• Title/Summary/Keyword: Lumbar magnetic resonance imaging

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The Study on Effectiveness of Oriental Medicine Treatment for Lumbar Disc Herniation Inpatients on 208 Cases (요추 추간판 탈출증 입원환자 208례를 통한 한방치료의 효과 연구)

  • Jung, Jae-Hoon;Kim, Won-Woo;Seong, Ik-Hyun;Lee, Kap-Soo;Cho, Chang-Young;Kum, Chang-Jun;Kim, Hee-Jung;Ha, In-Hyuk
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.1
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    • pp.77-86
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    • 2013
  • This study was introduced the short-term effectiveness of Oriental medicine treatment for lumbar disc herniation inpatients. We selected 208 inpatients with a magnetic resonance imaging(MRI)-confirmed lumbar disc herniation since June 2012 until August 2012. Their demographics characterisitics, numeric rating scale(NRS) and Oswestry back-related disability index(ODI) for low or leg pain, lumbar flexion and extension angle were assessed at baseline and when discharged from the hospital. When it measured the straight leg raisingscale(SLR), the low side of the angle was examined. Treatment every patient has received as follow; herbal medicine, bee venom, acupuncture and physical examination, spinal manipulation. NRS of low back pain and leg pain and ODI is $5.6{\pm}2.3$, $4.9{\pm}2.8$ and $45.5{\pm}20.0$, respectively at baseline and $2.8{\pm}1.8$, $2.7{\pm}1.9$ and $27.2{\pm}14.1$, respectively when discharged from the hospital. range of motion(ROM) of lumbar flexion and extension angle and SLR is $70.0{\pm}27.1$, $15.4{\pm}7.2$ and $61.3{\pm}23.0$ respectively at baseline and $80.5{\pm}16.9$, $18.25{\pm}4.1$ and $73.2{\pm}14.0$, respectively when discharged from the hospital. It shows that statistically significant improved(P<0.001). Furthermore, regarding patient satisfaction with the treatment, excellent(33.7%), good(55.4%), normal(10.4%), poor(0.5%), it suggests that most patients(89%) satisfied with the treatment.

Imaging Features of Solitary Spinal Plasmacytoma in a Dog (개 척추에서 발생한 고립성 형질세포종의 자기공명영상 증례)

  • Keh, Seo-Yeon;Choi, Mi-Hyun;Lee, Nam-Soon;Kim, Tae-Hyun;Jang, Jae-Young;Kim, Hyun-Wook;Yoon, Junghee
    • Journal of Veterinary Clinics
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    • v.31 no.3
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    • pp.237-240
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    • 2014
  • A 12-year-old, intact, female Alaskan malamute presented with severe spinal pain and hind limb lameness. On radiographs, a round, demarcated lytic lesion was identified in the central fifth lumbar vertebra. On magnetic resonance imaging (MRI), the lesion involving the spinal cord appeared hypointense on T1 weighted, hyperintense on T2 weighted, heterogeneously enhanced on post-contrast T1 weighted, and hypointense on GE images. A focal, small, ill-defined, lytic lesion was also observed radiographically in the sixth lumbar vertebra, it appeared as a focal hyperintense lesion on T1 weighted, T2 weighted, and GE images and showed focal enhancement on post-contrast T1 weighted images. She was euthanized owing to extreme pain and severe and progressive clinical signs; a plasmacytoma was histopthologically diagnosed. This report presents an unusual type of spinal tumor, plasmacytoma. MRI is a useful modality to evaluate the anatomic location and extension of spinal lesions.

Imaging of Sequestered Lumbar Discs (요추 분리추간판의 영상 소견)

  • Gangwon Jeong;Heecheol Park;Sun Joo Lee;Dae-Hyun Park;Sung Hwa Paeng;Eugene Lee
    • Journal of the Korean Society of Radiology
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    • v.85 no.1
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    • pp.3-23
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    • 2024
  • Intervertebral disc herniation is frequently encountered in radiological practice. Sequestered disc herniation occurs when the disc material undergoes degeneration and completely loses continuity with the parent nucleus pulposus. Sequestered discs can reside within and outside the spinal canal, exerting a mass effect on adjacent structures, compressing nerve pathways, and eliciting a range of clinical symptoms. In particular, sequestered discs within the dura cannot be identified without durotomy. Therefore, precise preoperative localization is crucial for surgical planning. On MRI, the signal intensity of the sequestered disc may vary due to independent degeneration processes. Additionally, most sequestered disc fragments show varying degrees of peripheral enhancement depending on the degree of angiogenesis and granulation around the isolated tissue. In this article, we review various imaging findings and the location of the sequestered disc to provide patients with an accurate diagnosis and appropriate treatment direction.

Case Report of 6 Patients Not Improved after Conservative Treatment of Herniated Lumbar Intervertebral Disc (요추간판탈출증으로 보존적 치료후 호전되지 않는 환자 6 례 보고)

  • Lee, Sam-Ro;Kim, Hyun-Jung;Byun, Jae-Young;Ahn, Soo-Gi;Lee, Jong-Deok
    • Journal of Acupuncture Research
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    • v.17 no.3
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    • pp.265-276
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    • 2000
  • Objectives : The purpose of this study is to observe the clinical characteristics of 6 patients who were not improved after admitted conservative treatment in this 311 patients. Methods : We retrospectivety reviewed 311 patients of Herniated Lumbar Intervertebral Disc which undenvent admitted conservative treatment from November 1997 to June 2000. 311 patients were diagnosed by computed tomography or magnetic resonance imaging in addition to physical examination. Other complications were not detected in 311 patients with Hemiated Lumbar Intervertebral Disc. In case that the scoliosis appeared to caused by severe pain, we included this scoliosis patient with the object of survey. Results : 1. In 6 patients who were not improved, 4 patients were large herniation and 2 patients were medium herniation. 2. In all of 6 patients, the angle of straight leg raising test was low and was not imporved unril discharge. 3. X-ray findings showed straightening in all of 6 patients, disc space narrowing in 3 of 6 patients. 4. X-ray findings showed scoliosis in 3 of 4 patients who were severe pain. 5. The onset was relarively long from 30 days to 7 years. 6. The age was relatively young from 10's to 30's. 7. The adimission date was ralatively long from 32 days to 105 days. Conclusions : In 6 patients, there were observed much volume of disc herniation, low angle of straight leg raising test, young people in an age group, straightening of x-ray finding.

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Fistula Formation Between the Disc and Dura after Percutaneous Endoscopic Lumbar Discectomy - A Case Report - (경피적 내시경 요추 추간판 절제술 후 발생한 추간판과 경막 사이의 누공 형성 - 증례 보고 -)

  • Kim, Hak Sun;Kim, Hyoung Bok;Chung, Hoon-Jae;Yang, Jea Ho
    • Journal of Korean Society of Spine Surgery
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    • v.25 no.4
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    • pp.180-184
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    • 2018
  • Study Design: Case report Objectives: To document fistula formation between the disc and dura by an unrecognized dural tear after percutaneous endoscopic lumbar discectomy (PELD). Summary of Literature Review: The risk of durotomy is relatively low with PELD, but cases of unrecognized durotomies have been reported. An effective diagnostic tool for such situations has not yet been identified. Materials and Methods: A patient twice underwent transforaminal PELD under the diagnosis of a herniated lumbar disc at L4-5. She still complained of intractable pain and motor weakness around the left lower extremity at 6 months postoperatively. Magnetic resonance imaging showed no specific findings suggestive of violation of the nerve root. However, L5 and S1 nerve root injury was noted on electromyography. An exploratory operation was planned to characterize damage to the neural structures. Results: In the exploration, a dural tear was found at the previous operative site, along with a fistula between the disc and dura was also found at the dural tear site. The durotomy site was located on the ventrolateral side of the dura and measured approximately 5 mm. The durotomy site was repaired with Nylon 5-0 and adhesive sealants. The patient's preoperative symptoms diminished considerably. Conclusions: Fistula formation between the disc and dura can be caused by an unrecognized dural tear after PELD. Discography is a reliable diagnostic tool for fistulas formed by an unrecognized durotomy.

Effects of Korean Medical Combination Treatment for Lumbar Spinal Herniated Intervertebral Disc : accompanying or not High-intensive zone(HIZ) (요추 추간판 탈출증에 대한 한방 치료의 효과 연구 : High-intensive zone(HIZ) 유무에 따라)

  • Jang, Jae Won;Lee, Ji Won;Roh, Ji Ae;Lee, Gi Eon;Kim, Hyun Joong;Hong, Jung Soo;Kim, Dong Jin
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.13 no.2
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    • pp.47-63
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    • 2018
  • Objectives : The purpose of this study was to analyze the effects of lumbar spinal herniated intervertebral Disc on MRI accompanying or not High-intensive zone(HIZ) by Korean Medical Combination Treatment Methods : 324 patients who received inpatient treatment from January 2017 to September 2017 in the Daejeon-Jaseng of Korean Medicine Hospital were divided into 2 groups by High-intensive zone(HIZ) confirmed with a Lumbar spine magnetic resonance imaging. All patients received a combination of treatment including acupunture, chuna manual therapy, pharmacopunture, herbal medication. They were compared and analyzed on the basis of improvement between measuring Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), EuroQol-5 Dimension Index (EQ5D Index), physical examination as they were hospitalized and as they were discharged. The statistically significance was evaluated by SPSS 18.0 for windows. Results : After treatment, Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), EuroQol-5 Dimension Index (EQ5D Index), physical examination was improved respectively. But there was no statistically significance between 2 group's improvement after treatment. Conclusions : After inpatient treatment by Korean Medical Combination Treatment, Most patient's pain, disability and Health Related Quality of Life was improved significantly. But there was no statistically difference between accompanying or not High-intensive zone(HIZ). So We think that future research of higher quality and correct statistics shall be necessary.

The Effect of Complex Korean Medicinal Treatment with Chuna Manual Therapy and Radiological Characteristics on 2 Cases of Chronic Pain after Spondylolisthesis Posterior Lumbar Fusion Surgery: Cases Report (척추전방전위증 요추 후방유합술 이후 만성통증 환자 2례를 대상으로 추나 치료를 적용한 한방복합치료 효과와 영상의학적 특성: 증례 보고)

  • Jeong, Hyeon-Gyo;Kim, Yu-Gon;Kim, Dae-Ho;Lim, Jin-Woong;Kim, Yong-Hwa;Kang, Deok;Jeong, Hwe-Joon;Shin, Kyung-Moon;Shin, Dong-Hoon;Yang, Jae-Woo;Oh, Ji-Hoon
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.16 no.2
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    • pp.79-86
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    • 2021
  • Objectives This study aimed to assess the role of complex Korean medicinal treatment with Chuna manual therapy in two patients with chronic pain after posterior lumbar fusion surgery. Methods A retrospective analysis was performed on 2 patients postoperatively based on their medical records. The surgery regions were verified using T2-weighted axial magnetic resonance imaging. Patients with chronic pain after spondylolisthesis posterior lumbar fusion surgery received complex Korean medicinal treatment with Chuna manual therapy during hospitalization. Numeric rating scale (NRS) in the degree of 0-10 and Oswestry disability index (ODI) were measured before and after treatment. Results Case 1 had an improved NRS score from 7 to 4, and Case 2 had an improved NRS score from 7 to 5. In addition, ODI score improved in both cases. Conclusions Complex Korean medicinal treatment with Chuna manual therapy is effective for relief from chronic pain after posterior lumbar fusion surgery.

Comparison of mDixon, T2 TSE, and T2 SPIR Images in Magnetic Resonance Imaging of Lumbar Sagittal Plane (요추 시상면 자기공명 영상검사에서 mDixon과 T2 TSE, T2 SPIR 영상의 비교 연구)

  • Jung, Da-Bin;Lee, Hae-Kag;Heo, Yeong-Cheol
    • Journal of the Korean Society of Radiology
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    • v.15 no.6
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    • pp.927-933
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    • 2021
  • The purpose of this study was to compare and analyze the differences in scan time, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) in the third lumbar vertebral region including the back fat, spinal cord, and cerebrospinal fluid using the mDixon, T2 TSE, and T2 spectral pre-saturation with inversion-recovery (SPIR) techniques. With the factors affecting the SNR fixed, the lumbar sagittal plane images of 30 adults were compared on mDixon, T2 TSE, and T2 SPIR imaging tests. The test times for mDixon, T2 TSE, and T2 SPIR were 115 seconds, 60 seconds, and 60 seconds, respectively. The mDixon T2 images showed higher SNR than the T2 TSE images at the third lumbar vertebral region (p<0.05), lower SNR in the back fat and cerebrospinal fluid (p<0.05) areas, and comparable SNR in the spinal cord (p>0.05). The CNR between the third lumbar vertebral area and back fat was higher in the mDixon T2 images, and the CNR of the cerebrospinal fluid and spinal cord images was higher in the T2 TSE images (p<0.05). The mDixon T2 FS images CNR was lower for the 3rd lumbar vertebral body region and back fat than the T2 SPIR images, and higher for the spinal cord and cerebrospinal fluid images (p<0.05). The CNR between the third lumbar body and back fat areas was higher in the mDixon T2 FS images (p<0.05), and there was no difference in the CNR in the images of the cerebrospinal fluid and the spinal cord (p>0.05). It is difficult to determine whether the mDixon technique is superior to the conventional T2 TSE and T2 SPIR techniques in terms of test time, SNR, and CNR. This study was confined to patients with simple lower back pain and was limited by controlled experimental conditions. Studies using clinically applied protocols are warranted in the future.

MR Imaging Characteristics of Primary T-Cell Lymphoma of the Cauda Equina: A Case Report and Literature Review (말총의 원발성 T세포 림프종에서 MR 영상 소견: 증례 보고와 문헌 고찰)

  • Younguk Kim;Guen Young Lee;Sujin Kim;Kwang-sup Song;Hee Sung Kim
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1613-1618
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    • 2021
  • Primary central nervous system lymphoma is a rare form of extranodal non-Hodgkin lymphoma, and primary T-cell lymphoma of the cauda equina is extremely rare. We describe a case involving a 56-year-old female who presented with low back pain and radiating leg pain for 4 months. MRI of the lumbar spine revealed an elongated, multinodular intradural lesion of approximately 10 cm from the L4 body to the S2 body level with iso-signal intensity on T1-weighted imaging, heterogeneous iso- and high-signal intensity on T2-weighted imaging, and a heterogeneous intense enhancement on gadolinium contrast-enhanced T1-weighted imaging. A peripheral T-cell lymphoma of the cauda equina was diagnosed on the basis of immunohistochemical and T-cell receptor gamma gene rearrangement analysis after intradural biopsy of the mass.

A Study on Clinical Findings about Vertebral Disease Diagnosed with MRI (MRI로 진단된 척추질환의 임상적 소견)

  • Kim, Ham-Gyum
    • Journal of radiological science and technology
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    • v.29 no.3
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    • pp.157-165
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    • 2006
  • In order to analyze clinical characteristics like sex- and age-based onset frequency and onset region from vertebral disease cases, this study investigated total 1,291 cases of vertebral disease that were diagnosed via magnetic resonance imaging(MRI) from January to December 2004 at B University Hospital in metropolitan area. For higher diagnostic accuracy in cases of spinal disorder diagnosed, this study analyzed findings from data reading conducted by veteran specialists in diagnostic radiology. But this study excluded uncertain lesion cases, the cases requiring differential diagnosis from other disorders and so on from subjects under analysis. This study employed superconductive 1.5 Tesla SIGNA MR/i for MRI test and basically received resulting images via FSE(fast spin echo). In particular, this study obtained T1 and T2 myelogram with regard to regional characteristics(such as cervical vertebrae, thoracic vertebrae and lumbar vertebra) and imaging characteristics for sagittal and transverse section. As a result, this study came to the following conclusions : 1. In terms of general characteristics of subjects under analysis, male group comprised 53.5% and female 46.5% out of total 1,291 subjects. 2. The regional onset frequency of spinal disorders was converged primarily on lumbar vertebra(65.5%), which was followed by cervical vertebrae(27.3%) and thoracic vertebrae(7.0%) respectively. 3. Top 10 cases with high onset frequency of spinal disorders can be listed as follows : 1) posterior bulging disc 65.8% 2) narrowing of neural foramen 23.8% 3) herniated intervertebral disc (HIVD) 22.4% 4) spinal stenosis 16.7% 5) osteochondrosis 6.4% 6) compression fracture 6.4% 7) facet joint arthropathy 6.2% 8) spondylolisthesis 6.0% 9) spinal cord tumor 3.5% 10) inter body fusion 2.6%

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