• Title/Summary/Keyword: Thoracic Spine

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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.

Late Occurrence of Cervicothoracic Ossification of Posterior Longitudinal Ligaments in a Surgically Treated Thoracic OPLL Patient

  • Hyun, Seung-Jae;Kim, Jong-Soo;Hong, Seung-Chyul
    • Journal of Korean Neurosurgical Society
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    • v.47 no.1
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    • pp.55-57
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    • 2010
  • Ossification of the posterior longitudinal ligament (OPLL) in the thoracic spine is rare, even in the Far East. A 45-year-old female presented with a 4month history of progressive motor weakness in the lower extremities, numbness below the midthoracic area, and spastic gait disturbance. Neuroradiological examinations revealed massive OPLLs at the T4-T6 levels with severe anterior compression of the spinal cord. Anterior decompressive corpectomies with bone grafts were performed from T4 to T6 using a trans-thoracic approach. After surgery, the patient made an uneventful recovery. However, eleven years after surgery, the patient developed recurrent lower extremity weakness and spastic gait disturbance. De novo OPLLs at the C6-T2 levels were responsible for the severe spinal cord compression on this occasion. After second surgery, paralysis in both legs was resolved. We present a rare case of late cervicothoracic OPLL in a patient surgically treated for thoracic OPLL.

Effect of Posterior-Anterior Mobilization of the Thoracic Spine on Pain, Respiratory Function, and Thoracic Circumference in Patients With Chronic Low Back Pain

  • Park, Ju-jung;Chon, Seung-chul
    • Physical Therapy Korea
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    • v.25 no.4
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    • pp.37-45
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    • 2018
  • Background: Posterior-anterior (PA) vertebral mobilization, a manual therapy technique has been used for relieving pain or stiffness treating in spinal segment for in clinical practice, however evidence to gauge efficacy is yet to be synthesised. Objects: This study aimed to investigate the effect of PA mobilization of the thoracic spine on the respiratory function in patients with low back pain (LBP). Methods: The study participants included 30 patients with chronic LBP. They were randomly allocated to the experimental and control groups. The experimental and control groups received PA mobilization of the T1-T8 level of the thoracic spine and placebo mobilization, respectively. All patients received interventions for 35 minutes a day, five times a week, over 2-week period, respectively. Forced vital capacity (FVC), forced expiratory volume in 1 second ($FEV_1$), peak expiratory flow (PEF), forced expiratory flow 25~75% ($FEF_{25{\sim}75%}$), and chest wall expansion were measured before and after the intervention. Statistical analysis was performed using independent t-test and two-way analysis of variance, and Pearson's correlation analysis was used to compare the correlation between respiratory function and chest measurement. Results: The experimental group showed significant improvements in FVC, $FEV_1$, PEF, $FEF_{25{\sim}75%}$ (p<.05), and chest wall expansion (p<.05) compared with the control group. Conclusion: PA mobilization of the upper thoracic spine may be beneficial for improving respiratory function parameters including FVC, $FEV_1$, PEF, $FEF_{25{\sim}75%}$, and chest wall expansion in patients with chronic LBP.

Solitary Plasmacytoma in the Thoracic Spine with Massive Aggregation of Histiocytes

  • Kim, Jung-Soo;Hwang, Soo-Hyun;Lee, Chul-Hee;Kang, Dong-Ho
    • Journal of Korean Neurosurgical Society
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    • v.40 no.2
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    • pp.114-116
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    • 2006
  • A Solitary plasmacytoma of bone[SPB] is a rare disease. This paper reports a case of SPB with massive aggregation of histiocytes known as pseudo-Gaucher cells. A 40-year-old male presented with progressive paraparesis and paraesthesia. The Magnetic Resornance Image[MRI] revealed a tumor mass in the thoracic spine that occupied the three colum. The tumor invaded the epidural space of T6 vertebra with compression of the spinal cord. There were no laboratory abnormalities. It was gross totally resected and his neurological symptoms improved. The microscopic examination revealed a plasmacytoma with massive aggregation of histiocytes. Futher neuroradiological studies were carried out and no other lesions were detected.

Effects of Thoracic Mobility Exercise on Cervicothoracic Function, Posture and Pain in Individuals With Mechanical Neck Pain (등뼈 가동성 운동이 기계적 목통증 환자의 목등뼈부 기능 수준과 자세, 통증 수준에 미치는 영향)

  • Lee, Hwa-jeong;Kim, Suhn-yeop
    • Physical Therapy Korea
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    • v.26 no.3
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    • pp.42-56
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    • 2019
  • Background: Individuals with mechanical neck pain show biomechanical and neurophysiological changes, including cervical spine muscle weakness. As a result of deep muscle weakness, it causes stability disability and reduced upper thoracic spine mobility, which finally leads to functional movement restriction such as limited range of motion and dysfunction. Recent studies have shown that thoracic spine manipulation and mobilization could reduce symptoms of mechanical neck pain in patients. Objects: The purpose of this study was to investigate the effects of thoracic mobility exercise on cervicothoracic function, posture feature, and pain intensity in individuals with mechanical neck pain. Methods: The study subjects were 26 persons who were randomly assigned to the experimental (with thoracic mobility exercise) and control groups (without thoracic mobility exercise), with 13 subjects in each group. The cervicothoracic function (neck functional disability level and cervicothoracic range of motion), posture feature, and pain rating (using a quadrupled visual analogue scale [QVAS]) were measured before, after 3 weeks, and after 6 weeks. Results: Statistically significant group-by-time interactions were found with repeated analyses of variance for the Korean neck disability index (KNDI), all cervical range of motion (CROM), all thoracic range of motion (TROM), cranial rotation angle, sagittal shoulder posture (SSP), and QVAS (p<.05). All groups showed significant improvements from all times in all the evaluated methods. The KNDI, CROM, TROM of left rotation, and SSP in the experimental group showed significant improvements after 3 weeks, and the TROM of the right rotation and QVAS in the experimental group showed significant improvements after 6 weeks when compared with the control group. Conclusion: Thoracic mobility exercise during 6 weeks might be effective intervention to improve the functional level, posture feature, and QVAS pain rating for managing individuals with mechanical neck pain.

Neurofibromatosis (Von Recklinghausen's Diseased) in Mediastinum -3 case- (종격동에 발생한 다발성 신경섬유종증 -3례 보고-)

  • Pyeon, Seung-Hwan;Jeong, Il-Yeong;Choe, Pil-Jo;U, Jong-Su
    • Journal of Chest Surgery
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    • v.29 no.1
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    • pp.120-124
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    • 1996
  • We report three cases of posterior mediastinal tumor in Von Recklinghausen's disease on 12-yearsy old boy, 8-years-old girl and 6-years-old boy. Especially the last case was combinded with "Dumbbell" neurilemmoma of cervical spine. In the first case, preoperative CT scan showed a homogeneous large mass In the posterior mediastinum. But the mass did not show intraspinal invasion on the chest MRI scan. In the last case, cervical spine CT with thecal enhancement shows dumbbell shaped neurofibroma, compressed spinal cord and thecal sac In three cases we removed all the masses successfully and the patients were discharged safely without significant problem.t problem.

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Radiograph-based Diagnostic Methods for Thoracic and Lumbar Spine Malposition in Chuna Manual Therapy Using Biomarkers (단순 방사선 영상기반 바이오마커를 활용한 흉·요추의 추나의학적 변위 진단 방법)

  • Jin-Hyun Lee;Minho Choi;Joong Il Kim;Jun-Su Jang;Tae-Yong Park
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.18 no.2
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    • pp.1-8
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    • 2023
  • Objectives This study aimed to propose biomarkers for diagnosing Chuna manual therapy (CMT) based on X-ray images in the thoracic and lumbar spines. Methods Through a literature review and expert consensus process, diagnostic biomarkers for CMT were selected based on the listing system in thoracic and lumbar radiograph anterior-posterior (AP) and lateral views. Results 1. Diagnostic biomarkers were derived from four points on the outer contour of the vertebral body in the thoracic and lumbar spine radiograph lateral view, enabling the diagnosis of flexion and extension malposition. 2. Additional diagnostic biomarkers were identified in the thoracic and lumbar radiographAP view, utilizing points on the outer contour of the vertebral body. These biomarkers facilitate the diagnosis of lateral bending. Moreover, biomarkers derived from the innermost point of the pedicle contour allow for the diagnosis of rotation malposition. 3. Furthermore, through the biomarkers proposed in this study, all malpositions of the thoracolumbar spines and complex Type I and II malpositions can be diagnosed in CMT. Conclusions The biomarkers reported in this study consist of minimal points to determine the position of the vertebral body, providing the advantage of simplicity while minimizing potential errors during the CMT diagnostic process. Further clinical research and the development of related programs should be pursued to expand the evidence for CMT.

Aneurysmal Bone Cyst of the Thoracic Spine with Scoliosis - Case Report - (척추 측만증을 동반한 흉추에 발생한 동맥류성 골낭종 - 증례 보고 -)

  • Han, Chung-Soo;Kim, Ki-Tack;Cho, Chang-Hyun;Yang, Hyoung-Seop
    • The Journal of the Korean bone and joint tumor society
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    • v.5 no.1
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    • pp.76-81
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    • 1999
  • Aneurysmal bone cysts are uncommon bony lesions of the spine. Approximately 3-20% of the aneurysmal bone cysts occur in the spine, predominantly in the lumbar region, but they may occur at the any level of the spine. These lesions commonly arise from the neural arch and occasionally invade the pedicle and the vertebral body. The clinical diagnosis of a spinal lesion can be very difficult in the early stages of the disease because specific symptoms and signs are usually absent or only amount to back pain. However, depending on the level of involvement and the extent of neurological compression, a wide variety of neurological symptoms and signs may appear, ranging from mild radicular symptoms to complete paraplegia or tetraplegia. Available treatment options include complete excision or curettage of the lesion with bone graft, but where excision cannot be achieved, low dose radiation or arterial embolization may be used. We report a case of aneurysmal bone cyst in the pedicle of the T10 spine with nonstructural scoliosis of $40^{\circ}$ Cobb's angle which was treated successfully with only curettage of the lesion.

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A Clinical Study on the Correlation between Spine Deformity and Foot Abnormality (척추변형과 족부병변의 임상적 상관관계)

  • Choi, Hyun-Im;Park, Hung-Ki;Ju, Mu-Yeol
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.10 no.1
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    • pp.117-128
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    • 2004
  • I have processed all the data by using SPSS PC+. And my research process was investigated for 34 students on the Forward Bending Test, Foot Printer Test, Feedoscope Test, X-ray Test and so on. The object of this thesis is to study the correlation between spine deformity and foot abnormality in a theoretical and empirical method. The main results of this study were as follows: 1. There was statistical significance on the correlation between foot length and spine length. 2. Spinal curve is the smallest on the pes plannus group and the biggest on the pes cavus group without statistical significance. 3. Left lumbar curve is the smallest, and right thoracic spine curve is the biggest on the left foot pattern group with statistical significance. 4. On the foot weight bearing groups, there was statistical significance both of between left and right foot groups. 5. There was no statistical significance on the t-test analysis between left and right foot area according to spinal curve typology. But there was tendency that thoracic spine curve is bigger in the same side of the foot area and lumbar spine curve is bigger in the opposite side of foot area.

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The Study of Vertebral Palpation (척추부 촉진에 관한 연구)

  • Park, Youn-Ki
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.16 no.1
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    • pp.57-63
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    • 2010
  • The palpation of spinous process and transverse process of vertebra are important part of the assesment and treatment from Orthopedic manual therapy. But the palpation area is descriptive differently each of literatures. So we generally got these outcomes. : There are C2, C3, C4 and C6 process as a bony landmarks and these are important part of establish the precise location of pain appears from cervical spine. Even though C7 process regard a prominent part, it is hard to distinguish C6 and process of T1. Thru that differentiation, grab the patient's forehead and try them cervical and hyper-extension check any movement of process or put on the fingers on C7 preocess and check the movement. The palpation of thoracic spine process is the land mark which determines general level orientation in the spine easily, there are T2, T7 spinous process. However, It is depends on how do you test the patient's arm when you palpate it and it can effect on spinous process. The transverse process of C1 is the only spot for palpation in cervical spine, and T1-3, T12 transverse process can palpate it when it stands on the process. The end of T4-6, T11 is placed on middle on vertebra of transverse process and transverse process. T7-9, T10 transverse process is place on same position as spinous process which is upper part of the spine.

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