• 척추신경추나의학회지
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• 제9권1호
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• pp.15-26
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• 2014

Objectives : The purpose of this study was to evaluate the effect of Korean medicicine treatment in patients with Spondylolisthesis and Lumbar Herniated Intervertebral Disc(HIVD). Methods : This clinical study was carried out on 62 patients who were diagnosed as spondylolisthesis and lumbar herniated intervertebral disc(HIVD) on L-spine X-ray and L-spine magnetic resonance imaging(MRI), who had been admitted from Feb. 2013 to Apr. 2014. All of 62 patients were treated with acupuncture, chuna treatment and herbal medicine during the whole admission period. Numerical rating scale(NRS) was used to evaluated the effectiveness of the oriental medical treatment. Results : 1. Distribution showed female predominance in general. 2. Degenerative type is the most common in this study. 3. In the duration of symptoms, the largest group was" Subacute"(32.26%). 4. Almost of patients had radiation pain, but in SLR test and valsalva test, more patients had no significant sign. 5. Spondylolytic type involved the 5th lumbar vertebra in 80% and degenerative type involved the 4th lumbar vertebra in 53.84%. 6. Most of case were grade 1(93.54%) in degree of slipping. 7. By the oriental medical treatment, NRS reduction in spondylolytic spondylolisthesis, was better than degenerative spondylolisthesis. Conclusions : The result of treatment by Korean medical is satisfactory for the tretment of spondylolisthesis.

• 척추신경추나의학회지
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• 제18권2호
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• pp.1-8
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• 2023

Objectives This study aimed to propose biomarkers for diagnosing Chuna manual therapy (CMT) based on X-ray images in the thoracic and lumbar spines. Methods Through a literature review and expert consensus process, diagnostic biomarkers for CMT were selected based on the listing system in thoracic and lumbar radiograph anterior-posterior (AP) and lateral views. Results 1. Diagnostic biomarkers were derived from four points on the outer contour of the vertebral body in the thoracic and lumbar spine radiograph lateral view, enabling the diagnosis of flexion and extension malposition. 2. Additional diagnostic biomarkers were identified in the thoracic and lumbar radiographAP view, utilizing points on the outer contour of the vertebral body. These biomarkers facilitate the diagnosis of lateral bending. Moreover, biomarkers derived from the innermost point of the pedicle contour allow for the diagnosis of rotation malposition. 3. Furthermore, through the biomarkers proposed in this study, all malpositions of the thoracolumbar spines and complex Type I and II malpositions can be diagnosed in CMT. Conclusions The biomarkers reported in this study consist of minimal points to determine the position of the vertebral body, providing the advantage of simplicity while minimizing potential errors during the CMT diagnostic process. Further clinical research and the development of related programs should be pursued to expand the evidence for CMT.

• 한국전문물리치료학회지
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• 제18권1호
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• pp.57-63
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• 2011

The purpose of this study was to identify the effects of manual facilitation and a stick on lumbar and hip joint flexion angles in subject with lumbar flexion syndrome during forward bending from a sitting position. Fifteen subjects with lumbar flexion syndrome were recruited for this study. As a pretest, all subjects performed three repetitions of bending the trunk forward until the tips of their fingers touched the target bar. After this pretest, the subjects practiced the forward bending of the trunk 10 times, using either manual facilitation or a stick. Then, as a posttest, all subjects repeated the pretest procedure. The flexion angles of lumbar spine and hip joint during forward bending in a sitting position were measured using a three-dimensional motion analysis system. A paired t-test was used to determine the statistical differences between pre-test and post-test flexion angles and pre- and post-test flexion angle differences between forward bending with manual facilitation and forward bending with a stick. The level of statistical significance was set at p=.05. The results of the study showed that the angle of the lumbar flexion decreased significantly and the bilateral hip flexion angle increased significantly when performing forward bending with stick and manual facilitation. Furthermore, the angle of lumbar flexion decreased significantly and the angle of bilateral hip flexion increased significantly in forward bending with a stick compared to forward bending with manual facilitation. The findings of this study indicate that both forward bending with manual facilitation and sticks could be used to prevent excessive lumbar flexion and increase hip flexion, and that forward bending with a stick is more effective than forward bending with manual facilitation for inducing lumbar spine and hip joint angle changes.

• 대한의용생체공학회:의공학회지
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• 제29권2호
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• pp.139-145
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• 2008

Many recent studies suggest that the posterior dynamic stabilization(PDS) can be a more physiologically-relevant alternative to the rigid fixation for the patients suffering from low back pain. However, its biomechanical effects or clinically proven efficacies still remain unknown. In this study, we evaluated kinematic behaviors of the lower lumbar spine with the PDS system and then compared to those of the rigid fixation system using finite element (FE) analysis. A validated FE model of intact lumbar spine(L2-L5) was developed. The implanted model was then constructed after modification from the intact to simulate two kinds of pedicle screw systems (PDS and the rigid fixation). Hybrid protocol was used to flex, extend, laterally bend and axially rotate the FE model. Results showed that the PDS systems are more flexible than rigid fixation systems, yet not flexible enough to preserve motion. PDS system allowed $16.2{\sim}42.2%$ more intersegmental rotation than the rigid fixation at the implanted level. One the other hand, at the adjacent level it allowed more range of motion ($2.0%{\sim}8.3%$) than the rigid fixation. The center of rotation of the PDS model remained closer to that of the intact spine. These results suggest that the PDS system could be able to prevent excessive motion at the adjacent levels and restore the spinal kinematics.

• 대한방사선기술학회지:방사선기술과학
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• 제22권2호
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• pp.41-46
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• 1999

Osteoporosis, which causes mainly fracture of the spine, proximal femur and distal radius by minimal trauma, is a major public health problem and its prevalence is steadily increasing in Korea according to the development of public health care. There are reliable methods for diagnosis based on bone densitometry. Early detection and intervention are important for reducing the incidence of fractures. A consensus definition of osteoporosis, based on bone density measurement, has been developed by the World Health Organization(WHO). In this study, bone mineral density(RMD) was measured by dual energy x-ray absorptiometry(DEXA) at the proximal femur and lumbar spine in 132 post-menopausal women. The purpose of this study is to find influential factors on the BMD of the proximal femur and the lumbar spine and to analyze correlation between BMD and the problematic factors. We obtained the following results : 1. Mean BMD score, T-score and Z-score of the proximal femur were $0.81(g/cm^2)$, -2.45(S.D.) and -2.09(S.D.) respectively and in the lumbar spine were $0.83(g/cm^2)$, -2.02(S.D.), -2.43(S.D.) respectively. 2. In correlation analysis between BMD and many factors, correlation coefficients were -0.467, 0.212, -0.321 and 0.241 in age, height, duration after menopause respectively. BMI and the residuals were comparatively small. 3. Correlation coefficients to age matched BMD, in height and body weight were 0.222 and 0.241, in age and duration after menopause were -0.268, -0.282. 4. The fracture threshold of proximal femur BMD to the 90th percentile was $0.845(g/cm^2)$. 5. At the result of multiple regression analysis, age, body weight, $BMI(kg/m^2)$ and duration after menopause described as significant variables.

• Investigative Magnetic Resonance Imaging
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• 제19권4호
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• pp.224-230
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• 2015

Purpose: To determine whether we should recommend ultrasonography (US) for an incidental thyroid nodule identified by additional cervicothoracic sagittal T2-weighted image (C-T sag T2WI) of lumbar spine magnetic resonance imaging (MRI). Materials and Methods: A retrospective study of 61 patients who underwent both lumbar spine MRI and thyroid US between December 2011 and April 2015 was conducted. For all US-found thyroid nodules > 1 cm, investigators evaluated whether there was any correlation between thyroid nodule detectability by C-T sag T2WI and US features such as echogenicity, composition, or suspicion of malignancy. Results: Solid hypoechoic (2/4; 50%) or mixed echoic nodules (4/8; 50%) appeared to be found relatively more easily by C-T sag T2WI than more benign-looking solid isoechoic (1/4; 25%) or spongiform nodules (0/6; 0%). Among six nodules with ultrasonographic suspicion for malignancy, only one nodule was detected by C-T sag T2WI. Conclusion: If an incidental thyroid nodule is seen by C-T sag T2WI, it would be better to recommend thyroid US for identifying malignancy.

• Journal of Veterinary Science
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• 제22권1호
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• pp.3.1-3.13
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• 2021

Background: Multifidus muscle stiffness decreases in patients with lumbar intervertebral disk herniation; however, age-related changes in humans have not been reported. Objectives: The reliability of ultrasound shear wave elastography in dogs, and changes in the shear elastic modulus of the thoracolumbar multifidus muscle with aging in dogs, were investigated. Methods: Twelve beagle dogs were divided into 2 groups based on the age of onset of intervertebral disk herniation: young (aged not exceeding 2 years; 1.3 ± 0.6 years old, n = 5) and adult (4.9 ± 1.2 years old, n = 7). The shear elastic modulus of the multifidus muscle, from the thirteenth thoracic spine to the fourth lumbar spine, was measured using ultrasound shear wave elastography. The length, cross-sectional area and muscle to fat ratio of the multifidus muscle, and the grade of intervertebral disk degeneration, were assessed using radiographic and magnetic resonance imaging examinations. Results: The length and cross-sectional area of the multifidus muscle increased caudally. In the young group, the shear elastic modulus of the multifidus muscle of the thirteenth thoracic spine was less than that of the third lumbar spine. In the adult group, the shear elastic modulus of the multifidus muscle of first and third lumbar spine was lower than that of the same site in the young group. Conclusions: Ultrasound can be used to measure shear wave elastography of the thoracolumbar multifidus in dogs. If the multifidus muscle stiffness decreases, we should consider age-related change.

• 척추신경추나의학회지
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• 제8권2호
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• pp.79-86
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• 2013

Objective : The purpose of this study was to suggest (diagnostic) criteria for lumbar disc space and see the correlation between lumbar disc space narrowing and the level of HIVD. Methods : We looked at the 113 patients diagnosed disc space narrowing with lumbar x-ray and MRI films who have visited Jaseng Hospital of Oriental Medicine with low back pain in October,2013. The width of lumbar disc space and the severity of Herniated Intervertebral Disc(HIVD) on MRI films were collected and stastically analyzed using one-way ANOVA. Results : In this study, measured value(%) for lumbar disc space of the group diagnosed serious HIVD, such as protrusion, extrusion and migration was significantly decresed compared to the normal group and the bulging group. Conclusion : There was a significant correlation between lumbar disc space narrowing and the level of HIVD.

• The Korean Journal of Pain
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• 제18권1호
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• pp.34-38
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• 2005

Background: Over the years, disc surgery has progressively evolved in the direction of decreasing trauma and its invasiveness. Conventional open surgery has many complications, such as scarring, instability, bleeding and a relative high mortality rate. Minimally invasive spinal surgery is now an alternative to a traditional discectomy. Herein, we present an operative technique, and the early results, for a percutaneous endoscopic lumbar discectomy in herniated lumbar disc disease. Methods: 43 patients, including 27 men and 16 women, with ages ranging from 18 to 66 years, were enrolled in this study. All the patients showed a protruded or extruded soft disc herniation at the lumbar level on magnetic resonance imaging and computed tomography. A percutaneous endoscopic lumbar discectomy was applied to the patients, and clinical responses evaluated using MacNab's criteria. Results: 40 patients were regarded as showing successful responses (93.1%), and there were no severe complications, such as a hematoma, nerve injury, postoperative dysesthesia or death. One patient underwent fusion surgery for remnant back pain six month later. Conclusions: We conclude that, in properly selected patients, a percutaneous endoscopic lumbar discectomy is a safe, noninvasive and effective treatment modality for herniated lumbar intervertebral disc disease.

• 척추신경추나의학회지
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• 제13권2호
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• pp.1-10
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• 2018

Objectives : To evaluate the evidence supporting the effectiveness and safety of Chuna manual therapy(CMT) for lumbar spinal stenosis Methods : We searched 10 electronic databases(Pubmed, EMBASE, Cochrane Library, CAJ, RISS, KISS, KISTI, KMBASE, DBpia, NDSL) and related 2 journals up to October 2018. We included randomized controlled trials(RCTs) of testing CMT for lumbar spinal stenosis patients. The methodological quality of RCTs related assessed by the Cochrane risk of bias tool 1.0. Results : Three RCTs were eligible in our inclusion criteria. The meta-analysis of 3 studies showed positive results for the using CMT for lumbar spinal stenosis. Conclusions : The review found favorable evidence of CMT for treating lumbar spinal stenosis with meta-analysis. However, our systematic review has limited evidence to support CMT for lumbar spinal stenosis because of low quality of original articles and further well-designed RCTs should be encouraged.