• 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.

• 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 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.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 Korean Neurosurgical Society
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• v.40 no.4
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• pp.249-255
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• 2006

Objective : This study is to evaluate the efficacy of dorsal short-segment fixation in unstable thoracolumbar junction fractures. Methods : The cases of 20 patients who underwent dorsal short-segment fixation were reviewed retrospectively. Clinical outcomes were analysed using Sonntag's pain level, work status, and neurological scale according to the modified Frankel classification. Radiological outcomes were analysed using Mumford's anterior body compression[%], canal compromise ratio, and Cobb's kyphotic angle. Results : At the latest clinical follow-up [average=14.6 months]. there were 19 [95.0%] in group I and 1 patient [5.0%] in II in pain level. The postoperative work status were 17 [85.0%] in group I, 2 patients [10.0%] in II, and 1 patient [5.0%] in V. Surgery brought to improve the neurologic status. In success group [19 cases, 95%], the average canal compromise ratio was reduced from 0.57 [${\pm}0.07$] to 0.05 [${\pm}0.08$] [P<005], the average anterior body compression [%] was reduced from 41% [${\pm}17$] to 18% [${\pm}14$] [P<0.05], and the average preoperative kyphotic angle was $20.0^{\circ}$ [${\pm}9.0$], and corrected to $5.7^{\circ}$ [${\pm}7.1$] postoperatively, and progressed to $7.8^{\circ}$ [${\pm}6.2$] at the latest follow-up. There was a case of implantation failure in an elderly osteoporotic patient. Conclusion : Although there are limitations in the patient number and follow-up period, the present study favors dorsal short-segment fixation for selective cases in unstable thoracolumbar junction fractures.

• Korean Journal of Radiology
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• v.19 no.6
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• pp.1140-1146
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• 2018

Objective: To compare the spinal enumeration methods that establish the first lumbar vertebra in patients with spinal variants. Materials and Methods: Of the 1446 consecutive patients who had undergone computed tomography of the spine from March 2012 to July 2016, 100 patients (62 men, 38 women; mean age, 47.9 years; age range, 19-88 years) with spinal variants were included. Two radiologists (readers 1 and 2) established the first lumbar vertebra through morphologic analysis of the thoracolumbar junction, and labeled the vertebra by counting in a cranial-to-caudal manner. Inter-observer agreement was established. Additionally, reader 1 detected the 20th vertebra under the assumption that there are 12 thoracic vertebra, and then classified it as a thoracic vertebra, lumbar vertebra, or thoracolumbar transitional vertebra (TLTV), on the basis of morphologic analysis. Results: The first lumbar vertebra, as established by morphologic analysis, was labeled by each reader as the 21st segment in 65.0% of the patients, as the 20th segment in 31.0%, and as the 19th segment in 4.0%. Inter-observer agreement between the two readers in determining the first lumbar vertebra, based on morphologic analysis, was nearly perfect (${\kappa}$ value: 1.00). The 20th vertebra was morphologically classified as a TLTV in 60.0% of the patients, as the first lumbar segment in 31.0%, as the second lumbar segment in 4.0%, and as a thoracic segment in 5.0%. Conclusion: The establishment of the first lumbar vertebra using morphologic characteristics of the thoracolumbar junction in patients with spinal variants was consistent with the morphologic traits of vertebral segmentation.

• Korean Journal of Veterinary Research
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• v.35 no.4
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• pp.863-868
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• 1995

Electroacupuncture therapy was performed in 2 dogs with thoracolumbar disc disease. Case was a 3-year-old female chihuahua with a calcified disc between the 13th thoracic and 1st lumbar vertebrae. Treatment was done by electroacupuncture at San sho yu, Shen yu, Huan tiao and Fu yang-San yin jiao with the current of 0.5~8 volts, 30 Hz for 30 min. She could pass feces and urine 2 days, and walk 9 days after the beginning of the therapy. Case 2 Was a 6-year-old male cocker spaniel with 4 calcified discs(T12-T13, T13-L1, L2-L3 and L6-L7) and spondylosis(lumbosacral junction). Treatment was done by electroacupuncture at Tian ping, Bai hui and Pung kung yu with the current of 2~4 volts, 30 Hz for 20 min. He could pass feces 6 days, urine 8 days, and stand 21 days, after the beginning of the therapy.

• Journal of Yeungnam Medical Science
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• v.19 no.2
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• pp.73-91
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• 2002

Method of management of the spine injury should be determined, based on the status of neurological injury as well as on the presence of traumatic instability. At the thoracic and lumbar spine, patterns of neurological injury are different from the cervical spine due to their neuro-anatomical characteristics. Especially, at the thoracolumbar junction, neurological injury patterns with their respective prognosis vary from the complete cord injury or conus medullaris syndrome to the cauda equina syndrome according to the injury level. The concept of Holdsworth's instability based on the posterior ligament complex theory has evolved into the current 3-column theory of Denis. Flexion-rotation injury and fracture-dislocation are well known to be unstable that surgical fixation is frequently needed for these injuries. However, there have been some controversies for the stability of burst fractures and their treatment, such as indirect or direct decompression and anterior or posterior approach. In this article, current concepts and management of traumatic instabilities at the thoracic and lumbar spine have been reviewed and summarized.

• 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.

• Physical Therapy Korea
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• v.28 no.3
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• pp.227-234
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• 2021

Background: The serratus posterior inferior (SPI) muscle originates from the spinous process of T11-L2 and inserts at the lower border of the 9-12th ribs. This muscle is involved in thoracolumbar rotation and stability. Several positions can be used to improve trunk stability; the quadruped position is a good position for easily maintaining a neutral spine. In particular, during one arm lifting, various muscles act to maintain a neutral trunk position, and the SPI is one of these muscles. If trunk stability is weakened, uncontrolled trunk rotation may occur at this time. Tape can be used to increase trunk stability. There have been no studies on the effect of taping applied to the SPI muscle on thoracolumbar junction (TLJ) stability. Objects: This study compared the TLJ rotation angle between three different conditions (without taping, transverse taping, and SPI muscle direction taping). Methods: Thirty subjects were recruited to the study (18 males and 12 females). The TLJ rotation angle was measured during one arm lifting in a quadruped position (ALQP). Two taping methods (transverse and SPI muscle direction taping) were applied, and the TLJ rotation angle was measured in the same movement. Results: SPI muscle direction taping significantly reduced TLJ rotation compared to that without taping (p < 0.001) and with transverse taping (p < 0.001). There was a significant difference in the TLJ rotation angle between transverse taping and SPI muscle direction taping (p < 0.017). Conclusion: SPI muscle direction taping reduces the TLJ rotation angle during ALQP. Therefore, SPI muscle direction taping is one method to improve TLJ stability and reduce uncontrolled TLJ rotation during ALQP.