• Title/Summary/Keyword: Lumbar Region

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Brown-Sequard Syndrome Caused by a Cervical Synovial Cyst

  • Kim, Seok Won;Ju, Chang Il;Kim, Hyeun Sung;Kim, Yun Sung
    • Journal of Korean Neurosurgical Society
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    • v.55 no.4
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    • pp.215-217
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    • 2014
  • Synovial cysts are recognized as an uncommon cause of radicular and myelopathic symptoms. They are most frequently found in the lumbar region. The cervical spine or cervicothoracic junction is a rare location for a degenerative intraspinal synovial cyst as compared with the lumbar spine. At given cervical spinal levels, synovial cysts probably share clinical features with disc herniation and stenosis. However, the pathogenesis of synovial cysts remains still controversial. Here, we report a rare case of a synovial cyst in the lower cervical spine presented as Brown-Sequard syndrome and include a brief review of the literature. To the best of our knowledge, no previous report has been issued in the English literature on a synovial cyst presenting with Brown-Sequard syndrome. Neurologic function recovered completely after complete removal of the cyst and expansive laminoplasty.

Surgical versus Conservative Treatment for Lumbar Disc Herniation with Motor Weakness

  • Choi, Hong-Seok;Kwak, Kyung-Woo;Kim, Sang Woo;Ahn, Sang Ho
    • Journal of Korean Neurosurgical Society
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    • v.54 no.3
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    • pp.183-188
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    • 2013
  • Objective : The aim of this study is to assess outcomes during first one year for patients with severe motor weakness caused by lumbar disc herniation that underwent surgical or nonsurgical treatment. Methods : The 46 patients with motor weakness because of lumbar disc herniation who were treated at neurosurgical department and rehabilitation in our hospital from 2006 to 2010, retrospectively. Each group had 26 surgical treatments and 20 conservative treatments. We followed up 1, 3, 6 months and 12 month and monitored a Visual Analogue rating Scale (VAS) of back and leg pain, Oswestry Disability Index (ODI) and degree of motor weakness. We analyzed the differences between surgical and nonsurgical groups using Mann-Whitney U test and repeat measure ANOVA in each follow-up periods. Results : In the recovery of motor weakness, surgical treatment uncovered a rapid functional recovery in the early periods (p=0.003) and no difference between groups at the end of follow-up period was found (p>0.05). In VAS of back and leg, the interaction between time and group was not found (p>0.05) and there was no difference between groups (p>0.05). In ODI, the interaction between time and group was not found (p>0.05) and there was no difference between groups (p>0.05). Conclusion : Surgical treatment for motor weakness caused by herniated intervertebral disc resulted in a rapid recovery in the short-term period, especially 1 month. We think early and proper surgical treatment in a case of motor weakness from disc herniation could be a good way for providing a chance for rapid alleviation.

The Effects of Head Support on Muscle Activity and Pain in a Forward-leaning Posture

  • Kim, Kang-hee;Ko, Yoon-hee;Yoon, Tae-lim
    • Physical Therapy Korea
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    • v.27 no.4
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    • pp.264-271
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    • 2020
  • Background: Because a forward-leaning posture can cause increased back muscle activity and pain. Therefore, an innovative method to reduce back muscle activity and pain is required. Objects: This study aimed to investigate the effects of a head support on muscle activity and pain in a forward-leaning posture. Methods: A total of 14 male and 16 female students (average age, 21.65 ± 2.37 years; height, 166.15 ± 7.90 cm; and weight, 60.65 ± 9.00 kg) were recruited for the experiment. Two of them were excluded due to musculoskeletal disorders. The muscle activity and pain in the forward-leaning posture were assessed while participants washed dishes for 7 minutes with and without a head support. The condition of using a head support was randomly performed with a 5-minutes break. To confirm a lumbar flexion angle of 30° during the experiment, myoVIDEO was used, and surface electromyography was used to measure muscle activity. Pain was assessed using a 10-point visual analog scale (VAS). The Wilcoxon signed-rank test was used to analyze the data, with p < 0.05 indicating statistical significance. Results: The cervical, thoracic, and lumbar erector spinae muscle activities significantly decreased with the use of the head support, but there was no significant change in the gluteus maximus. There was a significant decrease in the VAS score for the lumbar erector spinae (p < 0.05), but there was no significant change in the VAS score for the cervical region. Conclusion: The use of a head support in a forward-leaning posture reduced cervical, thoracic, and lumbar erector muscle activity and pain. Therefore, it could be recommended during working in a forward-leaning posture, such as during dishwashing, cooking, and working as a factory employee.

The reliability of the nonradiologic measures of thoracic spine rotation in healthy adults

  • Hwang, Donggi;Lee, Ju Hyeong;Moon, Seongyeon;Park, Soon Woo;Woo, Juha;Kim, Cheong
    • Physical Therapy Rehabilitation Science
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    • v.6 no.2
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    • pp.65-70
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    • 2017
  • Objective: The purpose of this study was to examine the intertester reliability and validity of four nonradiologic measurements of thoracic spine rotation in healthy adults. Design: Descriptive laboratory study. Methods: This study was conducted on 20 male and 20 female university students aged between 19 and 26. To measure thoracic rotation, a goniometer, a bubble inclinometer, a dual inclinometer, and a smartphone application-clinometer were used. The measurement was performed twice for each device and the same measurement was performed by two examiners. The measurements were performed in the lumbar locked position. The arm in the direction of rotation was taken back and placed onto the back of the lumbar region. With right and left trunk rotation, the head was rotated together but remained in the center line so that the axial rotation was maintained. Both examiners performed the measuring procedures and directly handled the measuring instrument. All measurement results were recorded by the recorder. Results: The range of motion (ROM) of thoracic rotation in lumbar locked position for all four devices was 47 degrees. The intra-rater reliability estimates ranged from 0.738 to 0.906 (p<0.05). The inter-rater reliability estimates ranged from 0.736 to 0.853 (p<0.05). The goniometer, bubble inclinometer, dual inclinometer, and smartphone clinometer showed high validity (p<0.05). This result indicates that all four devices may be used by the same examiner and by other examiners obtaining follow-up measurement. Conclusions: The use of the goniometer, bubble inclinometer, dual inclinometer, and smartphone clinometer for measurements in the lumbar locked posture are reliable and valid nonradiologic measures of thoracic rotational ROM in healthy adults.

The Trend Review of Acupoints for Lumbar HIVD Treatment and the Literature Review of Anatomical Location of Hwatahyeopcheock (요각통 및 요추간판탈출증 침 치료에 다용되는 혈위 조사 및 협척혈의 해부학적 위치에 대한 문헌적 고찰)

  • Lee, Min-Su;Kang, Kyung-Rae;Woo, Ki-Won;Baek, Sang-Hyun;Ha, In-Hyuk;Shin, Min-Sik;Lee, Jin-Ho
    • Korean Journal of Acupuncture
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    • v.32 no.3
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    • pp.81-89
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    • 2015
  • Objectives : The purpose of this study is to explore the trends of acupoints used for lumbar HIVD(Herniated Intervertebral Disc) and treatment and anatomical location of Hwatahyeopcheock. Methods : We searched the latest clinical studies on acupuncture treatment for lumbar HIVD(Herniated Intervertebral Disc) through domestic studies search. To analyze the data, we categorized them by year and article types of literatures and investigated often-used acupoints and acupuncture types for treatment by reading treatment part of every paper searched. Domestic and Chinese literatures related to Hwatahyeopcheock were also studied for its anatomical location. Results : Total 50 articles are searched and local points are more used than distant points for lumbar HIVD(Herniated Intervertebral Disc) and most of them showed curative effects. Back-su points were used the most and Hwatahyeopcheock use accounted for one-third of the articles. In the articles of Hwatahyeopcheock use, except for one, patients complained of both low back pain and radiating pain, and all of them showed positive results after treatment. Conclusions : Back su point is considered to have its meaning as physical region where patients feel pain including herniated disc level rather than the effect meridian system makes. Through document research and meridian muscle theory, we found that Hwatahyeopcheock means vertebral facet joint, intervertebral foramen and surrounding muscle, nerve, blood vessel and related spinal nerves.

Factors Affecting Cage Obliquity and the Relationship between Cage Obliquity and Radiological Outcomes in Oblique Lateral Interbody Fusion at the L4-L5 Level

  • CheolWon Jang;SungHwan Hwang;Tae Kyung Jin;Hyung Jin Shin;Byung-Kyu Cho
    • Journal of Korean Neurosurgical Society
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    • v.66 no.6
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    • pp.703-715
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    • 2023
  • Objective : This retrospective study investigated the factors that affect cage obliquity angle despite orthogonal maneuvers performed during oblique lateral interbody fusion (OLIF) and assessed the relationship between cage obliquity angle and radiological outcomes post-surgery. Methods : Twenty-nine males who underwent L4-L5 OLIF for lumbar degenerative disease between 2019 and 2021 with a followup duration greater than 12 months were analyzed. Radiological parameters were measured including psoas muscle volume, total psoas area index (total psoas muscle area [cm2]/height squared [m2]), distance from the iliac artery to the origin of the psoas muscle (DIAPM), angle between the origin of the psoas muscle and the center of the vertebral disc (APCVD), iliac crest height, disc height, lumbar flexibility (lumbar flexion angle minus extension angle), cage location ratio, cage-induced segmental lumbar lordosis (LL) (postoperative index level segmental LL minus used cage angle), foraminal height changes, fusion grade. Results : DIAPM, APCVD, iliac crest height, postoperative index level segmental LL, and cage-induced segmental LL were significantly correlated with OLIF cage obliquity angle. However, other radiological parameters did not correlate with cage obliquity. Based on multiple regression analysis, the predictive equation for the OLIF cage obliquity angle was 13.062-0.318×DIAPM+0.325×1APCVD+0.174×iliac crest height. The greater the cage obliquity, the smaller the segmental LL compared to the cage angle used. Conclusion : At the L4-L5 level, OLIF cage obliquity was affected by DIAPM, APCVD, and iliac crest height, and as the cage obliquity angle increases, LL agnle achievable by the used cage could not be obtained.

Effects of the trunk stabilization exercise on muscle activity in lumbar region and balance in the patients with hemiplegia (중추신경발달치료를 이용한 몸통 안정화 운동이 뇌졸중 환자의 허리부위 근 활성도와 균형에 미치는 효과)

  • Shim, Hyun-Bo;Cho, Hwi-young;Choi, Won-Ho
    • The Journal of Korean Physical Therapy
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    • v.26 no.1
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    • pp.33-40
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    • 2014
  • Purpose: The aim of this study was to identify the effects of the lower trunk stabilization exercise using neurodevelopmental technique (NDT) on muscle activity in lumbar region and balance in the patients with hemiplegia. Methods: Fifteen participants were allocated in two groups: NDT group (n=8) or control group (n=7). NDT group performed NDT exercise program, while control group conducted walking exercise. Both interventions were given for 30 minutes a day, 3 times a week, for 5 weeks. To measure the muscle activity in rectus abdominis (RA), external oblique (EO) and internal oblique (IO), electromyography (EMG) was used. And, Timed-Up and Go (TUG) test and Berg-Balance Scale (BBS) were performed to assess balance before and after intervention. Results: NDT group showed a significant improvement of muscle activity in RA and EO, while control group did not show significant changes in three muscles. Also, there was a significant difference in muscle activity of RA and EO between two groups. In BBS and TUG test, participants in two groups showed significant improvements after intervention. Especially, significant difference was observed in TUG test between two groups (p<.05). Conclusion: This study demonstrated that NDT exercise is an effective intervention to improve the muscle activity in trunk region and to increase balance in patients with stroke. Thus, we suggested that NDT exercise program would be a treatment intervention in stroke rehabilitation.

The Effect of Stability Exercise For Pain Level of Cervical and Lumbar Region, Muscle Volume and Fat Mass Composition in Body of High School in Man volleyball Player (고등학교 남자배구선수들의 안정화운동에 대한 경.요부의 통증수준과 근육량, 체지방에 미치는 영향)

  • Won, Sang-Hee;Jeon, Cha-Sun;Yu, Woung-Sik
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.15 no.1
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    • pp.41-48
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    • 2009
  • Purpose: to program introduction the effects of stability sling exercise and common exercise of high school in man volleyball player. Methods: This study divided the subjects into a sling-exercise group and a common exercise group to compare after practicing exercises twice per week for 8 weeks (total 16 times). To compare the means of the experimental group and the control group on each variable, the ANOVA for repeated measure was used and if there was any significant difference across the measurement times, post-hoc comparisons were conducted for the difference. Results: The T-tests for group difference according to exercise type on each of the variables showed the results as follows. The pain in cervical region is experimental and control groups pain correlation were not significant(p>0.05). But lumbar region experimental and control groups were significant(p<0.05). Muscle volume was increased during 8weeks in experimental and control groups. But experimental and control groups muscle volume correlation were not significant(p>0.05). Conclusion: Fat Mass composition was decreased during 8 weeks in experimental and control groups. But experimental and control groups mass composition correlation were not significant(p>0.05).

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Comparison Measurement Error of T-score Between Lumbar and Femoral Neck According to Kind of DXA (DXA측정기 종류에 따른 요추부와 대퇴경부 골밀도 값의 측정오차 비교)

  • Han, Beom-Hee;Jung, Hong-Ryang;Lim, Cheong-Hwan;Lee, Hye-Nam;Jeong, Cheon-Soo;Lee, Sang-Ho
    • The Journal of the Korea Contents Association
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    • v.10 no.3
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    • pp.250-257
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    • 2010
  • In this study, three different devices, Norland, Osteocore and Lunar were used to compare and analyze the measurement error by each bone density measurement device by classifying the physical characteristics into age, height and weight, the subject of total 300 sampling 100 persons for each device. Categorizing Lumbar region and Femoral neck as normal (T-score$\geqq$-1.0), osteopenia (-1.0>T-score>-2.5) and osteoporosis (T-score$\leqq$-2.5), the findings were observed as follows. Norland device showed the least measurement error in age and height, while Lunar showed the least in weight among the devices. And, the result of comparing the bone density measurement error based on the lumbar region showed that all of Lunar, Norland and Osteocore have the least variation of measurement error in osteopenia and the result of comparing based on the femoral neck showed that all of Lunar, Norland and Osteocore have the least variation of measurement error in osteoporosis. For each variable, the measurement error was observed to be vary upon the device. To solve this, standardized common Phantom should be used to compare and converge the measured value of each company and cross-calibration would be necessary when replacing the software.

Effects of Root of Cibotii Rhizoma on Neuronal Damage of Spinal Cord Contusion Injury in Rats (구척(狗脊)이 흰쥐의 척수압박에 의한 신경세포 손상에 미치는 영향)

  • Park, Won-Sang;Kim, Eun-Seok;Shin, Jung-Won;Kim, Bum-Hoi;Kim, Seong-Joon;Kang, Hee;Sohn, Nak-Won
    • Journal of Korean Medicine Rehabilitation
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    • v.20 no.2
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    • pp.1-15
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    • 2010
  • Objectives : This study was performed to evaluate the effects of root of Cibotii rhizoma(CR) ethanol extract on the tissue and neuronal damage of the spinal cord injury(SCI). Methods : SCI was induced by mechanical contusion following laminectomy of 10th thoracic vertebra in Sprague-Dawley rats. CR was orally given once a day for 7 days after SCI. Tissue damage and nerve fiber degeneration were examined with cresyl violet and luxol fast blue(LFS) histochemistry. HSP72(as neuronal damage marker), MAP2(as nerve fiber degeneration marker), c-Fos(immediate early gene), and Bax(pro-apoptotic molecule) expressions were examined using immuno-histochemistry. Individual immuno-positive cells expressing HSP72, MAP2, c-Fos and Bax were observed on the damaged level and the upper thoracic and lower lumbar spinal segments. Results : 1. CR reduced degeneration of nerve fibers and motor neuron shrinkage in the ventral horn of the lower lumbar spinal segment, but generally it did not seem to ameliorate the tissue injury following SCI. 2. CR reduced demyelination in the ventral and lateral funiculus of the lower lumbar spinal segment. 3. CR reduced HSP72 expression on the neurons in the peri-central canal gray matter adjacent to the damaged region. 4. CR strengthened MAP2 expression on the motor neurons in the ventral horn and on nerve fibers in the lateral funiculus of the lower lumbar spinal segment. 5. CR reduced c-Fos positive cells in the peri-lesion and the dorsal horn of the damaged level and in the ventral horn of the lower lumbar spinal segment. 6. CR reduced Bax positive cells in the peri-lesion and the dorsal horn of the damaged level and in the ventral horn of the lower lumbar spinal segment. Conclusions : These results suggest that CR plays an inhibitory role against secondary neuronal damage and nerve fiber degeneration. following SCI.