• Title/Summary/Keyword: Lumbar Vertebrae

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Effectiveness of percutaneous epidural neuroplasty using a balloon catheter in patients with chronic spinal stenosis accompanying mild spondylolisthesis: a longitudinal cohort study

  • Myong-Hwan Karm;Chan-Sik Kim;Doo-Hwan Kim;Dongreul Lee;Youngmu Kim;Jin-Woo Shin;Seong-Soo Choi
    • The Korean Journal of Pain
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    • v.36 no.2
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    • pp.184-194
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    • 2023
  • Background: Degenerative lumbar spondylolisthesis (DLS) is frequently associated with lumbar spinal stenosis (LSS) and conservative treatments such as epidural steroid injection do not have long-term benefits in LSS patients with DLS. This study evaluated the effectiveness of percutaneous epidural neuroplasty using a balloon catheter in patients with LSS and DLS. Methods: Patients' sex, age, body mass index, diabetes, hypertension, stenosis grading, pain duration, location, pain intensity, and medications were retrieved from electronic medical records. At 1, 3, and 6 months following the procedure, data on pain severity, medication usage, and physical functional status were analyzed. A generalized estimating equations model was used at the six-month follow-up. Patients were divided into those with DLS (the spondylolisthesis group) and those without DLS (the no spondylolisthesis group) to evaluate whether the effects of percutaneous epidural neuroplasty using a balloon catheter were different. Results: A total of 826 patients were included (spondylolisthesis: 433 patients, 52.4%; no spondylolisthesis: 393 patients, 47.6%). Age, body mass index, hypertension, pain location, and stenosis grading were statistically different between the two groups. The generalized estimating equations analyses with unadjusted and adjusted estimation revealed a significant improvement in the estimated mean numerical rating scale of pain intensities compared to that at baseline in both groups (P < 0.001). Any adverse events that occurred were minor and temporary. Conclusions: Percutaneous epidural neuroplasty using a balloon catheter may be an alternative treatment option for patients with chronic LSS, regardless of accompanying DLS, who have had failed conservative management.

Contralateral Pedicular Fracture with Unilateral Spondylolysis

  • Jeong, In-Ho;Hwang, Eai-Hong;Bae, Weon-Tae
    • Journal of Korean Neurosurgical Society
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    • v.46 no.6
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    • pp.584-587
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    • 2009
  • Although most authors regard contralateral pedicular fracture with unilateral spondylolysis as an unstable condition and recommend surgical management when immobilization fails in promoting bony healing of the fracture, few researchers have investigated the natural history of pedicle fracture or the causal relationship between symptoms and the fracture. In addition, there are no detailed guidelines that address the management of this disease. We report a rare case of contralateral pedicular fracture associated with unilateral spondylolysis at the L5 level which was successfully treated by rehabilitation with activity modification.

Successful Treatment of Infantile Fibrosarcoma Spinal Metastasis by Chemotherapy and Stereotactic Hypofractionated Radiotherapy

  • Lo, Cheng-Hsiang;Cheng, Shin-Nan;Lin, Kuen-Tze;Jen, Yee-Min
    • Journal of Korean Neurosurgical Society
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    • v.54 no.6
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    • pp.528-531
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    • 2013
  • We report a case of infantile fibrosarcoma in an 8-month-old boy manifested as a right-sided lower leg mass. Repeated local recurrence and distant metastasis were noted during the following three-year period. Whole body fluoro-deoxyglucose positron emission tomography scan revealed an asymptomatic metastasis involving the fourth lumbar vertebrae. The patient received chemotherapy (VAC regimen) with Cyberknife$^{(R)}$ stereotactic hypofractionated radiotherapy (26 Gy; 4 fractions). This treatment reduced tumor size by 23% without acute radiation toxicity even after 33 months. This case suggests that combining chemotherapy and this form of radiotherapy may be safe and effective against childhood spinal metastasis.

Vertebral Metastasis from Squamous Cell Carcinoma of the Anal Canal

  • Jwa, Cheol-Su;Sim, Sook-Young;Kim, Gang-Hyun;Kang, Jae-Kyu
    • Journal of Korean Neurosurgical Society
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    • v.42 no.1
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    • pp.46-48
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    • 2007
  • Distant metastasis of squamous cell carcinoma from the anal canal is an uncommon event. However, hematogenous spread to the vertebrae may occur in the course of this disease. The route of metastasis from the anal canal seems to be Batson's vertebral venous system. A 52-year-old female patient presented with lower back and right leg pain of one-week history. She has undergone radiotherapy and chemotherapy for squamous cell carcinoma of the anal canal and then was followed by surgical resection. Three months later, magnetic resonance images of the lumbar spine disclosed a well-enhanced mass of L5 vertebral body compressing the thecal sac. Surgical decompression and biopsy were performed. Histopathological study confirmed carcinoma of the squamous cell origin. We report a ra re case of vertebral metastasis from squamous cell carcinoma of the anal canal with a pertinent review of literature.

Electroacupuncture therapy for the treatment of thoracolumbar disc disease in dogs (개의 흉·요추 디스크 질환에 대한 전침요법 시술 예)

  • Seo, Kang-moon
    • Korean Journal of Veterinary Research
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    • v.35 no.4
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    • pp.863-868
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    • 1995
  • Electroacupuncture therapy was performed in 2 dogs with thoracolumbar disc disease. Case was a 3-year-old female chihuahua with a calcified disc between the 13th thoracic and 1st lumbar vertebrae. Treatment was done by electroacupuncture at San sho yu, Shen yu, Huan tiao and Fu yang-San yin jiao with the current of 0.5~8 volts, 30 Hz for 30 min. She could pass feces and urine 2 days, and walk 9 days after the beginning of the therapy. Case 2 Was a 6-year-old male cocker spaniel with 4 calcified discs(T12-T13, T13-L1, L2-L3 and L6-L7) and spondylosis(lumbosacral junction). Treatment was done by electroacupuncture at Tian ping, Bai hui and Pung kung yu with the current of 2~4 volts, 30 Hz for 20 min. He could pass feces 6 days, urine 8 days, and stand 21 days, after the beginning of the therapy.

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Anatomic Consideration of Spondylolysis and Spondylolisthesis type (척추 분리증과 척추 전방 전위증의 분류에 따른 해부학적 특성)

  • Kim gi-won
    • The Journal of Korean Physical Therapy
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    • v.15 no.4
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    • pp.24-33
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    • 2003
  • Spondylolysis and spondylolisthesis are two conditions that directly involve changes in the vertebra. Spondylolysis is defined as a defect in the pars interarticularis, the region of the lamina between the superior and inferior articular facets. Progression of the defect can result in spondylolisthesis, which is defined as a subluxation or 'slippage' of two adjacent vertebrae. In the low back it occurs most commonly at the lumbosacral level; next in frequency is spondylolisthesis of the fourth lumbar vertebra on the fifth. To provide the reader with information about the aetiology and anatomical consideration of spondylolysis and spondylolisthesis type. Spondylolisthesis has recently been classified by Wiltse and others into five types based on the suspected aetiology; dysplastic, isthmic, degenerative, posttraumatic, pathologic and postsurgical. Of these five types, isthmic spondylolisthesi and degenerative spondylolisthesis, both of which are frequently associated with low back and lower limb pain.

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Classification and visualization of primary trabecular bone in lumbar vertebrae

  • Basaruddin, Khairul Salleh;Omori, Junya;Takano, Naoki;Nakano, Takayoshi
    • Advances in biomechanics and applications
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    • v.1 no.2
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    • pp.111-126
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    • 2014
  • The microarchitecture of trabecular bone plays a significant role in mechanical strength due to its load-bearing capability. However, the complexity of trabecular microarchitecture hinders the evaluation of its morphological characteristics. We therefore propose a new classification method based on static multiscale theory and dynamic finite element method (FEM) analysis to visualize a three-dimensional (3D) trabecular network for investigating the influence of trabecular microarchitecture on load-bearing capability. This method is applied to human vertebral trabecular bone images obtained by micro-computed tomography (micro-CT) through which primary trabecular bone is successfully visualized and extracted from a highly complicated microarchitecture. The morphological features were then analyzed by viewing the percolation of load pathways in the primary trabecular bone by using the stress wave propagation method analyzed under impact loading. We demonstrate that the present method is effective for describing the morphology of trabecular bone and has the potential for morphometric measurement applications.

Radiogyaphic and Ultrasonographic Diagnosis of Pyelonephritis in 2 dogs (개에서 신우신염의 방사선학적 및 초음파학적 진단 2례)

  • 이기창;최민철
    • Journal of Veterinary Clinics
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    • v.19 no.3
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    • pp.371-374
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    • 2002
  • A female 8-year-old Pug weighing 7.3 kg and a female 10-year-old Maltese dog weighing 3.5 kg showing anorexia and vomiting for a few weeks were referred to Veterinary Medical leaching Hospital, Seoul National University. Radiographic findings were an enlarged right kidney in a pug dog and a radiopaque material on the right ureteral region lateral to the third lumbar vertebrae with indefinite right kidney contour in a Maltese dog, repectively. Excretory urography performed in a Pug dog revealed a poor opacified enlarged right kidney with absent of pelvic recesses and pelvic dilation with proximal ureteral dilation on contralateral kidney. Ultrasonographic findings were enlarged kidney with dilated pelvis and echogenic sediment within the medulla in both dogs and especially an engorged proximal ureter and a thin rim of functional renal tissue remains in a Maltese dog. Those diagnostic findings indicated high possibility of pyelonephritis and these were confirmed by pathologic examination. Radiography and ultrasonography, although not giving final diagnosis for pyelonephritis, are useful for assessment and diagnosis of pyelonephritis.

Retroperitoneal Yolk Sac Tumor in Adult Woman Presenting as Spinal Cord Compression and Fatal Pulmonary Tumor Embolism

  • Yi, Hyeong-Joong;Bak, Koang-Hum
    • Journal of Korean Neurosurgical Society
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    • v.39 no.4
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    • pp.296-299
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    • 2006
  • A 35-year-old woman, previously treated for systemic metastases from retroperitoneal yolk sac tumor, presented with progressive painful paraparesis. Preoperative images showed severe cord compression by the metastatic infiltration of the lumbar vertebrae and epidural mass as well as a huge retroperitoneal mass. While performing unremarkable surgery in prone position, the patient abruptly fell into hypoxic insults and circulatory arrest. Intraoperative pulmonary tumor embolism was deemed a cause of death. When planning operative procedure for this dangerous malignancy, scrupulous manipulation is mandated and the possibility of fatal pulmonary tumor embolism should also be addressed and fully discussed preoperatively.

The Influence of Different Quantitative Knowledge of Results on Performance Error During Lumbar Proprioceptive Sensation Training (양적 결과지식의 종류가 요추의 고유수용성감각 훈련에 미치는 영향)

  • Cynn, Won-Suk;Choi, Houng-Sik;Kim, Tack-Hoon;Roh, Jung-Suk;Yi, Jin-Bock
    • Physical Therapy Korea
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    • v.11 no.3
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    • pp.11-18
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    • 2004
  • This study is aimed at investigating the influence of different quantitative knowledge of results on the measurement error during lumbar proprioceptive sensation training. Twenty-eight healthy adult men participated and subjects were randomly assigned into four different feedback groups(100% relative frequency with an angle feedback, 50% relative frequency with an angle feedback, 100% relative frequency with a length feedback, 50% relative frequency with a length feedback). An electrogoniometer was used to determine performance error in an angle, and the Schober test with measurement tape was used to determine performance error in a length. Each subject was asked to maintain an upright position with both eyes closed and both upper limbs stabilized on their pelvis. Lumbar vertebrae flexion was maintained at $30^{\circ}$ for three seconds. Different verbal knowledge of results was provided in four groups. After lumbar flexion was performed, knowledge of results was offered immediately. The resting period between the sessions per block was five seconds. Training consisted of 6 blocks, 10 sessions per one block, with a resting period of one minute. A resting period of five minutes was provided between 3 blocks and 4 blocks. A retention test was performed between 10 minutes and 24 hours later following the training block without providing knowledge of results. To determine the training effects, a two-way analysis of variance and a one-way analysis of variance were used with SPSS Ver. 10.0. A level of significance was set at .05. A significant block effect was shown for the acquisition phase (p<.05), and a significant feedback effect was shown in the immediate retention phase (p>.05). There was a significant feedback effect in the delayed retention phase (p<.05), and a significant block effect in the first acquisition phase and the last retention phase (p<.05). In conclusion, it is determined that a 50% relative frequency with a length feedback is the most efficient feedback among different feedback types.

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