• Journal of Korean Neurosurgical Society
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• v.45 no.3
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• pp.192-195
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• 2009

We present a case of an acute psoas muscle hematoma following percutaneous endoscopic lumbar discectomy. A 60-year-old female who presented with far lateral lumbar disc herniation underwent endoscopic discectomy on the right side at the L4-5 level. On the second postoperative day, the patient complained of severe right flank and leg pain and her blood pressure decreased. A computed tomography scan showed a large acute psoas muscle hematoma at right L4-5 level. The patient was transfused with packed red blood cells and placed at absolute bed rest. After observing the patient in intensive care, the severe flank and leg pain subsided, but the mild back pain persisted. Although percutaneous endoscopic lumbar discectomy is an effective minimally invasive surgical technique for the treatment of lumbar disc herniation, this case highlights the inherent risks of acute lumbar segmental vessel injury.

• Journal of the Korean Society of Radiology
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• v.81 no.6
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• pp.1511-1516
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• 2020

The anomalous retro-psoas iliac artery is an extremely rare congenital iliolumbar vascular anomaly. A 51-year-old woman presented to our emergency department with worsening right lower extremity pain and weakness for 3 months. CT angiography of the right lower extremity showed no evidence of stenosis in the lower extremity arteries and the incidental finding of an anomalous right retro-psoas iliac artery. Herein, we report a rare case of anomalous retro-psoas iliac artery. Surgeons and clinicians need to be aware of this rare congenital anomaly to avoid severe complications during pelvic or orthopedic surgery.

• The Korean Journal of Pain
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• v.23 no.2
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• pp.131-136
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• 2010

Background: We prospectively evaluated the incidence and possible factors causing intramuscular injection during lumbar sympathetic ganglion block and compared the multiple needle technique to the single technique to obtain a profound and complete block effect. Methods: Among 83 patients, 58 patients (group A, n = 27, multiple needle technique and group B, n = 31, single needle technique) were reevaluated for the changes of skin temperature (Ts) and mean segment of longitudinal contrast spread. After injecting the contrast agent, the incidence of psoas muscle injection and the change of Ts was compared between two groups. Results: The incidence of psoas muscle injection was 21.3% (46/216) and it was associated with the level of injection (L2) significantly (${\chi}_2$ = 14.773, P = 0.001). $DT^{post}$ (postblock temperature difference between ipsilateral and contralateral great toe, $4.6{\pm}2.8^{\circ}C$, $1.8{\pm}1.6^{\circ}C$, P < 0.001 for group A and B) and $DT^{net}$ ($DT^{post}$ - $DT^{pre}$, $3.9{\pm}2.7^{\circ}C$, $1.5{\pm}1.5^{\circ}C$, P < 0.001 for group A and B) was significantly higher in group A. The mean segment of longitudinal contrast spread was $8.1{\pm}0.9$ for group A and $3.2{\pm}1.6$ for group B (P < 0.001). Conclusions: The LSGB at the L2 level showed the lowest incidence of psoas muscle injection of contrast. Multiple needle approach showed more significant increase of $DT^{net}$ and $DT^{post}$.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.5 no.1
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• pp.36-40
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• 2012

Although surgical drainage has been performed in most reported cases of psoas abscess, ultrasonographically guided percutaneous drainage could be effective treatment for psoas abscess. However, utility of percutaneous drainge under ultrasound is less well established. We present a patient in whom fungal psoas abscess was managed by ultrasonographically guided percutaneous aspiration with literature review. Drainage was done by needle aspiration under ultrasound guidance and there was no procedural complication. After aspiration, Candida Albicans was found as a causing organism responsible for abscess and abscess could be successfully treated by repeated aspiration and appropriate antifungal therapy.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.8 no.2
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• pp.39-46
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• 2013

Objectives : To identify the association between cross-sectional area of lumbar regional muscle and stability(ST), center of pressure(COP) assessed by tetrax. Methods : Patients(n=55) who had taken L-SPINE MRI and Tetrax(Sunlight, Israel) were analyzed retrospectively. To evaluate the cross-sectional area of lumbar regional muscle, L-SPINE MRI was used. Data of ST, COP were accumulated by using dynamic equilibrium analysis by Tetrax. Of the lumbar regional muscles, the Psoas muscles and the Paraspinalis muscles were examined. Using Pearson correlation, we analyzed COP, ST and the difference between the cross-sectional area of lumbar regional muscles. Results : The variance of cross-sectional area of both sides of Psoas muscle and COP had moderate positive correlation(r=0.621). Between variance of cross-sectional area of both sides of Paraspinalis and lumbar regional muscle and COP there was low positive correlation(r=0.287, r=0.329) ST also had low correlation with variance of cross-sectional area of both sides of Psoas muscle. Conclusion : The variance of cross-sectional area between both sides of Psoas muscle had moderate correlation with COP.

• Journal of Korean Neurosurgical Society
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• v.64 no.3
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• pp.447-459
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• 2021

Objective : Oblique lateral interbody fusion (OLIF) is becoming the preferred treatment for degenerative lumbar diseases. As beginners, we performed 143 surgeries over 19 months. In these consecutive cases, we analyzed the learning curve and reviewed the complications in our experience. Methods : This was a retrospective study; however, complications that were well known in the previous literature were strictly recorded prospectively. We followed up the changes in estimated blood loss (EBL), operation time, and transient psoas paresis according to case accumulation to analyze the learning curve. Results : Complication-free patients accounted for 43.6% (12.9%, early stage 70 patients and 74.3%, late stage 70 patients). The most common complication was transient psoas paresis (n=52). Most of these complications occurred in the early stages of learning. C-reactive protein normalization was delayed in seven patients (4.89%). The operation time showed a decreasing trend with the cases; however, EBL did not show any significant change. Notable operation-induced complications were cage malposition, vertebral body fracture, injury to the ureter, and injury to the lumbar vein. Conclusion : According to the learning curve, the operation time and psoas paresis decreased. It is important to select an appropriately sized cage along with clear dissection of the anterior border of the psoas muscle to prevent OLIF-specific complications.

• Journal of Chest Surgery
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• v.48 no.6
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• pp.443-446
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• 2015

A 36-year-old man, who had undergone thoracoscopic anterior spinal fusion using the plate system and posterior screw fusion three months previously, presented to our hospital with left flank pain and fever. Computed tomography indicated the presence of a psoas muscle abscess. However, after two days of percutaneous catheter drainage, a mycotic abdominal aortic pseudoaneurysm was detected via computed tomography. We performed in situ revascularization using a prosthetic graft with omental wrapping. Methicillin-resistant Staphylococcus aureus was identified on blood and pus culture, and systemic vancomycin was administered for one month. Although the abscess recurred, it was successfully treated with percutaneous catheter drainage and systemic vancomycin administration for three months, without the need for instrumentation removal. The patient remained asymptomatic throughout two years of follow-up.

• The Korean Journal of Pain
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• v.6 no.2
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• pp.224-230
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• 1993

Most patients who have suffered from pain and muscle weakness on femoral nerve distributing area show no definite pathologic finding on X-ray or laboratory examinations. Therefore proper diagnosis is difficult to determine for the proper treatment of the symptoms. Based on my clinical experiences and anatomical studies, I have found most of these symptoms are a result of femoral nerve compression on trigger point of psoas major muscle. Accordingly, releasing the compression of femoral nerve by Laser stimulation and local anesthetic injection to the identified trigger point of psoas major muscle was found to be an effective treatment for femoral neuralgic pain.

• Journal of Life Science
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• v.21 no.1
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• pp.1-8
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• 2011

The purpose of this study was to investigate whether 12-weeks of movement training would increase the psoas major cross-sectional area (CSA) in senior men and women. Fifty eight men and women aged 65 to 80 years old ($69.6{\pm}3.7$, 30 male, 28 female) were divided into a control (n=19) and exercise group (n=39). Subjects were assessed before and after the training program for stature, body mass, and magnetic resonance imaging of the psoas major and the quadriceps muscle. The experimental group performed exercises using machines designed to improve the movement of the hip at a frequency of twice every week, with a total of 23 trainings in 12-weeks. Magnetic resonance images of both thighs and the abdomen and psoas major were obtained, aimed at 50% of the length of the greater trochanter and the lower edge of the femur and between the fourth (L4) and fifth (L5) lumbars. A 9.4% increase in the psoas major CSA in the training group was observed. In the male and female breakdown, a 11.5% and 8.4% change was observed in males and females, respectively. In the quadriceps, there was no significant statistical improvement in either males or females. Furthermore, in the control group, there was no significant change seen in either the psoas major or the quadriceps. As a result of conducting training that enables upkeep of posture and smooth linkage of the lumbar spine, the pelvis and thighbone, the psoas major CSA of older adults were improved in a short period of time. For this reason, the possibility of improving the psoas CSA, which decreases remarkably with increased age, by improving the linkage of the body trunk is also suggested.

• Journal of the Korea Convergence Society
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• v.9 no.3
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• pp.137-144
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• 2018

The purpose of this study was to investigate the fusion effects and difference them of the deep transverse stroking, manual stretching exercise and active muscle release technique on psoas major muscle thickness and muscle tone, and pelvic angle in non-specific low back pain patients. Psoas major muscle thickness was significantly decreased after the application of the deep transverse stroking $0.19{\pm}0.16cm$ (p <0.05), manual stretching exercise $0.18{\pm}0.14cm$ (p <0.05), and active muscle release technique $0.43{\pm}0.35cm$ (p <0.05). The pelvic angle was significantly decreased after the application of the deep transverse stroking $4.48{\pm}1.63^{\circ}$ (p <0.05), manual stretching exercise $5.36{\pm}2.04^{\circ}$ (p <0.05), and active muscle release technique $7.24{\pm}2.23^{\circ}$ (p <0.05). The Psoas major muscle tone was significantly decreased after application of the deep transverse stroking $0.96{\pm}0.93Hz$ (p <0.05), but manual stretching exercise $0.87{\pm}1.20Hz$ (p> 0.05) and active muscle release technique $0.82{\pm}0.98Hz$ (p> 0.05) there was no significant difference after application. There were no significant differences between the three intervention methods in the pelvic angle and psoas major muscle thickness and tone changes. In order to change psoas major muscle thickness and pelvic angle, three intervention methods should be applied appropriately according to the condition and environment of the patient, and deep transverse stroking is more effective for changing psoas major muscle tone.