• 제목/요약/키워드: low-back pain

검색결과 1,510건 처리시간 0.031초

골(骨)스캔을 이용(利用)한 천장관절(薦腸關節)/천골섭취비(薦骨攝取比)의 정량적(定量的) 측정(測定) (Sacroiliac Joint/Sacrum Uptake Ratio Measured by Quantitative Sacroiliac Joint Scintigraphy)

  • 이영열;박선양;이명철;최성재;조보연;최강원;고창순
    • 대한핵의학회지
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    • 제16권2호
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    • pp.63-70
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    • 1982
  • To evaluate the diagnostic usefulness and significance of quantitative sacroiliac joint scintigraphy in the assessment of sacroiliitis, we measured Sacroiliac Joint/Sacrum Uptake Ratio(SIS Ratio) by region of interest(ROI) method using $^{99m}Tc-methylene$ diphosphonate. The observed results were as follows: 1. Using ROI method, the SIS ratios for the control group of 65 persons were $1.05{\pm}0.08$(left) and $1.06{\pm}0.07$(right) which were narrower in range than those of slice method $(mean{\pm}S.D.)$. 2. The effects of age, gender and laterality on SIS ratio were not significant. 3. In left side, one of 6 patients with rheumatoid arthritis had SIS ratio in excess of 2 standard deviation of normal control group, and remainder had SIS ratios within normal limit. In right side, 3 patients had SIS ratios in excess of 2 standard deviation of normal control group, and remainder, within normal limit. 4. In both sacroiliac joint, 2 of 3 patients having sacroiliitis clinically with Reiter's syndrome whose pelvis A-P X-ray findings showed normal had high SIS ratios (left/right; 1.31/1.69, 1.90/1.80), but SIS ratio of one patient who had no evidence of sacroiliitis clinically was within normal limit. 5. In 6 patients with ankylosing spondylitis in both sacroiliac joints, 4 whose pelvis A-P Xray findings showed severe sclerotic change of sacroiliac joints had SIS ratio within normal limit or below that of normal control group, and SIS ratios of 2 patients whose pelvis A-P X-ray findings showed were increased. 6. 4 of 5 patients with low back pain of which cause could not be evaluated clinically and radiologically had SIS ratios in excess of that of normal control group. It would be concluded that quantitative sacroiliac joint scintigraphy is useful and sensitive screening method in the diagnosis as well as in the assessment clinical activity of sacroiliitis.

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Laminotomy with Continuous Irrigation in Patients with Pyogenic Spondylitis in Thoracic and Lumbar Spine

  • Kim, Sung-Hyun;Lee, Jung-Kil;Jang, Jae-Won;Seo, Bo-Ra;Kim, Tae-Sun;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • 제50권4호
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    • pp.332-340
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    • 2011
  • Objective : Pyogenic spondylitis often results in acute neurological deterioration requiring adequate surgical intervention and appropriate antibiotic treatment. The purpose of this study was to conduct an analysis of the clinical effect of continuous irrigation via laminotomy in a series of patients with pyogenic spondylitis in thoracic and lumbar spine. Methods : The authors conducted a retrospective investigation of 31 consecutive patients with pyogenic thoracic and lumbar spondylitis who underwent continuous irrigation through laminotomy from 2004 to 2008. The study included 22 men and 9 women, ranging in age from 38 to 78 years (mean 58.1 years). The average follow-up duration was 13.4 months (range, 8-34 months). We performed debridement and abscess removal after simple laminotomy, and then washed out epidural and disc space using a continuous irrigation system. Broad spectrum antibiotics were administered empirically and changed according to the subsequent culture result. Clinical outcomes were based on the low back outcome scale (LBOS), visual analogue scale (VAS) score, and Frankel grade at the last follow-up. Radiological assessment involved plain radiographs, including functional views. Results : Common predisposing factors included local injection for pain therapy, diabetes mellitus, chronic renal failure, and liver cirrhosis. Causative microorganisms were identified in 22 cases (70.9%) : Staphylococcus aureus and Streptococcus spp. were the main organisms. After surgery, LBOS, VAS score, and Frankel grade showed significant improvement in most patients. Spinal stability was maintained during the follow-up period, making secondary reconstructive surgery unnecessary for all patients, except one. Conclusion : Simple laminotomy with continuous irrigation by insertion of a catheter into intervertebral disc space or epidural space was minimally invasive and effective in the treatment of pyogenic spondylitis. This procedure could be a beneficial treatment option in patients with thoracolumbar spondylitis combined with minimal or moderate destructive change of vertebrae.

로지스틱 회귀 분석을 이용한 고관절 내회전 각도와 단분절 요추 추간판 탈출증 발생 부위의 상관성 분석 (Analysis of the Relationship between Hip Internal Rotation Angle and the Site of Herniation of Single Level Lumbar Intervertebral Disc Using Logistic Regression)

  • 김신웅;남항우;김세준;손슬기;김종수;정재현;윤영웅;최영준;문병헌;유수빈;임한빛;김동환
    • 한방재활의학과학회지
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    • 제24권4호
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    • pp.117-127
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    • 2014
  • Objectives The purpose of this study is to find out the relationship between the hip internal rotation angle and the site of herniation of single level lumbar intervertebral disc. Methods This study was carried out to 418 patients with lumbar disc herniation diagnosed by M.R.I, who visited Bu-Chun Jaseng Hospital of Korean Medicine with low back pain. Researchers measured their hip internal rotation angle and analyzed the relationship between the hip internal rotation angle and the site of herniation of single level lumbar intervertebral disc. Results 1. Excessive right internal rotation of hip joint increases risk of L5/S1 HIVD. 2. Limited left internal rotation of hip joint decreases risk of L4/L5 HIVD. 3. In cases of L4/L5 HIVD level, there was evidence that the prevalence of HNP in men was 1.85 times as higher than that in women. 4. In cases of L5/S1 HIVD level, there was the evidence that the prevalence of HNP in men was 0.64 times as lower than that in women. Conclusions In single-segment lumbar HIVD patients, limited left internal rotation of hip joint decreases risk of HIVD of L4/5 and excessive right internal rotation of hip joint mainly leads to L5/S1 HIVD.

산업장 여성 근로자의 건강과 약물사용 (A Study on Health condition and Drug use of Female Workers in Incheon area)

  • 조원순
    • 한국보건간호학회지
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    • 제9권2호
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    • pp.17-32
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    • 1995
  • The purpose of this study is to promote health for young female workers. It is based on questionnaires collected from 215 female workers in Incheon area. This study includes health condition (fatigue scores), occupational disease, knowledge of abused drugs and the actual condition of drug use. The results are summerized as follows: - $47.4\%$ visited their health center and were treated with diseases like cold and headache $(34.9\%)$, gastroenteric disease $(6.5\%)$, trauma $(7.9\%)$ and chronic disease such as diabetes and hypertension $(3.3\%)$ - $44.7\%$ received regular health education and $4.7\%$ among them received education on abused drugs. - $20.5\%$ were suffering from work related diseases such as gastroenteric disease, headache, trauma, repiratory disease, skin problem, arthritis, low back pain, shortsightness and tuberculosis. - Total mean fatigue score as an indication of health status was $9.0\pm5.4$ points out of 30 points. Physical mean score (group I) was $3.92\pm2.2$ points and psychological mean score was $2.5\pm2.3$ points and neurosensory mean score was $2.6\pm2.1$ points out of each 10 points. - They recognized analgesics $(55.0\%)$ and the next are laxatives $(49.8\%)$, inhalants $(40.0\%)$, narcotics $(24.2\%)$, stimulants $(24.0\%)$, antihistamines$(5.9\%)$, diuretics $(3.0\%)$, tranquilizer $(2.4\%)$ and sedatives $(1.4\%)$ - They used analgesics $(37.2\%)$ the most and then laxatives $(6.0\%)$, stimulants$(5.6\%)$, diuretics $(1.9\%)$, antihistamines$(0.5\%)$, And nobody used tranquilizer, sedatives, narcotics and inhalant. - The relationship between career, drug abuse education, health center utilization and and the actual condition of drug using was examined. The longer the career and the more educated with drug abuse, the less drug used. And those who utilized health center rarely used more drugs. - The relationship between career, health center utilization, the score of fatigue and use of analgesics was also examined. Those group who have a longer career above 3 years and the group who have never used health center used more analgesics. And the group of fatigue score above 11.0 points used a little more analgesics than the other group. These results indicate that analgesics are the most frequent used drugs among female workers. Those analgesics such as geborin, penzal, saridon, aspirin, tyrenol should be used properly. These basic data is submitted for the education and consultation which are carried out by industrial nurses for promoting health of industrial workers.

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교통사고 환자 77례에 대한 임상적 고찰 (The Clinical Study on 77 Traffic Accident Patients)

  • 황희상;정기훈;전재천;박재연;김민석;이태호;노정두;이은용
    • 척추신경추나의학회지
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    • 제4권2호
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    • pp.85-98
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    • 2009
  • Objectives : The purpose of this study was to find out tendency of traffic accident patients treated in korean medicine hospital. Methods : We investigated 77 patients who were treated in Semyung University Korean Medicine Hospital from 1 st, January, 2007 to the 30st September, 2009. Results and Conclusions : 1. In distribution of gender and age, the rate of male was 36.4%, that of female was 63.6% and majority of patients were twenties, thirties and forties. 2. In the traffic accident patterns, the most was car crash from behind(49.4%) and after traffic accident, 42 patients(54.6%) visited our hospital in less than 5 days. 3. 22 patients(28.6%) choose the oriental medical treatment for primary care. And 35 patients(45.4%) visited our hospital due to preference of oriental medicine. 4. In partial pain, most was the neck(76.6%), followed by low back(61.0%). 5. In radiation test(excluded sprain and straightening), the most was HIVD of L-SPINE(14.0%). 6. In the periods of admission, less than 7 days was the 1st(36.4%), 14 days was the 2nd(27.3%). 7. The treatment was effective to 67 patients out of 77 patients who had been hospitalized.

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만성허리통증자의 호흡 패턴과 배부 운동성 변화에 대한 주관적 허리부위 불안정성 요소의 유용성에 관한 연구 (A Study on the Usefulness of Subjective Lumbar Instability Factor for Respiratory Pattern Change and Abdominal Mobility in Peoples with CLBP)

  • 기철;이관우
    • 한국산학기술학회논문지
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    • 제21권3호
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    • pp.206-214
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    • 2020
  • 본 연구는 만성허리통증자를 대상으로 주관적 허리부위 불안정성 요소(SLIF)와 호흡패턴변화(RPC), 배부운동성(AM) 간의 상관성을 조사하고자 하였으며, 만성허리통증(CLBP)을 가진 36명의 성인이 본 연구에 참여하였다. 대상자들은 28개 항목의 SLIF 양성반응 조사 후, 양성반응 수(PRN)에 따라 3개 그룹으로 나뉘었다. 노력성호흡운동과 운동조절훈련 동안에 총 12개의 비생리학적 호흡패턴변화를 관찰과 촉지를 통해 조사하였고, 3가지의 호흡패턴변화[갈비가로막 호흡패턴변화(CDRPC), 호흡정지변화(BHC), 전체 호흡패턴변화(TRPC)] 점수를 산출하였다. 배부 운동성 변화는 줄자를 이용하여 몸통의 칼돌기(AM1)와 10th 갈비뼈(AM2) 수준에서 최대 흡기와 호기 사이의 둘레 길이 차이로 조사하였다. SLIF의 양성 반응수에 따라 RPC 점수와 AM을 비교하고, 이들의 상관성을 분석하였다. 그 결과, SLIF 양성반응수는 CDRPC 점수, BHC 점수, 전체 RPC 점수와 양의 상관성을, AM1과 AM2와는 음의 상관성을 나타내었다. 본 연구결과에 기초하여, SLIF 검사의 양성결과 조합은 CLBP자의 비생리적 호흡패턴변화에 대한 예측 변수가 될 수 있고, 이러한 임상적 예측은 평가시간의 절약과 함께 효율적 치료접근에 도움이 될 수 있다.

남녀 대학생의 척추만곡에 관한 연구 (A Study of Spinal Curvature in Female and Male University Students)

  • 이병규;남기석;이충휘
    • 한국전문물리치료학회지
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    • 제5권3호
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    • pp.72-87
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    • 1998
  • This study examined the rates of spinal abnormal curvature and the correlation of the Body Mass Index (BMI), Low Back Pain (LBP) and spinal curvature by measuring scoliosis, kyphosis, and lordosis in university students. The study population included 67 male, 92 female university students, making a total of 159, in Wonju City. Spinal curvature was measured by an electrogoniometer in a computerized skeletal analysis system. Lateral curvature of spine of more than 10 degrees was considered as nonspostural scoliosis. The correlation of BMI, LBP and the spinal curvature was analysed by Pearson's correlation coefficient and t-test. The following results were obtained: 1. The overall incidence and rate of scoliosis in cases with a greater than 10 degree curve in males was an incidence of 8 and a rate of 11%. In females the incidence was 36 and the rate 39.2%. 2. The overall incidence and rate of kyphosis of less than 20 degrees in males was a rate of 9 and an incidence of 11.9%. In females, the rate was 5 and the incidence 5.4%. In kyphosis cases of more than 40 degrees, the male rate was 5 and the incidence 7.7%. For female the rate was 13 and the incidence 14.2%. 3. The overall incidence and rate of lordosis with curves of less than 20 degrees was a rate of 6 for males and an incidence of 9.0%. For females, the rate was 5 and the incidence 5.4%. In cases of more than 50 degrees lordosis, the female rate was 2 and the incidence 2.2%. There were no males in this category. 4. There was a negative correlation between kyphosis and BMI. The greater the kyphotic curve, the less the BMI in males (p<0.05). There was no significant BMI difference by gender in either scoliosis or lordosis. There was, however, a significantly decreased sacral angle in the female group with LBP. The results of this study cannot be generalized to the general population because the subjects were all from one university. The measurements were quite reliable because the angles determined by the Metrocom System were highly correlated with radiologic findings. This study shows the need for a regular screening system for spinal curvatures in university health examination procedures.

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홍화자(紅花子) 약침요법(藥鍼療法)을 가미한 한방치료로 호전된 마미증후군(馬尾症候群) 환자(患者) 1례(例) (A Case of Cauda Equina Syndrome Treated with Additional Carthami Semen Herbal Acupuncture Therapy)

  • 서보명;이윤경;김성웅;이세연;임성철;정태영;안희덕;한상원;서정철
    • Korean Journal of Acupuncture
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    • 제22권1호
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    • pp.33-41
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    • 2005
  • 갑작스러운 요통과 양측하지통, 하지의 근력 감소, 대소변 장애 및 운동, 감각장애로 양방병원에서 마미증후군으로 진단받고 추궁판 절제술과 감압술을 시행 후 임상적인 호전을 보이지 않은 환자 1례에 대해 홍화자(紅花子) 약침요법(藥鍼療法)을 중심으로 복합적인 한방치료를 시행한 결과 요통에 대한 VAS와 요통점수표, ODI 항목에서는 각 항목 모두에서 현저한 호전 양상을 나타내었다. 운동기능 및 보행에 있어서 입원 당시에 보행기에 의지하여 보행하였는데 치료 후에는 안독으로 보행이 가능하고 일상적인 가벼운 생활도 가능해지게 되었다. 배뇨기능에 있어서도 자발적인 배뇨가 가능할 정도로 완전회복 되었다. 하지만 배변의 상태는 입원 당시와 치료 후에는 변의가 느껴지는 것 이외에 자발적인 배변은 이루어지지 않았다. 감각 기능의 회복에 있어서도 온통각, 압촉각과 하지 냉감은 호전 양상을 보였으나 안장 감각과 괄약근의 기능은 거의 회복되지 않았다. 본 연구를 기초로 하여 향후 수술이나 양방적인 치료 후에 발생할 수 있는 후유증의 관리에 있어서 홍화자(紅花子) 약침(藥鍼)에 대한 더욱 심도있는 후속 연구가 이루어져야 할 것이다.

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충북 지역 결혼이주 여성 출신국가별 건강행태, 건강상태, 보건의료이용 실태 비교 (The Comparative analysis of health behaviors, health Status, and health care utilization by the homeland of the internationally married women immigrants living in Chungbuk)

  • 전미양;김현숙;김희자;이효정
    • 한국산학기술학회논문지
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    • 제13권8호
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    • pp.3500-3512
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    • 2012
  • 본 연구의 목적은 결혼이주 여성의 건강행태, 건강상태, 보건의료 이용 실태를 출신 국가에 따라 비교 분석하는 것이다. 연구 대상은 충청북도 7개 지역 다문화센터에 등록되어 있는 결혼이주 여성 171명이며, 자료수집은 7개 언어로 번역된 구조화된 설문지를 활용하여 2010년 9월~11월까지 3개월간 실시하였다. 결혼이주 여성의 출신 국가에 따라 비교한 결과, 건강행태에서는 고강도 운동, 걷기 운동, 체중조절, 아침식사 횟수가 차이를 보였고, 건강상태에서는 요통 발생율과 비만도가 차이가 있었으며, 보건의료 이용에서는 건강검진 경험, 주이용 의료기관, 의료기관 미방문 이유에 있어서 차이가 나타났다. 본 연구결과를 근거로 결혼이주 여성의 건강 정책을 수립한다면 결혼이주 여성에게 가장 적절한 보건의료서비스를 제공할 수 있을 것이다.

Evaluation of the Degenerative Changes of the Distal Intervertebral Discs after Internal Fixation Surgery in Adolescent Idiopathic Scoliosis

  • Dehnokhalaji, Morteza;Golbakhsh, Mohammad Reza;Siavashi, Babak;Talebian, Parham;Javidmehr, Sina;Bozorgmanesh, Mohammadreza
    • Asian Spine Journal
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    • 제12권6호
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    • pp.1060-1068
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    • 2018
  • Study Design: Retrospective study. Purpose: Lumbar intervertebral disc degeneration is an important cause of low back pain. Overview of Literature: Spinal fusion is often reported to have a good course for adolescent idiopathic scoliosis (AIS). However, many studies have reported that adjacent segment degeneration is accelerated after lumbar spinal fusion. Radiography is a simple method used to evaluate the orientation of the vertebral column. magnetic resonance imaging (MRI) is the method most often used to specifically evaluate intervertebral disc degeneration. The Pfirrmann classification is a well-known method used to evaluate degenerative lumbar disease. After spinal fusion, an increase in stress, excess mobility, increased intra-disc pressure, and posterior displacement of the axis of motion have been observed in the adjacent segments. Methods: we retrospectively secured and analyzed the data of 15 patients (four boys and 11 girls) with AIS who underwent a spinal fusion surgery. We studied the full-length view of the spine (anterior-posterior and lateral) from the X-ray and MRI obtained from all patients before surgery. Postoperatively, another full-length spine X-ray and lumbosacral MRI were obtained from all participants. Then, pelvic tilt, sacral slope, curve correction, and fused and free segments before and after surgery were calculated based on X-ray studies. MRI images were used to estimate the degree to which intervertebral discs were degenerated using Pfirrmann grading system. Pfirrmann grade before and after surgery were compared with Wilcoxon signed rank test. While analyzing the contribution of potential risk factors for the post-spinal fusion Pfirrmann grade of disc degeneration, we used generalized linear models with robust standard error estimates to account for intraclass correlation that may have been present between discs of the same patient. Results: The mean age of the participant was 14 years, and the mean curvature before and after surgery were 67.8 and 23.8, respectively (p<0.05). During the median follow-up of 5 years, the mean degree of the disc degeneration significantly increased in all patients after surgery (p<0.05) with a Pfirrmann grade of 1 and 2.8 in the L2-L3 before and after surgery, respectively. The corresponding figures at L3-L4, L4-L5, and L5-S1 levels were 1.28 and 2.43, 1.07 and 2.35, and 1 and 2.33, respectively. The lower was the number of free discs below the fusion level, the higher was the Pfirrmann grade of degeneration (p<0.001). Conversely, the higher was the number of the discs fused together, the higher was the Pfirrmann grade. Conclusions: we observed that the disc degeneration aggravated after spinal fusion for scoliosis. While the degree of degeneration as measured by Pfirrmann grade was directly correlated by the number of fused segments, it was negatively correlated with the number of discs that remained free below the lowermost level of the fusion.