• 대한한방내과학회지
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• 제40권6호
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• pp.1248-1258
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• 2019

Objective: The purpose of this study was to report the radiological and symptomatic changes in a patient with acute herniated lumbar disc due to coughing, treated with megadose pharmacopuncture and combined Korean medicine. Methods: MRI examination diagnosed an acute lumbar disc herniation by coughing. We performed a combination treatment of megadose pharmacopuncture and integrated Korean medicine. NRS, ODI, EQ-5D, SLR test, and big toe extension test were checked on admission, after two weeks, on discharge, and after four months to confirm symptom improvements. Results: In the acute stage of lumbar intervertebral disc rupture, megadose pharmacopuncture combined with Korean medicine treatment showed improvement in NRS, ODI, EQ-5D, SLRT, and big toe extension tests. In addition, absorption of the herniated intervertebral discs was observed through an MRI scan on discharge. Conclusions: For patients with herniated lumbar disc acutely deteriorated by coughing, a combination of megadose pharmacopuncture with Korean medicine treatment may be a solution.

• The Korean Journal of Pain
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• 제30권4호
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• pp.281-286
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• 2017

Background: Magnetic resonance imaging (MRI) of the spine is the preferred diagnostic tool for pathologic conditions affecting the spine. However, in patients receiving epidural corticosteroid injection (ESI) for treatment of spinal diseases, there is a possibility of misreading of MR images because of air or fluid in the epidural space after the injection. Therefore, we defined the characteristics of abnormal changes in MRI findings following an ESI in patients with low back pain. Methods: We reviewed the medical records of 133 patients who underwent MRI of the lumbar spine within 7 days after ESI between 2006 and 2015. All patients were administered an ESI using a 22-gauge Tuohy needle at the lumbar spine through the interlaminar approach. The epidural space was identified by the loss of resistance technique with air. Results: The incidences of abnormal changes in MRI findings because of ESI were 54%, 31%, and 25% in patients who underwent MRI at approximately 24 h, and 2 and 3 days after ESI, respectively. Abnormal MRI findings included epidural air or fluid, needle tracks, and soft tissue changes. Epidural air, the most frequent abnormal finding (82%), was observed in 41% of patients who underwent MRI within 3 days after injection. Abnormal findings due to an ESI were not observed in MR images acquired 4 days after ESI or later. Conclusions: Pain physicians should consider the possibility of abnormal findings in MR images acquired after epidural injection using the interlaminar approach and the loss of resistance technique with air at the lumbar spine.

• The Journal of Korean Physical Therapy
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• 제14권3호
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• pp.136-144
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• 2002

The Purpose of this study was to compare the lumbar strength and lumbar flexor/extensor ratio between spondylolisthesis and herniated disc patients. The patients who had a subacute low back pain have been proved to each disease through MRI and we measured the maximal isometric strength of all patients(28) through MedX lumbar extension machine(Ocala, FL). In all patients, males had higher lumbar extensor strength than that of females. Especially, the spondylolisthesis patients had lower lumbar extensor strength than that of herniated disc patients. The statistical significant(p<.05, p<.01) differences were manifested in $48^{\circ},\;60^{\circ}\;and\;72^{\circ}$ between male groups. Also the statistical significant (p<.05) differences were manifested in $60^{\circ}\;and\;72^{\circ}$between female groups. In the lumbar flexor/ extensor ratio, the males of spondylolisthesis groups represented the functional weakness in the flexed portion of the range of motion, and the females of spondylolisthesis and the all patients of herniated disc represented the functional weakness in the extended portion of the range of motion. In conclusion, we may propose the program such that the spondylolisthesis males must increase the ratio of extended portion exercise, and the spondylolisthesis females and herniated disc patients must increase the ratio of flexed portion exercise.

• Investigative Magnetic Resonance Imaging
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• 제22권1호
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• pp.18-25
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• 2018

Purpose: To investigate the various imaging factors associated with aggravation of lumbar disc herniation (LDH) and develop a scoring system for prediction of LDH aggravation. Materials and Methods: From 2015 to 2017, we retrospectively reviewed the magnetic resonance imaging (MRI) findings of 60 patients (30 patients with aggravated LDH and 30 patients without any altered LDH). Imaging factors for MRI evaluation included the level of LDH, disc degeneration, back muscle atrophy, facet joint degeneration, ligamentum flavum thickness and interspinous ligament degeneration. Flexion-extension difference was measured with simple radiography. The scoring system was analyzed using receiver operating characteristic (ROC) analysis. Results: The aggravated group manifested a higher grade of disc degeneration, back muscle atrophy and facet degeneration than the control group. The ligamentum flavum thickness in the aggravated group was thicker than in the group with unaltered LDH. The summation score was defined as the sum of the grade of disc degeneration, back muscle atrophy and facet joint degeneration. The area under the ROC curve showing the threshold value of the summation score for prediction of aggravation of LDH was 0.832 and the threshold value corresponded to 6.5. Conclusion: Disc degeneration, facet degeneration, back muscle atrophy and ligamentum flavum thickness are important factors in predicting aggravation of LDH and may facilitate the determination of treatment strategy in patients with LDH. The summation score is available as supplemental data.

• 한국임상수의학회지
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• 제17권1호
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• pp.279-284
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• 2000

A 3.5kg, 3-year-old castrated male Japanese domestic cat withpelvic limb ataxia and dysuria was referred to the Veterinary Medical Center of the Tokyo University. On the neurologic examination findings, both pelivic had a LMN paresis. The cat was FeLV positive and FIV negative. Radiographic findings did not identify the spinal lesions. In magnetic resonance images(MRI) of the lumbar spinal cord, the cat had the lesions in the lumbar(L) 1 and L3, characterized by hyperintensity on a transverse T2-weighted and T1-weighted images, and contrast enhancement was evident. The mass removed by dorsal laminectomy. Histopathological examination of the mass revealed spinal lymphoma. Three weeks after the surgery, the cat administered chemotherapy protocol for lymphoma by current protocol. Two weeks after chemotherapy, the cat had a metastasis to bone marrow and died.

• The Korean Journal of Pain
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• 제29권4호
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• pp.270-273
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• 2016

Muscular hypertrophy is caused mainly due to myopathic disorder. But, it is also rarely produced by neurogenic disorder. A 74-year-old woman complained of right calf pain with hypertrophy for several years. Recent lumbar spine magnetic resonance imaging (MRI) showed central and lateral canal narrowing at the L4-L5 intervertebral space. Lower extremity MRI revealed fatty change of right medial head of the gastrocnemius and soleus, causing right calf hypertrophy. Electrodiagnostic examinations including electromyography and nerve conduction velocity testing demonstrated $5^{th}$ lumbar and $1^{st}$ sacral polyradiculopathy. Integrating all the results, the diagnosis was neurogenic muscle hypertrophy. Neurogenic muscle hypertrophy is very rare, but we recommend that clinicians consider this problem when a patient complains of lower limb hypertrophy and pain.

• Korean Journal of Radiology
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• 제24권3호
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• pp.224-234
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• 2023

Magnetic resonance imaging (MRI) is a standard imaging modality for diagnosing spinal stenosis, which is a common degenerative disorder in the elderly population. Standardized interpretation of spinal MRI for diagnosing and grading the severity of spinal stenosis is necessary to ensure correct communication with clinicians and to conduct clinical research. In this review, we revisit the Lee grading system for central canal and neural foraminal stenosis of the cervical and lumbar spine, which are based on the pathophysiology and radiologic findings of spinal stenosis.

• Journal of Korean Neurosurgical Society
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• 제57권4호
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• pp.295-297
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• 2015

We report the case of 57-year-old woman diagnosed with Charcot-Marie-Tooth (CMT) disease and lumbar disk herniation (LDH). She had left leg weakness and foot numbness, foot deformity (muscle atrophy, high arch, and clawed toes). The lumbar spine MRI showed LDH at L4-5. Additionally, electrophysiology results were consistent with chronic peripheral motor-sensory polyneuropathy (axonopathy). In genetic testing, 17p11.2-p12 duplication/deletions characteristic of CMT disease were observed. We confirmed the patient's diagnosis as CMT disease and used conservative treatment.

• 한방재활의학과학회지
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• 제27권3호
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• pp.107-115
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• 2017

Objectives This study is planned to classify correlation between HIVD of L-spine MRI and Digital Infrared Thermal Image (DITI). Methods We measured the temperature of both leg whose 120 men and 116 women patients with lumbar pain in Bucheon Jaseng Korean Medicine Hospital. And We use Magnetic Resonance Imaging (MRI) for classifying the patients who has lumbar intervertebral disc or not. Results 1) There was no statistical relation between difference of both leg's temperature and gender (p>0.05). 2) There was meaningful statistical relation between difference of both leg's temperature and age (p<0.05). 3) There was meaningful statistical relation between direction of HIVD of L-spine and direction of temperature reduction. 4) There was meaningful statistical relation between the severity of HIVD of L5/S1 and degree of temperature reduction. But there was no statistical relation between the severity of HIVD of L3/4, L4/5 and degree of temperature reduction. Conclusions We can use Digital Infrared thermal image (DITI) on low back pain patients for diagnosis. But we should not use DITI alone. DITI has limit in diagnosis.

• Journal of Korean Neurosurgical Society
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• 제41권6호
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• pp.377-381
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• 2007

Objective : The aim of this study was to evaluate the morphometric changes in neuroforamen in grade I isthmic spondylolisthesis by anterior lumbar interbody fusion [ALIF]. Methods : Fourteen patients with grade I isthmic spondylolisthesis who underwent single level ALIF with percutaneous pedicle screw fixation were enrolled. All patients underwent standing lateral radiography and magnetic resonance imaging [MRI] before surgery and at 1 week after surgery. For quantitative analysis, the foraminal height, width, epidural foraminal height, epidural foraminal width, and epidural foraminal area were evaluated at the mid-portion of 28 foramens using T2-weighted sagittal MRI. For qualitative analysis, degree of neural compression in mid-portion of 28 foramens was classified into 4 grades using T2-weighted sagittal MRI. Clinical outcomes were assessed using Visual Analogue Sale [VAS] scores for leg pain and Oswestry disability index before surgery and at 1 year after surgery. Results : The affected levels were L4-5 in 10 cases and L5-S1 in 4. The mean foraminal height was increased [p<0.001], and the mean foraminal width was decreased [p=0.014] significantly after surgery. The mean epidural foraminal height [p<0.001], epidural foraminal width [p<0.001], and epidural foraminal area [p<0.001] showed a significant increase after surgery. The mean grade for neural compression was decreased significantly after surgery [p<0.001]. VAS scores for leg pain [p=0.001] and Oswestry disability index [p=0.001] was decreased significantly at one year after surgery. Conclusion : Foraminal stenosis in grade I isthmic spondylolisthesis may effectively decompressed by ALIF with percutaneous pedicle screw fixation.