• Asian Spine Journal
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• 제12권6호
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• pp.981-986
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• 2018

Study Design: Retrospective case series. Purpose: Cauda equina syndrome (CES) is associated with etiologies such as lumbar disc herniation (LDH) and lumbar canal stenosis (LCS). CES has a prevalence of 2% among patients with LDH and exhibits variable outcomes, even with early surgery. Few studies have explored the factors influencing the prognosis in terms of bladder function. Therefore, we aimed to assess the factors contributing to bladder recovery and propose a simplified bladder recovery classification. Overview of Literature: Few reports have described the prognostic clinical factors for bladder recovery following CES. Moreover, limited data are available regarding a meaningful bladder recovery status classification useful in clinical settings. Methods: A single-center retrospective study was conducted (April 2012 to April 2015). Patients with CES secondary to LDH or LCS were included. The retrieved data were evaluated for variables such as demographics, symptom duration, neurological symptoms, bladder symptoms, and surgery duration. The variable bladder function outcome during discharge and at follow-up was recorded. All subjects were followed up for at least 2 years. A simplified bladder recovery classification was proposed. Statistical analyses were performed to study the correlation between patient variables and bladder function outcome. Results: Overall, 39 patients were included in the study. Majority of the subjects were males (79.8%) with an average age of 44.4 years. CES secondary to LDH was most commonly seen (89.7%). Perianal sensation (PAS) showed a significant correlation with neurological recovery. In the absence of PAS, bladder function did not recover. Voluntary anal contraction (VAC) was affected in all study subjects. Conclusions: Intactness of PAS was the only significant prognostic variable. Decreased or absent VAC was the most sensitive diagnostic marker of CES. We also proposed a simplified bladder recovery classification for recovery prognosis.

• 대한영상의학회지
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• 제85권1호
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• pp.54-76
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• 2024

후관절병증은 퇴행성 추간판 질환 또는 척추관 협착증과 같은 척추 퇴행성 질환과 잘 동반되는 진행성 퇴행성 질환이다. 요추의 후관절병증은 근위부 하지의 통증을 유발할 수 있지만 그 증상과 영상 소견이 비특이적이기 때문에 추간판 탈출증이나 신경근 압박에 의한 통증과 감별이 어렵다. 또한 치료적 요추 후관절 내 스테로이드 주사는 현재까지 그 근거가 낮다고 분류되어 있으나, 다른 여러 연구들에서는 후관절 내 스테로이드 주사의 치료적 효과를 보고하고 있다. 실제 진료 현장에서는 치료적 후관절 내 스테로이드 주사 시술이 증가하고 있는 추세로, 본 종설에서는 후관절 내 주사에 대한 저자들의 경험을 바탕으로 요추 후관절 내 주사의 임상적 유용성 및 시술의 안전성에 대해서 소개하고자 한다.

• 대한한방부인과학회지
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• 제19권3호
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• pp.203-213
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• 2006

Purpose : This study was carried out to evaluate correlation between Bone Mineral Density(BMD) and degenerative lumbar disease in postmenopausal low back pain patients. Methods : 69 postmenopausal patients with low back pain were examined. Magnetic resonance imaging was performed to evaluate degenerative lumbar disease and bone mineral density of lumbar spine was measured by Dual energy X-ray absorptiometry. Data were analyzed by Pearson's Linear Correlation Coefficient. Results : In postmenopausal patients with low back pain, BMD(T-score, Z-score) had negative correlation with the grade of intervertebral disc herniation and positive correlation with weight. Other lumbar diseases including Spinal stenosis, Spondylolisthesis and Facet joint arthrosis didn't have significant correlation with BMD. Conclusion : In postmenopausal patients with low back pain, BMD(T-score, Z-score) had inverse relationship with the grade of intervertebral disc herniation.

• The Korean Journal of Pain
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• 제14권2호
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• pp.245-248
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• 2001

Lysis of epidural adhesion has been done in patients with refractory lumbar radiculopathies. Cauda equina syndrome is a rare complication of epidural block. We report on a case of cauda equina syndrome following epidural adhesiolysis in a patient with spinal stenosis. The patient complained of numbness of the perineum, weakness of the left leg, an inability to void and fecal incontinence. She was treated with medication, bladder training and physical therapy, and finally recovered 1 month after the procedure without any sequelae. We suggest that the causative factors are osmotic damage produced by the subarachnoid injection of large doses of hypertonic saline and temporary neural compression due to spinal stenosis.

• The Korean Journal of Pain
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• 제27권1호
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• pp.3-15
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• 2014

As our population ages and the rate of spine surgery continues to rise, the use epidural lysis of adhesions (LOA) has emerged as a popular treatment to treat spinal stenosis and failed back surgery syndrome. There is moderate evidence that percutaneous LOA is more effective than conventional ESI for both failed back surgery syndrome, spinal stenosis, and lumbar radiculopathy. For cervical HNP, cervical stenosis and mechanical pain not associated with nerve root involvement, the evidence is anecdotal. The benefits of LOA stem from a combination of factors to include the high volumes administered and the use of hypertonic saline. Hyaluronidase has been shown in most, but not all studies to improve treatment outcomes. Although infrequent, complications are more likely to occur after epidural LOA than after conventional epidural steroid injections.

• Journal of Korean Neurosurgical Society
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• 제40권1호
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• pp.35-37
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• 2006

We present a case of acute spinal epidural hematoma[EDH] following unilateral laminectomy for bilateral decompression[ULBD]. A 45-year-old male presented with severe multi-level spinal stenosis underwent ULBD on the left side at the L2-3 and L3-4 level. Five hours after operation, paraparesis developed along with severe bilateral buttock pain. The CT scan showed an acute spinal EDH at the L2-3 level. The acute spinal EDH was successfully decompressed after emergency decompressive surgery with performing an additional laminectomy on the contralateral side at the L2-3 level. Although ULBD is an effective minimally invasive surgical technique for treating spinal stenosis, the possibility of acute spinal EDH should be kept in mind, as happened in our case.

• Journal of Korean Neurosurgical Society
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• 제37권1호
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• pp.63-66
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• 2005

The authors report a case of Currarino triad which had a congenital anorectal stenosis associated with a sacral defect and a presacral mass. A 1-year-old female presented with constipation since birth. Neurological deficits were not found on admission. She had had a diverting colostomy due to anorectal stenosis at another hospital before admission. Lumbar X-ray films showed bony defect caudal to the third sacral vertebra. Magnetic resonance image demonstrated a round cystic pelvic mass which was connected with a dural sac via anterior sacral defect. Posterior approach with Intradural removal of the presacral cystic mass was performed and followed by anoplasty by a pediatric surgeon. The cystic mass was verified histologically as mature teratoma with cystic change. Postoperatively, the urinary function and bowel movement remained intact. Currarino triad should be suspected and evaluated physically and radiographically in a case of congenital anorectal stenosis. Prompt recognition and close cooperation between pediatric surgeons and neurosurgeons is advisable to ensure adequate surgical treatment.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2003년도 추계학술대회 논문요약집
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• pp.18-18
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• 2003

• 대한기계학회논문집A
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• 제30권12호
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• pp.1509-1517
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• 2006

The intervertebral fusion was reported to increase the degeneration of the neighboring region. Recently, a new technique of inserting an interspinous process fixator has been introduced to minimize the degenerative change in the lumbar spine. This study analyzed biomechanical effects of the fixator in the lumbar spine, and designed a new prototype to improve flexibility of the fixator with a reduced size. The evaluation was based on the displacement, stiffness and von-Mises stress obtained from the mechanical test and finite element analysis. A finite element lumbar model of L1 to L5 was constructed. The finite element model was used to analyze intervertebral fusion, insertion of a commercial fixator and a new prototype. The range of motion of intervertebral segments and pressures at vertebral discs were calculated from FEA. The results showed that the stiffness of the prototype was reduced by 32.9% than that of the commercial one.

• 한방재활의학과학회지
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• 제25권2호
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• pp.135-153
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• 2015

Objectives The purpose of this study was to investigate the characteristics of inpatients who were admitted to Korean medicine hospital due to low back pain. Methods The current study was designed as a retrospective chart review to investigate descriptive characteristics of LBP patients. The clinical records of 601 patients who were hospitalized for treatment of LBP in Cheonan Korean Medicine Hospital, Daejeon University from 1st, January, 2013 to 31th, December, 2013 were analyzed. Results 1. Most frequently given diagnosis was sprain and strain of lumbar (45.93%). 2. Female outnumbered male patients in all disease groups except fracture of lumbar spine. 3. In distribution according to age, sprain and strain of lumbar, HNP of L-spine and lumbago with sciatica were most frequent at 30s, fracture of lumbar spine was most frequent at 50s and spinal stenosis was most frequent at 70s. 4. The most frequently motive for low back pain was traffic accident (35.4%) 5. Patients with no related medical history were 76.95% 6. 0~1week interval between onset and visit to Korean Medicine Hospital was most frequent in all disease groups. 7. 50.85% of patients went through treatment at medical institutions before the admitting to Korean Medicine Hospital. 8. The average admission days of female was higher than male's. And age goes up, average duration of admission was longer. 9. In most (74.59%) of the patients, symptoms were more than improved. 10. Most frequently prescribed examination was X-ray (65.13%). 11. Most frequently prescribed herb medicine was whal-lak-tang (Huoluo-tang). Conclusions In most (74.59%) of the patients, symptoms were more than improved, especially in sprain and strain of lumbar and lumbago with sciatica. But Patients with a local hospital statistic is not be representative of the incidence of the population. In order to obtain more accurate statistics, it is necessary to compare analysis collect statistics from other medical hospitals.