• Journal of Korean Neurosurgical Society
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• v.44 no.3
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• pp.166-169
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• 2008

Sacral insufficiency fractures are usually known to develop in elderly patients with osteoporosis without definite trauma history. It is difficult to diagnose the sacral insufficiency fracture at an early stage because lower lumbar diseases. concurrently or not, may also be presented with similar symptoms and signs. We report a rare case of sacral insufficiency fracture who was not diagnosed initially but, instead, showed progressively worsening of clinical symptoms and radiological findings after decompression surgery for upper level lumbar stenosis.

• The Korean Journal of Pain
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• v.2 no.1
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• pp.78-84
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• 1989

Steroid and local anesthetics were injected into the epidural space through the posterior sacral foramen or lumbar approach in 4 patients for the purposes of relieving severe low back pain and radiculopathy. These patients were referred from other sections dealing with low back pain and radiculopathy, because one could not tolerate the surgical stress due to a heart problem, another two did not want the operation and the last had post-laminectomy status. All patients were satisfied with the results subjectively.

• Journal of Korean Neurosurgical Society
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• v.39 no.4
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• pp.310-313
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• 2006

Although lipomyelomeningocele and dermoid cyst are formed during a similar embryologic developmental stage of 'neural tube formation', they are caused by entirely different embryologic mechanisms. We encountered a case, which has not been previously reported, that had a lumbar subcutaneous dermoid cyst associated with lipomyelomeningocele. A 52-year-old man presented with a slowly growing lumbar mass of 3 years duration, which had been present since birth. Lumbosacral magnetic resonance imaging[MRI] showed lipomyelomeningocele at the L3, 4 and 5 levels and a subcutaneous cystic mass of high signal intensity on the T2 weighted image and iso or low signal intensity on the T1 weighted image. He underwent total resection of the lumbar subcutaneous mass. Intraoperative findings and histological examination were consistent with the preoperative diagnosis of a 'dermoid cyst'. We demonstrate that the formation of a dermoid cyst might coexist with lipomyelomeningocele during the embryologic developmental stage.

• Journal of Korean Neurosurgical Society
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• v.38 no.6
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• pp.481-483
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• 2005

We report a rare case of spontaneous spinal subdural hematoma[SSDH]. A 63-year-old man presented with radicular pain and paraparesis on both legs for several months. On magnetic resonance images, SSDH was found in lumbar region. Electrodiagnostic report showed bilateral lumbosacral polyradiculopathy, such as cauda equina syndrome. SSDH was drained with lumbar drainage at L4-5 level without direct exploration. The patient improved after drainage of the hematoma and then he was able to walk independently.

• Journal of Yeungnam Medical Science
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• v.37 no.2
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• pp.84-89
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• 2020

Spinal pain is a common patient complaint in clinical practice. Conservative treatment methods include oral medication, physical therapy, injections, and spinal orthoses. The clinical application of orthoses is debated because of potential complications associated with long-term use, such as muscle weakness and joint contracture. We reviewed the orthoses most frequently used to manage spinal pain. We review the use of soft cervical and Philadelphia collars, lumbosacral corsets, and thoracolumbosacral orthosis to manage spinal pain. Spinal orthoses can help reduce pain by protecting the muscles and joints of the injured spinal region, preventing or correcting malformations, and limiting trunk flexion, extension, lateral flexion, and rotation. The short-term use of spinal orthoses is known to improve pain and disability during the treatment period without significant adverse effects. Spinal orthoses are expected to alleviate pain and improve patients' lifestyle.

• Anatomy and Cell Biology
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• v.57 no.2
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• pp.320-323
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• 2024

Sciatic nerve (SN) is the thickest and longest nerve of the body. Deviations from the normal anatomical origin and level of bifurcation of SN have been frequently reported. In the present case, we are presenting a unique scenario of origin of terminal branches of the SN-tibial nerve (TN) and common peroneal nerve (CPN) in the pelvic region itself from divisions arising directly from the lumbosacral plexus. This variation was associated with origin of posterior femoral cutaneous nerve from the superior division of CPN with anomalous communicating branches between pudendal nerve and TN. The unique characteristics of the present case are the presence of 'pseudoganglion' found on the inferior division of TN. The present case stands out as the first of its kind to mention such pseudoganglion. Knowledge of some unusual findings like presence of pseudoganglion and intercommunications between nerves have clinical implications in anesthesiology, neurology, sports medicine, and surgery.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.2 no.2
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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.

• Journal of Acupuncture Research
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• v.27 no.4
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• pp.19-28
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• 2010

Objectives : To demonstrate the need for differential diagnosis between discogenic pain and lumbar sprain and strain in acute low-back pain patients. Methods : Outpatients who made their first visits during May 1, 2009 to Oct. 30, 2009(n=53) were examined by history taking, physical examination, X-rays, and CT imaging. Disorders found on lumbosacral spine X-ray cuts and those on lumbosacral spine CT images were separately recorded. The relationship between treatment period, disc space narrowing and disc degeneration on X-rays, and HIVD on CT images was examined. Results : 1. Correlation between disc space narrowing on X-rays and HIVD found on CT images was analyzed. 21(72.41%) out of 29 patients having disc space narrowing on X-rays and HIVD on CT at the same level required treatment for over 8 weeks. 2. 2(50%) out of 4 Lawrence classification grade I patients, 8(66.67%) out of 12 grade II patients, and 14(70%) out of 20 grade III patients needed treatment for over 8 weeks. Conclusions : Disc space narrowing on X-ray and HIVD on CT at the same level, or disc space narrowing and disc degeneration on X-ray image alone indicate a tendency for treatment periods over 8 weeks, which is longer than the conventional treatment period for lumbar strain and sprain.

• The Journal of Korean Physical Therapy
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• v.16 no.3
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• pp.86-96
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• 2004

A clinical study about painful manifestation on lumbar with regard to movement change of trunk The purpose of this study is to present the basis of low back pain therapy which is close examined of back muscle that is the main reason for that case of back pain when trunk rotation, flexion and extension. Therefore this study, which is based on literature review and clinical experience, has tried to figure out that back pain which is considered to be significant for the most increasing time, posture, motion, painful area, involved muscle have any influence on trunk rotation, flexion and extension This study has done with the patients in oriental rehabilitation clinic, K-oriental hospital, from Jan, 2003 to Dec, 2003. Total cases were 145(male:$39\%$-52 patients, female:$64.1\%$-93 patients) those who complained lumbosacral pain with radiating that makes patient unable to bending or extending the trunk. And they were surveyed retrospect way, checking the medical record and that of therapist. Results are as followings. 1. For sprain patient, $34.5\%$ complained pain on extension, and among them, the most remarkably, patients who did right rotation extension pattern were $20\%$. Herniated disc patient shows greater limit on flexion when trunk moves bending route, but right rotation with extension pattern shows the most limitation on flexion-extension according to the rotation of trunk 2. Cases of morning back pain($60.5\%$) showed high value on right rotation extension pattern($18.6\%$), right rotation flexion pattern($16.3\%$) but did not show big difference on left flexion and extension pattern 3. Patients those who complain pain on sitting position showed highest value each left, right $14.6\%$ of left and right rotation extension pattern 4. Among extension painful patient, there showed highest value of each $32.5\%$ on right rotation extension pattern, and $20.0\%$ on right rotation flexion pattern. 5. Tenderness distribution of quadratus lumborum showed $34.5\%$ on right rotation extension pattern, $20.7\%$ on left rotation extension pattern, and that of iliopsoas muscle at right rotation flexion pattern showed right muscle $20.0\%$, left $50.0\%$ Derived from the results of survey above, for sprain and HIVD patient showed greatest pain on right rotation pattern, for pain plus patient on right rotation extension among those who has extreme pain on sitting in the morning described tenderness on right quadratus lumborum, and those who complain pain on left rotation extension described tenderness on left lumborum the most Decisively, it is possible to figure out the problem muscle that involved when I found the time, position, motion that aggravating and painful area. Therefore this study would be expected to be able to be a useful clinical materials on diagnosis and therapy of low back pain.

• Journal of Korean Society of Spine Surgery
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• v.25 no.4
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• pp.185-195
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• 2018

Study Design: Literature review. Objective: Ultrasound-guided injections are a common clinical treatment for lower lumbosacral pain that are usually performed before surgical treatment if conservative treatment fails. The aim of this article was to review ultrasound-guided injections in the lumbar and sacral spine. Summary of Literature Review: Ultrasound-guided injections, unlike conventional interventions using computed tomography or C-arm fluoroscopy, can be performed under simultaneous observation of muscles, ligaments, vessels, and nerves. Additionally, they have no radiation exposure and do not require a large space for the installation of equipment, so they are increasingly selected as an alternative method. Materials and Methods: We searched for and reviewed studies related to the use of ultrasound-guided injections in the lumbar and sacral spine. Results: In order to perform accurate ultrasound-guided injections, it is necessary to understand the patient's posture during the intervention, the relevant anatomy, and normal and abnormal ultrasonographic findings. Facet joint intra-articular injections, medial branch block, epidural block, selective nerve root block, and sacroiliac joint injections can be effectively performed under ultrasound guidance. Conclusions: Ultrasound-guided injections in the lumbar and sacral spine are an efficient method for treating lumbosacral pain.