• Journal of Korean Neurosurgical Society
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• v.60 no.2
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• pp.125-129
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• 2017

Lumbar degenerative kyphosis (LDK) is a subgroup of the flat-back syndrome and is most commonly caused by unique life styles, such as a prolonged crouched posture during agricultural work and performing activities of daily living on the floor. Unfortunately, LDK has been used as a byword for degenerative sagittal imbalance, and this sometimes causes confusion. The aim of this review was to evaluate the exact territory of LDK, and to introduce another appropriate term for degenerative sagittal deformity. Unlike what its name suggests, LDK does not only include sagittal balance disorder of the lumbar spine and kyphosis, but also sagittal balance disorder of the whole spine and little lordosis of the lumbar spine. Moreover, this disease is closely related to the occupation of female farmers and an outdated Asian life style. These reasons necessitate a change in the nomenclature of this disorder to prevent misunderstanding. We suggest the name "primary degenerative sagittal imbalance" (PDSI), which encompasses degenerative sagittal misalignments of unknown origin in the whole spine in older-age patients, and is associated with back muscle wasting. LDK may be regarded as a subgroup of PDSI related to an occupation in agriculture. Conservative treatments such as exercise and physiotherapy are recommended as first-line treatments for patients with PDSI, and surgical treatment is considered only if conservative treatments failed. The measurement of spinopelvic parameters for sagittal balance is important prior to deformity corrective surgery. LDK can be considered a subtype of PDSI that is more likely to occur in female farmers, and hence the use of LDK as a global term for all degenerative sagittal imbalance disorders is better avoided. To avoid confusion, we recommend PDSI as a newer, more accurate diagnostic term instead of LDK.

• Journal of radiological science and technology
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• v.44 no.2
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• pp.85-90
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• 2021

The purpose of this study is to consider usefulness of using AEC mode and importance of patient center location in L-spine lateral radiography by comparing dose and image quality according to the change of patient center location with using AEC mode or not. In this study, guide wire is attached to the human body phantom's lumbar spine and the lead ruler is attached to the bottom of the wall detector to find out center location in detector. ESD, mAs, and EI were selected as dose factors, and image quality was compared through SNR. With the lumbar spine located center of the detector, dose factors and image quality were compared according to using AEC mode or not. Afterwards, phantom moved 4 cm and 8 cm back and forth and compared dose factors and image quality. The exposure parameters were 85 kVp, 320 mA, x-ray field size 10×17 inch, and the distance between the center X-ray and the detector was fixed at 100 cm. The center X-ray was perpendicular to the fourth lumbar spine and the only bottom AEC chamber was used. All data were analyzed by independent t-test and ANOVA. As a result of this study, with AEC when the center is matched, ESD was 1.31±0.01 mGy, without AEC was 2.12±0.01 mGy. SNR was shown to be 22.81±1.83, and 23.44±1.87 respectively. When the phantom's center moves 4 cm, 8 cm forward, and 4 cm, 8 cm backward, ESD were 1.09±0.004 mGy, 0.32±0.003 mGy, 1.19±0.017 mGy, 1.11±0.006 mGy respectively, SNR were 18.29±0.60 dB, 11.11±0.22 dB, 18.98±0.80 dB, 17.71±0.82 dB. Using AEC in L-spine lateral radiography reduced ESD by 38%, EI by 35%, and mAs by 38%, without any difference in SNR(p<0.05). When the phantom's center moves 4 cm, 8 cm forward, and 4 cm, 8 cm backward, ESD was decreasing each 16%, 75%, 9%, 15%, EI was decreasing each 14%, 77%, 15%, 20%, mAs was decreasing each 15% 75% 9%, 15%. SNR was decreasing each 19%, 51%, 17%, 22%.

• Journal of radiological science and technology
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• v.31 no.1
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• pp.25-31
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• 2008

Purpose : This study was conducted to understand for the diagnostic discordance of bone mineral density(BMD) in DEXA(Dual Energy X-ray Absorptiometry). And the diagnostic difference between lumbar spine and femur neck, forearm was evaluated using T-score. Materials and Methods : We studied 220 females measured BMD on lumbar spine, and femur neck, forearm including ward's triangle and ultra digital(UD). We were distinguished T-score into normal, osteopenia, osteoporosis(WHO classification) and evaluated discordance rate according to age and degree of bone loss. Correlation analysis and chi-square test between L-spine, L-4, femur neck, Ward, Forearm, UD were carried out. Results : In the lumbar spine, the number of normal were in 57(25.9%), osteopenia in 86(39.1%), osteoporosis in 77(35.0%). In the L-4 and ward's triangle, the number of osteoporosis were in 78(35.5%), in 126(57.3%). There was significant correlation between lumbar, femur neck and forearm BMD in all cases. The discordance of BMD between lumbar and femur were 57%, lumbar and forearm 43%, forearm and femur 51%. The discordance rates of normal, osteopenic, osteoporotic groups were 39%, 64%, 43%, respectively, showing the highest discordance rate in osteopenia patients. In normal group of lumbar spine, the discordance rate was 25%, 23%, 11%, 65%, 86% in 30', 40', 50', 60', 70', respectively. In osteopenia, osteoporosis group of lumbar spine, the discordance rate was 62%, 55%, 36%, 20%, 9% in 30', 40', 50', 60', 70', respectively. Conclusion : It was different of the results of BMD with lumbar, femur and forearm site. The discordance rate was decreased with age in osteopenia, osteoporosis lumbar spine. In osteopenia group, the discordance rate was the highest. So, it is necessary that the BMD of lumbar, femur neck and forearm should be checked.

• Journal of Korean Neurosurgical Society
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• v.30 no.6
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• pp.790-794
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• 2001

Spinal osteochondroms are very rare, and are thought to arise through a process of progressive endochondral ossification of aberrant cartilage of a growth plate, as a consequence of congenital defect or trauma. A case of diffuse type osteochondroma involving the posterior elements of L1-L5 that progressed after laminectomy in a 33-year-old man is reported. Usually, the spinal osteochondroma shows clear demarcation between tumor margin and normal spine elements, and can be exised completely. However, there was no clear demarcation between tumor and normal spine element in our case and therefore it was not possible to removal completely.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.4 no.1
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• pp.7-20
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• 1998

Activity of the trunk muscles is essential for maintaining stability of the lumbar spine because of the unstable structure of that portion of the spine. The central nervous system deals with stabilization of the spine by contraction of the abdominal and multifidus muscles in anticipations of reactive forces produced by limb movement. Recent evidence indicates that the lumbar multifidus muscle and transversus abdominis muscle may be involved in controlling spinal stability. Stabilization training in neutral spine is an integrated approach of education in proper posture and body mechanics along with exercise to improve strength, flexibility, muscular and cardiovascular endurance, and coordination of movement.

• Journal of Korean Neurosurgical Society
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• v.53 no.4
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• pp.255-257
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• 2013

Lumbar discal cyst is a rare cause of radiculopathy. Their exact pathogenesis and the optimal treatment modality remain unidentified. Depending on their location, discal cysts cannot always be easily identified intraoperatively. We describe 2 patients with discal cysts and introduce an intraoperative discography technique for discal cyst location. Both patients were treated with surgical excision; with intraoperative discography, the cystic lesions could easily be detected and removed.

• Journal of Korean Neurosurgical Society
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• v.53 no.1
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• pp.52-56
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• 2013

Four patients underwent lumbar surgery. In all four patients, the dura was minimally torn during the operation. However, none exhibited signs of postoperative cerebrospinal fluid leakage. In each case, a few days after the operation, the patient suddenly experienced severe recurring pain in the leg. Repeat magnetic resonance imaging showed transdural nerve rootlets entrapped in the intervertebral disc space. On exploration, ventral dural tears and transdural nerve rootlet entrapment were confirmed. Midline durotomy, herniated rootlet repositioning, and ventral dural tear repair were performed, and patients' symptoms improved after rootlet repositioning. Even with minimal dural tearing, nerve rootlets may become entrapped, resulting in severe recurring symptoms. Therefore, the dural tear must be identified and repaired during the first operation.

• The Journal of Korea CHUNA Manual Medicine
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• v.2 no.1
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• pp.111-120
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• 2001

We reviewed literatures of western and oriental medicine about postoperative management of spine. Traditionally, with orthoses and bed rest, many physicians restricted activity of daily life and back exercises of patients who had taken spine surgery. More aggressive early mobilization, however, such as strengthening exercise and stretching after 4 weeks of surgery gets grounds nowadays. Physical therapies including manipulation, TENS, MENS, ultrasound and cryotherapy are being used as helpful treatment modalities of postoperative pain and swelling. Failed back surgery syndrome occurs due to wrong patient, diagnosis and surgery and is managed with conservative treatment or reoperation. In oriental medicine, treatments of musculoskeletal injuries including surgical wound are based on the balance of chi(氣) and blood(血).

• Journal of Korean Neurosurgical Society
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• v.56 no.1
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• pp.66-70
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• 2014

Sympathetic dysfunction is one of the possible complications of anterior spine surgery; however, it has been underestimated as a cause of complications. We report two successful experiences of treating severe dysesthetic pain occurring after anterior spine surgery, by performing a sympathetic block. The first patient experienced a burning and stabbing pain in the contralateral upper extremity of approach side used in anterior cervical discectomy and fusion, and underwent a stellate ganglion block with a significant relief of his pain. The second patient complained of a cold sensation and severe unexpected pain in the lower extremity of the contralateral side after anterior lumbar interbody fusion and was treated with lumbar sympathetic block. We aimed to describe sympathetically maintained pain as one of the important causes of early postoperative pain and the treatment option chosen for these cases in detail.

• The Journal of Korea CHUNA Manual Medicine
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• v.6 no.1
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• pp.41-50
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• 2005

The aim of this study is to estimate clinical outcome of Conservative treatment for patients with Herniated Intervertebral Disc(HIVD) of lumbar spine. We investigated the 33 cases of Inpatients who were diagnosed as the HIVD of L-Spine and were treated Acupuncture therapy, Herb-medicine, Bee-vom treatment in Oriental Medicine Hospital from March 1, 2005 to November 31, 2005. We evaluated the subjective symptoms by Visual Analogue Scale, Hudgin's classification and follow-up of Activity Daily Living status. The improvement index showed that the oriental medical conservative therapy improved the symptom of HIVD effectively.