우리들병원, SBS 세상에서 가장 아름다운 여행을 통해 의료지원

우리들병원, SBS 세상에서 가장 아름다운 여행을 통해 의료지원

​출처: 우리들병원 블로그 ,  SBS

어렸을 때부터 몸이 약해, 또래 아이들과 쉽게 어울리지 못한다는 지호..  유일한 가족인 지호 엄마 역시 교통사고 이후 허리 통증이 심각해져 일을 할 수 없는 상황.  지호를 위해서라도 하루빨리 건강해지고 싶지만 빠듯한 형편 탓에.. 근본적인 치료와 정밀검사는 엄두도 내지 못하고 있다. 안타까운 상황 속에 우리들병원에서 지호엄마의 진료에 도움을 주기로 약속했다고 합니다. 좋은 일 많이 하시네요^^ ​

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만성요통환자들을 위한 새로운 치료방법 '인트라 스파인' _우리들병원 배준석 진료부장

우리들병원 최경철 부장 SCI(E)급 논문 출판_Percutaneous endoscopic intra-annular subligamentous herniotomy for large central disc herniation: a technical case report

우리들병원 최경철 부장님이 SCI(E)급 학술지인 SPINE저널에 논문을 출판 하였습니다.
젊은환자들에게 종종 발생하는 거대디스크 탈출증의 새로운 내시경 치료방법에 대한 증례보고 입니다. 
기존에는 내시경을 섬유륜쪽으로 25도 정도 접근시켜 치료했던 것에 반해 이 거대디스크 내시경 치료법은 15도 가량만 접근하여 디스크에 가해지는 손상도 최소화 하였습니다.
논문에 수술방법이 자세히 기술되어 있으니 읽어보시면 도움이 많이 될 듯 합니다.
서지정보 클릭하시면 SPINE홈페이지로 이동합니다^^

*Title: Percutaneous endoscopic intra-annular subligamentous herniotomy for large central disc herniation: a technical case report

*Authors: Lee SH, Choi KC, Baek OK, Kim HJ, Yoo SH

*Bibliography: Spine(Phila Pa 1976). 2014 Apr 1;39(7):E473-9

STUDY DESIGN

Technical case report

OBJECTIVE

To describe the novel technique of percutaneous endoscopic herniotomy using a unilateral intra-annular subligamentous approach for the treatment of large centrally herniated discs.

SUMMARY OF BACKGROUND DATA

Open discectomy for large central disc herniations may have poor long-term prognosis due to heavy loss of intervertebral disc tissue, segmental instability, and recurrence of pain.

METHODS

▶Subjects: 6 patients treated using percutaneous endoscopic herniotomy with a unilateral intra-annular subligamentous approach (2011.01~06)

-presented with back and leg pain, and/or weakness due to a large central disc herniation were.

RESULTS

The patients experienced relief of symptoms and intervertebral disc spaces were well maintained.

The annular defects were noted to be in the process of healing and recovery.

CONCLUSION

Percutaneous endoscopic unilateral intra-annular subligamentous herniotomy was an effective and affordable minimally invasive procedure for patients with large central disc herniations, allowing preservation of nonpathological intradiscal tissue through a concentric outer-layer annular approach.

1st Disc Talk International

6월 3일에 서울 조선호텔에서 disc talk international이 개최되었습니다!
강남 우리들병원에서 주최한 행사로 척추건강에 대한 국제적인 강연입니다.
가나, 세네갈, 그리스 등 다국적의 대사 및 관계자들이 참여하여 유익한 시간을 가졌습니다^^

Threaded fusion cages for lumbar interbody fusions. An economic comparison with 360 degrees fusions

Brief reviw

*Title: Threaded fusion cages for lumbar interbody fusions. An economic comparison with 360 degrees fusions

*Author: Charles Dean Ray

*Bibliography: Spine(Phila Pa 1976). 1997 Mar 15;22(6):681-5

STUDY DESIGN

-Compared the surgical and hospitalization costs, operating times, and blood loss attributable to lumbar interbody fusions at one and two lumbar levels by the use of two device systems

:1) the Ray Threaded Fusion Cage, and 2) an anteroposterior interbody technique with pedicle screw and rod stabilization (360 degrees fusion).

-Prospective cohort study

-The clinical efficacy and complication rate of each method were similar.

OBJECTIVES

Data were analyzed to compare the newer threaded fusion cage method with the well established 360 degrees technique.

SUMMARY OF BACKGROUND DATA

-Interbody bone grafts are a proven concept to obtain solid spinal fusions.

-A variety of mechanical means are used to stabilize the graft material during the fusion growth

and have been shown to be important in facilitating both the rate and ultimate quality of the fusion.

METHODS

▶Number of Subjects: 50 patients having severe, disabling back pain with discal degeneration (1991~1995)

- Ray Threaded Fusion Cages: 25

Anteroposterior interbody fusion procedures using pedicle screws (360 degrees technique): 25

-All implants were performed by the same surgeon in the same hospital.

-All fusions were judged solid by established radiologic criteria.

-Cost comparisons were made from pertinent medical records using inflation-corrected 1995 U.S. dollars.

RESULTS

▶The average combined (surgeon, hospital, anesthesiologist) costs

*1 level  /  2 level

- threaded fusion cage: $25,171   /  $33,113

-360 degrees procedures: $41,813   /  $47,320

(difference: 40% or $16,642   /  30% or $14,207)

▶The average saving

-threaded fusion cage: $14,639 per case (total $365,975)

-360 degrees procedures: $365,966 (total)

-10 of the 360 degrees fusion cases required later instrumentation removal, adding $8,635 to the costs of each such case, a final difference of $22,889 compared with an equivalent threaded fusion cage case.

-The actual collections on threaded fusion cage cases were 81% of billed costs and the actual collections on 360 degrees cases were 73% of billed costs.

CONCLUSIONS

-Assuming that the fusion success, clinical outcome, and complication rates are sufficiently similar between these two techniques, the striking improvement in overall surgical and hospitalization costs, surgical time, and blood losses provided by the threaded fusion cage technique can be major decision points in method selection.

-Further, no threaded fusion cage case having a normal adjacent level preoperatively developed a fusion transition syndrome over a followup period from 3 to 29 months (averaging 24 months) that required a second fusion procedure, and no cage had to be removed because of instrumentation-associated pain, although each of these problems are known to occur in at lease 10% of pedicle screw implants.

Ten of the 25 (40%) 360 degrees fusion cases in this study required subsequent instrumentation removal, although no case has required adjacent level surgery for transition syndrome.