative challenges in managing the obese patient include anesthesia considerations related to impaired preoperative cardiac and respiratory function, technical difficulties associated with intubation, positioning, and gaining venous and arterial access for monitoring and administering medications. Obesity has also been implicated in delayed wound healing and thrombophlebitis. Materials and Methods : One hundred twenty seven patients with spondylolisthesis treated with decompression and fusion were retrospectively evaluated. Forty four patients were obese and remaing eighty three patients were nonobese. The operation time, amount of transfusion, duration of hospital stay and clinical outcomes were studied. Results : There were no significant differences between the obese and control groups in terms of duration of surgery (224 versus 200 min), amount of transfusion (2.6 versus 2.2 pint), duration of hospital stay (21.3 versus 19.7 days), and symptom improvement (74% versus 73%). Conclusions : Obesity is not a predictor of poor outcome as well as a factor associated with high perioperative complication rate in lumbar spine surgery.

경추부 측괴나사못 고정술을 위한 경추부 측괴의 자기공명영상을 이용한 측정

석경수,김기택,이상훈,류경남 대한척추외과학회 2002 대한척추외과학회지 Vol.9 No.2

척추의 수술적 치료 사례

석경수 대한운동사협회 2005 대한운동사협회 운동사대회자료집 Vol.2005 No.-

제 1-2 경추 후방 유합술 실패후 재수술로서 시행한 제 1-2 경추 관절 관통 나사못 고정술 -증례보고-

석경수,김기택,이상훈 대한척추외과학회 2002 대한척추외과학회지 Vol.9 No.3

강직성 척추염 환자에서 후만 변형의 교정시 Chin-brow vertical angle의 의의

석경수,김기택,김진문,정광훈 대한척추외과학회 2002 대한척추외과학회지 Vol.9 No.2

At Least One Cyclic Teriparatide Administration Can Be Helpful to Delay Initial Onset of a New Osteoporotic Vertebral Compression Fracture

석경수,이병호,이환모,문성환,김희준,김학선,박진오 연세대학교의과대학 2014 Yonsei medical journal Vol.55 No.6

Purpose: Teriparatide markedly increases bone formation and strength, while reducingthe incidence of new-onset osteoporotic vertebral compression fractures (OVCFs). In some countries, expenses for teriparatide use are covered by medical insurance for up to 6 months; however, the national medical insurance of the authors’country does not cover these expenses. This retrospective cohort study comparedthe therapeutic effects of teriparatide on the initial onset of a new OVCF aftertreatment of osteoporosis and/or related OVCFs with regard to therapeutic durations of longer than 3 months (LT3M) or shorter than 3 months (ST3M). Materialsand Methods: From May 2007 to February 2012, 404 patients who were prescribed and administered teriparatide and who could be followed-up for longer than 12 months were enrolled. They were divided into two groups depending on teriparatide duration: LT3M (n=132) and ST3M (n=272). Results: The group with the teriparatide duration of LT3M showed significantly less development of an initialOVCF within 1 year (p=0.004, chi-square). Duration of teriparatide use, body mass index, pre-teriparatide lowest spinal bone mineral density, and severity of osteoporosissignificantly affected multiple regression analysis results (p<0.05). Survivalanalysis of first new-onset OVCFs demonstrated a significantly better survivalrate for the LT3M group (log rank, p=0.005). Also, the ST3M group showed a higher odds ratio of 54.00 for development of an initial OVCF during follow-up than the LT3M group (Mantel-Haenzel common odds ratio, p=0.006). Conclusion: At least one cyclic teriparatide administration is recommended to provide a protectiveeffect against the initial onset of a new OVCF for up to one year after therapy.

노인 환자에서 척추경 나사못을 이용한 요추부 수술

석경수,이환모,김남현,박민철 대한척추외과학회 1999 대한척추외과학회지 Vol.6 No.1

연구계획 : 척추경 나사못 고정술을 시행한 노인 환자군에서 후향적 연구를 시행하였다. 연구목적 : 척추경 나사못 고정술을 시행한 노인 환자군에서의 수술 결과와 수술 전후의 합병증에 대하여 알아보 고자 한다. 대상 및 방법 : 감압술과 척추경 나사못 고정술을 시행한 60세이상의 환자중 최소 2년이상 추시가 가능하였던 33명 을 대상으로 하였다. 의무기록과 방사선 검사소견을 검토하여 나이, 성별, 이환부위, 재원기간, 수술시간, 수혈량, 임 상결과, 합병증, 술전 동반질환, 유합범위, 유합기간, 유합율을 조사하였다. 결과 : 남자 13명, 여자 20명이었고 평균 연령은 63.8 (60~74) 세이었다. 술전 진단명은 척추관 협착증 2 3례, 퇴행성 척추전방전위증 8례, 협부형 척추전방전위증 2례이었다. 유합 범위는 한분절이 21례, 다분절이 12례로 평균 1.5 분절 이었고 술전 동반질환은 16명의 환자에서 12가지 질환이 있었다. 수술시간은 평균 204.7 분, 수혈량은 2.5 파인트, 재원 기간은 17.8 일이었다. 만족스러운 임상결과는 2 7명( 81.8 % ) 에 있었고 유합율은 93.8 % 이었으며 유합기간은 평균 5.6 개 월이었다. 합병율은 21.2%, 사망률은 3 . 0 % 이었다. 술전 내과적 동반질환이 있었던 환자에서 술후 전신적 합병율이 의의있게 높았다. 결론 : 60세 이상의 노인 환자군에서 척추경 나사못을 이용한 요추부 수술은 연령과 관계없이 만족스러운 임상결 과와 높은 유합율을 얻을 수 있는 유용한 술식으로 사료되었으나 술전 동반 질환이 있던 경우 술후 전신적 합병증 의 빈도가 높았다. 따라서 술전 동반 질환이 있는 고위험 환자군에서는 술전, 술중, 술후 환자 관리에 주의를 요할 것으로 사료되었다. Study Design : A retrospective study was performed in elderly patients undergoing lumbar spinal fusion using pedicle screw fixation. Objectives : To investigate perioperative complications and surgical outcomes in elderly patients who underwent lumbar spinal fusion with pedicle screw fixation. Summary of Literature Review : There have been few reports regarding the lumbar spinal fusion using pedicle screws in the elderly, especially in the Korean literature. Materials and Methods : Thirty-three patients over 60 years of age who underwent decompression and instrumented fusion with pedicle screws were retrospectively evaluated. Minimum follow-up was 2 years. We reviewed medical records and radiological films. We studied age, sex, lesion site, duration of hospital stay, operating time, amount of transfusion, clinical outcomes, complications, preoperative co-morbidity, fusion level, time at which fusion was complete, and fusion rate. Results : The 33 patients consisted of 13 male and 20 female patients. Mean age was 63.8 (60-74) years. Preoperative diagnoses were spinal stenosis, 23, degenerative spondylolisthesis, 8, and spondylolytic spondylolisthesis, 2. Twenty-one cases involved single level and 12 cases involved multiple levels. Sixteen patients had 12 co-morbidities. The mean fusion segments were 1.5 (1-3) segments. The mean operating time was 204.7 (115-330) minutes. The mean amount of transfusion was 2.5 (0-6) pints. The mean duration of hospital stay was 17.8 (13-29) days. Satisfactory clinical outcomes were found in 27 patients (81.8%). Fusion rate was 93.8%. The time at which fusion was complete was 5.6 (3-12) months. Complication rate was 21.2%. Mortality rate was 3.0%. There was a high postoperative complication rate in patients who had had medical problems before the operation, which was statistically significant. Conclusions : Pedicle screw fixation in patients over 60 years was a useful method for the treatment of degenerative spinal disorders. However, patients with preoperative co-morbidity showed a very high medical complication rate. Therefore, careful perioperative management was recommended in high-risk elderly patients with preexisting medical problems.