• 척추신경추나의학회지
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• 제4권2호
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• pp.109-120
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• 2009

Objectives : We already know the importance of stability and flexibility on the vertebra. It is important to keep the lumbar lordosis for stability and flexibility. We hope to reduce lower back pain and low extremity pain by changing the angle of the Lumbar Kyphosis through conservative treatment. We have evaluated the effect of conservative treatment with Saamchimbeop Pejeonggyeok by experimenting one patient suffering from Lumbar Kyphosis with lower back pain and low extremity pain. Methods : One patients were diagnosed as Lumbar Kyphosis through X-ray examination. We used conservative treatment, especially Pejeonggyeok Treatment to the patients and measured NRS((Numerical Rating Scale), rating scale for low back pain, low extremity pain and SLR(Straight Leg Raising) test and walking time in whole term of admission, and we also measured flexion, extension angle and lumbar kyphosis using lumbar x-ray lateral view after diganosing by Lumbar Kyphosis. Results and Conclusions : After treating conservative therapy, We figured out that the patient were on the mend, and we found out the angle change in flexion, extension and lumbar Kyphosis. These results suggest that Pejeonggyeok Treatment were effective to improved Lumbar Kyphosis and reduced the low back pain.

• Journal of Korean Neurosurgical Society
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• 제54권5호
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• pp.384-389
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• 2013

Objective : Use of quantitative computed tomography (CT) to evaluate bone mineral density was suggested in the 1970s. Despite its reliability and accuracy, technical shortcomings restricted its usage, and dual-energy X-ray absorptiometry (DXA) became the gold standard evaluation method. Advances in CT technology have reduced its previous limitations, and CT evaluation of bone quality may now be applicable in clinical practice. The aim of this study was to determine if the Hounsfield unit (HU) values obtained from CT correlate with patient age and bone mineral density. Methods : A total of 128 female patients who underwent lumbar CT for back pain were enrolled in the study. Their mean age was 66.4 years. Among them, 70 patients also underwent DXA. The patients were stratified by decade of life, forming five age groups. Lumbar vertebrae L1-4 were analyzed. The HU value of each vertebra was determined by averaging three measurements of the vertebra's trabecular portion, as shown in consecutive axial CT images. The HU values were compared between age groups, and correlations of HU value with bone mineral density and T-scores were determined. Results : The HU values consistently decreased with increasing age with significant differences between age groups (p<0.001). There were significant positive correlations (p<0.001) of HU value with bone mineral density and T-score. Conclusion : The trabecular area HU value consistently decreases with age. Based on the strong positive correlation between HU value and bone mineral density, CT-based HU values might be useful in detecting bone mineral diseases, such as osteoporosis.

• Journal of Korean Neurosurgical Society
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• 제62권1호
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• pp.61-70
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• 2019

Objective : Corpectomy of the first lumbar vertebra (L1) for the management of different L1 pathologies can be performed using either an anterior or posterior approach. The aim of this study was to evaluate the usefulness of a retroperitoneal extrapleural approach through the twelfth rib for performing L1 corpectomy. Methods : Thirty consecutive patients underwent L1 corpectomy between 2010 and 2016. The retroperitoneal extrapleural approach through the 12th rib was used in all cases to perform single-stage anterior L1 corpectomy, reconstruction and anterior instrumentation, except for in two recurrent cases in which posterior fixation was added. Visual analogue scale (VAS) was used for pain intensity measurement and ASIA impairment scale for neurological assessment. The mean follow-up period was 14.5 months. Results : The sample included 18 males and 12 females, and the mean age was 40.3 years. Twenty patients (67%) had sensory or motor deficits before the surgery. The pathologies encountered included traumatic fracture in 12 cases, osteoporotic fracture in four cases, tumor in eight cases and spinal infection in the remaining six cases. The surgeries were performed from the left side, except in two cases. There was significant improvement of back pain and radicular pain as recorded by VAS. One patient exhibited postoperative neurological deterioration due to bone graft dislodgement. All patients with deficits at least partially improved after the surgery. During the follow-up, no hardware failures or losses of correction were detected. Conclusion : The retroperitoneal extrapleural approach through the 12th rib is a feasible approach for L1 corpectomy that can combine adequate decompression of the dural sac with effective biomechanical restoration of the compromised anterior loadbearing column. It is associated with less pulmonary complication, no need for chest tube, no abdominal distention and rapid recovery compared with other approaches.

• 대한세포병리학회지
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• 제8권2호
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• pp.164-169
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• 1997

A case of plasmacytoma of the ovary and breast, which developed in a patient with a solitary plasmacytoma in the lumbar vertebra for nine months, was diagnosed cytologically and histologically. Enlargement of the right ovary and multiple palpable masses in the right and left breast were already present at six months after the diagnosis of vertebral solitary plasmacytoma. At eight months, plasma cell leukemia developed, and nine months the enlarged both ovaries, replaced by yellowish-gray solid tumors showed infiltration of immature plasma cells. The cytologic features of the ovarian tumors were same with those of the breast tumor. The tumor cells were of predominantly immature plasma cells with one or more nuclei. Some mature plasma cell had an eccentric nucleus with single nucleolus and peripherally clumped chromatin. Binucleated or multinucleated giant cells were often present. Histologically, sheets of poorly differentiated plasmacytoid tumor cells were separated by strands of hyaline fibrous tissue. On immunohistochemical stains, the tumor cells showed strong reactivity for lambda-light chain but no reaction for kappa-light chain, cytokeratin, or leukocyte common antigen.

• 한국임상수의학회지
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• 제29권1호
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• pp.98-102
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• 2012

A 1.5-year-old male Golden Retriever was presented with worsening lameness of two month duration. Abnomral findings of blood works and serum chemistry included anemia, thrombocytopenia, hypercalcemia and hyperglobulinemia. Radiography revealed osteolysis of polyostotic regions including right femur and tibia, bilateral ilium, and spinous processes from the 13th thoracic vertebra to 5th lumbar vertebra. Enlarged multiple lymph nodes and mixed echo pattern of muscular region ventral to vertebra were observed with ultrasonography. Because concentrations of both parathyroid hormone and parathyroid hormone related peptide were all within reference ranges, humoral hypercalcemia by tumor was ruled out and extensive osteolysis was considered as the cause of hypercalcemia. Based on radiographic and ultrasonographic study, lymphoma, multiple myeloma and osteomyelitis were included in differential diagnosis. Fungal serologic test was negative. Monoclonal gammopathy was not found on serum protein electrophoresis. Cytological and histopathological examinations of the lytic lesions revealed neoplastic lymphoid proliferation, and B cell type clonal expansion was detected by polymerase chain reaction for the antigen receptor gene rearrangement. The case was diagnosed as B cell lymphoma involving polyostotic regions.

• 한국정밀공학회지
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• 제27권2호
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• pp.137-144
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• 2010

In general, spinal fusion surgery takes pressure off the pain induced nerves, by restoring the alignment of the spine. Therefore spinal fixation system is used to maintain the alignment of spine. In this study, a biomechanical study was performed comparing the SROM(Spinal Range Of Motion) of three types of system such as Rigid, Dynesys, and Fused system to analyze the behavior of spinal fixation system inserted in vertebra. Dynesys system, a flexible posterior stabilization system that provides an alternative to fusion, is designed to preserve inter-segmental kinematics and alleviate loading at the facet joints. In this study, SROM of inter-vertebra with spinal fixation system installed in the virtual vertebra from L4 to S1 is estimated. To compare with spinal fixation system, a simulation was performed by BRG. LifeMOD 2005.5.0 was used to create the human virtual model of spinal fixation system. Through this, each SROM of flexion, extension, lateral bending, and axial rotation of human virtual model was measured. The result demonstrates that the movement of Dynesys system was similar to normal condition through allowing the movement of lumbar.

• Journal of Korean Neurosurgical Society
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• 제41권3호
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• pp.207-209
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• 2007

We present an elderly patient with unilateral foraminal stenosis treated by isthmus resection. An 83-year-old female could not walk due to severe leg pain along right L5 sensory dermatome. Despite the laminotomy for spinal stenosis on the right side at the L4-5 level, her leg pain did not improve. Careful review of computed tomography scans and coronal source images of magnetic resonance myelography revealed foraminal stenosis on the right side at the L5 vertebra. Because of medical problem, she underwent isthmus resection on the right side at the L5 level instead of total facetectomy and fusion. After surgery, her leg pain was markedly improved. Isthmus resection showed successful result for this medically compromised elderly patient with unilateral foraminal stenosis.

• 대한기계학회:학술대회논문집
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• 대한기계학회 2007년도 춘계학술대회A
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• pp.746-750
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• 2007

Vertebroplasty has drawn much attention as a medical treatment for the compression fracture of spine, which strengthens the vertebral body and corrects deformity, and relieves pain in patients by injecting bone cement. However vertebroplasty can cause fracture on adjacent vertebra due to relative stiffness change. This study involves the biomechanical evaluation of the vertebroplasty especially on adjacent vertebral body. The finite element method has been employed to analyze the patient who was treated vertebroplasty under static and dynamic loading. For this study, a three-dimentioal model of the three-level ligamentous lumbar segment ($L1{\sim}L3$)is created from medical image data (CT)and compared with the experimental results in vitro.

• Journal of Korean Neurosurgical Society
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• 제45권3호
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• pp.188-191
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• 2009

The presence of distant metastases from differentiated thyroid carcinoma decreases the 10-year survival rates of patients by 50%. This is a report of a 61-year-old female with follicular thyroid carcinoma who presented initially with low back pain. 2-deoxy-2-[18F] fluoro-D-glucose whole-body positron emission tomography/computed tomography (PET/CT) demonstrated a hypointensity lesion in the left thyroid gland with malignant uptake in L1 vertebra and magnetic resonance images revealed paravertebral and epidural extension of mass in L1 vertebra. After thyroidectomy, histopathological study showed a follicular carcinoma. We performed L1 total en bloc spondylectomy with expandable cage for long-term local control. The technical details of total en bloc spondylectomy in follicular carcinoma are described herein.

• The Journal of Korean Physical Therapy
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• 제15권4호
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• pp.24-33
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• 2003

Spondylolysis and spondylolisthesis are two conditions that directly involve changes in the vertebra. Spondylolysis is defined as a defect in the pars interarticularis, the region of the lamina between the superior and inferior articular facets. Progression of the defect can result in spondylolisthesis, which is defined as a subluxation or 'slippage' of two adjacent vertebrae. In the low back it occurs most commonly at the lumbosacral level; next in frequency is spondylolisthesis of the fourth lumbar vertebra on the fifth. To provide the reader with information about the aetiology and anatomical consideration of spondylolysis and spondylolisthesis type. Spondylolisthesis has recently been classified by Wiltse and others into five types based on the suspected aetiology; dysplastic, isthmic, degenerative, posttraumatic, pathologic and postsurgical. Of these five types, isthmic spondylolisthesi and degenerative spondylolisthesis, both of which are frequently associated with low back and lower limb pain.