1.Segmentary Mobility of the Lumbar Spine in the Diagnosis of Low Back Pain
The Journal of the Korean Orthopaedic Association 1972;7(4):393-404
Segmentary mobility of the mobile lumbar spines upon a total of 90 cases was studied by means of the functional radiographic examination. Segmentary mobility was determined by Falconer method. The cases were divided into four groups as Group I, 20 cases, who had no symptoms on low back, Group II, 20 cases, who had herniated disc in L4-5 confirmed either by surgery or by myelography, Group III, 30 cases, who had low back pain and neurological signs of L5 root irritation, and Group IV, 20 cases, who had low back pain as well as neurological signs of S1 root irritation. The result of the analysis was concluded as follows: 1. Total mobility of the lumbar spine in group I was significantly higher than other groups. Large normal variation in segmentary mobility of the lumbar spine was found, however, the mean angle of the segmentary mobility was highest in L4-5 and higher in the order of L5-S1, L4-3, L3-2 and L2-1. 2. Total mobility of the lumbar spine in group II was markedly reduced compared with group I, however, proportion of the segmentary mobility of L4-5 versus total mobility of the lumbar spine was somewhat higher than that of group 3. Total mobility of the lumbar spine in group III was significantly reduced than group I and significantly higher than group II. Proportion of the segmentary mobility of L4-5 versus total mobility of the lumbar spine in group III was somewhat higher than group I and the same as group II. 4. Total mobility of the lumbar spine in group IV was reduced than group I and group III, and higher than group II. Proportion of the segmentary mobility of L5-S1 was significantly higher than any other group. 5. In the groups with low back pain and herniated disc, in other words, there was found relatively increased segmentary mobility in the affected lumbar segments in contrast to reduced mobility of the total lumbar segments.
Diagnosis
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Intervertebral Disc Displacement
;
Low Back Pain
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Methods
;
Myelography
;
Spine
2.Lumbar Epidural Venography in the Diagnosis of Lumbar Disc Herniation
Kwang Jin RHEE ; Hak Young KIM ; Sung Ho YUNE ; Dong Ik LEE
The Journal of the Korean Orthopaedic Association 1982;17(2):222-228
Epidural venography is a relatively simple and highly accurate method in the diagnosis of lumbar disc herniation. Angiographic visualization of the epidural vein has been tried and investigated by intraosseus injection of contrast agent into lumbar spinous process and intravascular injection into iliac vein since first report in 1954. Recently, lumbar epidural venography is instituted by selective catheterization of ascending lumbar vein or internal iliac vein. Lumbar epidural venography is valuable for the diagnosis of herniated lumbar disc, not demonstrated by myelography. Especially, lumbar epidural venography is more accurate than myelography in the diagnosis of L5-Sl disc herniation and in the case of extreme lateral herniation. Other advantages of epidural venography are low incidence of complication and ease of performance. Epidural venography may be recommended as an alternative rnethod rather than as adjunctive to myelography. We report 20 cases of epidural venography, compared with myelographic and operative findings.
Catheterization
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Catheters
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Diagnosis
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Iliac Vein
;
Incidence
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Methods
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Myelography
;
Phlebography
;
Veins
3.Significance of CT after discography
Key Yong KIM ; Duck Yun CHO ; Yung Tae KIM ; Kyu Jeong HAN
The Journal of the Korean Orthopaedic Association 1989;24(1):207-211
There was a development of the diagnostic aids such as electromyography, discography, epidural venography, myelography, and CT in lumbar disc herniation. In 1984, Edgardo et al. described that the diagnosis of unusual extreme lateral disc herniation might be suggested by CT, but the diagnosis was made more certain with CT done after discography. Also, in 1986, Michael et al. reported,that the addition of CT to lumbar discography could help the clinician to obtain an anatomically valid diagnosis in people who, in spite of prior negative diagnosis evaluation, continue with significant clinical symptoms of low back pain and sciatica. The authors have studied 25 cases of CT after discography from July 1984 to June 1987. The results were as follows;1) CT after discography, which was a diagnostic method of direct visualization of nucleus pulposus herniation, shown same finding as previous CT in 16 cases and more accurate finding of herniated site snd size in 2 cases. 2) In one csse, the diagnosis of extreme lateral disc herniation, which was suggested by previous CT, made more certain with CT after discography. 3) There was false negative in 6 cases.
Diagnosis
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Electromyography
;
Low Back Pain
;
Methods
;
Myelography
;
Phlebography
;
Sciatica
4.Clinical Analysis of C.N.S. Cysticercosis.
Soo Ho CHO ; Choong Bae MOON ; Byung Yon CHOI
Yeungnam University Journal of Medicine 1984;1(1):25-34
During last 10 years we experienced 25 cases of C.N.S. cysticercosis. Now clinical analysis and evaluation of our cases were made and the results are followings; 1. Prevalence in man and women are nearly same and about 70% of cases are distributed between 20-50 years old. 2. According to Nieto's classification, mostly are ventricular (44%) and parenchymal type (36%). 3. Clinical manifestations were IICP (92%), focal neurological deficits (68%), seizure (48%), altered mental status (36%) and others listed on table 7. 4. In ventricular type, IICP and cerebellar dysfunction signs were predominated but seizure and focal neurological deficits were commonly seen in parenchymal type. 5. Subcutaneous cysticercus nodules were palpated in 32% of cases. 6. Positive stool ova was observed in 29% of cases. 7. Radiologic studies revealed as followings: 16% of cases showed abnormal findings on plain film, 84% on angiography, 94% on ventriculography and 100% on computed tomography and myelography. Computed tomography looks like most helpful diagnostic method for C.N.S. cysticercosis, they usually revealed lucent cystic lesion, hydrocephalic findings and contrast enhancement. 8. Suboccipital craniectomy, craniotomy with removal of parenchymal cyst or laminectomy were done according to location and types of lesion. 72% of operated cases revealed good results and mortality was 4% of cases.
Angiography
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Cerebellar Diseases
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Classification
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Craniotomy
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Cysticercosis*
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Cysticercus
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Female
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Humans
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Laminectomy
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Methods
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Mortality
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Myelography
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Ovum
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Prevalence
;
Seizures
5.Axon Count and Sympathetic Skin Responses in Lumbosacral Radiculopathy.
Hacer ERDEM TILKI ; Melek COSKUN ; Neslihan Unal AKDEMIR ; Lutfi INCESU
Journal of Clinical Neurology 2014;10(1):10-16
BACKGROUND AND PURPOSE: Electrodiagnostic studies can be used to confirm the diagnosis of lumbosacral radiculopathies, but more sensitive diagnostic methods are often needed to measure the ensuing motor neuronal loss and sympathetic failure. METHODS: Twenty-six patients with lumbar radiculopathy and 30 controls were investigated using nerve conduction studies, motor unit number estimation (MUNE), testing of the sympathetic skin response (SSR), quantitative electromyography (QEMG), and magnetic resonance myelography (MRM). RESULTS: Using QEMG as the gold standard, the sensitivity and specificity of MUNE for the abductor hallucis longus muscle were 71.4% and 70%, respectively. While they were 75% and 68.8%, respectively, when used MRM as gold standard. The sensitivity and specificity of MUNE for the extensor digitorum brevis muscle were 100% and 84.1%, respectively, when the peroneal motor amplitude as the gold standard. The SSR latency was slightly longer in the patients than in the controls. CONCLUSIONS: MUNE is a simple and sensitive test for evaluating autonomic function and for diagnosing lumbosacral radiculopathy in patients. MUNE could be used routinely as a guide for the rehabilitation of patients with radiculopathies. SSR measurements may reveal subtle sympathetic abnormalities in patients with lumbosacral radiculopathy.
Axons*
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Diagnosis
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Electromyography
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Humans
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Methods
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Motor Neurons
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Muscles
;
Myelography
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Neural Conduction
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Radiculopathy*
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Rehabilitation
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Sensitivity and Specificity
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Skin*
6.Computed tomography in lumbar herniated disc
Chul Soon CHOI ; Kee Hyun CHANG ; Man Chung HAN
Journal of the Korean Radiological Society 1984;20(3):407-413
197 spine CTs were performed from 29th, March 1982 to 7th March, 1984. Among them, 39 patients preoperatively diagnosed as herniated nucleus pulposus ar bulging disc with CT and myelography were operated. 43 disc spaces ofdisc disease were analysed in true positive and false negative cases. Finally the accuracy, sensitivity and specifictiy of spine CT and myelography ar calculated. The resuslts are as follows; 1. The CT findings of disc diseases are in order of frequency, asymmetrical obliteration of epidural fat (82%), ventral indentation orcompression on dural sac(72%), focal protrusion of disc(64%), root changs
Constriction, Pathologic
;
Humans
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Hypertrophy
;
Intervertebral Disc Displacement
;
Methods
;
Myelography
;
Spine
;
Vacuum
;
Zygapophyseal Joint
7.Analysis of Operative Treatment of 154 Herniated Intervertebral Disc in Lumbar Spine
The Journal of the Korean Orthopaedic Association 1980;15(2):218-222
One hundred and fifty-four operative cases of herniated intervertebral disc were evaluated in department of Orthopedic Surgery, National Police Hospital from June 1973 to May 1979. The results were obtained as follows: 1. Out of the 154 patients, there were 137 male and 17 female cases. The ratio between male and female was 8:1. 2. The majority (72%) of the herniated intervertebral disc was found in the age group of 20 to 40 years. 3. The most common site of the lesion was between L4 and L5 vertebrae (70%). 4. About 90% of the patient showed significant sign in myelographic and clinical studies. 5. To prevent adhesion of sciatic nerve & dura after the operation, spraying the methyl-prednisolone over the operative site and covering dura with fat in spinal canal could be resulted in good method. 6. The dissecting type is considered to be what operators should observe attentively during the operation. 7. The result of treatment was excellent in 94 cases (61%) and good in 47 cases (30%).
Female
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Humans
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Intervertebral Disc
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Male
;
Methods
;
Myelography
;
Orthopedics
;
Police
;
Sciatic Nerve
;
Spinal Canal
;
Spine
8.The Significance of Computerized Tomography in Spinal Stenosis
Hee Joong KIM ; Han Koo LEE ; Seong Il BIN
The Journal of the Korean Orthopaedic Association 1985;20(1):46-52
Spinal stenosis is a localized narrowing of spinal canal due to strurctural abnormalities. Its symptoms are obscure, and characterized by chronic, poorly localized, bilateral nerve root compression signs. Computerized tomography(CT) has been accepted as almost an absolute diagnostic method for spinal stenosis after its application in the orthopedic field. During the period of 2 years, from March 1982 to March 1984, 26 cases of spinal stenosis were treated surgically after botlt CT scanning and myelography. We obtained following results about advantage of CT scanning in spinal stenosis. 1. Myelography showed following findings: Hourglass defect 9, Complete block 8, Unilateral focal defect 4, Uniform narrowing 1, Mixed 2, Negative finding 2. Myelographic finding was not specific for spinal stenosis and diagnostic accuracy was inferior to CT. 2. The type of spinal stenosis was identified by CT scan finding. Of 26 cases, 21 cases were degenerative spinal stenosis, of which central stenosis was present in 7 cases, and lateral stenosis was present in all cases. The remaining 5 cases were combined type, and both central and lateral stenosis were present in all cases. 3. The diagnostic accuracy,in localizing the level of stenosis was 61.5% by myelography, and 96.2% by CT scan. CT was especially superior to myelography in the localization of the multi-segmental stenosis. 4. CT gives valuable information about extent and degree of stenosis, especially lateral recess stenosis, thus helping the surgeon to decide on the extent of decompressive lamininectomy preoperatively.
Clothing
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Constriction, Pathologic
;
Methods
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Myelography
;
Orthopedics
;
Radiculopathy
;
Spinal Canal
;
Spinal Stenosis
;
Tomography, X-Ray Computed
9.Comparative Study of the Clinically Diagnosed Herniated Nucleus Pulposus with the Computed Tomographic and Myelographic Finding
Jung Tak SUH ; Chong Il YOO ; Hui Taeg KIM
The Journal of the Korean Orthopaedic Association 1987;22(3):707-716
79 patients with suspected H.N.P. of lumbar vertebrae were studied from June 1983 to June 1986 who had had both metrizamide myelography and computed tomography. Comparative study of the findings from clinical examination, CT and myelography of them are as follows. l. In physical examination, S.L.R.T. was most common sign, 58 patient(73.4% of study group) showed positive in S.L.R.T.(30~70 range). Of these positive patients in S.L.R.T. 41.4% was the patients who were younger than 30 years of age and also had pressure sign of nerve root on CT and myelography. These group showed highest positive rate in S.L.R.T. 2. In CT and myelographic study, the most frequent occurence of H.N.P. were seen in L4–5, L5–S1, L3–4 in order and myelography showed higher positive rate in L4–5 intervertebral space while CT showed higher positive rate in LS–S1. 3. On CT, facet joint arthritis or stenosis were seen in 49.4% of the study group and 53.7% of computed tomographic positive patients of H.N.P. 4. Corresponding rate of positive sign of H.N.P. between CT and myelographic findings were seen 71 intervertebral spaces, which means 84.5% of 84 positive spaces on CT and 88.8% of 80 positive spaces on myelography. 5. In 49 intervertebral spaces clinical sign, CT and myelographic findings were all positive. In another words 58.3% of 84 positive intervertebral spaces on CT and 61.3% of 80 positive spaces on myelography showed all positive sign on clinical examentation, CT and myelography. 6. L5–Sl intervertebral spaces showed most controversial results in comparative study of CT and myelography. 7. 25 of 26 positive spaces on CT(96.2%) and 23 of 26 positive spaces of myelography(88.5%) were confirmed by operation and all 3 false-negative on myelography were found in L5–Sl intervertebral space. 8. Most diagnostic differences were seen in L5–S1, which has wider epidural space. CT showed higher sensitivity than myelography in this study. For its higher sensitivity and non-invasiveness CT is thought to be first recommendable method for diagnosis of H.N.P. and myelography is recommended as second best choice where diagnostic differences are seen.
Arthritis
;
Constriction, Pathologic
;
Diagnosis
;
Epidural Space
;
Humans
;
Lumbar Vertebrae
;
Methods
;
Metrizamide
;
Myelography
;
Physical Examination
;
Zygapophyseal Joint
10.The Significance of the Myelography in the Herniation of Intervertebral Disc
Kwon Ick HA ; Sung Ho HAHN ; Min Young CHUNG ; Yang Hee PARK ; Sung Jin CHO
The Journal of the Korean Orthopaedic Association 1987;22(4):908-913
The herniation of intervertebral disc is possibly diagnosed through the myelography, electromyography, discography or computerized tomography. Among them, the myelography is regarded as the popularized method that helps accurate analysis on the location and pattern of the lesion. The authors have studied 363 cases of herniated intervertebral disc with respect to the diagnostic accuracy of myelographic examination from January, 1982 to December, 1985 at the Department of Orthopedic Surgery and Radiology, National Police Hospital. The results were as follows; 1. The most common age group was 21 to 30 years old and ratio of male and female was 9.7: l. 2. The most common site of the lesion was between L4 and L5 vertebra in myelography. 3. Of the 363 cases which underwent the myelography, 305(84.0%) represented positive findings. 4. Myelographic accuracy was coincided with the clinical diagnosis regarding the location of herniation of intervertebebral disc in 262 cases(72.1%).
Diagnosis
;
Electromyography
;
Female
;
Humans
;
Intervertebral Disc
;
Male
;
Methods
;
Myelography
;
Orthopedics
;
Police
;
Spine