• Journal of Korean Physical Therapy Science
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• v.28 no.3
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• pp.42-52
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• 2021

Background: The purpose of this study was to investigate the effects of the severity and direction of lumbar disc herniation (LDH) on the facet joints and paraspinal muscles. Design: Cross-sectional design. Methods: The subjects were divided according to the diagnosis for severity of unilateral herniation of L4-L5 disc. The groups consisted of disc protrusion group (n=15), disc extrusion group (n=15), and no disc herniation group (n=15). The asymmetry and angle of facet joints and the cross-sectional area of paraspinal muscles were analyzed and compared using magnetic resonance imaging (MRI). Results: The results showed that the angle of facet tropism was larger in disc extrusion group than the disc protrusion group and the difference was found to be significant difference (p<0.01). In addition, when both left and right angles of patients with unilateral disc herniation were measured, the results showed larger facet joint angle in the herniated area of the disc extrusion group than in the disc protrusion group. When paraspinal muscles were measured according to the severity of disc herniation and the degree of facet joint asymmetry, there was no difference in paraspinal muscles between the disc protrusion and disc extrusion groups. Meanwhile, the multifidus muscle was smaller in the group with facet tropism than the group without facet tropism (p<0.03), while there were no significant differences in the erector spinae and psoas muscles. Conclusion: Progression of disc herniation resulted in increased facet joint tropism, increased angle of the facet joints in the direction of disc herniation, and decreased size of the multifidus muscle.

• Korean Journal of Radiology
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• v.22 no.10
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• pp.1690-1696
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• 2021

Objective: To describe the anatomic locations and imaging features of posterior lung herniation in unilateral pulmonary agenesis and aplasia, focusing on radiograph-CT/MRI correlation. Materials and Methods: A total of 10 patients (seven with pulmonary agenesis and three with pulmonary aplasia, male: female = 1:9, mean age 7.3 years, age range from 1 month to 20 years) were included. Chest radiographs (n = 9), CT (n = 9), and MRI (n = 1) were reviewed to assess the type of lung underdevelopment, presence of anterior and posterior lung herniation, bronchus origin, supplying artery, and draining vein of the herniated lung. Results: Pulmonary agenesis/aplasia more commonly affected the left lung (n = 7) than the right lung (n = 3). Anterior lung herniation was observed in nine of the 10 patients. Posterior lung herniation was observed in seven patients with left pulmonary agenesis/aplasia. Two patients showed posterior lung herniation crossing the midline but not beyond the aorta, and five patients showed the posteriorly herniated right lower lobe crossing the midline to extend into the left hemithorax farther beyond the descending thoracic aorta through the space between the esophagus and the aorta. This anatomical configuration resulted in a characteristic radiographic finding of a radiolucent area with a convex lateral border and a vertical medial border in the left lower lung zone, revealing a tongue-like projection on CT and MRI. Conclusion: Posterior lung herniation occurs in unilateral left lung agenesis/aplasia. Approximately 70% of the cases of posterior lung herniation reveal a unique radiolucent tongue-like projection in the left lower lung zone on imaging studies, which is caused by the extension of the posteriorly herniated right lung farther beyond the descending aorta.

• Journal of Korean Neurosurgical Society
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• v.29 no.5
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• pp.628-634
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• 2000

Objective : The introduction of MRI makes it easy to detect multiple lumbar disc herniation. However, MRI is not a physiologic test for detecting the symptomatic level. For the surgical plan, it is very important to determine the symtomatic level among the multiple lumbar disc herniation. In this regard, we studied diagnostic significance of discography on multiple lumbar disc herniation in determining the symptomatic level. Method and Material : We retrospectvely analyzed the discographic and clinical findings of 121 patients with multiple lumbar disc herniation for investigating the diagnostic availability of discography. All were surgically treated from January 1995 through May 1998. Result : Discography provocated the same pain as usual symptom in 99 out of 121 patients(81.8%). Compared with surgical findings, the diagnostic accuracy of the discography in multiple lumbar disc herniation was 75.6%, sensitivity was 64.6%, and specificity 87.2%. There was no correlation between the pain provocation of discography and the extent of annular degeneration on CT/discogram. The pain provocation showed good correlation with the extent of annular disruption on CT/discogram. The rate of same result(correlation rate) between the discography and D.I.T.I was 81.4% in multiple lumbar disc herniation patients with unilateral leg pain. Conclusion : These results indicate that in multiple lumbar disc herniation, the discography is considered useful diagnostic tool to determine the symptomatic level and to decide the surgical plan.

• Journal of Korean Medicine Rehabilitation
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• v.19 no.3
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• pp.81-90
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• 2009

Objectives : To analyze the therapeutic outcomes of back pain modalities in patients with disc herniation according to the change of Magnetic Resonanse Imaging(MRI) whom were treated with herbal medicine, chuna, acupuncture, bee-venom acupuncture. Methods : Clinical outcomes of 35 patients diagnosed with lumbar disc herniation by MRI examination, treated conservatively, were analyzed according to MRI follow-up change. Patients underwent MRI examaintion at baseline and after 24th week of treatment. Patients are divided into three groups ; improved, unchanged, worsened. 35 patients with lumbar disc herniation were treated with chuna therapy, acupuncture, bee-venom acupuncture once a week and took herbal medicine after a meal two times daily. The patients' clinical outcomes were assessed at baseline, 12th week, 24th week by Visual analogue scale(VAS), Oswestry disability index(ODI). Results : 1. MRI follow-up exams on regression of disc herniation resulted on 42.86% of cases by conservative treatment. 2. VAS(low back pain and sciatica) and ODI of disability of daily activities showed significant decrease in "improved" and "unchanged" groups compared to "worsened" group(P<0.05). 3. VAS(low back pain and sciatica) and ODI change after treatment did not show any relationship with MRI follow-up change(P<0.05). Conclusions : This study suggests that "improved" and "unchanged" groups compared to "worsened" group on MRI follow-up in patients with lumbar disc herniation were more effective when treated with herbal medicine, chuna therapy, acupuncture, bee-venom acupuncture. MRI follow-up change does not affect clinical changes in patients with lumbar disc herniation.

• Journal of Veterinary Clinics
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• v.39 no.6
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• pp.334-341
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• 2022

A decrease in the paraspinal muscle cross-sectional area (CSA) and functional cross-sectional area (FCSA) are associated with low back pain and disc herniation in humans. This study examined whether chronicity or lateralization of disc herniation affects the CSA and FCSA of the paraspinal muscles. The CSA and FCSA of the paraspinal muscles between the 12th and 13th thoracic vertebrae were measured in 31 dogs with intervertebral disc herniation (IVDH). The muscle CSA and FCSA were evaluated by dividing the values of the body weight, spinal disc CSA, and spinal canal CSA to offset the differences in body type between subjects. In the chronic IVDH group, the ratio of the paraspinal muscle CSA divided by the body weight was significantly lower, and fat infiltration in the paraspinal muscle was significantly higher than in the acute group. The lateralization of the disc herniation was significantly related to the changes in the paraspinal muscle CSA. In the right-sided disc herniation group, right epaxial muscle CSA was significantly reduced compared to the left-sided disc herniation group. The change in the paraspinal muscle might be a helpful indicator to localize less obvious disc pathologies and target the search for the pathology responsible for disc-related symptoms in dogs.

• Journal of Korean Neurosurgical Society
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• v.46 no.5
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• pp.505-510
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• 2009

The possible causes of Brown-S$\acute{e}$quard Syndrome (BSS) have been frequently observed with spinal trauma and extramedullary spinal tumors, but the cervical disc herniation to cause BSS is rare. The authors present five cases of patients who were diagnosed with BSS resulting from cervical disc herniation, and the results of the literature in view of their distinctive symptoms and clinical outcomes. Postoperatively, the patients showed complete or almost complete recovery from their motor and sensory deficits. On the basis of our cases, it is important to diagnose it early by cervical magnetic resonance imaging, especially in the absence of the typical symptoms of cervical disc herniation or other obvious etiology of extremity numbness. Immediate surgical treatment is also essential for a favorable functional neurological recovery.

• Journal of Chest Surgery
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• v.44 no.6
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• pp.455-457
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• 2011

A 70-year-old male visited urgent care due to coughing for 1 month and left chest pain. He had no history of trauma. The initial chest computed tomography (CT) showed the 7th left intercostal lung herniation. A follow-up CT showed an intercostal lung herniation combined with a bowl herniation, which had developed due to a Morgagni's hernia. An emergency operation was performed due to the incarceration of the bowl and lung. The primary repair of the diaphragm was performed and the direct approximation of the 7th intercostal space was determined. We concluded that the defect of the diaphragm and the intercostal muscle was a congenital lesion, and the recurrent coughing was the aggravating factor of herniation.

• Journal of Korean Neurosurgical Society
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• v.42 no.5
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• pp.419-420
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• 2007

Low back pain is common during pregnancy. However, the prevalence of symtomatic lumbar disc herniation is rare, and cauda equina syndrome due to disc herniation during pregnancy is even rarer. We report a rare case of lumbar disc herniation causing cauda equina syndrome during third trimester of pregnancy which successfully treated by endoscopic discectomy. This case shows that endoscopic discectomy can be the treatment option for the lumbar disc herniation during pregnancy.

• The Korean Journal of Pain
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• v.23 no.1
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• pp.51-54
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• 2010

A herniated intervertebral disc is the most common type of soft tissue mass lesion within the lumbar spinal canal. Magnetic resonance imaging (MRI) is a useful tool for the assessment of patients with lower back pain and radiating pain, especially intervertebral disc herniation. MRI findings of intervertebral disc herniation are typical. However, from time to time, despite an apparently classic history and typical MRI findings suggestive of disc herniation, surgical exploration fails to reveal any lesion of an intervertebral disc. Our patient underwent lumbar disc surgery with the preoperative diagnosis of lumbar disc herniation; however, nothing could be found during the surgical procedure, except a swollen nerve root.

• Journal of Korean Neurosurgical Society
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• v.52 no.1
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• pp.62-66
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• 2012

The authors report 2 cases of nerve root herniation after discectomy of a large lumbar disc herniation caused by an unrecognized dural tear. Patients complained of the abrupt onset of radiating pain after lumbar discectomy. Magnetic resonance imaging showed cerebrospinal fluid signal in the disc space and nerve root displacement into the disc space. Symptoms improved after the herniated nerve root was repositioned. Clinical symptoms and suggestive radiologic image findings are important for early diagnosis and treatment.