• Title, Summary, Keyword: Spinal Disease

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Kinetic Analysis of Foot Balance and Gait Patterns in Patients with Adult Spinal Disease (성인 척추질환자의 발균형 및 보행형태에 대한 운동역학적 분석)

  • Park, Jae Soung;Lee, Joong Sook
    • Korean Journal of Sport Biomechanics
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    • v.29 no.1
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    • pp.23-32
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    • 2019
  • Objective: The aim of this study was to provide kinematic data on the characteristics of spinal disease patients by comparing and analyzing kinematic variables related to foot balance and gait pattern of spinal disease. Method: The subjects of the study included 40 adult men and 60 adult women who visited the hospital in Busan. Patients who were diagnosed with spinal disease by a physician through X-ray examination were selected as subjects for the diagnosis of vertebral disc herniation, spinal stenosis, spinal disease diagnosed with spinal disease and the general public. Left and right foot pressure and contact area were checked by Gaitview pro meter. X-ray photographs were taken with a Zen-2090 mobile fluoroscopy under physicians' direct participation. One-way ANOVA was performed to compare the differences between the kinematic variables and post-hoc was performed by the Duncan method. Results: The difference in contact area between the left foot and the right foot was $115.30{\pm}14.15cm^2$ in the left side and $124.25{\pm}13.65cm^2$ in the left side in the spinal disease patients. The difference in pressure between the left and right side of the spinal disease patients was wider than that of the general people. Especially, the right side of the spinal disease patients showed a larger area of left foot contact than the general population. Conclusion: Spinal disease patients have wider contact area of the left foot than those of the general population. In the case of right spinal disease, the left foot support area is widened due to pain. In the gait, women showed slightly more posterior body center than men, and the upper body muscle imbalance and immobilization due to the spinal disease caused imbalance of the muscles moving to the lower limb, It was analyzed to inhibit movement.

A Study on the Korean Medical Quality Assessment of Spinal Disease -Focusing on Admission Patients- (척추질환의 한의적정성 평가 연구 -입원환자 중심으로-)

  • Park, Jung-Sik;Lim, Hyung-Ho
    • Journal of Korean Medicine Rehabilitation
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    • v.25 no.3
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    • pp.11-26
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    • 2015
  • Objectives The purpose of this study is to assess the quality of spinal disease focusing on Korean medical hospital admission patients. Methods The disease code related to spinal disease was selected based on the contents of development of clinical quality indicators for spinal disease. The assessment analysis of feasibility was conducted through medical history analysis that targets spinal disease patients, current development of clinical quality indicators for spinal disease, and relevant literature. Results The indicator items of structure, process, and results were classified and selected, and so were the detailed indicator entries. After that, the appropriate reference value was chosen. The final selected quality indicators were 3 items from structure, 9 items from process, 4 items from results, including 3 monitoring items, total 16 items was chosen. Conclusions Clinical research for the adequacy assessment should be conducted and the index entry and indicators should be reassessed through an expert group discussion. Training for the evaluation indicators and association with relevant society will motivate hospitals to voluntarily improve their quality.

Microbiology and Epidemiology of Infectious Spinal Disease

  • Jeong, Se-Jin;Choi, Seung-Won;Youm, Jin-Young;Kim, Hyun-Woo;Ha, Ho-Gyun;Yi, Jin-Seok
    • Journal of Korean Neurosurgical Society
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    • v.56 no.1
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    • pp.21-27
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    • 2014
  • Objective : Infectious spinal disease is regarded as an infection by a specific organism that affects the vertebral body, intervertebral disc and adjacent perivertebral soft tissue. Its incidence seems to be increasing as a result of larger proportion of the older patients with chronic debilitating disease, the rise of intravenous drug abuser, and the increase in spinal procedure and surgery. In Korea, studies assessing infectious spinal disease are rare and have not been addressed in recent times. The objectives of this study are to describe the epidemiology of all kind of spinal infectious disease and their clinical and microbiological characteristics as well as to assess the diagnostic methodology and the parameters related to the outcomes. Methods : A retrospective study was performed in all infectious spinal disease cases presenting from January 2005 to April 2010 to three tertiary teaching hospitals within a city of 1.5 million in Korea. Patient demographics, risk factors, clinical features, and outcomes were assessed. Risk factors entailed the presence of diabetes, chronic renal failure, liver cirrhosis, immunosuppressants, remote infection, underlying malignancy and previous spinal surgery or procedure. We comparatively analyzed the results between the groups of pyogenic and tuberculous spinal infection. SPSS version 14 statistical software was used to perform the analyses of the data. The threshold for statistical significance was established at p<0.05. Results : Ninety-two cases fulfilled the inclusion criteria and were reviewed. Overall, patients of tuberculous spinal infection (TSI) and pyogenic spinal infection (PSI) entailed 20 (21.7%) and 72 (78.3%) cases, respectively. A previous spinal surgery or procedure was the most commonly noted risk factor (39.1%), followed by diabetes (15.2%). The occurrence of both pyogenic and tuberculous spondylitis was predominant in the lumbar spine. Discs are more easily invaded in PSI. At initial presentation, white cell blood count and C-reactive protein levels were higher in PSI compared to TSI (p<0.05). Etiological agents were identified in 53.3%, and the most effective method for identification of etiological agents was tissue culture (50.0%). Staphyococcus aureus was the most commonly isolated infective agent associated with pyogenic spondylitis, followed by E. coli. Surgical treatment was performed in 31.5% of pyogenic spondylitis and in 35.0% of tuberculous spondylitis cases. Conclusion : Many previous studies in Korea usually reported that tuberculous spondylitis is the predominant infection. However, in our study, the number of pyogenic infection was 3 times greater than that of tuberculous spinal disease. Etiological agents were identified in a half of all infectious spinal disease. For better outcomes, we should try to identify the causative microorganism before antibiotic therapy and make every effort to improve the result of culture and biopsy.

Prevalence, Distribution, and Significance of Incidental Thoracic Ossification of the Ligamentum Flavum in Korean Patients with Back or Leg Pain : MR-Based Cross Sectional Study

  • Moon, Bong Ju;Kuh, Sung Uk;Kim, Sungjun;Kim, Keun Su;Cho, Yong Eun;Chin, Dong Kyu
    • Journal of Korean Neurosurgical Society
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    • v.58 no.2
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    • pp.112-118
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    • 2015
  • Objective : Thoracic ossification of the ligamentum flavum (OLF) is a relatively rare disease. Because of ambiguous clinical symptom, it is difficult for early diagnosis of OLF and subsequent treatment can be delayed or missed. Therefore, the purpose of this study is to comprehensively assess the prevalence and distribution of thoracic OLF by magnetic resonance imaging (MRI) and coexisting spinal disease in Korean patients with back pain or leg pain. Methods : The sample included 2134 Korean patients who underwent MRI evaluation for back pain. The prevalence and distribution of thoracic OLF were assessed using lumbar MRI with whole spine sagittal images. Additionally, we examined the presence of coexisting lumbar and cervical diseases. The presence of thoracic OLF as well as clinical parameters such as age, sex, and surgery were retrospectively reviewed. Results : The prevalence of thoracic OLF in total patients was 16.9% (360/2134). The prevalence tended to increase with aging and was higher in women than in men. The lower thoracic segment of T10-11 was the most frequently affected segment. Of the 360 patients with OLF, 31.9% had coexisting herniated thoracic discs at the same level. Approximately 74% of the patients with OLF had coexisting lumbar and cervical disease. Nine (2.5%) of 360 OLF patients underwent surgery for thoracic lesion. Conclusion : The prevalenceof thoracic OLF was relatively higher than those of previous reports. And coexisting lumbar and cervical disease were very frequent. Therefore, we should check coexisting spinal diseases and the exact diagnostic localization of ossification besides lumbar disease.

A Study on Incidence of Spinal Disease by Occupational Type (직업 유형에 따른 척추질환 유병률 조사)

  • Jeong, Beoul;Shin, Dong-Jae
    • Journal of Korean Medicine Rehabilitation
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    • v.20 no.4
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    • pp.131-138
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    • 2010
  • Objectives : Recently work-related musculoskeletal disorders have increased in various workplaces and many reports have been confirming this, but a comparative study on incidence of spinal disease by occupation has not been established yet. So this study was designed to clarify the distinction on incidence of spinal disease between white and blue collar workers. Methods : The subjects who visited with spinal disease to Ja-Seng oriental hospital from January to April in 2020 were selected and divided into white collar workers(n=844) and blue collar workers(n=333). We counted the number of patients with each spinal disease in both groups and carried out comparative analysis in five items(herniated nucleus pulposus(HNP), stenosis, spondylosis, sprain, etc). All data were analyzed by chi-square test. Results and Conclusions : Whit collar workers had higher incidence in HNP(p=0.030), sprain(p=0.016),etc(p=0.035) than blue collar workers, while blue collar workers had higher incidence in stenosis(p=0.002). But we think that the confidence is low in stenosis because the number of cases are very small. There were no significance between two groups with spondylosis.

Consideration of Imaging Studies for Degenerative Spine Disease (퇴행성 요추질환 영상의 고찰)

  • Sin, Jung-Sub;Kim, Jae-Hun
    • Journal of the Korean Society of Physical Medicine
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    • v.2 no.1
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    • pp.93-99
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    • 2007
  • Purpose : The aim of this study is to consider degenerative spine disease theoretically and compare plain radiography which is a basic study for low back pain with MRI in cases of degenerative lumbar spine disease to find out whether the abnormalities agree with each other. Methods : In 4 cases of lumbar degenerative disease, we studied the relation of the abnormalities such as disc space narrowing, spinal space narrowing, loss of lordosis and osteophytes on plain radiography with those on MRI of HIVD, spinal stenosis and spondylolisthesis. Results : Many abnormalities such as disc space narrowing, spinal space narrowing, loss of lordosis, osteophytes and change of cortex & bone marrow on plain radiography suggest HIVD, spinal stenosis, spondylolysis or spondylolisthesis on MRI. Conclusion : For low back pain patients, plain radiography is a basic study in diagnosis of HIVD, spinal stenosis, spondylolysis or spondylolisthesis but MRI or CT scan is necessary to develop(build) a treatment plan like an operation.

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Chronic Spinal Epidural Hematoma Related to Kummell's Disease

  • Kim, Heyun-Sung;Lee, Seok-Ki;Kim, Seok-Won;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.49 no.4
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    • pp.231-233
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    • 2011
  • Chronic spinal epidural hematoma related to Kummell's disease is extremely rare. An 82-year-old woman who had been managed conservatively for seven weeks with the diagnosis of a multi-level osteoporotic compression fracture was transferred to our institute. Lumbar spine magnetic resonance images revealed vertebral body collapse with the formation of a cavitary lesion at L1, and a chronic spinal epidural hematoma extending from L1 to L3. Because of intractable back pain, a percutaneous vertebroplasty was performed. The pain improved dramatically and follow-up magnetic resonance imaging obtained three days after the procedure showed a nearly complete resolution of the hematoma. Here, we present the rare case of a chronic spinal epidural hematoma associated with Kummell's disease and discuss the possible mechanism.

Microsurgical Treatment of Sporadic and von Hippel-Lindau Disease Associated Spinal Hemangioblastomas: A Single-Institution Experience

  • Das, Joe M.;Kesavapisharady, Krishnakumar;Sadasivam, Saravanan;Nair, Suresh Narayanan
    • Asian Spine Journal
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    • v.11 no.4
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    • pp.548-555
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    • 2017
  • Study Design: Retrospective cohort study. Purpose: To examine the clinical profile and surgical complications in patients with spinal hemangioblastomas and to evaluate the long-term outcome in them. Overview of Literature: Although considered to be histologically benign, hemangioblastomas may cause significant neurological deficits. The proportion of spinal hemangioblastomas associated with von Hippel-Lindau (VHL) disease has been estimated be 13%-59%. Preoperative neurological function correlates with postoperative neurological status. Studies have shown no difference in outcomes between sporadic and VHL-associated spinal hemangioblastomas. Methods: This retrospective study included 14 consecutive patients treated for spinal hemangioblastomas at our institute between January 2000 and June 2013. The mean follow-up period was 5 years. Magnetic resonance imaging of the complete neuraxis was performed in all cases, and preoperative embolization was performed in two cases. Results: In total, 14 patients underwent 18 surgeries, of which 15 were for spinal hemangioblastomas. Of all the patients, 86% had motor weakness and 79% presented with sensory disturbances. Preoperative McCormick functional grades were grade I in 7 (50%), grade II in 3 (21%), and grade III in 4 (29%) patients; 50% patients were diagnosed with VHL disease. All patients underwent complete resection of the tumor. Eight patients experienced deterioration in their neurological status in the immediate postoperative period; among them, five had gradual improvement. At 5-year follow-up, 11 (78.57%) patients showed good functional outcomes. Conclusions: Microsurgical excision of spinal hemangioblastomas can cause postoperative morbidity, mainly in the form of neurological deterioration. Almost half of our patients had deterioration in the McCormick grade in the immediate postoperative period. However, a complete microsurgical excision can result in good long-term functional outcomes, as most of the immediate postoperative neurological deterioration in our patients was reversible. There was no difference in the long-term functional outcomes between sporadic and VHL-associated spinal hemangioblastomas.

Increased Prevalence of Chronic Disease in Back Pain Patients Living in Car-dependent Neighbourhoods in Canada: A Cross-sectional Analysis

  • Zeglinski-Spinney, Amy;Wai, Denise C.;Phan, Philippe;Tsai, Eve C.;Stratton, Alexandra;Kingwell, Stephen P.;Roffey, Darren M.;Wai, Eugene K.
    • Journal of Preventive Medicine and Public Health
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    • v.51 no.5
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    • pp.227-233
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    • 2018
  • Objectives: Chronic diseases, including back pain, result in significant patient morbidity and societal burden. Overall improvement in physical fitness is recommended for prevention and treatment. Walking is a convenient modality for achieving initial gains. Our objective was to determine whether neighbourhood walkability, acting as a surrogate measure of physical fitness, was associated with the presence of chronic disease. Methods: We conducted a cross-sectional study of prospectively collected data from a prior randomized cohort study of 227 patients referred for tertiary assessment of chronic back pain in Ottawa, ON, Canada. The Charlson Comorbidity Index (CCI) was calculated from patient-completed questionnaires and medical record review. Using patients' postal codes, neighbourhood walkability was determined using the Walk Score, which awards points based on the distance to the closest amenities, yielding a score from 0 to 100 (0-50: car-dependent; 50-100: walkable). Results: Based on the Walk Score, 134 patients lived in car-dependent neighborhoods and 93 lived in walkable neighborhoods. A multivariate logistic regression model, adjusted for age, gender, rural postal code, body mass index, smoking, median household income, percent employment, pain, and disability, demonstrated an adjusted odds ratio of 2.75 (95% confidence interval, 1.16 to 6.53) times higher prevalence for having a chronic disease for patients living in a car-dependent neighborhood. There was also a significant dose-related association (p=0.01; Mantel-Haenszel chi-square=6.4) between living in car-dependent neighbourhoods and more severe CCI scores. Conclusions: Our findings suggest that advocating for improved neighbourhood planning to permit greater walkability may help offset the burden of chronic disease.

Multiple Hemangioblastomas on Cerebellum and Spinal Cord in a Patient of Von Hippel-Lindau Disease - A Case Report - (본 히펠 린다우병 환자에서 소뇌와 척수에 동시에 발생한 혈관아세포종 - 증례보고 -)

  • Yoon, Chang Sik;Ha, Young Soo;Park, Chong Oon;Hyun, Dong Keun
    • Journal of Korean Neurosurgical Society
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    • v.30 no.8
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    • pp.1023-1027
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    • 2001
  • Hemangioblastomas are rare benign tumor of the central nervous system that commonly occur in the posterior fossa around the 4th ventricle. In case of von Hippel-Lindau disease, hemangioblastomas involve multiple regions such as cerebellum, spinal cord and brainstem but, rarely show simultaneous involvement of cerebellum and spinal cord. We have experienced a case of multiple hemangioblastomas that were located at the cerebellum, cervical cord and conus medullaris and also had multiple lesions that a part of von Hippel-Lindau disease ; retinal angioma, syringomyelia, multiple cyst on kidney and pancreas, renal cell carcinoma on left kidney. Hemangioblastomas on cerebellum and spinal cord were removed totally, retinal angioma was treated with laser photocoagulation and renal cell carcinoma was also totally excised. The authors report a case of von Hippel-Lindau disease had multiple located hemangioblastomas on cerebellum, cervical cord and conus medullaris with review of literature.

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