• Journal of Korean Neurosurgical Society
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• v.41 no.1
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• pp.61-64
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• 2007

Lumbo-sacral junction is a transition lone between the mobile lumbar spine and immobile pelvis. Lumbosacral junction has been considered to be the most troublesome portion of the spine to be fused because of the difference in anatomical and biomechanical factors between spine and pelvis. A metastatic sacral tumor in a 57-year-old man was resected, followed by unilateral lumbo-iliac fixation across lumbosacral junction using modified Galveston technique. Rigid fixation was successfully achieved. Detailed anatomy and surgical techniques are presented.

• The Korean Journal of Pain
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• v.13 no.1
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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 Korean Neurosurgical Society
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• v.47 no.1
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• pp.1-6
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• 2010

Objective: On the basis of preoperative computed tomography (CT) scans, we studied the change of the size of anterior primary division (APD) of the L5 spinal root in the presence of foraminal/extraforaminal entrapment of the L5 spinal root. Methods: Two independent radiologists retrospectively reviewed the preoperative CT scans of 27 patients treated surgically and compared the sizes of the APDs on bilateral L5 spinal roots. If one side APO size was larger than the other side APD size, it was described as left or right "dominancy" and regarded this as "consensus (C)" in case that there was a consensus between the larger APD and the location of sciatica, and regarded as "non-consensus (NC)" in case that there was not a consensus. Oswestry Disability Index (ODI) scores were used for preoperative and postoperative evaluation. Results: On CT scans, twenty-one (77%) of 27 patients were the consensus group (APD swelling) and 6 (22%) were a non-consensus group (APD no swelling). In 9 patients with acute foraminal disc herniations, asymmetric enlargement of the APD on L5 spinal root was detected in all cases (100%) and detected in 11 (64%) of 17 patients with stenosis. Preoperative ODI score was 75-93 (mean 83) and postoperative 001 scores were improved to 13-36 (mean 21). The mean follow-up period was 6 months (range, 3-11 months). Conclusion: An asymmetric enlargement of the APD on L5 spinal root on CT scans is meaningfully associated with a foraminal or extraforaminal entrapment of the L5 spinal root on the lumbosacral junction.

• Journal of Korean Neurosurgical Society
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• v.48 no.4
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• pp.347-353
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• 2010

Objective : Iliac screw fixation has been used to prevent premature loosening of sacral fixation and to provide more rigid fixation of the sacropelvic unit. We describe our technique for iliac screw placement and review our experience with this technique. Methods : Thirteen consecutive patients who underwent spinopelvic fixation using iliac screws were enrolled. The indications for spinopelvic fixation included long segment fusions for spinal deformity and post-operative flat-back syndrome, symptomatic pseudoarthrosis of previous lumbosacral fusions, high-grade lumbosacral spondylolisthesis, lumbosacral tumors, and sacral fractures. Radiographic outcomes were assessed using plain radiographs, and computed tomographic scans. Clinical outcomes were assessed using the Oswestry Disability Index (ODI) and questionnaire about buttock pain. Results : The median follow-up period was 33 months (range, 13-54 months). Radiographic fusion across the lumbosacral junction was obtained in all 13 patients. The average pre- and post-operative ODI scores were 40.0 and 17.5, respectively. The questionnaire for buttock pain revealed the following : 9 patients (69%) perceived improvement; 3 patients (23%) reported no change; and 1 patient (7.6%) had aggravation of pain. Two patients complained of prominence of the iliac hardware. The complications included one violation of the greater sciatic notch and one deep wound infection. Conclusion : Iliac screw fixation is a safe and valuable technique that provides added structural support to S1 screws in long-segment spinal fusions. Iliac screw fixation is an extensive surgical procedure with potential complications, but high success rates can be achieved when it is performed systematically and in appropriately selected patients.

• Journal of Veterinary Clinics
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• v.41 no.2
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• pp.133-138
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• 2024

An 8-year-old, spayed female Persian cat weighing 3.6 kg presented with a lumbosacral mass and bilateral weight bearing hindlimb lameness. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a dumbbell-shaped heterogeneous mass extending through the internal surface of the ileum and surrounding the lumbosacral junction. CT also revealed extensive osteoproliferation and bone lysis of the sacrum, but no evidence of any pulmonary metastasis. Furthermore, MRI revealed a focal area in the spinal cord showing connection with the adjacent tumor, suggesting tumor invasion into the spinal cord. Low-grade myxoid chondrosarcoma was histopathologically diagnosed. This is the first report describing CT and MRI findings of spinal cord chondrosarcoma in veterinary medicine. This study suggests that combining CT with MRI is a more sensitive tool for evaluating spinal tumors than using CT or MRI alone.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.5 no.2
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• pp.113-125
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• 2010

Objectives: We have evaluated the effects of conservative treatment on one patient who was diagnosed to thoraco-lumbar junction and lumbo-sacral junction transitional zone syndrome. so, we investigate thoraco-lumbar junction and Jumbo-sacral junction tranzitional zone syndrome that was suggested by Maigne R. Methods : One patient was diagnosed as T12-L1 herinated intervetebral disc through MRI. We diagnosed the patient to transitional zone syndrome by symptoms and physical examination and used Acupuncture therapy, Cox technique to the patient. We measured Visual Analog Scale(VAS) before and after treatment. Results: After treating Acupuncture therapy, Cox technique in the case, We find out that the patient was improved. VAS score changed from 7 to 2 and physical examinations are improved. Conclusions: We improved the patient who had thoraco-lumbar junction and lumbo-sacral junction transitional zone syndrome by Cox technique and Acupuncture therapy, and we found that thoraco-lumbar junction related lumbo-sacral junction.

• Korean Journal of Veterinary Research
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• v.35 no.4
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• pp.863-868
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• 1995

Electroacupuncture therapy was performed in 2 dogs with thoracolumbar disc disease. Case was a 3-year-old female chihuahua with a calcified disc between the 13th thoracic and 1st lumbar vertebrae. Treatment was done by electroacupuncture at San sho yu, Shen yu, Huan tiao and Fu yang-San yin jiao with the current of 0.5~8 volts, 30 Hz for 30 min. She could pass feces and urine 2 days, and walk 9 days after the beginning of the therapy. Case 2 Was a 6-year-old male cocker spaniel with 4 calcified discs(T12-T13, T13-L1, L2-L3 and L6-L7) and spondylosis(lumbosacral junction). Treatment was done by electroacupuncture at Tian ping, Bai hui and Pung kung yu with the current of 2~4 volts, 30 Hz for 20 min. He could pass feces 6 days, urine 8 days, and stand 21 days, after the beginning of the therapy.

• The Korean Journal of Pain
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• v.20 no.2
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• pp.130-137
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• 2007

Background: We evaluated the role and effects of prolotherapy in patients presenting with lower back pain and detected sacral asymlocation, by retrospectively analyzing the results of prolotherapy performed at our institute. Methods: Twenty-three patients with referred pain in the lower back rather than distinct radiculopathy, were detected to have sacral asymlocation by simple X-ray from May 2004 through July 2005. The patients were treated with prolotherapy and manipulation by the Ongley's method around the lumbosacral junction, iliolumbar ligament, and sacroiliac joint. They were treated for approximately one to two week intervals, and during this period were rechecked by X-ray and evaluated using the visual analogue scale (VAS). Results: A total of 23 patients were included in the study (10 male and 13 female), and the average age was 41 years. The average VAS at the time of visit was B.5, the average treatment time was 4,7 days, and the average VAS after treatment was 2.1. Conclusions: Back pain, and associated leg and buttock pain, originate from several causes. In these case analyses, instability around the lumbosacral area and sacral asymlocation might have been important causes of patient back pain and associated buttock and leg pain. We therefore applied prolotherapy as well as manipulation techniques devised by Ongley to these patients, and obtained good results.

• Archives of Plastic Surgery
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• v.37 no.6
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• pp.827-830
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• 2010

Purpose: Congenital spinal dermal sinus tract is a rare lesion connecting skin to deeper structures including neural tissue. It results from the failure of the neuroectoderm to separate from the cutaneous ectoderm in the third to fifth week of gestation. The common locations are the lumbosacral and occipital regions. Sometimes it extends to spinal canal. In this paper we report a case of congenital spinal dermal sinus tract in the coccyx. Methods: A 21-month-old male child born after an uncomplicated full-term pregnancy was admitted to our institute with a midline dermal sinus and a cartilaginous protrusion in the coccygeal region. There were no signs of infection. Neurologic examination showed no functional deficit in both lower limbs. He was treated with complete excision of the tract and an underlying accessory cartilage. Results: The spinal dermal sinus tract was extended from the skin to the coccyx. The stalk was loosely attached to the accessory cartilage of coccyx. At that point, it was dissected from the accessory cartilage and resected. The accessory cartilage was also resected at the bone and cartilage junction. During the follow-up period of 6 months, the wound healed well without any complication nor recurrence. Conclusion: Congenital spinal dermal sinus tract is known as a form of spinal dysraphism. In order to prevent complications, timely surgical intervention including complete resection of sinus tract with correction of associated abnormalities is of utmost importance.

• Journal of Korean Neurosurgical Society
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• v.64 no.3
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• pp.386-405
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• 2021

Recent advancements in basic research on the process of secondary neurulation and increased clinical experience with caudal spinal anomalies with associated abnormalities in the surrounding and distal structures shed light on further understanding of the pathoembryogenesis of the lesions and led to the new classification of these dysraphic entities. We summarized the changing concepts of lesions developed from the disordered secondary neurulation shown during the last decade. In addition, we suggested our new pathoembryogenetic explanations for a few entities based on the literature and the data from our previous animal research. Disordered secondary neurulation at each phase of development may cause corresponding lesions, such as failed junction with the primary neural tube (junctional neural tube defect and segmental spinal dysgenesis), dysgenesis or duplication of the caudal cell mass associated with disturbed activity of caudal mesenchymal tissue (caudal agenesis and caudal duplication syndrome), failed ingression of the primitive streak to the caudal cell mass (myelomeningocele), focal limited dorsal neuro-cutaneous nondisjunction (limited dorsal myeloschisis and congenital dermal sinus), neuro-mesenchymal adhesion (lumbosacral lipomatous malformation), and regression failure spectrum of the medullary cord (thickened filum and filar cyst, low-lying conus, retained medullary cord, terminal myelocele and terminal myelocystocele). It seems that almost every anomalous entity of the primary neural tube may occur in the area of secondary neurulation. Furthermore, the close association with the activity of caudal mesenchymal tissue in secondary neurulation involves a wider range of surrounding structures than in primary neurulation. Although the majority of the data are from animals, not from humans and many theories are still conjectural, these changing concepts of normal and disordered secondary neurulation will provoke further advancements in our management strategies as well as in the pathoembryogenetic understanding of anomalous lesions in this area.