• Title/Summary/Keyword: Psoas

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Psoas Compartment Blockade in a Laterally Herniated Disc Compressing the Psoas Muscle - A Case Report -

  • Kim, Hye-Young;Park, Jin-Woo;Park, Soo-Young;Moon, Jee-Youn;Shin, Jae-Hyuck;Park, Sang-Hyun
    • The Korean Journal of Pain
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    • v.25 no.2
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    • pp.116-120
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    • 2012
  • A psoas compartment block has been used to provide anesthesia for orthopedic surgical procedures and analgesia for post-operative pain. Currently, this block is advocated for relieving pain in the lower extremity and pelvic area resulting from various origins. We report a case of a 69-year-old male patient who had gait abnormality with posterior pelvic and hip pain, which were both aggravated by hip extension. From the magnetic resonance image, the patient was found to have a laterally herniated intervertebral disc at the L2/3 level, which compressed the right psoas muscle. This was thought to be the origin of the pain, so a psoas compartment block was performed using 0.25% chirocaine with triamcinolone 5mg, and the pain in both the pelvis and hip were relieved.

A Study of the Depth from the Skin to the Psoas Compartment under C-arm Guidance (C자형 영상증강장치를 사용한 방사선 투시하에 피부로부터 대요근 근구까지의 깊이에 대한 연구)

  • Woo, Sung-Hoon;Kang, Jung-Gwon;Oh, Wan-Soo;Hong, Ki-Hyuk
    • The Korean Journal of Pain
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    • v.13 no.1
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    • pp.93-96
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    • 2000
  • Background: Psoas compartment block with local anesthetics and corticosteroids is one of the treatments which provides long term analgesia of the lower back and anterior thigh unilaterally, and its technical easiness and safety allows blind application without C-arm guidance in the out-patient clinic. This study aimed to evaluate the mean of the depth from the skin to the psoas compartment, and its correlation to the following attributes: age, weight, height and PI (Ponderal Index). Methods: We investigated 28 patients who underwent psoas compartment block. All blocks were performed using Chayen's method (punctured at the point of 3 cm caudally and 5 cm laterally from the 4th lumbar vertebral spinous process) with a 22 G, 8 cm Tuohy needle under C-arm guidance. We recorded the depth from skin to the psoas compartment, height, weight and PI (weight (kg)/height (cm)$\times100$ (%)). Data were analyzed using the Pearson product-moment correlation coefficients. The correlations between the depth and other attributes identified by p-value of less than 0.05 were considered statistically significant. Results: The mean depths from skin to the psoas compartment were $6.02{\pm}0.28$ cm in men, $5.44{\pm}0.22$ cm in women. There is no significant correlation between the depth and other patient's attributes. Conclusions: The mean depths from skin to the psoas compartment may be one of the guide for psoas compartment block in outpatient clinics without C-arm guidance.

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Psoas Compartment Block for the Relief of Lumbar and Left Thigh Pain after Operation of Second Lumbar Compression Fracture -A case report- (척추 수술 후 발생된 요부 및 좌측 대퇴전부 통증 치료를 위한 대요근 근구 차단술의 효과 -증례 보고-)

  • So, Keum-Young;Park, You-Jin;Koog, Jong-Soo
    • The Korean Journal of Pain
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    • v.11 no.2
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    • pp.314-316
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    • 1998
  • Psoas compartment block has been used to provide anesthesia and analgesia of hip joint. This block is advocated for relief of pain of various origins in the thigh, leg and lumbar area. A-40-year-old women complained of pain in the left thigh and lumbar area after operation of the second lumbar vertebral compression fracture. To relieve pain, caudal block was performed. This block reduced in lumbar pain but left thigh pain persisted. So, we were performed psoas compartment block using mepivacaine and dexamethasone, which relieved the pain in the left thigh and lumbar area. We recommend psoas compartment block as useful and simple method for patients with thigh and lumbar area pain, especially when the epidural block is not feasible.

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The Influence of Psoas Muscle Contracture on Autonomic Nervous System Activity (요근 긴장이 자율신경계 활성도 변화에 미치는 영향)

  • Lee, Jung-Ho;Kim, Ho-Jun;Lee, Myeong-Jong
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.3 no.1
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    • pp.73-82
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    • 2008
  • Objectives : This study was performed to examine the hypothesis that the structural imbalance affect cardiac function and autonomic reflex system and to investigate the possibility of the chiropractic care for cardiovascular system. Methods : 78 of Dong-Guk University students with structural imbalance were recruited for the investigation from March to June 2007. Heart rate variability, Buss and Durkee Hostility inventory(BDHI) and physical examinations to evaluate psoas muscle contracture were performed. Results : Left psoas muscle contracture was associated with decrease of LF/HF ratio(p=0.048). Conclusion : Left side contracture of psoas muscle showed a tendency to decrease sympathetic activity.

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Reactive muscle control, sternocleidomastoid and psoas, and sit-up impossible; an experimental study (윗몸일으키기가 불가한 요통 환자에 대한 흉쇄유돌근과 요근의 반응성 근육조절 치료 방법의 적용에 관한 실험)

  • Kim, Wan-Tae
    • Journal of Korean Physical Therapy Science
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    • v.13 no.1
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    • pp.75-82
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    • 2006
  • Purpose: The purpose of this experimental study have been testifying about reactive muscle control regarding sternocleidomastoid and psoas. Low back pain patient do not sit-up exercise without abnormality of trunk flexor. The reason of problem is unbalance sternocleidomastoid and psoas. According to George J, Goodheart who have been developing Applied Kinesiology (A. K.) since reactive muscle recognized gait testing in 1964. Materials and Methods: From September, 2004 to February, 2005, I have controled sternocleidomastoid and psoas. It is applied to the patients who are unable sit up exercise at Yang-Dong local clinic, Yang-Pyung county, Kyung-Gi Do province in Korea. 24 Patients divided 2 groups. A group is applied general physical therapy. Also B group is added reactive muscle control from M.E.M.P.T.(Korean society of muscle and energy monitoring physical therapy) Results : The results of this study follow. 1. Possible sit up group 8 persons of the second group. 2. Not possible sit up group the others. Conclusion: The study present that reactive muscle control sternocliedomastoid and psoas is useful in patient with low back pain is difficult to sit up.

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The Findings of Relation between Cross-sectional Area of Lumbar Paraspinal Muscle and Prognosis in Patients of Acute and Chronic Low Back Pain Patients (급성 및 만성 요통환자의 요부주위근 횡단면적과 요통 예후의 상관관계 연구)

  • Nam, Ji Hwan;Lee, Chong Hwan;Lee, Seul Ji;Kim, Kie Won;Lee, Min Jung;Jun, Jae Yun;Lim, Su Jin;Hong, Nam Jung;Song, Ju Hyun
    • Journal of Acupuncture Research
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    • v.30 no.4
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    • pp.45-53
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    • 2013
  • Objectives : The purpose of this study was to evaluate the relationship between cross-sectional areas of the paraspinal and psoas muscles with low back pain. Methods : We assessed the cross-sectional area of the psoas and paraspinal muscles at the superior part of L4 level and vertebral body of L4 of 132 patients who were hospitalized with a chief complaint of low back pain at Jaseng Hospital of Korean Medicine from January 2013 to April 2013. After calculating the mean psoas area, we divided the patients into 2 groups by whether the psoas cross section was larger or smaller than the mean, and compared the admission period, verbal numeric rating scale(NRS) of low back pain(LBP), and improvement of verbal NRS of LBP. We also subcategorized the patients into acute and chronic groups according to the duration period, and compared the cross-sectional area of the psoas and paraspinal muscles. Results : Although analyses of the verbal NRS of LBP, and improvement of verbal NRS of LBP between groups with larger and smaller psoas cross section areas showed no significant difference, the admission period was significantly shorter in the group with larger psoas cross section areas. There was no significant difference in analyses of cross section areas in the acute and chronic groups. Of the possible prognostic variables, improvement of verbal NRS of LBP showed no correlation, while the admission period displayed a significant correlation. The cross-sectional area of the psoas and paraspinal muscles divided by the area of the vertebral body of L4 had a significant negative correlation with age. Conclusions : The cross-sectional area of the psoas and paraspinal muscles were correlated with the admission period in LBP patients, and the cross-sectional area of the surrounding muscles divided by the area of the L4 vertebral body was negatively correlated with age.

Correlations of Cross-sectional Areas of Psoas and Paraspinal Muscles in Patients with Lumbar Disc Herniation According to the Age Groups (연령대별 요추 추간판탈출증 환자의 요근과 척추주위근 단면적에 대한 분석)

  • Kong, Deok-Hyun;Bae, Kwang-Ho;Go, Ho-Yeon;Kang, Myung-Jin;Kim, Jun-Su;Yang, Kee-Young;Lee, Jae-Hoon;Eun, Young-Jun
    • Journal of Korean Medicine Rehabilitation
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    • v.20 no.4
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    • pp.159-169
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    • 2010
  • Objectives : This study was designed to evaluate the correlation of the cross-sectional areas(CSA) of paraspinalis(iliocostalis lumborum, multifidus, longissimus thoracis parts lumborum) and psoas muscle and sex, age, change of the VAS(visual analogue scale) and past history of chronic low back pain in patients suffering from HIVD(herniation of intervertebral disc). Methods : Medical records of 140 subjects with HIVD were retrospectively reviewed. The MRI(magnetic resonance imaging) findings on the patients were scanned and analyzed by PiView program to find the paraspinal and psoas muscle CSA and were evaluated by the correlation of sex, age, change of the VAS, and past history of chronic low back pain. Results : There was significant difference between groups in male and female, young-adults age and middle age, middle age and old age, young-adults age and old age. But the correlation of the paraspinal and psoas muscle CSA and past history of chronic low back pain were partially significant. On the other hand, the correlation of the paraspinal and psoas muscle CSA and change of the VAS were not significant. Conclusions : These results suggest that the cross-sectional areas(CSA) of paraspinalis and psoas muscle have relevance to sex and age.

A Study on Correlation between the Axial Section Area in Psoas Major Muscle and Nucleus Discharge Part of HIVD of L-spine (추간판 탈출증의 수핵 탈출부위와 요근의 좌우 단면적 넓이와의 상관관계)

  • Kim, Hyung-Kil;Lee, Dong-Eun;Cho, Woong-Hee;Kim, Doo-Hee;Park, Won-Hyung;Cha, Yun-Yeop;Choi, Ga-Young
    • Journal of Korean Medicine Rehabilitation
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    • v.21 no.4
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    • pp.111-118
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    • 2011
  • Objectives: This study was designed to correlation between the axial section area in psoas major muscles and uncleus discharge pat of HIVD(herniated intervertebral disc) of lumbar(L)-spine. Methods: We measured the axial section area in psoas muscles. Then through the medical charts, we investigated nucleus discharge pat of HIVD of L-spine. We analyzed the relationship between them. Results: There was no significant correlation nucleus discharge part and psoas major muscle's axial section area. There was significant correlation aging and psoas major muscle's axial section area with control the sex. Conclusions: According to above results, there was no significant the area of axial section in psoas major muscles and nucleus discharge part of HIVD of L-spine.

A Case of Tuberculous Psoas Abscess Caused by Tuberculous Lymphadenopathy (결핵성 림프절염에 이차적으로 발생한 결핵성 요근 농양 1예)

  • Park, Mi Youn;Park, Jin Young;Yu, Ji Youn;Kim, Seung Su;Kim, Myung Sook;Kim, Ji Chang;Ahn, Chang Joon
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.6
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    • pp.517-521
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    • 2008
  • A tuberculous psoas abscess is a frequently described complication of tuberculous spondylitis. Although rare, a tuberculous psoas abscess can develop without any demonstrable spinal involvement. In patients with no evidence of sponylitis, the abscess may result from direct spread from the involved lymph node or via a hematogeous route. The treatment of a psoas abscess is either drug therapy or surgical intervention in conjunction with drug therapy. Image-guided percutaneous drainage in conjunction with drug therapy is also a safe and effective treatment for a tuberculous psoas abscess. We report an unusual case of bilateral tuberculous psoas abscesses without any concomitant spinal involvement. The tuberculous psoas abscess may have formed by fistulization between the necrotic lymph node and psoas sheath. The diagnosis was confirmed by computed tomography and a histology examination of the biopsy sample. The patient improved after administering anti-tuberculous agents for 2 years along with surgical and percutaneous drainage of the abscess.

Pyogenic Spondylitis with Diffuse Spinal Epidural Abscess - A Case Report - (미만성 척수 경막외 농양을 동반한 화농성 척추염 - 증 례 보 고 -)

  • Kim, Hun;Kim, Sung Min;Chung, Dai Jin;Shim, Young Bo;Park, Yong Kee;Choi, Sun Kil
    • Journal of Korean Neurosurgical Society
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    • v.29 no.8
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    • pp.1074-1079
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    • 2000
  • We report a case of pyogenic spondylitis on L2 and L3 with diffuse epidural abscess up to T4 to L3 and large psoas abscess. A forty-nine-year old male was presented with progressive back pain, left flank pain and ab-dominal distention, weakness of the both legs and voiding and defecation difficulty during last 2 months. Initially multiple coronal hemilaminectomies from T4 to T12 were done for the treatment of diffuse thoracic epidural ab-scess. Then second operation via left retroperitoneal approach was performed for lumbar spondylitis and psoas abscess on third day after initial operation. After removal and curettage of pyogenic psoas and epidural abscess and spondylitis (L2-L3), iliac bone grafting with Keneda instrumentation from L1 to L4 was done simultaneously. Postoperative course has been unevenful without recurrent infection. The literature on diffuse epidural and large psoas abscess with pyogenic spondylitis are reviewed and instrumentation for stabilization of pyogenic spondylitis is also discussed.

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