No abstract available.
Absorptiometry, Photon* ; Bone Density* ; Femur* ; Osteoporotic Fractures*

We reviewed the knee radiographs of 68 cases of arthroscopically-proven discoid lateral meniscus to evaluate usefulness of plain radiographs in diagnosing discoid lateral meniscus. The subject included 42 cases of complete type and 26 cases of incomplete type discoid lateral meniscus. Knee radiographs of 70 cases which had no pathology of the meniscus in knee arthroscopy were used as controls. We excluded patients who had a significant history of trauma and who were under 16 years of age or over 60 to avoid measuring radiographs of skeletally immature or degenerative knees. The absolute values and relative normalized values of specific knee dimensions such as a squared-off appearance of the lateral femoral condyle, widened femorotibial joint space, cupping of the lateral tibial plateau, obliquity of the lateral tibial plateau articular surface, high fibular head and hypoplasia of the Iateral intercondylar spine in discoid lateral meniscus and normal controls were compared. Among these dimensions, high fibular head and widened lateral tibiofemoral joint space showed statistically significant difference between the discoid lateral meniscus group and normal control group. We suggest that these findings could be useful in screening lateral discoid meniscus in plain radiographs.
Arthroscopy ; Head ; Humans ; Joints ; Knee* ; Mass Screening ; Menisci, Tibial* ; Pathology ; Spine

No abstract available.
Absorptiometry, Photon* ; Bone Density* ; Osteoporotic Fractures* ; Spine*

This study was aimed (1) to evaluate osteoporotic vertehral fracture using normal morphometric dimensions in the Korean women (2) to test the relative importance of vertebral morphometry and fracture characteristics in predicting lumbar spine hone mineral density (3) to study clinical significance of the patients of 2 standard deviation to 3 standard deviation morphometric value. Normal morphometric data was ohtained from 60 heolthy women and 100 women with osteoporotic vertebral fracture defined by normal morphometry were evaluated. Fracture identification by 3SD cut off value was almost similar with that of qualitative method. Fracture identification by 2SD cut off value showed an increased number of fractures on the mid thoracic and thoracolumbar junction. Distrihution of the osteoporotic vertehral fracture showed double peaks on mid thoracic and thoracolumbar junction. Bone mineral density of third lumhar spine (LSBMD) in the multiple fracture group was significantly decreased from that of the single tracture group(p<0.05). LSBMD in the disperse fracture group was not different from that of the cluster fracture group(P>0.05). Comparing LSBMD of 3SD, 2SD-3SD fracture group and controls, the 3SD fracture group showed lowest value (P<0.01). But LSBMD of 2SD-3SD fracture group showed no difference with that of controls. Fracture threshold was 0.847gm/cm2 in 90th percentile. The correlation of LSBMD with the sum of normalized height of vertebral bodies, the sum of the deformity ratio of the vertebral body and spinal deformity index were all statistically insignificant.
Bone Density* ; Congenital Abnormalities ; Female ; Humans ; Osteoporosis ; Spine

Background: Bupivacaine was introduced to be a long-acting spinal anesthetic agent. It has been argued about whether the addition of epinephrine prolongs the bupivacaine action or not. The aim of this present investigation was to find out the effect of additional epinephrine on spinal anesthesia with bupivacaine. Methods: 47 patients undergoing an operation on lower extremity were randomly allocated to 2 groups. All patients were anesthetized by subarachnoid block with 0.5% bupivacaine in 8% glucose, which was mixed with 0.2 ml of normal saline in group non-E (n=24) and 0.2 ml of 1:1,000 epinephrine in group E (n=23). We evaluated blood pressure and heart rate, the sensory and motor blockade and voiding time after spinal anesthesia. Results: The systolic blood pressure (SBP) at 8 and 10 min after anesthesia were lower in group non-E than in group E (p<0.05). The trend of decreasing diastolic blood pressure was similar in both groups. The heart rate(HR) at 2 min after anesthesia was lower in group non-E than in group E (p<0.05). The sensory block in T10 was produced faster in group non-E (7 min) than in group E (11 min)(p<0.05). And the maximal sensory block level and its reaching time was T7 and 14 min in group non-E, and T8 and 17 min in group E (p=0.12, p=0.11). Two segment regression time was 124 min in group non-E, and 184 min in group E (p=011). The onset time of motor block to Bromage scale 3 was 12 min in group non-E and 16 min in group E (p=0.06). The recovery time from complete motor block to Bromage scale 1 after maximal motor block was 263 min in group non-E, and 278 min in group E. The time at which patients voided after anesthesia was 469 min in group non-E, and 466 min in group E. Three patients urinated by using a urinary catheter in each group. Conclusions: The addition of epinephrine to bupivacaine for spinal anesthesia can slow the decrease in SBP and increase the HR at early stage of anesthesia, and slow the sensory block.
Anesthesia ; Anesthesia, Spinal* ; Blood Pressure ; Bupivacaine* ; Epinephrine* ; Glucose ; Heart ; Heart Rate ; Humans ; Lower Extremity ; Urinary Catheters

No abstract available.
Tibia*

Spinal dimensions (anterior, mid, and posterior height of the vertebral body) and shape variation (wedge compression, biconcave, and crush ratio) were obtained from plain radiographs of healthy Korean men and women. The purpose of this study was to define vertebral fracture from normal spinal morphometry of Korean men and women and to compare spinal dimension between men and women. Healthy 100 men and 100 women were included in this study. Plain lateral radiographs of thoracic and lumbar vertebrae were taken with standard method. Quantitative morphometry (anterior, mid, and posterior height of the vertebral body) was performed with plain radiographs. Spinal shape variations (wedge compression, biconcave, and crush ratio) were calculated from morphometric data. Spinal dimensions and shape variation of Korean men and women were presented, and morphometric cut-off vaiues for vertebral fracture were evaluated(mean-3xSD). Spinal dimensions of men were greater than women in all level (p<0.01). Wedge compression ratios (T6, 7, 8, 9, 12, L5 level) and biconcave ratios (T12, Ll, 4, 5 level) and crush ratios (Tll, L4, L5 level) were different between men and women (p<0.01). Spinal dimensions and shape variation from quantitative morphometry can be used in objective definition of vertebral fracture which can be used in medicolegal problem, workers compensation and medical insurance.
Female ; Humans ; Insurance ; Lumbar Vertebrae ; Male ; Spine ; Workers' Compensation

No abstract available.
Femur* ; Tibia*

STUDY DESIGN: A retrospective study. OBJECTIVES: To assess the relationship between surgical outcomes and preoperative MRI findings, a retrospective review was conducted on the surgical outcomes depending on the preoperative MRI findings including type of herniation and Modic changes. SUMMARY OF LITERATURE REVIEW: In most reports, the patients that have large disc herniation were expected to have improved surgical outcomes. However, there have been controversies regarding the outcomes and Modic changes. MATERIALS AND METHODS: The retrospective review was conducted in 82 patients who underwent a discectomy for single level lumbar disc herniation. The average follow-up period was 34.2 months. Among their preoperative baseline MRI measurements, the stage of disc herniation, degree of nerve root compression, degree of dural sac compression, and Modic change of vertebral endplate were evaluated for the subsequent comparison between the preoperative and postoperative changes and ODI score. RESULTS: Patients with extrusion or sequestration type showed significant improvements compared to the patients with protrusion type disc herniation. By degree of nerve root compression, patients with root compression showed significant improvements compared to the patients who had contact type. The degree of dural sac compression revealed no correlation with changes in the ODI score. 23 of the 82 patients, the preoperative MRI showed a Modic change. Compared to the group who did not show such a Modic change, they turned out to be unrelated to the preoperative and postoperative changes in the ODI score. CONCLUSIONS: Patients who had extrusion or sequestration type disc herniation showed a better clinical improvement than protrusion type. Patients with compression type root lesion showed better clinical improvement than contact type root lesion. No correlation was noted regarding the outcomes of the surgical treatment and degree of dural sac compression or Modic changes.
Diskectomy ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging* ; Radiculopathy ; Retrospective Studies

No abstract available.