• Title/Summary/Keyword: spinal pain

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Hemilaminectomy for Herniated Discs at the Cervicothoracic Junction in a Beagle Dog (편측추궁절제술을 이용한 비글견의 경흉연접부 추간판 탈출증의 치료)

  • Kang, Byung-Jae;Kweon, Oh-Kyeong
    • Journal of Veterinary Clinics
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    • v.31 no.6
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    • pp.511-514
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    • 2014
  • A 7-year-old, female Beagle dog presented with a primary complaint of severe neck pain and paretic gait. A lesion was suspected between C6 and T2 on the basis of neurological examinations. Magnetic resonance imaging of the cervicothoracic spine revealed herniation of disc material from the C7-T1 intervertebral space resulting in marked spinal cord compression. Hemilaminectomy was performed to treat the intervertebral disc disease at C7-T1. Treatment was effective and the clinical condition of the dog was remarkably improved. This result suggests that hemilaminectomy is an effective option for surgical treatment of intervertebral disc disease at the cervicothoracic junction in dogs.

Effects of High Frequency Warm Needling of LI4 Acupoint on the Carrageenan-induced Arthritis in Rats (합곡(合谷)(LI4)의 고주파 온침 자극이 흰쥐의 족과(足踝) 관절염(關節炎)에 미치는 효과)

  • Park, Sang-Yeon;Kwon, Oh-Sang;Choi, Won-Jong;Kim, Jae-Hyo;Kim, Kyung-Sik;Sohn, In-Chul;Ahn, Seong-Hun
    • Korean Journal of Acupuncture
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    • v.26 no.2
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    • pp.61-74
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    • 2009
  • Objectives: The warm needling technique is a method which combines the effects of acupuncture with those of moxibustion. The purpose of this study was to find the stimulus effects of a high frequency warm needling device when stimulating acupoint $LI_4$ on the carrageenan-induced arthritis. Methods: This study was to observe the effects to edema reaction, WBF(weight bearing force), NO concentration, nNOS expression after the electro high frequency stimulus of high frequency warm needling device on LI4 with insulated acupuncture needle. Results: The effect of the high frequency warm needling device is to rise up the temperature in proportion to the current intensity. After stimulating on the acupoint $LI_4$ of the carrageenan-induced arthritis in rats with the high frequency warm needling device, it significantly reduced edema in the rat's foot. In addition, WBF, NO concentration of spinal cord (nmol/mg), and nNOS relative expression were reduced. Conclusions: The above results support the idea that stimulus by the high frequency warm needling device on $LI_4$ produces a potent analgesic effect in the arthritis pain model of the rat. Moreover, stimulus by the high frequency warm needling device modulates endogenous NO through the suppression of nNOS protein expression.

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Endoscopic Spine Surgery

  • Choi, Gun;Pophale, Chetan S;Patel, Bhupesh;Uniyal, Priyank
    • Journal of Korean Neurosurgical Society
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    • v.60 no.5
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    • pp.485-497
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    • 2017
  • Surgical treatment of the degenerative disc disease has evolved from traditional open spine surgery to minimally invasive spine surgery including endoscopic spine surgery. Constant improvement in the imaging modality especially with introduction of the magnetic resonance imaging, it is possible to identify culprit degenerated disc segment and again with the discography it is possible to diagnose the pain generator and pathological degenerated disc very precisely and its treatment with minimally invasive approach. With improvements in the optics, high resolution camera, light source, high speed burr, irrigation pump etc, minimally invasive spine surgeries can be performed with various endoscopic techniques for lumbar, cervical and thoracic regions. Advantages of endoscopic spine surgeries are less tissue dissection and muscle trauma, reduced blood loss, less damage to the epidural blood supply and consequent epidural fibrosis and scarring, reduced hospital stay, early functional recovery and improvement in the quality of life & better cosmesis. With precise indication, proper diagnosis and good training, the endoscopic spine surgery can give equally good result as open spine surgery. Initially, endoscopic technique was restricted to the lumbar region but now it also can be used for cervical and thoracic disc herniations. Previously endoscopy was used for disc herniations which were contained without migration but now days it is used for highly up and down migrated disc herniations as well. Use of endoscopic technique in lumbar region was restricted to disc herniations but gradually it is also used for spinal canal stenosis and endoscopic assisted fusion surgeries. Endoscopic spine surgery can play important role in the treatment of adolescent disc herniations especially for the persons who engage in the competitive sports and the athletes where less tissue trauma, cosmesis and early functional recovery is desirable. From simple chemonucleolysis to current day endoscopic procedures the history of minimally invasive spine surgery is interesting. Appropriate indications, clear imaging prior to surgery and preplanning are keys to successful outcome. In this article basic procedures of percutaneous endoscopic lumbar discectomy through transforaminal and interlaminar routes, percutaneous endoscopic cervical discectomy, percutaneous endoscopic posterior cervical foraminotomy and percutaneous endoscopic thoracic discectomy are discussed.

Preoperative arterial embolization of heterotopic ossification around the hip joint

  • Kim, Jin Hyeok;Park, Chankue;Son, Seung Min;Shin, Won Chul;Jang, Joo Yeon;Jeong, Hee Seok;Lee, In Sook;Moon, Tae Young
    • Journal of Yeungnam Medical Science
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    • v.35 no.1
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    • pp.130-134
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    • 2018
  • Heterotopic ossification (HO) around the hip joint is not uncommon following neurological injury. Often, surgical treatment is performed in patients with restricted motion and/or refractory pain due to grade III or IV HO according to Brooker classification. The major complication that occurs as a result of surgical HO removal is perioperative bleeding due to hyper-vascularization of the lesion. Here, we report a case of preoperative embolization in a 51-year-old male patient presenting with restricted bilateral hip range of motion (ROM) due to HO following a spinal cord injury. In the right hip without preoperative arterial embolization, massive bleeding occurred during surgical removal of HO. Thus, the patient received a transfusion postoperatively due to decreased serum hemoglobin levels. For surgery of the left hip, preoperative embolization of the arteries supplying HO was performed. Surgical treatment was completed without bleeding complications, and the patient recovered without a postoperative transfusion. This case highlights that, while completing surgical removal for ROM improvements, orthopedic surgeons should consider preoperative arterial embolization in patients with hip HO.

Cervical Open-Door Laminoplasty by Hydroxyapatite Implant Insertion Without Suturing

  • Kawanabe, Yoshifumi;Fujimoto, Motoaki;Sato, Tsukasa
    • Neurospine
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    • v.15 no.4
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    • pp.362-367
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    • 2018
  • Objective: To assess the efficacy of cervical open-door laminoplasty by hydroxyapatite implant insertion between the lamina and the lateral mass without suturing. Methods: All patients who underwent cervical open-door laminoplasty with C2/C7 undermining and insertion of hydroxyapatite implants from C3 to C6 were retrospectively evaluated for surgical time and neurological outcomes according to the Japanese Orthopaedic Association (JOA) score. To assess the alignment of the cervical spine and postoperative cervical pain, the C2-7 angle and a visual analogue scale score were used, respectively. Results: The population consisted of 102 women and 222 men ranging in age from 32 to 90 years. The average surgical time was 86 minutes. Fourteen of 1,296 hydroxyapatite implants were kept in place with sutures due to a weak restoration force of the hinge during surgery. No hydroxyapatite implant dislocation was detected on cervical computed tomography at 1 year after surgery. The average JOA score was $10.2{\pm}2.5$ before surgery and $14.6{\pm}2.8$ at 1 year after surgery. The average recovery rate was 61.8%. The average C2-7 angle at the neutral position was $7.1^{\circ}{\pm}6.2^{\circ}$ before surgery and $6.5^{\circ}{\pm}6.3^{\circ}$ at 1 year after surgery. Conclusion: This method enabled us to achieve minimal exposure of the lateral mass, prevention of lateral mass injury and dural injury, and a shorter surgical time while maintaining acceptable surgical outcomes. The idea that firm suture fixation is needed to prevent spacer deviation during cervical open-door laminoplasty may need to be revisited.

Clinical Case Report: Postoperative Rehabilitation Protocol for Spondylolisthesis in Korean Medicine Treatment (후방 요추체간 유합술을 시행한 척추 전위증 환자의 한방 재활치료 프로토콜을 적용한 임상 치료 효과: 증례 보고)

  • Lee, Eun-Byeol;Park, Na-Ri;Lee, Yun-Jin;Kang, Seok-Beom;Woo, Chang-Hoon;Ahn, Hee-Duk;Yang, Doo-Hwa
    • Journal of Korean Medicine Rehabilitation
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    • v.31 no.1
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    • pp.165-173
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    • 2021
  • Objectives The objective of this study is to propose postoperative rehabilitation for spondylolisthesis after posterior lumbar interbody fusion (PLIF) in Korean medicine and to report its effectiveness. Methods There were two patients who were received Korean medicine with acupuncture, herbal medicine, cupping and exercise treatment after PLIF. Patients were evaluated numeric rating scale (NRS), Oswestry disability index (ODI), pain free walking distance (PFWD), Korean modified index (K-MBI), EuroQol-5 dimension (EQ-5D) index. Results Case 1 was improved NRS from 7 to 3, Case 2 was improved NRS from 7 to 2. Also, ODI, PFWD, K-MBI, EQ-5D score were improved in both cases. Conclusions This study suggests that Korean medicine rehabilitation could be effective for spondylolisthesis after PLIF.

Comparison of Postural Alignment and Foot Pressure Balance according to the Dysmenorrhea Degree in 20's Women (20대 여성의 월경곤란증 정도에 따른 자세 정렬과 족저압 균형에 대한 비교)

  • Park, Sieun;Kim, Da-Jeong;Choi, Yoo-Rim
    • The Journal of the Korea Contents Association
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    • v.22 no.3
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    • pp.576-585
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    • 2022
  • In determining the cause of dysmenorrhea, it is necessary to investigate postural alignment and balance. The purpose of this study is to compare and analyze whether there is a difference in posture alignment and foot pressure balance according to the dysmenorrhea degree. The subjects were twenty female students in their 20s, who had pain caused by dysmenorrhea. According to the degree of dysmenorrhea, the subjects were divided into mild and severe groups. In the results, there was a significant difference only in shoulder height asymmetry angle between the mild and severe groups (p<0.05), and there was no significant difference in pelvic and knee joint alignment. In the correlation analysis, there was a significant positive correlation between the dysmenorrhea score (MDQ) and shoulder height asymmetry angle was found. These results indicate that dysmenorrhea symptom and asymmetric alignment of shoulder are related. To analyze these factors, further research will need to investigate the correlation between dysmenorrhea and spinal alignment.

Cauda Equina Syndrome after Percutaneous Balloon Kyphoplasty for Pathologic Compression Fracture (병적 척추체 압박 골절 환자에서 경피적 풍선 척추 성형술 시행 후 발생한 마미 증후군)

  • Park, Sung Jun;Park, Myung Hoon;Park, Jae Woo;Cho, Kyu Jung
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.90-94
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    • 2020
  • Percutaneous balloon kyphoplasty is an option for pain relief in pathological vertebral compression fractures. Complications related to cement leakage through cortical defects have been reported. On the other hand, dural compression due to retropulsion of the tumor mass is rarely reported. The authors report a case of a 65-year female patient who had cauda equina syndrome after a percutaneous balloon kyphoplasty in a pathological vertebral fracture, even though epidural compression were not found prior to surgery. Magnetic resonance imaging revealed retropulsion of the tumor mass into the spinal canal through the disrupted posterior vertebral cortex.

Bilateral foot drop caused by T12 infectious spondylitis after vertebroplasty: a case report

  • Kim, Dong Hwan;Shin, Yong Beom;Ha, Mahnjeong;Kim, Byung Chul;Han, In Ho;Nam, Kyoung Hyup
    • Journal of Trauma and Injury
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    • v.35 no.1
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    • pp.56-60
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    • 2022
  • The most common cause of foot drop is lumbar degenerative disc herniation, particularly at L4/5. We present a rare case of spinal cord injury accompanied by a thoracolumbar lesion that presented with bilateral foot drop. A 69-year-old male patient presented with sudden-onset severe bilateral leg pain and bilateral foot drop. Radiologic findings revealed T12 spondylitis compressing the conus medullaris. He had undergone vertebroplasty for a T12 compression fracture after a fall 6 months before. A physical examination showed bilateral foot drop, paresthesia of both L5 dermatomes, increased deep tendon reflex, and a positive Babinski sign. An acute bilateral L5 root lesion and a conus medullaris lesion were suspected based on electromyography. A surgical procedure was done for decompression and reconstruction. After the operation, bilateral lower extremity muscle strength recovered to a good grade from the trace grade, and the patient could walk without a cane. The current case is a very rare report of bilateral foot drop associated with T12 infectious spondylitis after vertebroplasty. It is essential to keep in mind that lesions of the thoracolumbar junction can cause atypical neurological symptoms. Furthermore, understanding the conus medullaris and nerve root anatomy at the T12-L1 level will be helpful for treating patients with atypical neurological symptoms.

Early initiation of breastfeeding and factors associated with its delay among mothers at discharge from a single hospital

  • Mary, J. Jenifer Florence;Sindhuri, R.;Kumaran, A. Arul;Dongre, Amol R.
    • Clinical and Experimental Pediatrics
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    • v.65 no.4
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    • pp.201-208
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    • 2022
  • Background: According to the National Family Health Survey-4, in India, 78.9% of deliveries occur in institutions, although only 42.6% of new mothers initiate breastfeeding within 1 hour of delivery. Purpose: To estimate the proportion of early initiation of breastfeeding (EIBF) among new mothers at discharge from a tertiary care hospital and identify the determinants of delayed initiation of breastfeeding among them. Methods: This was a hospital-based analytical cross-sectional study of 108 new mothers. After obtaining Institutional Review Board approval and informed consent, we interviewed the new mothers on the day of discharge. Multivariate logistic regression was performed using IBM SPSS Statistics ver. 24. Results: The median breastfeeding initiation time was 90 minutes (interquartile range, 30-180 minutes). Overall, 43.5% of the mothers practiced EIBF, 77.4% practiced exclusive breastfeeding, and 43.5% were rooming in at discharge. Reasons for breastfeeding delays included extended recovery time from spinal anesthesia, maternal lassitude, and uncomfortable breastfeeding position due to post-cesarean pain. In the multivariate analysis, a birth weight less than 2,500 g (adjusted odds ratio [aOR], 4.33; 95% confidence interval [CI], 1.12-16.82; P=0.03), cesarean section delivery (aOR, 4.68; 95% CI, 1.57-13.92; P=0.005), and mother's poor knowledge of breastfeeding (aOR, 4.61; 95% CI, 1.44-14.72; P=0.010) were more likely to delay the initiation of breastfeeding. Conclusion: EIBF was practiced by less than half of the new mothers as determined by the cesarean section, baby's birth weight, and mothers' awareness of breastfeeding. Thus, it is vital to improve breastfeeding and nutritional counseling among mothers during the antenatal period and improve healthcare professionals' training to facilitate EIBF, even in circumstances such as cesarean section.