• Title/Summary/Keyword: Spinal MRI

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Electrical Acupuncture Combined Bee Venom Therapy for Pain and Disability Induced Intervertebral Herniated Disc of L-spine;A Pilot Study

  • Kwon, Young-Dal
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.3
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    • pp.703-707
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    • 2008
  • To examine the efficacy of electrical acupuncture combined bee venom in controlling low back with leg pain induced Herniated Intervertebral Disc (HIVD). 13 patients (men 8, women 5; age $41.30\;{\pm}\;17.27$) diagnosed as HIVD by CT or MRI had low back and leg pain as a chief complaint and diseases such as spinal tumor, infection and fracture were excluded. They were treated by electrical acupuncture (8 Hz) combined bee venom therapy three times a week in Wonkwang University Hospital, and pain intensity with VAS and functioning with Roland-Morris Disability Qestionnaire(RDQ) were measured at the baseline(B), and 4 weeks after treatment. The data were analyzed with Wilcoxon signed ranks test(SPSS12.0) and the level set for statistical significance was P<0.05. The pain was significantly reduced by two combined treatments (=0.002;$B7.69{\pm}2.06$,4Wks$4.70{\pm}2.72$). The function was also significantly improved by both treatments(=0.001;$B12.15{\pm}6.85$,4Wks$6.85{\pm}5.15$). The results suggest that a combination of acupuncture and bee venom therapy may be beneficial for low back pain from HIVD. In future, randomized clinical trials including follow-up are needed to examine the effects of these therapies.

Intramuscular Sparganosis in the Gastrocnemius Muscle: A Case Report

  • Kim, Jeung Il;Kim, Tae Wan;Hong, Sung Min;Moon, Tae Yong;Lee, In Sook;Choi, Kyung Un;Yu, Hak Sun
    • Parasites, Hosts and Diseases
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    • v.52 no.1
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    • pp.69-73
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    • 2014
  • Sparganosis is a parasitic infection caused by the plerocercoid tapeworm larva of the genus Spirometra. Although the destination of the larva is often a tissue or muscle in the chest, abdominal wall, extremities, eyes, brain, urinary tract, spinal canal, and scrotum, intramuscular sparganosis is uncommon and therefore is difficult to distinguish from a soft tissue tumor. We report a case of intramuscular sparganosis involving the gastrocnemius muscle in an elderly patient who was diagnosed using ultrasonography and MRI and treated by surgical excision. At approximately 1 cm near the schwannoma at the right distal sciatic nerve, several spargana worms were detected and removed.

Long-Term Follow Up of Refractory Myotonia Associated with Hyperadrenocorticism in a Maltese Dog

  • Nam, Sookin;Kang, Byeong-Teck;Song, Kun-ho;Seo, Kyoung-won
    • Journal of Veterinary Clinics
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    • v.37 no.5
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    • pp.273-277
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    • 2020
  • A 12-year-old, female Maltese was referred with uncontrolled hyperadrenocorticism (HAC). Despite well management of HAC through treatment with trilostane and serial monitoring with ACTH stimulation tests for over three years, stiffness of the neck and limbs progressively worsened over time. Neurological test was performed, which showed no abnormalities of cranial nerves. Proprioception was delayed but the cause appeared to be due to stiffness of limb muscles. Muscle tone had increased over time and stiffness had worsened to the extent where it made walking difficult. MRI scans showed no orthopedic or spinal diseases, and pituitary microadenoma was confirmed with pituitary gland measurement of 6 × 6.4 × 4.5 mm (H × W × L). Electromyography presented random discharges with fluctuating amplitude and frequency, which were consistent with myotonic discharges. There were no improvements of myotonic signs despite treatment for HAC with trilostane. Supplementation of L-carnitine and coenzyme Q-10 to mitigate muscle stiffness, following diazepam and methocarbamol to help with muscle rigidity, failed to show any positive effect and the dog died a sudden death, 1,182 days after the initial visit.

Paraplegia following Epidural Steroid Injection -A case report- (경막외 스테르이드 주입후 발생한 하지마비 -증례 보고-)

  • Chung, So-Young;Song, Jang-Ho;Lee, Mi-Ra;Lee, Hong-Sik;Park, Dong-Ho
    • The Korean Journal of Pain
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    • v.7 no.1
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    • pp.106-112
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    • 1994
  • This report documents a case of paraplegia which apparently occurred following epidural injection of triamcinolone (40 mg) and 0.125% bupivacaine(10 ml). The patient's condition was progressive until she experienced paraplegia and dissociative sensory loss below T5(Rt) and T10(Lt) dernatomes, along with urinary and fecal incontinence lasting 24 hours. CT and MRI were normal. Three months after the onset of paraplegia, the patient could only slightly move her legs. After 8 months of the initial paraplegia, she was able to walk with assistance, and to perceive pinrick sensation in her right leg, and tingling in her left leg. She could also void and defecate. At 16 months, paraplegia and sensory loss were slightly recovered. The cause for this paraplegia is still unknown, but it may be from exacerbation of preexisting disease, acute transverse myelitis, anterior spinal artery syndrome, or neurotoxicity.

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Late Blink Reflex Abnormality in a Patient with Dysgeusia: A Case Report (미각 이상 환자에서의 후기 눈깜박 반사 검사 이상소견: 증례보고)

  • Park, Hong Bum;Han, A Reum;Kim, Ki Hoon;Park, Byung Kyu;Kim, Dong Hwee
    • Journal of Electrodiagnosis and Neuromuscular Diseases
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    • v.20 no.2
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    • pp.144-147
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    • 2018
  • Although dysgeusia can occur as a consequence of stroke attacks, many physicians and patients tend to overlook it. A 50-year old woman complained of a 2-week history of abnormal sense of taste on the anterior two-thirds of right tongue. Blink reflex test demonstrated prolonged ipsilateral and contralateral R2 responses with the right supraorbital nerve stimulations, which suggest the lesion on the descending pathway. Brainstem magnetic resonance imaging (MRI) demonstrated abnormal findings in the right lower dorsal pons, anterior to 4th ventricle, lateral to inferior colliculus, and at the level of the pontomedullary junction, which was compatible with solitary tract nucleus and spinal trigeminal nucleus. Brainstem infarction should be considered in patients who have abnormal sense of taste. Additionally, blink reflex test may be helpful for the detection of central origin dysgeusia.

A Human Case of Lumbosacral Canal Sparganosis in China

  • Fan, Jian-Feng;Huang, Sheng;Li, Jing;Peng, Ren-Jun;Huang, He;Ding, Xi-Ping;Jiang, Li-Ping;Xi, Jian
    • Parasites, Hosts and Diseases
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    • v.59 no.6
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    • pp.635-638
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    • 2021
  • In this study, we intended to describe a human case of lumbosacral canal sparganosis in People's Republic of China (China). A 56-year-old man was admitted to Xiangya Hospital Central South University in Changsha, Hunan province, China after having an experience of perianal pain for a week. An enhancing mass, a tumor clinically suggested, was showed at the S1-S2 level of the lumbosacral spine by the examination of magnetic resonance imaging (MRI) with gadolinium contrast. The patient was received the laminectomy from S1 to S2, and an ivory-white living worm was detected in inferior margin of L5. In ELISA-test with cerebrospinal fluid (CSF) and serum samples, anti-sparganum antibodies were detected. He had a ingesting history of undercooked frog meat in his youth. By the present study, a human case of spinal sparganosis invaded in lumbosacral canal at the S1-S2 level was diagnosed in China. Although the surgical removal of larvae is known to be the best way of treatment for sparganosis, we administered the high-dosage of praziquantel, albendazole and dexamethasone to prevent the occurrence of another remain worms in this study.

A Case of Amyotrophic Lateral Sclerosis (근 위축성 측삭 경화증 환자 1례 보고)

  • Kim, Tae-jung;Moon, A-ji;Lee, Seoung-geun;Lee, Key-sang
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.13 no.1
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    • pp.77-85
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    • 2012
  • Amyotrophic lateral sclerosis(ALS) is a progressive disorder that causes degeneration of motor neurons of the brain and spinal cord. It is characterized by loss of motor neurons leading to muscle weakness, and sensation and mental function stay intact during the course of the disease. Diagnostic tests include magnetic response imaging(MRI), electromyogram(EMG), muscle biopsy, and blood tests. In order to a definitive diagnosis of ALS, damage must be evident in both upper and lower motor neurons. When three limbs are sufficiently affected, the diagnosis is ALS. There is no cure for ALS. We experienced one case of ALS, the patients was diagnosed as ALS by EMG and symptoms. We diagnosed her as ShinEumHur(SEH) and treated by Choakwiyeum(左歸飮). We report the change of her symptoms through oriental medical treatment.

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The Value of X-ray Compared with Magnetic Resonance Imaging in the Diagnosis of Traumatic Vertebral Fractures

  • Lee, Yang Woo;Jang, Jae Ho;Kim, Jin Joo;Lim, Yong Su;Hyun, Sung Youl;Yang, Hyuk Jun
    • Journal of Trauma and Injury
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    • v.30 no.4
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    • pp.158-165
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    • 2017
  • Purpose: The purpose of this study was to evaluate the diagnostic accuracy of X-rays in patients with acute traumatic vertebral fractures visiting the emergency department and to analyze the diagnostic value of X-rays for each spine level. Methods: We retrospectively analyzed basal characteristics by reviewing medical records of 363 patients with adult traumatic vertebral fractures, admitted to the emergency center from March 1, 2014 to February 28, 2017. We analyzed spine X-rays and magnetic resonance imaging (MRI) scans to determine distribution according to the vertebral level, and we evaluated the efficacy of X-rays by comparing discrepancies between X-rays and MRI scans. Results: For a total of 363 patients, the mean age was 56.65 (20-93) and 214 (59%) were males. On the basis of X-rays, 67 cases (15.1%) were of the cervical spine, 133 cases (30.0%) were of the thoracic spine, and 243 cases (54.9%) were of the lumbar spine. In particular, the thoracolumbar region (T11-L2) was the most common, with 260 cases (58.7%). In X-rays, fractures were the least in the upper thoracic region (T1-T3), whereas MRI scans revealed fairly uniform distribution across the thoracic spine. Sensitivity of X-rays was lowest in the upper thoracic spine and specificity was almost always greater than 98%, except for 94.7% in L1. Positive predictive value was lower in the mid-thoracic region (T4-T9) and negative predictive value was slightly lower in C6, T2, and T3 than at other sites. Diagnostic accuracy of X-rays by vertebral body, transverse process, and spinous process according to fractured vertebral structures was significantly different according to vertebral level. Conclusions: Diagnostic accuracy of X-rays was lower in the upper thoracic region than in other parts. Further studies are needed to identify better methods for diagnosis considering cost and neurological prognosis.

Various MRI Findings of Toxocara canis Myelitis (개회충 척수염의 다양한 자기공명영상 소견)

  • Sun Young Park;Kyung Seok Park;Eugene Lee;Joon Woo Lee;Yun Jung Bae;Yusuhn Kang;Joong Mo Ahn;Heung Sik Kang
    • Journal of the Korean Society of Radiology
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    • v.81 no.1
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    • pp.135-146
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    • 2020
  • Purpose To describe magnetic resonance imaging (MRI) findings in 10 cases of Toxocara canis myelitis and to analyze these findings to aid in the diagnosis of this condition. Materials and Methods From June 2015 to March 2018, we retrospectively analyzed the electronic medical records and MR images of patients who were diagnosed with Toxocara canis myelitis. The analysis of the MR images was based on a discussion between an experienced spinal radiologist and a radiology resident. Results This study classified MRI findings into the following two types. Type 1 was defined as central and diffuse T2 high signal intensity on the axial plane, which was observed in 50% of all cases. All lesions showed avid enhancement, mostly in the posterolateral or posterior region (4 cases, 80%). Type 2 was defined as wedge-shaped or focal T2 high signal intensity in the posterolateral or posterior region and corresponded to the remaining 50% of the cases. In this case, the extent of the lesion was relatively small and contrast enhancement was observed in only one case. Conclusion This study revealed that various imaging findings could be observed in cases of Toxocara canis myelitis, and the findings were classified into two types.

Relationship between the Progression of Kyphosis in Thoracolumbar Osteoporotic Vertebral Compression Fractures and Magnetic Resonance Imaging Findings (흉요추 골다공증성 압박 골절에서의 후만 변형의 진행과 자기공명영상 소견 사이의 관계)

  • Jun, Deuk Soo;Baik, Jong-Min;Kwon, Hyuk Min
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.4
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    • pp.336-342
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    • 2019
  • Purpose: To examine the relationship between the progression of a kyphotic deformity and the magnetic resonance imaging (MRI) findings in conservatively treated osteoporotic thoracolumbar compression fracture patients. Materials and Methods: This study categorized the patients who underwent conservative treatment among those patients who underwent treatment under the suspicion of a thoracolumbar compression fracture from January 2007 to March 2016. Among them, this retrospective study included eighty-nine patients with osteoporosis and osteopenia with a bone density of less than -2.0 and single vertebral body fracture. This study examined the MRI of anterior longitudinal ligament or posterior longitudinal ligament injury, superior or inferior endplate disruption, superior of inferior intravertebral disc injury, the presence of low signal intensity on T2-weighted images, and bone edema of intravertebral bodies in fractured intravertebral bodies. Results: In cases where the superior endplate was disrupted or the level of bone edema of the intravertebral bodies was high, the kyphotic angle, wedge angle, and anterior vertebral compression showed remarkably progression. In the case of damage to the anterior longitudinal ligament or the superior disc, only the kyphotic angle was markedly prominent. On the T2-weighted images, low signal intensity lesions showed a high wedge angle and high anterior vertebral compression. On the other hand, there were no significant correlations among the posterior longitudinal ligament injury, inferior endplate disruption, inferior disc injury, and the progression of kyphotic deformity and vertebral compression. The risk factors that increase the kyphotic angle by more than 5° include the presence of injuries to the anterior longitudinal ligament, superior endplate disruption, and superior disc injury, and the risk factors were 21.3, 5.1, and 8.5 times higher than those of the uninjured case, and the risk differed according to the level of bone edema. Conclusion: An osteoporotic thoracolumbar compression fracture in osteoporotic or osteopenic patients, anterior longitudinal ligament injury, superior endplate and intravertebral disc injury, and high level of edema in the MRI were critical factors that increases the risk of kyphotic deformity.