• 대한물리의학회지
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• 제5권4호
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• pp.615-621
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• 2010

Purpose : The purpose of this study was to compare chronic LBP patients and asymptomatic subjects on measures of multifidus size (cross-sectional area;CSA, thickness) and symmetry (proportional difference of relatively larger side to smaller side). Methods : Data were obtained from 12 asymptomatic subjects without a prior history of LBP (8 females, 4 males), and a retrospective audit was undertaken of records from 12 chronic low back pain patients (8 females, 4 males). CSA and Thickness of the lumbar multifidus muscles was measured from axial T1-weighted magnetic resonance images(MRI). Results : The results of the analysis showed that chronic LBP patients had significantly smaller multifidus CSA and thickness than asymptomatic subjects at L4-5 vertebral levels(p<.05). The asymmetry between sides was seen at L4- L5 vertebral level in patients with chronic low back pain presentations(p<.05). Conclusions : MRI provided a quantitative measure of change between asymptomatic subjects and chronic low back pain patients of multifidus muscle. MRI identified significant differences in cross-sectional area and thickness and helps to evaluate clinically and plan the treatment modalities of LBP.

• Korean Journal of Radiology
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• 제22권2호
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• pp.225-232
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• 2021

Objective: To determine whether changes in the transiting nerve rootlet or its surroundings, as seen on MRI performed after lumbar hemilaminectomy, are associated with persistent postoperative pain (PPP), commonly known as the failed back surgery syndrome. Materials and Methods: Seventy-three patients (mean age, 61 years; 43 males and 30 females) who underwent single-level partial hemilaminectomy of the lumbar spine without postoperative complications or other level spinal abnormalities between January 2010 and December 2018 were enrolled. Two musculoskeletal radiologists evaluated transiting nerve rootlet abnormalities (thickening, signal alteration, distinction, and displacement), epidural fibrosis, and intrathecal arachnoiditis on MRI obtained one year after the operations. A spine surgeon blinded to the radiologic findings evaluated each patient for PPP. Univariable and multivariable analyses were used to evaluate the association between the MRI findings and PPP. Results: The presence of transiting nerve rootlet thickening, signal alteration, and ill-distinction was significantly different between the patients with PPP and those without, for both readers (p ≤ 0.020). Conversely, the presence of transiting nerve rootlet displacement, epidural fibrosis, and intrathecal arachnoiditis was not significantly different between the two groups (p ≥ 0.128). Among the above radiologic findings, transiting nerve rootlet thickening and signal alteration were the most significant findings in the multivariable analyses (p ≤ 0.009). Conclusion: On MRI, PPP was associated with transiting nerve rootlet abnormalities, including thickening, signal alterations, and ill-distinction, but was not associated with epidural fibrosis or intrathecal arachnoiditis. The most relevant findings were the nerve rootlet thickening and signal alteration.

• 한국산학기술학회논문지
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• 제18권8호
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• pp.317-323
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• 2017

본 연구의 목적은 요통으로 추간공 접근법과 추궁간판 접근법을 사용하여 요부 경막외 신경차단술을 받은 환자를 대상으로 시술 후 자기공명영상 소견이 어떻게 다른지 조사하는 것이었다. 연구 방법은 신경차단술 후 자기공명영상의 이상 소견에 대해 분석한 관찰 연구이다. 연구 대상자는 2007년 1월에서 2016 12월 사이에 일개 대학병원 통증클리닉에서 요부 경막외 신경차단술 24시간 후에 요추부 자기공명영상을 촬영한 78명의 환자를 대상으로 하였다. 신경차단술을 받은 대상자 중에서 추궁간판 접근법을 사용한 환자는 36명이었고, 추간공 접근법을 사용한 환자는 42명이었다. 경막외 신경차단술 후 자기공명영상에서 비정상적인 소견을 보인 환자들의 비율은 추간공 접근법을 사용한 군(7%)에 비해 추궁간판 접근법을 사용한 군(53%)에서 많았다. 비정상적인 자기공명영상 소견은 경막외 공기, 유체, 연부 조직의 변화, 바늘 자국 등이었다. 전체 비정상소견 중에서는 경막외 공기가 72%로 다수를 차지했다. 위의 연구결과를 고려할 때 요부 경막외 신경차단술을 시행 후 24시간 이내에 자기공명영상을 촬영할 경우에는, 시술 시 추간공 접근법을 이용하는 것이 자기공명영상의 판독 오류 또는 해석의 어려움을 줄이는데 도움이 될 것이다. 또한 추궁간판 접근법을 이용하여 시술하는 경우에는 자기공명영상에서 경막외 공기 등의 이상 소견이 발견될 가능성에 주의할 필요가 있다.

• 척추신경추나의학회지
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• 제7권2호
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• pp.83-90
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• 2012

Objectives : The perpose of this study was to observe the correlation between lumbar lordotic angle and radiological result. Methods : We randomly selected among the 150 patients with lumbar X-ray and MRI films who have visited Jaseng Hospital of Oriental Medicine with low back pain. Radiographic lumbar lordotic angle and lumbar HIVD were collected and stastically analyzed. Results : In this study, if the finding of a X-ray showed straightening of lumbar lordotic curve, based on MRI finding, the number of HIVD increased. Conclusions : There was a significant correlation between lumbar hypolordosis and HIVD, hypolordosis complained mare HIDVs.

• Investigative Magnetic Resonance Imaging
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• 제15권2호
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• pp.123-129
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• 2011

목적 : 재발성 요통을 호소하는 환자들에서 최초 증상 발생시 촬영한 요추부 자기공명영상과 증상 재발시 촬영한 추적 요추부 자기공명영상을 비교하여 요추간판 병변의 변화 양상을 알아보고자 한다. 대상 및 방법 : 요통이 재발하여 추적 요추부 자기공명영상을 촬영한 50명의 환자 (연령범위 15~79세, 평균나이 49.8세)의 추간판 소견을 후향적으로 분석하였다. 최초 증상 발생시 촬영한 요추부 자기공명영상과 비교하여, 추적 자기공명영상에서 제 1-2 요추간판부터 제 5 요추-1천골 추간판 각각에 대한 형태학적 변화 유무와 변화가 있을 경우 호전 또는 악화를 평가하였다. 결과 : 50명의 환자, 250개의 추간판에서 219개 (87.6%)의 추간판은 변화를 보이지 않았다. 반면에 변화를 보인 31개 (12.4%)의 추간판에서 24개는 악화되었고, 7개는 완화되었다. 최초 추간판의 형태학적 상태를 기준으로 추적 관찰시, 형태학적 변화를 보인 경우는 모두 최초 자기 공명영상에서 추간판의 팽대, 돌출 혹은 탈출을 보였는데, 그 중 탈출되었던 추간판이 33.3%로 가장 많은 변화를 보였다. 요추간판 level을 기준으로 추적 관찰시, 제 4-5 요추간판이 15개로 가장 많은 변화를 보였다. 결론 : 재발성 요통은 추적 자기공명영상에서 추간판 탈출의 악화와 연관성이 낮은 것으로 판단되며, 요통을 유발할 수 있는 다른 원인에 대한 종합적인 평가가 필요하다고 본다.

• Journal of Korean Neurosurgical Society
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• 제52권5호
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• pp.447-451
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• 2012

Objective : To characterize the importance of the vertical angle of the sacral curvature (VASC) in lumbar disc herniations. Methods : Morphological data derived from lumbar sagittal MRI imaging. The statistical significance of the findings are discussed. The angles of 60 female patients with lumbar disc herniations (LDH) were compared with the 34 female patients without LDH. Results : 128 of the 185 patients met our inclusion criteria. The vertical angle of sacral curvature is statistically significantly bigger in females with lumbar disc herniations when compared to subjects in control group, 28.32 and 25.4, respectively. (p=0.034<0.05). Same difference was not seen in males. Conclusion : The vertical angle of sagittal sacral curvature may be another risk factor in females with lumbar disc herniations.

• Journal of Korean Neurosurgical Society
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• 제50권3호
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• pp.201-204
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• 2011

Objective : To quantitatively evaluate the asymmetry of the multifidus and psoas muscles in unilateral sciatica caused by lumbar disc herniation using magnetic resonance imaging (MRI). Methods : Seventy-six patients who underwent open microdiscectomy for unilateral L5 radiculopathy caused by disc herniation at the L4-5 level were enrolled, of which 39 patients (51.3%) had a symptom duration of 1 month or less (group A), and 37 (48.7%) had a symptom duration of 3 months or more (group B). The cross-sectional areas (CSAs) of the multifidus and psoas muscles were measured at the mid-portion of the L4-5 disc level on axial MRI, and compared between the diseased and normal sides in each group. Results : The mean symptom duration was $0.6{\pm}0.4$ months and $5.4{\pm}2.7$ months for groups A and B, respectively (p<0.001). There were no differences in the demographics between the 2 groups. There was a significant difference in the CSA of the multifidus muscle between the diseased and normal sides (p<0.01) in group B. In contrast, no significant multifidus muscle asymmetry was found in group A. The CSA of the psoas muscle was not affected by disc herniation in either group. Conclusion : The CSA of the multifidus muscle was reduced by lumbar disc herniation when symptom duration was 3 months or more.

• 한국산학기술학회논문지
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• 제13권5호
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• pp.2133-2141
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• 2012

본 연구의 목적은 척추감압치료와 한의학적 치료법으로 치료된 요부디스크 탈출 6례에 관한 자기공명영상의 변화를 보고하는 것이다. 디스크 높이는 $T_2$-강조 자기공명영상의 시상면으로 측정되었다. 탈출된 디스크의 크기는 MRI와 디스크 탈출지수로 측정되었다. 디스크퇴행에 관한 등급체계와 연산은 MRI 신호강도, 디스크구조, 수핵과 섬유륜의 구별을 기초로 하였다. 디스크 높이, 디스크 탈출지수와 디스크 변성등급은 MRI로부터 측정하여 치료 전과 후에 수집되었다. 본 증례연구가 보여주는 것은 디스크 탈출에 대한 감압치료가 디스크 높이를 제외한 디스크 탈출지수, 디스크 재생에 긍정적인 영향을 미친다는 것이다. 디스크 탈출에 대한 감압치료의 사용에 관한 임상적 증거는 제한된 연구 때문에 미비하다. 따라서 이 분야에 주의를 기울이기 위한 더 많은 시도들은 명확한 결론을 내리기 위해서 필요할 것으로 사료된다.

• Journal of Korean Neurosurgical Society
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• 제38권2호
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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.

• 척추신경추나의학회지
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• 제2권1호
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• pp.49-57
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• 2007

Objectives : This study was performed to evaluate the effect of Bee Venom Acupuncture Therapy on Lumbar Spinal Stenosis. Methods : The patient was diagnosed as Lumbar Spinal Stenosis through Lumbar spine MRI and treated with Bee Venom Acupuncture Therapy and so on and measured of VAS and ODI score to evaluate treatment effects. Results and Conclusions : ROM of Lumbar, Milgram test and sensory test has improved. VAS and ODI score were also decreased.