• 제목/요약/키워드: lumbar vertebra

검색결과 147건 처리시간 0.021초

Clinical and Radiologic Analysis of Posterior Apophyseal Ring Separation Associated with Lumbar Disc Herniation

  • Bae, Jung-Sik;Rhee, Woo-Tack;Kim, Woo-Jae;Ha, Seong-Il;Lim, Jae-Hyeon;Jang, Il-Tae
    • Journal of Korean Neurosurgical Society
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    • 제53권3호
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    • pp.145-149
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    • 2013
  • Objective : We analyzed the clinical and radiologic features of posterior apophyseal ring separation (PARS) with lumbar disc herniation and suggest the proper management options according to the PARS characteristics. Methods : We reviewed case series of patients with PARS who underwent surgery of lumbar disc herniation. Preoperative symptoms, neurologic status, Body Mass Index, preoperative and postoperative Visual Analogue Scale (VAS) and Korean-Oswestry Disability Index (K-ODI) scores, operation types were obtained. PARS size, locations, the degree of resection were assessed. Results : PARS was diagnosed in 109 (7.5%) patients among 1448 patients given surgical treatment for single level lumbar disc herniation. There were 55 (50.5%) small PARS and 54 (49.5%) large PARS. Among the large PARS group, 15 (27.8%) had lower endplate PARS of upper vertebra at the level of disc herniation. Thirty-nine (72.2%) were upper endplate PARS of lower vertebra. Among the group with upper endplate PARS of lower vertebra, unresected PARS was diagnosed in 12 (30.8%) cases and resected PARS was diagnosed in 27 (69.2%) cases. VAS and K-ODI scores changes were $3.6{\pm}2.9$ and $5.4{\pm}6.4$ in the unresected PARS group, $5.8{\pm}2.1$ and $11.3{\pm}7.1$ in the resected PARS group. The group with upper endplate PARS of lower vertebra showed significant difference of VAS (p=0.01) and K-ODI (p=0.013) score changes between unresected and resected PARS groups. Conclusion : The large PARS of upper endplate in lower vertebra should be removed during the surgery of lumbar disc herniation. High level or bilateral side of PARS should be widely decompressed and arthrodesis procedures are necessary if there is a possibility of secondary instability.

한우(韓牛)의 척추측마취(脊椎側痲醉) (A Technique for Paravertebral Anesthesia in Korean Cattle)

  • 남치주;이흥식;이인세
    • 대한수의학회지
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    • 제23권1호
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    • pp.119-122
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    • 1983
  • Paravertebral anesthesia for operation of abdominal wall in Korean cattle were effectively accomplished with the following technique. Any problems in surgical procedure were not observed under the block of ventral branches of the last thoracic nerve and the first and second lumbar nerves with the administration of preanesthetic. The site of injection for blocking of ventral branches of the thirteenth thoracic nerve were approximately 5cm lateral to the midline from the posterior edge of spinous process of the 13th thoracic vertebra and about 10ml of local anesthetic was injected immediately anterior to the transverse process of the first lumbar vertebra through thin site. The block of ventral branches of the first and second lumbar nerves were obtained by injecting 10ml of local anesthetic immediately below the posterior edge of transverse process of the 2nd and 4th lumbar vertebra, respectively.

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피하지방층과 등뼈 영역을 이용한 초음파 영상에서의 근육 영역 추출 (Extraction of Muscle Areas form Ultrasonographic Images using Subcutaneous Fat Areas and Thoracic Vertebra)

  • 김광백
    • 한국컴퓨터정보학회논문지
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    • 제17권5호
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    • pp.29-32
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    • 2012
  • 본 논문에서는 요부 영상에서 근육을 추출하는 방법을 제안한다. 제안된 방법은 요부 초음파 영상에서 피하지방층과 등뼈 영역을 각각 분류하여 피하지방층의 하단 부분과 등뼈의 상단 부분의 경계선을 개선된 4방향 윤곽선 추적 알고리즘을 적용하여 추출하고 이 두 경계선 내에 있는 영역을 요부의 근육 영역으로 추출한다. 본 연구에서 제안한 방법을 392개의 요부 초음파 영상에 적용하여 근육 영역을 추출한 결과, 제안된 방법은 94% 이상의 추출률을 보였다.

초음파를 활용한 하지와 체간부위의 신경차단술 (Ultrasound Guided Nerve Block at Vertebra and Lower Extremity)

  • 박형규
    • Clinical Pain
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    • 제20권2호
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    • pp.93-98
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    • 2021
  • The use of ultrasonography has recently been increasing in musculoskeletal diagnosis or intervention treatment. Ultrasound guided procedure offers a reliable alternative to fluoroscopy or computed tomography for lumbar medial branch block, facet joint block and peripheral nerves of lower extremity. Further, there is no exposure to radiation and additional equipment necessary for the protection against radiation is required. And ultrasound guided procedure needs smaller space than fluoroscopy guided procedure with real time images in the outpatient department. This article reviews ultrasound guided procedure at lumbar vertebra and peripheral nerves of lower extremity.

허리 디스크탈출증 환자의 재위치 감각과 근 피로도에 미치는 안정화운동 프로그램의 영향 (The Effects of Lumbar Repositioning Sense and Muscle Fatigue after Stabilization Exercise Program in Disc Disease Patients)

  • 김명준
    • 대한물리치료과학회지
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    • 제16권3호
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    • pp.11-17
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    • 2009
  • Background: The purpose of this study was designed to find out the effectiveness of reposition sense, muscle fatigue response on lumbar spine after apply lumbosacral stabilization exercise program to 4 patients with chronic low back pain and for 12 weeks. Method: In this study the reposition sense was measured in 3 angle(60, 30, 12) of the lumbar spine motion with blind by MedX test machine and the difference of instability to lumbar vertebra segments in flexion, extension test of standing position and spinal load test Mattress Test by Spinal Mouse. The stabilization exercise program was applied 2 times a week for 12 weeks in hospital and 2 times a day for 20 minutes at home. Result: The results of the present study were that the repositioning sense was appeared the most error in 12 angles of lumbar flexion and Men was appeared to decrease an error more than female in average value of 4 angles after 12 weeks. And average error of male was decrease more than female. Thus the effects of lumbosacral stabilization exercise was improved repositioning sense of prorioceptor. Fatigue response test(FRT) results, in male, was raised muscle fatigue rate during increase weight, on the other hand female appeared lower than male. Conclusion: As a results, lumbosacral stabilization exercise was aided to improvement of lumbar spine repositioning sense and vertebra segments stabilization. It was showed the rate of decrease in typically 12 degree angle point of each 3 angle(60, 36, 12). Especially, that spine instability patients will have a risk when in lifting a load or working with slight flexion posture around 12 degree during the daily of living life and it is probably to increase recurrence rate. Thus, not only lumbar extension muscle strength but also stability of vertebra segments in lumbar spine may be very important.

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퇴행성 및 협부형 척추전방전위증 환자의 시상면상 형태의 임상례 보고 (The Saggital Alignment in Degenerative and Isthmic Spondylothesis Patients : A Clinical Survey)

  • 이진혁;강만호;설무창;조계창;진은석;이한
    • 척추신경추나의학회지
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    • 제3권1호
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    • pp.55-64
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    • 2008
  • Objective : Spondylothesis is a disease which sagittal facet of vertebral body's invariable alignment is being broken and vertebral body being pushed forward. Main pattern of spondylothesis is isthmic spondylothesis by isthmus defect or fracture, degenerative spondylothesis occurred by desiccated change of intervertebral disc or vertebral condyle joint's ligament. The purpose of this study is to assess the difference of the Pelvic angles, Lumbosacral angles, Pelvic tilt, and Lumbar lordotic angles of the spondylothesis patients. Methods : We analyzed the lateral view of lumbar spine of 49 isthmic spondylothesis patients, 45 degenerative spondylothesis patients and 26 patients who haven't been diagnosed as vertebra disease. We investigated each patient's pelvic angle, lumbosacral angle, pelvic tilt and lumbar lordotic angle. Results and Conclusion : 1. Pelvic incidence, in cases of degenerate spondylothesis patients, is higher than spondylothesis patients but shows less significance. On the contrary significance is higher than the group haven't been diagnosed as vertebra disease. 2. Lumbosacral incidence, in cases of isthmic spondylothesis patients, shows higher significance than degenerative spondylothesis patients and the group haven't been diagnosed as vertebra disease. 3 Pelvic tilt, in cases of degenerative spondylothesis patients, shows higher significance than isthmic spondylothesis patients and the group haven't been diagnosed as vertebra disease. 4. Lumbar lordotic angle, in cases of isthmic spondylothesis patients, shows higher significance than degenerative spondylothesis patients and the group haven't been diagnosed as vertebra disease. 5. Degenerative spondylothesis patient shows specific impression, a forwardly moved high femoral axial and as a result of large lumbrosacral angle and lumbar lordotic angle shows specific impression, an increased weight pressure on sacrum.

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요추굴곡신연기법과 좌위흉요추교정법을 이용한 청소년기 특발성 척추측만증 환자 치험 2례 (A Clinical Two Case Studies on Juvenile Idiopathic Scoliosis Treated by Lumbar Flexion-Distraction Manipulation And Sitting Position Thoracic And Lumbar Vertebra Adjustment Manipulation)

  • 장홍규;양두화;우창훈;안희덕
    • 척추신경추나의학회지
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    • 제9권1호
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    • pp.103-114
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    • 2014
  • Objectives : The purpose of this study was to report clinical effects of Lumbar flexion-distraction manipulation and Sitting position thoracic and lumbar vertebra adjustment manipulation on patient with Juvenile idiopathic scoliosis Methods : The patients have been treated with the above two Chuna manual manipulations. We measured Cobb's angle, VNRS before and after treatment Results : After treatment, we confirmed these transition : In first case, Cobb's angle of T-spine changed from 27 to 23 : Cobb's angle of L-spine changed from 17 to 10 : VNRS changed from 6 to 2. In second case Cobb's angle of T-spine changed from 30 to 21 : Cobb's angle of L-spine changed from 16 to 16 : VNRS chagned from 6 to 3 Conclusion : The result suggests that these two Chuna manual manipulations were effective treatment on patients with Juvenile idiopathic scoliosis.

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허리의 척수신경위치와 실리콘을 이용한 척추사이구멍에 대한 형태학적 분석 (Spinal Nerve Position and Morphometric Analysis with Silicon Molds in the Cadaveric Lumbar Intervertebral Foramen)

  • 권순욱
    • 해부∙생물인류학
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    • 제31권4호
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    • pp.151-158
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    • 2018
  • 척추사이구멍은 인접한 두 척추뼈와 그 사이의 척추사이원반으로 구성된다. 이전의 척추사이구멍에 대한 연구들은 다양한 방법으로 수행이 되었다. 이번 연구에서는 실리콘 주형을 이용해서 척추사이구멍의 특징을 알아보았다. 시신18구를 해부하여 허리의 척추사이구멍을 해부하였다. 첫째로는 척수신경의 위치를 측정하였다. 둘째로는 척추사이구멍을 덮고있는 모든 조직을 제거하여 척추사이구멍 단면의 가장 좁은 부위를 측정하였다. 조직이 제거된 척추사이구멍은 실리콘주형으로 채워졌다. 실리콘주형이 굳어진 다음에는 구멍에서 분리되었다. 단면으로 잘린 실리콘주형을 종이 위에 도장처럼 찍고, 그것을 컴퓨터에 저장하였다. 척추사이구멍의 주형의 면적, 둘레, 높이, 폭이 컴퓨터에서 분석되었다. 허리의 다섯 개 척추사이구멍에서 면적과 둘레는 통계학적인 차이를 보이지 않았다. 하지만 둘째에서 다섯째 허리뼈에 걸쳐서 높이는 낮아지는 경향, 폭은 넓어지는 경향을 보였다. 또한 높이와 폭은 다섯째 구멍에서 유의미한 차이가 있었다. 높이는 다른 구멍들 중에서 가장 낮았고, 폭은 가장 넓었다. 척수신경은 첫째에서 넷째허리뼈에서는 척추사이원반 근처를 지나갔고, 다섯째허리뼈에서는 척추사이원반 아래쪽으로 지나갔다. 이번 연구는 척추사이구멍의 3차원적 입체 구조를 실리콘주형으로 확인하였다. 기존의 평면적 연구에서 관찰되지 않았던 다른 성질들을 확인할 수 있었다. 즉, 허리척추뼈에서 척추사이구멍의 면적과 둘레는 일정하였으나 높이와 폭은 전체적으로 변화하는 양상을 보였다.

척추성형술 시술 후 요추의 동적 특성 (Dynamic Characteristics of Lumbar Spine After Vertebroplasty)

  • 김상협;고성광;채수원;박정율
    • 한국정밀공학회:학술대회논문집
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    • 한국정밀공학회 2005년도 추계학술대회 논문집
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    • pp.240-243
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    • 2005
  • Osteoporosis, one of the age-related disease causes vertebra body fracture due to weakening trabecular bone and makes a substantial effect on load sharing among vertebras. Recently, vertebroplasty is one of the most popular treatment, as augmenting PMMA into vertebra. Biomechanical studies about vertebroplasty have been evaluated by several experiments or analysis under static loading but there has been no study on response under dynamic loading. This study included the FE analysis of patients who treated vertebroplasty under dynamic loading. For this study, 3-D FE model of lumbar spine(L1-L2) was modeled from CT scanning data and compared with experimental results in vitro in order to validate this model. Biomechanical behavior about each of normal person, osteoporotic patient and patient treated vertebroplasty for quantitative evaluations of vertebroplasty was compared and investigated.

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화타협척혈에 대한 문헌적 고찰 (The Treatise Research on Hua-Tuo-Jia-Ji-Xue(華佗夾脊穴))

  • 안수기;이삼로;양유선
    • Journal of Acupuncture Research
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    • 제17권4호
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    • pp.139-148
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    • 2000
  • Objectives : Hua-Tuo-Jia-Ji-Xue(華佗夾脊穴) is the Jing-Wai-Qi-Xue(經外奇穴) that is widely used in clinic and effective in Acupuncture and Moxibustion. But the location, number, acupuncture method, clinical application of Hua-Tuo-Jia-Ji-Xue have not been explained clearly and consistently; moreover, studies or clinical reports about this are insufficient. The purpose of this study is to investigate the location, number, acupuncture method, clinical apptication of Hua-Tuo-Jia-Ji-Xue. Methods : We investigated Hua-Tuo-Jia-Ji-Xue through survey of 11 books and 26 relevant journals published in China Results : 1. Hua-Tuo-Jia-Ji-Xue is located in about 0.5 Cun(寸) at both sides of spinous process of each vertebra. 2. There is differ as the number of Hua-Tuo-Jia-Ji-Xue is 34, 48, 56, 58 in each documents. Hua-Tuo-Jia-Ji-Xue located in first, second cervical vertebra and first sacrum is low in application frequency, Hua-Tuo-Jia-Ji-Xue located from third cervical vertebra to fourth lumbar vertebra is high in apptication frequency. Therefore, all of the acupoints located in about 0.5 Cun(寸) both sides of spinous process of cervical, thoracic, lumbar and sacral vertebrae are regarded as Hua-Tuo-Jia-Ji-Xue in wide meaning. 3. There are Kou-Ci-Fa(叩刺法), Qian-Ci-Fa(淺刺法), Yan-Pi-Ci-Fa(沿皮刺法), Shen-Ci-Fa(深刺法) in acupuncture method of Hua-Tuo-Jia-Ji-Xue. Acupuncturing depths, directions is differ in each location(cervical, thoracic, lumbar vertebra, sacrum) and have something to do with therapeutic effect of Hua-Tuo-Jia-Ji-Xue. The feeling that patient receive after acupuncture is the key to the treatment of disease. 4. The clinical application of each Hua-Tuo-Jia-Ji-Xue is mainly selected by distribution of meridians, nerve roots, vertebral segments which are attacked with a disease. The musculoskeletal diseases in treatment of disease by Hua-Tuo-Jia-Ji-Xue are the most common as 12 cases. Second, there are many reports about nervous system diseases. In addition, good therapeutic results by application of Hua-Tuo-Jia-Ji-Xue are reported in some diseases, for instance, diseases of five viscera and six entrails, organ, tissue Conclusions : Hua-Tuo-Jia-Ji-Xue is located in about 0.5 Cun(寸) at both sides of spinous process of each cervical, thoracic lumbar and sacral vertebra. Therapeutic effect of Hua-Tuo-Jia-Ji-Xue has something to do with acupuncturing depths, directions and feelings. Hua-Tuo-Jia-Ji-Xue is mainly selected by distribution of meridians, nerve roots, vertebral segments which are attacked with a disease and is mainly applied musculoskeletal diseases, nervous system diseases.

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