• Title/Summary/Keyword: Nucleus Pulposus

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Acute Intervertebral Disc Protrusion in a Korean Domestic Shorthaired Cat: Clinical and MRI Findings

  • Lee, Narae;Lee, Young-jae;Song, Jin-young;An, Dae-gi;Kang, Byeung-taek;Chang, Jin-hwa;Chang, Dong-woo
    • Journal of Veterinary Clinics
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    • v.34 no.6
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    • pp.467-469
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    • 2017
  • Signalment: A 7-month-old, female domestic shorthaired cat was presented for acute pelvic limb paraparesis. Results: There was no abnormality on survey radiographs and blood analysis, however neurological examination revealed proprioception positioning and hopping was absent in the pelvic limbs. Also, anal tone and perineal sensation were reduced. Magnetic resonance (MR) imaging showed nucleus pulposus dehydration and disc protrusion at T12-T13. Ill-defined diffuse lesion was found at T10-L2 level and it showed isointense on T1-weighted images and hyperintense on T2-weighted and FLAIR images. This lesion was considered as edematous lesion secondary to disc protrusion. The presumptive diagnosis was focal spinal cord edema associated with intervertebral disc protrusion. A traumatic aetiology was suspected. The cat was treated corticosteroids and analgesic and clinical sign improved following 9 days of treatment. Clinical relevance : Intervertebral disc protrusion is rare disease in a cat. However, it could be considered as a cause of paraparesis in cats.

Temporal Expression of Interleukin-1${\beta}$ in the Dorsal Root Ganglion in a Rat Model of Lumbar Disc Herniation

  • Kim, Su-Jeong;Gu, Hee-Jin;Cho, Yun-Woo;Park, Hea-Woon;Lee, Joon-Ha;Hwang, Se-Jin;Ahn, Sang-Ho
    • The Journal of Korean Physical Therapy
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    • v.22 no.3
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    • pp.93-98
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    • 2010
  • Purpose: To investigate temporal changes in IL-1${\beta}$ mRNA expression in spinal dorsal horn (DH) and dorsal root ganglion (DRG) in a rat lumbar disc herniation (LDH) model. Methods: Autologous nucleus pulposus, harvested from the tail disc between the second and third coccygeal vertebrae (Co2-3), was implanted next to the left L5 nerve root just proximal to the DRG after partial laminectomy. IL-1${\beta}$ mRNA expression was investigated in DRG and DH in our LDH model. Real-time PCR assays were done using a 7500 Real Time PCR system (Applied Biosystems, USA). Results: Expression of IL-1${\beta}$ in DRG and DH was observed for 30 days postoperatively. Expression of IL-1${\beta}$ mRNA in the ipsilateral DRG of the LDH group gradually increased from 5 to 30 days after surgery. The amount of IL-1${\beta}$ in the contralateral DRG peaked 10 days after surgery and then gradually decreased. However, there was no difference in IL-1${\beta}$ mRNA expression in spinal DH between the LDH group and the sham-operated group. Conclusion: Long-term expression of IL-1${\beta}$ in the LDH model may worsen the chronic pain state. Future studies on inhibition of IL-1${\beta}$ expression in the LDH model will be needed to develop selective treatment strategies for patients with LDH.

Health Condition and Work-related Musculoskeletal Disorders in Greenhouse Vegetable Farmers (시설채소 농업인의 건강 상태 및 근골격계 질환 실태)

  • Kim, Kyung Ran;Choi, Jeong Hwa;Lee, Kyung Suk;Song, Eun Young
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.18 no.1
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    • pp.49-61
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    • 2008
  • The objective of this study is to survey the risk factors of greenhouse vegetables farmers' work-related musculoskeletal disorders(MSDs). To offer the fundamental data for agricultural improvement of greenhouse vegetable farms, the questionnaire of MSDs and heath condition were carried out. A group of 736 workers(males=492, females=244) in 6 branches constitutes the population and database for the analysis between 2004 and 2005. The sample branch was chosen based on paper are watermelon, strawberry, tomato, melon, cucumber, lettuce. The results are as follows: 1. Smoking rates in cucumber and tomato is the highest. 2. Drinking rates in strawberry, cucumber and lettuce is the highest in males, watermelon and melon are the highest in females. 3. Regular exercise rates in melon are the highest. 4. Physical and mental fatigue in females is higher than that of males in most crops except melon. That of strawberry and tomato is the highest. 5. The prevalence rates of medical diagnosed diseases are higher in order of osteoarthritis, herniated nucleus pulposus(HNP), and hypertension. That of strawberry, melon, and cucumber is high in case of osteoarthritis; Strawberry, melon, and watermelon are high in case of HNP. 6. Prevalence rates of musculoskeletal symptoms among the various pain areas are higher in order of low back, knees, and shoulders. That of tomato and watermelon is high in case of low back; strawberry and tomato are high in case of knees. These results can be used practically for agricultural improvement of greenhouse vegetables farms to prevent MSDs.

Accidental Subdural Injection during Attempted Cervical Epidural Block: Radiologic Evidence -A case report- (경추부 경막외 차단 중 발생한 경막하 주사의 영상 소견 -증례보고-)

  • Ko, Hyun Hak;Kim, Ji Soo;Lee, Jae Jun;Hwang, Sung Mi;Lim, So Young
    • The Korean Journal of Pain
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    • v.22 no.1
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    • pp.83-87
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    • 2009
  • Case reports after accidental subdural injection during attempted epidural block have usually described extensive neuraxial blocks with a characteristic radiographic appearance on contrast injection. We experienced a case of cervical subdural injection with unusual clinical findings and radiographic appearance. A 51-year-old female patient with central herniated nucleus pulposus at cervical (C5/6) and lumbar level (L4/5, L5/S1) was referred to the pain clinic. During attempted cervical epidural block at the C6/7 interspace with fluoroscopy, injection of the 4 ml contrast showed posterior spread at cervical level. After cervical epidural steroid injection, the contrast was also confined to the posterior aspect of the spinal canal at lumbar level with fluoroscopy. In order to discriminate subdural space from epidural space, we performed transforaminal epidural injection of the 2 ml contrast at the L5/S1 interspace and we could confirm cervical epidural injection was made into the subdural space. We discuss the clinical characteristics of a subdural injection and the appearance of the cervical and lumbar subdurogram.

Change of the Intervertebral Foraminal Pressure after Removal of the Disc Material (디스크 제거 후 추간공내 압력의 변화)

  • Hong, Chang Kie;Park, Chong Oon;Hyun, Dong Keun;Ha, Young Soo
    • Journal of Korean Neurosurgical Society
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    • v.30 no.2
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    • pp.144-149
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    • 2001
  • Objective : Spinal nerve root compression occurs commonly in conditions, such as herniated nucleus pulposus, spinal stenosis, intervertebral foraminal stenosis, and trauma. However, the pathophysiolosy of the symptoms and signs related to spinal nerve root compression is poorly understood. The purpose of the present study was to assess and compare the changes of various pressures of intervertebral foraminal pressure before and after decompression. Method : After laminetomy without foraminotomy was performed, pressure sensor tip of Camino parenchymal type was located at the middle-central portion of the intervertebral foramen and anterior portion of nerve root for the foraminal pressure before decompression of the intervertebral foramen. After laminectomy with foraminotomy, the same method was used for the foraminal pressure after decompression. The authors studied 40 consecutive patients (57 disc spaces) with severe constant root pain to the lower leg, pain unrelived by bed rest, and minimal tension signs, diagnosed by MRI. Results : In patients with intervertebral foraminal stenosis, the intraforaminal pressure was decreased from $86{\pm}2.23mmHg$ to $17.1{\pm}1.51mmHg$ and in patients without stenosis, from $55.9{\pm}1.08mmHg$ to $11.9{\pm}1.25mmHg$. All patients below 20mmHg after decompression showed good outcome, but 4 cases who showed poor outcome had foraminal stenosis, posterolateral type of the herniated disc, and above 30mmHg of foraminal pressure after decompression. Conclusion : These findings suggest that if the foraminal pressure falls below 20mmHg after decompression, good outcome can be anticipated. Central type of the herniated disc shows better outcome compared to the posterolateral type.

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Comparison of Root Images between Post-Myelographic Computed Tomography and Magnetic Resonance Imaging in Patients with Lumbar Radiculopathy

  • Park, Chun-Kun;Lee, Hong-Jae;Ryu, Kyeong-Sik
    • Journal of Korean Neurosurgical Society
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    • v.60 no.5
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    • pp.540-549
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    • 2017
  • Objective : To evaluate the diagnostic value of computed tomography-myelography (CTM) compared to that of magnetic resonance imaging (MRI) in patients with lumbar radiculopathy. Methods : The study included 91 patients presenting with radicular leg pain caused by herniated nucleus pulposus or lateral recess stenosis in the lumbar spine. The degree of nerve root compression on MRI and CTM was classified into four grades. The results of each imaging modality as assessed by two different observers were compared. Visual analog scale score for pain and electromyography result were the clinical parameters used to evaluate the relationships between clinical features and nerve root compression grades on both MRI and CTM. These relationships were quantified by calculating the receiver-operating characteristic curves, and the degree of relationship was compared between MRI and CTM. Results : McNemar's test revealed that the two diagnostic modalities did not show diagnostic concurrence (p<0.0001). Electromyography results did not correlate with grades on either MRI or CTM. The visual analog pain scale score results were correlated better with changes of the grades on CTM than those on MRI (p=0.0007). Conclusion : The present study demonstrates that CTM could better define the pathology of degenerative lumbar spine diseases with radiculopathy than MRI. CTM can be considered as a useful confirmative diagnostic tool when the exact cause of radicular pain in a patient with lumbar radiculopathy cannot be identified by using MRI. However, the invasiveness and potential complications of CTM are still considered to be pending questions to settle.

The Effects of Integrative Intervention Approach on a Patient with Lumbar HNP : A Case Report (요추 추간판탈출증 환자에 대한 통합적 중재접근의 효과: 단일사례연구)

  • Lee, Jae-Hong;Son, Jong-Chan;Koo, Seong-Rin;Lee, Seok-Hun;Lee, Dong-Hun;Shin, Yong-Wung;Choi, Ja-Eun;Han, Jae-Kyoung;Kim, Dong-Han;Kim, Jeong-Min;Kim, Min-Chul;Jan, Jin-A;Hwang, Sung-Hyun;Kwon, Won-An
    • PNF and Movement
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    • v.10 no.2
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    • pp.33-39
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    • 2012
  • Purpose : The purpose of this case report was to examine the effects of intergrative intervention approach on a patient with lumbar herniated nucleus pulposus (HNP). Methods : The subject was a 53 years old woman with lumbar HNP. The subject received conventional physical therapy combined with exercise therapy and manual therapy. Pain on visual analog scale (VAS), finger to floor (FTF), lumbar lateral flexion, L5 motor, and straight Leg-Raising (SLR) were evaluated at baseline and after 4 weeks. Results : The change of VAS, FTF, left lateral flexion, and right lateral flexion were decreased (9 vs. 5, 41 vs, 25, 56 vs. 42, 54 vs. 41, respectively) and the change of L5 motor and SLR were increased (Fair vs. Fair+, 60 vs. 75, respectively). Conclusion : Our findings suggest that Integrative intervention may be considered in patient with lumbar HNP.

Histological Changes of Cervical Disc Tissue in Patients with Degenerative Ossification

  • Xiong, Yang;Yang, Ying-Li;Gao, Yu-Shan;Wang, Xiu-Mei;Yu, Xing
    • Journal of Korean Neurosurgical Society
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    • v.65 no.2
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    • pp.186-195
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    • 2022
  • Objective : To explore the histological feature of the cervical disc degeneration in patients with degenerative ossification (DO) and its potential mechanisms. Methods : A total of 96 surgical segments, from cervical disc degenerative disease patients with surgical treatment, were divided into ossification group (group O, n=46) and non-ossification group (group NO, n=50) based on preoperative radiological exams. Samples of disc tissues and osteophytes were harvested during the decompression operation. The hematoxylin-eosin staining, Masson trichrome staining and Safranin O-fast green staining were used to compare the histological differences between the two groups. And the distribution and content of transforming growth factor (TGF)-β1, p-Smad2 and p-Smad3 between the two groups were compared by a semi-quantitative immunohistochemistry (IHC) method. Results : For all the disc tissues, the content of disc cells and collagen fibers decreased gradually from the outer annulus fibrosus (OAF) to the central nucleus pulposus (NP). Compared with group NO, the number of disc cells in group O increased significantly. But for proteoglycan in the inner annulus fibrosus (IAF) and NP, the content in group O decreased significantly. IHC analysis showed that TGF-β1, p-Smad2, and p-Smad3 were detected in all tissues. For group O, the content of TGF-β1 in the OAF and NP was significantly higher than that in group NO. For p-Smad2 in IAF and p-Smad3 in OAF, the content in group O were significantly higher than group NO. Conclusion : Histologically, cervical disc degeneration in patients with DO is more severe than that without DO. Local higher content of TGF-β1, p-Smad2, and p-Smad3 are involved in the disc degeneration with DO. Further studies with multi-approach analyses are needed to better understand the role of TGF-β/Smads signaling pathway in the disc degeneration with DO.

Effect of 2-D DBP/PLGA Hybrid Films on Attachment and Proliferation of Intervertebral Disc Cells (2차원적 DBP/PLGA 하이브리드 필름이 디스크 세포의 부착과 증식에 미치는 영향)

  • Ko, Youn-Kyung;Jeong, Jae-Soo;Kim, Soon-Hee;Lim, Ji-Ye;Rhee, John-M.;Kim, Moon-Suk;Lee, Hai-Bang;Khang, Gil-Son
    • Polymer(Korea)
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    • v.32 no.2
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    • pp.109-115
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    • 2008
  • Because demineralized bone particle (DBP) contains various bioactive molecules such as cytokines, it is widely used biomaterials in the field of tissue engineering. In this study, we investigated the effect of 2-dimensional DBP/PLGA hybrid films on adhesion, proliferation and phenotype maintenance of intervertebral disc cells. PLGA films incorporated with different amount (0, 10, 20, 40 and 80 wt%) of DBP were prepared by the solvent evaporation method and characterized by scanning election microscopy (SEM). PLGA film has a flat and smooth surface. According to the increase of content of DBP, the surface of DBP/PLGA film exhibited few agglomerates and increased the roughness of the surface. Annulus fibrosus (AF) and nucleus pulposus (NP) cells were cultured on PLGA and DBP/PLGA film surface, and then examined the cell adhesion and proliferation by the cell count and SEM observation. The result of cell count and SEM observation revealed that 10 and 20% DBP in DBP/PLGA films were superior to adhesion and proliferation of both AF and NP cells. We confirmed that specific gene expression of disc cells on DBP/PLGA film based on the cell count result. Disc cells seeded on 20% DBP/PLGA film expressed the gene of type I and II collagen continuously. Therefore, pertinent content of biomaterials could provide more appropriate condition on adhesion and proliferation of cell. And this results may be used as a basic data for the intervertebral disc regeneration using tissue engineering.

Changes of Lumbar Lordosis According to Different Heel Heights in Normal Adults and Patients with HNP (정상인과 요추 추간판 탈출증 환자에서 구두 뒷굽 높이에 따른 요추전만도의 변화)

  • Moon, Dong-Chul;Kown, Young-Shil;Song, Ju-Young;Nam, Ki-Won;Song, Ju-Min;Kim, Dong-Hyun;Baek, Su-Jeong;Ku, Hyun-Mo;Choi, Jin-Ho;Kim, Jin-Sang
    • The Journal of Korean Physical Therapy
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    • v.13 no.2
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    • pp.467-475
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    • 2001
  • The purpose of this study was to evaluate changes of static lumbar lordosis by different heel heights in normal adults and patients with herniation of nucleus pulposus(HNP). The lumbar lordosis was examined while standing on barefoot, on heel support with 4cm heel, and with 8cm heel in 10 normal adults and 10patients with HNP. Standing lumbar lateral view was performed by 20 minutes adaptation with corresponding shoe types. The angle of lumbar lordosis was taken with Wiltse and Winter's method(angles between upper margin of 1 st lumbar body and upper margin of 5th lumbar body). The results of this study were as follow: 1. Significant statistical decrease in lumbar lordosis was observed as heel heights were increased from barefoot to 8cm high heel in normal adults(p<0.05). 2. There were no significant differences in lumbar lordosis according to three different heel heights in patients with HNP(p>0.05). 3. In comparison of barefoot, There were statistically significant decrease in HNP patients compared with normal adults in terms of lumbar lordosis(p<0.05).

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