• 제목/요약/키워드: Lumbosacral radiculopathy

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만성 요천추부 신경근병증 환자의 보행분석 (Gait Analysis of the Chronic Lumbosacral Radiculopathic Patients)

  • 최병옥;유재응;정석
    • 한국전문물리치료학회지
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    • 제11권3호
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    • pp.19-24
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    • 2004
  • The purposes of this study were to analyze gait patterns of patients with chronic lumboscaral radiculopathy and to investigate gait parameters which can reflect a functional deficit in relation to the level of lumbosacral radiculopathy. The study population consisted of 25 patients of chronic lumbosacral radiculopathy and 25 healthy control subjects. Conventional physical examinations and three-dimensional gait analyses were performed on all participants. The data were analyzed using an independent sample t-test. The results were as follows: (1) In the patients' group, cadence, walking velocity, stride length and double support time were less than in the control group (p<.05). (2) In the patients' group, maximum flexion of hip, maximum flexion of loading response, maximum flexion of swing phase on the knee and maximum plantar flexion of pre-swing were less than the control group (p<.05). Using three-dimensional gait analysis, we could identify specific gait parameters to reflect a functional deficit related to the level of lumbosacral radiculopathy.

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침치료 및 Cox 수기요법을 이용한 요천추 신경근병증 환자의 치험 2례 - 침근전도 검사상의 호전을 중심으로 - (The Case Report on Improved Change of Lumbosacral Radiculopathy Using Acupuncture Therapy and Cox Technique - In the Point of Needle Electromyogram -)

  • 정민규;황형주;박영회;금동호
    • 한방재활의학과학회지
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    • 제19권4호
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    • pp.203-217
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    • 2009
  • Objectives : We have evaluated the effects of conservative treatment on two patients who were diagnosed to lumbosacral radiculopathy. Methods : Two patients were diagnosed as lumbosacral radiculopathy through needle electromyoram. We used acupuncture therapy, Cox technique to the patients. We measured visual analog scale(VAS) and needle electromyogram before and after treatment. Results : After treating acupuncture therapy, Cox technique in the cases, We find out that the patients were improved, and changed of needle electromyogram result. Conclusions : These results suggest that Cox thechnique and acupuncture therapy were effective to lumbosacral radiculopathy and reduced the low back pain and the leg myasthenic.

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

  • 김호봉;이진희;김종열;배성수
    • The Journal of Korean Physical Therapy
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    • 제11권3호
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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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급, 만성 요천추부 신경근병증 환자의 신체진찰과 근전도의 임상적 의미 (Clinical Value of Physical Examination and Electromyography in Acute and Chronic Lumbosacral Radiculopathy)

  • 정유형;정하목;강석;윤준식
    • Clinical Pain
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    • 제19권2호
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    • pp.90-96
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    • 2020
  • Objective: To investigate the diagnostic accuracy of two physical examinations (straight leg raise [SLR] and Bragard test) and electromyography (EMG) in patients with lumbosacral monoradiculopathy in acute and chronic state on confirmation of different diagnostic criteria (MRI vs MRI and diagnostic selective nerve root block [DSNRB]). Method: We identified 297 participants retrospectively from the departmental database. MRI evidence of L5 or S1 nerve root compression and a positive result in diagnostic SNRB served as reference standards. They were divided into two groups by the symptom duration: lasting more than 12 weeks in the chronic group and less than 12 weeks in the acute group. The diagnostic value of clinical tests and EMG were compared. Results: The clinical tests (SLR and Bragard test) done in acute stage on detection by MRI and DSNRB had the highest sensitivity (68%) compared to the chronic stage (63%), but sensitivity was low (57%) on confirmation of MRI alone. However, there was no significant difference on sensitivity and specificity of EMG regardless of reference standards and symptom duration. Electromyography was a significant predictor of neuropathic abnormalities on both acute (OR, 6.3; 95% CI, 2.4 to 16.7; p<0.01) and chronic (OR, 6.8; 95% CI, 2.9 to 16.3; p<0.01). Conclusion: In general, individual physical tests are easy to do and a combination of those tests could be a sensitive indicator of L5 or S1 radiculopathy. Furthermore, the use of provocation tests could provide useful information, especially in proceeding therapeutic selective nerve root block.

요통한자(腰痛患者)에 대(對)한 경천골공(經薦骨孔) 경막외(硬膜外) 스테로이드 주입요법(注入療法) -병례보고(病例報告)- (Trans-Sacral Steroid Injection for Low Back Pain and Lumbosacral Radiculopathy)

  • 민경태;윤덕미;오흥근
    • The Korean Journal of Pain
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    • 제2권1호
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    • pp.78-84
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    • 1989
  • Steroid and local anesthetics were injected into the epidural space through the posterior sacral foramen or lumbar approach in 4 patients for the purposes of relieving severe low back pain and radiculopathy. These patients were referred from other sections dealing with low back pain and radiculopathy, because one could not tolerate the surgical stress due to a heart problem, another two did not want the operation and the last had post-laminectomy status. All patients were satisfied with the results subjectively.

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척추수술후증후군 환자에서 경구용 Prostaglandin E1에 의한 치료 경험 -증례보고- (Experience of Administering Oral Prostaglandin E1 for Failed Back Surgery Syndrome -A case report-)

  • 이해광;우승훈;이우용
    • The Korean Journal of Pain
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    • 제19권1호
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    • pp.101-103
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    • 2006
  • Oral prostaglandin E1 (PGE1) is a medicine that is clinically applied during a treatment of patients suffering with vascular disease with chronic arterial obstruction because it has vasodilation and anti-platelet effects. The mechanisms of lumbosacral symptoms associated with spinal stenosis probably include vascular insufficiency with hypoxic injury to the cauda equina and the nerve roots. Thus, increasing the blood supply would be beneficial to improve the pathophysiologic condition. Several studies on the improvement of clinical symptoms of spinal stenosis by PGE1 treatment have been reported on. In this case, 47-year old female underwent posterior compression and posterolateral fusion with a cage at L2-4 due to L3 compression fracture, and she did not show improvement of the radiating pain of her right leg after the operation. Therefore, she received repetitive epidural catheterization and adhesiolysis, epidural block and physical therapy, but her symptoms deteriorated after temporary improvement. Finally, she was given PGE1 and the radiculopathy was completely improved, although some muscle weakness still remained.

An Unappreciated Correlation : Surgical Treatment of Lumbosacral Disc Disease and Erectile Dysfunction

  • Kulaksizoglu, Haluk;Kaptan, Hulagu
    • Journal of Korean Neurosurgical Society
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    • 제47권4호
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    • pp.282-286
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    • 2010
  • Objective : The aim of the present study was to assess the effect of lumbar disc herniation surgery for low back pain on the erectile functioning. Methods : Thirty-eight patients, with age ranging from 22 to 56 years, who had presented with pain due to herniated lumbar discs were included in the study. International Index of Erectile Function (IIEF) Short Form questionnaire was used to evaluate the erectile functioning. Patient visits on the 1st week,1st month and 3rd month postoperatively were analyzed. Pain scores were also noted together with side effects and the complications of the surgery. Results : Of the 38 patients, 18 patients had reported erectile dysfunction; 10 patients mild and 8 patients moderate erectile dysfunction. Twenty patients did not report erectile problems. The herniation levels mostly were L5-S1 in 12 (31.6%). Overall, erectile dysfunction rates have improved in 31.7% of those previously with erectile dysfunction in a 3 month period after the surgery. Best results were obtained in those patients with mild erectile dysfunction preoperatively. Conclusion : Mild erectile dysfunction together with radiculopathy tends to improve after lumbosacral disc surgery. Moderate and severe erectile dysfunction may be related to a more severe nerve injury or to vascular and/or psychiatric factors. An evaluation of erectile functioning should routinely be performed in patients with lumbosacral disc disease both for data accumulation and for medico legal causes since the documentation of the correlation between erectile dysfunction and lumbosacral disc disease is still lacking.

요천추부 신경근병증의 치료를 위한 경추간공 경막외 스테로이드 주입과 요추 및 미추 경막외 스테로이드 주입의 비교 (Comparison of Transforaminal Epidural Steroid Injection and Lumbar/Caudal Epidural Steroid Injection for the Treatment of Lumbosacral Radiculopathy)

  • 정선섭;이원형
    • The Korean Journal of Pain
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    • 제18권1호
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    • pp.23-28
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    • 2005
  • Background: An epidural steroid injection (ESI) is usually used for the treatment of low back pain with radiculopathy. An ESI can be performed by two procedures: I) a lumbar or caudal epidural steroid injection and II) a transforaminal epidural steroid injection. Methods: Ninety-three patients, who had undergone transforaminal epidural steroid injection (Group II), and either a lumbar or caudal epidural steroid injection (Group I), were retrospectively studied. The authors assessed the pain, walking, standing improvement and side effects after each procedure, which were evaluated as being very good, good, fair or poor. Data were collected from the patients medical records and analyzed using the chi-squared test. P < 0.05 was considered significant. Results: There were no statistically significant differences in the pain, walking, standing improvement and side effects between the two groups. However, there was a statistically significant difference in the pain improvement following transforaminal epidural steroid injection in those not effectively responding to an initial lumbar or caudal epidural block in Group II. Conclusions: A transforaminal epidural steroid injection is a useful alternative to a lumbar or caudal epidural steroid injection for low back pain with radiculopathy.

가관절을 이루고 있지 않은 편측의 통증을 호소한 베르톨로티 증후군 (Unusual Lower Back Pain on the Non-Articulated Side in Patient with Bertolotti's Syndrome)

  • 김인아;이종인;장용준;박혜연
    • Clinical Pain
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    • 제20권1호
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    • pp.49-52
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    • 2021
  • Bertolotti's syndrome (BS) refers to chronic low back pain (LBP) associated with lumbosacral transitional vertebrae (LSTV). Many studies suggest that the anomalous articulation alters biomechanics, resulting in discomfort on the ipsilateral side. Herein, we present an unusual case of BS presenting pain on the non-articulated side. A 46-year-old man visited our clinic with history of chronic LBP, refractory to treatment of analgesics, modalities and manual therapies. Electrodiagnostic studies showed no evidence of lumbosacral radiculopathy. Radiographies noted unilateral pseudoarticulation of L5~S1 vertebrae, on the contralateral side of his pain. The pain improved dramatically after sacroiliac joint block and facet joint block with iliolumbar ligament infiltration on the non-articulated side. Clinicians should be cautious that the unaffected joint in BS may serve an important role in altered lumbopelvic biomechanism, since it might eventually lead to intractable chronic LBP when overlooked.