• Journal of Korean Neurosurgical Society
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• v.38 no.6
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• pp.481-483
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• 2005

We report a rare case of spontaneous spinal subdural hematoma[SSDH]. A 63-year-old man presented with radicular pain and paraparesis on both legs for several months. On magnetic resonance images, SSDH was found in lumbar region. Electrodiagnostic report showed bilateral lumbosacral polyradiculopathy, such as cauda equina syndrome. SSDH was drained with lumbar drainage at L4-5 level without direct exploration. The patient improved after drainage of the hematoma and then he was able to walk independently.

• The Journal of Korean Physical Therapy
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• v.19 no.3
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• pp.41-46
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• 2007

Purpose: This study was to investigate how dose the radiography findings are to magnetic resonance (MR) image findings in the L5-S1 instability patients. The subjects of this study were comprised of eleven males and fifteen females, who had Lumbago and agreed with this research. Methods: Radiography and MR images of Lumbar spine were acquired respectively from subjects in conditions of maximum flexion and extension. The horizontal and angular displacements in lumabosacral spine radiography were used to assess the instability of lumbar spine. MR images were also used to evaluate the intervertebral disc abnormalities and change of bone marrow. Results: The results are as follows. 1. In the case of flexion transitional displacement proposed by Dupuis et al, the specificity and negative predictive value were good accuracy ($0.7{\sim}0.8$), and the negative predictive value was in average. In the case of extension displacement, the negative predictive value was about average ($0.6{\sim}0.7$), but the sensitivity, specificity and positive predictive value were below the poor (<0.6). On the other side, the specificity was about average but other things were below in the case of angular displacement. 2. In the case of flexion transitional displacement proposed by Dupuis et al., compared with the intervertebral disc abnormalities, the negative prediction value was excellent, the sensitivity good, and the specificity about average. In the case of extension, the negative prediction value was about average, but the other things were poor. On the other side the specificity and negative predictive value had good accuracy and the sensitivity and positive prediction value were below average in the case of angular displacement. Conclusion: The above results show that the radiography finding is sufficiently helpful to find the lumbar spine instability as an economic point of view.

• The Korean Journal of Pain
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• v.31 no.2
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• pp.87-92
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• 2018

Background: An epidural steroid injection (ESI) is a commonly administered procedure in pain clinics. An unintentional lumbar facet joint injection during interlaminar ESI was reported in a previous study, but there has not been much research on the characteristics of an unintentional lumbar facet joint injection. This study illustrated the imaging features of an unintentional lumbar facet joint injection during an interlaminar ESI and analyzed characteristics of patients who underwent this injection. Methods: From December 2015 to May 2017, we performed 662 lumbar ESIs and we identified 24 cases (21 patients) that underwent a lumbar facet joint injection. We gathered data contrast pattern, needle approach levels and directions, injected facet joint levels and directions, presence of lumbar spine disease as seen on magnetic resonance images (MRI), and histories of lumbar spine surgeries. Results: The contrast pattern in the facet joint has a sigmoid or ovoid contrast pattern confined to the vicinity of the facet joint. The incidence of unintentional lumbar facet joint injection was 3.6%. The mean age was 68.47 years. Among these 21 patients, 14 (66.7%) were injected in the facet joint ipsilaterally to the needle approach. Among the 20 patients who received MRI, all (100%) had central stenosis and 15 patients (75%) had severe stenosis. Conclusions: When the operator performs an interlaminar ESI on patients with central spinal stenosis, the contrast pattern on the fluoroscopy during interlaminar ESI should be carefully examined to distinguish between the epidural space and facet joint.

• Korean Journal of Digital Imaging in Medicine
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• v.13 no.4
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• pp.145-151
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• 2011

The purpose of this study is to know some changes of resolution and image if we remove scattered ray using lead plate when doing lumbar lateral projection. Using 3 DR system(2 FD types, 1 CCD type) equipments and 2 film system equipments, we gain the image whether the phantom of abdomen equivalent sticking resolution chart has lead plate or not, whether we do collimation or not. Also, we use ion chamber, measure radiation exposure rate and change to entrance surface dose from it. we gain that images in the greatest condition of taking in clinic. 5 people in this group decoded resolution with our eyes, measured thickness of images and compared them from each equiments. Resolution has difference to size of collimation in DR FD type. Also there is no difference the original image with the new image which we abbreviated mAs. In DR CCD type, resolution didn't have difference whether lead plate is or not and whether we do collimation or not. In film type, existing or nonexisting of lead plate didn't influence on resolution. Lead plate makes the quality of image higher due to reducing scattered ray, it doesn't influence on resolution.

• Journal of Korean Neurosurgical Society
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• v.53 no.1
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• pp.31-38
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• 2013

Objective : Asymptomatic patients show high degeneration prevalence at lumbar disc in previous literatures. Unfortunately, there are few Korean data, so the authors attempted to analyze the prevalence of disc degeneration in highly selective asymptomatic Korean subjects using MRI. Methods : We performed 3 T MRI sagittal scans from T12 to S1 on 102 asymptomatic subjects (50 men and 52 women) who visited our hospital between the ages of 14 and 82 years (mean age 46.3 years). All images were read independently by three observers (two neurosurgeons and one neuroradiologist) who were not given any information about the subjects. We classified grading for lumbar disc herniation (HN), annular fissure (AF), and nucleus degeneration (ND), using disc degeneration classification. Results : The prevalence of HN, AF, and ND were 81.4%, 76.1%, and 75.8% respectively. Almost all levels showed an age-related proportional tendency with some exceptions. Conclusion : In asymptomatic Korean subjects, the abnormal findings showed high prevalence of AF, ND, and extrusion. Especially in young ages, the authors found that bulging, protrusion, and AF showed high prevalence at L4/5 and L5/S1. And ND showed high prevalence at L5/S1. So, all lumbar disc degenerations are not pathologic, especially in children and adolescents.

• Journal of the Korea Society of Computer and Information
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• v.18 no.8
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• pp.27-31
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• 2013

In this paper, we propose a new quantization method using fuzzy C-means clustering(FCM) for lumbar ultrasound image recognition. Unlike usual histogram based quantization, our method first classifies regions into 10 clusters and sorts them by the central value of each cluster. Those clusters are represented with different colors. This method is efficient to handle lumbar ultrasound image since in this part of human body, the brightness values are distributed to doubly skewed histogram in general thus the usual histogram based quantization is not strong to extract different areas. Experiment conducted with 15 real lumbar images verified the efficacy of proposed method.

• Journal of Korean Medicine Rehabilitation
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• v.19 no.4
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• pp.151-163
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• 2009

Objectives : In the assessment of the lumbar spine by magnetic resonance imaging (hereinafter, "MRI"), changes in the paraspinal muscles are overlooked. The purpose of our study is to examine the correlation between the multifidus muscle atrophy on MRI findings and the clinical findings in low back pain (hereinafter, "LBP") patients. Methods : The retrospective study on 38 LBP patients, presenting either with or without associated leg pains, was undertaken. The MRI findings on the patients were visually analysed to find out a lumbar multifidus muscle atrophy, disc herniation, disc degeneration, spinal stenosis and nerve root compressions. The clinical history in each case was obtained from their case notes and pain drawing charts. Results : The lumbar multifidus muscle atrophy has occurred from more than 80% of the patients with LBP. Most of lumbar multifidus muscle atrophies have increased from lower level of lumbar spine. It was bilateral in the majority of the cases. In addition, multifidus muscle atrophy was correlated to the patient's age, disc degenerations and spinal stenosis. On the contrary, gender, the duration of LBP, referred leg pain, disc herniation and nerve root compressions had no relevance to multifidus muscle atrophies. Therefore, when assessing the MRIs of the lumbar spine, we should have more attetion on multifidus muscle, because it has lot's of information about spinal neuropathy problems. Conclusions : Therefore, the examination of multifidus muscle atrophies should be considered when assessing the MRIs of the lumbar spine. In addition, it helps to evaluate and plan the treatment modalities of LBP. Moreover, it prevents from LBP by discovering the importance between the multifidus muscle and the spine stabilization exercise.

• The Korean Journal of Pain
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• v.23 no.1
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• pp.18-23
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• 2010

Background: Complications following lumbar transforaminal epidural injection are frequently related to inadvertent vascular injection of corticosteroids. Several methods have been proposed to reduce the risk of vascular injection. The generally accepted technique during epidural steroid injection is intermittent fluoroscopy. In fact, this technique may miss vascular uptake due to rapid washout. Because of the fleeting appearance of vascular contrast patterns, live fluoroscopy is recommended during contrast injection. However, when vascular contrast patterns are overlapped by expected epidural patterns, it is hard to distinguish them even on live fluoroscopy. Methods: During 87 lumbar transforaminal epidural injections, dynamic contrast flows were observed under live fluoroscopy with using digital subtraction enhancement. Two dynamic fluoroscopy fluoroscopic images were saved from each injection. These injections were performed by five physicians with experience independently. Accuracy of live fluoroscopy was determined by comparing the interpretation of the digital subtraction fluoroscopic images. Results: Using digital subtraction guidance with contrast confirmation, the twenty cases of intravascular injection were found (the rate of incidence was 23%). There was no significant difference in incidence of intravascular injections based either on gender or diagnosis. Only five cases of intravascular injections were predicted with either flash or aspiration of blood (sensitivity = 25%). Under live fluoroscopic guidance with contrast confirmation to predict intravascular injection, twelve cases were predicted (sensitivity = 60%). Conclusions: This finding demonstrate that digital subtraction fluoroscopic imaging is superior to blood aspiration or live fluoroscopy in detecting intravascular injections with lumbar transforaminal epidural injection.

• The Journal of Korean Physical Therapy
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• v.23 no.6
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• pp.9-14
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• 2011

Purpose: The pelvic tilting exercise is a well recognized rehabilitation maneuver. However, little information is available on the changes of lumbar segmental motion during pelvic tilting. This study was conducted to measure the kinematics of the pelvic tilting exercise on the supine and prone positions via fluoroscopy. Methods: A total of 10 female subjects were enrolled. During anterior, neutral, and posterior pelvic tilting, radiographs were taken in each exercise via fluoroscopy (ARCADIS Orbic, Siemens, USA). Images were sent to the picture archiving communication system (PACS), and the digitized images were analyzed using LabVIEW software (National Instruments, USA). Lumbosacral lordosis and the intervertebral body angle, intervertebral disc angle, and intervertebral displacement were analyzed. Results: The results of lumbar kinematic analysis during three tilting postures in the supine and prone positions demonstrated that lumbosacral lordosis and the intervertebral body angle and intervertebral disc angle were significantly higher when the pelvis was tilted anteriorly (p>0.05). However, there was no significant difference between anterior and neutral tilting in the intervertebral disc angle at the L3/4 level in the prone position (p>0.05), and there was no significant difference among tilting positions in intervertebral body displacement in the prone position (p>0.05). Conclusion: This study provides scientific evidence about the pelvic tilting exercise in lumbosacral segmental motion. Depending on the pelvic tilting exercise, kinematic changes were demonstrated in both positions, especially in the supine position. It is suggested that the supine position is effective for mobility, but it should be used carefully for the LBP (Low back pain) patient with hypermobility.

• Journal of the Korean Orthopaedic Association
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• v.55 no.3
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• pp.261-265
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• 2020

A lumbar juxtafacet cyst is a rare disease that causes low back pain, radiculopathy and neurological claudication by compressing the nerve roots. A 34-year-old male complained of severe low back pain and radicular pain in the right lower extremity. Magnetic resonance images revealed a cyst at the lateral recess of the spinal canal between the L3-4 disc and posterior facet joint that extended to the L4 body level. Under the guidance of an image intensifier, needle aspiration of the cyst was performed, which extracted 1.5 ml of serous, yellowish colored fluid. After the aspiration, the symptoms subsided dramatically. The follow-up magnetic resonance images showed no recurrence of the cyst. To the best of the author's knowledge, there are no reports of lumbar juxtafacet cyst treated with needle aspiration in Korea. This case is reported with a review of the relevant literature.