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Lumbar Spine Fracture Secondary to a Virtual Reality Game: A Case Report 虚拟实境游戏致腰椎骨折1例报告
Pub Date : 2020-12-01 DOI: 10.4184/JKSS.2020.27.4.147
Ho Sung Han, Jemin Yi
Study Design: Case report. Objectives: We report a case of lumbar spine fracture sustained during a virtual reality (VR) game. Summary of Literature Review: As video games have evolved, so have video game-related injuries. Because VR gamers wear headsets that block their ability to see the surroundings, it is thought that VR gamers are more at risk than previous video gamers. However, no VR game–related injuries have yet been reported. Materials and Methods : A 53-year-old man sustained a lumbar spine fracture during a VR game. Because the game simulated his fall from a building, he lost his balance and fell down on the floor. A compression fracture of the third lumbar vertebra was demonstrated by imaging and conservative management using rigid orthosis was done. Results: At a 1-year follow up, computed tomography showed complete bone union of L3. Conclusions: Even though the activity was simulated, the resulting injury was all too real. Clinicians should never underestimate the risk of VR game injuries and should consider them in the differential diagnosis of musculoskeletal injuries.
研究设计:病例报告。目的:我们报告一个在虚拟现实(VR)游戏中腰椎骨折的病例。随着电子游戏的发展,与电子游戏相关的伤害也在不断发展。因为虚拟现实游戏玩家戴着耳机,阻挡了他们看到周围环境的能力,所以人们认为虚拟现实游戏玩家比以前的电子游戏玩家更危险。然而,目前还没有VR游戏相关伤害的报道。材料和方法:一名53岁男性在玩VR游戏时腰椎骨折。因为游戏模拟了他从建筑物上摔下来,他失去了平衡,摔倒在地板上。第三腰椎压缩性骨折经影像学证实,采用刚性矫形器进行保守治疗。结果:在1年的随访中,计算机断层扫描显示L3骨完全愈合。结论:尽管这些活动是模拟的,但造成的伤害却是真实的。临床医生不应低估VR游戏损伤的风险,并应在肌肉骨骼损伤的鉴别诊断中考虑它们。
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引用次数: 0
The Effectiveness of Decompression Surgery on Low Back Pain in Patients with Central Lumbar Spinal Stenosis 减压手术治疗中枢性腰椎管狭窄症腰痛的疗效观察
Pub Date : 2020-11-09 DOI: 10.21203/rs.3.rs-102430/v1
Sangbong Ko, Jaejun Lee, Junho Nam
Background: Patients with central lumbar spinal stenosis (CLSS) complain of not only the lower leg symptoms but also low back pain (LBP) simultaneously in many cases. Therefore, patients who undergo decompressive surgery expect recovery from LBP as well as lower leg symptoms, and surgeons who perform decompression surgery are making efforts to improve both symptoms. The objective of this study is to investigate whether decompression surgery can improve low back pain and symptoms of lower limb pain in patients with one level central lumbar spinal stenosis.Methods: The present study included 39 patients who had findings of central lumbar spinal stenosis and underwent decompression surgery due to its corresponding claudication and lower leg radiating pain complaints from 2013 to 2018. Their pain (lower leg radiating pain and low back pain) and functional outcomes (Oswestry Disability Index (ODI), Roland–Morris Disability Questionnaire (RMDQ), and Short Form-36 (SF-36)) were evaluated before surgery and 6 and 12 months after surgery.Results: Mean lower leg radiating pain continuously showed statistically significant improvement (p < 0.05, p = 0.003); however, the clinical significance of differences above minimum clinically important difference (MCID) was up to 6 months. Mean low back pain was 4.72 ± 3.40 before surgery, 2.33 ± 2.27 at 6 months after surgery, and 2.21 ± 2.02 at 12 months after surgery, showing statistically and clinically significant improvement (p < 0.05) up to 6 months after surgery, after which there were no findings of improvement. Conclusion: Decompression surgery for patients with central lumbar spinal stenosis showed clinically significant improvements in lower leg radiating pain and low back pain up to 6 months after surgery and continuous improvements in lower leg radiating pain up to 12 months, but there was no continuous improvement in LBP.
背景:中枢性腰椎管狭窄症(CLSS)患者在许多病例中不仅有下肢症状,而且同时有腰痛(LBP)。因此,接受减压手术的患者期望从LBP和下肢症状中恢复,而进行减压手术的外科医生正在努力改善这两种症状。本研究的目的是探讨减压手术是否可以改善一节段中央腰椎管狭窄患者的腰痛和下肢疼痛症状。方法:本研究纳入2013年至2018年39例因相应的跛行和下肢放射痛主诉而出现中央腰椎管狭窄并行减压手术的患者。术前、术后6个月和12个月评估患者的疼痛(下肢放射痛和腰痛)和功能结局(Oswestry残疾指数(ODI)、Roland-Morris残疾问卷(RMDQ)和SF-36)。结果:下肢放射痛持续平均改善有统计学意义(p < 0.05, p = 0.003);而最小临床重要差异(minimum clinical important difference, MCID)以上差异的临床意义可达6个月。平均腰痛术前为4.72±3.40,术后6个月为2.33±2.27,术后12个月为2.21±2.02,术后6个月均有显著改善(p < 0.05),术后无明显改善。结论:中枢性腰椎管狭窄症患者行减压手术后,术后6个月下肢放射痛和腰痛均有临床显著改善,术后12个月下肢放射痛持续改善,但LBP无持续改善。
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引用次数: 0
Comparison of Implant Failure between Cement Augmented Cannulated Pedicle Screws and Solid Pedicle Screws and Associated Risk Factors in Lumbar Fusion Surgery: A Pilot Study 腰椎融合术中水泥增强空心椎弓根螺钉与实心椎弓根螺钉植入失败及相关危险因素的比较:一项初步研究
Pub Date : 2020-09-01 DOI: 10.4184/jkss.2020.27.3.89
S. Choi, J. M. Hur, Jooyoung You, Chang-Nam Kang
Study Design: Retrospective pilot study Objectives: To compare and analyze the rate and risk factors of implant failure according to the use of solid pedicle screws or cement augmented cannulated pedicle screws in lumbar fusion surgery. Summary of Literature Review: In previous studies, the use of cement augmented cannulated pedicle screws was found to improve the pull-out strength and to reduce the risk of implant failure in patients with osteoporosis. However, the clinical risk factors for implant failure have not been established. Materials and Methods: From January 2016 to December 2018, 177 patients with spine fracture and degenerative thoracolumbar disease were included in a retrospective study, and the patients underwent spinal fusion surgery using pedicle screws. Solid pedicle screws were used in 118 patients and cement augmented cannulated pedicle screws were used in 59 patients. During the follow-up period, simple radiography and computed tomography were performed to evaluate cases of implant failure, including pedicle screw loosening, migration, and pull-out, and to analyze risk factors for implant failure. Implant failures were observed in 21 patients (11.9%, 21/177) during the follow-up period. Of the 21 patients with implant failure, 18 were in the solid pedicle screw group (15.3%, 18/118), and 3 patients were in the cement augmented cannulated pedicle screw group (5.1%, 3/59). The difference was statistically significant (p<0.05). Age over 65 years, osteoporosis, autoimmune disease (rheumatoid arthritis, systemic lupus erythematosus, etc.), chronic kidney disease, and steroid use (<0.05) were statistically significantly more common in patients who experienced implant failure. In a multiple logistic regression analysis, age over 65 (odds ratio, 4.47; p=0.032), osteoporosis (odds ratio, 3.68; p=0.017), autoimmune disease (odds ratio, 3.59; p=0.039), and chronic kidney disease (odds ratio, 4.67; p=0.043) were statistically significant risk factors for implant failure. Conclusions: Patients underwent thoracolumbar fusion who were over 65 years of age, had osteoporosis, chronic kidney disease, or autoimmune disease showed a high implant failure rate. The use of cement augmented cannulated pedicle screws might be an effective method to significantly decrease the likelihood of implant failure in patients with these risk factors.
研究设计:回顾性先导研究目的:比较分析腰椎融合手术中使用实心椎弓根螺钉或水泥增强空心椎弓根螺钉的失败率及危险因素。文献综述:在以往的研究中发现,骨质疏松患者使用水泥增强空心椎弓根螺钉可提高其拔出强度,降低种植体失败的风险。然而,种植体失败的临床危险因素尚未确定。材料与方法:2016年1月至2018年12月,回顾性研究177例脊柱骨折合并退行性胸腰椎疾病患者,采用椎弓根螺钉行脊柱融合手术。118例患者使用实心椎弓根螺钉,59例患者使用水泥增强空心椎弓根螺钉。在随访期间,通过简单的x线摄影和计算机断层扫描来评估种植体失败的病例,包括椎弓根螺钉松动、移位和拔出,并分析种植体失败的危险因素。在随访期间,21例患者(11.9%,21/177)出现种植体失败。21例假体失败患者中,实椎弓根螺钉组18例(15.3%,18/118),水泥增强空心椎弓根螺钉组3例(5.1%,3/59)。差异有统计学意义(p<0.05)。年龄大于65岁、骨质疏松、自身免疫性疾病(类风湿关节炎、系统性红斑狼疮等)、慢性肾脏疾病、类固醇使用(<0.05)在种植体失败患者中更为常见,差异有统计学意义。在多元logistic回归分析中,年龄大于65岁(优势比4.47;P =0.032),骨质疏松症(优势比3.68;P =0.017),自身免疫性疾病(优势比3.59;P =0.039)和慢性肾脏疾病(优势比4.67;P =0.043)是种植体失败的有统计学意义的危险因素。结论:65岁以上、骨质疏松、慢性肾脏疾病或自身免疫性疾病的胸腰椎融合患者植入物失败率高。对于有这些危险因素的患者,使用水泥增强空心椎弓根螺钉可能是一种有效的方法,可以显著降低种植体失败的可能性。
{"title":"Comparison of Implant Failure between Cement Augmented Cannulated Pedicle Screws and Solid Pedicle Screws and Associated Risk Factors in Lumbar Fusion Surgery: A Pilot Study","authors":"S. Choi, J. M. Hur, Jooyoung You, Chang-Nam Kang","doi":"10.4184/jkss.2020.27.3.89","DOIUrl":"https://doi.org/10.4184/jkss.2020.27.3.89","url":null,"abstract":"Study Design: Retrospective pilot study Objectives: To compare and analyze the rate and risk factors of implant failure according to the use of solid pedicle screws or cement augmented cannulated pedicle screws in lumbar fusion surgery. Summary of Literature Review: In previous studies, the use of cement augmented cannulated pedicle screws was found to improve the pull-out strength and to reduce the risk of implant failure in patients with osteoporosis. However, the clinical risk factors for implant failure have not been established. Materials and Methods: From January 2016 to December 2018, 177 patients with spine fracture and degenerative thoracolumbar disease were included in a retrospective study, and the patients underwent spinal fusion surgery using pedicle screws. Solid pedicle screws were used in 118 patients and cement augmented cannulated pedicle screws were used in 59 patients. During the follow-up period, simple radiography and computed tomography were performed to evaluate cases of implant failure, including pedicle screw loosening, migration, and pull-out, and to analyze risk factors for implant failure. Implant failures were observed in 21 patients (11.9%, 21/177) during the follow-up period. Of the 21 patients with implant failure, 18 were in the solid pedicle screw group (15.3%, 18/118), and 3 patients were in the cement augmented cannulated pedicle screw group (5.1%, 3/59). The difference was statistically significant (p<0.05). Age over 65 years, osteoporosis, autoimmune disease (rheumatoid arthritis, systemic lupus erythematosus, etc.), chronic kidney disease, and steroid use (<0.05) were statistically significantly more common in patients who experienced implant failure. In a multiple logistic regression analysis, age over 65 (odds ratio, 4.47; p=0.032), osteoporosis (odds ratio, 3.68; p=0.017), autoimmune disease (odds ratio, 3.59; p=0.039), and chronic kidney disease (odds ratio, 4.67; p=0.043) were statistically significant risk factors for implant failure. Conclusions: Patients underwent thoracolumbar fusion who were over 65 years of age, had osteoporosis, chronic kidney disease, or autoimmune disease showed a high implant failure rate. The use of cement augmented cannulated pedicle screws might be an effective method to significantly decrease the likelihood of implant failure in patients with these risk factors.","PeriodicalId":430424,"journal":{"name":"Journal of Korean Society of Spine Surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130992376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
L1 Slope as an Indicator of Thoracolumbar Sagittal Balance in Osteoporotic Vertebral Fractures L1斜率作为骨质疏松性椎体骨折胸腰椎矢状平衡的指标
Pub Date : 2020-09-01 DOI: 10.4184/jkss.2020.27.3.96
Sang-Min Lee, Ji-Hun Park, Young-Jae Chang, Seong-Woo Shim, Sung-nyun Baek, Yong-Soo Choi
Study Design: Feasibility study. Objectives: To evaluate the association between L1 slope and thoracolumbar spinal parameters of sagittal balance in cases of osteoporotic vertebral fracture. Summary of Literature Review: Recently, interest has emerged in the sagittal parameters of the thoracolumbar spine in cases of osteoporotic vertebral fracture. Materials and Methods: Eighty-five patients were enrolled in this study, including 36 patients with recent osteoporotic vertebral fractures (group 1) and 49 patients who did not have vertebral fractures (group 2). Radiographic parameters including L1 slope, C7 plumb line (C7 PL), sagittal imbalance (C7 PL >50 mm), lumbar lordosis, thoracic kyphosis, pelvic tilt, S1 slope, local kyphotic angle were evaluated on standing lateral radiographs of the whole spine. We analyzed correlations between L1 slope and these parameters. Results: Of the sagittal parameters of the spine, the mean L1 slope, C7 PL, thoracic kyphosis, lumbar lordosis, S1 slope, pelvic tilt, and local kyphotic angle were 10.43°, 92.43 mm, 29.30°, 30.31°, 25.27°, 27.27°, 9.90° in group 1 and 9.41°, 68.50 mm, 20.09°, 23.25°, 22.03°, 31.43°, 8.21° in group 2, respectively. There were significant differences in thoracic kyphosis (p=0.01) and lumbar lordosis (p=0.04) between the two groups. L1 slope was positively correlated with thoracic kyphosis (r=0.46, p=0.01), lumbar lordosis (r=0.51, p=0.01), and local kyphotic angle (r=0.29, p=0.04) in group 1. Conclusions: These results suggest that L1 slope is a central indicator for the evaluation of thoracolumbar sagittal balance in osteoporotic vertebral fractures.
研究设计:可行性研究。目的:探讨骨质疏松性椎体骨折患者L1斜率与胸椎矢状平衡参数的关系。文献综述:最近,人们对骨质疏松性椎体骨折病例中胸腰椎的矢状面参数产生了兴趣。材料与方法:85例患者入组,其中近期骨质疏松性椎体骨折患者36例(1组),无椎体骨折患者49例(2组)。在全脊柱站立侧位片上评价L1斜率、C7铅线(C7 PL)、矢状面不平衡(C7 PL >50 mm)、腰椎前凸、胸椎后凸、骨盆倾斜、S1斜率、局部后凸角等影像学参数。我们分析了L1斜率与这些参数之间的相关性。结果:脊柱矢状面参数中,1组L1坡度、C7 PL、胸后凸、腰椎前凸、S1坡度、骨盆倾斜、局部后凸角的平均值分别为10.43°、92.43 mm、29.30°、30.31°、25.27°、27.27°、9.90°,2组为9.41°、68.50 mm、20.09°、23.25°、22.03°、31.43°、8.21°。两组患者胸椎后凸(p=0.01)和腰椎前凸(p=0.04)差异均有统计学意义。L1斜率与1组胸椎后凸(r=0.46, p=0.01)、腰椎前凸(r=0.51, p=0.01)、局部后凸角(r=0.29, p=0.04)呈正相关。结论:这些结果表明L1斜率是评估骨质疏松性椎体骨折胸腰椎矢状面平衡的中心指标。
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引用次数: 1
Thoracic Chordoma in an Atypical Location Mimicking an Esophageal Adenocarcinoma: A Case Report 异位胸椎脊索瘤与食管腺癌:1例报告
Pub Date : 2020-09-01 DOI: 10.4184/jkss.2020.27.3.109
S. Supreeth, Chang-Hee Cho, Sang-Il Kim, Young-Hoon Kim
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引用次数: 0
Percutaneous Para-Pedicular Vertebroplasty for an Uppermost Instrumented Vertebral Fracture: A Case Report 经皮椎弓根旁椎体成形术治疗上部椎体骨折1例报告
Pub Date : 2020-09-01 DOI: 10.4184/jkss.2020.27.3.103
I. Son, Jong-Suk Yoon, Hoon-Jae Chung, Min-Seok Kang
Study Design: Case report. Objectives: This case report presents a surgical technique used to perform vertebral anterior column stabilization in an elderly male patient who had recently been diagnosed with an uppermost instrumented vertebral fracture (IVF) at the site of previous posterior lumbar instrumented fusion (PIF). Summary of Literature Review: Although conservative treatment is also used for IVF, the proximal junction of PIF is an area where the compression load is concentrated biomechanically, so the uppermost IVF often requires surgical treatment. This may require fixation of extended segments and more surgical morbidity. Materials and Methods: A 73-year-old male patient who had undergone PIF from L2 to L5 more than 20 years previously was recently diagnosed with uppermost IVF without a traumatic event. He complained of persistent back pain even after 2 months of conservative treatment. He ultimately underwent percutaneous vertebroplasty through the parapedicular approach. Result: The patients showed a favorable outcome at a 1-year follow-up. Conclusions: Percutaneous vertebroplasty through the parapedicular approach for uppermost IVF at the site of a previous PIF might be a feasible and less invasive alternative.
研究设计:病例报告。目的:本病例报告介绍了一种外科技术用于椎体前柱稳定的老年男性患者,该患者最近被诊断为在先前腰椎后路内固定融合术(PIF)部位发生最上层内固定椎体骨折(IVF)。文献综述总结:虽然体外受精也采用保守治疗,但PIF近端交界处是生物力学上压缩负荷集中的区域,因此最上面的体外受精通常需要手术治疗。这可能需要延长节段的固定和更多的手术并发症。材料和方法:一名73岁男性患者,20多年前从L2到L5进行了PIF,最近被诊断为无创伤性事件的最上层体外受精。患者在保守治疗2个月后仍持续背痛。他最终通过椎弓根旁入路接受了经皮椎体成形术。结果:随访1年,患者预后良好。结论:经椎弓根旁入路的经皮椎体成形术是一种可行且侵入性较小的选择。
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引用次数: 0
Comparison of Disc Degeneration between the Cervical and Lumbar Spine 颈腰椎椎间盘退变的比较
Pub Date : 2020-06-01 DOI: 10.4184/jkss.2020.27.2.62
M. Park, S. Moon, Hyung Joon Kim, Jeong Hwan Lee, Tae-Hwan Kim, J. Oh, K. Riew
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引用次数: 0
Functional Myelography as a Diagnostic Tool in Patients with a Mismatch between Symptoms and MRI Findings 功能性脊髓造影作为症状与MRI表现不匹配患者的诊断工具
Pub Date : 2020-06-01 DOI: 10.4184/jkss.2020.27.2.55
W. Song, Young-Sang Lee, Joonha Lee, Jin Kim
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引用次数: 0
Volumetric Assessment of Fusion Mass and Its Clinical Correlations in Posterior Lumbar Interbody Fusion Depending on the Type of Bone Graft 植骨类型对腰椎后路椎间融合术融合块体积评估及其临床相关性的影响
Pub Date : 2020-06-01 DOI: 10.4184/jkss.2020.27.2.39
J. Lee, Quan You Li, K. Kang, B. Chang, Choon-Ki Lee, J. Yeom, Ho-Joong Kim
{"title":"Volumetric Assessment of Fusion Mass and Its Clinical Correlations in Posterior Lumbar Interbody Fusion Depending on the Type of Bone Graft","authors":"J. Lee, Quan You Li, K. Kang, B. Chang, Choon-Ki Lee, J. Yeom, Ho-Joong Kim","doi":"10.4184/jkss.2020.27.2.39","DOIUrl":"https://doi.org/10.4184/jkss.2020.27.2.39","url":null,"abstract":"","PeriodicalId":430424,"journal":{"name":"Journal of Korean Society of Spine Surgery","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134177775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Adhesive Arachnoiditis of the Lumbar Spine after Endoscopic Discectomy: A Case Report 内窥镜椎间盘切除术后腰椎粘连蛛网膜炎1例报告
Pub Date : 2020-06-01 DOI: 10.4184/jkss.2020.27.2.84
D. Ha, S. Oh, Baek-kyu Kim
{"title":"Adhesive Arachnoiditis of the Lumbar Spine after Endoscopic Discectomy: A Case Report","authors":"D. Ha, S. Oh, Baek-kyu Kim","doi":"10.4184/jkss.2020.27.2.84","DOIUrl":"https://doi.org/10.4184/jkss.2020.27.2.84","url":null,"abstract":"","PeriodicalId":430424,"journal":{"name":"Journal of Korean Society of Spine Surgery","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114614489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Journal of Korean Society of Spine Surgery
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