• 제목/요약/키워드: lumbar vertebra

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협척혈(夾脊穴)에 전침(電鍼)을 이용한 척추전방전위증 환자에 대한 임상적 고찰 (The Clinical Study of Electroacupuncture Treatment at Hua-Tuo-Jia-Ji-Xue on Spondylolisthesis)

  • 정영표;정효근;강수우;위준;윤여충;채우석;위통순
    • Journal of Acupuncture Research
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    • 제25권1호
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    • pp.221-232
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    • 2008
  • Objectives : The study was performed to evaluate the effect of treatment for spondylolisthesis by using electroacupuncture at Hua-Tuo-Jia-Ji-Xue is located about 0.5Cun(寸) at both sides of spinous process of each vertebra. Methods : This clinical study was carried out 5 case with spondylolisthesis, who had bean treated from December, 2006 to November, 2007, in the department of acupuncture and moxibustion, Dongshin University Oriental Medical Hospital. We treated the patient who was diagnosed as spondylolisthesis by simple X-ray or MRI. Results : 1. Degenerative type is 3 cases, and isthmic type is 2 cases. 2. In the distribution of injured level was between 4-5th lumbar vertebra the most(3 cases). 3. The improvement index showed 0.29, 0.56, 0.43 points in degerative type, and 0.39, 0.36 points in isthmic type. 4. Therapeutic efforts above "good" by Kim's criteria was 4 cases. 5. Good improvement was showed in VAS about average 3.4. Conclusions : There was reports about Hua-Tuo-Jia-Ji-Xue electronic acupuncture treatment of patients with spondylolisthesis. It is very effective to improve condition of patients with spondylolisthesis.

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Use of Imaging Agent to Determine Postoperative Indwelling Epidural Catheter Position

  • Uchino, Tetsuya;Hagiwara, Satoshi;Iwasaka, Hideo;Kudo, Kyosuke;Takatani, Junji;Mizutani, Akio;Miura, Masahiro;Noguchi, Takayuki
    • The Korean Journal of Pain
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    • 제23권4호
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    • pp.247-253
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    • 2010
  • Background: Epidural anesthesia is widely used to provide pain relief, whether for surgical anesthesia, postoperative analgesia, treatment of chronic pain, or to facilitate painless childbirth. In many cases, however, the epidural catheter is inserted blindly and the indwelling catheter position is almost always uncertain. Methods: In this study, the loss-of-resistance technique was used and an imaging agent was injected through the indwelling epidural anesthesia catheter to confirm the position of its tip and examine the migration rate. Study subjects were patients scheduled to undergo surgery using general anesthesia combined with epidural anesthesia. Placement of the epidural catheter was confirmed postoperatively by injection of an imaging agent and X-ray imaging. Results: The indwelling epidural catheter was placed between upper thoracic vertebrae (n = 83; incorrect placement, n = 5), lower thoracic vertebrae (n = 123; incorrect placement, n = 5), and lower thoracic vertebra-lumbar vertebra (n = 46; incorrect placement, n = 7). In this study, a relatively high frequency of incorrectly placed epidural catheters using the loss-of-resistance technique was observed, and it was found that incorrect catheter placement resulted in inadequate analgesia during surgery. Conclusions: Although the loss-of-resistance technique is easy and convenient as a method for epidural catheter placement, it frequently results in inadequate placement of epidural catheters. Care should be taken when performing this procedure.

골다공증에 따른 부위별 골 밀도와 구조의 변화 (Regional variation in vertebral bone density and structure due to osteoporosis)

  • 박정홍;이성재;장한;최우성;강철;탁계례
    • 대한의용생체공학회:학술대회논문집
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    • 대한의용생체공학회 1998년도 추계학술대회
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    • pp.169-170
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    • 1998
  • In this study, regional variation in vertebral bone density due to osteoporosis were investigated using a method that employs images from QCT. QCT images(1mm thick slices) of the first lumbar vertebra from a normal person (23/M, BMD=139.8mg/ml) and from an osteoporotic patient (54/F, BMD=82.0mg/ml) were obtained. Uniform settings (140kVp, 204mA) were used and images of 300 Hounsfield Unit or greater were selectied to filler out soft tissue interference. To assess the regional variation of the area fraction the vertebral body was divided into 3 layers and each layer contained 9 regions. Area faction was calculated based on image analysis data. Our results showed that the area fraction at the middle of the vertebra was quite lower than the endplate and peripheral regions, but the area fraction values from the osteoporotic patient were uniform throughout the entire height of the vertebral body, which indicates the significant drop of BMD had occurred near both end-plates due to the osteoporosis, especially at the peripheral regions. Our results suggest the susceptability of the vertebrae to compression fracture types in osteoporotic spine.

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Fractal dimension analysis on CBCT scans for detecting low bone mineral density in postmenopausal women

  • Carvalho, Bruno Fontenele;de Castro, Julia Goncalves Koehne;de Melo, Nilce Santos;Figueiredo, Paulo Tadeu de Souza;Moreira-Mesquita, Carla Ruffeil;de Paula, Ana Patricia;Sindeaux, Rafael;Leite, Andre Ferreira
    • Imaging Science in Dentistry
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    • 제52권1호
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    • pp.53-60
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    • 2022
  • Purpose: The aim of this study was to compare the fractal dimension (FD) measured at 2 bone sites (second cervical vertebra and mandible) on cone-beam computed tomography (CBCT). The research question was whether FD could serve as an accessory tool to refer postmenopausal women for densitometric analysis. Therefore, the reliability and accuracy of FD were evaluated. Materials and Methods: In total, 103 postmenopausal women were evaluated, of whom 52 had normal bone mineral density and 51 had osteoporosis, according to dual X-ray absorptiometry of the lumbar spine and hip. On the CBCT scans, 2 regions of interest were selected for FD analysis: 1 at the second cervical vertebra and 1 located at the mandible. The correlations between both measurements, intra- and inter-observer agreement, and the accuracy of the measurements were calculated. A P value less than 0.05 was considered to indicate statistical significance for all tests. Results: The mean FD values were significantly lower at the mandibular region of interest in osteoporotic patients than in individuals with normal bone mineral density. The areas under the curve were 0.644 (P=0.008) and 0.531 (P=0.720) for the mandibular and vertebral sites, respectively. Conclusion: FD at the vertebral site could not be used as an adjuvant tool to refer women for osteoporosis investigation. Although FD differed between women with normal BMD and osteoporosis at the mandibular site, it demonstrated low accuracy and reliability.

이행성 척추에 동반된 골수부종 환자의 복합한방치료: 증례보고 (Combined Korean Medicine Treatment of Lumbosacral Transitional Vertebra with Localized Bone Marrow Edema: A Case Report)

  • 채지원;이윤하;최동주;안상준;최현진;황보승윤;백혜경
    • 한방재활의학과학회지
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    • 제32권1호
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    • pp.125-131
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    • 2022
  • This study was to investigate the effectiveness of combined Korean medicine treatment on a patient who was diagnosed on lumbosacral transitional vertebra (LSTV) with localized bone marrow edema. The patient was treated with acupuncture, pharmacopucture, cupping and herbal medicine. We evaluated patient's progress using range of motion (ROM), EuroQol-5 dimensions (EQ-5D), Oswestry disability index (ODI), numerical rating scale (NRS), patient global impression of change, self-walkable distance. NRS of back pain decreased from 7 to 5, at the same time NRS of lower limb decreased from 4 to 3. EQ-5D score increased from 0.24 to 0.646. ODI score improved 80 to 62. Self-walkable distance and lumbar spine ROM also increased. As a result, clinical improvements were found in a patient. In conclusion, this study shows that Korean medicine treatment can be considered as effective conservative care for LSTV with localized bone marrow edema.

개 척추에서 발생한 고립성 형질세포종의 자기공명영상 증례 (Imaging Features of Solitary Spinal Plasmacytoma in a Dog)

  • 계서연;최미현;이남순;김태현;장재영;김현욱;윤정희
    • 한국임상수의학회지
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    • 제31권3호
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    • pp.237-240
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    • 2014
  • 12살령의 암컷 알라스칸 말라뮤트가 후지 파행과 통증으로 내원하였다. 방사선 검사에서 요추 5번 추체 내 방사선 투과성 병변이 확인되었다. MR 영상에서 요추 5번 추체에서 T1 저신호, T2 고신호, GE 저신호 및 조영 후 T1 영상에서 이질적인 조영 증가 병변이 확인되었고, 병변은 척수까지 침입하여 척수 실질을 심하게 압박하고 있었다. 요추 6번 추체 내에서도 국소적인 방사선 투과성 병변이 확인되었으며, MR 영상에서 T1, T2 및 GE 고신호 및 조영 후 국소적인 조영 증가 병변이 관찰되었다. 심한 통증으로 안락사 후, 생검을 통해 형질세포종이 진단되었다. 척수 질환 환자에서 종양은 반드시 고려되어야 하며 영상 검사가 병변의 위치와 범위를 평가하는데 도움이 된다. 이 증례는 개 척추에서 발생한 고립성 형질세포종의 영상에 대한 유용한 정보를 제공할 것이라 생각한다.

MRI로 진단된 척추질환의 임상적 소견 (A Study on Clinical Findings about Vertebral Disease Diagnosed with MRI)

  • 김함겸
    • 대한방사선기술학회지:방사선기술과학
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    • 제29권3호
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    • pp.157-165
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    • 2006
  • 자기공명영상에 의해 진단된 척추질환에 대하여 성별 및 나이별 발생빈도, 발생부위 등 임상적 특성을 분석하여 임상에서 참고 자료로 활용할 수 있도록 하였다. 수도권 소재의 B대학병원에서 2004년 1월부터 12월까지 척추 자기공명영상 검사를 하여 척추질환 유소견자로 진단된 총 1,291명을 대상으로 하였고, 수집된 자료는 SPSS WIN 11.5 프로그램을 이용하여 분석하였으며, 그 결과는 다음과 같다. 1. 연구의 조사대상자에 대한 일반적 특성은 총 1,291명 중 남자가 53.5%, 여자 46.5%이었다. 2. 척추질환의 부위별 발생빈도는 요추 65.6%, 경추 27.3%, 흉추 7.0% 순으로 나타났다. 3. 척추질환의 빈도가 높은 상위 10개 질환은 다음과 같다. 1) posterior bulging disc 65.8%. 2) narrowing of neural foramen 23.8% 3) herniated intervertebral disc (HIVD) 22.4% 4) spinal stenosis 16.7% 5) osteochondrosis 6.4% 6) compression fracture 6.4% 7) facet joint arthropathy 6.2% 8) spondylolisthesis 6.0% 9) spinal cord tumor 3.5% 10) inter body fusion 2.6%

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척추전방전위증의 한방 치료에 관한 임상적 고찰 (Clinical Study of the Treatment of Spondylolisthesis)

  • 김현중;이삼로;변재영;안수기
    • Journal of Acupuncture Research
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    • 제17권3호
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    • pp.106-115
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    • 2000
  • 1997년 4월 1일부터 2000년 1월 31일까지 요통 및 하지통을 주소로 원광대학교 부속 광주한방병원에 척추전방전위증을 진단받고 입원 치료한 환자 28례를 분석하여 다음과 같은 결론을 얻었다. 1. 성별은 여성에 호발(82.1%)하였고, 원인에 따른 성별 분포는 협부형은 여성이 16례(76.2%)였고, 퇴행형은 여성이 7례(100%)였다. 2. 병력기간별 분포로는 최급성기가 32.1%로 가장 많았다. 남자는 80%가 최급성기 환자였고, 여자는 각 유형별로 고른 분포를 보였다. 3. 발병동기별 분포는 과로가 35.7%로 가장 많았다. 4. 원인별 분류에 따르면 협부형이 75%였고, 퇴행형이 25%였다. 5. 병변의 발생부위는 협부형의 경우 57.1%가 제5요추, 퇴행형의 경우 57.1%가 제4요추이다. 6. 전위정도는 대부분(96.4%)이 grade I이다. 7. 증상은 요통이 78.6%, 하지방산통이 92.9%이고, grade III 이상의 통증이 심한 환자가 25례(89.3%)로 거의 대부분 이었다. 8. 치료성적은 71.4%에서 good 이상의 만족스런 결과를 보였다. 이상의 결과로 보아 철추전방전위증 역시 요통의 범주로 놓고 볼 때 한방적인 치료만으로도 만족할만한 효과를 거둘 수 있음을 알 수 있으며 앞으로 척추전방전위증의 한방적 치료에 대한 더 깊이 있는 연구가 필요하리라 사료된다.

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후방경유 요추 융합수술시 척추후관절낭 손상의 운동역학적 영향 (Biomechanical Effects of Facet Capsule Injuries in Posterior Lumbar Fusion Operations)

  • 박승원;김영백;황성남;최덕영;권정택;민병국;석종식
    • Journal of Korean Neurosurgical Society
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    • 제30권3호
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    • pp.358-365
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    • 2001
  • Objectives : Although posterior lumbar fusion operations had been reported to accelerate spinal degeneration, there have been only a few studies for their biomechanical effects. We have studied the change of motion range at the vertebral joint one level above the fusion(UVJ) in pedicle screw fixation group(PSF)(n=13) where facet capsule was destroyed and in posterior lumbar interbody fusion group(PLIF)(n=8) where it was spared. Patients and Methods : The patients were divided into early(3 to 6 months) and late(over 12 months) according to postoperative follow-up period. The flexion, extension and flexion-extension angles(FA, EA, FEA) were measured at the UVJ with pre-operative, early and late post-operative films. Results : Mean age and male to female ratio were $52.7{\pm}9.3$ and 1 : 3.2. Mean follow-up periods were $144.1{\pm}30.0$ and $528.8{\pm}160.3$ days in early and late groups, respectively. The FEA and FA in the late PSF($11.8{\pm}3.1$, $8.5{\pm}2.9$) were significantly greater than pre-operative angles($7.8{\pm}3.9$, $5.1{\pm}3.7$)(p<0.01, p<0.05). All angles in the PLIF showed no significant changes with time. The FEA and FA in the late PSF($11.8{\pm}3.1$, $8.5{\pm}2.9$) were significantly greater than those of the late PLIF($7.6{\pm}2.3$, $3.4{\pm}2.0$)(p<0.01, p<0.001). All angles at early follow-up period were similar between PSF and PLIF. The EA showed no significant change in relation with follow-up period or fusion method. Conclusion : As a result, the facet capsule injury in pedicle screw fixation seems to be related with increased flexion angle or degeneration of the adjacent joint above the fused vertebra in the late phase.

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요통환자에 대한 PNF 적용 효과에 관한 고찰 (Review of the effect of PNF application on low back pain patient)

  • 김태호;김은정;정재민;윤영조;한진태
    • PNF and Movement
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    • 제6권1호
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    • pp.33-40
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    • 2008
  • Purpose : When the pliability of the Lumbar is degraded, the kinesiology function undergoes an influence and it receives an overload. Finally, it is connected with a Lumbar muscular injury. When it does the regular exercise treatment the lumbago patient the balance and function of changeover are improved. The purpose of this study is to review of effect of the PNF application for lumbago patient Methods : By using internet, we research the PubMed, Science Direct, KISS, DBpia and the article on the effect of PNF. We selected the article between 1970 and 2007. Key words were low back pain, lumbago, PNF. Results : PNF is a therapeutic exercise for central nervous system(CNS) patient and the peripheral nervous system(PNS) patient and it is widely applied from sports medicine in the last. According to research of the Jung Young Jo(2007) and Han Kou Soo(2002), PNF technique improves the pain and a condition of the lumbago patient. And the affection balanced change and dynamic balance change and spontaneous movable scope are improved. And it improved to daily life activity. According to research of Moore and Hutton(1980), Lee Kyoung Hye(1999), PNF stretching where it is one of muscular relaxation is good in lumbar muscle fascia ache solutions, and PNF stretching that muscle is relaxed and increases ROM by Reflective system of the vertebra. These researches is relation all each other. it have appeared many report of research about Pliability, muscular power, balance, mobility improve ADL movement of attendance ability and functional action improved excise therapy put effect about lumbago patient recently, it have appeared research about therapy of lumbago patient through PNF. But PNF technique is not application about lumbago patient in clinic, therefore also it is not enough for case study about this therapy. Conclusion : PNF improve combination operation of muscle, inconvenience decrease from daily life activity, ROM(range of movement) of lumbar is increase and Lumbago reduce. So we suggest that PNF will be applies on the lumbago patient and must do a many research.

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