• 제목/요약/키워드: 척추 협착증

검색결과 65건 처리시간 0.023초

퇴행성 요추 척추관 협착증의 한의표준임상진료지침 핵심질문 설정에 대한 환자 인식 설문 조사: 단면 설문 연구 (Patient's Perception for Developing Research Questions of a Clinical Practice Guideline of Korean Medicine for Degenerative Lumbar Spinal Stenosis: A Descriptive Cross-Sectional Survey)

  • 최서영;배지민;최지원;양기영;이병렬;김건형
    • Korean Journal of Acupuncture
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    • 제35권3호
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    • pp.130-138
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    • 2018
  • Objectives : The purpose of this study is to explore patients' perceptions that deserve attention when designing core questions for a clinical practice guideline of Korean medicine(KM) for degenerative lumbar spinal stenosis (LSS). Methods : Patients who had been admitted to Pusan National Korean Medicine Hospital from November 1, 2015 to October 31, 2016 were invited to the survey. Patients were eligible if they were both clinically and radiologically confirmed as degenerative LSS. The structured questionnaire was distributed by mail and outpatient visits. Questions included types of experienced Korean/Western medical interventions for LSS, their perceived effectiveness on symptoms, the necessity for studies of KM for degenerative LSS, the types of KM interventions to be investigated and the types of outcome measures after treatments. Data were descriptively analysed. Results : Twenty of thirty-one invited participants responded to the questionnaire. Acupuncture and herbal medicine were the most frequently used KM interventions. Eighteen respondents reported that KM treatments were helpful for their improvement. Sixteen patients who mentioned that research on KM is needed chose acupuncture as the top priority(88%) among KM interventions. The most important outcomes in the view of nineteen respondents included functional recovery (68%) and pain relief (53%). Thirteen respondents (65%) replied that both short-term and long-term outcome were important for them. Conclusions : Our findings may have limited validity due to the small number of respondents and the potential selection and information bias. Further qualitative studies and large-scale surveys to comprehensively identify patients' views are warranted.

인공추간판 슬라이딩 코어의 곡률반경 변화가 종판의 접촉압력에 미치는 영향 (Effect of the Radius of Curvature on the Contact Pressure Applied to the Endplate of the Sliding Core in an Artificial Intervertebral Disc)

  • 김철웅
    • 대한기계학회논문집A
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    • 제36권1호
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    • pp.29-35
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    • 2012
  • 척추관 협착증은 감압술과 융합술 그리고 인공추간판 치환술 등이 있으며, 2000년대 중반부터는 인공추간판 치환술이 널리 시술되고 있다. 인공추간판의 연구는 추간판의 자유도 및 추체의 굴곡-신전, 측굴전, 축회전에 대한 해석이 핵심기술이지만, 시술 후 수년이 경과하여 발생하는 피로파손이 새롭게 큰 문제점으로 대두되고 있다. 따라서 인공추간판 연구는 슬라이딩 코어의 피로특성 및 내구성 향상에 집중되어야 한다. 본 연구에서는 세계적으로 가장 많이 사용되는 인공추간판 제품(SB Charit$\acute{e}$ III)을 기초로 유한요소모델을 제작하고, 슬라이딩 코어의 곡률반경과 마찰계수의 변화가 von-Mises 응력과 접촉압력에 미치는 영향을 평가하였다. 이와 같은 결과를 바탕으로 새로운 인공추간판 모델들 (Model-I, -II, -III)을 제안하고 일정수명 후 발생할 수 있는 슬라이딩 코어의 피로파손 거동에 대해 SB Charit$\acute{e}$ III의 결과와 비교 평가하였다.

백서의 척추간 신경공 협착증 모델에서 Lipo-Prostaglandin E1의 정주효과 (The Effect of Intravenous Lipo-Prostaglandin E1 Injectioin in a Rat Foraminal Stenosis Model)

  • 윤혜경;이평복;한진수;박상현;이승윤;김양현;김용철;이상철
    • The Korean Journal of Pain
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    • 제20권1호
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    • pp.15-20
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    • 2007
  • Background: Lipo-prostaglandin E1 (Lipo-$PGE_1$) has vasodilating and platelet aggregation inhibitory characteristics and it has been used as a treatment for patients with blood flow dysfunction disease. Based on the mechanisms of lumbar spinal stenosis, including veno congestion, neuro-ischemia and mechanical compression, we aimed to study whether intravenous Lipo-$PGE_1$ injection has any therapeutic effect on hyperalgesia in a rat foraminal stenosis model. Methods: In this study, twenty male Sprague-Dawley rats were divided into the control (n = 10) and Lipo-$PGE_1$ (n = 10) groups. A small stainless steel rod was inserted into the L5-6 intervertebral foramen to induce intervertebral foramen stenosis and chronic DRG compression. In the Lipo-$PGE_1$ group, $0.15{\mu}g/kg$ of Lipo-$PGE_1$ were injected intravenously via a tail vein for 10 days starting from the $3^{rd}$ day after operation. Behavioral testing for mechanical and thermal hyperalgesia was performed for 3 weeks after the injections. Results: From the $10^{th}$ day after Lipo-$PGE_1$ injection, the rats in the experimental group showed significant recovery of their mechanical threshold, and this effect was maintained for 3 weeks. No significant differences of the thermal hyperalgesia were observed between the two groups. Conclusions: These findings suggest that intravenously injected Lipo-$PGE_1$ may be effective for alleviating neuropathic pain, which isthe main symptom of spinal stenosis, by improving the blood flow dysfunction.

요추 MR영상에 포함된 경흉추 시상T2강조영상의 효용성 평가 (The Value of Additional Cervicothoracic Spine Sagittal T2-weighted Images Included in Routine Lumbar Spine MR Imaging)

  • 서지운;박소영;이준우;이근영;강흥식
    • Investigative Magnetic Resonance Imaging
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    • 제17권2호
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    • pp.91-100
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    • 2013
  • 목적: 요추 MR 영상에 추가된 경흉추 시상T2강조영상(CT SAG T2WI)의 임상적 효용성을 평가하고자 한다. 대상과 방법: 2005년 1월부터 2005년 12월까지 요추 MRI를 시행하였던 2,113명의 환자를 대상으로 하였다. 경흉추 시상T2강조영상을 후향적으로 분석하였고, 의무기록을 후향적으로 검토하여 경추 또는 흉추 병변의 추가적인 평가를 위한 MRI 또는 CT 시행여부와 이러한 병변에 대한 치료 및 경과를 알아보았다. 결과: 2,113명중 139명의 환자에게서 총 142개의 병변이 경흉추 시상T2강조영상에서 관찰되었다. 요추 MRI 촬영시, 환자의 자세변화 없이 2분 이내에 경흉추 시상T2강조영상을 추가적으로 얻었다. 13명의 환자만이 경추 또는 흉추의 병변에 대해 MR영상 또는 CT를 시행하였고, 7명의 환자는 T2강조영상 고신호강도 여부에 상관 없이 척추관협착증 또는 추간판탈출증에 대해 수술적 치료를 받았다. 결론: 요추 MRI촬영 시, 2분 이내로 소요되는 경흉추 시상T2강조영상의 추가촬영은 요추의 증상으로 오인된 경흉추의 병변을 평가하는데 유용하다.

지방종을 동반한 척추관협착증 환자의 복합한방치료 치험 1예 (A Case Report of Combined Korean Medicine Treatment of Spinal Stenosis with Lipomatosis)

  • 김미혜;한수빈;박병학;손재민;이남우;한정훈;강도현;민태운;안재서;이한솔;이현준
    • 한방재활의학과학회지
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    • 제30권4호
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    • pp.195-201
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    • 2020
  • Spinal epidural lipomatosis is a rare disorder characterized by overgrowth of fat in the extradural space, causing spinal stenosis with compression of the neural elements. This study reports on the effectiveness of Korean medicine treatment on a patient who was diagnosed on lumbar stenosis with lipomatosis. The patient was treated with Korean traditional medicine including pharmacopucture, acupuncture, Chuna manual treatment, and Korean herbal medicine, cupping. Numerical rating scale (NRS), Oswestry disability index (ODI), Euroqol five dimension (EQ-5D) index, lumbar range of motion were used as objective tools for evaluating the patient's progress. Back NRS decreased from 6 to 3. In the case of lower limbl radiation NRS, 5 was reduced to 3 upon discharge. EQ-5D index also increased from 0.751 to 0.766. For ODI, the score dropped from 26.67 to 24.44 on hospitalization. As a result, clinical improvements were found in a patient. In conclusion, this study shows that Korean medicine treatment can be considered as effective conservative care for spinal stenosis with lipomatosis.