• Title/Summary/Keyword: Lumbar Examination

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Multi-access for the Diagnosis of Missed Upper Lumbar Disc Herniation

  • Lee, Dong-Yeob;Kim, Hyung-Seok;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • v.38 no.2
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    • pp.144-146
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    • 2005
  • Herein, a case of missed upper lumbar disc herniation, diagnosed by thorough neurological examination, digital infrared thermographic imaging[DITI], and repeated magnetic resonance[MR] image study, is reported. A 36-year-old female presented with intractable leg pain on left anterior thigh. Although she underwent lumbar MR image at other hospital, she was misdiagnosed as acute sprain. Neurological examination suggested the possibility of upper lumbar disc herniation, which was confirmed by DITI, MRI, and selective root block. After operation, her leg pain was significantly improved. It should be considered that upper lumbar disc herniation might be misdiagnosed as an acute sprain, as in our case. A high index of suspicion based on thorough neurological examination is most important in such cases. Then, multi-access such as DITI, MR image, and selective block, base on thorough neurological examination, are warranted.

Effect of Field Size on the Clinical Exposure Index for Lumbar Spine X-ray Examination (노출지수를 이용한 요추 X선 촬영의 조사야 유효성 평가)

  • Park, Hyemin;Yoon, Yongsu;Kim, Jungsu;Jeong, Hoiwoun
    • Journal of radiological science and technology
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    • v.44 no.3
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    • pp.183-187
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    • 2021
  • The field size of the lumbar spine X-ray examination, which belongs to the most frequent examination in general radiography, is 5 times wider than the width of the lumbar spine. Exposure index (EI) as per International Electrotechnical Commission has a proportional relationship with the dose incident on the image receptor for clinical protocols in addition to RQA5, which is a calibration beam quality. In this study, the effectiveness of the set field size was evaluated through the change of EI according to the size of field during lumbar spine X-ray examinations. Lumbar anterior-posterior and lateral examinations was performed using a whole-body phantom, and the national average exposure conditions of Korea investigated in 2017 were introduced for the X-ray exposure. As a result of comparing the EI displayed on the console of digital radiography system for the three field size in ① 18 × 36 cm2 ② 25 × 36 cm2 ③ 36 × 36 cm2, the EI values showed a tendency to increase as the field size increased. Since the patient dose, such as organ dose around the lumbar spine, increases as the field size becomes larger, thus, if the EI obtained from the field size at a level that does not interfere with diagnosis is set as a reference, the effectiveness of the field size can be evaluated through the EI displayed on the console when the lumbar spine X-ray examination is conducted.

A Case of Lumbar Plexopathy Diagnosed by Magnetic Resonance Imaging (자기공명영상술로 진단된 요신경총병증 환자 1예)

  • Kim, Ho-Jung;Kim, Byung-Jo;Hong, Suk Joo;Koh, Seong-Beom;Lee, Dae-Hie
    • Annals of Clinical Neurophysiology
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    • v.8 no.2
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    • pp.174-178
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    • 2006
  • The diagnosis of peripheral neuropathy had been performed by electrophysiologic studies and neurologic examination. However, Magnetic Resonance Imaging (MRI) has recently been proposed as a supplementary tool for its diagnosis. A 55-year-old woman presented with back pain and painful proximal weakness of the right leg. Neurologic examination and electrophysiologic studies suggested an upper lumbar plexopathy. MRI disclosed the signal change in lumbar plexus with the atrophy of the innervating muscles. We report a patient with idiopathic lumbar plexopathy confirmed by MRI.

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Magnetic Resonance Imaging Follow-up Study on Two Cases of Lumbar intervertebral Disc Sequestration Patients Treated with Oriental Medicine Treatment (한방 요법으로 호전된 부골화된 요추 추간판 탈출증 환자에서의 영상의학적 변화)

  • Lee, Ki-Su;Hong, Kwon-Eui
    • Journal of Pharmacopuncture
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    • v.14 no.3
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    • pp.99-107
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    • 2011
  • Objectives : The purpose of this study is to report the image changes of two cases of Lumbar intervertebral Disc Sequestration after oriental medical treatment. Methods : We examined 2 patients with Lumbar intervertebral Disc Sequestration who showed changes on MRI images before/after the treatment. And we assessed clinical symptoms by using numeric rating scale(NRS) and straight leg raising test(SLRT). Results & Conclusions : In this study, the first MRI examination of Lumbar intervertebral Disc Sequestration patients was performed at the first visit and re-examination of MRI was done after treatment. In each case, the size of the disc sequestration was considerably reduced in MRI image. And both patients represented effective improvment in NRS score and SLRT test angle.

The study of stability exercise using pressure biofeedback unit for low back pain (요통에서의 pressure biofeedback unit(stabilizer)를 사용한 안정화 운동)

  • Kim, Gook-Joo;Kong, Kwan-Woo;Kwon, Sun-Oh;Jang, Yong-Geun;Hwang, Hee-Jun;Park, Jun-Ki
    • Journal of Korean Physical Therapy Science
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    • v.19 no.2
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    • pp.63-71
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    • 2012
  • Purpose : This study aimed to acquire a basic knowledge about lumbar stability and inquire into exercise approach of pressure biofeedback unit for lumbar stability. Methods : This study was composed with reviewed theory of lumbar stability and several books and articles for exercise using pressure biofeedback unit. Results : The stability of lumbar should work symmetrical with passive, active, control subsystem in neutral zone, and local muscles should be using for stability. Especially, selective using of transverse abdominis work for lumbar stability importantly. The control of using pressure biofeedback unit may important not only examination but treatment. Conclusion : The stability of lumbar need co-contraction of specific local muscle and training for timing as well as using pressure biofeedback unit for accurate control may use for examination and therapedic approach.

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Two Cases on Tortipelvis caused by Lumbar Disc Herniation - Using Mckenzie Method Treatment (요추 추간판 탈출증에 의한 골반경사 치험 2례 - Mckenzie 수기요법을 이용)

  • Hwang, Hyung-Joo;Heo, Kwang-Ho;Keum, Dong-Ho
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.2 no.1
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    • pp.85-97
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    • 2007
  • Objectives : We evaluated the effect of Mckenzie method treatment by participating two patients suffering from Tortipelvis by lumbar disc herniation. Methods : Two patients were diagnosed as Tortipelvis by lumbar disc herniation through CT scan and X-ray examination. We used Mckenzie method and measured VAS(Visual analogue scale). Results and Conclusions : After using Mckenzie method treatment, We found out a recovery from both patients suffering from Tortipelvis by lumbar disc herniation. The result, through our study, suggests that Mckenzie method treatment was effective to cure the Tortipelvis by lumbar disc herniation. It also was effective to reduce the low back pain and to stabilize the lumbar disc herniation.

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Five Clinical Cases on Atrophy of the Lumbar Multifidus Muscle on Lumbar Herniation of Nucleus Purposus at CT Imaging (요추간판 탈출증 환자의 전산화 단층 촬영 검사상 다열근 위축에 대한 증례 5례 보고)

  • Jung, Min-Gyu;Lee, Kil-Joon;Hwang, Hyung-Joo;Keum, Dong-Ho
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.3 no.2
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    • pp.61-68
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    • 2008
  • Objectives : Lumbar multifidus muscle stabilize lumbar spine. Atrophy of multifidus muscle follows disfunction of low back pain patient's activity and increase the reoccurency of herniation of nucleus purposus surgery. Lumbar herniation of nucleus purposus if common cause of low back pain. We have evaluated the atrophy of multifidus of nucleus purposus. Methods : Five patients were diagnosed as Lumbar herniation of nucleus purposus through the CT imaging. CT imaging were visually analysed to know lumbar multifidus muscle atrophy. Results and Conclusions : Examination of multifidus muscle atrophy should be considered with assessing CT imaging of lumbar spine. It may help for further evaluation and planning the treatment of Lumbar herniation of nucleus purposus patient.

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Effect of Work Environment and Low Back Pain on the Structural and Muscle Strength Changes in Lumbar Spine (작업환경과 요통이 요추의 구조 및 근력의 변화에 미치는 영향)

  • Kim, Na-Yeon;Kang, Jae-Hui;Lee, Hyun
    • Journal of Acupuncture Research
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    • v.27 no.3
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    • pp.93-104
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    • 2010
  • Objectives : The purpose of this study is to observe the effects of work environment and low back pain on the structural and muscle strength changes in lumbar spine to helpful for preventation and cure of low back pain. Methods : Through measuring of lumbosacral angle, lumbar lordotic angle, lumbar gravity line ratio analyzed structure of lumbar spine and using Trunk Extension Flexion Program of CYBEX NORM System(cybex770+TMC, USA) analyzed Flex. PT, Ext. PT, E/F ratio of lumbar spine of company employees given a medical examination. Results : According to work environment, lumbar gravity line ratio is higher in white collar group than in blue collar group, Ext. PT is significantly lower in white collar group than in blue collar group. According to low back pain or not, lumbar gravity line ratio, Ext. PT is lower in low back pain group than in non-low back pain group. Conclusions : Work environment and low back pain effects on the structural and muscle strength changes in lumbar spine.

Intradural Migration of a Sequestrated Lumbar Disc Fragment Masquerading as a Spinal Intradural Tumor

  • Kim, Hyeong-Suk;Eun, Jong-Pil;Park, Jung-Soo
    • Journal of Korean Neurosurgical Society
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    • v.52 no.2
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    • pp.156-158
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    • 2012
  • Intervertebral intradural lumbar disc herniation (ILDH) is a quite rare pathology, and isolated intradural lumbar disc herniation is even more rare. Magnetic resonance imaging (MRI) may not be able to reveal ILDHs, especially if MRI findings show an intact lumbar disc annulus and posterior longitudinal ligament. Here, we present an exceedingly rare case of an isolated IDLH that we initially misidentified as a spinal intradural tumor, in a 54-year-old man hospitalized with a 2-month history of back pain and right sciatica. Neurologic examination revealed a positive straight leg raise test on the right side, but he presented no other sensory, motor, or sphincter disturbances. A gadolinium-enhanced MRI revealed what we believed to be an intradural extramedullary tumor compressing the cauda equina leftward in the thecal sac, at the L2 vertebral level. The patient underwent total L2 laminectomy, and we extirpated the intradural mass under microscopic guidance. Histologic examination of the mass revealed a degenerated nucleus pulposus.

Correlation Analysis of Factors Affecting the Collimator Size used during Lumbar Spine Lateral Examination in Digital Radiography System (디지털 방사선 장비에서 요추 측면 검사 시 사용되는 조사야 크기에 영향을 미치는 요인의 상관관계 분석)

  • Young-Cheol Joo;Sin-Young Yu
    • Journal of the Korean Society of Radiology
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    • v.18 no.4
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    • pp.345-353
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    • 2024
  • The purpose of this study was to suggest an appropriate collimation size and central X-ray incidence point by analyzing the correlation between the collimation size used in lumbar lateral examination and factors affecting the collimation size. the lumbar lateral examination results of 148 patients suitable for the purpose of this study were analyzed. The measurement method was to set the total horizontal width shown in the image to the size of the irradiation field(collimation) used during the examination. The distance connected vertically from the end of the dorsal field to the apophyseal joint of the third lumbar vertebra(AJD), the distance from the dorsal end of the image field to the center of the body of the third lumbar vertebra(BD), and the distance from the end of the dorsal field of the image to the center of the pedicle of the third lumbar vertebra(PD). The distance was measured. For comparative analysis of the mean values of dependent variables according to gender, age, height, weight, and body mass index, the mean values were compared using the independent samples t test and one-way ANOVA. For post hoc analysis, duncan was used. The correlation between independent and dependent variables was analyzed using Pearson correlation analysis. In this study, statistical significance was set at a p value of 0.05 or lower. The average value of the collimation size during the lumbar spine lateral examination was 252.45 mm, AJD was 102.11 mm, BD was 141.17 mm, and PD was 119.73 mm. The mean values of collimation size, AJD, BD, and PD were larger in men than in women, but statistical significance for the difference in mean values by gender was found only in BD (p<0.05). There was a slight difference in the mean value of each group according to age, but there was no statistical significance (p>0.05). The collimation size and mean values of AJD, BD, and PD according to height, weight, and body mass index differed depending on the independent variables, and the differences were all statistically significant (p<0.05). As a result of the correlation analysis, field size and AJD, BD, and PD showed no correlation with gender and age, a weak positive correlation with height, and a medium positive correlation with weight and body mass index. The results of this study showed that CS was correlated with height, weight, and BMI during lumbar lateral examination. If the entrance point of the central X-ray is moved to the appophyseal joint by considering weight and BMI when adjusting the collimation size in clinical practice, it is expected that the collimation size can be reduced bu about 5%.