A comprehensive knowledge of spinal biomechanics is of importance for the understanding of all aspect of spinal kinematics, clinical analysis and management of spinal problems. The spine is a biomechanical structure. The spine is a composit of the motion segments including sophisticated ligaments and reinforced muscles on the back, abdomen and rib cage. With an integrity of the biomechanical structure of spine, it has fundamental biomechanical functions such as allowing the physiologic motion smoothly between the head & pelvis, resist the destructive motions by stiffening the spine, transfer the weight evenly and protect the delicate vulnerable spinal cord. The data of the biomechanical aspects enable to know the characteristics of spine, to analysis the clinical situations, and to manage the spinal problems in ideal manner so as to contribute spine in healthy.
Abdomen ; Biomechanical Phenomena ; Head ; Ligaments ; Muscles ; Pelvis ; Ribs ; Spinal Cord ; Spine

There were few reports on minor injuries such as strains of hand, wrist and elbow, but there was no report on the supracondylar fracture of the femur in Bowler. The fracture is induced if the stance motion is unbalanced during the body weight shift from the throw in bowling.
Body Weight ; Elbow ; Femur ; Hand ; Wrist

The author reviewed 67 cases having medial instability of the knee joint from 1971 to 1980 who were treated by surgery at the Department of Orthopaedic Surgery at Ewha Womans University Hospital. The author reviewed 67 cases which showed medial instability from 1971 to 1980 who had been treated by surgery in the Department of Orthopaedic Surgery at Ewha Womans University Hospital and summarized as follows. 1. The majority of the medial instability was due to rupture of medial collateral ligament with capsular ligament (43.3%), and the rest were due to rupture of tibial collateral ligament only (35.8%). 2. The medial instability also produced by rupture of the other structures of the medial side of the knee joint without tibial collateral ligament rupture. 3. The stress radiogram was important guide line for the diagnosis of the injury of the medial structures of the knee joint. 4. The degree of medial joint space opening was increased with the number of structures injured.
Collateral Ligaments ; Diagnosis ; Female ; Humans ; Joints ; Knee Joint ; Knee ; Ligaments ; Medial Collateral Ligament, Knee ; Rupture

Lumbar discography was described as the clinical diagnostic method by Lindblom in 1948, but its clinical value is still controversial. There are many false positive on lumbar discography. As CT scans are new widely available, axial discography only deserve to evaluate accureately. In 41 patients of lower back apin, radiating pain & claudication that was not improved with conservative treatment for 2 weeks, plain and axial discography were performed. The results were as follows :l. Among the 41 patients, herniated lumbar disc swere 19 cases, lumbar syndromes were 8 cases, spondylolisthesis were 8 cases and spinal stenosis were 6 cases. 2. Among the 95 level of discography, the level of L4-5 & L5-Sl were 81%. 3. The incidence of pathologic discs classified by Quinnell classification and Dallas discography description at plain axial discography were 65%, 74%, respectively. 4. Among the 19 cases of operated herniated lumbar discs, false negative and false positive plain discagraphy were 21%, 11%, respectively. And false negative axial discography is 5.3%. 5. There was a significant relationship between pain on provocation test and degeneration of discs. 6. We can confirmed the pathologic discs prior to operation.
Back Pain ; Classification ; Humans ; Incidence ; Methods ; Spinal Stenosis ; Spondylolisthesis ; Tomography, X-Ray Computed

No abstract available.
Magnetic Resonance Imaging*

In the investigation of patients with internal disc disruption, a discography has been the best method to decide whether intervertebral disc is normal or abnormal. Magnetic resonance imaging (MRI) of the spine is a new technique which offers an alternative method of obtaining this information. Some authors have reported MRI was more accurate than discography, but other reports have indicated discography was more useful test in symptomatic lumbar disc disease. The authors performed retrospective study to evaluate the diagnostic value of the image findings of MRI and discography in the internal disc disruption. Image findings of MRI and discography were analyzed comparing to pattern of provocative pain during discography. The concordant pain at discography was considered as a gold standard for evaluation of the diagnostic value of these modalities. The image findings of MRI and discography for 60 discs of 21 patients were graded and compared with the pain response at discography. The validity and predictive value (PV) of these modalities were calculated and the correlation between these image findings was evaluated. The sensitivities of discography and MRI were 83.3% and 90.9% respectively. The specificities of these findings were 47.1% and 46.7%. The positive PV of discography and MRI were 52.6% and 55.6%, and the negative PV were 80% and 87.5% respectively. There was no statistical significance in these discrepancies. The determinations of symptomatic disc level based on image findings are unreliable. The MRI can be considered as a screening test for internal disc disruption since it is non-invasive and sensitive diagnostic tool. The fusion level should be decided by the pain pattern at discography.
Humans ; Intervertebral Disc ; Magnetic Resonance Imaging* ; Mass Screening ; Retrospective Studies ; Spine

Objective: To study the relationship between the damage of the central neuron and the brain structure and function of the rats with chronic stress.Methods: Male Wistar rats(n=30) weighting about 185-255g were divided into the test group(T,n=15) and the contral group(C,n=15) randomly.The rats in group T were exposed to various types of stresses every day for consecutive 21 days.The rats in group C did not receive any stress during 21 days.Every rat was weighed,open-field tested and measured for the brain by MR before the test and on the 22nd day.Also,on the 22nd day,the brains were removed and cut coronally.The apoptosis was detected by techniques of terminal deoxynucleotibyl transferase(TdT)-mediated dUTP nick end labling(TUNEL).Results: Weight and the result of Open-field test: compared with group C,group T showed less weight,increased stopping time in the center,decreasing rearing and grooming and increased defecation after 21-day stress(P

Anterior plate fixation of the cervical spine provides good primary stability to allow early mobilization without significant external support. Despite the obvious advantages of anterior cervical fixation, neurological injury resulting from the direct trauma of a drill bit or screw are possibile with this technique. In addition, screw loosening leading to dyphagia has been reported. The cervical spine locking plate (CSLP) system maintains the mechanical advantages of internal fixation and eliminate the neurological risks of perforating the posterior cortex. The purpose of this study is to review our experience with this device, to critically assess its ability to stabilize the cervical spine, and to assess for complications associated with this device. The authors reviewed 28 consecutive patients in whom the CSLP system was applied between April 1994 to April 1995. Average age was 44 years ranged from nineteen to seventy-two. Patients with trauma were eight and degenerative diseases were twenty. Eighteen screws were inserted in C3 bodies, twenty-four in C4, forty-one in C5, thirty-six in C6, twenty-four in C7, two in Tl and nine on grafted bone. With a mean follow-up of 15 months, 27 of 28 patients went on to fusion. Mean time to fusion was three months (range 2-5). Fusion status of one patient was considered as uncertain. Three patients had screws placed in the disc rather than in bone. One patient suffered deep wound infection, which developed to tracheoesophagial fistula. No patient showed neurological injury as a result of this device.
Early Ambulation ; Fistula ; Follow-Up Studies ; Humans ; Spine* ; Transplants ; Wound Infection

Objective To study the expression levels of interlukin-18(IL-18) in the CA1 region of the hippocampus and habenular of the rats with chronic stress. Methods Male Wistar rats (n = 30) weighting about 185～255g were divided into test group (T, n = 15) and control group (C, n = 15) randomly. The rats in group T were exposed to various types of stresses every day for consecutive 21 days. The rats in group C did not receive any stress during 21 days. Weighting and open-field tests were carried out on each rat before the test and on the 22nd day. On the 22nd day, brains were removed and cut coronally. Immunohistochemistry method was used to measure the expression levels of IL-18. Results After 21 -day stress, the body weight, erection time, rearing times, horizontal crossing numbers,modifying times and defecation in group T((297.33 ±25.83)g,(5.14 ±2.02)s,(19.00 ± 9.01), (9.47 ±3.64),(3. 93 ± 1. 87)and(4. 93 ± 1. 94)) were significantly different from those of group C((322.00 ±30.34)g,(1.97 ±0.93)s,(39.80 ±18.58),(14.80 ±5.88),(7.27 ±2.87)and(1.93 ±1.16)) (P < 0.01, P < 0.05). The average optical density values of IL-18 positive cells in CA1 region and habenular in group T ((0.3923 ±0.0084 and 0.4577 ±0.0234)) were higher than that in group C ((0. 3165 ±0.0063 and 0. 3400 ±0.0097)) (P<0.01). Conclusion The expression levels of IL-18 of the hippocampus glial cells and of the habenular neurons in the rats is increase after the chronic stress.

The tibial plateau fracture is a common fracture in the knee joint. Tibial plateau fracture involves most always the articulating cartilage and produce the disability of the knee joint oftenly. The 25 cases of tibial fractures have been classified by Hohls method and analysed their clinical courses more than three month period. The 13 cases out of 25 had treated in conservative method such as plaster of Paris with or without closed reduction. Remaining 12 cases were treated operatively due to the failure of closed reduction or associated injury of major ligaments. More than 8 mm of depression or 5 mm split of the plateau fragment is classified as failure of closed reduction. Excellent end result is obtained in 21 cases with free of pain on walking and full range of joint motion without instability and muscle weakness, Three cases were classified as Good result with occasional pain on walking, range of joint motion is available more than 0~90 degree and good grade of muscle power without instability. One case was poor in result with instability of joint and pain on walking. The radiological end result of accurate reduction of fragment is not closely correlated with functional result in the treatment of tibial plateau fracture. The most important factor in the treatment of tibial plateau fracture is the exercises of the joint as early as possible.
Calcium Sulfate ; Cartilage ; Depression ; Exercise ; Joints ; Knee Joint ; Ligaments ; Methods ; Muscle Weakness ; Tibial Fractures ; Walking