• Title/Summary/Keyword: Lumbar spinal disease

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Analysis on Ga-Rak market workers' disease and treatment of Traditional Korean Medicine(TKM) (pilot study) (가락시장 근로자의 병증과 한의학적 치료에 대한 예비 분석)

  • Yoo, Jae-Ryong;Song, Ho-Sueb
    • Journal of Pharmacopuncture
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    • v.7 no.2
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    • pp.109-119
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    • 2004
  • Objective : To broaden our understanding on occupational disease of market workers and to evaluate the effect of TKM treatment focusing on acupuncture and herb medicine and to promote base studies and clinical trials on occupational disease. Materials and Methods : Analysis was done on 33 Ga-Rak market workers' chart which had been selected through investigation of 1508 outpatient's chart of Kyung Won University Hospital from Jun. 1st, 2002 to May. 31th, 2003. Results : 1. Out of 33 patients, Men had more occupational diseases than women had and Most people were in their forties. 2. Major cause of the disease include repetitve bending, heavy weight lifting and overwork. 3. Past History of patients mostly include frequent lumbar sprain, periarthritis of shoulder, lumbar HNP 4. The patients with occupational disease were diagnosed as lumbar sprain, periarthritis of shoulder, lumbar HNP, degenerative spondylosis, spinal stenosis and their chief complaints were low back pain, omalgia, back pain with radicular pain. 5. The duration of treatment was mostly within a week. 6. Acupuncture, Bee Venom Acupuncture, moxibustion, Herb-medicine, extract, taping therapy, physical therapy were used as treatment methods. 7. Applied herb medicine were composed of 8 kinds of prescriptions and extract were made up of 6 prescriptions 8. Applied acupoints belonged mainly to 14 meridians 9. The treatment of herb medicine combined with acupuncture proved effective in treating the ocupational disease. Conclusion : The occupational disease of patients working in Ga-Rak market were closely related with overwork, especially with repetitive bending and heavy weight lifting and TKM treatment focusing on acupuncture combined with herb medicine was effective in treating occupational disease.

Alteration of the Static Posture of Spine under Different Types and Amounts of Loading (가방 하중의 크기와 방식에 따른 척추 정적 자세의 변화)

  • Park, Yong-Hyun;Kim, Young-Kwan;Kim, Yoon-Hyuk
    • Journal of Biomedical Engineering Research
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    • v.32 no.3
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    • pp.230-236
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    • 2011
  • The aim of this study was to investigate the alteration of lumbar spine and trunk postures on different load-carrying types and amounts under static loading. Two load-carrying types(unilateral carrying: UC vs. bilateral carrying: BC) and four different loads(0, 5, 10, and 15 kg) were randomly tested in this study. Carrying a heavy bag would affect human body posture, specifically lumbar spine curvature, which is considered as one of sources of back problems. Previous studies have not paid attention to the approach of the multisegment model of the lumbar spine and trunk. This study separated two compartments of trunk segment(the lumbar and thorax) in the analysis. The multisegment model of the lumbar spine in addition to Helen-Hayes marker set was used. Eight motion analysis cameras and a force plate were utilized. Ten male subjects(mean mass, $70.6{\pm}3.97$ kg; mean height, $178{\pm}4.18$ m) having no musculoskeletal disease participated in this study. We analyzed trunk angles in three anatomical planes and the spinal curvature in sagittal and frontal planes. Increased loading in both UC and BC significantly resulted in increases in trunk forward lean but only UC induced increases in trunk lateral lean. In addition, increased loading in BC produced flatten lumbar curvature in sagittal plane. As far as coupling motion, subjects tended to use axial rotation of the lumbar spine in transverse plane in response to increased UC loading. Finally, it is concluded that the increased static loading in UC rather than in BC tends to causes combined alterations of the spinal postures(sagittal and transverse planes together), which would be vulnerable to improper mechanical stresses on the spine.

Idiopathic Hypertrophic Spinal Pachymeningitis : Report of Two Cases and Review of the Literature

  • Kim, Jee-Hee;Park, Young-Mok;Chin, Dong-Kyu
    • Journal of Korean Neurosurgical Society
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    • v.50 no.4
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    • pp.392-395
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    • 2011
  • Idiopathic hypertrophic spinal pachymeningitis (IHSP) is a rare inflammatory disease characterized by hypertrophic inflammation of the dura mater and various clinical courses that are from myelopathy. Although many associated diseases have been suggested, the etiology of IHSP is not well understood. The ideal treatment is controversial. In the first case, a 55-year-old woman presented back pain, progressive paraparesis, both leg numbness, and voiding difficulty. Initial magnetic resonance imaging (MRI) demonstrated an anterior epidural mass lesion involving from C6 to mid-thoracic spine area with low signal intensity on T1 and T2 weighted images. We performed decompressive laminectomy and lesional biopsy. After operation, she was subsequently treated with steroid and could walk unaided. In the second case, a 45-year-old woman presented with fever and quadriplegia after a spine fusion operation due to lumbar spinal stenosis and degenerative herniated lumbar disc. Initial MRI showed anterior and posterior epidural mass lesion from foramen magnum to C4 level. She underwent decompressive laminectomy and durotomy followed by steroid therapy. However, her conditions deteriorated gradually and medical complications occurred. In our cases, etiology was not found despite through investigations. Initial MRI showed dural thickening with mixed signal intensity on T1- and T2-weighted images. Pathologic examination revealed chronic nonspecific inflammation in both patients. Although one patient developed several complications, the other showed slow improvement of neurological symptoms with decompressive surgery and steroid therapy. In case of chronic compressive myelopathy due to the dural hypertrophic change, decompressive surgery such as laminectomy or laminoplasty may be helpful as well as postoperative steroid therapy.

Considerations for Fluoroscopic Guided Intervention in Lumbar Spine (방사선 투시장치를 이용한 요추 중재술 시 고려점)

  • Kim, Dong-Hyun;Song, Kwang-Sup
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.3
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    • pp.210-221
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    • 2020
  • Spinal block procedures are useful methods that reduce the need for surgical treatment. In addition to their therapeutic aspects of pain relief, in many patients, they are also used for diagnostic purposes to distinguish from symptoms originating from extra-spinal areas. Therefore, these procedures are the most basic technique for orthopedic surgeons dealing with diseases from limbs and spine. On the other hand, despite the simplicity of the instruments and drugs used, the overall understanding of them and the lack of knowledge of the possible side effects and complications can cause serious harm to the patient at the beginning of the trial. Therefore, it is necessary to understand the types of drugs used in the spinal block procedures, pharmacokinetic properties, and the side effects of each drug. In addition, efforts should be made to identify their indications, as well as advantages and disadvantages of each procedure to avoid possible complications. The purpose of this review was to provide basic knowledge and skills necessary for lumbar spinal block procedures as well as provide the reader with the ability to perform themselves.

Investigation of High-Sensitivity C-reactive Protein and Erythrocyte Sedimentation Rate in Low Back Pain Patients

  • Park, Chan-Hong;Lee, Sang-Ho
    • The Korean Journal of Pain
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    • v.23 no.2
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    • pp.147-150
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    • 2010
  • Background: Chronic low back pain can be a manifestation of lumbar degenerative disease, herniation of intervertebral discs, arthritis, or lumbar stenosis. When nerve roots are compromised, low back pain, with or without lower extremity involvement, may occur. Local inflammatory processes play an important role in patients with acute lumbosciatic pain. The purpose of this study was to assess the value of erythrocyte sedimentation rate (ESR) and high sensitivity C-reactive protein (hsCRP) measurements in patients with chronic low back pain or radiculopathy. Methods: ESR and hsCRP were measured in 273 blood samples from male and female subjects with low back pain and/or radiculopathy due to herniated lumbar disc, spinal stenosis, facet syndrome, and other diseases. The hsCRP and ESR were measured prior to lumbar epidural steroid injection. Results: The mean ESR was 18.8 mm/h and mean hsCRP was 1.1 mg/L. ESR had a correlation with age. Conclusions: A significant systemic inflammatory reaction did not appear to arise in patients with chronic low back pain.

Severe Paraspinal Muscle Atrophy with Fatty Degeneration in a Young Adult: A Case Report (젊은 성인의 척추주위근에 발생한 지방 변성을 동반한 심한 근위축: 증례보고)

  • Huh, Jae-Won;Yang, Won-Jong;Park, Eunhee;Lee, Jae Eun;Kim, Chul-Hyun
    • Journal of Electrodiagnosis and Neuromuscular Diseases
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    • v.20 no.2
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    • pp.130-134
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    • 2018
  • A 36-year-old male patient developed diffuse low back pain. His past medical history was unremarkable and had no family history of neuromuscular disease. He had no bladder and bowel problems. Creatine kinase was 172 U/L (normal < 170). Other fluid and blood chemistry tests were normal. Manual muscle test grades of extremities and sensory examination were normal. Muscle stretch reflexes were normal. Fasciculations and myotonia were not detected. Straight leg raising test was negative. There was no spinal root compression, spinal stenosis, or signal intensity change of spinal cord on magnetic resonance imaging (MRI). Fatty change and atrophy of the cervical, thoracic and lumbar paraspinal muscles were noted on MRI. Nerve conduction studies were normal. Electromyography showed 1+ positive sharp waves in the lumbar paraspinal muscles. Electromyography of upper and lower extremity muscles revealed no abnormal spontaneous activity. We report a rare case of severe paraspinal muscle atrophy with fatty degeneration in a Young Adult.

Large Sized Common Iliac Artery Aneurysm with Thrombus Developing a Diagnostic Confusion in a Patient with Sciatica

  • Jeon, Ik Chan;Kim, Sang Woo;Jung, Young Jin
    • The Korean Journal of Pain
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    • v.27 no.4
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    • pp.360-364
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    • 2014
  • The causes of sciatica are variable and include musculoskeletal, dermatologic, infectious, neoplastic, and vascular disorders. In many cases, the symptom is usually caused by degenerative disease in the spine with the compression or irritation of spinal nerve. On the other hands, there are also several announced extra-spinal causes including aneurysm, diabetes, and radiation for sciatica in a low rate. Among the extra-spinal cases, aneurysms arising from iliac vessels are sometimes developing a diagnostic confusion with the spinal causes, and delayed diagnosis can lead to poor prognosis. It is very important to pay attention weather the aneurysmal cause is involved in the symptom of sciatica.

The Change of Sagittal Alignment of the Lumbar Spine after Dynesys Stabilization and Proposal of a Refinement

  • Park, Won Man;Kim, Chi Heon;Kim, Yoon Hyuk;Chung, Chun Kee;Jahng, Tae-Ahn
    • Journal of Korean Neurosurgical Society
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    • v.58 no.1
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    • pp.43-49
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    • 2015
  • Objective : $Dynesys^{(R)}$ is one of the pedicle-based dynamic lumbar stabilization systems and good clinical outcome has been reported. However, the cylindrical spacer between the heads of the screws undergoes deformation during assembly of the system. The pre-strain probably change the angle of instrumented spine with time and oblique-shaped spacer may reduce the pre-strain. We analyzed patients with single-level stabilization with $Dynesys^{(R)}$ and simulated oblique-shaped spacer with finite element (FE) model analysis. Methods : Consecutive 14 patients, who underwent surgery for single-level lumbar spinal stenosis and were followed-up more than 24 months (M : F=6 : 8; age, $58.7{\pm}8.0$ years), were analyzed. Lumbar lordosis and segmental angle at the index level were compared between preoperation and postoperative month 24. The von Mises stresses on the obliquely-cut spacer ($5^{\circ}$, $10^{\circ}$, $15^{\circ}$, $20^{\circ}$, $25^{\circ}$, and $30^{\circ}$) were calculated under the compressive force of 400 N and 10 Nm of moment with validated FE model of the L4-5 spinal motion segment with segmental angle of $16^{\circ}$. Results : Lumbar lordosis was not changed, while segmental angle was changed significantly from $-8.1{\pm}7.2^{\circ}$ to $-5.9{\pm}6.7^{\circ}$ (p<0.01) at postoperative month 24. The maximum von Mises stresses were markedly decreased with increased angle of the spacer up to $20^{\circ}$. The stress on the spacer was uneven with cylindrical spacer but it became even with the $15^{\circ}$ oblique spacer. Conclusion : The decreased segmental lordosis may be partially related to the pre-strain of Dynesys. Further clinical and biomechanical studies are required for relevant use of the system.

Wedge Shape Cage in Posterior Lumbar Interbody Fusion : Focusing on Changes of Lordotic Curve

  • Kim, Joon-Seok;Oh, Seong-Hoon;Kim, Sung-Bum;Yi, Hyeong-Joong;Ko, Yong;Kim, Young-Soo
    • Journal of Korean Neurosurgical Society
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    • v.38 no.4
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    • pp.255-258
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    • 2005
  • Objective : Lumbar lordotic curve on L4 to S1 level is important in maintaining spinal sagittal alignment. Although there has been no definite report in lordotic value, loss of lumbar lordotic curve may lead to pathologic change especially in degenerative lumbar disease. This study examines the changes of lumbar lordotic curve after posterior lumbar interbody fusion with wedge shape cage. Methods : We studied 45patients who had undergone posterior lumbar interbody fusion with wedge shape cage and screw fixation due to degenerative lumbar disease. Preoperative and postoperative lateral radiographs were taken and one independent observer measured the change of lordotic curve and height of intervertebral space where cages were placed. Segmental lordotic curve angle was measured by Cobb method. Height of intervertebral space was measured by averaging the sum of anterior, posterior, and midpoint interbody distance. Clinical outcome was assessed on Prolo scale at 1month of postoperative period. Results : Nineteen paired wedge shape cages were placed on L4-5 level and 6 paired same cages were inserted on L5-S1 level. Among them, 18patients showed increased segmental lordotic curve angle. Mean increased segmental lordotic curve angle after placing the wedge shape cages was $1.96^{\circ}$. Mean increased disc height was 3.21mm. No cases showed retropulsion of cage. The clinical success rate on Prolo's scale was 92.0%. Conclusion : Posterior lumbar interbody fusion with wedge shape cage provides increased lordotic curve, increased height of intervertebral space, and satisfactory clinical outcome in a short-term period.

Homeopathy - A Safe, Much Less Expensive, Non-Invasive, Viable Alternative for the Treatment of Patients Suffering from Loss of Lumbar Lordosis

  • Haque, Saiful;Das, Debarsi;Bhattacharya, Saugato;Sarkar, Tathagato;Khuda-Bukhsh, Anisur Rahman
    • Journal of Pharmacopuncture
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    • v.19 no.4
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    • pp.359-362
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    • 2016
  • Objectives: Loss of lumbar lordosis causing pain and curvature of the vertebral skeleton to one side is a relatively uncommon disease. To our knowledge, successful treatment of loss of lumbar lordosis with any potentized homeopathic drug diluted above Avogadro's limit (that is, above a potency of 12C) has not been documented so far. In this communication, we intend to document a relatively rare case of loss of lumbar lordosis with osteophytic lippings, disc desiccation, and protrusion, causing a narrowing of secondary spinal canal and a bilateral neural foramina, leading to vertebral column curvature with acute pain in an adolescent boy. Methods: The patient had undergone treatment with orthodox Western medicines, but did not get any relief from, or cure of, the ailment; finally, surgery was recommended. The patient's family brought the patient to the Khuda-Bukhsh Homeopathic Benevolent Foundation where a charitable clinic is run every Friday with the active participation of four qualified homeopathic doctors. A holistic method of homeopathic treatment was adopted by taking into consideration all symptoms and selecting the proper remedy by consulting the homeopathic repertory, mainly of Kent. Results: The symptoms were effectively treated with different potencies of a single homeopathic drug, Calcarea phos. X-ray and magnetic resonance imaging (MRI) supported recovery and a change in the skeletal curvature that was accompanied by removal of pain and other acute symptoms of the ailment. Conclusion: Homeopathy can be a safe, much less expensive, non-invasive, and viable alternative for the treatment of such cases.