• The Journal of Korean Orthopaedic Ultrasound Society
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• v.6 no.2
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• pp.81-93
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• 2013

This review was described to investigate the feasibility of using ultrasound as an image tool for interventions of lumbar spine. This article will first provide an overview of lumbosacral spine surface anatomy and sonoanatomy. A detailed understanding of anatomy is critical for interpretation of ultrasound and procedural performance at spine. Fluoroscopy is most commonly used in interventional spine procedures, but radiation exposure is the major concern when obtaining fluoroscopic images. Ultrasound is radiation-free, is easy to use, and can provide real-time images with high accuracy. Also this device can be used in virtually any clinical setting. Ultrasound guidance offers a reliable alternative to fluoroscopy or computed tomography for lumbar interventions and can be safely performed without radiation exposure.

• The Korean Journal of Pain
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• v.13 no.1
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• pp.111-114
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• 2000

Pain around the posterior iliac crest area is usually attributed to disorders of the lower lumbar or lumbosacral spine. However, low back pain arising from the thoracolumbar region is common and it is very similar to low back pain of lumbosacral origin. Low back pain of thoracolumbar origin is clinically distinguished from other nonspecific low back pain syndrome. It is characterized by symptoms localized at one posterior iliac crest innervated by posterior branch of $T_{12}$ spinal nerve. Patients never complain of spontaneous pain at the thoracolumbar junction. Only localized tenderness over involved segments of thoracolumbar junction can be noted. We report two cases of posterior iliac crest pain of thoracolumbar origin which was relieved by the treatment on the thoracolumbar junction.

• Journal of Acupuncture Research
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• v.27 no.3
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• pp.93-104
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• 2010

Objectives : The purpose of this study is to observe the effects of work environment and low back pain on the structural and muscle strength changes in lumbar spine to helpful for preventation and cure of low back pain. Methods : Through measuring of lumbosacral angle, lumbar lordotic angle, lumbar gravity line ratio analyzed structure of lumbar spine and using Trunk Extension Flexion Program of CYBEX NORM System(cybex770+TMC, USA) analyzed Flex. PT, Ext. PT, E/F ratio of lumbar spine of company employees given a medical examination. Results : According to work environment, lumbar gravity line ratio is higher in white collar group than in blue collar group, Ext. PT is significantly lower in white collar group than in blue collar group. According to low back pain or not, lumbar gravity line ratio, Ext. PT is lower in low back pain group than in non-low back pain group. Conclusions : Work environment and low back pain effects on the structural and muscle strength changes in lumbar spine.

• Journal of Korean Neurosurgical Society
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• v.48 no.6
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• pp.496-500
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• 2010

Objective : Surgical treatment of lumbosacral foraminal stenosis requires an understanding of the anatomy of the lumbosacral area in individual patients. Unilateral facetectomy has been used to completely decompress entrapment of the L5 nerve root, followed in some patients by posterior lumbar interbody fusion (PLIF) with stand-alone cages Methods : We assessed 34 patients with lumbosacral foraminal stenosis who were treated with unilateral facetectomy and PLIF using stand-alone cages in our center from January 2004 to September 2007. All the patients underwent follow-up X-rays, including a dynamic view, at 3, 6, 12, 24 months, and computed tomography (CT) at 24 months postoperatively. Clinical outcomes were analyzed with the mean numeric rating scale (NRS), Oswestry Disability Index (ODI) and Odom's criteria. Radiological outcomes were assessed with change of disc height, defined as the average of anterior, middle, and posterior height in plain X-rays. In addition, lumbosacral fusion was also assessed with dynamic X-ray and CT. Results : Mean NRS score, which was 9.29 prior to surgery, was 1.5 at 18 months after surgery. The decrease in NRS was statistically significant. Excellent and good groups with regard to Odom's criteria were 31 cases (91%) and three cases (9%) were fair. Pre-operative mean ODI of 28.4 decreased to 14.2 at post-operative 24 months. In 30 patients, a bone bridge on CT scan was identified. The change in disc height was 8.11 mm, 10.02 mm and 9.63 mm preoperatively, immediate postoperatively and at 24 months after surgery, respectively. Conclusion : In the treatment of lumbosacral foraminal stenosis, unilateral facetectomy and interbody fusion using expandable stand-alone cages may be considered as one treatment option to maintain post-operative alignment and to obtain satisfactory clinical outcomes.

• 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.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.3 no.1
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• pp.55-64
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• 2008

Objective : Spondylothesis is a disease which sagittal facet of vertebral body's invariable alignment is being broken and vertebral body being pushed forward. Main pattern of spondylothesis is isthmic spondylothesis by isthmus defect or fracture, degenerative spondylothesis occurred by desiccated change of intervertebral disc or vertebral condyle joint's ligament. The purpose of this study is to assess the difference of the Pelvic angles, Lumbosacral angles, Pelvic tilt, and Lumbar lordotic angles of the spondylothesis patients. Methods : We analyzed the lateral view of lumbar spine of 49 isthmic spondylothesis patients, 45 degenerative spondylothesis patients and 26 patients who haven't been diagnosed as vertebra disease. We investigated each patient's pelvic angle, lumbosacral angle, pelvic tilt and lumbar lordotic angle. Results and Conclusion : 1. Pelvic incidence, in cases of degenerate spondylothesis patients, is higher than spondylothesis patients but shows less significance. On the contrary significance is higher than the group haven't been diagnosed as vertebra disease. 2. Lumbosacral incidence, in cases of isthmic spondylothesis patients, shows higher significance than degenerative spondylothesis patients and the group haven't been diagnosed as vertebra disease. 3 Pelvic tilt, in cases of degenerative spondylothesis patients, shows higher significance than isthmic spondylothesis patients and the group haven't been diagnosed as vertebra disease. 4. Lumbar lordotic angle, in cases of isthmic spondylothesis patients, shows higher significance than degenerative spondylothesis patients and the group haven't been diagnosed as vertebra disease. 5. Degenerative spondylothesis patient shows specific impression, a forwardly moved high femoral axial and as a result of large lumbrosacral angle and lumbar lordotic angle shows specific impression, an increased weight pressure on sacrum.

• Journal of Korean Neurosurgical Society
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• v.54 no.6
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• pp.537-539
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• 2013

Charcot spinal arthropathy is a rare, progressive type of vertebral joint degeneration that occurs in the setting of any preexisting condition characterized by decreased afferent innervation to the extent that normal protective joint sensation in the vertebral column is impaired. The authors report on a case of Charcot arthropathy of the lower lumbar spine mimicking a spinal tumor following cervical cord injury.

• The Journal of Korea CHUNA Manual Medicine
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• v.4 no.1
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• pp.157-165
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• 2003

Low back pain (LBP) is a significant in today's society, with lifetime include factors associated with LBP ar reporter. Among the causes, aberration of posture may play a role in the development of LBP. Many investigators have assessed the curvature of spine in standing posture. But LBP is associated with Lumber Hyperlordosis of Hyperlordosis is controversial Subjects: In conservative treatment(acupuncture, herb med, manipulation & TENS. exercise, potural correction) for a 40 years old woman who had low back pain(V AS) be caused by decrease lumbar lordotic angie. Objectives: The object is change of lumbar lordotic angle of a 40 years old woman who had low back pain with Lumbar hyperlordosis, In conservative treatment. Method: In conservative treatment, We added taping therapy(mechanical correction taping of Kinesio Taping) about Lumbar Lordosis. Conclusion: We experienced a 40 years old woman who had love pack pain with Lumbar hyperlordosis. In conservative treatment, Her pain was Improved by additional taping therapy In company with decrease of Lumbar Lordosis. 1. abnormal spinal curvature, specially lumbar hyperlordosis act on induction & perpetuation agent for low back pain 2. In a patient had low back pain with lumbar hyperlordosis, change of lumbar lordotic angle is of utility value for the effect of treatment and assessment of prognosis. 3. pain control is more relative with change of lumbosacral angle than lumbar lordotic angle, in patient had low back pain with lumbar hyperlordosis. 4. mechanical taping therapy with elastic adhesive tape is effective for patient had low back pain with lumbar hyperlordosis

• Neurospine
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• v.15 no.4
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• pp.383-387
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• 2018

Objective: Lower back pain (LBP) is a worldwide health problem, and magnetic resonance imaging (MRI) is a common modality used to aid in its diagnosis. Although specific guidelines for assessing the necessity of MRI usage exist, the use of MRI as the initial imaging method for LBP seems to be more common than necessary in general practice. Methods: We conducted a retrospective chart review of 313 patients who had undergone MRI of the lumbosacral spine during 2014-2015. We recorded and compared various factors, including age, sex, body mass index, current smoking status, race, symptoms, MRI findings, and progression to surgery within the next year. All rates were compared according to whether the MRI results showed radiographically significant findings (MRI-positive) or not (MRI-negative) using the chi-square or Fisher exact tests (if the expected cell count was <5). All analyses were performed using SAS version 9.4. Results: There were no statistically significant differences in the rates of each symptom between the MRI-positive and MRI-negative groups, which accounted for 58.5% (183 of 313) and 41.5% (130 of 313) of the MRIs, respectively. The difference in the rate of surgery in the next year (18% among MRI-positive patients and 8.5% among MRI-negative patients) was found to be statistically significant (p<0.05). Conclusion: Based on our findings, 41.5% of patients underwent lumbar MRI unnecessarily and 81% of patients with positive MRIs did not have surgery within the next year. Further physician training is needed to avoid unnecessary investigations and expenditures.

• Asian Spine Journal
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• v.12 no.6
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• pp.1069-1077
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• 2018

Study Design: A case study. Purpose: To assess the chronological changes of the disease-related kyphosis after chemotherapy alone, secondly to clarify the role of growth cartilage in the healed lesion on kyphosis change, and to define the accurate prediction time in assessing residual kyphosis. Overview of Literature: None of the previous papers up to now dealt with the residual kyphosis, stability and remodeling processes of the affected segments. Methods: One hundred and one spinal tuberculosis children with various stages of disease processes, age 2 to 15 years, were the subject materials, between 1971 to 2010. They were treated with two different chemotherapy formula: before 1975, 18 months of triple chemotherapy (isoniazid [INH], para-aminosalicylic acid, streptomycin); and since 1976, 12 months triple chemotherapy (INH, rifampicin, ethambutol, or pyrazinamide). The first assessment at post-chemotherapy one year and at the final discharge time from the follow-up (36 months at minimum and 20 years at maximum) were analyzed by utilizing the images effect of the remaining growth plate cartilage on chronological changes of kyphosis after initiation of chemotherapy. Results: Complete disc destruction at the initial examination were observed in two (5.0%) out of 40 cervical spine, eight (26.7%) out of 30 dorsal spine, and six (19.4%) out of 31 lumbosacral spine. In all those cases residual kyphosis developed inevitably. In the remainders the discs were partially preserved or remained intact. Among 101 children kyphosis was maintained without change in 20 (19.8%), while kyphosis decreased in 14 children (13.7%), and increased in 67 children (66.3%) with non-recoverably damaged growth plate, respectively. Conclusions: It could tentatively be possible to predict the deformity progress or non-progress and spontaneous correction at the time of initial treatment, but it predictive accuracy was low. Therefore, assessment of the trend of kyphotic change is recommended at the end of chemotherapy. In children with progressive curve change, the deformity assessment should be continued till the maturity.