• 제목/요약/키워드: Lumbar spine MRI

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요추 추간판 탈출증을 동반한 척추전방전위증의 한방치료에 관한 임상적 고찰 (Clinical Study of the Treatment of Spondylolisthesis with Lumbar Herniated Intervertebral Disc)

  • 김태호;윤태경;윤영웅;정선영;이차로
    • 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.

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Prevalence of Disc Degeneration in Asymptomatic Korean Subjects. Part 1 : Lumbar Spine

  • Kim, Sang Jin;Lee, Tae Hoon;Lim, Soo Mee
    • Journal of Korean Neurosurgical Society
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    • 제53권1호
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    • pp.31-38
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    • 2013
  • Objective : Asymptomatic patients show high degeneration prevalence at lumbar disc in previous literatures. Unfortunately, there are few Korean data, so the authors attempted to analyze the prevalence of disc degeneration in highly selective asymptomatic Korean subjects using MRI. Methods : We performed 3 T MRI sagittal scans from T12 to S1 on 102 asymptomatic subjects (50 men and 52 women) who visited our hospital between the ages of 14 and 82 years (mean age 46.3 years). All images were read independently by three observers (two neurosurgeons and one neuroradiologist) who were not given any information about the subjects. We classified grading for lumbar disc herniation (HN), annular fissure (AF), and nucleus degeneration (ND), using disc degeneration classification. Results : The prevalence of HN, AF, and ND were 81.4%, 76.1%, and 75.8% respectively. Almost all levels showed an age-related proportional tendency with some exceptions. Conclusion : In asymptomatic Korean subjects, the abnormal findings showed high prevalence of AF, ND, and extrusion. Especially in young ages, the authors found that bulging, protrusion, and AF showed high prevalence at L4/5 and L5/S1. And ND showed high prevalence at L5/S1. So, all lumbar disc degenerations are not pathologic, especially in children and adolescents.

Evaluation of the Degenerative Changes of the Distal Intervertebral Discs after Internal Fixation Surgery in Adolescent Idiopathic Scoliosis

  • Dehnokhalaji, Morteza;Golbakhsh, Mohammad Reza;Siavashi, Babak;Talebian, Parham;Javidmehr, Sina;Bozorgmanesh, Mohammadreza
    • Asian Spine Journal
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    • 제12권6호
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    • pp.1060-1068
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    • 2018
  • Study Design: Retrospective study. Purpose: Lumbar intervertebral disc degeneration is an important cause of low back pain. Overview of Literature: Spinal fusion is often reported to have a good course for adolescent idiopathic scoliosis (AIS). However, many studies have reported that adjacent segment degeneration is accelerated after lumbar spinal fusion. Radiography is a simple method used to evaluate the orientation of the vertebral column. magnetic resonance imaging (MRI) is the method most often used to specifically evaluate intervertebral disc degeneration. The Pfirrmann classification is a well-known method used to evaluate degenerative lumbar disease. After spinal fusion, an increase in stress, excess mobility, increased intra-disc pressure, and posterior displacement of the axis of motion have been observed in the adjacent segments. Methods: we retrospectively secured and analyzed the data of 15 patients (four boys and 11 girls) with AIS who underwent a spinal fusion surgery. We studied the full-length view of the spine (anterior-posterior and lateral) from the X-ray and MRI obtained from all patients before surgery. Postoperatively, another full-length spine X-ray and lumbosacral MRI were obtained from all participants. Then, pelvic tilt, sacral slope, curve correction, and fused and free segments before and after surgery were calculated based on X-ray studies. MRI images were used to estimate the degree to which intervertebral discs were degenerated using Pfirrmann grading system. Pfirrmann grade before and after surgery were compared with Wilcoxon signed rank test. While analyzing the contribution of potential risk factors for the post-spinal fusion Pfirrmann grade of disc degeneration, we used generalized linear models with robust standard error estimates to account for intraclass correlation that may have been present between discs of the same patient. Results: The mean age of the participant was 14 years, and the mean curvature before and after surgery were 67.8 and 23.8, respectively (p<0.05). During the median follow-up of 5 years, the mean degree of the disc degeneration significantly increased in all patients after surgery (p<0.05) with a Pfirrmann grade of 1 and 2.8 in the L2-L3 before and after surgery, respectively. The corresponding figures at L3-L4, L4-L5, and L5-S1 levels were 1.28 and 2.43, 1.07 and 2.35, and 1 and 2.33, respectively. The lower was the number of free discs below the fusion level, the higher was the Pfirrmann grade of degeneration (p<0.001). Conversely, the higher was the number of the discs fused together, the higher was the Pfirrmann grade. Conclusions: we observed that the disc degeneration aggravated after spinal fusion for scoliosis. While the degree of degeneration as measured by Pfirrmann grade was directly correlated by the number of fused segments, it was negatively correlated with the number of discs that remained free below the lowermost level of the fusion.

요추 추간판 탈출증 환자의 굴곡신연기법 치료효과에 대한 임상적 고찰 (A Clinical study on the Effect of Chuna to Herniated Lumbar Disc Patients)

  • 이길재;이병이;장건;송윤경;임형호
    • 척추신경추나의학회지
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    • 제2권2호
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    • pp.79-88
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    • 2007
  • Objectives : This research is aimed to confirm the treating patients with herniated lumbar disc using Chuna treatment. Methods : Out of patients who were confirmed to have a herniated lumbar disc by MRI among the patients in oriental medical hospital of Kyungwon University from July 2005 to Dec 2006, we dived 15 people was treated common treatment, 15 people was treated both common treatment and Chuna treatment. We measured Visual Analog Scale(VAS) and symptom grade before and after treatment in each groups. Statistical analysis was performed by using SPSS program. Results : The result of the Visual Analog Scale(VAS) and symptom grade before and after treatment between two group, shows that the improvement of Back pain and Sciatica in common treatment with Chuna treatment group is more effective than that in only common treatment group.

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굴곡신연기법을 이용한 흉요추 추간판 탈출증과 척추 측만증의 치험 1례 (A Case Report on the Thoracic & Lumbar Disc and Scoliosis Treated by Flexion-Distraction Technique)

  • 김세종;민부기;윤일지;오민석
    • 척추신경추나의학회지
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    • 제1권2호
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    • pp.73-80
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    • 2006
  • 2006년 6월 13일부터 2005년 7월 10일까지 대전대학교 부속 청주한방병원 한방재활과에 입원하였던 교통사고로 인하여 악화된 요통 및 하지 방산통의 임상증상을 보이며 신경학적인 이학검사 및 X-ray 혹은 자기공명영상(MRI)에서 흉요추 추간판 탈출증 및 척추 측만증으로 확진된 환자에게 굴곡신연기법을 병행한 치료법을 시술하여 요통의 호전 및 측만각의 개선 효과를 거두어 이에 보고하는 바이다.

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요추 추간판탈출증 환자 6례에 대한 감압치료와 추나치료의 비교 임상보고 (Clinical Case Report on Comparison Between 6 Herniated Lumbar Disc Patients Which Were Divided into Two Groups each Treated by Decompression Therapy and Chuna Treatment.)

  • 필감흔;김에스더;송용선;김동은
    • 척추신경추나의학회지
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    • 제4권1호
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    • pp.75-84
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    • 2009
  • Objective : The purpose of the study is to compare the effects and efficacy of both treatments. Methods : 2 groups were divided among 6 patients who admitted to Jeonju Wonkwang hospital attached to Wonkwang University from 2009. jan. 1 to 2009. feb. 28 were diagnosed as herniated lumbar disc by lumbar CT or MRI. Each groups were treated by decompression therapy and chuna traetment daily and were measured under visual analogue scale and ODI score starting from the day of admission, after 1week, and second week to compare the results. Results and Conclusions : Decompression therapy and chuna treatment both showed effects on treating the patients though chuna traetment apparently revealed to be slightly more efficient. Due to the lack of abundant clinical data it was not objective in a strict sense but it was clinically meaningful enough.

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요추부 후종인대에서 발생한 결절종 (Spinal Ganglion Cyst of Lumbar Posterior Longitudinal Ligament)

  • 노성우;임승철;이호규;강신광
    • Journal of Korean Neurosurgical Society
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    • 제29권4호
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    • pp.543-549
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    • 2000
  • 결절종은 말초 관절이나 인대에서 비교적 흔히 발견되나 척추 내 결절종은 드물게 보고되고 있다. 저자들은 5예의 요추후종인대에서 발생한 결절종을 경험하고 이들의 임상적, 방사선학적 특징, 수술소견 등에 대하여 고찰하였다. 저자들의 예에서 요추 내 결절종은 요통 및 하지통증을 유발하여 임상적으로 요추간반탈출증과 유사한 소견을 보였다. 요추 MRI상 진단이 가능하였고 5예 모두에서 특징적으로 요추디스크의 퇴행성 변화와 연관되어 있었으며 결절종이 요추디스크와 바로 인접된 부위에 위치하였다. 본 소견으로 저자들은 요추후종인대에서 발생한 결절종은 디스크의 퇴행성 변화와 밀접한 관계가 있다고 추론하였다. 수술은 5예 모두에서 완전절제가 가능하였고 전 예에서 수술 후 증상호전을 보였다.

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Magnetic Resonance Imaging Grading Systems for Central Canal and Neural Foraminal Stenoses of the Lumbar and Cervical Spines With a Focus on the Lee Grading System

  • Jiwoon Seo;Joon Woo Lee
    • Korean Journal of Radiology
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    • 제24권3호
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    • pp.224-234
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    • 2023
  • Magnetic resonance imaging (MRI) is a standard imaging modality for diagnosing spinal stenosis, which is a common degenerative disorder in the elderly population. Standardized interpretation of spinal MRI for diagnosing and grading the severity of spinal stenosis is necessary to ensure correct communication with clinicians and to conduct clinical research. In this review, we revisit the Lee grading system for central canal and neural foraminal stenosis of the cervical and lumbar spine, which are based on the pathophysiology and radiologic findings of spinal stenosis.

요추간판탈출증 환자의 요천각, 요추중력중심선 및 요추전만각의 통계적 관찰 (Statistical Study of the Ferguson's Angle, Lumbar Gravity Line and Lumbar Lordotic Angle in HIVD Patients.)

  • 고동현;홍순성;이진호;정성엽;신준식
    • 척추신경추나의학회지
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    • 제2권2호
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    • pp.17-32
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    • 2007
  • Objectives : The lumbosacral joint is unstable area from an anatomical viewpoint, while it is also a very mobile area in ordinary life, so that clinically major causes of low back pain originate in this joint. The purpose of this study is to assess the difference of the Ferguson's angles, Lumbar gravity lines, Lumbar lordotic angles among Herniated of Intervertebral Disc(HIVD) patients. Methods : We analyzed the lateral view of lumbar spine checked at erect position on 88 patients who had been diagnosed as HIVD by Magnetic Resonance Imaging(MRI). We investigated the Ferguson's angle, Lumbar gravity line, Lumbar lordotic angle on X-ray film. Results and Conclusions : In the acute lumbago group the Ferguson's angle had a tendency to decrease, while in the chronic group it had a tendency to increase. In the acute lumbago group the Lumbar gravity line fell in front of the normal range(sacrum), while in the chronic group it fell behind the normal range(sacrum). In the acute lumbago group the Lumbar lordotic angle usually decreased, while in the chronic group it increased. The Ferguson's angle and the Lumbar gravity line, the Ferguson's angle and the Lumbar lordotic angle, the Lumbar gravity line and Lumbar lordotic angle each had a positive realtionship. The Ferguson's angle, the Lumbar gravity line and the Lumbar lordotic angle was less influenced by the level of HIVD and was more influenced by how long the patient had the pain. The correlationship between each factor was less in the chronic lumbago group than the acute group. In the chronic lumbago group the instability of the lumbosacral joint increased, while in the acute group the compression of the weight on the sacrum increased.

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Central Nervous System Involvement of Acute Lymphoblastic Leukemia

  • Hyun, Seung-Jae;Kim, Young-Baeg;Yu, Hyeon;Hong, Hyun-Jong
    • Journal of Korean Neurosurgical Society
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    • 제40권1호
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    • pp.54-57
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    • 2006
  • Central nervous system[CNS] involvement of acute lymphoblastic leukemia may occur. However, CNS involvement as a first manifestation of leukemia is very rare. An 8-year-old girl complained of a backache after playing in the water. Neurological examination detected progressing paraparesis. Magnetic resonance imaging[MRI] of the thoracolumbar spine showed a well-circumscribed homogeneous posterior extradural mass lesion extending from T7 to T9. MRI of the brain showed diffused fatty marrow replacement of the calvarium and the skull base. We report a patient with epidural Burkitt's lymphoma of the thoracic and lumbar vertebra causing compression of the spinal cord after pathologic evaluation. The tumor consisted mainly of lymphoblastic cells, which were identical to those originally seen in the bone marrow aspiration and biopsy. After decompressive laminectomy she began consolidation chemotherapy.