• Title/Summary/Keyword: Thoraco-Lumbar Spine

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The Effect on Trunk Forward Flexion Motion of Thoraco-Abdominal Breathing Pattern Correction for Life Care Promotion in Lumbar Instability People (라이프케어증진을 위한 흉·복부 호흡패턴교정이 요추부 불안정성자들의 몸통 전방 굴곡 동작에 미치는 영향)

  • Ki, Chul;Heo, Myoung
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.8
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    • pp.245-253
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    • 2020
  • This study has conducted to investigate the changes in the mobility of the three thoraco-abdominal lines(TAMs) during breathing and in the thoracic and lumbar spine mobility(TSM, LSM) during trunk forward flexion, after breathing pattern correction. The 30 subjects with lumbar instability(LI) have divided into the breathing pattern correction exercise(BPC) group of 15 subjects and the lumbar stabilization exercise(LSE) group of 15 subjects and performed each exercise for 40 minutes at one session, and a total of 18 sessions were applied for 6 weeks. As a result, The BPC group during breathing showed a significant increase in all TAMs(p<.001) and in the TSM(p<.001) than the LSE group. Besides, had a more decrease in the LSM than the LSE group(p<.001). The BPC showed high positive correlations with TAMs(rest: r=.868, forced: r=.870) and the TSM(r=.672) and had a negative correlation with the LSM(r=-.420). Based on this result of the study, the authors believe that the BPC in LI people could decrease the lumbar flexion mobility when they have motion of trunk forward flexion with promotions in the thoracic spine and rib joint mobility by improvements in relative mobility of thoraco-abdominal lines.

The Clinical Study of 35 Admission Patients to Oriental Medical Hospital due to Thoraco-Lumbar Compression Fracture (흉요추부 압박골절 진단을 받고 한방병원에 입원한 환자 35명에 대한 임상적 고찰)

  • Jin, Eun-Seok;Koh, Dong-Hyun;Kim, Ha-Neul;Kim, Joo-Won;Hong, Soon-Sung;Kim, Han-Kyum;Lee, Jin-Hyuk
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.3 no.2
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    • pp.19-27
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    • 2008
  • Objective : The purpose of this study is to investigate the results of korean traditional conservative therapy for thoraco-lumbar compression fracture and it's recovery rate and different result in accordance with sex, age, medical history. Method : We studied about 35 cases who were admitted to Jaseng Hospital of Oriental Medicine with diagnosis of 'Thoraco lumbar compression fracture' with X-ray examination. Result : Out of 35 patients 31 patients discharged with satisfying results. Most of the compression fracture occurred in age of $60{\sim}70$. And the single fractured patients recovered more easily than the multi-level fractured patients. It didn't affect the results whether the patient had another vertebral disease(such as Herniated intervertebral disc or osteoporosis) or not. And most of the patients who had vertebral compression fracture visited the western medicine hospital first. Conclusions : We analyzed the tendency of the patients who had vertebral compression fracture, and concluded that the conservative Korean traditional therapy is an effective means of treatment for the patients who have thoraco-lumbar compression fracture.

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Kinematic Analysis of Thoraco-Lumbar Spine in Bad Postures During Daily Life (일상 생활 중의 나쁜 자세에 따른 흉·요추 관절의 기구학 해석)

  • Han, Ah-Reum;Jeong, Ji-In;Feng, Jun;Kim, Yoon-Hyuk
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.36 no.11
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    • pp.1105-1110
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    • 2012
  • The spine is one of the most important skeletal joints, and it strongly affects the health of the musculoskeletal system. A normal spine has an S-shape, and it is very important to maintain this shape. Recently, spinal diseases such as low back pain have increased rapidly, especially among the elderly. Some of these diseases are caused by congenital spinal disorders and sporting and accident injuries as well as by bad postures. Improper spinal postures could generate excessive disc pressure, which is related to degeneration and pain. Therefore, in this study, we investigated the three-dimensional kinematic parameters of the thoraco-lumbar joint in several bad postures using a motion capture analysis technique. Different bad postures created a significant amount of flexion/extension, side bending, and axial rotation angle compared with neutral postures. Further study is necessary to investigate the disc pressure and ligament force due to the increase in joint rotation from the bad postures.

The Case Study on Thoraco-lumbar junction and Lumbo-sacral junction Transitional Zone Syndrome. (복합적으로 병발한 등-허리, 허리-엉치 이행부위 증후군에 대한 증례를 통한 고찰)

  • Hwang, Eun-Mi;Jung, Min-Gyu;Park, Young-Hoi;Keum, Dong-Ho
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.5 no.2
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    • pp.113-125
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    • 2010
  • Objectives: We have evaluated the effects of conservative treatment on one patient who was diagnosed to thoraco-lumbar junction and lumbo-sacral junction transitional zone syndrome. so, we investigate thoraco-lumbar junction and Jumbo-sacral junction tranzitional zone syndrome that was suggested by Maigne R. Methods : One patient was diagnosed as T12-L1 herinated intervetebral disc through MRI. We diagnosed the patient to transitional zone syndrome by symptoms and physical examination and used Acupuncture therapy, Cox technique to the patient. We measured Visual Analog Scale(VAS) before and after treatment. Results: After treating Acupuncture therapy, Cox technique in the case, We find out that the patient was improved. VAS score changed from 7 to 2 and physical examinations are improved. Conclusions: We improved the patient who had thoraco-lumbar junction and lumbo-sacral junction transitional zone syndrome by Cox technique and Acupuncture therapy, and we found that thoraco-lumbar junction related lumbo-sacral junction.

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Conservative treatment of Osteoporotic Compression Fractures in Thoracolumbar spine (골다공증성 흉요추부 압박 골절에서의 보존적 치료)

  • Kang, Kyu-Bok;Koh, Young-Do
    • Journal of Trauma and Injury
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    • v.18 no.2
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    • pp.107-111
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    • 2005
  • Backgrounds: To evaluate the effectiveness of conservative treatment in osteoporotic thoraco-lumbar compression fractures and to identify the factors influencing the progression of compression. Materials and Methods: From January 2003 to October 2004, Patients who were admitted to our hospital for osteoporotic thoraco-lumbar compression fractures were reviewed retrospectively with follow-up more than 12 months (ave. 14.6 months). With simple x-ray lateral view, we evaluate wedge compression ratio (WCR) and kyphotic angle (KA) at initial and final follow-up. We separate the patients into two groups baesed on the amount of progression of vertebral compression and evaluate a relation with BMD, vertebral fracture level, initial WCR, initial KA. All datas were statistically analyzed. Results: An average of T-score was -3.5 and the changes of KA between initial and final follow-up were average $3.5^{\circ}$. Compression of anterior column were progressed to 8.5%. The changes between initial and final WCR in Group I (N=24) was 17.8%, and Group II (N=18) was 3.3%. T-score in group I was -3.4 and group II was -3.8 (p=0.228). vertebral fracture level were 10 T12, 12 L1, 2 L2 in group I; 6 T12, 6 L1, 6 L2 in group II (p=0.156). Initail WCR was 0.74 in group I, 0.63 in group II, and there was statistical difference between two groups(p=0002). Initial kyphotic angle was $13.9^{\circ}$in group I, $16.2^{\circ}$in group II repectively (p=0.392). Conclusion: The conservative treatment with short-term bed rest and early embulation is effective and valuable method to patients who have osteoporotic thoraco-lumbar compression fractures. There was no statistical difference between two groups according to BMD, vertebral fracture level, KA. But in comparison with initail WCR between two groups, there was statistical difference. That means, in the case of small initial compression of anterior column, the progression of compression was bigger than else. In these patients, more strict use of appropriate brace and careful follow-up should be needed.

Minimally Invasive Option Using Percutaneous Pedicle Screw for Instability of Metastasis Involving Thoracolumbar and Lumbar Spine : A Case Series in a Single Center

  • Park, Ho-Young;Lee, Sun-Ho;Park, Se-Jun;Kim, Eun-Sang;Lee, Chong-Suh;Eoh, Whan
    • Journal of Korean Neurosurgical Society
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    • v.57 no.2
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    • pp.100-107
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    • 2015
  • Objective : To report a minimally invasive treatment option using percutaneous pedicle screw fixation with adjuvant treatment for metastatic thoraco-lumbar and lumbar spinal tumors. Methods : This is a retrospective study of charts of patients with spinal metastases. All were older than 18 years of age and were considered to have more than 3 months of life expectancy. The patients had single or two level lesions, and compression fracture or impending fracture. Exclusion criterion was metastasis showing severe epidural compression with definite neurological symptoms. Usually spinal segments from one level above to below pathology were stabilized. Visual analog scale (VAS) score for pain assessment and Frankel scale for neurological deficit were used, while pre- and post-operative performance status was evaluated using the Eastern Cooperative Oncology Group (ECOG). Results : Twelve patients (nine men, three women; median age 54.29 years) underwent surgery. All patients presented with back pain with/without radicular pain. There were no early complications and perioperative mortalities. Following surgery, a significant difference between average pre- and post-operative VAS scores was found (p=0.003). Overall, 91.8% of patients (11/12) experienced improvement in their ECOG score post-operatively. The mean ambulation time was 196.9 days [95% confidence interval (CI), 86.2-307.6 days; median, 97 days]. During follow-up, nine patients died and the mean overall survival time in enrolled twelve patients was 249.9 days (95% CI, 145.3-354.4 days; median, 176 days). Conclusion : Minimally invasive treatment using percutaneous pedicle screw fixation with adjuvant treatment is a good alternative treatment option for potential instability of the thoraco-lumbar and lumbar spinal metastasis.

Evaluation of Organ and Effective Dose using A PC-Based Monte Carlo Program in AEC Mode and Fix Mode for the whole spine antero-posterior radiography (전 척추 전.후 방향 검사 시 AEC Mode와 Fix Mode에서 PC-Based Monte Carlo Program을 이용한 장기선량 및 유효선량 평가)

  • Kim, Jeong Jin;Jang, Seong Won;Park, Jang Heum;Lee, Kwan Seob;Ha, Dong Yoon
    • Korean Journal of Digital Imaging in Medicine
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    • v.14 no.2
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    • pp.23-31
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    • 2012
  • There are AEC mode and fix mode to exposure when the whole spine antero-posterior radiography is done by using DR equipment. This study compared the utility of fix mode to AEC mode, by evaluating organ dose and effective dose and by examining the quality of radiographic image. GE DEFINIUM 8000 and ART-200X Rando Phantom manufactured by Flukebiometical were used for this study. The Rando phantom was set in front of wall detector of X-rays equipment. AEC mode was set at 80kVp and Fix mode was set at 80kVp, 25mAs, 32mAs, 40mAs, and 50mAs. Whole spine AP image were aquired by combining C, T-L and L-S spine images obtained through 3 exposures. When obtaining C, T-L and L-S spine images, were checked for Air kerma (mGy) value calculated by UNFORS Xi meter attached at the phantom surface of center of radiation field. The effective and organ doses were compared by PCXMC program (PC-Based Monte Carlo Program). The quality of obtained radiographic image was evaluated visually by 3 radiologists using resolution chart. When the effective doses was calculated based on tissue weighting factor of ICRP-103, 1.278mSv was measured by AEC mode, and Fix mode measured 0.405mSv at 25mAs, 0.518mSv at 32mAs, 0.649mSv at 40mAs, and 0.810mSv at 50mAS. In addition, the organ dose measured with esposure at 25mAs by Fix mode was almost equivalent to the organ dose by AEC mode, at the esophagus, thyroid, oral mucosa, salivaly glands located at the cervical spine part, while the organ dose by Fix mode was in general lower than the organ dose by AEC mode at the other organs. When Fix mode at 32mAs, 40mAs, and 50mAs was compared to AEC mode for organ dose in 26 organs, AEC mode had higher measurement in 21 organs but not for than brain, trachea, thyroid, oral mucosa, and salivaly glands which are located at the cervical spine part. The image quality evaluated by resolution test chart was much higher with AEC mode than the quality with Fix mode at all exposure conditions. However, while the image quality of cervical spine exposured at 50mAs by Fix mode was lower than the quality of AEC mode, thoraco-lumbar spine and lumbo-sacral spine were calculated and the quality was similar to AEC mode. Scoliosis occurs mainly at thoraco-lumbar and lumbo-sacral spine, not at cervical spine. Compared to AEC mode, Using the appropriate protocol (80kVp, 50mAs) of fix mode for whole spine AP radiography was thought to be useful because the image quality of the thoraco-lumar and lumbo-sacral spine was similar on AEC mode, Also organ and effective doses can be decreased with Fix mode. Therefore, It is considered that fix mode can be used properly with AEC mode for whole spine AP radiography when considering patient's body posture.

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Multiple Spinal Cord Recurrences of an Intracranial Ependymoma after 14 Years

  • Hong, Semie;Choe, Woo Jin;Moon, Chang Taek
    • Journal of Korean Neurosurgical Society
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    • v.54 no.6
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    • pp.521-524
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    • 2013
  • Ependymoma can spread via cerebrospinal fluid, but late spinal recurrences of intracranial tumor are very rare. We describe a case of a 33-year-old male who presented with multiple, delayed, recurrent lesions in the spinal cord from an intracranial ependymoma. The patient underwent gross total resection and postoperative radiation therapy 14 years prior to visit for a low grade ependymoma in the 4th ventricle. The large thoraco-lumbar intradural-extramedullary spinal cord tumor was surgically removed and the pathologic diagnosis was an anaplastic ependymoma. An adjuvant whole-spine radiation therapy for residual spine lesions was performed. After completion of radiation therapy, a MRI showed a near complete response and the disease was stable for three years.

The Effects of Hip Joint Movement on the Lumbo-pelvic Muscle Activities and Pelvic Rotation During Four-point Kneeling Arm and Leg Lift Exercise in Healthy Subjects

  • Nam-goo Kang;Won-jeong Jeong;Min-ju Ko;Jae-seop ,Oh
    • Physical Therapy Korea
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    • v.30 no.2
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    • pp.144-151
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    • 2023
  • Background: The gluteus maximus (GM) muscle comprise the lumbo-pelvic complex and is an important stabilizing muscle during leg extension. In patients with low back pain (LBP) with weakness of the GM, spine leads to compensatory muscle activities such as instantaneous increase of the erector spinae (ES) muscle activity. Four-point kneeling arm and leg lift (FKALL) is most common types of lumbopelvic and GM muscles strengthening exercise. We assumed that altered hip position during FKALL may increase thoraco-lumbar stabilizer like GM activity more effectively method. Objects: The purpose of this study was investigated that effects of the three exercise postures on the right-sided GM, internal oblique (IO), external oblique (EO), and multifidus (MF) muscle activities and pelvic kinematic during FKALL. Methods: Twenty eight healthy individuals participated in this study. The exercises were performed three conditions of FKALL (pure FKALL, FKALL with 120° hip flexion of the supporting leg, FKALL with 30° hip abduction of the lifted leg). Participants performed FKALL exercises three times each condition, and motion sensor used to measure pelvic tilt and rotation angle. Results: This study demonstrated that no significant change in pelvic angle during hip movement in the FKALL (p > 0.05). However, the MF and GM muscle activities in FKALL with hip flexion and hip abduction is greater than pure FKALL position (p < 0.001). Conclusion: Our finding suggests that change the posture of the hip joint to facilitate GM muscle activation during trunk stabilization exercises such as the FKALL.

Acupuncture in Patients with a Vertebral Compression Fracture: A Protocol for a Randomized, Controlled, Pilot Clinical Trial

  • Lee, Hyun-Jong;Seo, Jung-Chul;Park, Sung-Hoon;Kwak, Min-Ah;Shin, Im Hee;Min, Bo-Mi;Cho, Min-Su;Roh, Woon-Seok;Jung, Jin-Yong
    • Journal of Pharmacopuncture
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    • v.18 no.1
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    • pp.79-85
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    • 2015
  • Objectives: A vertebral compression fracture (VCF) is characterized by back pain and fracture of a vertebral body on spinal radiography. VCFs of the thoraco lumbar spine are common in the elderly. In general, appropriate analgesics should be prescribed to reduce pain and, thus, promote early mobilization. The ideal treatment approach for VCFs has not been determined. In Korea, acupuncture and herbal medication have been used to treat VCFs for many years. There is empirical evidence that acupuncture might benefit patients with a VCF. However, no randomized, controlled, clinical trials evaluating the efficacy and the safety of acupuncture for treating a VCF have been published. Therefore, we designed a randomized, controlled, pilot, clinical trial to obtain information for the design of a further full scale trial. Methods: A five week protocol for a randomized, controlled, pilot, clinical trial is presented. Fourteen patients will be recruited and randomly allocated to two groups: a control group receiving interlaminar epidural steroid injections once a week for three weeks, and an experimental group receiving interlaminar epidural steroid injections plus acupuncture treatment (three acupuncture sessions per week for three weeks, nine sessions in total). The primary outcomes will be the pain intensity (visual analogue scale and PainVision$^{TM}$ system). The secondary outcome measurements will be the answers on the short form McGill pain questionnaire and the oswestry disability index. Assessments will be made at baseline and at one, three, and five weeks. The last assessment (week five) will take place two weeks after treatment cessation. This study will provide both an indication of feasibility and a clinical foundation for a future large scale trial. The outcomes will provide additional resources for incorporating acupuncture into existing treatments, such as nonsteroidal anti-inflammatory medications, narcotics and vertebral augmentation. This article describes the protocol.