• Title/Summary/Keyword: Thoracolumbar region

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Spinal Epidural Lipomatosis Secondary to Hypothyroidism in a Siberian Husky Dog

  • Jeong, Ju-Young;Hwang, Tae-Sung;Song, Kun-Ho;Song, Joong-Hyun
    • Journal of Veterinary Clinics
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    • v.39 no.5
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    • pp.235-239
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    • 2022
  • A 10-year-old neutered male Siberian Husky presented with paraparesis and severe lethargy. On physical examination, the patient was unable to weight-bear and walk and exhibited significant muscle mass loss in both hindlimbs and generalized truncal alopecia with a dull coat of hair. On neurological examination, cranial lumbar vertebral pain, hind limb cross-extensor reflex, delayed hindlimb postural reaction, upper motor neuron bladder dysfunction, and total absence of cutaneous trunci reflex were identified. Computed tomography revealed diffuse idiopathic skeletal hyperostosis and spondylosis deformans of the cervical and thoracolumbar vertebrae. In addition, a generalized decrease in bone mineral density of the vertebrae was identified. Magnetic resonance imaging showed hyperplasia of the epidural fat compressing the spinal cord in the thoracolumbar region and concurrent mild multiple intervertebral disc herniations. No specific findings were observed in cerebrospinal fluid analysis. Blood analysis of thyroid function revealed decreased total T4 and free T4 levels, and increased TSH levels. The patient was tentatively diagnosed with spinal epidural lipomatosis (SEL) secondary to hypothyroidism. The patient was treated with levothyroxine, firocoxib, and gabapentin. Clinical signs gradually improved, and the patient showed normal ambulation 40 days after treatment initiation. SEL is extremely rare in dogs. To the best of our knowledge, this is the first case report of SEL secondary to hypothyroidism that was treated conservatively. Secondary SEL can be sufficiently managed by treating the underlying cause, if possible.

A Survey Study of the Juvenile Idiopathic Scoliosis Using Radiation Indirect Examination (방사선 간접검사를 이용한 청소년의 척추 측만증에 관한 연구)

  • Kim, Kee-Bog;Jung, Hong-Ryang
    • Journal of radiological science and technology
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    • v.28 no.4
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    • pp.327-332
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    • 2005
  • The purpose of this Study was to investigate the prevalence rate of idiopathic scoliosis to the students from the elementary to the university in S city of Chung-Nam using 100 mm Mirror Camera radiation indirect examination units, with on age range of between eight and thirteen (1.526 subjects), fourteen and sixteen (462 subjects), seventeen and eighteen (291 subjects), nineteen and twenty four(508 subjects) and total of 2,787 participants with the 590 male subjects and 2,197 female subjects. The results of this study can be summarized and compared the primary examination with the secondary test of greater than $10^{\circ}$of Cobb's Angle were obtained as follows; 1. Indirect Examination were conducted to find idiopathic scoliosis amomg total 2.787 subjects, 257 subjects (9.2%) who showed positive sign greater than $10^{\circ}$in the Cobb's Angle ; below age of thirteen (132 subjects), between fourteen and sixteen (52 subjects), seventeen and eighteen (35 subjects), nineteen and twenty four (38 subjects). The $x^2-test$ analysis of Indirect Examination showed no statistical significant difference association between the age range and $10^{\circ}$Cobb's Angle of spinal curve(P>0.059). 2. The numbers of idiopathic scoliosis of greater than $10^{\circ}$Cobb's Angle of spinal curve in the primary examination were observed in 147 subjects (57.2%) at the Thoracolumbar region, 81subjects (31.5%) at the Thoracic region, 20 subjects (7.8%) at the Cervicothoracic region, 7 subjects (2.7%) at the Lumbar region, 2 subjects (0.8%) at the Cervical region. So, the large numbers were Thoracolumbar region, 183 participants (71.2%) showed the right side curve of scoliosis and 74 participant (28.8%) showed the left side curve of scoliosis. 3. The main region of the pain in one's own self more than $10^{\circ}$ Cobb's angle of spinal curve were no pain 219 subjects (85.2%), 18 subjects (7.0%) at the Lumbar region, 9 subjects (3.5%) at the Cervical region, 7 subjects (2.7%) at the Thoracic region, 2 subjects (0.7%) at the shoulder girdle region, 1 subjects (0.39%) at the pelvis and whole body region. There was statistical significant difference association between the Cobb's Angle of spinal curve and the main pain region of one's (P<0.006). This study may be significant to an early stage investigate of the prevalence rate of idiopathic scoliosis in the juveniles using 100 mm Mirror Camera radiation indirect examination units. The results of this study help that the students in a stage on growth the basis of data early discovery and therapy of idiopathic scoliosis.

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Spinal Intradural Extramedullary Cavernoma Presenting with Intracranial Superficial Hemosiderosis

  • Jin, Yong-Jun;Chung, Sang-Bong;Kim, Ki-Jeong;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.49 no.6
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    • pp.377-380
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    • 2011
  • A case of intradural extramedullary cavernous angioma is presented with headache, dizziness, and bilateral sensorineural hearing loss caused by an intracranial superficial hemosiderosis. It was incidentally found in a patient with a 3-month history of sustained headache, dizziness and a 3-year history of hearing difficulty. The neurological examination was unremarkable in the lower extremity. MR images showed an intracranial superficial hemosiderosis mostly in the cerebellar region. Myelography and MR images of the thoracolumbar spine revealed an intradural extramedullary mass, which was pathologically proven to be a cavernous angioma. T12 total laminoplastic laminotomy and total tumor removal were performed without any neurologic deficits. The patient's symptoms, including headache and dizziness, have been absent for three years. Intradural extramedullary cavernous angioma can present with an intracranial superficial hemosiderosis as a result of chronic subarachnoid hemorrhage.

Far lateral lumbar disc extrusion in a dachshund dog

  • Kim, Jaehwan;Kim, Hyoju;Hwang, Jeongyeon;Eom, Kidong
    • Korean Journal of Veterinary Research
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    • v.59 no.3
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    • pp.165-169
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    • 2019
  • A 6-year-old Dachshund was presented with acute, non-localized pain without neurological dysfunction. Radiography revealed multiple calcifications of intervertebral discs and narrowing of disc space in the thoracolumbar region. Computed tomography and magnetic resonance imaging revealed calcified disc-like material entrapped in the left extraforaminal area and showed a displaced nerve root. Fenestration and removal of the extruded disc material were performed in a routine manner. Histopathological examination showed degenerative disc materials with severe calcification both in the nucleus pulposus and around the annulus fibrosis. Based on imaging, surgical, and histopathologic results, the dog was diagnosed with far lateral lumbar disc extrusion.

Nonaneurysmal Subarachnoid Hemorrhage : Rare Complication of Vertebroplasty

  • Lim, Jae-Bum;Park, Joung-Soo;Kim, Ealmaan
    • Journal of Korean Neurosurgical Society
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    • v.45 no.6
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    • pp.386-389
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    • 2009
  • On rare occasions, percutaneous vertebroplasty (PV) may be associated with adverse spinal and extraspinal events. Subarachnoid hemorrhage (SAH) has not been reported complication following a PV. This is a report of two elderly women with spine compressions who developed idiopathic SAH after injecting polymethylmethacrylate into the thoracolumbar region transcutaneously. PV was performed as an usual manner on prone position under local anesthesia for these patients. During the interventions, two patients complained of a bursting nature of headache and their arterial blood pressure was jumped up. Computed tomography scans revealed symmetric SAH on the both hemispheres and moderate degree of hydrocephalus. Any intracranial vascular abnormalities for their SAH were not evident on modern neuroangiography modalities. One patient received a ventricular shunt surgery, but both fully recovered from the procedure-related SAH. The pathophysiologic mechanism that induce SAH will be discussed, with suggesting the manner that prevent and minimize this rare intracranial complication after PV.

Change in Each Vertebral Segment During Smartphone Usage with Both Hands while in the Standing Position

  • Cho, Sung-Hak;Moon, Hyun-Ju
    • PNF and Movement
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    • v.17 no.1
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    • pp.41-46
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    • 2019
  • Purpose: Continuous use of a smartphone increases the angle of forward bending of the user's cervical vertebrae, causing pain in the shoulders and back, including the thorax, lumbar region, and vertebrae. Although there are many studies on changes in the cervical spine due to smartphone usage, the changes in the shoulders, thoracolumbar spine, and pelvic have rarely been compared. The purpose of this study is to investigate the change in the spinal segments, shoulders, and pelvic when using a smartphone with both hands while in the standing position. Methods: This study was conducted on 35 adults in their twenties. The selection criteria for the subjects were limited to those in a similar age group, thus excluding posture differences according to age, and to those who did not have specific diseases or pain in the spinal and musculoskeletal system for 12 months prior to the study. In this study, we used a 3D spinal diagnostic imaging system (Back Mapper, Frickenhausen) to compare the changing conditions in each vertebral segment before and during smartphone usage with both hands while in the standing position. Posture differences according to smartphone usage were compared using the paired t-test for the motion of each spinal segment. Results: This study showed that the thoracic and lumbar angle increased posteriorly during smartphone usage (p<0.05). In addition, the anterior rotation angle of the shoulder bone significantly increased, but no significant difference occurred in the pelvic region. Conclusion: Based on the results of this study, smartphone usage with both hands while in the standing position showed that the spine, as a whole, forms a kyphotic curve. Therefore, we propose to present a postural guideline for correct smartphone usage, considering the change in each vertebral segment.

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.

Evaluation of the Effect of Location and Direction of the Scoliotic Curve on Postural Balance of Patients with Idiopathic Scoliosis (특발성 척추측만증 환자의 척추 만곡 위치와 방향이 자세 균형에 미치는 영향성 평가)

  • Jung, Ji-Yong;Kim, Jung-Ja
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.4
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    • pp.341-348
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    • 2017
  • This study examined the effects of the location and direction of the scolioti curve on postural balance in patients with idiopathic scoliosis. Fifteen subjects were divided into three groups: right thoracic curve group, left lumbar curve group, and double curve group. The dynamic trunk motion (angle variation in the lumbar, thoracolumbar, lower thoracic and upper thoracic region) and plantar pressure distribution (maximum force and peak pressure) were assessed using an ultrasound-based motion analysis system and Emed-at platform system. From the results, it was confirmed that patients with idiopathic scoliosis showed postural imbalance with an increased angle and pressure asymmetry according to the location and direction of the scoliotic curve for dynamic trunk motion and plantar pressure distribution. In addition, there were differences in the postural balance pattern between the single curve and double curve groups. Further studies for developing a rehabilitation training device will be conducted to improve the postural control ability and trunk balance as well as treat scoliosis based on the results of this study.