• Title/Summary/Keyword: L-spine

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Herniated Lumbar Disc Combined with Spinal Intradural Extramedullary Cysticercosis

  • Choi, Kyeong-Bo;Hwang, Byeong-Wook;Choi, Won-Gyu;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • v.48 no.6
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    • pp.547-550
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    • 2010
  • Spinal cysticercosis is a very uncommon manifestation of neurocysticercosis which is caused by the larvae of Taenia solium. However, it can develop as a primary infection through blood stream or direct larval migration. It can result in high recurrence and severe neurologic morbidity if not treated appropriately. We report the case of a 43-year-old woman who presented with severe lower back pain and left leg radiating pain in recent 2 weeks. Magnetic resonance image (MRI) of lumbar spine demonstrated extruded disc at the L5-S1 level combined with intradural extramedullary cystic lesion. We performed the open lumbar microdiscectomy (OLM) at L5-S1 on the left with total excision of cystic mass. After surgery, the patient showed an improvement of previous symptoms. Diagnosis was confirmed by histopathological examination as intradural extramedullary cysticercosis. We discuss clinical features, diagnostic screening, and treatment options of spinal cysticercosis.

Radiographic Parameters of Segmental Instability in Lumbar Spine Using Kinetic MRI

  • Jang, Se-Youn;Kong, Min-Ho;Hymanson, Henry J.;Jin, Tae-Kyung;Song, Kwan-Young;Wang, Jeffrey C.
    • Journal of Korean Neurosurgical Society
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    • v.45 no.1
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    • pp.24-31
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    • 2009
  • Objective : To investigate the effectiveness of radiographic parameters on segmental instability in the lumbar spine using Kinetic magnetic resonance imaging (MRI). Methods : Segmental motion, defined as excessive (more than 3 mm) translational motion from flexion to extension, was investigated in 309 subjects (927 segments) using Kinetic MRI. Radiographic parameters which can help indicate segmental instability include disc degeneration (DD), facet joint osteoarthritis (FJO), and ligament flavum hypertrophy (LFH). These three radiographic parameters were simultaneously evaluated, and the combinations corresponding to significant segmental instability at each level were determined. Results : The overall incidence of segmental instability was 10.5% at L3-L4, 16.5% at L4-L5, and 7.3% at L5-S1. DD and LFH at L3-L4 and FJO and LFH at L4-L5 were individually associated with segmental instability (p<0.05). At L4-L5, the following combinations had a higher incidence of segmental instability (p<0.05) when compared to other segments : (1) Grade IV DD with grade 3 FJO, (2) Grade 2 or 3 FJO with the presence of LFH, and (3) Grade IV DD with the presence of LFH. At L5-S1, the group with Grade III disc and Grade 3 FJO had a higher incidence of segmental instability than the group with Grade I or II DD and Grade 1 FJO. Conclusion : This study showed that the presences of either Grade IV DD or grade 3 FJO with LFH at L4-L5 were good indicators for segmental instability. Therefore, using these parameters simultaneously in patients with segmental instability would be useful for determining candidacy for surgical treatment.

A Clinical Study on Idiopathic Scoliosis with the Dynamic Corrective Brace (Dynamic Corrective Brace를 이용한 특발성 척추측만증의 치료효과에 관한 증례보고)

  • Kim, Chang-Nyun;Yoon, Min-Young;Lee, Joo-Kang;Min, Ji-Yun;Cho, In-Hee;Kim, Tae-Soo
    • Journal of Acupuncture Research
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    • v.22 no.4
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    • pp.21-26
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    • 2005
  • Objectives : This study is designed to evaluate the Effectiveness of dynamic corrective brace on patient of idiopathic scoliosis. Methods : We have investigated 3 patients with idiopathic scoliosis, confirmed X-ray and weared dynamic corrective brace from December 2003 to December 2004. Results : After 12 months of application with dynamic corrective brace, One case, the T-spine Cobb's angle correctability was 47% and the L-spine was 84%, another case, the L-spine Cobb's angle correctability was 59%, the other case, the T-spine Cobb's angle correctability was 32% and the L-spine was 52%. Conclusion : These results suggest that the dynamic corrective brace was effective treatment modality on patient of idiopathic scoliosis.

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A Case Report of Nocturnal pain in Patients Diagnosed with HIVD of L-spine Treated by Samul-tang(Siwu-tang) Gagam and Chuna Manual Treatment (야간통을 주증으로 한 요추 추간판 탈출증 환자에 대한 사물탕가감방과 추나요법병행치료 증례보고)

  • Song, Kwang-Chan;Seo, Ji-Yeon;Cho, Myoung-Ui;Song, Seung-Bae;Moon, Hee-Young;Kwon, Ok-Jun;Ju, Yeung-Guk;Kim, Kil-Hwan
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.12 no.2
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    • pp.43-52
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    • 2017
  • Objectives : To report cases of HIVD of L-Spine successfully treated with Korean medical treatment including Samul-tang(Siwu-tang) Gagam. and Chuna manual treatment. Methods : Three patients diagnosed with HIVD of L-Spine were treated with Korean medical treatment including Samul-tang(Siwu-tang) Gagam and Chuna manual treatment. Numeric Rating Scale(NRS), Oswestry low back pain Disablility Index(ODI) scores and EQ-5D were collected before and after treatment for comparison. Results : There was a significant decrease in NRS, ODI scores.And, there was a significant increase EQ-5D. The mean NRS score decresed from 10 to 1.33, ODI from 66.66 to 8.88. Tne mean EQ-5D score incresed from 0.225 to 0.856. Conclusion : The result suggests Korean medical treatment including Samul-tang(Siwu-tang) Gagam and Chuna manual treatment can be an effective treatment on patients with HIVD of L-Spine.

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Unilateral Isthmus Resection for Elderly Foraminal Stenosis

  • Lee, Dong-Yeob;Lee, Sang-Ho;Lee, Han-Soon
    • Journal of Korean Neurosurgical Society
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    • v.41 no.3
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    • pp.207-209
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    • 2007
  • We present an elderly patient with unilateral foraminal stenosis treated by isthmus resection. An 83-year-old female could not walk due to severe leg pain along right L5 sensory dermatome. Despite the laminotomy for spinal stenosis on the right side at the L4-5 level, her leg pain did not improve. Careful review of computed tomography scans and coronal source images of magnetic resonance myelography revealed foraminal stenosis on the right side at the L5 vertebra. Because of medical problem, she underwent isthmus resection on the right side at the L5 level instead of total facetectomy and fusion. After surgery, her leg pain was markedly improved. Isthmus resection showed successful result for this medically compromised elderly patient with unilateral foraminal stenosis.

Acute Spinal Epidural Hematoma Following Unilateral Laminectomy for Bilateral Decompression

  • Lee, Dong-Yeob;Lee, Sang-Ho;Jang, Jee-Soo
    • Journal of Korean Neurosurgical Society
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    • v.40 no.1
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    • pp.35-37
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    • 2006
  • We present a case of acute spinal epidural hematoma[EDH] following unilateral laminectomy for bilateral decompression[ULBD]. A 45-year-old male presented with severe multi-level spinal stenosis underwent ULBD on the left side at the L2-3 and L3-4 level. Five hours after operation, paraparesis developed along with severe bilateral buttock pain. The CT scan showed an acute spinal EDH at the L2-3 level. The acute spinal EDH was successfully decompressed after emergency decompressive surgery with performing an additional laminectomy on the contralateral side at the L2-3 level. Although ULBD is an effective minimally invasive surgical technique for treating spinal stenosis, the possibility of acute spinal EDH should be kept in mind, as happened in our case.

Biomechanical Effect of Total Disc Replacement on Lumbar Spinal Segment : A Finite Element Analysis (추간판 치환술이 요추분절에 미치는 생체역학적 영향 : 유한요소해석)

  • Park, Won-Man;Kim, Ki-Tack;Hong, Gyu-Pyo;Kim, Yoon-Hyuk;Oh, Taek-Yul
    • Korean Journal of Computational Design and Engineering
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    • v.13 no.1
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    • pp.58-66
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    • 2008
  • The artificial discs have recently used to preserve the motion of the treated segment in lumbar spine surgery. However, there have been lack of biomechanical information of the artificial discs to explain current clinical controversies such as long-term results of implant wear and excessive facet contact forces. In this study, we investigated the biomechanical effects of three artificial implants on the lumbar spinal segments by finite element analysis. The finite element model of intact lumbar spine(L1-S) was developed and the three implants were inserted in L4-L5 segment of the spine model. 5 Nm of flexion and extension moments were applied on the superior plate of L1 with 400 N of compressive load. Excessive motions and high facet contact forces at the surgical level were generated in the all three implanted models. In the flexion, the peak von-Mises stresses in the semi-constrained type implant was higher than those in the un-constrained type implant which would cause wear on the polyethylene core. The results of the study would provide a biomechanical guideline for selecting optimal surgical approach or evaluating the current design of the implants, or developing a new implant.

The Clinical Case Report on Idiopathic Scoliosis with Chuna Therapy and Acupuncture Therapy (추나요법과 침치료를 이용한 특발성 척추측만증의 보존적 치료 치험 2례)

  • Yeom, Sun-Kyu;Jin, Eun-Seok;Jeong, Hae-Chan;Kim, Han-Kyum;Lee, Jin-Hyuk
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.5 no.2
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    • pp.77-84
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    • 2010
  • Objectives : The propose of this study is to compare X-ray Cobb각 and clinical symptoms. Methods : Clinical datas were compared Cobb각 with X-ray Full spine A.P. and lateral view. Results : After treatment, One case, the L-spine Cobb각 correctability was 93.76%, the other case, the C-T spine Cobb각 correctability was 37.49%, the T-L spine Cobb각 correctability was 85.83%. Conclusions : The result suggest that chuna and acupuncture therapy was effective treatment on patients with idiopathic scoliosis. Also we experienced improvement of symptoms to this patient.

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Percutaneous Endoscopic Interlaminar Discectomy for L5-S1 Disc Herniation: Axillary Approach and Preliminary Results

  • Lee, Seung-Cheol;Lee, Sang-Ho;Choi, Won-Chul;Choi, Gun;Shin, Song-Woo;Kaul, Richard
    • Journal of Korean Neurosurgical Society
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    • v.40 no.2
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    • pp.79-83
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    • 2006
  • Objective : The purpose of this study was to describe a surgical technique of axillary approach of percutaneous endoscopic interlaminar discectomy for L5-S1 disc herniation and its preliminary results. Methods : From July 2002 to September 2003, 101 patients with lumbar radiculopathy due to L5-S1 disc herniation, who were treated by percutaneous interlaminar endoscopic discectomy, were retrospectively reviewed. There were 57 males and 44 females with a mean age of 44.8 years [range, 18 to 62 years]. The surgery consisted of needle insertion into the epidural space via the interlaminar space, sequential dilatation, and endoscopic discectomy through the axillary area of the S1 root. Results : The mean follow-up period was 14.5 months and the average surgical time was 41 min. According to the modified Macnab criteria, 44 patients [43.6%] had excellent outcomes, 49 [48.5%] had good results and only 8 [78%] had fair or poor outcomes. Four patients had a revision microdiscectomy due to incomplete removal of disc fragment. There were no major complications related to this surgical approach. Conclusion : Axillary approach of percutaneous endoscopic interlaminar discectomy is safe and effective procedure for the treatment of L5-Sl disc herniation. It combines the advantages of MED and conventional percutaneous endoscopic discectomy.

A Study on Correlation between the Axial Section Area in Psoas Major Muscle and Nucleus Discharge Part of HIVD of L-spine (추간판 탈출증의 수핵 탈출부위와 요근의 좌우 단면적 넓이와의 상관관계)

  • Kim, Hyung-Kil;Lee, Dong-Eun;Cho, Woong-Hee;Kim, Doo-Hee;Park, Won-Hyung;Cha, Yun-Yeop;Choi, Ga-Young
    • Journal of Korean Medicine Rehabilitation
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    • v.21 no.4
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    • pp.111-118
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    • 2011
  • Objectives: This study was designed to correlation between the axial section area in psoas major muscles and uncleus discharge pat of HIVD(herniated intervertebral disc) of lumbar(L)-spine. Methods: We measured the axial section area in psoas muscles. Then through the medical charts, we investigated nucleus discharge pat of HIVD of L-spine. We analyzed the relationship between them. Results: There was no significant correlation nucleus discharge part and psoas major muscle's axial section area. There was significant correlation aging and psoas major muscle's axial section area with control the sex. Conclusions: According to above results, there was no significant the area of axial section in psoas major muscles and nucleus discharge part of HIVD of L-spine.