• Title/Summary/Keyword: Vertebral level

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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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Impact of Screw Type on Kyphotic Deformity Correction after Spine Fracture Fixation: Cannulated versus Solid Pedicle Screw

  • Arbash, Mahmood Ali;Parambathkandi, Ashik Mohsin;Baco, Abdul Moeen;Alhammoud, Abduljabbar
    • Asian Spine Journal
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    • v.12 no.6
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    • pp.1053-1059
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    • 2018
  • Study Design: Retrospective review. Purpose: To detect the effect of cannulated (poly-axial head) and solid (mono-axial head) screws on the local kyphotic angle, vertebral body height, and superior and inferior angles between the screw and the rod in the surgical management of thoracolumbar fractures. Overview of Literature: Biomechanics studies showed that the ultimate load, yield strength, and cycles to failure were significantly lower with cannulated (poly-axial head) pedicle comparing to solid core (mono-axial head). Methods: The medical charts of patients with thoracolumbar fractures who underwent pedicle screw fixation with cannulated or solid pedicle screws were retrospectively reviewed; the subjects were followed up from January 2011 to December 2015. Results: Total 178 patients (average age, $36.1{\pm}12.4years$; men, 142 [84.3%]; women, 28 [15.7%]) with thoracolumbar fractures who underwent surgery and were followed up at Hamad Medical Corporation were classified, based on the screw type as those with cannulated screws and those with solid screws. The most commonly affected level was L1, followed by L2 and D12. Surgical correction of the local kyphotic angle was significantly different in the groups; however, there was no significant difference in the loss of correction of the local kyphotic angle of the groups. Surgical correction of the reduction in the vertebral body height showed statistical significance, while the average loss of correction in the reduction of the vertebral body height was not significantly different. The measurement of the angles made by the screws on the rods was not significantly different between the cannulated (poly-axial head) and solid (mono-axial head) screw groups. Conclusions: Solid screws were superior in terms of providing increased correction of the kyphotic angle and height of the fractured vertebra than the cannulated screws; however, no difference was noted between the screws in the maintenance of the superior and inferior angles of the screw with the rod.

Relationship between the Progression of Kyphosis in Thoracolumbar Osteoporotic Vertebral Compression Fractures and Magnetic Resonance Imaging Findings (흉요추 골다공증성 압박 골절에서의 후만 변형의 진행과 자기공명영상 소견 사이의 관계)

  • Jun, Deuk Soo;Baik, Jong-Min;Kwon, Hyuk Min
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.4
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    • pp.336-342
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    • 2019
  • Purpose: To examine the relationship between the progression of a kyphotic deformity and the magnetic resonance imaging (MRI) findings in conservatively treated osteoporotic thoracolumbar compression fracture patients. Materials and Methods: This study categorized the patients who underwent conservative treatment among those patients who underwent treatment under the suspicion of a thoracolumbar compression fracture from January 2007 to March 2016. Among them, this retrospective study included eighty-nine patients with osteoporosis and osteopenia with a bone density of less than -2.0 and single vertebral body fracture. This study examined the MRI of anterior longitudinal ligament or posterior longitudinal ligament injury, superior or inferior endplate disruption, superior of inferior intravertebral disc injury, the presence of low signal intensity on T2-weighted images, and bone edema of intravertebral bodies in fractured intravertebral bodies. Results: In cases where the superior endplate was disrupted or the level of bone edema of the intravertebral bodies was high, the kyphotic angle, wedge angle, and anterior vertebral compression showed remarkably progression. In the case of damage to the anterior longitudinal ligament or the superior disc, only the kyphotic angle was markedly prominent. On the T2-weighted images, low signal intensity lesions showed a high wedge angle and high anterior vertebral compression. On the other hand, there were no significant correlations among the posterior longitudinal ligament injury, inferior endplate disruption, inferior disc injury, and the progression of kyphotic deformity and vertebral compression. The risk factors that increase the kyphotic angle by more than 5° include the presence of injuries to the anterior longitudinal ligament, superior endplate disruption, and superior disc injury, and the risk factors were 21.3, 5.1, and 8.5 times higher than those of the uninjured case, and the risk differed according to the level of bone edema. Conclusion: An osteoporotic thoracolumbar compression fracture in osteoporotic or osteopenic patients, anterior longitudinal ligament injury, superior endplate and intravertebral disc injury, and high level of edema in the MRI were critical factors that increases the risk of kyphotic deformity.

Relations between Scoliosis and Gastroenteric Disorder (척추 측만과 위장장애와의 관련성)

  • 홍상진;김은영
    • Korean Journal of Health Education and Promotion
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    • v.21 no.1
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    • pp.319-328
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    • 2004
  • The purpose of this study was to examine the relation between thoracic scoliosis and gastroenteric disorder. In this article, We surveyed sixty two patients and investigated through a questionnaire the health and meal habits, digestive trouble levels, stress levels(BEPSI-K), and the stress response index(SRI). Participants were classified according to each group in over $10^{\circ}$(vertebral scoliosis), under $10^{\circ}$(functional scoliosis) and made a diagnosis of X-ray of scoliosis grade. The data was took statistics on two group by independent t-test, chi-square test with SPSS/PC+ 10.0 program. The statistically significance was a p<.05 and the following results were obtained; 1. In general characteristics, The thoracic scoliosis was as many as women, weight 50∼60kg, height 160∼170cm, married person. 2. Relations between health and meal habit with thoracic scoliosis was not statistically significant(p>.05). 3. Relations between thoracic scoliosis and digestive trouble level was statistically significance (p<.05). 4. Relations between thoracic scoliosis and incidence rate of internal disease was statistically significant(p<.05). 5. Relations between thoracic scoliosis and stress(BEPSI-K) was statistically significant(p<.05). 6. Relations between thoracic scoliosis and stress(SRI) was statistically significant(p<.05). These results lead us to the conclusion that thoracic scoliosis influences digestive trouble, incidence rate of internal disease and stress. However, there results are not easy to explain because of the limitations of a few subjects and a single comparison. Therefore, further research on this study thoroughgoing inspection would clarify the association of thoracic scoliosis and gastroenteric disorders.

Quantitative analysis of lumbar multifidus atrophy with low back pain patients using Magnetic Resonance Image (자기공명영상(MRI)을 통한 요통환자의 다열근 위축에 대한 정량적 분석)

  • Yang, Dae-Jung
    • Journal of the Korean Society of Physical Medicine
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    • v.5 no.4
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    • pp.615-621
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    • 2010
  • Purpose : The purpose of this study was to compare chronic LBP patients and asymptomatic subjects on measures of multifidus size (cross-sectional area;CSA, thickness) and symmetry (proportional difference of relatively larger side to smaller side). Methods : Data were obtained from 12 asymptomatic subjects without a prior history of LBP (8 females, 4 males), and a retrospective audit was undertaken of records from 12 chronic low back pain patients (8 females, 4 males). CSA and Thickness of the lumbar multifidus muscles was measured from axial T1-weighted magnetic resonance images(MRI). Results : The results of the analysis showed that chronic LBP patients had significantly smaller multifidus CSA and thickness than asymptomatic subjects at L4-5 vertebral levels(p<.05). The asymmetry between sides was seen at L4- L5 vertebral level in patients with chronic low back pain presentations(p<.05). Conclusions : MRI provided a quantitative measure of change between asymptomatic subjects and chronic low back pain patients of multifidus muscle. MRI identified significant differences in cross-sectional area and thickness and helps to evaluate clinically and plan the treatment modalities of LBP.

The Study of Vertebral Palpation (척추부 촉진에 관한 연구)

  • Park, Youn-Ki
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.16 no.1
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    • pp.57-63
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    • 2010
  • The palpation of spinous process and transverse process of vertebra are important part of the assesment and treatment from Orthopedic manual therapy. But the palpation area is descriptive differently each of literatures. So we generally got these outcomes. : There are C2, C3, C4 and C6 process as a bony landmarks and these are important part of establish the precise location of pain appears from cervical spine. Even though C7 process regard a prominent part, it is hard to distinguish C6 and process of T1. Thru that differentiation, grab the patient's forehead and try them cervical and hyper-extension check any movement of process or put on the fingers on C7 preocess and check the movement. The palpation of thoracic spine process is the land mark which determines general level orientation in the spine easily, there are T2, T7 spinous process. However, It is depends on how do you test the patient's arm when you palpate it and it can effect on spinous process. The transverse process of C1 is the only spot for palpation in cervical spine, and T1-3, T12 transverse process can palpate it when it stands on the process. The end of T4-6, T11 is placed on middle on vertebra of transverse process and transverse process. T7-9, T10 transverse process is place on same position as spinous process which is upper part of the spine.

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Five-Year Follow-up of an Ovarian Cancer Patient with Brain and Vertebral Metastasis Using Integrative Cancer Treatment: A Case Report (통합암치료를 적용한 난소암 뇌, 척추전이 환자의 5년 추적관찰 증례보고)

  • Hye-ri Bae;Eun-ji Kim;Nam-hun Lee
    • The Journal of Internal Korean Medicine
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    • v.44 no.6
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    • pp.1346-1353
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    • 2023
  • Objectives: This long-term case report presents the case of an ovarian cancer patient with brain, cervical lymph node, and vertebral metastasis suppressed by traditional Korean medicine in combination with cytokine-induced killer (CIK) cell-based immunotherapy. Methods: The patient received acupuncture, moxibustion, GunChil-go, Hangam-dan, and CIK cell-based immunotherapy. The Eastern Cooperative Oncology Group and tumor markers were used to evaluate the treatment effects. Results: Integrative cancer treatment suppressed the progression of cancer, and the patient achieved eight-year survival. The performance status improved, and the tumor marker level was maintained. Conclusions: We suggest that an integrative cancer treatment that includes traditional Korean medicine can be a meaningful treatment option for advanced ovarian cancer.

Radiculopathy Caused by Discal Cyst

  • Kim, Sae Young
    • The Korean Journal of Pain
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    • v.27 no.1
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    • pp.86-89
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    • 2014
  • Discal cyst is an intraspinal cyst with a distinct communication with the corresponding intervertebral disc. It is a rare condition and could present with radiculopathy similar to that caused by lumbar disc herniation. We present a patient with a large discal cyst in the ventrolateral epidural space of the $5^{th}$ lumbar vertebral (L5) level that communicated with the adjacent $4^{th}$ lumbar and $5^{th}$ lumbar intervertebral disc, causing L5 radiculopathy. We alleviated the radiating pain with selective transforaminal epidural blocks.

The clinical study on 44 cases of patient with Thoracolumbar Compression Fracture (흉(胸)·요추(腰椎) 압박골절(壓迫骨折) 환자(患者)에 대한 임상적(臨床的) 고찰(考察))

  • Lim, Jeoung-Eun;Kim, Kee-Hyun;Hwang, Hyeon-Seo
    • Journal of Acupuncture Research
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    • v.17 no.2
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    • pp.41-51
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    • 2000
  • Clinical observation was made on 44 cases of stable thoracolumbar compression fracture that were confirmed through simple x-ray and neurological examination. They were hospitalized and treated by acupuncture and moxibustion, bed rest, herb medicine and physical therapy. If necessary, patient was given an enema. The results obtained are as follows. 1. The patient distribution ratio, in regard to sex, was shown to be 1: 13.7 for males to females. In regard to age, it was shown that people in their 60's was the most predominant case, followed by people in their 70's, 80's, 50's and 40's, respectively. 2. In regard to contributing factors, it was observed that accidental falls were most frequent, followed by reasons unknown, repetitive lifting of heavy objects, overlaboring and bruise in that order. 3. In regard to duration of illness before treatment, it was found that treatment within 1 week was most predominant, followed by over 4 weeks, and 1-2 weeks, respectively. 4. With regard to the duration of hospitalization, hospitalization within 2 weeks was found to be most predominant, followed by 2-4 weeks. 5. In regard to the level of the affected vertebral body; The affected vertebral bodies distributed between T3 to L5 except for T7; T12 was found to be most predominant, followed in turn by L1 and L5. 6. In regard to the number of affected vertebral bodies, 2 was the most frequent followed by 1 and 3, in that order. The average of the number of affected vertebral bodies was observed to be 2.8 and single vertebral body compression fracture was shown to have no clinical and statistical difference as compared with multiple vertebral body compression fractures. 7. In regard to the grade of the seriousness of symptoms, it was found that Grade IV was most predominant, followed by Grade III. 8. With regard to signs at the first medical examination, low back pain was seen in the highest number, and followed in order by gait disturbance, flank pain, flexion-extension disturbance, disturbance of rotation to right or left, and bowel dysfunction. 9. Concerning the effect of treatment, good results were most predominantly seen, and 95.5% of total patients showed fair results. 10. The duration of admission treatment due to the grade of clinical symptoms was as follows; In the case of the Grade IV, it was observed that within 2 weeks was most predominant and for Grade III was 2-4 weeks. It was also found that the grade of clinical symptoms was not in proportion to the duration of admission treatment. 11. In regard to the result of treatment due to the grade of clinical symptoms; It was found that in the case of Grade IV, within 2 weeks was most predominant, and for Grade III, it was found to be 2-4 weeks. 12. Intestinal obstruction was shown in 50% of total patients; In the case of duration of constipation, more than 1 week was found to be most predominant, followed by 2 and 4 days respectively. 13. With regard to the treatment of intestinal obstruction, using acupuncture and moxibustion, herb - medicine and enema together were found to be most effective. 14. Intestinal obstruction was mostly seen in the case of Grade IV.

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Comparative Analysis of Spontaneous Infectious Spondylitis : Pyogenic versus Tuberculous

  • Lee, Yangwon;Kim, Bum-Joon;Kim, Se-Hoon;Lee, Seung-Hwan;Kim, Won-Hyung;Jin, Sung-Won
    • Journal of Korean Neurosurgical Society
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    • v.61 no.1
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    • pp.81-88
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    • 2018
  • Objective : Spondylitis is often chemotherapy resistant and requires long-term treatment. Without adequate chemotherapy, the outcome can be fatal or result in severe neurologic damage. Therefore, differentiating the etiology of spondylitis is very important, particularly in spontaneous cases. As the prevalence of tuberculosis in Korea has decreased in recent years, updated clinical research about spondylitis is warranted. Methods : From April 2010 to March 2016, data from spondylitis patients were collected retrospectively. In total, 69 patients (51 with pyogenic spondylitis and 18 with tuberculous spondylitis) were included. Clinical data, laboratory findings including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level, measurements of Cobb angles at the initial and final follow-up, and radiologic features on magnetic resonance imaging (MRI) scans were evaluated. To test differences between the pyogenic and tuberculous groups, numerical data were compared using the student's t-test and Mann-Whitney U test, and categorical data were compared using the chi-square test and Fisher's exact test. Results : The patients' mean age was 60.0 years. Male sex was slightly predominant (56.5%). There was no difference in mean age and sex between the two groups. The pyogenic group had a relatively higher proportion of immunocompromised patients. The peak CRP value was higher in the pyogenic group than in the tuberculous group (14.08 mg/dL and 8.50 mg/dL, respectively, p=0.009), whereas the ESR was not significantly different between the groups (81.5 mm/h and 75.6 mm/h, respectively, p=0.442). Radiologically, the presence of disc space sparing and vertebral body collapse differed between the groups. In the tuberculous group, the disc was more commonly preserved on contrast-enhanced MRI (50% and 23.5%, respectively, p=0.044), and vertebral body collapse was more common (66.6% and 15.7%, respectively, p<0.001). The mean length of hospitalization was longer in the pyogenic group (56.5 days and 41.2 days, respectively, p=0.001). Four mortality cases were observed only in the pyogenic group. The most commonly isolated microorganism in the pyogenic group was Staphylococcus aureus(S. aureus) (methicillin susceptible S. aureus and methicillin resistant S. aureus [MRSA] in 8 and 4 cases, respectively). Conclusion : The clinical and radiological manifestations of spontaneous spondylitis differ based on the causative organism. Pyogenic spondylitis patients tend to have a higher CRP level and a more severe clinical course, whereas tuberculous spondylitis patients present with destruction of the vertebral body with disc sparing more frequently. The presence of MRSA is increasing in community-acquired spondylitis cases.