• Journal of Korean Neurosurgical Society
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• 제53권3호
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• pp.145-149
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• 2013

Objective : We analyzed the clinical and radiologic features of posterior apophyseal ring separation (PARS) with lumbar disc herniation and suggest the proper management options according to the PARS characteristics. Methods : We reviewed case series of patients with PARS who underwent surgery of lumbar disc herniation. Preoperative symptoms, neurologic status, Body Mass Index, preoperative and postoperative Visual Analogue Scale (VAS) and Korean-Oswestry Disability Index (K-ODI) scores, operation types were obtained. PARS size, locations, the degree of resection were assessed. Results : PARS was diagnosed in 109 (7.5%) patients among 1448 patients given surgical treatment for single level lumbar disc herniation. There were 55 (50.5%) small PARS and 54 (49.5%) large PARS. Among the large PARS group, 15 (27.8%) had lower endplate PARS of upper vertebra at the level of disc herniation. Thirty-nine (72.2%) were upper endplate PARS of lower vertebra. Among the group with upper endplate PARS of lower vertebra, unresected PARS was diagnosed in 12 (30.8%) cases and resected PARS was diagnosed in 27 (69.2%) cases. VAS and K-ODI scores changes were $3.6{\pm}2.9$ and $5.4{\pm}6.4$ in the unresected PARS group, $5.8{\pm}2.1$ and $11.3{\pm}7.1$ in the resected PARS group. The group with upper endplate PARS of lower vertebra showed significant difference of VAS (p=0.01) and K-ODI (p=0.013) score changes between unresected and resected PARS groups. Conclusion : The large PARS of upper endplate in lower vertebra should be removed during the surgery of lumbar disc herniation. High level or bilateral side of PARS should be widely decompressed and arthrodesis procedures are necessary if there is a possibility of secondary instability.

• Korean Journal of Veterinary Research
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• 제23권1호
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• pp.119-122
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• 1983

Paravertebral anesthesia for operation of abdominal wall in Korean cattle were effectively accomplished with the following technique. Any problems in surgical procedure were not observed under the block of ventral branches of the last thoracic nerve and the first and second lumbar nerves with the administration of preanesthetic. The site of injection for blocking of ventral branches of the thirteenth thoracic nerve were approximately 5cm lateral to the midline from the posterior edge of spinous process of the 13th thoracic vertebra and about 10ml of local anesthetic was injected immediately anterior to the transverse process of the first lumbar vertebra through thin site. The block of ventral branches of the first and second lumbar nerves were obtained by injecting 10ml of local anesthetic immediately below the posterior edge of transverse process of the 2nd and 4th lumbar vertebra, respectively.

• Journal of the Korea Society of Computer and Information
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• 제17권5호
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• pp.29-32
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• 2012

In this paper, we propose a novel method to extract muscle area from lumbar ultrasonographic image. The muscle area resided in lumbar area can be defined as the area between thoracic vertebra and subcutaneous fat area. A modified 4-directional contour tracing algorithm is designed to detect the boundaries and candidate areas are extracted and verified by the morphological characteristics of lumbar area. The experiment using 392 lumbar images verifies that the proposed method is sufficiently effective by showing over 94% accuracy in extraction.

• Clinical Pain
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• 제20권2호
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• pp.93-98
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• 2021

The use of ultrasonography has recently been increasing in musculoskeletal diagnosis or intervention treatment. Ultrasound guided procedure offers a reliable alternative to fluoroscopy or computed tomography for lumbar medial branch block, facet joint block and peripheral nerves of lower extremity. Further, there is no exposure to radiation and additional equipment necessary for the protection against radiation is required. And ultrasound guided procedure needs smaller space than fluoroscopy guided procedure with real time images in the outpatient department. This article reviews ultrasound guided procedure at lumbar vertebra and peripheral nerves of lower extremity.

• Journal of Korean Physical Therapy Science
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• 제16권3호
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• pp.11-17
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• 2009

Background: The purpose of this study was designed to find out the effectiveness of reposition sense, muscle fatigue response on lumbar spine after apply lumbosacral stabilization exercise program to 4 patients with chronic low back pain and for 12 weeks. Method: In this study the reposition sense was measured in 3 angle(60, 30, 12) of the lumbar spine motion with blind by MedX test machine and the difference of instability to lumbar vertebra segments in flexion, extension test of standing position and spinal load test Mattress Test by Spinal Mouse. The stabilization exercise program was applied 2 times a week for 12 weeks in hospital and 2 times a day for 20 minutes at home. Result: The results of the present study were that the repositioning sense was appeared the most error in 12 angles of lumbar flexion and Men was appeared to decrease an error more than female in average value of 4 angles after 12 weeks. And average error of male was decrease more than female. Thus the effects of lumbosacral stabilization exercise was improved repositioning sense of prorioceptor. Fatigue response test(FRT) results, in male, was raised muscle fatigue rate during increase weight, on the other hand female appeared lower than male. Conclusion: As a results, lumbosacral stabilization exercise was aided to improvement of lumbar spine repositioning sense and vertebra segments stabilization. It was showed the rate of decrease in typically 12 degree angle point of each 3 angle(60, 36, 12). Especially, that spine instability patients will have a risk when in lifting a load or working with slight flexion posture around 12 degree during the daily of living life and it is probably to increase recurrence rate. Thus, not only lumbar extension muscle strength but also stability of vertebra segments in lumbar spine may be very important.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• 제3권1호
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• pp.55-64
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• 2008

Objective : Spondylothesis is a disease which sagittal facet of vertebral body's invariable alignment is being broken and vertebral body being pushed forward. Main pattern of spondylothesis is isthmic spondylothesis by isthmus defect or fracture, degenerative spondylothesis occurred by desiccated change of intervertebral disc or vertebral condyle joint's ligament. The purpose of this study is to assess the difference of the Pelvic angles, Lumbosacral angles, Pelvic tilt, and Lumbar lordotic angles of the spondylothesis patients. Methods : We analyzed the lateral view of lumbar spine of 49 isthmic spondylothesis patients, 45 degenerative spondylothesis patients and 26 patients who haven't been diagnosed as vertebra disease. We investigated each patient's pelvic angle, lumbosacral angle, pelvic tilt and lumbar lordotic angle. Results and Conclusion : 1. Pelvic incidence, in cases of degenerate spondylothesis patients, is higher than spondylothesis patients but shows less significance. On the contrary significance is higher than the group haven't been diagnosed as vertebra disease. 2. Lumbosacral incidence, in cases of isthmic spondylothesis patients, shows higher significance than degenerative spondylothesis patients and the group haven't been diagnosed as vertebra disease. 3 Pelvic tilt, in cases of degenerative spondylothesis patients, shows higher significance than isthmic spondylothesis patients and the group haven't been diagnosed as vertebra disease. 4. Lumbar lordotic angle, in cases of isthmic spondylothesis patients, shows higher significance than degenerative spondylothesis patients and the group haven't been diagnosed as vertebra disease. 5. Degenerative spondylothesis patient shows specific impression, a forwardly moved high femoral axial and as a result of large lumbrosacral angle and lumbar lordotic angle shows specific impression, an increased weight pressure on sacrum.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• 제9권1호
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• pp.103-114
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• 2014

Objectives : The purpose of this study was to report clinical effects of Lumbar flexion-distraction manipulation and Sitting position thoracic and lumbar vertebra adjustment manipulation on patient with Juvenile idiopathic scoliosis Methods : The patients have been treated with the above two Chuna manual manipulations. We measured Cobb's angle, VNRS before and after treatment Results : After treatment, we confirmed these transition : In first case, Cobb's angle of T-spine changed from 27 to 23 : Cobb's angle of L-spine changed from 17 to 10 : VNRS changed from 6 to 2. In second case Cobb's angle of T-spine changed from 30 to 21 : Cobb's angle of L-spine changed from 16 to 16 : VNRS chagned from 6 to 3 Conclusion : The result suggests that these two Chuna manual manipulations were effective treatment on patients with Juvenile idiopathic scoliosis.

• Anatomy & Biological Anthropology
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• 제31권4호
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• pp.151-158
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• 2018

The intervertebral foramen is formed by two adjacent vertebrae and an intervertebral disc. Previous studies examining the foramen have been performed using various methods. The author obtained characteristics of the intervertebral foramen based on silicon mold. The author used 18 cadavers and dissected the lumbar intervertebral foramen. First, positional levels of the spinal nerve in the intervertebral foramen were measured. Second, after being removed all tissues covering the intervertebral, bony foramen was filled with melted silicon to mold the cross section. Subsequently, the solidified silicon mold was removed and stamped on a paper. The paper was scanned and analyzed area, perimeter, height and width of the intervertebral foramen on a computer. Area (average, $9.43mm^2$) and perimeter (average, 48.02 mm) did not show any statistical significant pattern for any lumbar vertebral levels. However, the height and width significantly differed at the fifth lumbar vertebra, which had the shortest height (the fifth, 13.00 mm; average, 15.78 mm) and longest width (the fifth, 8.61 mm; average, 7.87 mm), although there were similar patterns in case of area and perimeter of the first to fourth lumbar vertebra. Height had a decrease tendency while width had an increase tendency both from the second to fifth lumbar vertebra. Spinal nerves went through near the intervertebral disc level from the first to fourth lumbar vertebra, although they passed below the disc at the fifth level. This study provides a different view of methodology for the 3-dimensional aspect for the intervertebral foramen. Results of this study may indicate that height and width of the intervertebral foramen changed along all lumbar vertebral levels; nevertheless, area and perimeter of the intervertebral foramen remained constant.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 한국정밀공학회 2005년도 추계학술대회 논문집
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• pp.240-243
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• 2005

Osteoporosis, one of the age-related disease causes vertebra body fracture due to weakening trabecular bone and makes a substantial effect on load sharing among vertebras. Recently, vertebroplasty is one of the most popular treatment, as augmenting PMMA into vertebra. Biomechanical studies about vertebroplasty have been evaluated by several experiments or analysis under static loading but there has been no study on response under dynamic loading. This study included the FE analysis of patients who treated vertebroplasty under dynamic loading. For this study, 3-D FE model of lumbar spine(L1-L2) was modeled from CT scanning data and compared with experimental results in vitro in order to validate this model. Biomechanical behavior about each of normal person, osteoporotic patient and patient treated vertebroplasty for quantitative evaluations of vertebroplasty was compared and investigated.

• Journal of Acupuncture Research
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• 제17권4호
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• pp.139-148
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• 2000

Objectives : Hua-Tuo-Jia-Ji-Xue(華佗夾脊穴) is the Jing-Wai-Qi-Xue(經外奇穴) that is widely used in clinic and effective in Acupuncture and Moxibustion. But the location, number, acupuncture method, clinical application of Hua-Tuo-Jia-Ji-Xue have not been explained clearly and consistently; moreover, studies or clinical reports about this are insufficient. The purpose of this study is to investigate the location, number, acupuncture method, clinical apptication of Hua-Tuo-Jia-Ji-Xue. Methods : We investigated Hua-Tuo-Jia-Ji-Xue through survey of 11 books and 26 relevant journals published in China Results : 1. Hua-Tuo-Jia-Ji-Xue is located in about 0.5 Cun(寸) at both sides of spinous process of each vertebra. 2. There is differ as the number of Hua-Tuo-Jia-Ji-Xue is 34, 48, 56, 58 in each documents. Hua-Tuo-Jia-Ji-Xue located in first, second cervical vertebra and first sacrum is low in application frequency, Hua-Tuo-Jia-Ji-Xue located from third cervical vertebra to fourth lumbar vertebra is high in apptication frequency. Therefore, all of the acupoints located in about 0.5 Cun(寸) both sides of spinous process of cervical, thoracic, lumbar and sacral vertebrae are regarded as Hua-Tuo-Jia-Ji-Xue in wide meaning. 3. There are Kou-Ci-Fa(叩刺法), Qian-Ci-Fa(淺刺法), Yan-Pi-Ci-Fa(沿皮刺法), Shen-Ci-Fa(深刺法) in acupuncture method of Hua-Tuo-Jia-Ji-Xue. Acupuncturing depths, directions is differ in each location(cervical, thoracic, lumbar vertebra, sacrum) and have something to do with therapeutic effect of Hua-Tuo-Jia-Ji-Xue. The feeling that patient receive after acupuncture is the key to the treatment of disease. 4. The clinical application of each Hua-Tuo-Jia-Ji-Xue is mainly selected by distribution of meridians, nerve roots, vertebral segments which are attacked with a disease. The musculoskeletal diseases in treatment of disease by Hua-Tuo-Jia-Ji-Xue are the most common as 12 cases. Second, there are many reports about nervous system diseases. In addition, good therapeutic results by application of Hua-Tuo-Jia-Ji-Xue are reported in some diseases, for instance, diseases of five viscera and six entrails, organ, tissue Conclusions : Hua-Tuo-Jia-Ji-Xue is located in about 0.5 Cun(寸) at both sides of spinous process of each cervical, thoracic lumbar and sacral vertebra. Therapeutic effect of Hua-Tuo-Jia-Ji-Xue has something to do with acupuncturing depths, directions and feelings. Hua-Tuo-Jia-Ji-Xue is mainly selected by distribution of meridians, nerve roots, vertebral segments which are attacked with a disease and is mainly applied musculoskeletal diseases, nervous system diseases.