• Title/Summary/Keyword: Lumbar vertebra

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Effects of Changes in Postural Alignment on Foot Pressure and Balance of Patients with Stroke (뇌졸중 환자에서 자세정렬변화가 족저압 및 균형에 미치는 영향)

  • Yang, Dae-Jung;Park, Seung-Kyu;Kang, Jeong-Il;Park, Seong-Bin
    • The Journal of Korean Physical Therapy
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    • v.26 no.4
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    • pp.226-233
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    • 2014
  • Purpose: This study was conducted in order to investigate the exercise limit that may occur depending on changes in postural alignment by examining the significance of postural alignment changes, foot pressure, and balance of patients with stroke. Methods: In this study, 50 patients diagnosed with a stroke were selected as subjects. Imbalance of postural alignment of the trunk, pelvic tilt of trunk rotation of the body, angle of kyphotic curving of the thoracic, and angle of lordotic curving of the lumbar vertebra were measured. Foot pressure was examined by measuring average pressure and weight bearing. Balance was examined by measuring the center of pressure and limit of stability. Results: The significance of postural alignment, foot pressure, and weight bearing of the non-paretic side was examined. In addition, the significance between postural alignment and balance was examined. Conclusion: It is thought that limits of foot pressure and balance in the standing position can be caused by postural alignment. Thus, both a therapeutic intervention program and postural alignment training should be provided together in order to improve the function of patients with stroke.

Effect of Abdominal Muscle Activity in Combination with the Abdominal Drawing-in Maneuver for Grip Strength in Healthy Young Adults (정상 성인에서 복부 드로우-인 기법을 동반한 복부근 활성화가 파악력에 미치는 영향)

  • Lee, Mi-Young
    • The Journal of Korean Physical Therapy
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    • v.24 no.1
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    • pp.1-6
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    • 2012
  • Purpose: The grip strength is influenced by various factors, such as position of the upper extremity, characteristics of the hand, and general physical condition. In this study, we investigated whether abdominal muscle activity in combination with the abdominal drawing-in maneuver has any effect on the grip strength in healthy young adults. Methods: This study included 31 healthy subjects (16 males, 15 females). We used surface electromyography and pressure bio-feedback unit for this experiment. All Subjects were placed in a cock-lying position with comfort and the grip strength was measured. On the following day, the pressure bio-feedback unit was placed beneath their fifth lumbar vertebra, and the, grip strength was measured again. This time, the measurement was taken while drawing-in their abdomen below the navel gently and gradually, while maintaining a neutral pelvic position. Results: The grip strength was significantly increased when subjects performed the drawing-in maneuver than when they were comfortable (p<0.05). In addition, activations of the rectus abdominal muscles significantly increased (p<0.05). Conclusion: In the current study, we found that abdominal muscle activity, in combination with the abdominal drawing-in maneuver, affected the grip strength, positively. Therefore, we suggest that this result should be considered when evaluating the grip strength.

Successful Treatment of a Symptomatic Discal Cyst by Percutaneous C-arm Guided Aspiration

  • Yu, Hyun Jeong;Park, Chan Jin;Yim, Kyoung Hoon
    • The Korean Journal of Pain
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    • v.29 no.2
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    • pp.129-135
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    • 2016
  • Although discal cysts are a rare cause of low back pain and radiculopathy. Currently, surgical excision is usually the first-line treatment for discal cysts. However, alternative treatment methods have been suggested, as in some cases symptoms have improved with interventional therapies. A 27-year-old man presented with an acute onset of severe pain, and was found to have a discal cyst after an open discectomy. The patient underwent cyst aspiration and steroid injection through the facet joint under C-arm guidance. After the procedure, the patient's pain improved to NRS 0-1. On outpatient physical examination 1 week, and 1 and 3 months later, no abnormal neurological symptoms were present, and pain did not persist; thus, follow-up observation was terminated. When a discal cyst is diagnosed, it is more appropriate to consider interventional management instead of surgery as a first-line treatment, while planning for surgical resection if the symptoms do not improve or accompanying neurologic deficits progress.

Percutaneous Vertebroplasty in Treatment of Osteoporotic Vertebral Body Fractures : Early Result (골다공증성 추체골절에 대한 경피적 척추성형술 : 초기성적)

  • You, Young Sang;Shin, Jae Hack;Kim, Il-Man
    • Journal of Korean Neurosurgical Society
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    • v.30 no.2
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    • pp.163-167
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    • 2001
  • Objective : Percutaneous vertebroplasty has recently been introduced as an interesting therapeutic alternative for the treatment of thoracolumbar vertebral body fractures in elderly persons with osteoporosis. The authors present the early results of this method. Method and Material : From July 1999 to April 2000, percutaneous transpedicular technique was used in 20 patients (2 men and 18 women) whose mean age was 67.5 years old(range 59-79) with painful vertebral compression(22) and burst(2) fractures. The interval between fracture and vertebroplasty ranged 1 day to 4 months. The procedure involved percutaneous puncture of the injured vertebra via transpedicular approach under fluoroscopic guidance, followed by injection of polymethylmetacrylate(PMMA) into the vertebral body through a disposable 11-guage Jamshidi needle. Result : The most common cause of fracture was slip down and the most frequent injured level was the twelfth thoracic spine. The procedure was technically successful bilaterally in 18 patients(9 thoracic and 15 lumbar spines) with an average injection amount of 7.7ml PMMA in each level. Seventeen(94.4%) patients reported significant pain relief immediately after treatment. Two leaks of PMMA were detected with postoperative CT in spinal epidural space and extravertebral soft tissue without clinical symptoms. Conclusion : Although this study represents the early results, percutaneous vertebroplasty seems to be valuable tool in the treatment of painful osteoporotic vertebral body fractures in elderly, providing acute pain relief and early mobilization.

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Multimodal Treatment for Various Clinical Features in Bertolotti's Syndrome (베르톨로티 증후군의 다양한 임상 양상에 대한 포괄적 치료)

  • Kang, Dong-Ha;Kim, Da-Sol;Won, Yu-Hui;Park, Sung-Hee;Ko, Myoung-Hwan;Seo, Jeong-Hwan;Kim, Gi-Wook
    • Clinical Pain
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    • v.19 no.2
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    • pp.133-137
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    • 2020
  • Bertolotti's syndrome (BS) is a disease that should be differentiated from low back pain (LBP) in young patients. BS shows an anatomical abnormality in which elongated transverse processes of the last lumbar vertebra articulate or fuse with varying degrees to the sacrum or ilium according to radiologic findings, which is associated with the clinical feature of LBP or radiating pain. In this case report, we describe various clinical features such as a waddling gait with severe foot and triceps surae muscle pain, in addition to the typical symptom of BS such as LBP. We report the various clinical symptoms and treatment progress in this case and review the literature.

A case of fused thoracic vertebrae, and lumbar vertebrae, sacrum and ilium of African elephant (Loxodonta africana) were fused one another partially (아프리카코끼리(Loxodonta africana)의 흉추골유합과 요추골, 천골 및 장골이 유합된 1례)

  • Kim, Chong-sup;Won, Chung-kil;Cho, Gyu-hen;Cho, Kyu-woan;Park, Joong-suk;Rho, Gyu-jin
    • Korean Journal of Veterinary Research
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    • v.42 no.2
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    • pp.131-136
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    • 2002
  • The vertebrae of female African elephant (Loxodonta africana) of twenty-eight years old were observed macroscopically. The result was summarized as follows; the vertebral formula of African elephant was $C_7$ $T_{21}$ $L_3$ $S_4$ $Cd_{21}$. The total length of the vertebral column removed intervertebreal disks was 353 cm. The length of each segment of vertebral column was 44 cm in cervical, 142 cm in thoracic, 21 cm in lumbar, 27 cm in sacral and 119 cm in caudal vertebrae. The 17th and 18th thoracic vertebrae (T) were partially fused each other in four parts: the transverse processes of 17th and 18th T, caudal articular process of 17th T and cranial articular process of 18th T, left mammilary process of 18th T and left transverse process of 17th T, and vertebral arch of 17th and 18th T, respectively. Others partial fusions also observed among the third luwbar, sacrum and ilium. These were in between transverse process of third lumbar vertebra and cranial parts of wing of sacrum, lateral part of sacrum and tuber sacrale, respectively. The sternum was consisted of three pieces; one is a part of anterior prestemum, two is the part from caudal demifacet at second facet to cranial demifacet at third facet in middle mesosternum, which is divided vertically into an half at second and third facets, respectively, and the last is the part between caudal demifacet of third facet in middle mesosternum and the posterior xiphisternum. There are 21 pairs of ribs, six sternal, ten asternal ribs and the last five being floating ribs.

Effects of Korean Medicine Treatment for a Patient with Lumbar Radiculopathy Diagnosed with Bertolotti's Syndrome: A Case Report (베르톨로티 증후군으로 확인된 요추 신경병증 환자에 대한 한의학적 치료 효과: 증례보고)

  • Han, Jeonghun;Park, Byunghak;Son, Jaemin;Lee, Namwoo;Kang, Dohyeon;Min, Taewoon;Ahn, Jaeseo;Lee, Hansol;Lee, Hyunjun;Ji, Hyungwook;Cho, Sohyun;Lee, Seongmin;Kim, Hankyul
    • Journal of Korean Medicine Rehabilitation
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    • v.31 no.4
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    • pp.203-210
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    • 2021
  • Bertolotti's syndrome is a rare spinal disease and it is known to cause low back pain due to a lumbosacral transitional vertebra. There has been rare study of Bertolotti's syndrome. This study reports the effects of Korean medicine treatment on the patient who was diagnosed on Bertolotti's syndrome. The patient was treated with Korean medicine treatment including acupuncture, pharmacopuncture, herbal medicine, and Chuna manual therapy during 40 days. Numerical rating scale (NRS), Euroqol five dimension (EQ-5D) index, Oswestry disability index (ODI), lumbar range of motion were used for assessment. After treatment, low back pain NRS decreased from 3 to 2, and low limb pain NRS decreased from 5 to 2. EQ-5D index, ODI and lumbar range of motion also were improved. This study shows Korean medicine treatment can be an effective care for Bertolotti's syndrome.

Is It Appropriate to Insert Pedicle Screws at an Infected Vertebral Body in the Treatment of Lumbar Pyogenic Spondylodiscitis? (요추부 화농성 척추염의 수술적 치료: 이환된 추체에 척추경 나사 고정이 타당한가?)

  • Na, Hwa-Yeop;Jung, Yu-Hun;Lee, Joo-Young;Kim, Hyung-Do
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.5
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    • pp.419-426
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    • 2021
  • Purpose: In the surgical treatment of pyogenic lumbar spondylodiscitis, screw insertion at the affected vertebra has been avoided because of biofilm formation, and the risk of infection recurrence. The authors analyzed the success rate of infection treatment while minimizing the number of instrumented segments by inserting pedicle screws into the affected vertebrae. Therefore, this study examined the usefulness of this technique. Materials and Methods: From January 2000 to June 2018, among patients with pyogenic lumbar spondylodiscitis treated surgically, group A consisted of patients with pedicle screws inserted directly at the affected vertebrae (28 cases), and group B underwent fusion by inserting screws at the adjacent normal vertebrae due to bone destruction of the affected vertebral pedicle (20 cases). The classified clinical results were analyzed retrospectively. All patients were treated via the posterior-only approach, so the affected disc and sequestrum were removed. Posterior interbody fusion was performed with an autogenous strut bone graft, and the segments were then stabilized with pedicle screw systems. The hospitalization period, operation time, amount of blood loss, EQ-5D index, duration of intravenous antibiotics, and the clinical and radiological results were analyzed. Results: In group A, the number of instrumented segments, operation time, blood loss, and EQ-5D index at one month postoperatively showed significant improvement compared to group B. There were no significant differences in the duration of antibiotic use, hospitalization, radiological bone union time, sagittal angle correction rate, and recurrence rate. Conclusion: Minimal segmental fixation, in which pedicle screws were inserted directly into the affected vertebrae through the posterior approach, reduced the surgery time and blood loss, preserved the lumbar motion by minimizing fixed segments and showed rapid recovery without spreading or recurrence of infection. Therefore, this procedure recommended for the surgical treatment of lumbar pyogenic spondyodiscitis.

Arthroscopic Treatment of Calcific Tendinitis of the Rotator Cuff (회전근 개 석회화 건염의 관절경적 치료)

  • Lee Kwang-Won;Ryu Chang-Soo;Kim Ha-Yong;Kim Byung-Sung;Choy Won-Sik
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.1
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    • pp.27-31
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    • 2001
  • Purpose : The purpose of this study was to evaluate results of the arthroscopic treatment of calcific tendinitis of the shoulder resistant to conservative treatment. Materials and Methods : From March, 1996 to June, 1998, fourteen patients underwent shoulder arthroscopy to treat resistant calcific tendinitis of the rotator cuff despite conservative treatment for more than 6 months. Calcium deposits were localized to the supraspinatus tendon only in eleven patients, the supraspinatus and infraspinatus tendon in two patients, and to the supraspinatus and subscapularis tendon in one patient. Each shoulder was evaluated with UCLA shoulder rating scale and Constant-Murley score Results : The Constant-Murley pain score improved from average score 3.2 before surgery to average score 8.3 after surgery, and the UCLA functional average score improved from 4.5 preoperatively to 8.3 postoperatively. Preoperative ROM averaged $110^{\circ}$ of flexion, $45^{\circ}$ of external rotation, $90^{\circ}$ of abduction, and internal rotation with the thumb reaching to the spinous process of the third lumbar vertebra, but postoperative range of motion averages improved as follows: $170^{\circ}$ or flexion, $50^{\circ}$ of external rotation, $140^{\circ}$ abduction, and internal rotation with the spinous process of the twelveth thoracic vertebra. Overall 3 patients were rated excellentm 9 were good, 2 were fair. Conclusion : Shoulder arthroscopy is an effective treatment in patients with refractory calcific tendinitis.

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Effects of Anesthetics on Somatosensory Evoked Potentials (SEPs) in Dogs (마취제가 개의 Somatosensory Evoked Potentials (SEPs)에 미치는 영향)

  • Hong, Yeon-Jung;Jeong, Seong-Mok;Nam, Tchi-Chou
    • Journal of Veterinary Clinics
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    • v.19 no.3
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    • pp.277-282
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    • 2002
  • This study was designed to evaluate the effects of anesthetics on waveform of SEPs and to authorize possible anesthetic protocol for measurement of the somatosensory evoked potentials (SEPs). Thirteen anesthetic methods were used. The SEPs were recorded on two channels (between the 5th and 6th lumbar vertebra as the channel 1 and between the 11th and 12th thoracic vertebra as the channel 2) following stimulation of posterior tibial nerve. ID analyze SEPs wave, latency and conduction velocity were measured. Among thirteen anesthetic methods, standard SEPs waveforms were observed in dogs anesthetized with following six methods: Acepromazine + Thiepfntal Na + Isoflurane, Acepronazine + Propofol + Isoflurane, Diazepam + Xylazine, Xylazine + Ketamine, Acepromazine + Propofol infusion and Propofol infusion. Above six methods could be used with sufficient anesthetic depth. The differences of latency and conduction velocity among six groups were minimal compared to general waveform of SEPs. These results indicate that the six anesthetic methods can be used for recording SEPs in the dog. In particular, Diazepam + Xylazine and XylaBine + Ketamine as injectable anesthesia are considered more convenient than other four methods in veterinary medicine.