• Title/Summary/Keyword: Spinous

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The Comparison of Biomechanical Changes between Spinous Process Osteotomy and Conventional Laminectomy (극돌기 절골술과 추궁판 절제술에 대한 생역학적 비교)

  • Kang, Kyoung-Tak;Son, Ju-Hyun;Chun, Heoung-Jae;Kim, Ho-Joong
    • Proceedings of the KSME Conference
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    • 2008.11a
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    • pp.1651-1654
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    • 2008
  • Previous reports have introduced the technique of spinous process osteotomy to decompress spinal stenosis, a procedure which aims to afford excellent visualization while minimizing destruction of tissures not directly involved in the pathologic process. However, bio-mechanically it has not been investigated whether the sacrifice of posterior spinous process might have potential risk of spinal instability or not, even though supra-spinous and inter-spinous ligament are preserved. Therefore the aim of this study is to evaluate the bio-mechanical properties after spinous process osteotomiy, using finite element analysis. In the model of spinous process osteotomy the increase of stress in the disc and segmental rangesof motions were not changed significantly. It is due to the fact that the instability of lumbar spine has been maintained by the two-types of ligaments compared with the prior surgical technique. Therefore, according to the finite element result on this study, these osotetomy was considered to be a clinicallysafe surgical procedure and could not cause the instability of patient.

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Multiple Cervical Spinous Process Fractures in a Novice Golf Player

  • Kim, Sei-Yoon;Chung, Sang Ki;Kim, Dong-Yun
    • Journal of Korean Neurosurgical Society
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    • v.52 no.6
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    • pp.570-573
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    • 2012
  • Avulsion of spinous process, also called Clay-shoveler's fracture, is most prevalent among those engaged in hard physical labor. To the best of the author's knowledge, only one case of multiple spinous process fractures of the upper thoracic spine in a novice golfer has been reported. A 45-year-old female presented with intractable posterior neck pain. The patient experienced a sharp, sudden pain on the neck while swinging a golf club, immediately after the club head struck the ground. Dynamic cervical radiographic findings were C6 and C7 spinous process fractures. Magnetic resonance imaging revealed C6 and C7 spinous process fractures without spinal cord pathology. The patient was treated with pain medications and cervical bracing. The patient's pain gradually improved. The injury mechanism was speculated to be similar to Clay-shoveler's fracture. Lower cervical spinous process fractures can be associated with a golf swing. If the patient complains of long lasting neck pain and has a history of golf activity, further study should be conducted to rule out lower cervical spinous fracture.

The Comparison of Biomechanical Changes between Spinous Process Osteotomy and Conventional Laminectomy (극돌기 절골술과 추궁판 절제술에 대한 생체역학적 비교)

  • Kang, Kyoung-Tak;Chun, Heoung-Jae;Son, Ju-Hyun;Kim, Ho-Joong;Moon, Seong-Hwan;Lee, Hwan-Mo;Kim, Ka-Yeon
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.33 no.7
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    • pp.645-651
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    • 2009
  • Previous studies have introduced the technique of spinous process osteotomy to decompress spinal stenosis, a procedure which aims to afford excellent visualization while minimizing destruction of tissues not directly involved in the pathologic process. However, biomechanically it has not been investigated whether the sacrifice of posterior spinous process might have potential risk of spinal instability or not, even though supra-spinous and inter-spinous ligaments are preserved. Therefore the aim of this study is to evaluate the biomechanical properties after spinous process osteotomy, using finite element analysis. The model of spinous process osteotomy exhibited no significant increase in disc stress or change in segmental range of motion. It is due to the fact that the instability of lumbar spine has been maintained by the two-types of ligaments compared with the prior surgical technique. Therefore, according to the finite element result on this study, this osotetomy was considered to be a clinically safe surgical procedure and could not cause the instability of the lumbar spine.

The Study of Vertebral Palpation (척추부 촉진에 관한 연구)

  • Park, Youn-Ki
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.16 no.1
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    • pp.57-63
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    • 2010
  • The palpation of spinous process and transverse process of vertebra are important part of the assesment and treatment from Orthopedic manual therapy. But the palpation area is descriptive differently each of literatures. So we generally got these outcomes. : There are C2, C3, C4 and C6 process as a bony landmarks and these are important part of establish the precise location of pain appears from cervical spine. Even though C7 process regard a prominent part, it is hard to distinguish C6 and process of T1. Thru that differentiation, grab the patient's forehead and try them cervical and hyper-extension check any movement of process or put on the fingers on C7 preocess and check the movement. The palpation of thoracic spine process is the land mark which determines general level orientation in the spine easily, there are T2, T7 spinous process. However, It is depends on how do you test the patient's arm when you palpate it and it can effect on spinous process. The transverse process of C1 is the only spot for palpation in cervical spine, and T1-3, T12 transverse process can palpate it when it stands on the process. The end of T4-6, T11 is placed on middle on vertebra of transverse process and transverse process. T7-9, T10 transverse process is place on same position as spinous process which is upper part of the spine.

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Spinous Process-Splitting Hemilaminoplasty for Intradural and Extradural Lesions

  • Lee, Young-Seok;Kim, Young-Baeg;Park, Seung-Won
    • Journal of Korean Neurosurgical Society
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    • v.58 no.5
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    • pp.494-498
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    • 2015
  • Objective : To describe a novel spinous process-splitting hemilaminoplasty technique for the surgical treatment of intradural and posterior epidural lesions that promotes physiological restoration. Methods : The spinous process was split, the area of the facet lamina junction was drilled, and en bloc hemilaminectomy was then performed. After removing intradural and posterior epidural lesions, we fitted the previously en bloc-removed bone to the pre-surgery same shape, and held it in place with non-absorbable sutures. Surgery was performed on 16 laminas from a total of nine patients between 2011 and 2014. Bony union of the reconstructed lamina was assessed using computed tomography (CT) at 6 months after surgery. Results : Spinous process-slitting hemilaminoplasty was performed for intradural extramedullary tumors in eight patients and for ossification of the ligament flavum in one patient. Because we were able to visualize the margin of the ipsilateral and contralateral dura, we were able to secure space for removal of the lesion and closure of the dura. None of the cases showed spinal deformity or other complications. Bone fusion and maintenance of the spinal canal were found to be perfect on CT scans. Conclusion : The spinous process-splitting hemilaminoplasty technique presented here was successful in creating sufficient space to remove intradural and posterior epidural lesions and to close the dura. Furthermore, we were able to maintain the physiological barrier and integrity after surgery because the posterior musculature and bone structures were restored.

Studies about Anatomical Relationships between the spinous and transverse processes of the thoracic spine using 3D-CT (3D-CT를 이용한 흉추의 극돌기와 횡돌기 사이의 관계에 대한 연구)

  • Geum, Ji-Hye;Baek, Dong-Gi;Go, Hyun-Il;Ha, Won-Bae;Lee, Jung-Han
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.14 no.2
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    • pp.135-146
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    • 2019
  • Objectives : There are many theories about the anatomical relationships between the thoracic spinous and transverse processes. However, these studies were all conducted on cadavers. Thus, there might be differences when applied to living individuals. Therefore, the aim of this study was to determine whether the theories were similar when measured in living individuals. Methods : We conducted studies with 10 individuals aged 20-30 using 3D-CT. Four different measurements were taken between the thoracic spinous and transverse processes. To facilitate the relationship analysis, the spinous process positioned between the traverse process of the segment and the lower segment was set to 0.5. The spinous process located at the height of the traverse process of the lower segment was set to 1. The spinous process located between the traverse process of the lower segment and the two segments below was set to 1.5. Results : Therefore, based on the aforementioned settings, T1-T4 were 1, T5-T7 were 1.5, T8-T10 were 1, and T11 and T12 were 0.5. This indicated that the spinous processes of T1-T4 and T8-T10 were equal in height to the transverse processes of the lower segment, and that T5-T7 were at the midpoint of the height of the transverse processes between the lower segment and two segments below, and T11, T12 corresponded to the midpoint between the traverse process of the segment and the lower segment. Conclusions : Neither 'Geelhoed's rule'nor 'the rule of three'was accurate when applied to living individuals. However, this study had some limitations, so further research is needed.

Isolated Spinous Process Fracture of the $7^{th}$ Cervical Vertebrae in a Novice Golfer: a case report (골프 초보자에서 발생한 제 7경추 극돌기 골절 -1예 보고-)

  • Hwang, Jung Chul;Chung, Duke Whan
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.11 no.2
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    • pp.96-98
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    • 2012
  • Fractures of isolated spinous processes of cervical and thoracic vertebrae are called as Clay shoveler's fracture. Such fractures related to sports activities are quite rare. In this report, a case of 27-year-old male with isolated spinous process fracture of C7 during golf swing is reported. The patient was prescribed on muscle relaxant and analgesic therapy. Cervical immobilization was maintained for four weeks with a cervical collar. The patient gradually recovered and was asymptomatic. He started playing golf twice a week after 5 months from the onset of pain.

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Minimally Invasive Removal of an Intradural Cervical Tumor : Assessment of a Combined Split-Spinous Laminectomy and Quadrant Tube Retractor System Technique

  • Kwak, Young-Seok;Kim, Kyoung-Tae;Cho, Dae-Chul;Kim, Young-Baeg
    • Journal of Korean Neurosurgical Society
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    • v.52 no.4
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    • pp.427-431
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    • 2012
  • Conventional laminectomy is the most popular technique for the complete removal of intradural spinal tumors. In particular, the central portion intramedullary tumor and large intradural extramedullary tumor often require a total laminectomy for the midline myelotomy, sufficient decompression, and adequate visualization. However, this technique has the disadvantages of a wide incision, extensive periosteal muscle dissection, and bony structural injury. Recently, split-spinous laminectomy and tubular retractor systems were found to decrease postoperative muscle injuries, skin incision size and discomfort. The combined technique of split-spinous laminectomy, using a quadrant tube retractor system allows for an excellent exposure of the tumor with minimal trauma of the surrounding tissue. We propose that this technique offers possible advantages over the traditional open tumor removal of the intradural spinal cord tumors, which covers one or two cervical levels and requires a total laminectomy.

Axial Neck Pain after Cervical Laminoplasty

  • Cho, Chul-Bum;Chough, Chung-Kee;Oh, Jong-Yang;Park, Hae-Kwan;Lee, Kyung-Jin;Rha, Hyoung-Kyun
    • Journal of Korean Neurosurgical Society
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    • v.47 no.2
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    • pp.107-111
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    • 2010
  • Objective : It has been demonstrated that cervical laminoplasty is an effective and safe method of treating multi-level cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament. However, recent reports have suggested that axial neck pain is frequently encountered after cervical laminoplasty. The aim of the present study was to determine clinical significance of the C7 spinous process on axial neck pain after cervical laminoplasty. Methods : A total of 31 consecutive patients that underwent cervical laminoplasty between March 2002 and December 2008 were reviewed. The authors evaluated and compared axial neck pain and lordotic angle in patients that underwent C7 spinous process preserving surgery (group 1, n=16) and in patients in which the C7 spinous process was sacrificed (group 2, n=15). Results : Severe or moderate early axial pain occurred in 56.2% of patients in group 1 and in 86.6% in group 2. Severe or moderate late axial pain occurred in 12.5% in group 1 and in 73.3% in group 2. Eighty-Six percent of patients in group 2 and 43% in group 1 experienced aggravation of their axial neck pain during the early postoperative period. Aggravation of axial neck pain during early postoperative period was less common in group 1 but not statistically significant (p=0.073). Sixty-six percent of patients in group 2 and 12% in group 1 had aggravated axial neck pain at late postoperative period and aggravation of late axial neck pain was significantly less common in group 1 (p=0.002). Conclusion : The present study demonstrates that C7 spinous process preserving laminoplasty decreases the incidence of aggravated axial neck pain after cervical laminoplasty.

Smooth Edge Images Based on a Multilevel Morphological Filter

  • Yang, S.Q.;Jia, C.Y.
    • Proceedings of the Korea Society for Simulation Conference
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    • 2001.10a
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    • pp.95-98
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    • 2001
  • Edge detection is an important problem in computer vision and image understanding. Because the threshold is difficult to properly determine, edge images gained by the usually gradient-based segmentation methods are often tend to have many disjoint or overlapping boundaries, which makes the edge images spinous. In this paper, a practical multilevel morphological filter is presented for smoothing spinous edge images. The experimental results show that the method is effective in dealing with the images of a target in the sky.

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