• Title/Summary/Keyword: Low lumbar spine

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Quantitative Ultrasound for Osteoporosis Screening in Postmenopausal Women (폐경 후 여성에서 골다공증의 조기검진도구로서 골초음파의 유용성)

  • Shin, Hee-Young;Jung, Eun-Kyung;Rhee, Jung-Ae;Choi, Jin-Su;Shin, Min-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.34 no.4
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    • pp.408-416
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    • 2001
  • Objectives : To evaluate the diagnostic value of quantitative ultrasound (QUS) in the prediction of osteoporosis as defined by dual energy x-ray absorptiometry (DEXA) in postmenopausal women. Methods : Questionnaires and height and weight measurements were used in the investigation of 176 postmenopausal women. QUS measurements were taken on the right calcaneus while bone mineral density (BMD) measurements of the lumbar spine and femoral neck were made with DEXA. The areas under the curves (AUC) of the speed of sound (SOS) for osteoporosis in the lumbar spine and femoral neck were obtained through receiver operating characteristic (ROC) analysis and evaluated. A comparison was made, for osteoporosis in the lumbar spine and femoral neck, between the AUCs of the logistic model with clinical risk factors and SOS. Results : Pearson's correlation coefficients of SOS and lumbar spine BMD, and of SOS and femoral neck BMD were 0.26 and 0.37. The AUC for the logistic model in its discrimination for lumbar spine osteoporosis was 0.764, and for SOS 0.605. The AUCs for the logistic model in its discrimination for femoral neck osteoporosis and for SOS were 0.890 and 0.892, respectively. Conclusions : These results suggest that the diagnostic value of QUS as a screening tool for osteoporosis is moderate for the femoral neck, but merely low for the lumbar spine and that the predictability provided by SOS is no better than that by the sole use of clinical risk factors in postmenopausal women.

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Lumbar Lordotic Angle Improvement by Combining Korean Medicine Treatment with Chuna Manual Therapy: Case Report (추나요법을 동반한 한방복합치료로 호전된 요추 전만각 1례: 증례보고)

  • Kim, Nam Hoon;Lee, Jung Min;Kim, Byung-Jun
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.17 no.1
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    • pp.55-60
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    • 2022
  • Objectives To introduce a case of a traffic accident trauma in a patient with lumbar kyphosis and straightened lumbar curvature, where the Korean medicine treatment with Chuna manual therapy (CMT) improved lumbar lordotic angle(LLA) and lower back pain. Methods Chuna manual therapy and other Korean medicine treatments; were provided to patient with a flat back posture and low back pain due to the trauma from a traffic accident. Cobb's angle to evaluate LLA and numeric rating scale (NRS) to evaluate pain were compared before and after the treatment. Results There was a significant increase in LLA to reach the normal range and a decrease in low back pain NRS after Korean medicine treatment with CMT for 9 days of admission treatment and 3 weeks of outpatient treatment. Conclusions This study suggests that Korean medicine treatment, including CMT, may improve low back pain as well as LLA of straightened lumbar curvatures in patients.

Characteristics of 601 Low Back Pain Patients: A Korean Medicine Hospital Experience, Retrospective Chart Review (요통으로 한방병원에 입원한 환자 601명에 대한 후향적 연구)

  • Nam, Dae-Jin;Oh, Min-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.25 no.2
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    • pp.135-153
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    • 2015
  • Objectives The purpose of this study was to investigate the characteristics of inpatients who were admitted to Korean medicine hospital due to low back pain. Methods The current study was designed as a retrospective chart review to investigate descriptive characteristics of LBP patients. The clinical records of 601 patients who were hospitalized for treatment of LBP in Cheonan Korean Medicine Hospital, Daejeon University from 1st, January, 2013 to 31th, December, 2013 were analyzed. Results 1. Most frequently given diagnosis was sprain and strain of lumbar (45.93%). 2. Female outnumbered male patients in all disease groups except fracture of lumbar spine. 3. In distribution according to age, sprain and strain of lumbar, HNP of L-spine and lumbago with sciatica were most frequent at 30s, fracture of lumbar spine was most frequent at 50s and spinal stenosis was most frequent at 70s. 4. The most frequently motive for low back pain was traffic accident (35.4%) 5. Patients with no related medical history were 76.95% 6. 0~1week interval between onset and visit to Korean Medicine Hospital was most frequent in all disease groups. 7. 50.85% of patients went through treatment at medical institutions before the admitting to Korean Medicine Hospital. 8. The average admission days of female was higher than male's. And age goes up, average duration of admission was longer. 9. In most (74.59%) of the patients, symptoms were more than improved. 10. Most frequently prescribed examination was X-ray (65.13%). 11. Most frequently prescribed herb medicine was whal-lak-tang (Huoluo-tang). Conclusions In most (74.59%) of the patients, symptoms were more than improved, especially in sprain and strain of lumbar and lumbago with sciatica. But Patients with a local hospital statistic is not be representative of the incidence of the population. In order to obtain more accurate statistics, it is necessary to compare analysis collect statistics from other medical hospitals.

A Comparison Study on the Change in Lumbar Lordosis When Standing, Sitting on a Chair, and Sitting on the Floor in Normal Individuals

  • Bae, Jun-Seok;Jang, Jee-Soo;Lee, Sang-Ho;Kim, Jin-Uk
    • Journal of Korean Neurosurgical Society
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    • v.51 no.1
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    • pp.20-23
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    • 2012
  • Objective : To compare radiographic analysis on the sagittal lumbar curve when standing, sitting on a chair, and sitting on the floor. Methods : Thirty asymptomatic volunteers without a history of spinal pathology were recruited. The study population comprised 11 women and 19 men with a mean age of 29.8 years. An independent observer assessed whole lumbar lordosis (WL) and segmental lordosis (SL) between L1 and S1 using the Cobb's angle on lateral radiographs of the lumbar spine obtained from normal individuals when standing, sitting on a chair, and sitting on the floor. WL and SL at each segment were compared for each position. Results : WL when sitting on the floor was reduced by 72.9% than the average of that in the standing position. Of the total decrease in WL, 78% occurred between L4 to S1. There were significant decreases in SL at all lumbar spinal levels, except L1-2, when sitting on the floor as compared to when standing and sitting on a chair. Changes in WL between the positions when sitting on a chair and when sitting on the floor were mostly contributed by the loss of SL at the L4-5 and L5-S1 levels. Conclusion : When sitting on the floor, WL is relatively low; this is mostly because of decreasing lordosis at the L4-5 and L5-S1 levels. In the case of lower lumbar fusion, hyperflexion is expected at the adjacent segment when sitting on the floor. To avoid this, sitting with a lordotic lumbar curve is important. Surgeons should remember to create sufficient lordosis when performing lower lumbar fusion surgery in patients with an oriental life style.

Study of spnial segmental stabilization for OMT in low back pain (요통 환자의 정형물리치료를 위한 척추분절 안정성에 관한 고찰)

  • Chang, Moon-Kyung
    • Journal of Korean Physical Therapy Science
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    • v.7 no.2
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    • pp.415-425
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    • 2000
  • It is well known that the lifetime incidence of low back pain is extraordinarily high, but those who incur the majority of the cost, both personally and financially, are the chronic pain. Stabilization programmers attracted our interest, with their aims of using the muscle system to protect spinal joint structures from further repetitive microtrauma, recurrent pain and degerative change. In overviewing the stabilizing role of the trunk and back mucles our attention became focused on muscles which controlled the lumbar and lumbosacral joints rather than on muscles which span the spine from the thorax to pelvis. It was considered that muscles such as the lumbar multifidus, transversus abdominis, and possibly also parts of the obliquus internus abdominis, would most likely function to stabilize the segments of the lumbar spine. In order to check if these muscles were functioning in low back pain patients, it was necessary to devise specific muscle tests. The new concept involves exercises using only relatively low activity levels in the muscles. More emphasis is placed on a motor skill which has to be relearned, practised and then gradully incorporated back into functional movement.

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The Effect of Acupotomy on Lumbar and Cervical Spine Combined with Oriental Medical Treatment: Report of Five Cases (척추질환에 도침치료를 포함한 한방복합치료 치험 5례)

  • Kim, So Yun;Kim, Hyun Ji;Ji, Young Seung;Lee, Seung Min;Kim, Young Il
    • Journal of Acupuncture Research
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    • v.31 no.2
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    • pp.183-193
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    • 2014
  • Objectives : The purpose of this study is to report the improvement in patients with lumbar, cervical or radiating pain to the extremity by means of acupotomy. Methods : We treated 5 patients who have a disease related with lumbar or cervical spine with acupotomy combined with oriental medical treatment. We checked numeric rating scale(NRS), oswestry low back pain disability index(ODI) or neck disability index(NDI), and range of motion(ROM). Results : NRS and ODI/NDI were decreased, and ROM improved at all cases. Conclusions : This study shows acupotomy has a meaningful effect when applied on lumbar and cervical spine.

Discal Cyst of the Lumbar Spine

  • Hwang, Jae-Ha;Park, In-Sung;Kang, Dong-Ho;Jung, Jin-Myung
    • Journal of Korean Neurosurgical Society
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    • v.44 no.4
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    • pp.262-264
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    • 2008
  • Discal cysts are rare lesions that can cause radiating leg pain. Because they are very rare, their natural history and the details of the therapeutic guidelines for the treatment of these cysts are still unknown. A 30-year-old male patient presented to our institute with radiating pain in his left leg and mild back pain. Magnetic resonance imaging (MRI) revealed an intraspinal extradural cystic mass with low signal intensity on T1-weighted images and high signal intensity on T2-weighted images at the L5-S1 level. The partial hemilaminectomy and cyst resection were performed. We report a patient with low back pain and radiating leg pain caused by a lumbar discal cyst and discuss the treatment of this cyst.

A study on relearning program of deep stabilizing muscle for low back pain (요통에 적용된 심부 안정근 재교육 프로그램에 관한 연구)

  • Koo, Hee-Seo;Kim, Soon-Ja
    • The Journal of Korean Physical Therapy
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    • v.16 no.4
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    • pp.11-22
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    • 2004
  • The concept of segmental stabilization has been one of the most exciting advancements in the field of physical therapy. Specific deep stabilizing muscle have proven to reverse motor control deficits that occurs after back injury. After an injury, a new motor programming strategy is adopted and there is excessive recruitment of the large , strong , global muscular system works instead of small segmental deep muscle recruitment for stability. Many physical therapists and doctors mistakenly prescribe therapeutic exercise for low back pain to use larger, superficial musculature to strengthen the spine for stability and pain control. But motor control coordination of local segmental muscle is actually the key to stability and pain control, not strengthening of global muscle. A recent focus in physiotherapy management of patients with chronic back pain has been the specific training of muscles surrounding the lumbar spine whose primary role is considered to be the provision of dynamic stability and segmental control to the spine. These are the deep transverse abdominis muscle and lumbar multifudus.

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Long Term Efficacy of Posterior Lumbar Interbody Fusion with Standard Cages alone in Lumbar Disc Diseases Combined with Modic Changes

  • Kwon, Young-Min;Chin, Dong-Kyu;Jin, Byung-Ho;Kim, Keun-Su;Cho, Yong-Eun;Kuh, Sung-Uk
    • Journal of Korean Neurosurgical Society
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    • v.46 no.4
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    • pp.322-327
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    • 2009
  • Objective : Posterior lumbar interbody fusion (PLIF) is considered to have the best theoretical potential in promoting bony fusion of unstable vertebral segments by way of a load sharing effect of the anterior column. This study was undertaken to investigate the efficacy of PLIF with cages in chronic degenerative disc disease with Modic degeneration (changes of vertebral end plate). Methods : A total of 597 patients underwent a PLIF with threaded fusion cages (TFC) from 1993 to 2000. Three-hundred-fifty-one patients, who could be followed for more than 3 years, were enrolled in this study. Patients were grouped into 4 categories according to Modic classification (no degeneration : 259, type 1 : 26, type 2 : 55, type 3 : 11). Clinical and radiographic data were evaluated retrospectively. Results : The clinical success rate according to the Prolo's functional and economic outcome scale was 86% in patients without degeneration and 83% in patients with Modic degeneration. The clinical outcomes in each group were 88% in type 1, 84% in type 2, and 73% in type 3. The bony fusion rate was 97% in patients without degeneration and 83% in patients with Modic degeneration. The bony fusion rate in each group was 81% in type 1, 84% in type 2, and 55% in type 3. The clinical success and fusion rates were significantly lower in patients with type 3 degeneration. Conclusion : The PLIF with TFC has been found to be an effective procedure for lumbar spine fusion. But, the clinical outcome and bony fusion rates were significantly low in the patients with Modic type 3. The authors suggest that PLIF combined with pedicle screw fixation would be the better for them.

Epidemiological and Lumbar x-ray Studies on the Low Back Pain of the Workers in an Automobile Industry (자동차 제조업체 근로자들의 요통에 대한 역학적 요추 x-선학적 고찰)

  • Kim, Soon-Lae
    • Research in Community and Public Health Nursing
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    • v.6 no.2
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    • pp.319-334
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    • 1995
  • To investigate the risk factors of low back pain, an epidemiological study was carried out among male workers aged 20-55 employed in an automobile industry in Korea during the time period from February 1993 to October 1995. Workers participated to this study were divided into low back pain group(LBP) and control group, according to the self-reports by written questionnaires. General characteristics, medical history, work related factors, fatigue, and MMPI were compared between two groups. To clarify the relationship between job related low back pain and radiologic features of lumbar spine, radiographic study was carried out. The resultant data were processed for $x^2-test$, t-test, and stepwise logistic regression to confirm the adjusted odds ratios. The results were as follows: 1. History of back disease, lifting and carrying work, excessive physical fatigue, and weakend back strength of individual workers were directly associated with low back pain. Odd ratios of these 4 risk factors of low back pain were 5.07, 3.34, 1.49, and 1.22 respectively. 2. The frequency of low back pain history was significantly higher in LBP group. 3. Back muscle strength of lumbar spine of LBP group were significantly lower than control group. 4. The workers in LBP group revealed high fatigue symptoms. 5. In MMPI test LBP group showed higher scales in hypochondriasis, depression, hysteria, psychopathic deviate, paranoia, psychasthenia, schizophrenia, and hypomania. 6. LBP group were more frequently involved in lifting and carrying, working in awkward position, bending, twisting and using lower extremities. 7. LBP group were exposed more to vibration during working. 8. In the Analysis of radiographs of lumbar spine, Jacob's line not crossing fourth lumhar disc space, transitional vertebrae and lumbar displacement more than 4.4mm in standing lateral view were more frequently observed in LBP group than control group. Through these results, it is concluded that identification of previous history of back problem, change of work or working environment for workers with previous back problem and measures to relieve both physical and psychological fatigue of the workers are required for optimal management of work-related back problems among workers. In the present study, several results were different from the previous reports: Jacob's line not corssing fourth lumbar disc space, lumbarization, and vertebral slipping (spondylolisthesis) more than 4.4mm are related to backache. Meticulous studies are required to elucidate the difference.

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