• Title/Summary/Keyword: Lumbar X-ray

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Difference of Lumbar Lordosis in Patients with Low Back Pain and Controls (일부 요통환자와 대조군의 요추 전만도 차이)

  • Kim Byung-Gon;Yi Seung-Ju;Kang Jeom-Cuk;Park Rae-Joon
    • The Journal of Korean Physical Therapy
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    • v.12 no.2
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    • pp.185-190
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    • 2000
  • Objectives: The purpose of this study was to compare the difference of Lumbar Lordosis Angle(LLA) between patients with Low Back Pain(LBP) and control groups. Methods: Questionnaires were completed by 40 adult LBP patients seeking physical therapy services and by 40 controls at the Department of Physical Therapy. Saejong Neurosurgical Clinic in Taegu city from October 1999 to March 2000. LLA was measured on lateral x-ray films in a standing position. The angle between a line parallel to the top of the first Lumbar(L1) and the top of the fifth Lumbar(L5) was defined LLA. Results: LLA of $29.88^{\circ}$ for LBP patients was a statistically significant decrease from that of $35.31^{\circ}$ for controls in the difference of lumbar lordosis(p<0.01). There were statistically significant differences between senders in patient groups. Females$(32.32^{\circ})$ had significantly greater angles than males$(27.32^{\circ})$(p<0.05), while $36.63^{\curc}$ for female was also greater than $34.12^{\circ}$ for male in the controls. No significant difference was found between age. In patient groups, $27.95^{\circ}$ for below age 40 was a smaller than $32.32^{\circ}$ for above, however, $35.82^{\circ}$ for below age 40 was a little greater than $34.27^{\circ}$ for above in controls. Patients in a sitting posture had greater LLA$(31.35^{\circ}$ than those standing$(28.93^{\circ})$, however values for controls were similar to each other. Conclusion: Results from this study indicate that distinct differences exist among patients and controls and gender, whereas little difference exists in age and working posture.

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Investigation on the Relationship in Acute Lateral Tortipelvis and Breaks in Low Back Pain Patient (요통 환자에서 급성 측방 골반 뒤틀림과 Breaks와 상관관계 분석)

  • Jang, Gun;Lee, Gil-Jae;Lee, Byeong-Yee;Song, Yun-Kyung;Lim, Hyung-Ho
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.2 no.2
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    • pp.171-179
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    • 2007
  • Objectives : To investigate the relationship in acute lateral tortipelvis and breaks in low back pain patients with acute lateral tortipelvis were discussed. Methods : The subject of this study consisted of 43 patients who were diagnosed as acute lateral tortipelvis by X-ray and 23 patients who were diagnosed as none tortipelvis by X-ray. We investigated acute lateral tortipelvis and breaks on X-ray film. Results and Conclusions : In the distribution of acute lateral tortipelvis, L4 was 17 cases(39.5%), L3 was 14 cases(32.6%), L2 was 9 cases(18.6%), L1 was 4 cases(9.3%) in the sequence. In acute lateral tortipelvis group, the number of breaks was more than none tortipelvis group(p>0.05). The most common parity of breaks was L4-5 in low back pain patient. Between distribution of lumbar level of acute lateral tortipelvis and breaks, there was no significant relationship.

Correlations of Lumbar and Femoral Bone Mineral Densities with Calcaneal Speed of Sound in Osteoporotic Woman (골다공증 여성에서 요추골 밑 대퇴골 부위의 골밀도와 종골 음속 사이의 상관관계)

  • Lee, Kang-Il;Choi, Min-Joo
    • The Journal of the Acoustical Society of Korea
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    • v.28 no.6
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    • pp.542-547
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    • 2009
  • In this in vivo study, correlations of lumbar and femoral bone mineral densities (BMDs) with calcaneal speed of sound (SOS) were investigated in 36 osteoporotic women. Areal BMDs of the L2-L4 lumbar spine and the right femoral neck were measured by using dual energy X-ray absorptiometry (DEXA). SOS of the right calcaneus was measured by using ultrasound bone densitometry. Pearson's correlation coefficient (r) and level of significance (p) were used to evaluate the correlations between measurements. Lumbar BMD was highly correlated with femoral BMD (r=0.81). Lumbar and femoral BMDs exhibited similar comparable negative correlations with age (r=-0.52 and r=-0.55). A moderate negative correlation was found between calcaneal SOS and age (r=-0.45). Calcaneal SOS was significantly correlated with lumbar and femoral BMDs, with a higher correlation with femoral BMD rather than with lumbar BMD (r=0.54 and r=0.62). However, calcaneal SOS may not be an optimum index for the estimation of BMD of the most important fracture sites, such as the lumbar and the femur, because it showed lower correlations with lumbar and femoral BMDs compared to that with calcaneal BMD. Therefore, the development of a quantitative ultrasound technology for the direct measurement of acoustic properties at the lumbar and the femur is required to estimate BMD of these sites more accurately.

Effects of Active Release Technique and Lumbar Stabilization Exercise on Pelvic Asymmetry, Muscle Activation and Pain in Chronic Low Back Pain Patients (능동이완기법과 허리안정화 운동이 만성허리통증 환자의 골반비대칭, 근활성도 및 통증에 미치는 영향)

  • Nam, Seungmin
    • Journal of The Korean Society of Integrative Medicine
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    • v.8 no.1
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    • pp.147-157
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    • 2020
  • Purpose : The purpose of this study was to investigate the effects of active release technique and lumbar stabilization exercise on pelvic asymmetry, muscle activation and pain in chronic low back pain patients. Methods : The subjects were 37 outpatients diagnosed with chronic low back pain. The patients were randomly divided into an active release technique therapy group (ART; n=18), and lumbar stabilization exercise group (LSE; n=19). These groups performed their respective therapy for a 30-minute session occurring two times a week over six-weeks period. To assess the patients' pelvic asymmetry, their pelvic tilt, and pelvic rotation was measured using X-ray imaging. EMG was used to evaluate the muscle activity of the lumbar muscle. The visual analogue scale (VAS) were used to measure the subjects' pain. Results : Both ART group, and LSE group exhibited statistically significant differences in their subjects' VAS and muscle activation of lumbar muscle after the therapy (p<.05). In ART group exhibited statistically significant decreases in their subjects' pelvic tilt and pelvic rotation after therapy (p<.05). There was a significant difference between the ART group, and LSE group (p<.05). Conclusion : The results of this study suggest that active release technique and lumbar stabilization exercise are effective in decrease pain and increase muscle activation in chronic low back pain patient. In addition active release technique is considered to be more effective in improving pelvic tilt and pelvic rotation than lumbar stabilization exercise.

Bone mineral Density of lumbar Spine in Children With Spastic Quadriplegia and Spastic Diplegia (경직성 사지마비와 양하지마비 아동의 요추부 골밀도)

  • Song, Ju-Young;Kim, Jin-Sang
    • Physical Therapy Korea
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    • v.8 no.1
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    • pp.51-58
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    • 2001
  • In children with cerebral palsy, bone density is decreased by disturbance of bone remodelling due to lack of normal weight bearing and muscle contraction through physical activity. Loss of bone density cause fracture, delays treatment with immobilization, and leads to functional limitation. The purpose of this study was to investigate bone mineral density of lumbar spine in children with spastic quadriplegia and diplegia. Six spastic quadriplegia and 14 spastic diplegia were evaluated in this study. QDR 4500 X-ray densitometer was used to measure bone density at lumbar spine (L1~L4). Children with cerebral palsy showed lower bone density than that of normal children. Bone density in children with spastic quadriplegia and diplegia was $-1.812{\pm}.962$, $-1.519{\pm}.935$, respectively. However, there was no significant differences in bone density between children with spastic quadriplegia and diplegia. There was no significant difference in bone density relation to motor development level, height, and weight. Further study is needed to find the appropriate interventions for preventing loss of bone density in children with cerebral palsy.

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Effects of Manual Therapy Approach for Lumbar Spondylolisthesis (요추부 전방전위증 환자의 도수치료 효과 연구)

  • Kang, Seok-Yeong;Kim, Myung-Joon;Lee, So-Hee
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.16 no.2
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    • pp.34-39
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    • 2010
  • Purpose : The purpose of this study is to find out the evidence concerning the effectiveness of manual therapy intervention in the treatment of low back pain related to spondylolisthesis Methods : 12men with lumbar pain from L5~S1 spondylolisthesis of 2 or 3 grade were treated during 12-week period. The manual therapy applied twice per week. The results of back and radiating pain were measured by VAS, and abdominal muscle strength was measured by Power track II. The measurement of degree of slip in spondylolisthesis was confirmed by the lateral view of X-ray and took a measurements of the anterior displacement of a vertebral body in relation to the vertebral below. Results : 1. There was significant decrease in the back and radiating pain.(p<0.05) 2. There was significant increase in the abdominal muscle strength.(p<0.05). 3. There was significant decrease in the degree of the anterior displacement. Conclusion: The intervention of manual therapy for lumbar spondylolisthesis is effective in back pain, radiating pain, abdominal muscle strength and degree of the anterior displacement. So, nonsurgical treatment should be attempted before surgical treatment.

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A Case Report on the Thoracic & Lumbar Disc and Scoliosis Treated by Flexion-Distraction Technique (굴곡신연기법을 이용한 흉요추 추간판 탈출증과 척추 측만증의 치험 1례)

  • Kim, Se-Jong;Min, Boo-Ki;Yoon, Il-Ji;Oh, Min-Suck
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.1 no.2
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    • pp.73-80
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    • 2006
  • This study is designed to evaluate the effect of flexion-distraction technique for the patient with thoracic & lumbar disc and scoliosis. After flexion-distraction technique the. results of VAS of lumbago, orthopedics tests, cobb's angle were improved significantly. It is suggested that flexion-distraction technique might be effective for the patient with Thoracic & Lumbar Disc and Scoliosis.

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The Study of Diagnostic Results Discordance Analysis on BMD Using DEXA (이중에너지 X선 흡수 계측법을 이용한 골밀도 검사 시 진단불일치에 대한 분석)

  • Park, Won-Kyu;Kang, Yeong-Han;Jo, Gwang-Ho
    • Journal of radiological science and technology
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    • v.31 no.1
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    • pp.25-31
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    • 2008
  • Purpose : This study was conducted to understand for the diagnostic discordance of bone mineral density(BMD) in DEXA(Dual Energy X-ray Absorptiometry). And the diagnostic difference between lumbar spine and femur neck, forearm was evaluated using T-score. Materials and Methods : We studied 220 females measured BMD on lumbar spine, and femur neck, forearm including ward's triangle and ultra digital(UD). We were distinguished T-score into normal, osteopenia, osteoporosis(WHO classification) and evaluated discordance rate according to age and degree of bone loss. Correlation analysis and chi-square test between L-spine, L-4, femur neck, Ward, Forearm, UD were carried out. Results : In the lumbar spine, the number of normal were in 57(25.9%), osteopenia in 86(39.1%), osteoporosis in 77(35.0%). In the L-4 and ward's triangle, the number of osteoporosis were in 78(35.5%), in 126(57.3%). There was significant correlation between lumbar, femur neck and forearm BMD in all cases. The discordance of BMD between lumbar and femur were 57%, lumbar and forearm 43%, forearm and femur 51%. The discordance rates of normal, osteopenic, osteoporotic groups were 39%, 64%, 43%, respectively, showing the highest discordance rate in osteopenia patients. In normal group of lumbar spine, the discordance rate was 25%, 23%, 11%, 65%, 86% in 30', 40', 50', 60', 70', respectively. In osteopenia, osteoporosis group of lumbar spine, the discordance rate was 62%, 55%, 36%, 20%, 9% in 30', 40', 50', 60', 70', respectively. Conclusion : It was different of the results of BMD with lumbar, femur and forearm site. The discordance rate was decreased with age in osteopenia, osteoporosis lumbar spine. In osteopenia group, the discordance rate was the highest. So, it is necessary that the BMD of lumbar, femur neck and forearm should be checked.

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A study on uncertainty by passage of time of stereotactic body radiation therapy for spine metastasis cancer (척추 전이암 환자의 정위적방사선치료 시 시간 경과에 따른 불확실성에 관한 연구)

  • Cho, Yong Wan;Kim, Joo Ho;Ahn, Seung Kwon;Lee, Sang Kyoo;Cho, Jeong Hee
    • The Journal of Korean Society for Radiation Therapy
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    • v.27 no.1
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    • pp.79-86
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    • 2015
  • Purpose : The purpose of this study was to determine the proper treatment time of stereotactic body radiation therapy for spine metastasis cancer by using the image guidance system of CyberKnife(Accuray Incorporated, USA) which is able to correct movements of patients during the treatment. Materials and Methods : Fifty seven spine metastasis cancer patients who have stereotactic body radiation therapy of CyberKnife participate, 8 of them with cervical spine cancer, 26 of them with thoracic spine cancer, and 23 of them with lumbar spine cancer. X-ray images acquired during the treatment were classified by treatment site. From the starting point of treatment, motion tendency of patients is analyzed in each section which is divided into every 5 minutes. Results : In case of cervical spine, there is sudden increase of variation in 15 minutes after the treatment starts in rotational direction. In case of thoracic spine, there is no significantly variable section. However, variation increases gradually with the passage of time so that it is assumed that noticeable value comes up in approximately 40 minutes. In case of lumbar spine, sharp increase of variation is seen in 20 minutes in translational and rotational direction. Conclusion : Without having corrections during the treatment, proper treatment time is considered as less than 15 minutes for cervical spine, 40 minutes for thoracic spine, and 20 minutes for lumbar spine. If treatment time is longer than these duration, additional patient alignments are required or PTV margin should be enlarged.

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Evaluation of the Degenerative Changes of the Distal Intervertebral Discs after Internal Fixation Surgery in Adolescent Idiopathic Scoliosis

  • Dehnokhalaji, Morteza;Golbakhsh, Mohammad Reza;Siavashi, Babak;Talebian, Parham;Javidmehr, Sina;Bozorgmanesh, Mohammadreza
    • Asian Spine Journal
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    • v.12 no.6
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    • pp.1060-1068
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    • 2018
  • Study Design: Retrospective study. Purpose: Lumbar intervertebral disc degeneration is an important cause of low back pain. Overview of Literature: Spinal fusion is often reported to have a good course for adolescent idiopathic scoliosis (AIS). However, many studies have reported that adjacent segment degeneration is accelerated after lumbar spinal fusion. Radiography is a simple method used to evaluate the orientation of the vertebral column. magnetic resonance imaging (MRI) is the method most often used to specifically evaluate intervertebral disc degeneration. The Pfirrmann classification is a well-known method used to evaluate degenerative lumbar disease. After spinal fusion, an increase in stress, excess mobility, increased intra-disc pressure, and posterior displacement of the axis of motion have been observed in the adjacent segments. Methods: we retrospectively secured and analyzed the data of 15 patients (four boys and 11 girls) with AIS who underwent a spinal fusion surgery. We studied the full-length view of the spine (anterior-posterior and lateral) from the X-ray and MRI obtained from all patients before surgery. Postoperatively, another full-length spine X-ray and lumbosacral MRI were obtained from all participants. Then, pelvic tilt, sacral slope, curve correction, and fused and free segments before and after surgery were calculated based on X-ray studies. MRI images were used to estimate the degree to which intervertebral discs were degenerated using Pfirrmann grading system. Pfirrmann grade before and after surgery were compared with Wilcoxon signed rank test. While analyzing the contribution of potential risk factors for the post-spinal fusion Pfirrmann grade of disc degeneration, we used generalized linear models with robust standard error estimates to account for intraclass correlation that may have been present between discs of the same patient. Results: The mean age of the participant was 14 years, and the mean curvature before and after surgery were 67.8 and 23.8, respectively (p<0.05). During the median follow-up of 5 years, the mean degree of the disc degeneration significantly increased in all patients after surgery (p<0.05) with a Pfirrmann grade of 1 and 2.8 in the L2-L3 before and after surgery, respectively. The corresponding figures at L3-L4, L4-L5, and L5-S1 levels were 1.28 and 2.43, 1.07 and 2.35, and 1 and 2.33, respectively. The lower was the number of free discs below the fusion level, the higher was the Pfirrmann grade of degeneration (p<0.001). Conversely, the higher was the number of the discs fused together, the higher was the Pfirrmann grade. Conclusions: we observed that the disc degeneration aggravated after spinal fusion for scoliosis. While the degree of degeneration as measured by Pfirrmann grade was directly correlated by the number of fused segments, it was negatively correlated with the number of discs that remained free below the lowermost level of the fusion.