• Title/Summary/Keyword: Upper lumbar

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Sacral Insufficiency Fracture, Usually Overlooked Cause of Lumbosacral Pain

  • Lee, Yong-Jeon;Bong, Ho-Jin;Kim, Jong-Tae;Chung, Dong-Sup
    • Journal of Korean Neurosurgical Society
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    • v.44 no.3
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    • pp.166-169
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    • 2008
  • Sacral insufficiency fractures are usually known to develop in elderly patients with osteoporosis without definite trauma history. It is difficult to diagnose the sacral insufficiency fracture at an early stage because lower lumbar diseases. concurrently or not, may also be presented with similar symptoms and signs. We report a rare case of sacral insufficiency fracture who was not diagnosed initially but, instead, showed progressively worsening of clinical symptoms and radiological findings after decompression surgery for upper level lumbar stenosis.

Successful Treatment of Severe Sympathetically Maintained Pain Following Anterior Spine Surgery

  • Woo, Jae Hee;Park, Hahck Soo
    • Journal of Korean Neurosurgical Society
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    • v.56 no.1
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    • pp.66-70
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    • 2014
  • Sympathetic dysfunction is one of the possible complications of anterior spine surgery; however, it has been underestimated as a cause of complications. We report two successful experiences of treating severe dysesthetic pain occurring after anterior spine surgery, by performing a sympathetic block. The first patient experienced a burning and stabbing pain in the contralateral upper extremity of approach side used in anterior cervical discectomy and fusion, and underwent a stellate ganglion block with a significant relief of his pain. The second patient complained of a cold sensation and severe unexpected pain in the lower extremity of the contralateral side after anterior lumbar interbody fusion and was treated with lumbar sympathetic block. We aimed to describe sympathetically maintained pain as one of the important causes of early postoperative pain and the treatment option chosen for these cases in detail.

Treatment of 43 Patients with Buerger's Disease (Buerger환자 43명의 치료 경험)

  • Cheun, Jae-Kyu;Jang, Young-Ho;Chung, Jung-Kil
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.114-119
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    • 1996
  • Buerger's disease is a nonatherosclerogic occlusive inflammatory disease of medium and small arteries, and veins, of unknown cause. It occurs predominantly in young males who are habitual tabacco users. These patients often complain of painful ulcerations of their digits. The care of this disease is very difficult when the treatment is delayed. Consequently, early treatments are most important to patients with Buerger's disease. This disease can be treated with sympathetic block such as stellate ganglion block for upper extremities and lumbar epidural block, and lumbar sympathetic block for lower extremities. Intravascular regional sympathetic block can be another method of treatment. However, discontinuation of smoking is the most basic and essential treatment for Buerger's disease. We treated 43 Buerger's disease patients with stellate ganglion block and laser therapy. The treatment was not effective for three patients who definitely required amputation.

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Lumbar Vertebral Osteomyelitis in a Dog (개에서 발생한 척추골 골수염 증례)

  • Lee, Min-Su;Jung, Mi-Ae;Jeong, Soon-Wuk;Park, Hee-Myung;Kim, Hwi-Yul;Eom, Ki-Dong
    • Journal of Veterinary Clinics
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    • v.25 no.1
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    • pp.64-66
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    • 2008
  • A castrated male, 9-year-old Yorkshire terrier was presented with a depression and bilateral hind limbs lameness. On physical examinations, upper motor neuron signs and stiffness of the hind limbs, back pain and progressive paresis were identified. Marked periosteal new bone formations and lysis include the first lumbar vertebra to the sacrum, bilateral iliums acetabulums and bilateral femoral heads were observed in survey radiographs. After death with septicemia suspected, renal infarction and the 5th vertebral osteomyelitis include pelvic periostitis were diagnosed in histological examination.

The Effect of Position on Measured Lung Capacity of Patients with Spinal Cord Injury (척수손상환자의 폐활량에 자세가 미치는 영향)

  • Kim, Myoung-Kwon;Hwangbo, Gak
    • Proceedings of the Korea Contents Association Conference
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    • 2012.05a
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    • pp.173-174
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    • 2012
  • To determine whether position affects measured lung capacity of spinal cord injury patients. The study subjects were 45 patients with spinal cord injury (cervical level 15, thoracic level 15, lumbar level 15). Subjects were provided with a full explanation of the experimental procedures and all provided written consent signifying their voluntary participation. We used a spirometer (Spirometer, Micromedical Ltd, UK) to measure pulmonary function in the supine and sitting positions (straightened upper body at an angle of $90^{\circ}$). Forced vital capacity (FVC), forced expiratory volume during the first second (FEV1), tidal volume (TV), and maximum insufflation capacity (MIC) were also measured. FVC, FEV1, TV, MIC (%) were greater in the supine than in the sitting position for those with injury at the cervical or thoracic injury level. On the other hand, FVC, FEV1, TV, MIC (%) were lower in the supine position for those with an injury at the lumbar level. More attention should be paid to the effect of injury level on measured lung capacity.

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The Contribution of Body Segments to the Club Head's Kinetic Energy in the Golf Swing (골프 스윙 시 클럽 헤드의 운동에너지에 대한 신체 분절의 기여도)

  • Chang, Jae-Kwan;Ryu, Ji-Seon;Yoon, Suk-Hoon
    • Korean Journal of Applied Biomechanics
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    • v.21 no.3
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    • pp.317-325
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    • 2011
  • The purpose of this study was to investigate the contributions of body joints to the kinetic energy of the clubhead in the golf swing. Three dimensional swing analysis was conducted on the seven KPGA golfers. The subjects were asked to swing with 45 inches of driver. The work done by body joints were computed by utilizing the inverse dynamics method. The order of work done by the body joints was lumbar > left hip > right shoulder > left wrist > right wrist > right hip at the first phase. At the second phase, the order of work done by the body joints was trunk > left elbow > right wrist > right shoulder > left wrist > right wrist. At the third phase, the order of work done by body joints was lumbar > right shoulder > left shoulder > left elbow > right wrist > right elbow. The sum of the work done by the body joints was lumbar > shoulder > wrist on the average. The kinetic energy of the club head was 430.11${\pm}$24.35 J and the subject's swing efficiency was shown as 31.82${\pm}$4.86% on the average. The contributions of body joints to the kinetic energy of the clubhead was the order of lumbar > upper right shoulder > left elbow > right wrist during the down swing.

A Clinical Review of the Patients in the Kim Chan Pain Clinic (김 찬 신경통증클리닉 환자의 통계고찰)

  • Han, Kyung-Ream;Park, Won-Bong;Kim, Wook-Seoung;Lee, Jae-Cheul;Lee, Kyung-Jin;Kim, Chan
    • The Korean Journal of Pain
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    • v.11 no.1
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    • pp.101-104
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    • 1998
  • Backgrouds: Twent five years have passed since the opening of the first pain clinic in korea, in 1973 at Yonsei University Hospital. The number of pain clinics are gradually increasing in recent times. It is important to plan for future pain clinics with emphasis on improving the quality of pain management. Therefore we reviewed the patients in our hospital to help us in planning for the future of our pain clinic. Methods: We analyzed 2656 patients who had visited our Kim Chan Pain Clinic, accordance to age, sex, disease, and type of treatment block, from July 1996 to August 1997. Results: The prevalent age group was in the fifties, 27.3%, seventy years and older compromised 9.2%. The most common disease were as follows: lower back pain(46.2%); cervical and upper extremities pain(23.1%); trigeminal neuralgia(7.2%); and hyperhydrosis(5.8%) Both nerve blocks and medication were prescribed as treatment. Lumbar epidural block(16.3%) and stellate ganglion block(15.6%) were the most frequent blocks performed among various nerve blocks. Among nerve block under C-arm guidance, lumbar facet joint block(24.4%) and lumbar root block(22.5%) were performed most frequently. Trigeminal nerve block(18.4%), thoracic(17.0%) and lumbar sympathetic ganglion block(11.4%) were next most prevalent blocks performed frequent block. Conclusions: Treatments at our hospital were focused on nerve blocks and medications prescriptions. Nerve blocks are of particular importance in the diagnosis and treatment of chronic pain. However in future, to raise the quality of pain management, we need to fucus on a multidisciplinary/interdisciplinary team approach.

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Clinical Identification of the Vertebral Level at Which the Lumbar Sympathetic Ganglia Aggregate

  • An, Ji Won;Koh, Jae Chul;Sun, Jong Min;Park, Ju Yeon;Choi, Jong Bum;Shin, Myung Ju;Lee, Youn Woo
    • The Korean Journal of Pain
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    • v.29 no.2
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    • pp.103-109
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    • 2016
  • Background: The location and the number of lumbar sympathetic ganglia (LSG) vary between individuals. The aim of this study was to determine the appropriate level for a lumbar sympathetic ganglion block (LSGB), corresponding to the level at which the LSG principally aggregate. Methods: Seventy-four consecutive subjects, including 31 women and 31 men, underwent LSGB either on the left (n = 31) or the right side (n = 43). The primary site of needle entry was randomly selected at the L3 or L4 vertebra. A total of less than 1 ml of radio opaque dye with 4% lidocaine was injected, taking caution not to traverse beyond the level of one vertebral body. The procedure was considered responsive when the skin temperature increased by more than $1^{\circ}C$ within 5 minutes. Results: The median responsive level was significantly different between the left (lower third of the L4 body) and right (lower margin of the L3 body) sides (P = 0.021). However, there was no significant difference in the values between men and women. The overall median responsive level was the upper third of the L4 body. The mean responsive level did not correlate with height or BMI. There were no complications on short-term follow-up. Conclusions: Selection of the primary target in the left lower third of the L4 vertebral body and the right lower margin of the L3 vertebral body may reduce the number of needle insertions and the volume of agents used in conventional or neurolytic LSGB and radiofrequency thermocoagulation.

Electromyographic Study of Lumbosacral Radiculopathy by Lumbar Disc (요추 추간원판에 의한 요천추 선경근 병변의 근전도 연구)

  • Kim Ho-Bong;Lee Jin-Hee;Kim Jong-Youl;Bae Sung-Soo
    • The Journal of Korean Physical Therapy
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    • v.11 no.3
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    • pp.1-12
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    • 1999
  • The aim of this study is to examine the sensitivity and characteristics of electromyography abnormalities detected by using various paramenters in patients with lumbosacral radiculopathies. EMG is widely used for disgnosing and localizing the level of radiculopathy. The results of the study were as follow : 1. In electromyography, L5 radiculopathy usa 95 cases(51.690). S1 radiculopathy was $45m(24.5\%)$ L4 radiculopathy was 18cases $(9.8\%)$, and L2, 3 radiculopathy was 8cases$(4.3\%)$. Remains 18cases$(9.8\%)$ had no definite radiculopathy. 2. Peroneal and tibial motor nerve conduction velocity studies were not significant as compared to the side to side. 3. Latency of H-reflex in L5 radiculopathy was $30.55\pm2.47$ in affected side, $29.47\pm2.29$ in unaffected side, in S1 radiculopathy was $33.00\pm2.03$ in affected side, R30.18\pm2.21$ in unaffected side. It was statistically significant(p<0.01). H-reflex mean difference of S1 radiculopathy group was significantly prolonged as compared to the L5 and S1 radiculopathies(p<0.001). 4. In L2, 3 radiculopathy, abnormal spontaneous activities and motor unit action potentials were showed high sensitivity in upper lumber paraspinal, hip adductors, quadriceps and iliopsoas muscles. 5. In L4 radiculopathy, lower lumbar paraspinal, tibialis anterior, quadriceps muscles were showed high sensitivity. 6. In L5 radiculopathy, lower lumbar paraspinal, extensor hallucis longus, extensor digitorum longus, peroneus longus, extensor digitorum brevis, gluteus maximus, tensor fasciae latae muscles were showed high sensitivity. 7. In S1 radiculopathy, lower lumbar paraspinal, gluteus maximus, peroneus longus, soleus, abductor hallucis, hamstrings, extensor digitorum brevis, extensor hallucis lognus, gastrocnemius muscles were showed high sensitivity.

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A Correlation between the Perceived Symptom of Musculoskeletal Diseases and Psychosocial Factors of Dental Professionals in C Region (C지역 치과종사자의 근골격계 질환 자각증상과 사회심리적 특성과의 관계)

  • Han, Ji-Hyoung;Kim, Jin;Nam, Soo-Hyoun;Kim, Chang-Hee
    • Journal of dental hygiene science
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    • v.10 no.4
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    • pp.279-286
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    • 2010
  • To investigate the correlation between the perceived symptom of musculoskeletal diseases and psychosocial factors in dental professionals in Chungcheong province, a self-administered survey was conducted on 206 dental professionals in Chungcheong province from March 9th, 2009 to March 28th, 2009. SPSS WIN 12.0 software was used to analyze the data and the following results were obtained. 1. As for the perceived symptom degree of musculoskeletal diseases based on measured body parts, the frequency of 'high' was the highest in all the parts of the body. 2. As for gender, females showed higher interest in musculoskeletal diseases than males (p=.000). As for age, subjects ranged 26~30 years showed the highest interest in musculoskeletal diseases, which was statistically significant (p=.000). 3. Work satisfaction showed a positive correlation with the perceived symptom of musculoskeletal diseases in lumbar group and lower extremity group. Work stress showed a weak negative correlation with the perceived symptom of musculoskeletal diseases in lumbar group and lower extremity group. Coworker satisfaction showed a positive correlations with the perceived symptom in upper extremity group and lower extremity group. Hospital satisfaction showed a positive correlations with the perceived symptom in upper extremity group, lumbar group and lower extremity group. Working environment satisfaction showed a positive correlations with the perceived symptom in neck group, shoulder group, upper extremity group and lower extremity group. This study showed a correlation between psychosocial factors and the perceived symptom of musculoskeletal diseases based on body parts. Therefore, psychosocial factors should be considered when the prevention and management program of musculoskeletal diseases are developed.