• Title/Summary/Keyword: Spine, disease

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Descending Necrotizing Mediastinitis Combined with Cervical Spine Injury (경추 손상과 동반된 하행성 괴사성 종격동염)

  • 금동윤;양보성
    • Korean Journal of Bronchoesophagology
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    • v.7 no.1
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    • pp.76-79
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    • 2001
  • A 60-year-old male was admitted due to cervical spine injury (C7-T1 fracture dislocation) and quadriparesis after slip down. During conservative management in department of neurologic surgery, he complainted of fever, dyspnea, neck swelling. Follow up cervicothoracic CT revealed abscess pocket in paraglottic, retropharyngeal, anterior cervical spaces and mediastinum. Also noted bilateral pleural effusions. Under impression of descending necrotizing mediastinitis (DNM). cervical drainage and bilateral chest tube insertion was performed immediately. On next day. mediastinal drainage through mediastinotomy was performed with careful handling of cervical spine. Escherichia coli was identified in bacteriologic culture. Wire fixation of dislocated C7-T1 spine through Posterior approach was performed on 30th days after mediastinotomy. Right chest tube was removed on 40th days. At now, the patient is on rehabilitation and physical training program. DNM is relatively rare, but lethal disease with high mortality. Immedate and sufficient mediastinal drainage is essential in treatment.

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Atypical Presentation of Spinal Tuberculosis Misadiagnosed as Metastatic Spine Tumor

  • Kim, Dong-Woo;Choi, Hyu-Jin;Kim, Hyung-Dong;Song, Young-Jin
    • Journal of Korean Neurosurgical Society
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    • v.39 no.6
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    • pp.451-454
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    • 2006
  • We present a case of a 68-year-old female with an atypical form of spinal tuberculosis, which involved posterior elements with multiple foci in two noncontiguous vertebral levels. The lesions caused spastic paraparesis and urinary hesitation. There was no evidence of pulmonary or other extrapulmonary tuberculous disease. Based on clinical and radiographic findings, this atypical spinal tuberculosis was preoperatively misdiagnosed as metastatic spine tumor. The histopathologic finding confirmed tuberculosis and the patient was treated successfully with surgery and antituberculous therapy. In case of a spinal lesion of unknown origin, it is important to be aware that atypical spinal tuberculosis can mimic metastatic spine tumor and tuberculosis should always be considered.

Pigmented Villonodular Synovitis on Lumbar Spine : A Case Report and Literature Review

  • Oh, Sung Woon;Lee, Min Ho;Eoh, Whan
    • Journal of Korean Neurosurgical Society
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    • v.56 no.3
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    • pp.272-277
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    • 2014
  • Pigmented villonodular synovitis (PVNS) is a benign proliferative joint disease with an uncertain etiology that uncommonly involves the spine. We present a case of PVNS involving the lumbar spine. A 38-year-old male developed back pain and pain in both legs caused by a mass in the L4 region of the right lamina. After gross total tumor removal, the symptoms improved. The pathological finding was synovial hyperplasia with accumulation of hemosiderin-laden macrophages. He was diagnosed with PVNS and experienced no recurrence for up to 2 years after surgery. In this report, we review the previous literature and discuss etiology, clinical manifestations, diagnosis, and treatment.

The Effects of Lumbar Repositioning Sense and Muscle Fatigue after Stabilization Exercise Program in Disc Disease Patients (허리 디스크탈출증 환자의 재위치 감각과 근 피로도에 미치는 안정화운동 프로그램의 영향)

  • Kim, Myung-Joon
    • Journal of Korean Physical Therapy Science
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    • v.16 no.3
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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.

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The Effects of Segmental Instability and Muscle Fatigue after Applying Sabilization Exercise Program In Degenerated Disc Disease Patients of Aged (노인 퇴행성디스크 환자의 안정화운동이 척추불안정과 피로도에 미치는 영향)

  • Kim, Hee-Ra
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.13 no.2
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    • pp.12-20
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    • 2007
  • The purpose of this study was designed to find out the effectiveness of vertebral segment instability, muscle fatigue response on lumbar spine after apply lumbosacral stabilization exercise program to 4 patients with chronic low back pain and for 12 weeks. In this study, 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(Matthiass 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. The results of the present study were as follows: 1. Instability test of lumbar vertebra segment is 2 type differential angle test between vertebrae segment and loading test of spine(matthiass) by Spinal Mouse. It appeared to improve stability of segments in sagittal plane after applying program. So lumbar spine curve increased lordosis toward anterior and was improved of the lumbar spine flexibility in flexion and extension. Specially, in matthiass test, (-) value was increased between lumbar vertebra segment when was the load on spine. And so applying stability improved after program. 2. Fatigue response test(FRT) results, in male, was raised muscle fatigue rate during increase weight, on the other hand female appeared lower than male. As a results, lumbosacral stabilization exercise was aided to improvement of lumbar spine vertebra segments stabilization. Spine instability patients will have a risk when in lifting a load or working with slight flexion posture 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.

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The Effects of Segmental Instability and Muscle Fatigue after Stabilization Exercise Program in Degenerated Disc Disease Patients of Aged (노인 퇴행성디스크 환자의 안정화운동이 척추불안정과 피로도에 미치는 영향)

  • Kim, Hee-Ra
    • Journal of Korean Physical Therapy Science
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    • v.13 no.4
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    • pp.7-16
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    • 2006
  • The purpose of this study was designed to find out the effectiveness of vertebral segment instability, muscle fatigue response on lumbar spine after apply lumbosacral stabilization exercise program to 4 patients with chronic low back pain and for 12 weeks. In this study, 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(Matthiass 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. The results of the present study were as follows: 1. Instability test of lumbar vertebra segment is 2 type differential angle test between vertebrae segment and loading test of spine(matthiass) by Spinal Mouse. It appeared to improve stability of segments in sagittal plane after program. So lumbar spine curve increased lordosis toward anterior and was improved of the lumbar spine flexibility in flexion and extension. Specially, in matthiass test, ( - ) value was increased between lumbar vertebra segment when was the load on spine. And so stability improved after program. 2. Fatigue response test(FRT) results, in male, was raised muscle fatigue rate during increase weight, on the other hand female appeared lower than male. As a results, lumbosacral stabilization exercise was aided to improvement of lumbar spine vertebra segments stabilization. Spine instability patients will have a risk when in lifting a load or working with slight flexion posture 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.

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Use of Quantitative Vertebral Bone Marrow Fat Fraction to Assess Disease Activity and Chronicity in Patients with Ankylosing Spondylitis

  • Ga Young Ahn;Bon San Koo;Kyung Bin Joo;Tae-Hwan Kim;Seunghun Lee
    • Korean Journal of Radiology
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    • v.22 no.10
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    • pp.1671-1679
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    • 2021
  • Objective: We quantitatively measured the fat fraction (FF) in the vertebrae of patients with ankylosing spondylitis (AS) using magnetic resonance imaging (MRI) and investigated the role of FF as an indicator of both active inflammation and chronicity. Materials and Methods: A total of 52 patients with AS who underwent spinal MRI were retrospectively evaluated. The FF values of the anterosuperior and anteroinferior corners of the bone marrow in the L1-S1 spine were assessed using the modified Dixon technique. AS activity was measured using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), AS Disease Activity Score (ASDAS), and serum inflammatory marker levels. AS disease chronicity was assessed by AS disease duration and the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). Univariable and multivariable regression analyses were conducted to investigate the correlation between FF and other clinical characteristics. Results: The mean FF ± standard deviation of the total lumbar spine was 43.0% ± 11.3%. At univariable analysis, spinal FF showed significant negative correlation with BASDAI (β = -0.474, p = 0.002) and ASDAS with C-reactive protein (ASDAS-CRP; β = -0.478, p = 0.002) and a significant positive correlation with AS disease duration (β = 0.440, p = 0.001). After adjusting for patient age, sex, and total mSASSS score, spinal FF remained significantly negatively correlated with BASDAI (β = -0.543, p < 0.001), ASDAS-CRP (β = -0.568, p < 0.001), and ASDAS with erythrocyte sedimentation rate (β = -0.533, p = 0.001). Spinal FF was significantly lower in patients with very high disease activity (ASDAS-CRP > 3.5) than in those with only high disease activity (2.1 ≤ ASDAS-CRP ≤ 3.5) (p = 0.010). Conclusion: Spinal FF may help assess both AS disease activity and chronicity.

A Study on Ankylosing Spodylitis in Traditional Korean Medical Perspective (강직성척추염(Ankylosing Spodylitis)에 대한 한의학적 이해)

  • Kim, Jong-Hyun;Yoon, Eun-Kyung;Baik, You-Sang;Jeong, Chang-Hyun;Jang, Woo-Chang;Lyu, Jeong-Ah
    • Journal of Korean Medical classics
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    • v.25 no.3
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    • pp.23-38
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    • 2012
  • Objective : Ankylosing Spodylitis(AS) is a chronic inflammatory disease that is notorious for its difficulty to cure. This study aims to interpret the mechanism of AS in the Traditional Korean Medical(TKM) perspective, and to understand the role of the spine. Method : Clinical manifestations of AS, epidemiological data and clinical cases were interpreted by traditional methodology. Result : The young age group of patients suffering from this condition suggests that the cause of this condition is not solely linked to deficiency of the Kidney[腎], which is a general cause for bone disease. Its symptoms are linked to obstruction in the upper body, which results in disturbance of Jeong(精) collection in the lower body. Based on other accompanying symptoms, together with its character as an autoimmune disease, a strong link to the spirit of the heart[心神] can be suggested. Conclusion : AS is closely linked not only to essence of kidney[腎陰], but to the spirit of the heart[心神] as well. From the TKM analysis of the spine, we can understand it as the basic pathway for the fundamental Gi(氣) circulation.

Diagnostic Usefulness of Digital Infrared Thermal Image in Carpal Tunnel Syndrome (수근관 증후군에서 적외선 체열 검사의 진단적 유용성)

  • Park, Jihyun;Lee, Jang Woo;Lee, Sang Eok;Kim, Byung Hee;Park, Dougho
    • Clinical Pain
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    • v.18 no.2
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    • pp.70-75
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    • 2019
  • Objective: The purpose of this study is to evaluate the usefulness of infrared thermography in patients with carpal tunnel syndrome by comparing with electrodiagnostic and ultrasonographic findings. Method: From January 2014 to October 2017, electrodiagnosis, ultrasound, and digital infrared thermal image (DITI) of unilateral carpal tunnel syndrome diagnosed in a single hospital were retrospectively analyzed. The subjects with bilateral symptoms of carpal tunnel syndrome, peripheral vascular disease, diabetes, thyroid disease, fibromyalgia, rheumatic disease, systemic infection, inflammation, malignant tumor, and other musculoskeletal disorders such as finger osteoarthritis, peripheral neuropathy, cervical radiculopathy, and the previous history of surgery were excluded. Results: Of 53 patients diagnosed with carpal tunnel syndrome, 11 were male and 42 were female. The visual analogue scale was 4.9 ± 1.9, and the duration of symptom was 11.8 ± 12.5 months. There was no statistically significant difference in the body surface temperature between the unaffected and affected sides. The severity of symptoms, electrodiagnostic findings, and cross-sectional area of the median nerve significantly correlates to each other. The temperature difference between the second fingers of the affected and unaffected sides showed a weak correlation with the amplitude of sensory nerve action potential and onset latency of compound muscle action potential, when there was no significant correlation with the other parameters. Conclusion: The difference in temperature on the surface of the body, which can be confirmed by DITI, is little diagnostic value when DITI is performed in unilateral carpal tunnel syndrome patients, especially when compared with ultrasonography.