• Title/Summary/Keyword: Lumbar vertebral

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Survey of Sonoanatomic Distances For Lumbar Medial Branch Nerve Blocks in Healthy Volunteers

  • Gharaei, Helen;Imani, Farnad;Solaymani-Dodaran, Masoud
    • The Korean Journal of Pain
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    • v.27 no.2
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    • pp.133-138
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    • 2014
  • Background: The precise knowledge of anatomy and the region of transverse process (TP) and superior articular processes (AP) and their distance from the skin are important in blocking and treating lumbar facet syndrome. Evaluation of these anatomic distances from 3rd and 5th lumbar vertebrae in both sides and in different body mass index (BMI) in healthy volunteers might improve knowledge of ultrasound (US) lumbar medial branch nerve blocks (LMBB). Methods: Bilateral US in the 3rd and 5th lumbar vertebrae of 64 volunteers carried out and the distance between skin to TP and skin to AP was measured. These distances were compared on both sides and in different BMI groups. The analysis was done using SPSS 11. Analysis of variance was used to compare the means at three vertebral levels (L3-L5) and different BMI groups. P values less than 0.05 were considered statistically significant. The paired t-test was used to compare the mean distance between skin to TP and skin to AP on both sides. Results: The distance between skin to TP and skin to AP of 3rd vertebrae to 5th vertebrae was increased in both right and left sides (P < 0.001) from up to down. The mean distance from skin to TP were greater on the left side compared to the right in all three vertebral levels from L3 to L5 (P values 0.014, 0.024, and 0.006 respectively). The mean distance from skin to TP and the skin to AP was statistically significant in different BMI groups (P < 0.001). Conclusions: We found many anatomic distances which may increase awareness of US guided LMBB.

The Change of Motion Ranges of Adjacent Vertebral Joints after Lumbar Fusion Operation (요추 고정수술 후 인접척추 운동범위의 변화)

  • Yeo, Sang-Jun;Park, Seung-Won;Kim, Young-Baeg;Hwang, Sung-Nam;Choi, Duck-Young;Suk, Jong-Sik;Chung, Dong-Kue;Min, Byung-Kook
    • Journal of Korean Neurosurgical Society
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    • v.29 no.11
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    • pp.1456-1460
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    • 2000
  • Objectives : Transpedicular screw fixation has become an important method for internal fixation in variety of disorders. However, acceleration of degeneration at the adjacent segment in any follow. The goal of this study is to review the change of motion ranges of vertebral joints adjacent to fused level in lumbar spine. Methods : This study consists of 22 patients with degenerative spinal instability. Treatment of spinal instability includes posterior fusion with transpedicular screw fixation or transpedicular screw fixation with posterior lumbar interbody fusion. The flexion-extension angle(FEA) was measured from dynamic views of lumbar spine taken both at preoperative and post operative period. Results : The FEA of upper vertebral joint adjacent(FEA-u) to a fused L4-5 level was increased(p=0.010). The FEA-u was increased in case of L5-S1 fusion(p=0.025). The change of FEA-u in case of L5-S1 fusion was greater than that in L4-5 fusion(p=0.013). Conclusion : After L4-5 fusion, there seems to be more meaningful increase in FEA of L3-4 than that of L5-S1. The reason may be due to the damage of L3-4 facet joints during the operation, the other possible explanation may be the anatomical stability of L5-S1 vertebral joint. The change of FEA-u of L5-S1 fusion is increased more than that of L4-5 fusion. Because there are compensations in the adjacent vertebrae both above and below the fused L4-5, the compensatory motion in FEA-u of L5-S1 fusion was greater than that of the L4-5 fusion.

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Combined Anterior and Posterior En Bloc Vertebrectomy for Lumbar Chordoma

  • Jung, Youn-Young;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.45 no.4
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    • pp.243-245
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    • 2009
  • Chordoma is a rare bone tumor derived from remnants of the notochord. The majority of chordomas involve the sacrum or skull base. We report a rare case of a L4 vertebral body chordoma treated with anterior en bloc vertebrectomy and posterior stabilization. No tumor recurrence was observed at the 5 year follow-up examination.

A case of fused thoracic vertebrae, and lumbar vertebrae, sacrum and ilium of African elephant (Loxodonta africana) were fused one another partially (아프리카코끼리(Loxodonta africana)의 흉추골유합과 요추골, 천골 및 장골이 유합된 1례)

  • Kim, Chong-sup;Won, Chung-kil;Cho, Gyu-hen;Cho, Kyu-woan;Park, Joong-suk;Rho, Gyu-jin
    • Korean Journal of Veterinary Research
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    • v.42 no.2
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    • pp.131-136
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    • 2002
  • The vertebrae of female African elephant (Loxodonta africana) of twenty-eight years old were observed macroscopically. The result was summarized as follows; the vertebral formula of African elephant was $C_7$ $T_{21}$ $L_3$ $S_4$ $Cd_{21}$. The total length of the vertebral column removed intervertebreal disks was 353 cm. The length of each segment of vertebral column was 44 cm in cervical, 142 cm in thoracic, 21 cm in lumbar, 27 cm in sacral and 119 cm in caudal vertebrae. The 17th and 18th thoracic vertebrae (T) were partially fused each other in four parts: the transverse processes of 17th and 18th T, caudal articular process of 17th T and cranial articular process of 18th T, left mammilary process of 18th T and left transverse process of 17th T, and vertebral arch of 17th and 18th T, respectively. Others partial fusions also observed among the third luwbar, sacrum and ilium. These were in between transverse process of third lumbar vertebra and cranial parts of wing of sacrum, lateral part of sacrum and tuber sacrale, respectively. The sternum was consisted of three pieces; one is a part of anterior prestemum, two is the part from caudal demifacet at second facet to cranial demifacet at third facet in middle mesosternum, which is divided vertically into an half at second and third facets, respectively, and the last is the part between caudal demifacet of third facet in middle mesosternum and the posterior xiphisternum. There are 21 pairs of ribs, six sternal, ten asternal ribs and the last five being floating ribs.

Lumbar Osteochondroma Arising from Spondylolytic L3 Lamina

  • Choi, Byung-Kwan;Han, In-Ho;Cho, Won-Ho; Cha, Seung-Heon
    • Journal of Korean Neurosurgical Society
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    • v.47 no.4
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    • pp.313-315
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    • 2010
  • Osteochondromas are common, benign tumors in the long bones, but osteochondromas are rare in the vertebrae. Most vertebral osteochondromas arise from the cervical or upper thoracic spine. However, lumbar osteochondromas have rarely been reported. In this report, a rare case of a lumbar osteochondroma arising from the spondylolytic L3 lamina in a 57-year-old woman is presented. She also had a ruptured disc and lumbar canal stenosis at L4-5-S1. The osteochondroma was completely removed and a posterior lumbar interbody fusion and instrumentation were performed. Considering the rarity of osteochondromas in the lumbar vertebrae, especially the L3 vertebra, it is possible that the pre-existing lumbar spondylolysis or spondylolisthesis was one of the factors affecting the occurrence or progression of the osteochondroma.

The Case Report about Herniation of Inter-Vertebral Disc Treated with Taping Therapy (첩대요법으로 호전된 요추 추간판탈출증 환자 1례 보고)

  • Cho, Young-Chae;Rhee, See-Hyung;Cho, Tae-Young;Lee, Byeong-Yee;Jin, Sung-Soon;Lim, Hyung-Ho
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.1 no.1
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    • pp.83-89
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    • 2006
  • Objectives : The objective of this study is to evaluate the treatment effect of Taping therapy in Herniation of Inter-Vertebral Disc. Methods : Taping therapy were performed for 31 days ambulatory care in a patient who had Herniation of Inter-Vertebral Disc. Results : Physical examination of Lumbar Spine has improved, VAS were also decreased. Conclusion: Taping therapy were effective in reducing the symptoms. We think that it need the further study and clinical trial for Herniation of Inter- Vertebral Disc.

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Repeat Vertebroplasty for the Subsequent Refracture of Procedured Vertebra

  • Choi, Sang Sik;Hur, Won Seok;Lee, Jae Jin;Oh, Seok Kyeong;Lee, Mi Kyoung
    • The Korean Journal of Pain
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    • v.26 no.1
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    • pp.94-97
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    • 2013
  • Vertebroplasty (VP) can effectively treat pain and immobility caused by vertebral compression fracture. Because of complications such as extravasation of bone cement (polymethylmethacrylate, PMMA) and adjacent vertebral fractures, some practitioners prefer to inject a small volume of PMMA. In that case, however, insufficient augmentation or a subsequent refracture of the treated vertebrae can occur. A 65-year-old woman visited our clinic complaining of unrelieved severe low back and bilateral flank pain even after she had undergone VP on the $1^{st}$ and $4^{th}$ (L1 and L4) lumbar vertebrae a month earlier. Radiologic findings showed the refracture of L1. We successfully performed the repeat VP by filling the vertebra with a sufficient volume of PMMA, and no complications occurred. The patient's pain and immobility resolved completely three days after the procedure and she remained symptom-free a month later. In conclusion, VP with small volume cement impaction may fail to relieve fracture-induced symptoms, and the refracture of an augmented vertebral body may occur. In this case, repeat VP can effectively resolve both the persistent symptoms and problems of new onset resulting from refracture of the augmented vertebral body due to insufficient volume of bone cement.

Percutaneous Vertebroplasty in Treatment of Osteoporotic Vertebral Body Fractures : Early Result (골다공증성 추체골절에 대한 경피적 척추성형술 : 초기성적)

  • You, Young Sang;Shin, Jae Hack;Kim, Il-Man
    • Journal of Korean Neurosurgical Society
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    • v.30 no.2
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    • pp.163-167
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    • 2001
  • Objective : Percutaneous vertebroplasty has recently been introduced as an interesting therapeutic alternative for the treatment of thoracolumbar vertebral body fractures in elderly persons with osteoporosis. The authors present the early results of this method. Method and Material : From July 1999 to April 2000, percutaneous transpedicular technique was used in 20 patients (2 men and 18 women) whose mean age was 67.5 years old(range 59-79) with painful vertebral compression(22) and burst(2) fractures. The interval between fracture and vertebroplasty ranged 1 day to 4 months. The procedure involved percutaneous puncture of the injured vertebra via transpedicular approach under fluoroscopic guidance, followed by injection of polymethylmetacrylate(PMMA) into the vertebral body through a disposable 11-guage Jamshidi needle. Result : The most common cause of fracture was slip down and the most frequent injured level was the twelfth thoracic spine. The procedure was technically successful bilaterally in 18 patients(9 thoracic and 15 lumbar spines) with an average injection amount of 7.7ml PMMA in each level. Seventeen(94.4%) patients reported significant pain relief immediately after treatment. Two leaks of PMMA were detected with postoperative CT in spinal epidural space and extravertebral soft tissue without clinical symptoms. Conclusion : Although this study represents the early results, percutaneous vertebroplasty seems to be valuable tool in the treatment of painful osteoporotic vertebral body fractures in elderly, providing acute pain relief and early mobilization.

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Study on body measurement of fetuses and neonates in Korean native goats (한국재래산양(韓國在來山羊)의 태아(胎兒) 및 신생자(新生仔)의 체적측정치(體尺測定値)에 관(關)한 연구(硏究))

  • Kim, Chong-sup;Choe, Sang-yong;Chung, Hyon-sik;Kim, Taeg-seog
    • Korean Journal of Veterinary Research
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    • v.28 no.2
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    • pp.213-219
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    • 1988
  • The measurement was investigated with 18 heads of fetus(60, 90, 120 days of gestation) and neonate in Korean native goats. The results were summerized as follows: 1. The crown-rump length of fetuses at 60, 90, 120 days of gestation and neonate was 8.71, 20.83, 31.10 and 34.93 cm, respectively. 2. The length of small intestine at 60, 90, 120 days of gestation and neonate was 32.28, 157.10, 303.52 and 457.06 cm, respectively. 3. The length of large intestine at 60, 90, 120 days of gestation and neonate was 9.20, 37.70, 82.06 and 94.46 cm, respectively. 4. The ratio of intestinal length to crown-rump length at 60, 90, 120 days of gestation and neonate was 4.76, 9.45, 12.40 and 15.79 times, respectively. 5. At 60 days of gestation, the total length of the vertebral column was $7.40{\pm}0.72cm$, The mean length of each segment of the vertebral column was $1.55{\pm}0.20cm$ in cervical, $2.29{\pm}0.21cm$ in thoracic, $1.46{\pm}0.10cm$ in lumbar, $0.51{\pm}0.04cm$ in sacral and $1.59{\pm}0.17cm$ in coccygeal vertebrae. 6. At 90 days of gestation, the total length of the vertebral column was $16.52{\pm}0.80cm$. The mean length of each segment of the vertebral column was $3.72{\pm}0.12cm$ in cervical, $5.09{\pm}0.26cm$ in thoracic, $3.22{\pm}0.04cm$ in lumbar, $1.97{\pm}0.03cm$ in sacral and $2.64{\pm}0.35cm$ in coccygeal vertebrae. 7. At 120 days of gestation, the total length of the vertebral column was $26.35{\pm}0.34cm$. The mean length of each segment of the vertebral column was $6.09{\pm}0.16cm$ in cervical, $7.81{\pm}0.07cm$ in thoracic, $5.08{\pm}0.07cm$ in lumbar, $3.07{\pm}0.02cm$ in and $4.31{\pm}0.02cm$ in coccygeal vertebrae. 8. In the neonate, the total length of the vertebral column was $32.41{\pm}1.57cm$. The mean length of each segment of vertebral was $7.70{\pm}0.25cm$ in cervical, $9.97{\pm}0.68cm$ in thoracic, $5.58{\pm}0.44cm$ in lumbar, $3.85{\pm}0.15cm$ in sacral and $5.05{\pm}0.06cm$ coccygeal vertebrae. 9. The chest girth at 60, 90, 120 days of gestation and neonate was $6.13{\pm}0.51$, $13.45{\pm}0.84$, $20.28{\pm}1.53$ and $22.94{\pm}1.75cm$, respectively. 10. The head length at 60, 90, 120 days of gestation and neonate was $2.93{\pm}0.07$, $6.67{\pm}0.13$, $8.84{\pm}0.51$ and $9.76{\pm}0.44cm$, respectively. 11. The width of the head at 60, 90, 120 days of gestation and neonate was $2.20{\pm}0.13$, $4.45{\pm}0.11$, $5.33{\pm}0.20$ and $5.51{\pm}0.32cm$, respectively.

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Biomechanics of the Lumbar Intervertebral Disk (요추디스크의 생체역학)

  • Park Ji-Whan
    • The Journal of Korean Physical Therapy
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    • v.2 no.1
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    • pp.103-112
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    • 1990
  • The intervertebral disc in the anterior portion of the function unit gives the spine its flexibility. The disc is attached closely to the vertebral endplates. Between these endplates and the annulus fibrosus, the nucleus pulposus of the lumbar disc is enclosed in a circle of unyielding tissues. Compressive pressure placed on the disc is dissipated circumferentially in a passive manner In response to the greater axial forced exerted on the lumbar spine in comparison to the cervical and thoracic spines, the nucleus pulposus has its greatest surface area in the lumbar spine. The intervertebral disc is not only structure that helps diss pate stresses placed on the spine. With flexion, extension, rotation, or shear stress, the load distribution on the function unit is shared by the intervertebral disc, anterior and posterior longitudinal ligaments, the facet joints and capsules, and other ligamentous structures like the ligamentum flavum, interspinous and supraspinous ligaments, which attach to the posterior elements of the functional unit.

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