• Title/Summary/Keyword: Spinal Diseases

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A Case of Intradural Extramedullary Cord Tumor Metastasis from Adenocarcinoma of the Lung (경막내 수외 척수로 전이된 폐선암 1예)

  • Lee, Je-Kyung;Lee, Yong-Chul;Rhee, Yang-Keun
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.2
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    • pp.262-266
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    • 1996
  • Intradural extramedullary spinal metastasis from systemic tumor is extremely rare but epidural extramedullary cord tumor metastasis from the lung is relatively common. A 57 year-old male patient was admitted to department of internal medicine and neurosurgery in Chonbuk National University Hospital because of coughing, low back pain radiate to the right great toe, and numbness of the right calf area. Spinal MRI scan revealed round oval shaped mass lesion on just below the level of the conus medullaris. Authors present the clinical, histologic, radiologic features of spinal intradural metastatic tumor and operative total removal followed by chemothrapy with an extensive review of literatures.

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A Comparative Performance Analysis of Segmentation Models for Lumbar Key-points Extraction (요추 특징점 추출을 위한 영역 분할 모델의 성능 비교 분석)

  • Seunghee Yoo;Minho Choi ;Jun-Su Jang
    • Journal of Biomedical Engineering Research
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    • v.44 no.5
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    • pp.354-361
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    • 2023
  • Most of spinal diseases are diagnosed based on the subjective judgment of a specialist, so numerous studies have been conducted to find objectivity by automating the diagnosis process using deep learning. In this paper, we propose a method that combines segmentation and feature extraction, which are frequently used techniques for diagnosing spinal diseases. Four models, U-Net, U-Net++, DeepLabv3+, and M-Net were trained and compared using 1000 X-ray images, and key-points were derived using Douglas-Peucker algorithms. For evaluation, Dice Similarity Coefficient(DSC), Intersection over Union(IoU), precision, recall, and area under precision-recall curve evaluation metrics were used and U-Net++ showed the best performance in all metrics with an average DSC of 0.9724. For the average Euclidean distance between estimated key-points and ground truth, U-Net was the best, followed by U-Net++. However the difference in average distance was about 0.1 pixels, which is not significant. The results suggest that it is possible to extract key-points based on segmentation and that it can be used to accurately diagnose various spinal diseases, including spondylolisthesis, with consistent criteria.

Newly Developed Weakness of Lower Extremities Despite Improved Brain Metastasis of Lung Cancer after Radiotherapy

  • Yang, Jae Hyun;Jang, Young Joo;Ahn, Se Jin;Kim, Hye-Ryoun;Kim, Cheol Hyeon;Koh, Jae Soo;Choe, Du Hwan;Lee, Jae Cheol
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.6
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    • pp.574-576
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    • 2009
  • An intramedullary spinal cord metastasis (ISCM) rarely develops in systemic cancer but is indicative of a poor prognosis. A 56-year-old man was admitted due to weakness of the lower extremities. He had received radiotherapy 3 months prior for a brain metastasis that had developed 1 year after achieving a complete response from chemotherapy for extended stage small cell lung cancer. Although the brain lesion had improved partially, ISCM from the cervical to lumbar-sacral spinal cords, which was accompanied by a leptomeningeal dissemination, was diagnosed based on magnetic resonance imaging of the spine and cerebrospinal fluid cytology. Finally, he died of sudden cardiac arrest during treatment. This is the first case of ISCM involving the whole spinal segments. Physicians should be aware of the subsequent development of ISCM in lung cancer patients with a previously known brain metastasis who present with new neurological symptoms.

A Rare Case of Syphilitic Myelitis of the Spinal Cord

  • Kim, Jin Hyeok;Jeong, Hee Seok;Park, Chankue;Ryu, Hwaseong;Roh, Ji Eun;Yeom, Jeong A;Kim, Tae un
    • Investigative Magnetic Resonance Imaging
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    • v.23 no.3
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    • pp.279-282
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    • 2019
  • Neurosyphilis is an infection of the brain or spinal cord that is caused by the bacterium Treponema pallidum. Syphilitic myelitis, which involves the spinal cord, is a very rare form of neurosyphilis seen in patients with syphilis. It requires differentiation from other diseases of the spinal cord, including idiopathic transverse myelitis and spinal cord infarction. Herein, we describe the presentation and diagnosis of syphilitic myelitis in a 43-year-old woman, based on a flip-flop sign and candle guttering appearance depicted in magnetic resonance imaging and laboratory tests.

A Case study about Paraplegia diagnosed as Spinal cord infarction (척수경색증으로 인한 하반신불수(下半身不隨) 환자에 대한 치험례)

  • Bae, Hyo-Sang;Han, Kyoung-Suk;Choi, Jae-Yeong;Park, Seong-Sik;Choi, Jeong-Rak
    • Journal of Sasang Constitutional Medicine
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    • v.14 no.2
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    • pp.160-168
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    • 2002
  • Spinal cord infarction in vascular impairment of spinal cord is rare in the world. and besides, because spinal cord has small cross-sectional area and almost all tract of sensory system and motor system pass away, spinal cord disease is one of the terrible diseases, that leaves usually permanent and severe neurological sequela. The case is about a patient who is 57 years old woman. Both of her legs were suddenly paralyzed and her case was diagnosed as spinal cord infarction in medical center. In our hospital, we focussed on her basic physiological condition-defecation, urination, dormitio, diet, etc. In the case of this patient, power and sense of both legs with physiolocal condition improved remarkably through Sasang Constitutional Medicine with rehabilitative therapy.

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Complex Korean Medical Treatment after Embolization for Myelopathy Due to Spinal Dural Arteriovenous Fistula: A Case Report (척수경막동정맥루로 인한 척수병증 환자의 색전술 이후 한의복합치료: 증례 보고)

  • Woo, Hyeon-Jun;Han, Yun-Hee;Lee, Jung-Han
    • Journal of Korean Medicine Rehabilitation
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    • v.31 no.3
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    • pp.105-114
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    • 2021
  • A 38-year-old Korean man without any other history was diagnosed with myelopathy due to a spinal dural arteriovenous fistula. Following embolization and high-dose steroid therapy, the patient was treated with complex Korean medical therapies including acupuncture, pharmacopuncture, electro-acupuncture, Chuna manual therapy, herbal medicine, and cupping therapy in addition to conventional treatment. To assess the patient's improvement, international standard for neurological classification of spinal cord injury, Korean version of modified Barthel index, functional independence measure, spinal cord independence measure III, walking index for spinal cord injury II, modified Ashworth scale were used. After treatment, the muscle strength and sensory function of the lower extremities were improved, and the spasticity was reduced, resulting in a rapid improvement in performance of daily activities. These results suggest that complex Korean medical therapies may be effective for myelopathy, and further clinical studies are needed to clarify their effects.

Management of Elderly Patients with Spinal Disease: Interventional Nonsurgical Treatment (고령 척추 질환자의 치료: 중재적 비수술 치료)

  • Park, Soo-An
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.1
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    • pp.9-17
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    • 2019
  • Owing to the upward shift in age structure, there is an increasing number of spinal diseases specific to elderly patients. Elderly spinal patients typically have a poor general condition with several medical comorbidities, low bone mineral density, more extensive and severe degeneration, and less effective treatment outcomes than young patients. This is why spinal physicians need to establish interventional nonsurgical treatment modalities for elderly patients with spinal disease. The objective of this study was to define the spinal disorders problematic to elderly patients and discuss the nonsurgical treatments for each subject.

The Effect of Combined Korean Medicine Treatment of Patients with Vascular Disease of Spinal Cord: A Case Report (혈관성 척수병증 환자에 대한 한의 복합 치료의 효과: 증례보고)

  • Hyeonsun Park;Sanghyeon Park;Jiho Lee;Seohyun Park;Dongho Keum
    • Journal of Korean Medicine Rehabilitation
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    • v.33 no.4
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    • pp.225-233
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    • 2023
  • This case study reports the clinical effect of Korean medicine treatment on vascular disease of spinal cord. A 58-year-old female patient was diagnosed as vascular disease of spinal cord and treated with combined Korean medicine treatment such as acupuncture, electro-acupuncture, herbal medication, and physical therapy for 16 days. The patient was assessed for International Standard for Neurological Classification of Spinal Cord Injury (ISNCSCI), Berg Balance Scale (BBS), and Numeral Rating Scale (NRS). After treatment, total scores of ISNCSCI, BBS, and NRS were numerically improved. Also symptoms of neurogenic bladder were improved. This study suggests that Korean medicine treatment could be effective treatment for vascular disease of spinal cord.

Analysis of Clinical Tendency of Spinal Disorder in Primary, Middle and High School Students in Korea (국내 초.중.고등학생들의 척추질환 진료경향 분석)

  • Kim, Min-Jung;Son, Chang-Gue;Heo, Dong-Seok;Hong, Kwon-Eui
    • Journal of Acupuncture Research
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    • v.27 no.2
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    • pp.43-49
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    • 2010
  • Objectives : Among young generation, the prevalence of spinal disorders is known to be increasing. This study aimed to analyze the clinical data of spinal disorder in young ages in Korea. Methods : Number of patient, kinds of disorder, and medical cost were analyzed for patients(7~18 years) underwent spinal disorders using computerized database of Health Insurance Review and Assessment Service(HIRAS) from 2004 to 2008. We included dorsopathies as spinal disorder according to Korean Classification of Diseases(KCD) and excluded spinal disorder caused by trauma. We compared the data of traditional Korean medicine treatment with that of western medical care. Results : 4.8% of the children and adolescents had medical treatment with spinal disorder in 2008. The claim number and medical cost for both traditional Korean medicine and western medicine treatment are increasing 1.8 and 1.3 times respectively over 5 years. Total medical spent of western clinic was 2.1 times than those of traditional Korean clinic. The most common spinal disorder was dorsalgia(31.8%) and scoliosis(13.5%) in western clinics while back pain(29.0%) and neck pain(10.8%) in oriental clinic. Conclusions : We first reported the clinical tendency of spinal disorder in Korean children adolescents from 2004 to 2008. This study will support the development of a strategy for traditional Korean medicine-based prevention or treatment of spinal disorders in young generation.