• Annals of Clinical Neurophysiology
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• 제24권1호
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• pp.26-29
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• 2022

Immune checkpoint inhibitors (ICIs) have emerged as one of the most promising therapeutic options for advanced cancers. While ICIs have improved survival in multiple cancers, their increased use is restricted by various immune-related adverse events. In this report we describe a patient with renal cell carcinoma who received a combination of ICIs, nivolumab plus ipilimumab, and who developed lumbosacral polyradiculoneuropathy. Corticosteroid use was an effective treatment for this patient.

• 대한자기공명의과학회:학술대회논문집
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• 대한자기공명의과학회 2007년도 학술대회
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• pp.39-39
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• 2007

• 한방재활의학과학회지
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• 제20권4호
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• pp.171-183
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• 2010

Objectives : The biomechanical relationship of leg length discrepancy(LLD), Lumbar lordosis, pelvic variance and degenerative scoliosis is one of the most important parameters when treat musculoskeletal disorders, however the reports are still controversial. The purpose of this study was to compare the relationships between the parameters and bothersomeness in subject with chronic ow back pain. Methods : Sixty female and eight male adults with non specific low back pain over 3 months were recruited. LLD was measured by tape measure method. Lumbar lordosis, lumbosacral angle and related pelvic parameters were measured using simple radiologic films of lumbosacral view. Results : Lumbar lordosis was significantly correlated to the lumbosacral angle, pelvic incidence and difference of the both iliac widths. Pelvic incidence had significant correlation with difference of the both iliac widths. And difference of both iliac widths was related with LLD by radiologic film. There was also significant correlation between the LLD by radiologic film and tape measurement. Visual analogue scale(chronic low back pain) of normal lordosis group was greater than hyperlordosis group. Conclusions : There were close biomechanical relationships between lumbar, pelvis, and lower extremity. But in order to determine the effect of structure on the chronic low back pain, global balance of musculoskeletal structure seems to be worth further researching.

• Journal of Korean Neurosurgical Society
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• 제58권4호
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• pp.357-362
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• 2015

Objective : To investigate risk factors for S1 screw loosening after lumbosacral fusion, including spinopelvic parameters and paraspinal muscles. Methods : We studied with 156 patients with degenerative lumbar disease who underwent lumbosacral interbody fusion and pedicle screw fixation including the level of L5-S1 between 2005 and 2012. The patients were divided into loosening and non-loosening groups. Screw loosening was defined as a halo sign larger than 1 mm around a screw. We checked cross sectional area of paraspinal muscles, mean signal intensity of the muscles on T2 weight MRI as a degree of fatty degeneration, spinopelvic parameters, bone mineral density, number of fusion level, and the characteristic of S1 screw. Results : Twenty seven patients showed S1 screw loosening, which is 24.4% of total. The mean duration for S1 screw loosening was $7.3{\pm}4.1$ months after surgery. Statistically significant risk factors were increased age, poor BMD, 3 or more fusion levels (p<0.05). Among spinopelvic parameters, a high pelvic incidence (p<0.01), a greater difference between pelvic incidence and lumbar lordotic angle preoperatively (p<0.01) and postoperatively (p<0.05). Smaller cross-sectional area and high T2 signal intensity in both multifidus and erector spinae muscles were also significant muscular risk factors (p<0.05). Small converging angle (p<0.001) and short intraosseous length (p<0.05) of S1 screw were significant screw related risk factors (p<0.05). Conclusion : In addition to well known risk factors, spinopelvic parameters and the degeneration of paraspinal muscles also showed significant effects on the S1 screw loosening.

• 대한물리치료과학회지
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• 제16권3호
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• pp.11-17
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• 2009

Background: The purpose of this study was designed to find out the effectiveness of reposition sense, muscle fatigue response on lumbar spine after apply lumbosacral stabilization exercise program to 4 patients with chronic low back pain and for 12 weeks. Method: In this study the reposition sense was measured in 3 angle(60, 30, 12) of the lumbar spine motion with blind by MedX test machine and the difference of instability to lumbar vertebra segments in flexion, extension test of standing position and spinal load test Mattress Test by Spinal Mouse. The stabilization exercise program was applied 2 times a week for 12 weeks in hospital and 2 times a day for 20 minutes at home. Result: The results of the present study were that the repositioning sense was appeared the most error in 12 angles of lumbar flexion and Men was appeared to decrease an error more than female in average value of 4 angles after 12 weeks. And average error of male was decrease more than female. Thus the effects of lumbosacral stabilization exercise was improved repositioning sense of prorioceptor. Fatigue response test(FRT) results, in male, was raised muscle fatigue rate during increase weight, on the other hand female appeared lower than male. Conclusion: As a results, lumbosacral stabilization exercise was aided to improvement of lumbar spine repositioning sense and vertebra segments stabilization. It was showed the rate of decrease in typically 12 degree angle point of each 3 angle(60, 36, 12). Especially, that spine instability patients will have a risk when in lifting a load or working with slight flexion posture around 12 degree during the daily of living life and it is probably to increase recurrence rate. Thus, not only lumbar extension muscle strength but also stability of vertebra segments in lumbar spine may be very important.

• The Journal of Korean Physical Therapy
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• 제23권5호
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• pp.15-21
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• 2011

Purpose: The purpose of this study was to describe the influence of respiration on the segmental motion of the lumbar spine in the lying position. Methods: Twelve healthy females without a history of low back pain participated. Lumbosacral lordosis, intervertebral body angles, intervertebral body displacements, and anterior heights of the intervertebral disc of the lumbar spine were measured at inspiration, expiration and forced expiration in the supine and prone positions via fluoroscopy. Results: The results of lumbar kinematic analysis in the supine position according to respiration pattern were as follows. The L4/5 intervertebral body angle was significantly higher at forced expiration than at expiration (p<0.05). The L3/4 anterior height of the intervertebral disc was significantly higher at expiration than at forced inspiration and the L5/S1 anterior height of the intervertebral disc was significantly higher at inspiration than at forced expiration (p<0.05). There were no significant differences in the intervertebral body displacements and lumbosacral lordosis in the supine position (p>0.05). The results of lumbar kinematic analysis in the prone position according to respiration pattern were as follows. The L5/S1 anterior height of the intervertebral disc was significantly higher at inspiration than at forced expiration (p<0.05). However, there was no significant difference in the intervertebral body angle, the intervertebral body displacements, and the lumbosacral lordosis (p>0.05). Conclusion: These findings suggested that respiration can affect the intervertebral body angle and anterior height of the intervertebral disc in some segments. The results from this study serve as a step in the development of guidelines for lumbar kinematic analysis for lumbar breathing training.

• The Journal of Korean Physical Therapy
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• 제13권1호
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• pp.127-137
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• 2001

Low back pain is significant problem in today's society, with lifetime incidence rate reported between 50% and 90%. Many factors associated with LBP are reported. The purpose of this studies were to be evaluated static standing posture aberrations in chronic LBP in comparison with healthy individuals. The samples including 80 subjects recruited to the following two groups:patients and control(normal) Questionnaires were completed by 40 LBP patients and 40 controls at the department of Physical Therapy, Saejong neurosurgical clinic in Taegu city from October 1, 1999 to March 30, 2000. The angle of lumbar lordosis was measured on lateral x-ray films with standing position. In LBP groups. the mean degree of lumbar lordosis, sacral inclination, and lumbosacral joint angle were 29.9 ${\pm}$ 9.3, 34.8 ${\pm}$ 8.2, and 12.7 ${\pm}$ 5.7 respectively. Control groups, the mean degree of lumbar lordosis, sacral inclination and lumbosacral joint angle were 35.3 ${\pm}$ 7.8, 34.9 ${\pm}$ 6.4 and 12.5 ${\pm}$ 4.3 respectively. there were significantly decreaseds in lumbar lordosis in Low back pain group. lumbar lordosis on the working posture had significant differences among groups(sitting position patients 31.4 ${\pm}$ 9.3, standing position patients 29.4 ${\pm}$ 9.3, sitting position control 35.0 ${\pm}$ 6.4, standing position control 35.5 ${\pm}$ 8.8, respectively) (p=0.034). sacral inclination on the working posture had differences among groups(sitting position patients 35.9 ${\pm}$ 8.7.standing position patients 33.6 ${\pm}$ 7.6, sitting position control 33.9 ${\pm}$ 5.9. standing position control 35.6 ${\pm}$ 6.8, respectively). lumbersacral joint angle on the working Posture had differences among groups(sitting position patients 12.0 ${\pm}$ 5.6, standing position patients 13.4 ${\pm}$ 5.9, sitting position control 11.2 ${\pm}$ 3.0. standing position control 13.4$^{\circ}$, respectively).

• The Journal of Korean Physical Therapy
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• 제23권6호
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• pp.9-14
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• 2011

Purpose: The pelvic tilting exercise is a well recognized rehabilitation maneuver. However, little information is available on the changes of lumbar segmental motion during pelvic tilting. This study was conducted to measure the kinematics of the pelvic tilting exercise on the supine and prone positions via fluoroscopy. Methods: A total of 10 female subjects were enrolled. During anterior, neutral, and posterior pelvic tilting, radiographs were taken in each exercise via fluoroscopy (ARCADIS Orbic, Siemens, USA). Images were sent to the picture archiving communication system (PACS), and the digitized images were analyzed using LabVIEW software (National Instruments, USA). Lumbosacral lordosis and the intervertebral body angle, intervertebral disc angle, and intervertebral displacement were analyzed. Results: The results of lumbar kinematic analysis during three tilting postures in the supine and prone positions demonstrated that lumbosacral lordosis and the intervertebral body angle and intervertebral disc angle were significantly higher when the pelvis was tilted anteriorly (p>0.05). However, there was no significant difference between anterior and neutral tilting in the intervertebral disc angle at the L3/4 level in the prone position (p>0.05), and there was no significant difference among tilting positions in intervertebral body displacement in the prone position (p>0.05). Conclusion: This study provides scientific evidence about the pelvic tilting exercise in lumbosacral segmental motion. Depending on the pelvic tilting exercise, kinematic changes were demonstrated in both positions, especially in the supine position. It is suggested that the supine position is effective for mobility, but it should be used carefully for the LBP (Low back pain) patient with hypermobility.

• Journal of Korean Neurosurgical Society
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• 제47권1호
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• pp.1-6
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• 2010

Objective: On the basis of preoperative computed tomography (CT) scans, we studied the change of the size of anterior primary division (APD) of the L5 spinal root in the presence of foraminal/extraforaminal entrapment of the L5 spinal root. Methods: Two independent radiologists retrospectively reviewed the preoperative CT scans of 27 patients treated surgically and compared the sizes of the APDs on bilateral L5 spinal roots. If one side APO size was larger than the other side APD size, it was described as left or right "dominancy" and regarded this as "consensus (C)" in case that there was a consensus between the larger APD and the location of sciatica, and regarded as "non-consensus (NC)" in case that there was not a consensus. Oswestry Disability Index (ODI) scores were used for preoperative and postoperative evaluation. Results: On CT scans, twenty-one (77%) of 27 patients were the consensus group (APD swelling) and 6 (22%) were a non-consensus group (APD no swelling). In 9 patients with acute foraminal disc herniations, asymmetric enlargement of the APD on L5 spinal root was detected in all cases (100%) and detected in 11 (64%) of 17 patients with stenosis. Preoperative ODI score was 75-93 (mean 83) and postoperative 001 scores were improved to 13-36 (mean 21). The mean follow-up period was 6 months (range, 3-11 months). Conclusion: An asymmetric enlargement of the APD on L5 spinal root on CT scans is meaningfully associated with a foraminal or extraforaminal entrapment of the L5 spinal root on the lumbosacral junction.

• 한방재활의학과학회지
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• 제32권1호
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• pp.125-131
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• 2022

This study was to investigate the effectiveness of combined Korean medicine treatment on a patient who was diagnosed on lumbosacral transitional vertebra (LSTV) with localized bone marrow edema. The patient was treated with acupuncture, pharmacopucture, cupping and herbal medicine. We evaluated patient's progress using range of motion (ROM), EuroQol-5 dimensions (EQ-5D), Oswestry disability index (ODI), numerical rating scale (NRS), patient global impression of change, self-walkable distance. NRS of back pain decreased from 7 to 5, at the same time NRS of lower limb decreased from 4 to 3. EQ-5D score increased from 0.24 to 0.646. ODI score improved 80 to 62. Self-walkable distance and lumbar spine ROM also increased. As a result, clinical improvements were found in a patient. In conclusion, this study shows that Korean medicine treatment can be considered as effective conservative care for LSTV with localized bone marrow edema.