• Title/Summary/Keyword: Lumbosacral

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Domestic Clinical Research Trends of Motion-Style Acupuncture Treatment: A Scoping Review (동작침법의 국내 임상 연구 동향: 주제범위 문헌고찰)

  • Jeon, Jong-Hyeok;Woo, Hyeon-Jun;Ha, Won-Bae;Geum, Ji-Hye;Han, Yun-Hee;Park, Shin-Hyeok;Lee, Jung-Han
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.4
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    • pp.19-32
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    • 2022
  • Objectives This scoping review aimed to investigate the domestic clinical research trends of motion-style acupuncture treatment (MSAT), identify diseases and symptoms for which MSAT is used, summarize specific methods of MSAT, and suggest the direction of future studies. Methods The study was conducted in accordance with a previously specified methodology, using the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) checklist. We searched nine electronic databases for studies on MSAT reported till March 21, 2022. The search terms were 'kinematic acupuncture,' 'MSAT,' 'motion style acupuncture,' and 'motion style treatment.' Results A total of 29 studies were included in our analyses; of them, 23 (79.3%) were before-after studies. Lumbosacral disease was the most common for which MSAT was applied (n=16). The frequency and duration of treatments differed depending on the researchers, and local acupoints (including ashi points) were used in 22 (75.9%) studies. In most cases, the method of mobilizing the joint or stretching the muscle in the disease area was used after inserting the acupuncture; however, in 7 studies, gait exercise was used. Most studies used MSAT in combination with other treatments. Conclusions This study supports the direction of future research by presenting the methodological applications of MSAT. To increase its clinical applicability, studies with a high level of evidence investigating the application to various body part, standardization and safety of MSAT are necessary.

Spinal Tuberculosis in Children: Predictable Kyphotic Deformity after Cure of the Tuberculosis (소아 척추 결핵: 투약 후의 병의 정지와 치유점, 그리고 후만 변형)

  • Moon, Myung-Sang;Kim, Dong-Hyeon;Kim, Sang-Jae;Moon, Hanlim;Kim, Sung-Soo;Kim, Sung-Sim
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.73-82
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    • 2017
  • Purpose: To assess the chronological changes of disease-related kyphosis after chemotherapy alone. Materials and Methods: A total of 101 children aged 2 to 15 years with spinal tuberculosis, accompanied by various stages of disease processes were enrolled for analysis. By utilizing the images in them, the growth plate condition and chronological changes of kyphosis after chemotherapy were analyzed at two points in time; the first assessment was at post-chemotherapy one-year and second at the final discharge. Results: Complete disc destruction in the cervical, dorsal and lumbosacral spines was observed in 2 out of 40 children (5.0%), 8 out of 30 children (26.7%), and 6 out of 31 children (19.4%), respectively. In those cases, the residual kyphosis inevitably developed. In the remaining children, the discs were intact or partially damaged. Among the 101 children kyphotic deformity was maintained without change in 20 children (19.8%). Kyphosis decreased in 14 children (13.9%), while it increased in 67 children (66.3%) with non-recoverably damaged growth plate. Conclusion: Although it is tentatively possible to predict the deformity progress or non-progress and spontaneous correction at the time of the initial treatment, its predictive accuracy is low. Therefore, assessment of the chronological changes should be performed at the end of chemotherapy. In children with progressive curve change, assessment of deformity should be continued until maturity.

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.

Diffuse Leptomeningeal Glioneuronal Tumor with FGFR1 Mutation in a 29-Year-Old Male (29세 남성에서 발생한 FGFR1 돌연변이를 동반한 미만성 연수막성 신경교종)

  • Minsu Kim;Ki Rim Lee;Gheeyoung Choe;Kihwan Hwang;Jae Hyoung Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.4
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    • pp.970-976
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    • 2023
  • This study reports on diffuse leptomeningeal glioneuronal tumor (DL-GNT) in a 29- year-old male. DL-GNT is a rare central nervous system (CNS) tumor mostly seen in children and only few cases have been reported in adult patients. Our patient presented with a chronic headache that lasted for five months. MR imaging showed mild hydrocephalus, multiple rim-enhancing nodular lesions in the suprasellar cistern, diffuse leptomeningeal enhancement in the lumbosacral area, and multiple small non-enhancing cyst-appearing lesions not suppressed on fluid attenuated inversion recovery (FLAIR) images in the bilateral basal ganglia, thalami, and cerebral hemispheres. Under the impression of germ cell tumor with leptomeningeal seeding, the patient underwent trans-sphenoidal tumor removal. DL-GNT was pathologically confirmed and FGFR1 mutation was detected through a next-generation sequencing test. In conclusion, a combination of leptomeningeal enhancement and multiple parenchymal non-enhancing cyst-appearing lesions not suppressed on FLAIR images may be helpful for differential diagnosis despite overlapping imaging features with many other CNS diseases that have leptomeningeal enhancement.

A Comparative Study on the Electrophysiological Properties of Medial and Lateral Spinoreticular Tract Cells in Cats (고양이의 내측 및 외측 척수망상로 세포의 전기생리학적 비교연구)

  • Lee, Suk-Ho;Jun, Jae-Yeol;Park, Choon-Ok;Goo, Yong-Sook;Kim, Jun;Sung, Ho-Kyung
    • The Korean Journal of Physiology
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    • v.24 no.1
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    • pp.181-194
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    • 1990
  • Antidromically activated spinoreticular tract (SRT) cell units in the lumbosacral enlargement of ${\alpha}-chloralose$ anesthetized cats were classified as medial and lateral SRT units according to the location of their axonal termination. Identified SRT units were tested fer antidromic conduction velocity, laterality of their axonal projection, the location in spinal gray, peripheral receptive field, the response pattern to graded mechanichal stimulation and the responsiveness to $A{\delta}$ and C volley of the peripheral nerve. 1) The 59% of 34 medial SRT units were recorded in ipsilateral side to the antidromic stimulation site, but 60% of the 47 lateral SRT units projected to contralateral side. 2) Most of the medial SRT cells and rostral ventrolateral medulla (RVLM)-projecting lateral SRT cells were recorded in lamina VII & VIII. The LRN (lateral reticular nucleus)-projecting SRT cells, however, distributed through all the laminae except superficial ones (I & II). 3) The identified SRT units were classified as low theshold (LT), deep, high threshold (HT), wide dynamic range (WDR) cells, based on the response patterns to graded mechanical stimuli. The proportion of SRT units which receive noxious input was 37.5%, 25% and 75% in the medial, LRN-projecting and RVLM SRT group, respectively. 4) There was no significant difference in the mean conduction velocities between the 3 groups. But the deep cells had significantly higher velocity than that of the HT cells. The above results show that the peripheral inputs to the SRT units are different in the 3 groups: medial, LRN & RVLM SRT group. Especially in case of the SRT cells projecting to RVLM which is a probable candidate fur the integration center of various pressor reflexes such as somatosympathetic reflex, the noxious informations occupy higher proportion of input to them than in other groups. Therefore the noxious information transmitted through the lateral SRT destined for RVLM is expected to play a role in somatosymapthetic reflex.

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Factors Associated with Conversion from Conservative to Surgical Treatment in Single-Level Lumbar Spinal Stenosis Patients (보존적 치료 중인 단분절 요추관 협착증 환자에서 수술적 치료로 전환과 관련된 연관 인자)

  • Ahn, Young-Joon;Im, Se-Hyuk;Park, Byung-Kyu
    • Journal of Korean Society of Spine Surgery
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    • v.25 no.4
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    • pp.160-168
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    • 2018
  • Study Design: Retrospective study of prospectively-collected data. Objectives: To determine the factors associated with conversion from conservative to surgical treatment in single-level lumbar spinal stenosis patients. Summary of Literature Review: Various reports have presented clinical outcomes after the surgical and nonsurgical treatment of spinal stenosis. However, few reports have investigated factors predicting conversion to surgery during the course of conservative treatment. Materials and Methods: We analyzed 40 patients who visited our hospital from May 2010 to May 2015 and were traceable for at least 3 years after being advised to undergo surgery following 3 months of conservative treatment. Of these patients, 20 underwent surgery and 20 did not. We then investigated the factors associated with conversion to surgical treatment. Clinical assessments were conducted using a questionnaire, and the overall area of the spinal canal and the muscle area within the spinal canal were measured using magnetic resonance imaging. Results: The average area of the spinal canal was $81.40{\pm}53.61mm^2$ in the surgical group, compared to $127.75{\pm}82.55mm^2$ in the nonsurgical group (p=0.042). The muscle area in the spinal canal was $5.17{\pm}1.30cm^2$ in the surgical group, whereas it was $6.40{\pm}1.56cm^2$ in the nonsurgical group (p=0.010). The patients in the surgical group were more likely to have experienced repetitive strain and to have frequently visited health clubs (p=0.047, p=0.037, respectively). However, regular stretching was more common in the nonsurgical group (p=0.028). Conclusions: The factors associated with conversion to surgical treatment were a narrow spinal canal, a small muscle area within the spinal canal, visiting health clubs, repetitive sprain, and not stretching. A small muscle area within the spinal canal can be considered as a key factor related to surgical conversion.

The Efficacy of the Change in Belly Board Aperture Location by the Addition of Bladder Compression Device for Radiotherapy of Rectal Cancer (직장암 환자의 골반 방사선치료에서 벨리보드 하위 경계 위치 변화의 영향)

  • Yoon, Hong-In;Chung, Yoon-Sun;Kim, Joo-Ho;Park, Hyo-Kuk;Lee, Sang-Kyu;Kim, Young-Suk;Choi, Yun-Seon;Kim, Mi-Sun;Lee, Ha-Yoon;Chang, Jee-Suk;Cha, Hye-Jung;Seong, Jin-Sil;Keum, Ki-Chang;Koom, Woong-Sub
    • Radiation Oncology Journal
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    • v.28 no.4
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    • pp.231-237
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    • 2010
  • Purpose: We investigated the effect of location changes in the inferior border of the belly board (BB) aperture by adding a bladder compression device (BCD). Materials and Methods: We respectively reviewed data from 10 rectal cancer patients with a median age 64 years (range, 45~75) and who underwent computed tomography (CT) simulation with the use of BB to receive pelvic radiotherapy between May and September 2010. A CT simulation was again performed with the addition of BCD since small bowel (SB) within the irradiated volume limited boost irradiation of 5.4 Gy using the cone down technique after 45 Gy. The addition of BCD made the inferior border of BB move from symphysis pubis to the lumbosacral junction (LSJ). Results: Following the addition of BCD, the irradiated volumes of SB and the abdominopelvic cavity (APC) significantly decreased ($174.3{\pm}89.5mL$ vs. $373.3{\pm}145.0mL$, p=0.001, $1282.6{\pm}218.7mL$ vs. $1,571.9{\pm}158mL$, p<0.001, respectively). Bladder volume within the treated volume increased with BCD ($222.9{\pm}117.9mL$ vs. $153.7{\pm}95.5mL$, p<0.001). The ratio of irradiated bladder volume to APC volume with BCD ($33.5{\pm}14.7%$) increased considerably compared to patients without a BCD ($27.5{\pm}13.1%$) (p<0.001), and the ratio of irradiated SB to APC volume decreased significantly with BCD ($13.9{\pm}7.6%$ vs. $24.2{\pm}10.2%$, p<0.001). The ratios of the irradiated SB volume and irradiated bladder volume to APC volume negatively correlated (p=0.001). Conclusion: This study demonstrated that the addition of BCD, which made the inferior border of BB move up to the LSJ, increased the ratio of the bladder to APC volume and as a result, decreased the irradiated volume of SB.