• Title/Summary/Keyword: low-back pain

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Clinical Study of the Treatment of Spondylolisthesis (척추전방전위증의 한방 치료에 관한 임상적 고찰)

  • Kim Hyun-Jung;Lee, Sam-Ro;Byun Jae-Young;Ahn Soo-Gi
    • Journal of Acupuncture Research
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    • v.17 no.3
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    • pp.106-115
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    • 2000
  • Objectives : This study was performed to evaluate the clinical results of the spodylolisthesis patients treated with oriental medical methods. Methods : We diagnosed spondylolisthesis by L-spine simple x-ray. 28 patients with spondylolisthesis were hospitalized at WonKwang University KwangJu Oriental Medical Hospital from April 1997 to January 2000 and treated by acupuncture, moxibustion, bed rest, herb-medicine and physical therapy. Results : 1. Distribution showed female predominence(82.1%) in general. 2. In the duration of symptoms, the largest group was the group of "acutest" (32.1%). 3. In the distribution of causes, the largest group was "overwork" (35.7%). 4. Isthmic type is the most common(75%) in etiology. 5. Isthmic type involved the 5th lumbar vertebra in 57.1% and degenerative type involved the 4th lumbar vertebra in 57.1%. 6. Most of cases were grade I(96.4%) in degree of slipping. 7. The common symptoms were radiating pain(92.9%) and low back pain(78.6%). 8. Therapeutic efforts above "good" by Kim's criteria was 20 cases(71.4%) Conclusions : The result of treatment by oriental medical methods is satisfactory for the treatment of spondylolisthsis.

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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.

Pain Complaint according to Usage of Standard-Sized Desks and Chairs for Middle and High School Students (중(中)·고등(高等) 학생(學生)들의 책상 및 의자(椅子)의 표준호식(標準號數) 사용여부(使用與否)와 통증(痛症) 호소율(呼訴率))

  • Kang, Kyung Yull;Cha, Byong Jun;Park, Jae Yong
    • Journal of the Korean Society of School Health
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    • v.8 no.2
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    • pp.219-232
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    • 1995
  • This study was conducted to examine both usage rate of standard sized desks and chairs for the middle and high school students and pain complant of students who use standard-size desk & chair in Taegu, Korea, by means of questionnaires with 1,201 students of both male and female middle and high schools in Taegu area from March 20 to April 19, 1995. The result of this study is summarized as follows. It was mostly shown that the desks and chairs used by those middle and high school students were 1-3 higher than their standard sizes, and that they also preferred a little higher size with respect to their desired sizes. The rate of students who use the standard size showed that the desk accounted for 30.5%, and chair for 21.0%, that the size bigger than the standard accounted for 61.3%, respectively, and 65.2, and that the size smaller than the standard accounted for 8.2%, respectively, and 13.8%. The using rate of the standard sized for the middle school students indicated that their desk accounted for 44.1%, and their chair for 26.0% which were higher than 16.1% and 14.7% for the high school students. Then, the rate of the male students indicated that their desk accounted for 31.5% and their chair for 24.5% which were higher than 29.6% and 17.6% of the female students. In addition, the using rate of the standard size for the public schools showed that the desk accounted for 34.2% and chair for 24.5% which were also higher than 27.1% and 17.5% of the private schools. It was shown, however, that the using rate of the standard size for both groups was lower. The most inconvenient factor in the usage of their desks appeared in such orders as their wear, narrow drawers, too low height and uneven face, while the factor in their chairs did in such orders as too hard chair body the surface and back part, wear, lower and higher height and narrow width. Their physical pains resulting from usage of those desks and chairs showed that the male and female middle school students' complaint rate of pains in their neck and shoulder accounted for 32.1%, respectively, and 36.0% which were highest, while those high school students' complaint rate in their waist accounted for 37.9%, respectively, and 44.1% which were hight. It was also shown that the bigger their height, the higher their complaint rate of pain in the waist, and that their complaint rate in the shoulder and neck was totally higher. When using the standard-sized desks and chairs, their complaint rate of pain in the shoulder and neck accounted for 25.4%, respectively, and 23.8%. As compared with them, when using the desks or chairs bigger than the standard size, their complaint rate accounted for 31.5%, respectively, and 31.8% which were high while it did 26.5% and 28.9% when using them smaller than the standard size which were also high, the usage of those standard-sized desks and chairs indicated lower complaint rate of pain in their waist than used the desks and chairs bigger or smaller than the standard size. The rate of the middle and high school students who use their standard size is very low and the size of their desks and chairs are quite different from those they hope to use and many students appeal their discomfort with their desks and chairs. Therefore, the school should try to provide the desks and chairs of the various students' standard sizes in consideration of their physical condition and it also should try to get extra desks and chairs of various sizes according to the students' standard size and their preference.

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Comparison of the Results of Ultrasound-guided Caudal Epidural Block - Herniated Intervertebral Disc vs Spinal Stenosis - (초음파를 이용한 미추 경막외 차단술의 결과 비교 - 추간판 탈출증과 척추관 협착증 -)

  • Kim, Young-Tae;Cho, Kyu-Jung;Ahn, Chi-Hoon
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.7 no.2
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    • pp.105-112
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    • 2014
  • Purpose: Ultrasound-guided epidural caudal block for low back pain and radiating pain is often performed in the treatment of outpatients. However, this procedure has a failure rate of up to 25% even when it performed by an experienced physician. The authors investigate the effectiveness of Ultrasound-guided epidural caudal block in patients related to disc herniation or spinal stenosis. Materials and Methods: Ultrasound-guided caudal epidural block was performed in 55 outpatients with LBP and radiating pain. Patient was placed in the prone position and sonographic image of sacral hiatus was obtained using linear probe. A 22-gauge needle was advanced into the sacrococcygeal membrane under ultrasound guidance and then medication was injected into the caudal epidural space. There were 31 cases of disc herniation, and 24 cases of spinal stenosis. Patients were evaluated by Visual Analog Scale (VAS) pain score at pre-treatment, post-treatment, 2 weeks and 4 weeks by telephone interviews. Results: 53 of the 55 cases (96.4%) of needle insertion into the sacral canal under ultrasound guidance were successful. Gender was not significantly different between disc herniation group and spinal stenosis group. But there was a significant age difference between disc herniation group ($42.3{\pm}10.8$), and spinal stenosis group ($62.8{\pm}15.1$) [p<0.001]. The VAS score at pre-treatment, post-treatment, 2 weeks, 4 weeks in disc group were 6.84, 3.1, 1.8 & 1.77. The VAS score at pre-treatment, post-treatment, 2 weeks, 4 weeks in spinal stenosis group were 6.88, 3.58, 4.33 & 4.88. The VAS score in both groups was significantly improved after the procedure (p<0.001). Over time, the two groups were statistically significant differences in VAS score after adjusting for age (p<0.001). Conclusion: Ultrasound-guided caudal epidural block seems to provide a high success rate and a significantly better response in disc group than spinal stenosis group.

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Differential Diagnosis of Metastatic Bone Disease and Benign Bone Disease on Spine SPECT in Patients with Low Back Pain (요통 환자의 척추골 SPECT에서 골전이 병변과 양성골질환의 섭취 양상 분석을 통한 감별진단이 가능한가)

  • Lee, Seung-Hun;Choi, Yun-Young;Cho, Suk-Shin
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.6
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    • pp.371-377
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    • 2001
  • Purpose: One or more abnormal vertebrae detected on bone scintigraphy is a common finding in clinical practice, and it could pose a diagnostic dilemma especially in cancer patients. as either metastasis or benign disease may cause scintigraphic abnormality. The purpose of this study was to determine whether additional spine SPECT has a role in differentiating malignant from benign lesions in patients with back pain. Materials and Methods: We reviewed spine SPECT studios obtained over a three-year period in 108 patients. Among them, forty-five patients with abnormal SPECT and clinically followed records were evaluated (20 cancer patients were included). Uptake patterns were classified as follows: 1. Body: diffusely increased uptake, linear increased uptake of end plate, segmental increased uptake, and cold defect, 2. Posterior element: posterior to body (pedicle), posterior to Intervertebral disc space (facet joint), and spinous process. Lesions were correlated with radiological findings and with final diagnosis. Results: Sixty-nine bone lesions were detected on SFECT images, including 18 metastases, 28 degenerative diseases and 21 compression fractures. Cold defect (6) and segmental increased uptake (5) were dominant findings in metastasis; linear increased uptake (12), and facet joint uptake (15) were in degenerative change; and diffuse increased uptake (9), and linear increased uptake (9) were in compression fracture. Conclusion: Cold defect and segmental increased uptake of body were characteristic findings of metastasis, but care should be taken because compression fracture also shows segmental increased uptake in some cases. Degenerative disease was easily diagnosed because of the typical finding of linear increased uptake of end plate and facet joint. Therefore, additional bone SPECT after planar bone scan would be helpful for differentiating metastasis from benign condition in cancer patients.

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An Analysis of Swimming Injuries and Their Rehabilitation (근육 골격계의 질환 및 재활분석(수영선수를 중심으로))

  • Kim, Kwi-Baek;Ji, Jin-Gu;Kwak, Yi-Sub
    • Journal of Life Science
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    • v.32 no.4
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    • pp.325-330
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    • 2022
  • While swimming is a very popular competitive sports activity, swimming injuries are unique due to the repetitive nature of the swimming stroke and demanding training programs that can result in upper limb overuse. Therefore, the primary objective of this review was to analyze swimmers' injury areas, injury types by stroke type, and swimming rehabilitation, as well as to discuss safety management for improving swimming performance. In this study, the injuries incurred in swimming events were discussed in the order of upper limb injuries (neck, shoulder, arm, and wrist), lower limb injuries (knee and ankle), and waist injuries. An analysis by stroke type found that shoulder injuries occurred most often with freestyle, backstroke, and butterfly strokes, followed by rotator cuff injury, impingement syndrome, and SLAP (superior labral tear from anterior to posterior) lesions. Knee injuries were associated with the breaststroke, whereas spinal cord injuries occurred with the breaststroke and butterfly stroke. Finally, back injuries were associated with the butterfly stroke. During the freestyle stroke, the shoulder undergoes repetitive overhead movement; hence, shoulder and musculoskeletal pain are the most common and well-documented complaints of swimmers. For safety management, coaches and instructors must ensure that athletes do sufficient warm-up and cool-down exercises to avoid injuries. In case of an injury, they should be familiar with first aid measures so that secondary damage can be prevented with its quick application. In addition, coaches and instructors need to be trained in injury prevention and treatment so that they can provide appropriate rehabilitation treatment for athletes. Although swimming-related injuries cannot be completely eliminated, to reduce them to a minimum, leaders need the knowledge to apply scientific and systematic training principles and methods individualized for each athlete.

Treatment Effect with Weekly Teriparatide in the Vertebral Compression Fractures in Patients with Severe Osteoporosis (심한 골다공증 환자에서 발생한 척추체 압박골절에 대한 주 단위 테리파라타이드(Teriparatide)의 투여 효과)

  • Hwang, Seok-Ha;Woo, Young-Kyun;Jeon, Ho-Seung;Suh, Seung-Pyo;Kim, Joo-Young;Kim, Jae-Nam
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.528-536
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    • 2019
  • Purpose: This study examined the effects of a weekly teriparatide on the change in vertebral compression ratio, back pain, and vertebral fracture healing in osteoporosis patients with vertebral compression fractured induced by low energy trauma. Materials and Methods: From January 2016 to December 2017, 57 patients with severe osteoporotic vertebral fractures with a T score of -3.5 or less were included in this study. The changes in the vertebral compression ratio, visual analogue scale (VAS), Oswestry disability index (ODI) for at least 6 months were examined. The morphology of bone marrow edema and the presence of intervertebral cleft, osteocalcin, and N-terminal telopeptide (NTx) were also investigated. Results: The mean compression ratio was 20% in the experimental group (teripratide group) at 3 months, and 38% in the control group. A significant difference in the compression ratio of the vertebral body over time was observed (p<0.05; t-test). A comparison of the compression ratio of the vertebral body with the follow-up duration in each group showed no significant increase in the, compression (p=0.063) in the experimental group and a significant increase in the control group (p<0.05). The mean time to reach the plateau of the compression rate was one month in the experimental group and three months in the control group. The VAS score in the experimental and control group was 0.39 and 1.07 points, respectively. The ODI score in the experimental and control group was 33.72 and 39.52, respectively. At the last follow-up radiographs, there were no cases with an intervertebral cleft (0%) in the experimental group and 1 case (2.2%) in the control group. A significant difference in the osteocalcin level was observed between the injury and 6 months after the injury (p=0.003). In addition, there was no significant difference in the NTx level between the injury and 6 months after injury (p=0.960). Conclusion: In vertebral compression fractures patients with severe osteoporosis, a weekly teriparatide can promote the union of fractures, prevent further collapse of the vertebral body, and reduce the back pain faster.

Prevalence of Musculoskeletal Symptom in Rural Farmers (농촌지역주민의 근골격계 증상 경험률)

  • Oh, Hae-Ok;Kam, Sin;Han, Chang-Hyun;Hwang, Byung-Deog;Mun, Hyo-Jung;Cha, Byung-Jun;Park, Sang-Yeon
    • Journal of muscle and joint health
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    • v.8 no.1
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    • pp.86-108
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    • 2001
  • This study was performed to examine the annual experience rate of musculoskeletal symptom and its related factors in rural farmers. Six-hundred and sixty one rural farmers were investigated by questionnaire survey through interview from July 1 to July 31 in 2000. The results were as follows; The rural farmers who had experienced musculoskeletal symptom during recent 1 year was 82.7% in male, 92.1% in female. The annual experience rate of musculoskeletal symptom by part of the body in male were turned out as back; 42.3% leg and knee; 36.4%, shoulder; 21.4%, arm and hand; 12.7%, elbow; 7.7%, hip; 6.8% neck; 6.4%, ankle and foot; 6.4% in order. The annual experience rate of musculoskeletal symptom by part of the body in female were turned out as back; 59.4%, leg and knee; 48.5%, shoulder; 20.2%, arm and hand; 13.8%, hip; 10.7%, neck; 6.8%, ankle and foot; 6.3%, elbow; 5.0% in order. The annual experience rate of musculoskeletal symptom, back pain, and pain on leg and knee were significantly higher in female. In male, the experience rate of musculoskeletal symptom was different significantly according to educational level, family size, economic status, status of smoking, duration of farming, type of major agricultural affairs. By the multiple logistic regression analysis for experience of musculoskeletal symptom, family size and economic status were the significant variables. It was higher in male with no or one family living together and low economic status. In female, the experience rate of musculoskeletal symptom was different significantly according to body mass index, perceived health status, type of agricultural affairs. By the multiple logistic regression analysis for experience of musculoskeletal symptom, body mass index, perceived health status, and type of major agricultural affairs were the significant variables. It was higher as female farmer's body mass index was increasing and when female farmer's perceived health status was not healthier, and it was lower when female farmer did livestock farming as major agricultural affair. The experience rate of musculoskeletal symptom was higher in the busy season for farmers and treatment methods for musculoskeletal symptom were physical therapy, medication, herb medical treatment, etc. In conclusion, because most of farmers experience musculoskeletal symptom, continuous systematic study on musculoskeletal symptom of farmers and active effort to prevent and manage musculoskeletal symptom of farmers are necessary.

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Surgical Treatment of Thoracoabdominal Aortic Aneurysm (흉복부 대동맥류의 외과적 치료)

  • Ahn, Hyuk;Kim, Jun-Seok
    • Journal of Chest Surgery
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    • v.29 no.2
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    • pp.177-184
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    • 1996
  • Between 1987 and 1994, 21 patients were treated surgically for aortic aneurysm involving the thoracoabdominal aorta. There were 11 males and 10 females, and their age ranged from 20 to 67 years old and mean age was 41.5 years. Many complained of back pain, chest pain or discomfort, and flank pain, but three patients were asymptomatic. 15 patients had chronic dissection (71.4%) and 6 had nondissecting fusiform or saccular aneurysm(28.5%), and of those 15 patients with chronic dissection, 6(28.5%) had atherosclerosis assniated with hypertension, 5 (23.8%) were Martian syndrome, and 2 (9.5%) were associated with pregnancy. The diameter of an aneurysm ranged from 6cm to 12cm, and their extent was classified as type I in 7(33.3%), type II in 8(38.1%), type III in 3(14.3%), and type IV in 3(14.3%) patients based on Crawford classification for TAA . Diseased aorta was replaced with artificial vascular graft in all but one patient. In whom the aortic tear site due to pseudoaneurysm was closed by primary suture. For the spinal cord protection during the operation, we used partial cardiopulmonary bypass (FV-FA or PA-FA bypass) in 12 patients (57.1%), Biopump (LA-FA bypass) in 4(19.0%), total circulartory arrest and CPB in 2 (9.5%), Gott's heparinized shunt in 1(4.7%), and simple aortic cross clamping in 2 (9.5%). The most common complication after the operation was hoarseness due to unilateral vocal cord palsy which onured in 5 patients (23.8%), and the next common complication was wound infection in 4 patients(19.0%), paraplegia in 2 patients (9.5%), chylothorax in 1 patient(4.7%). The hospital mortality rate was 9.5% (2deaths), and there was no late death. Our experience shows that the graft replacement of TAAA had reasonable rate of mortality, low rate of serious complication, and provided good post operative state of the pati nts, and since the thoracoabdominal aortic operation is not a high risky procedure anymore, we recommend a radical operation for the indicated patients.

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The Effects of Farming in Greenhouses with Respect to Subjective Fatigue Symptoms (비닐하우스 재배자의 피로자각증상에 관한 연구)

  • Hwang, Gyeong Ae;Lee, Sok Goo
    • Korean Journal of Occupational Health Nursing
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    • v.7 no.2
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    • pp.177-185
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    • 1998
  • The purposes of this study were to investigate the effects of farming in greenhouses with respect to subjective fatigue symptoms among farmers and the degree of symptoms. The study compared 176 green-house farmers with 216 open field farmers using a subjective fatigue symptoms rating scale developed by the Industrial Research Institute of Fatigue, Japanese Association for industrial Hygiene. 1. With respect to complaint rates of the subjective fatigue symptoms, the results indicated that greenhouse farmers have, in order of severity, high degrees of low back pain, difficulty in collecting thoughts, and apt to forget. 2. With respect to cumulative scores of fatigue symptoms, the results indicated that both groups of farmers exhibited a lack of attentiveness and a high degree of dullness and sleepiness(category I), body projection of fatigue(category II), and difficulty in concentration(category III). 3. With respect to general characteristics, it was found that the degrees of subjective fatigue symptoms were found to be higher among females, people with lower educational levels, and the elderly, regardless of the group. 4. With respect to work related factors, farmers with more years of experiences were found to have higher degrees of subjective fatigue symptoms, except for open field farmers with less than nine years experience. Both groups of farmers were found to have high degrees of subjective fatigue symptoms when working less than eight hours a day and less than six months a year. 5. With respect to health habits, for people who get less than eight hours of sleep per day exhibited higher fatigue scores than people who get more than eight hours. People who do not smoke and drink also exhibited higher fatigue scores than people who smoke and drink. 6. The results of multiple regression showed that the risk factors related to the subjective fatigue symptoms of farmers in the greenhouse group were ages, levels of education, sex and for the comparison group, were sex. years of farming, and hours of sleep. The R-square were 12.5% in the greenhouse group and 12.1% in the comparison son group. The differences between the greenhouse and open field farmers in the degrees of fatigue symptoms were found not to be statistically significant even if the working conditions of the greenhouse farmers were poor. This may be attributed to non-work related factors, i.e., social, economical, and psychological factors among greenhouse farmers.

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