• International Journal of Contents
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• v.17 no.1
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• pp.18-26
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• 2021

The obesity leads to be the result of the weakening of anatomical structure as well as the gravity effect. And, the obesity interferes with normal sagittal balance and fails to maintain a straight posture with minimal energy. Therefore, the obesity can be an important factor in causing back pain by changing the lumbar lordosis. In this study, we will present an appropriate angle of incidence for obese people to reduce the image distortion of L4, L5 during a general anteroposterior radiography examination. To reduce image distortion according to the change of lordosis, the angle of incidence was applied 9 ° and 21 ° to L4 and L5 vertebra body when obesity and low back pain (LBP) perform the general anteroposterior radiography examination.

• Clinical Pain
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• v.20 no.1
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• pp.35-38
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• 2021

Bertolotti's syndrome is a congenital abnormality in which the expanded lower lumbar transverse process articulates with the ilium or sacrum. It is an important cause of low back pain in children and adolescents that is frequently misdiagnosed. We describe the case of a 17-year-old girl with low back pain who had a 4-year history of juvenile idiopathic arthritis. She subsequently underwent plain radiography and magnetic resonance imaging and was eventually diagnosed with Bertolotti's syndrome. She was managed conservatively with 6 weeks of physical therapy and an exercise program, and her pain subsided. This case demonstrates the importance of considering anatomical and structural variants when evaluating low back pain in adolescents.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2004.10a
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• pp.1207-1210
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• 2004

As many humans age, degenerative lumbar spinal stenosis (DLSS) becomes a major cause of lower limb discomfort and disability. By surgical treatment method of DLSS, the existing surgical treatment methods using internal fixation have showed degeneration changes of an adjacent vertebrae and loss of lumbar spine lordosis-kyphosis due to eliminating a motion. For solving the problems of internal fixation, a novel interspinous spacer has been developed to treat DLSS by surgical treatment method. In this study, we evaluated the biomechanical effects of the interspinous spacer on the kinematics of the porcine lumbar spine before and after insertion of the implant. For this purpose, a device that is capable of measuring 3-D motions were built based on direct linear transformation (DLT) algorithm written with MATLAB program. Results showed that in extension, a change of the mean angle between the intact and the implanted specimens at L4-L5 was 1.87 degree difference and the implant reduced the extension range of motion of the L4-L5 (p＆lt;0.05). But the range of motion in flexion, axial rotation and lateral bending at the adjacent segments was not statistically affected by the implant. In conclusion, we thought that interspinous spacer may have remedical value for DLSS by flexing human lumbar spine.

• Physical Therapy Rehabilitation Science
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• v.1 no.1
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• pp.28-32
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• 2012

Objective: The purpose of this study is to compare chronic low back pain patients' pain provocation position so as to identify the relevance with lumbar stabilizing muscles atrophy and pain provocation position. Design: Cross-sectional study. Methods: Fifty five chronic low back pain patients were participated in this study. Subjects were eligible for study participation if they were 35-55 years old and had experienced low back pain for more than 3 months. Subjects were questioned about pain and pain provocation test were done. And then they were inspected their cross sectional area (CSA) of lumbar muscles (erector spinae, iliopsoas, and multifidus) by using computed tomography. Analyze the relevance through the result data with painful area, aspect of pain and pain provocation position. Results: CSA of erector spinae showed significant decrease on ipsilateral extension position (p<0.05). Iliopsoas muscle showed significant decrease on contralateral position (p<0.05). Multifidus showed significant decrease on the position of contralateral extension and contralateral flexion (p<0.05). Conclusions: Based on the results of our study, it may be possible to evaluate muscle atrophy by assessing causing position.

• The Journal of the Korean bone and joint tumor society
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• v.5 no.3
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• pp.183-189
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• 1999

Ewing's sarcoma is an uncommon malignant neoplasm of the long bone and it has a poor prognosis due to its early metastasis and aggressive local spread. It is mostly found before the age of 30 and it is rare in extraskeletal sites. Extraskeletal Ewing's sarcoma has been reported to occur in various sites including the larynx, scalp, nasal fossa, neck, chest wall, lung, pelvis, perineum, arm, finger, leg and toe, but it is extremely rare as a primary epidural tumor of the spine. We experienced a case of extraosseous epidural Ewing's sarcoma arising in the lumbar spinal canal at L3-L5 level in a 9-year-old boy. Following total laminectomy from L3 to L5 with a lumbar vertebrae and mass excision, he received chemotherapy with complete remission.

• Journal of Korean Neurosurgical Society
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• v.54 no.5
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• pp.426-430
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• 2013

The prognosis of solitary plasmacytoma varies greatly, with some patients recovering after surgical removal or local fractional radiation therapy, and others progressing to multiple myeloma years later. Primary detection of progression to multiple myeloma is important in the treatment of solitary plasmacytoma. There have been several analyses of the risk factors involved in the early progression to multiple myeloma. We describe one case of solitary plasmacytoma of the lumbar vertebra that was treated with surgical decompression with stabilization and additional radiotherapy. The patient had no factors associated with rapid progression to multiple myeloma such as age, size, immunologic results, pathological findings, and serum free light chain ratio at the time of diagnosis. However, his condition progressed to multiple myeloma less than two months after the initial diagnosis of solitary plasmacytoma. We suggest that surgeons should be vigilant in watching for rapid progression to multiple myeloma even in case that the patient with solitary plasmacytoma has no risk factors for rapid progression to multiple myeloma.

• Journal of International Academy of Physical Therapy Research
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• v.10 no.2
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• pp.1810-1817
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• 2019

Background: Effect of cervical and lumbar tractions on the reduction in the angle of curvature and the effect of a correction exercise or a general traction method on balance, muscle strength, pain, and body alignment, however insufficient research has been undertaken on self traction exercises targeting patients with scoliosis. Purpose: To determine the effect of cervical and lumbar tractions on the reduction in the angle of curvature and the effect of a correction exercise or a general traction method on balance, muscle strength, pain, and body alignment. Design: Randomized controlled clinical trial (single blinded) Methods: Twelve adults(20s) with scoliosis were included in this study and performed a traction program that was composed of a 5-min warm-up exercise, a 15-min main exercise, and a 5-min cool-down exercise (25 minutes in total), three times a week for four weeks. The Chiro traction machine was used for the self-traction exercise. Vertebral alignment, muscle strength, and flexibility were compared before and after the intervention using the paired T-test. Results: The scoliosis angle, pelvic torsion, and lumbar extensor were significantly changed by intervention; however, there was no significant difference in flexibility. Conclusion: The results revealed that self-traction exercise activated blood flow through the extension and contraction of muscles, effectively increasing the function of the muscles around the vertebrae.

• Journal of Korean Neurosurgical Society
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• v.61 no.1
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• pp.89-96
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• 2018

Objective : Morphometric data for the lumbar posterior longitudinal ligament (PLL) was investigated to identify whether there is a difference in the morphometry of the PLL of the lumbar spine at each level with respect to the pattern of intervertebral disc displacement. Methods : In 14 formalin-fixed adult cadavers (12 males and 2 females), from L1 to L5, the authors measured the width and height of the PLL and compared them with other landmarks such as the disc and the pedicle. Results : Horizontally, at the upper margin of the disc, the central portion of the superficial PLL covered 17.8-36.9% of the disc width and the fan-like portion of the PLL covered 63.9-76.7% of the disc width. At the level of the median portion of the disc, the PLL covered 69.1-74.5% of the disc width. Vertically, at the level of the medial margin of the pedicle, the fan-like portion of the PLL covered 23.5-29.9% of the disc height. In general, a significant difference in length was not found in the right-left and male-female comparisons. Conclusion : This study presents the morphometric data on the pattern of intervertebral disc displacement and helps to improve the knowledge of the surgical anatomy of the lumbar PLL.

• The Korean Journal of Pain
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• v.31 no.1
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• pp.27-38
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• 2018

Background: Related to escalating health care costs and the questionable effectiveness of multiple interventions including lumbar facet joint interventions, cost effectiveness or cost utility analysis has become the cornerstone of evidence-based medicine influencing coverage decisions. Methods: Cost utility of therapeutic lumbar facet joint nerve blocks in managing chronic low back pain was performed utilizing data from a randomized, double-blind, controlled trial with a 2-year follow-up, with direct payment data from 2016. Based on the data from surgical interventions, utilizing the lowest proportion of direct procedural costs of 60%, total cost utility per quality adjusted life year (QALY) was determined by multiplying the derived direct cost at 1.67. Results: Patients in this trial on average received $5.6{\pm}2.6$ procedures over a period of 2 years, with average relief over a period of 2 years of $82.8{\pm}29.6$ weeks with $19{\pm}18.77$ weeks of improvement per procedure. Procedural cost for one-year improvement in quality of life showed USD $2,654.08. Estimated total costs, including indirect costs and drugs with multiplication of direct costs at 1.67, showed a cost of USD $4,432 per QALY. Conclusions: The analysis of therapeutic lumbar facet joint nerve blocks in the treatment of chronic low back pain shows clinical effectiveness and cost utility at USD $2,654.08 for the direct costs of the procedures, and USD $4,432 for the estimated overall cost per one year of QALY, in chronic persistent low back pain non-responsive to conservative management.

• Journal of Korean Neurosurgical Society
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• v.52 no.1
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• pp.1-6
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• 2012

Objective : The purpose of this study was to evaluate the different patterns of bone loss between the lumbar spine and the femur after ovariectomy in rats. Methods : Twenty-four female Sprague-Dawley rats underwent a sham operation (the sham group) or bilateral ovariectomy (the ovariectomized group). Four and eight weeks after operation, six rats from each of the two groups were euthanized. Serum biochemical markers of bone turnover including osteocalcin and alkaline phosphatase (ALP), which are sensitive biochemical markers of bone formation, and the telopeptide fragment of type I collagen C-terminus (CTX), which is a sensitive biochemical marker of bone resorption, were analyzed. Bone histomorphometric parameters of the 4th lumbar vertebrae and femur were determined by micro-computed tomography. Results : Ovariectomized rats were found to have higher osteocalcin, ALP and CTX levels than sham controls. Additionally, 8 weeks after ovariectomy in the OVX group, serum levels of osteocalcin, ALP and CTX were significantly higher than those of 4 weeks after ovariectomy. Bone loss after ovariectomy was more extensive in the 4th lumbar spine compared to the femur. Bone loss in the 4th lumbar spine was mainly caused by trabecular thinning, but in the femur, it was mainly caused by trabecular elimination. Conclusion : The present study demonstrates different patterns of bone loss between the 4th lumbar spine and the femur in ovariectomized rats. Therefore, when considering animal models of osteoporosis, it is important that bone sites should be taken into account.