• Title/Summary/Keyword: Lumbosacral

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Comparing pain relief and functional improvement between methylprednisolone and dexamethasone lumbosacral transforaminal epidural steroid injections: a self-controlled study

  • Donohue, Nicholas K.;Tarima, Sergey S.;Durand, Matthew J.;Wu, Hong
    • The Korean Journal of Pain
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    • v.33 no.2
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    • pp.192-198
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    • 2020
  • Background: Previous studies have shown varying results between lumbosacral transforaminal epidural steroid injections (TFESIs) performed with particulate versus non-particulate corticosteroids. The purpose of this study was to investigate the difference in pain relief and functional improvement between particulate and nonparticulate lumbosacral TFESIs in patients who had undergone both injections, sequentially. Methods: This was a self-controlled, retrospective study of 20 patients who underwent both a methylprednisolone and a dexamethasone TFESI to the same vertebral level and side. Primary outcomes included pain relief according to the visual analogue scale (VAS) and functional improvement determined by a yes/no answer to questions regarding mobility and the activities of daily living. Post-injection data was recorded at 2, 3, and 6 months. Results: A decrease in VAS scores of -3.4 ± 3.0 (mean ± standard deviation), -3.1 ± 3.1, and -2.8 ± 3.4 was seen for the methylprednisolone group at 2, 3, and 6 months, respectively. Similar decreases of -3.9 ± 3.5, -3.4 ± 2.8, and -2.3 ± 3.4 were seen in the dexamethasone group. There was no significant difference in pain relief at any point between the two medications. The percentage of subjects who reported improved function at 2, 3, and 6 months was 65%, 51%, and 41%, respectively, for the methylprednisolone group and 75%, 53%, and 42% for the dexamethasone group. Conclusions: These findings support the use of non-particulate corticosteroids for lumbosacral TFESIs in the context of documented safety concerns with particulate corticosteroids.

Clinical Study on the Case of Patient with Lumbosacral Plexitis (요천추신경총병증으로 진단된 환자 1례에 대한 증례보고)

  • Kim, Jeong-Eun;Yoon, Hyun-Min;Ahn, Chang-Beohm;Jang, Kyung-Jun;Kim, Cheol-Hong;Jang, Sun-Hee;Park, Jae-Heung;Ku, Ji-Young;Lee, Chang-Hwan;Choi, Han-Na
    • Journal of Acupuncture Research
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    • v.26 no.5
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    • pp.161-169
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    • 2009
  • Objectives : The purpose of this study was to evaluate Oriental Medicine Therapy on the Lumbosacral plexitis patient. Methods : The patient was treated with dry needle acupuncture, bee venom pharmacupuncture, herb medicine, indirect moxibustion and physical therapy. We estimated S kinds of Symptoms by Visual Analog Scale, lower limb motor grade test, gait condition test and sensory examination to evaluate the effect of Oriental conservative treatment. Results : After treatment, patient's visual analogue scale score were generally decreased 10 to 4 and lower limb muscle power and gait condition were improved. Conclusions : Oriental Medicine Therapy might be an effective method to treat the Lumbosacral plexitis patient who was diagnosed as Wei Symptom. It is necessary to have more observation and many cases of patients with Lumbosacral plexitis.

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The Effect of Ankle-Foot Orthosis and Trunk Orthosis on Movement patterns used in a Supine to Stand Rising task (누운자세에서 똑바로 일어서기 운동형태에서 족관절보조기와 체간보조기의 영향)

  • kwon mi-ji
    • The Journal of Korean Physical Therapy
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    • v.16 no.2
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    • pp.22-32
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    • 2004
  • The purpose of this study was to examine the effect of ankle-foot orthosis and lumbosacral orthosis on movement patterns used to rise from the supine position to erect stance. Thirty-two healthy adults participated. Subjects were videotaped while rising from a supine position on a floor mat. Each subject performed 10 trials each of three condition;general condition, right ankle-foot orthosis, lumbosacral orthosis. subjects rose most commonly using a symmetrical push pattern of the upper extremities, a symmetrical squat pattern in the lower extremities, a symmetrical in the trunk under each of three conditions. Changes in the incidence of movement patterns occurred in lower extremities of the ankle-foot orthosis and lumbosacral orthosis condition and trunk of the ankle-foot orthosis condition. From a dynamic pattern theory perspective, ankle motion is a control variable for the supine position to erect standing movement.

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Lumbosacral plexopathy due to neurolymphomatosis superimposed on traumatic nerve injury

  • Hyun Jeong Lee;Jae Yoon Kim;Jaewon Beom
    • Annals of Clinical Neurophysiology
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    • v.25 no.1
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    • pp.45-49
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    • 2023
  • Neurolymphomatosis is the direct endoneurial infiltration of lymphoma cells. Bone marrow biopsy is a widely practiced procedure that is generally considered to be relatively safe. However, bone marrow biopsy can also result in pain and long-term consequences such as nerve injury. Here we report a case of a 68-year-old male who presented with lumbosacral plexopathy due to neurolymphomatosis that was superimposed on a probable traumatic lumbosacral plexopathy mostly involving the sciatic nerve immediately after a bone marrow biopsy.

Superior Gluteal Artery Perforator Turn-Over Flap Coverage for Lumboscaral Soft Tissue Defect in Ambulatory Patient (보행 환자에서의 위볼기동맥천공지뒤집기피판을 이용한 허리엉치 부위 연부조직 결손의 치료)

  • Moon, Suk-Ho;Kim, Dong-Seok;Oh, Deuk-Young;Lee, Jung-Ho;Rhie, Jong-Won;Seo, Je-Won;Ahn, Sang-Tae
    • Archives of Plastic Surgery
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    • v.37 no.5
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    • pp.712-716
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    • 2010
  • Purpose: Extensive lumbosacral defects after removal of spinal tumors have a high risk of wound healing problems. Therefore it is an effective reconstructive strategy to provide preemptive soft tissue coverage at the time of initial spinal surgery, especially when there is an instrument exposure. For soft tissue reconstruction of a lumbosacral defect, a variation of the gluteal flap is the first-line choice. However, the musculocutaneous flap or muscle flap that is conventionally used, has many disadvantages. It damages gluteus muscle and causes functional disturbance in ambulation, has a short pedicle which limits areas of coverage, and can damage perforators, limiting further surgery that is usually necessary in spinal tumor patients. In this article, we present the superior gluteal artery perforator turn-over flap that reconstructs complex lumbosacral defects successfully, especially one that has instrument exposure, without damaging the ambulatory function of the patient. Methods: A 67 year old man presented with sacral sarcoma. Sacralectomy with L5 corpectomy was performed and resulted in a $15{\times}8\;cm$ sized complex soft tissue defect in the lumbosacral area. There was no defect in the skin. Sacral stabilization with alloplastic fibular bone graft and reconstruction plate was done and the instruments were exposed through the wound. A $18{\times}8\;cm$ sized superior gluteal artery perforator flap was designed based on the superior gluteal artery perforator and deepithelized. It was turned over 180 degrees into the lumbosacral dead space. Soft tissue from both sides of the wound was approximated over the flap and this provided in double padding over the instrument. Results: No complications such as hematoma, flap necrosis, or infection occurred. Until three months after the resection, functional disturbances in walking were not observed. The postoperative magnetic resonance imaging scan shows the flap volume was well maintained over the instrument. Conclusion: This superior gluteal artery perforator turn-over flap, a modification of the conventional superior gluteal artery perforator flap, is a simple method that enabled the successful reconstruction of a lumbosacral defect with instrument exposure without affecting ambulatory function.

Analysis of Lumbosacral-Pelvic Parameters in Low Back Pain Patients (요통 환자의 요천추 및 골반 지표 분석)

  • Lee, Jin-Hyun;Jo, Dong-Chan;Kim, Chang-Gon;Moon, Su-Jeong;Park, Tae-Yong;Ko, Youn-Suk;Lee, Su-Kyung;Song, Yung-Sun;Lee, Jung-Han
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.2
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    • pp.139-149
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    • 2013
  • Objectives : The aim of this study was to investigate the characteristic of low back pain(LBP) and lumbosacral-pelvic alignments, and the relationship between them, depending on the presence and the duration of LBP. Methods : Ninety six patients were classified into the no LBP group(n=31), the acute LBP group(n=33) and the chronic LBP group(n=32), based on the presence and duration of LBP. In each group, lumbosacral-pelvic indicators were measured. The data were analysed by one way analysis of variance(ANOVA) and pearson correlation. Results : 1. The chronic LBP group showed the lower mean value in Ferguson angle, Lumbar lordosis angle, Pelvic Incidence and difference between left and right iliac height, being compared to acute LBP group. 2. There was not significant correlation between lumbosacral-pelvic alignments and LBP in every group. 3. A positive correlation was found among period of LBP and visual analogue scale(VAS), Oswestry disability index(ODI). Conclusions : For presence and duration of LBP, there were different characteristic values in descriptive statistics. And period of LBP is the most important factor for the degree of LBP. These results show that the lumbosacral-pelvic alignments and LBP have distinctive relationships depending on the duration of LBP.

The Change of Lumbar Mechanical Functions Caused by Recreational Exercise (여가성 운동이 요추의 역학적 기능에 미치는 영향)

  • Oh, Duck-Won;Yun, Hee-Jung;Yoo, Ji-Sun;Oh, Jae-Keun
    • Physical Therapy Korea
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    • v.6 no.1
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    • pp.23-34
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    • 1999
  • The purposes of this study were to investigate biomechanical variables of the lumbar spine for women who enjoy recreational exercises regularly, and to determine the factors that influence these variables. These variables were determined by the X-ray pictures of the lumbar area of 80 housewives who visited the department of rehabilitation at the Y Hospital from October 1997 to March 1998. The sacral inclination angle, the sacrohorizontal angle, the lumbosacral joint angle, and the lumbar lordotic angle were analysed. The t-test, correlation analysis, and multiple regression analysis were used to determine the significant differences and relationships among variables. The result were as follows: 1) There was a significant difference in the sacral inclination angle (p<0.01), the sacrohorizontal angle (p<0.05) and the lumbar lordotic angle (p<0.05) between the bilateral and the unilateral exercise group. 2) With the sacral inclination angle, the sacrohorizontal angle, the lumbosacral joint angle and the lumbar lordotic angle, correlation was found between the sacral inclination angle and the sacrohorizontal angle (p<0.01), the sacral inclination angle and the lumbosacral joint angle (p<0.05), the sacral inclination angle and the lumbar lordotic angle (p<0.05), and the sacrohorizontal angle and the lumbosacral joint angle (p<0.01). 3) In the bilateral exercise group, the sacral inclination angle correlated with age (p<0.01). The sacrohorizontal angle correlated with age (p<0.01) and exercise time (p<0.01). The lumbar lordotic angle correlated with age (p<0.05) and exercise duration (p<0.05). In the unilateral exercise group, the sacral inclination angle correlated with age (p<0.01), while the sacrohorizontal angle correlated with age (p<0.01) and exercise duration (p<0.05). The lumbar lordotic angle correlated with age (p<0.05).

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The effects of motorized flexion-distraction treatment on the lumbosacral region angle in patients with chronic low back pain (자동 굴곡-신연기법이 만성요통 환자의 요천추부 각도에 미치는 효과)

  • Ma, Sang-Yeol;Gong, Won-Tae;Cho, Gyo-Young
    • Journal of the Korean Data and Information Science Society
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    • v.20 no.2
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    • pp.339-348
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    • 2009
  • This study is to examine effects of motorized flexion-distraction treatment on the pain, lumbosacral angle, lumbar lordosis angle, and lumbar 5 (L5) intervertebral disc angle in patients with chronic low back pain. We selected 30 cases of chronic low back pain, which were evenly divided into two groups: experimental group and control group. We applied the same hot pack, interferential current therapy, and ultrasound therapy to both groups. The experimental group had additional treatment of motrized flexion-distraction therapy and control group had additional of stretching exercise. For each subject, the pain, lumbosacral angle, lumbar lordosis angle, and lumbar 5 (L5) intervertebral disc angle were measured before and after treatment, While experimental groups showed significant improvements after treatment, more significant effects were found in the experimental group.

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Correlation Analysis Between Narrowing Disc Space of Lumbar X-ray and HIVD of L-spine CT in Lumbosacral Strain Patients (좌섬요통환자에서 X-ray상 narrowing과 CT상 HIVD와의 연관성 분석)

  • Kim, Eun-young;Kim, Young-wook;Lee, Kyung-min;Kim, Ju-youn;Kim, Hyo-eun;Kang, Young-hwa;Seo, Jung-chul;Lim, Sung-chul;Han, Sang-won
    • Journal of Acupuncture Research
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    • v.19 no.6
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    • pp.125-133
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    • 2002
  • Objective : This study was designed to analyze the of correlation between narrowing disc space of lumbar X-ray and HIVD of L-spine CT in lumbosacral strain patients. Methods : 63 cases of lumbosacral strain patients who visited Bul-kyooh Oriental Hospital from June 13, 2000 to August 9, 2001 were selected. We performed the radiography by lumbar X-ray and L-spine CT for all cases. Results : 28 of 63 cases revealed narrowing disc space in Lumbar X-ray and these 28 cases were diagnosed as HIVD in L-spine CT at all. 35 of 63 cases revealed normal in Lumbar X-ray and 13 of these 35 cases were diagnosed as HIVD in L-spine CT. Conclusions : We found that narrowing disc space in lumbar X-ray has significant relevance to HIVD in L-spine CT(P-value = 0.001). For accurate diagnosis and treatment of lumbosacral strain patients. combination of clinical symptoms, physical examination and radiography of X-ray and HIVD is needed.

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The Study on Relation of Obesity and Low Back Pain Based on Body Composition using Segmental Bioelectrical Impedance Analysis and Radiological Parameter (체성분 분석 변수와 X-선 소견을 근거로 한 비만과 요통의 관계 연구)

  • Park, Ji-Hyun;Hong, Seo-Young
    • Journal of Korean Medicine Rehabilitation
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    • v.19 no.2
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    • pp.289-302
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    • 2009
  • Objectives : This study was performed in order to investigate the relation of body composition analysis and radiological parameter(lumbosacral angle, lumbar lordortic angle, lumbar gravity line). Methods : This study was carried out with the data from comprehensive medical testing. 75 subject aged 20-59 performed the segmental bioelectrical impedance analysis, questionnaire. And lumbosacral angle, lumbar lordortic angle and lumbar gravity line were measured in the standing position x-ray. Then we analyzed the data. Results : Low back pain(LBP) prevalence in high obesity index(Body Mass Index(BMI), Percentage of Body Fat(PBF), Waist Hip Ratio(WHR)) group was higher than LBP prevalence in normal obesity index group(p<0.01). In LBP group, lumbosacral angle, lumbar lordortic angle were significantly lager than Non-LBP group(p<0.001). And 75% of LBP group indicated abnormal lumbar gravity line ratio(0.67 < Normal lumbar gravity line ratio <1.00). When it comes to analyze relation between obesity index and radiological parameter, no-significant change was seen. Conclusions : This study carried as following research after the study on relation of obesity, LBP and trunk muscle strength. Results from this investigation showed positive correlation between obesity and LBP prevalence. But obesity index didn't indicate significant correlation with structural changes of lumbar vertebrae. When considering prior research, trunk muscle strength changes were more related to LBP prevelence in obese people. This results are expected to explain causes of LBP in obese group.