• Journal of Korean Medicine Rehabilitation
• /
• v.28 no.4
• /
• pp.33-41
• /
• 2018

Objectives The purpose of this study is to analyze the effects of Korean Medicine treatment on lumbar disc herniation (LDH) and predictive factors associated with disc resorption by magnetic resonance imaging (MRI). Methods A retrospective study was carried out in 79 lumbar disc herniation patients who had visited Haeundae Jaseng Hospital of Korean Medicine. Patients' diagnosis was based on MRI. MRI was performed on two or more occasions and patients were received Korean Medicine treatment within the period. The volume of each herniated disc was measured three-dimensionally and patient characteristics, interval between MRIs, herniated disc level, disc herniation type, disc migration, intactness of posterior longitudinal ligament (PLL), initial volume of herniated disc, modic change, disc resorption rate were statistically analyzed. Results The mean volumes of herniated discs before Korean Medicine treatment and after Korean Medicine treatment were $1,547.81{\pm}598.15mm^3$ and $947.06{\pm}335.28mm^3$, respectively. The mean resorption rate was $35.7{\pm}16.3%$. Disc extent, intactness of PLL and initial volume of herniated discs were significantly correlated with resorption rate (p=0.003, p=0.001 and p=0.024, respectively). Conclusions Korean Medicine treatment is an effective conservative treatment for lumbar disc herniation. Factors such as disc migration, intactness of PLL, initial volume of herniated disc have a significant association with disc resorption rate.

• The Journal of Churna Manual Medicine for Spine and Nerves
• /
• v.13 no.2
• /
• pp.47-63
• /
• 2018

Objectives : The purpose of this study was to analyze the effects of lumbar spinal herniated intervertebral Disc on MRI accompanying or not High-intensive zone(HIZ) by Korean Medical Combination Treatment Methods : 324 patients who received inpatient treatment from January 2017 to September 2017 in the Daejeon-Jaseng of Korean Medicine Hospital were divided into 2 groups by High-intensive zone(HIZ) confirmed with a Lumbar spine magnetic resonance imaging. All patients received a combination of treatment including acupunture, chuna manual therapy, pharmacopunture, herbal medication. They were compared and analyzed on the basis of improvement between measuring Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), EuroQol-5 Dimension Index (EQ5D Index), physical examination as they were hospitalized and as they were discharged. The statistically significance was evaluated by SPSS 18.0 for windows. Results : After treatment, Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), EuroQol-5 Dimension Index (EQ5D Index), physical examination was improved respectively. But there was no statistically significance between 2 group's improvement after treatment. Conclusions : After inpatient treatment by Korean Medical Combination Treatment, Most patient's pain, disability and Health Related Quality of Life was improved significantly. But there was no statistically difference between accompanying or not High-intensive zone(HIZ). So We think that future research of higher quality and correct statistics shall be necessary.

• The Journal of Korean Medicine
• /
• v.42 no.3
• /
• pp.1-8
• /
• 2021

Objectives: A critical pathway defines the optimal care process, sequencing and timing of intervention by multi-disciplinary health care teams for a particular diagnosis and procedure. It plays an important role as a cost-effective health care delivery system and a tool for quality control of medical and dental services by means of standardizing medical practices. The aim of this study is to investigate the satisfaction of patients and medical staff after implementation of a critical pathway for Korean medical treatment of lumbar disc herniation in integrative medical. Methods and Results: The pre-critical pathway group included 3 patients who underwent the implementation procedure from October 2020. All three patients have successfully been applied critical pathways during inpatient and outpatient treatment. Additionally, medical staff members were satisfied with the usefulness of the critical pathway. Conclusions: The implementation of critical pathway for the Korean medical treatment with lumbar disc herniation in integrative medical hospital can appraise possible applicability in actual clinical field.

• Journal of Yeungnam Medical Science
• /
• v.24 no.2
• /
• pp.206-215
• /
• 2007

Background : The prone position is often used for operations involving the spine and provides excellent surgical access. The complications associated with the prone position include ocular and auricular injuries, and musculoskeletal injuries. In particular, the prone position during general anesthesia causes hemodynamic changes. To evaluate the cardiovascular effects of the prone position in surgical patients during general anesthesia, we investigated the effects on hemodynamic change of the prone position with the Jackson spinal surgery table. Materials and Methods : Thirty patients undergoing spine surgery in the prone position were randomly selected. After induction of general anesthesia, intra-arterial and central venous pressures (CVP) were monitored and cardiac output was measured by $NICO^{(R)}$. We measured stroke volume, cardiac index, cardiac output, mean arterial pressure, heart rate, CVP and systemic vascular resistance (SVR) before changing the position. The same measurements were performed after changing to the prone position with the patient on the Jackson spinal surgery table. Results : In the prone position, there was a significant reduction in stroke volume, cardiac index and cardiac output. The heart rate, mean arterial pressure and CVP were also decreased in the prone position but not significantly. However, the SVR was increased significantly. Conclusion : The degree of a reduced cardiac index was less on the Jackson spinal surgery table than other conditions of the prone position. The reduced epidural pressure caused by free abdominal movement may decrease intraoperative blood loss. Therefore, the Jackson spinal surgery table provides a convenient and stable method for maintaining patients in the prone position during spinal surgery.

• Journal of Preventive Medicine and Public Health
• /
• v.30 no.4 s.59
• /
• pp.764-778
• /
• 1997

To find the medical insurance utilization of workers when suffering from low back pain, an analysis was made toward the data of medical insurance benefits matched with the general characteristics of 10,183 workers, who were registered continuously from 1993 to 1995 at a medical insurance cooperation for industrial workers. The results were as follows; 1. The period prevalence of the medical insurance utilization for low back pain for 3 years from 1993 to 1995 was calculated as 17.1% for male workers and 19.4% for female workers. Most common cause of utilization was other dorsopathies including the herniation of lumbar discs. 2. The utilization rate increased significantly as the present age and the age joining the company got older(p<0.001). As the duration of employment got longer, the utilization rate of the male showed the tendency to increase and that of the female increased significantly(p<0.05). Among male workers employed at cement and concrete manufacturing companies showed higher utilization rate and among female laborers showed significantly higher utilization rate than clerical workers(p<0.01). 3. Annual utilization rate for low back pain didn't show any difference, but the portion of other dorsopathies among cause of utilization showed the tendency to increase from 1993 to 1995. 4. The mean number of claims for outpatient medical care for low back pain differed significantly by age, working duration, type of industries, income level(p<0.05), and the mean of total visiting days for care of low back pain differed significantly by working duration. In conclusion, considering the fact that the medical insurance utilization for low back pain increased annually and other dorsopathies including the herniation of dorsopathies were increasing, an effective preventive or management program for low back pain toward worker employed at industries were required.

• Journal of Chest Surgery
• /
• v.38 no.12 s.257
• /
• pp.844-848
• /
• 2005

Background: Thoracic outlet syndrome(TOS) is caused by the compression of neurovascular structures that supply to the upper extremities. Only a few reports have been published in Korea, and this study attempts to investigate the clinical aspects and results of the patients who underwent surgical treatment. Material and Method: This study consist of 16 patients who underwent operations for thoracic outlet syndrome from May, 2002 to October, 2004. The surgical indications were confined to patients with: 1) symptom too severe to perform ordinary daily life because of pain, paresthesia, edema of upper extremities, 2) no improvement after proper physical therapy, 3) definite finding of compression confined by radiologic examinations (MRI, angiography, etc), and 4) no other diseases such as cervical intervertebral herniation, myositis, neurologic diseases below the brachial plexus. The surgical approaches were by transaxillary approaches in 12 cases, supraclavicular approaches in 2 cases, and infraciavicular approaches in 2 cases. Result: There were 15 males and one female with an average age of 23.9 years (range:19$\∼$39). Rib anomalies were observed in four cases (25.0$\%$), but the others had no abnormal ribs. Right lesions were found in eight cases (50.0$\%$), left lesions in five cases (31.3$\%$), and bilateral lesions in three cases (18.7$\%$). The follow-up period was 9$\∼$26 months and recurrence rate was 12.5$\%$ (2/16). Complications were one case of ulnar nerve palsy, one case of persistent pain despite radiologic improvement and three cases of wound dehiscence due to fat necrosis and hematoma. Conclusion: Although the choice of treatment in patients with TOS has been disputed, patients who have no response with proper physical therapies can benefit from the surgical treatment which may help patients to return to normal daily activity in shorter period of time.

• The Journal of the Korean bone and joint tumor society
• /
• v.11 no.2
• /
• pp.168-174
• /
• 2005

Purpose: We experienced 8 cases of osteoid osteoma arising around hip joint which had some characteristics that differ from those arising on long bone. we reports the characteristics of osteoid osteoma arising around the hip joint. Materials and Methods: 8 cases of osteoid osteoma were diagnosed during 1985 to 2004 at hanyang university hospital. all cases were comfirmed patholgically. 6 cases were male, 2 cases were female patients. The mean age was 17 years old (ranged from 8 to 29). They occurred in intertrochanteric area (4 cases), subtrochanteric area (2 cases), acetabulum (1 case) and femoral neck (1 case). We used radiologic tools including magnetic resonance image, computed tomography, bone scintigraphy. clinicopathologic test including erythrocyte sedimentation rate and Creactive protein. Results: The patients expressed various symptoms including thigh pain, knee pain, low back pain and radiating pain respectively. 2 patients had experienced operation on knee joint. 3 patients showed limping gait. Aspirin relieved the pain in 3 patients. The difference in circumference was 1cm between both thighs in 2 cases. Conclusion: Patients with osteoid osteoma arising around hip joint which have various symptoms such as severe knee pain and claudication, differ from infectious disease by clinicopathologic test including erythrocyte sedimentation rate and C- reactive protein and had better diagnostic result in computed tomography.

• Journal of Korean Medicine Rehabilitation
• /
• v.31 no.4
• /
• pp.105-116
• /
• 2021

Objectives Lumbar herniated intervertebral disc (L-HIVD) is common disease in which Western-Korean collaborative treatment is performed in Korea. This study aimed to analyze Western-Korean collaborative treatment utilization of Korean patients with L-HIVD using Health Insurance Review & Assessment Service's Patients Sample Data. Methods This study used the Health Insurance Review & Assessment Service-National Patient Sample (HIRA-NPS) in 2018. Claim data of L-HIVD patients were extracted. The claim data were rebuilt with the operational concept of 'episode of care' and divided into Korean medicine episode group (KM), Western medicine episode group (WM) and collaborative treatment episode group (CT). General characteristics, medical expenses and healthcare utilization were analyzed. In addition, the difference of average visit day and average medical expenses between non-collaborative group (KM plus WM) and CT were analyzed by the propensity score matching method. Results A Total of 64,333 patients and 365,745 claims were extracted. The number of episodes of WM, KM and CT was 69,383 (92.97%), 3,903 (5.23%), and 1,341 (1.80%) respectively. The frequency of collaborative treatment episode was higher in women and the age of 50s. The most frequently described treatment in CT was acupuncture therapy. As a result of the propensity score matching, the number of visit days and medical expenses in the collaborative treatment group was higher than in the non-collaborative group. Conclusions The analysis of healthcare utilization of Korean-Western collaborative treatment may be used as basic data for establishing medical policies and systematic collaborative treatment model in the future.

• Journal of the Korean Orthopaedic Association
• /
• v.55 no.1
• /
• pp.78-84
• /
• 2020

Purpose: This paper compares the clinical outcomes of patients who were treated with a cervical nerve block by ultrasound and C-arm and reports the complication. Materials and Methods: A total of 97 patients were treated with an ultrasound-guided nerve root block from May 1, 2015 to February 8, 2018. On the other hand, 94 patients were treated with a C-arm guided nerve root block. The consequences of the cervical pain and the radiating pain before and after the procedures were reviewed using the verbal numeric rating scale (VNRS). In addition, the complications related to the procedures from the daily notes from the chart were inspected. Results: Sixty-six cases out of 97 cases of ultrasound-guided nerve root block were enrolled in the study. The average age of the patients was 57 years, including 41 males and 25 females. Seventy seven out of 94 cases by a C-arm guided root block were included in the study. The average age of the patients was 55 years, including 40 males and 37 females. Before the nerve root block, the mean numeric rating pain scale (NRS) of the cervical pain in ultrasound-guided block decreased from 5.4 points to 2.7 points at three weeks and 1.4 points at six weeks (p=0.0023, p<0.001), and 3.1 points in the C-arm (p<0.001, p<0.001) at three weeks and 1.5 points at six weeks (p<0.001, p<0.001). In the case of radiating pain, the mean NRS in the ultrasound-guided nerve root block group improved from 6.3 points after the procedure to 2.8 points at three weeks and 1.5 points at six weeks (p<0.001, p<0.001). In the C-arm guided nerve root block group, the NRS improved from 7.4 points after the procedure to 3.3 points at three weeks and 1.9 points at six weeks. In the case of complications, Horner's syndrome and propriospinal myoclonus were observed in one case of C-arm guided block group. Conclusion: The clinical results of the patients who underwent ultrasound-guided cervical nerve root block were not significantly different from those who underwent a C-arm guided cervical nerve root block.