• The Korean Journal of Pain
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• v.13 no.1
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• pp.111-114
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• 2000

Pain around the posterior iliac crest area is usually attributed to disorders of the lower lumbar or lumbosacral spine. However, low back pain arising from the thoracolumbar region is common and it is very similar to low back pain of lumbosacral origin. Low back pain of thoracolumbar origin is clinically distinguished from other nonspecific low back pain syndrome. It is characterized by symptoms localized at one posterior iliac crest innervated by posterior branch of $T_{12}$ spinal nerve. Patients never complain of spontaneous pain at the thoracolumbar junction. Only localized tenderness over involved segments of thoracolumbar junction can be noted. We report two cases of posterior iliac crest pain of thoracolumbar origin which was relieved by the treatment on the thoracolumbar junction.

• Journal of Trauma and Injury
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• v.22 no.1
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• pp.24-28
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• 2009

Purpose: This was conducted to assess the need for conventional radiographs of the thoracolumbar spine for routine screening of trauma patients who revealed no spinal trauma on chest and abdominal computed tomography (CT). Methods: We performed a retrospective review of the medical records of trauma patients who underwent conventional radiographs of the thoracolumbar spine following a chest and abdominal CT that revealed no spinal trauma. Results: Two hundred seventy-five trauma patients underwent conventional radiographs of the thoracolumbar spine following a chest and abdominal CT that revealed no spinal trauma. In 274 of the cases, the thoracolumbar spine series was also negative. Conclusion: CT of the chest and abdomen is an adequate evaluation of the thoracolumbar spine in trauma patients who require routine thoracolumbar spine screening, making subsequent conventional radiographs of the thoracolumbar spine unnecessary.

• The Journal of Korea CHUNA Manual Medicine
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• v.5 no.1
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• pp.77-84
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• 2004

Objectives : This study was designed to investigate the correlation between thoracolumbar junction and back-su points, Hwatahyeopcheok points for treatment of low back pain in the thoracolumbar junction syndrome that was suggested by Maigne R. Method : We Investigate the acupuncture points that was correlated with the location of thoracolumbar junction area. And We tried to find out a common point between thoracolumbar junction and back-su points, Hwatahyeopcheok points for treatment of low back pain. Results and Conclusion : 1. It is considered that these points such as $BL_{20}$, $BL_{21}$, $BL_{22}$, and Hwatahyeopcheok points that are located from 11th thoraic spinous process to 2nd lumbar spinous process are correspond to the thoracolumbar junction area. 2. It is suggested that acupuncture treatment on $BL_{20}$, $BL_{21}$, $BL_{22}$, and Hwatahyeopcheok points can release the tenderness of the muscles, recover autonomic nervous function and release smooth muscles and vascular contraction, so it can treat low back pain caused by thoracolumbar junction.

• Journal of Korean Neurosurgical Society
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• v.62 no.1
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• pp.96-105
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• 2019

Objective : The aims in the management of thoracolumbar spinal fractures are not only to restore vertebral column stability, but also to obtain acceptable alignment of the thoracolumbar junction (T-L junction) to prevent complications. However, insufficient surgical correction of the thoracolumbar spine would be likely to cause late progression of abnormal kyphosis. Therefore, we identified the surgical factors that affected unfavorable radiologic outcomes of the thoracolumbar spine after surgery. Methods : This study was conducted in a single institution from January 2007 to December 2013. A total of 98 patients with unstable thoracolumbar spine fracture were included. In these patients, fixation was done through transpedicular screws with rods by three surgical patterns. We reviewed digital radiographs and analyzed the images preoperatively and postoperatively during follow-up visits to compare the change of the thoracolumbar Cobb angle with radiologic parameters and clinical outcomes. The unfavorable radiologic group was defined as the patients who were measured as having greater than 20 degrees of thoracolumbar Cobb angle on the last follow-up, or who underwent kyphotic progression of thoracolumbar Cobb angle greater than 10 degrees from the immediate postoperative state to final follow-up, or who had overt instrument failure with/without additional surgery. We assessed the risk factors that affected the unfavorable radiologic outcomes. Results : We had 43 patients with unfavorable radiologic outcomes, including 35 abnormal thoracolumbar alignments and 14 instrumental failures with/without additional surgery. The multivariate logistic regression test showed that immediate postoperative T-L junction Cobb angle less than 10.5 degrees was a statistically significant risk factor, as well as the presence of osteoporosis (p=0.017 and 0.049, respectively). Conclusion : Insufficient correction of thoracolumbar kyphosis was considered to be a major factor of an unfavorable radiological outcome. The spinal surgeon should consider that having a T-L junction Cobb angle larger than 10.5 degrees immediately after surgery could result in an unfavorable radiological outcome, which is related to a poor clinical outcome.

• Journal of Physiology & Pathology in Korean Medicine
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• v.32 no.4
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• pp.283-290
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• 2018

The aim of the study was to investigate the effect of Korean medicine treatments on pain reduction of thoracolumbar compression fracture patients. We analysed 48 patients who have been diagnosed as thoracolumbar compression fracture on Computed Tomography(CT) or Magnetic Resonance Imaging(MRI) scan and had admitted to Dunsan Korean Medical hospital from January 1,2014 to April 4, 2017. The analysis was conducted as retrospective study which analyzes patient's medical records. Statistical analysis was performed using the IBM SPSS statistics 24 program. We used Visual Analog Scale(VAS) and pain reduction scale to evaluate pain reduction of patients. The result showed that there were statistically significant pain reduction on thoracolumbar compression fracture patients treated with korean medicine treatments. In conclusion, we found that the korean medicine treatments showed positive effect on pain reduction of thoracolumbar compression fracture patients.

• Journal of Acupuncture Research
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• v.26 no.1
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• pp.15-22
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• 2009

Objectives : This study was performed to evaluate the effects of thoracolumbar junction's Hyeopcheok points(夾脊穴) for low-back pain in the thoracolumbar junction syndrome. Method : 1. Measurement : We investigated 26 patients with low-back pain. The unpleasantness of pain was measured by visual analogue scale(VAS), and the Oswestry low-back pain disability index(ODI). We compared the VAS and ODI scores of the two groups statistically. 2. Intervention : Use Acupuncture and bee venom injection in thoracolumbar junction's Hyeopcheok points that display main tender points. Also, herb medication and physical therapy was used. Results and Conclusion : As a result of treatment, thoracolumbar junction's Hyeopcheok points is very effective for low-back pain. However, more cases are required to oriental medicine in order to prove the availability.

• Journal of Korean Neurosurgical Society
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• v.41 no.2
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• pp.77-81
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• 2007

Objective : In a variety of thoracolumbar diseases, corpectomy followed by interbody bone graft and anterior instrumentation has allowed direct neural decompression and reconstruction of the weight-bearing column by short segments fusion. In this study, we compared spinal stability of the two different anterior thoracolumbar instruments : Z-plate and Kaneda device representing plate and two-rods type, respectively. Methods : A retrospective review was performed for all the patients with thoracolumbar diseases or traumas treated with anterior corpectomy, autologous iliac bone graft, and fixation with instruments from 1996 to 2000. For the anterior instrumentation, Z-plate or Kaneda device was used for 24 [M:F=5:9, average age=37] and 12 [M:F=9:3, average age=41] patients, respectively. The plain AP and lateral flexion-extension films were taken immediately after surgery and at each follow-up. The sagittal and coronal Cobb's angles at the operation segments were used to observe the change of initial fixation status. The surgical time length and bleeding amount of the two groups were compared. Intra-operative and post-operative instrument associated complications were evaluated. Student t-test was used for statistical analysis and p-value less than 0.05 was considered to be significant. Results : Mean follow-up durations for Z-plate and Kaneda device were 24 and 21 months, respectively. The fusion rate was 91% for Z-plate and 100% for Kaneda device. Two cases of Z-plate group showed instrumentation failure during the follow up period, in which additional surgery was necessary. The mean differences of sagittal Cobb's angles among the AP images immediate after surgery and at follow-up were 7 and 2 degrees for Z-plate and Kaneda device, respectively [p<0.05]. The mean differences of coronal Cobb's angles were 5 and 2 degrees for Z-plate and Kaneda device, respectively [p<0.05]. No Intra-operative complication has occurred in both groups. There was no difference in surgery time and bleeding amount between two groups. Conclusion : We think that Kaneda device [rod type] is stronger than Z-plate [plate type] to keep the spinal stability after anterior thoracolumbar surgery.

• Journal of Korean Neurosurgical Society
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• v.46 no.5
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• pp.437-442
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• 2009

Objective : To characterize perioperative biomechanical changes after thoracic spine surgery. Methods : Fifty-eight patients underwent spinal instrumented fusions and simple laminectomies on the thoracolumbar spine from April 2003 to October 2008. Patients were allocated to three groups; namely, the laminectomy without fusion group (group I, n = 17), the thoracolumbar fusion group (group II, n = 27), and the thoracic spine fusion group (group III, n = 14). Sagittal (ADS) and coronal (ADC) angles for adjacent segments were measured from two disc spaces above lesions at the upper margins, to two disc spaces below lesions at the lower margins. Sagittal (TLS) and coronal (TLC) angles of the thoracolumbar junction were measured from the lower margin of the 11th thoracic vertebra body to the upper margin of the 2nd lumbar vertebra body on plane radiographs. Adjacent segment disc heights and disc signal changes were determined using simple spinal examinations and by magnetic resonance imaging. Clinical outcome indices were determined using a visual analog scale. Results : The three groups demonstrated statistically significant differences in terms of angle changes by ANOVA (p<0.05). All angles in group I showed significantly smaller angles changes than in groups II and III by Turkey's multiple comparison analysis. Coronal Cobb's angles of the thoracolumbar spine (TLC) were not significantly different in the three groups. Conclusion : Postoperative sagittal balance is expected to change in the adjacent and thoracolumbar areas after thoracic spine fusion. However, its prevalence seems to be higher when the thoracolumbar spine is included in instrumented fusion.

• Journal of Korean Neurosurgical Society
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• v.57 no.3
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• pp.174-177
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• 2015

Objective : For improving the drawbacks of previous thoracolumbar spine trauma classification, the Spine Trauma Study Group was developed new classification, Thoracolumbar Injury Classification and Severity Score (TLICS). The simplicity of this scoring system makes it useful clinical application. However, considering criteria of Korean Health Insurance Review and Assessment Service (HIRA), the usefulness of TLICS system is still controversial in the treatment decision of thoracolumbar spine injury. Methods : Total 100 patients, who admitted to our hospital due to acute traumatic thoracolumbar injury, were enrolled. In 45, surgical treatment was performed and surgical treatment was decided following the criteria of HIRA in all patients. With assessing of TLICS score and Denis's classification, the treatment guidelines of TLICS and Denis's classification were applied to the criteria of Korean HIRA. Results : According to the Denis's three-column spine system, numbers of patients with 2 or 3 column injuries were 94. Only 45 of 94 patients (47.9%) with middle column injury fulfilled the criteria of HIRA. According to TLICS system, operation required fractures (score>4) were 31 and all patients except one fulfilled the criteria of HIRA. Conservative treatment required fractures (score<4) were 52 and borderline fracture (score=4) were 17. Conclusion : The TLICS system is very useful system for decision of surgical indication in acute traumatic thoracolumbar injury. However, the decision of treatment in TLICS score 4 should be carefully considered. Furthermore, definite criteria of posterior ligamentous complex (PLC) injury may be necessary because the differentiation of PLC injury between TLICS score 2 and 3 is very difficult.

• Journal of Trauma and Injury
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• v.31 no.2
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• pp.76-81
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• 2018

Fractures at the thoracolumbar region are commonly followed after major traumatic injuries, and up to 20% of these fractures are known to be burst fractures. Making surgical decisions for these patients are of great interest however there is no golden standard so far. Since the introduction of Thoracolumbar Injury Classification and Severity (TLICS) score in 2007, it has been widely used as a referential guideline for making surgical decisions in thoracolumbar fractures. However, there is still limitations in this system. In this clinical case report, we introduce a L1 burst fracture after motor vehicle injury, who was successfully treated conservatively even while she was graded as a TLICS 5 injury. A case report is presented as well as discussion on the limitations of this grading system.