• 대한물리의학회지
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• 제5권3호
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• pp.363-373
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• 2010

Purpose : The purpose of this study was to compare differences in thoracolumbar ranges of motions by comparing ratios among 4 type diagnosis for patient with chronic low back pain. Methods : The subjects were 58 chronic low back pain patients. A motion analysis program (Global Postural System) was used after photography for posture measurement. To analyze differences in mobility percentages and ratios of thoracolumbar ranges of motion, one-way ANOVA was used. Results : Regional difference spinal posture and movement were found to diagnosis patients with chronic low back pain. Comparison of thoracolumbar ranges of motion revealed significant differences in the thoracic region during forward-bending of the trunk (p<.05). In the upper thoracic region, the herniated intervertebral lumbar disc (HILD) group was significantly larger than the spinal stenosis/herniated intervertebral lumbar disc (SS/HILD) group (p<.05). In the lower thoracic region, chronic sprains (CS) were significantly greater than in the spinal stenosis (SS) group and in the (SS/HJLD) group (p<.05). Comparative analysis of thoracic/lumbar mobility ratio showed the CS group's ratio during forward bending was largest: 1.66, while the HILD group's ratio was smallest: 84 a significant difference between the two groups (p<.01). Diagnosis was not associated with difference in thoracolumbar backward-bending range of motion (p>.05). Conclusion : Theses results indicate the clinical efficacy of diagnosing for chronic low back pain by evaluating spinal mobility.

• The Korean Journal of Pain
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• 제13권1호
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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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• 제31권2호
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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.

• Journal of Korean Neurosurgical Society
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• 제30권10호
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• pp.1187-1192
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• 2001

Objective : The lateral extracavitary approach(LECA) to the thoracolumbar spine is known as one of procedure which allows not only direct vision of pathologic lesion, but also ventral decompression, and dorsal fixation of the spine through the same incision. However, some drawbacks of LECA, including the technically- demanding, time-consuming, unfamiliar surgical anatomy and excessive blood loss, make surgeons to hesitate to use this approach. This study is to provide the surgical anatomy of LECA using cadavers, for detailed informations when LECA is considered for the surgery. Methods : We performed the 10 cadaveric studies, 7 male and 3 female, and careful dissection was carried out on right side of thoracolumbar region, except one for thoracic region. The photographs with micro-lens were taken to depict the close-up findings and for demonstrating detailed anatomy. Results : The photographs and hand-drawings demonstrated the relationships among the musculature, segmental vessels and nerve roots seen during each dissection plane. The lateral branches of dorsal rami of spinal nerve and the transverse process were confirmed to be the most important landmark of this approach. Conclusion : We concluded that detailed anatomical findings for LECA through this step-by-step dissection would be useful during operative intervention to reduce the intraoperative complications in LECA.

• 대한골관절종양학회지
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• 제13권2호
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• pp.130-134
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• 2007

부신경절종은 발생학적으로 신경 능선 세포로부터 기원하는 종양으로 두경부에서 가장 많이 발생하나 드물게 종격동, 후복막 등의 내장 기관에서도 생기며 대부분 양성 경과를 보인다. 그 중 흉요추부의 경막내에 발생한 경우는 매우 드물며, 경추나 흉추보다는 요추부에 대부분 발생한다고 보고되었다. 지금까지 흉요추부의 부신경절종이 보고된 예는 드물기에 저자들은 부신경절종이 흉요추부의 경막내 수막외에 발생한 1예를 경험하여, 자기 공명 영상 및 조직학적 특징과 그 치료 결과를 문헌 고찰과 함께 보고하고자 한다.

• Journal of Veterinary Science
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• 제21권6호
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• pp.82.1-82.10
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• 2020

Background: The clinical presentation of horses with back pain (BP) vary considerably with most horse's willingness to take part in athletic or riding purpose becoming impossible. However, there are some clinical features that are directly responsible for the loss or failure of performance. Objectives: To investigate the clinical features of the thoracolumbar region associated with BP in horses and to use some of the clinical features to classify equine BP. Methods: Twenty-four horses comprised of 14 with BP and 10 apparently healthy horses were assessed for clinical abnormality that best differentiate BP from normal horses. The horses were then graded (0-5) using the degree of pain response, muscular hypertonicity, thoracolumbar joint stiffness and overall physical dysfunction of the horse. Results: The common clinical features that significantly differentiate horses with BP from non-BP were longissimus dorsi spasm at palpation (78.6%), paravertebral muscle stiffness (64.3%), resist lateral bending (64.3%), and poor hindlimb impulsion (85.7%). There were significantly (p < 0.05) higher scores for pain response to palpation, muscular hypertonicity, thoracolumbar joint stiffness and physical dysfunction among horses with BP in relation to non-BP. A significant relationship exists between all the graded abnormalities. Based on the cumulative score, horses with BP were categorized into mild, mild-moderate, moderate and severe cases. Conclusions: BP in horse can be differentiated by severity of pain response to back palpation, back muscle hypertonicity, thoracolumbar joint stiffness, physical dysfunctions and their cumulative grading score is useful in the assessment and categorization of BP in horses.

• 한국임상수의학회지
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• 제39권6호
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• pp.294-301
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• 2022

Three-dimensional (3D) printing technique has been widely used for accurate screw and pin placement in orthopedic surgery and neurosurgery. However, there are few reports comparing the accuracy between the patient-specific guides and freehand Kirschner wire (K-wire) placement in toy, small and medium breed dogs. This study aimed to assess the accuracy of 3D printed patient-specific guides (PSGs) in pin insertion in the thoracolumbar vertebrae of toy breed dogs and compare the outcomes between novice and experienced surgeons. The experiment was conducted on the thoracolumbar vertebrae of 21 euthanized toy breed dogs (median weight, 5.95 kg). The optimal insertion angle placement was determined and patient-specific guides for K-wire insertion were designed and 3D printed using computed tomography (CT) and a 3D computer-aided design program of three vertebrae (Thoracic 12-Lumbar 1). K-wire tracts were made by experienced and novice surgeons and compared to assess the accuracy based on postoperative CT. Based on postoperative CT, in the experienced group, 61 out of 63 pins (96.8%) were fully contained inside the vertebral body and lamina, whereas two pins (3.2%) had perforated the vertebral canal (grade 3, 2-4 mm breach). However, all the pins in the novice group were fully contained. The use of 3D printed PSGs for pin insertion in the thoracolumbar region is an accurate and safe alternative to freehand screw placement by novice surgeons in toy, small and medium breed dogs. Operations with 3D printed PSGs allow novice surgeons to achieve better or similar outcomes in accurate placement of pin/screws in vertebrae.

• 한국동물위생학회지
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• 제47권2호
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• pp.61-72
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• 2024

This study aimed to evaluate the feasibility of percutaneous endoscopic foraminotomy (PEF) for the treatment of intervertebral disc herniation of the thoracolumbar spine in large-breed dogs by comparing it with open hemilaminectomy (OH). Six large-breed canine cadavers were used in the present study. A barium and agarose mixture (BA-gel) simulating intervertebral disc herniation was injected into the spinal canal at two intervertebral spaces (T12-T13, L2-L3) of the thoracolumbar spine in each cadaver. PEF and OH were randomly allocated to the sites in each cadaver. Computed tomography was performed pre- and postoperatively. The incision length, vertebral window size, procedure time, and amount of simulated disc material removed were recorded to compare PEF and OH. Both procedures clearly exposed the simulated disc material and spinal cord. The size of the incision and vertebral window created after PEF was much smaller than those after OH. The surgical duration of PEF was longer than that of OH. However, no significant difference (P>0.05) was observed in the amount of BA-gel removed between PEF and OH. Thus, PEF could be used as an effective surgical option for intervertebral disc herniation of the thoracolumbar region in large-breed dogs in that it could lead to less tissue damage as well as sufficient removal of the simulated disc material.

• 한국임상수의학회지
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• 제20권4호
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• pp.519-522
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• 2003

An appearance of herniated intervertebral disc into thoracolumbar vertebral canal was evaluated in two patients using computed tomography (CT). Before CT scanning, plain radiography and myelography were performed in both cases. CT images were compared to those of myelography. Dogs were positioned in sternal recumbency under inhalation anesthesia and transverse slices with 2 mm thickness were obtained around thoracolumbar region. The transverse CT images were examined using both vertebral and spiral window mode. The most common findings on CT images were loss of vertebral canal epidural fat, bulging of vertebral canal disc margins, displacement of spinal cord and flatted vertebral canal. Whereas, narrowed intervertebral disc space and simple extradural pattern were the main findings on plain and contrast radiographs. CT imges showed the extent of the herniated disc lesion, type II intervertebral disc hernation, and the displacement of spinal cord in detail in both occations. It is considered that degree and precise localization of the intervertebral disc herniation and subtle lesion of spinal cord could be identified accurately using computed tomography.

• Journal of Korean Neurosurgical Society
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• 제44권5호
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• pp.334-337
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• 2008

Spinal intradural extramedullary teratoma is a rare condition that develops more commonly in children than in adults and may be associated with spinal dysraphism. We report a rare case of adult-onset intradural extramedullary teratoma in the thoracolumbar spinal cord with no evidence of spinal dysraphism and without the history of prior spinal surgery. The patient was a 38-year-old male whose chief complaint was urinary incontinence. X-ray images of the thoracolumbar spine showed the widening of the interpedicular distance and posterior marginal erosion of the vertebral bodies and pedicles at the T11, T12, and L1 level. Magnetic resonance imagings of the lumbar spine showed a lobulated inhomogeneous high signal intradural mass ($87{\times}29{\times}20mm$) between T11 and L1 and a high signal fluid collection at the T11 level. Laminectomy of the T11- L1 region was performed, and the mass was subtotally excised. The resected tumor was histopathologically diagnosed as a mature cystic teratoma. The patient's symptom of urinary incontinence was improved following the surgery.