• The Korean Journal of Pain
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• 제19권2호
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• pp.207-212
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• 2006

Background: The epidural injection technique is a commonly used intervention in the management of chronic spinal pain, which has the advantage of delivering various drugs, such as local anesthetics or steroids, in higher concentrations to the inflamed nerve root. A guidewire-reinforced epidural catheter was introduced through a Tuohy needle during the caudal epidural procedure, with a catheter threaded into the affected nerve roots and the spread-pattern of contrast agents observed under fluoroscopy. Methods: Sixty-seven patients with low back pain, who showed evidence of a herniated nucleus pulposus on magnetic resonance imaging, were included. All patients received fluoroscopically guided caudal epidural injections, with the guidewire-reinforced epidural catheter introduced through a Tuohy needle and threaded either to the right or left side toward the target nerve roots. After confirming the catheter tip position at the affected nerve root, 2 ml increments of contrast agents (up to 6 ml) were injected, and their corresponding AP fluoroscopic views were obtained. Three radiologists reviewed all the radiographic findings and measured the proportion of the area of contrast spread at the side of target nerve roots. Results: Greater proportion of the area of contrast spread was observed at the side of the target nerve roots (P < 0.0001). At each level of contrast injection (2-⁣, 4- ⁣ and 6 ml), more than 70% of the spread of contrast dye was observed at the side of the target nerve roots in 85%, 70%, and 55% of cases, respectively. Conclusions: The combination of a caudal epidural injection and use of a guidewire-reinforced epidural catheter significantly enhances the target specificity, as revealed by the selective spread of contrast dye at the side of target nerves.

• 척추신경추나의학회지
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• 제6권2호
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• pp.53-60
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• 2011

Objectives : The purpose of this study is to find out the relation between the height of intercrestal line, and HIVD(Herniated Intervertebral Disc)of Lumbar spine. Methods : We investigated 445 cases (208 male, 237 female) of patients who were diagnosed as HIVD of L-spine at either L4/5 or L5/S1 level. We analysed the relation between the height of intercrestal line and the level of HIVD. Results : 1. Among 445 cases, the level of intercrestal line with HIVD of L-spine at the specific location was different between male and female. In male, the intercrestal line is more likely to be located at L4 level, while in female more likely to be located at L5 level. 2. Among 445 cases, L5/S1 HIVD patients(272, 61.1%) were more than L4/5 HIVD patients(173, 38.9%). At L4 body area, L4/5 HIVD patients were more than L5/S1 HIVD patients, however, at L4/5 intervertebral area and L5 body area, L5/S1 HIVD patients were more than L4/5 HIVD patients. (p<0.01) 3. When the line is located at higher level, HIVD of L-spine tends to be occurred at L4/5 level. Contrastly, when the line is located at lower level, HIVD of L-spine tends to be occurred at L5/S1 level. (p<0.01) Conclusions : High intercrestal line leads to L4/5 HIVD, while low intercrestal line leads to L5/S1 HIVD. Possibly, it is caused by different length and thickness of the iliolumbar ligament.

• 한방재활의학과학회지
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• 제26권1호
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• pp.87-93
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• 2016

Objectives To analyze the resorption of herniated lumbar intervertebral disc on MRI in patients who were treated with Korean Medicine. Methods 78 patients with lumbar disc herniation were included, 47 males and 32 females. Patients' diagnosis was based on magnetic resonance imaging (MRI). All of the patients were only treated with Korean Medicine for 6 months treatment, and underwent MRI examination twice, pre-treatment and post-treatment. MR images were assessed by reduction in diameter of T2-weighted image between pre-treatment and post-treatment, and analyzed by differences in sex, age and disc type. Results 91.2% (71 people) of total patients had extrusion type. Korean medicine treatment reduced lumbar disc herniation diameter of all the patients from 7.11 mm to 3.67 mm on average (p<0.001). The reduction of diameter in the male group was 3.52 mm on average. The reduction of diameter in the female group was 3.32 mm on average. The reduction of diameter was 3.28 mm in the group below age 29, 3.88 mm in the 30~39 age group, 3.39 mm in the 40~49 age group, and 2.71 mm in the above 50 age group on average. Conclusions The MRI results suggest that lumbar herniated disc can resorb with Korean Medicine treatment. The likelihood of lumbar disc resorption was higher at extrusion type. but there was not a significant difference between the sexes and between ages.

• 한방재활의학과학회지
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• 제26권1호
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• pp.79-86
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• 2016

Objectives The purpose of this study was to compare the effects of MSAT (Motion style acupuncture treatment) using Sandbag regarding low back pain with HIVD of L-SPINE. Methods Forty patients received inpatient treatment from March 16 to May 16, 2015 in the Daejon-Jaseng oriental medicine hospital were divided into 2 groups by blocked randomization: Group A (n=20) is routine treatment on HIVD of L-SPINE with MSAT using Sandbag and Group B (n=20) is routine treatment on HIVD of L-SPINE (acupuncture, Shinbaro pharmacopuncture, herb medication, chuna treatment and physiotherapy). The MSAT (Motion style acupuncture treatment) using Sandbag was administered each day and both groups were received routine treatment each day. Evaluations were made before treatment, after 3 days and 7 days, and before discharge using the NRS (numeric rating scale) and ODI (oswestry disability index). The statistically significance was evaluated by SPSS 22.0 for windows. Results The NRS (numeric rating scale) and ODI (oswestry disability index) of both A and B groups after 3, 7 days and before discharge of treatment significantly decreased (p<0.05). Regarding group comparison, the NRS (numeric rating scale) and ODI (oswestry disability index) of A group was significantly lower than the B group at 3, 7 days, before discharge (p<0.05). Regarding improvement of the NRS (numeric rating scale) and ODI (oswestry disability index), A group was significantly lower than the B group at 3 day (NRS), 7 day (ODI) (p<0.05). There was significant difference between two groups at 7 days (NRS) and before discharge (p<0.05). Conclusions Compared to routine treatment, the MSAT (Mostion style acuputure treatment) using Sandbag significantly improved the NRS (numeric rating scale) and ODI (oswestry disability index) after 3, 7 days, and before discharge. Because early intervention determines the grade of Low back pain with HIVD of L-SPINE, the MSAT (Motion style acupuncture treatment) using Sandbag will be clinically helpful to patients at the early stage.

• 한방재활의학과학회지
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• 제23권1호
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• pp.77-86
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• 2013

This study was introduced the short-term effectiveness of Oriental medicine treatment for lumbar disc herniation inpatients. We selected 208 inpatients with a magnetic resonance imaging(MRI)-confirmed lumbar disc herniation since June 2012 until August 2012. Their demographics characterisitics, numeric rating scale(NRS) and Oswestry back-related disability index(ODI) for low or leg pain, lumbar flexion and extension angle were assessed at baseline and when discharged from the hospital. When it measured the straight leg raisingscale(SLR), the low side of the angle was examined. Treatment every patient has received as follow; herbal medicine, bee venom, acupuncture and physical examination, spinal manipulation. NRS of low back pain and leg pain and ODI is $5.6{\pm}2.3$, $4.9{\pm}2.8$ and $45.5{\pm}20.0$, respectively at baseline and $2.8{\pm}1.8$, $2.7{\pm}1.9$ and $27.2{\pm}14.1$, respectively when discharged from the hospital. range of motion(ROM) of lumbar flexion and extension angle and SLR is $70.0{\pm}27.1$, $15.4{\pm}7.2$ and $61.3{\pm}23.0$ respectively at baseline and $80.5{\pm}16.9$, $18.25{\pm}4.1$ and $73.2{\pm}14.0$, respectively when discharged from the hospital. It shows that statistically significant improved(P<0.001). Furthermore, regarding patient satisfaction with the treatment, excellent(33.7%), good(55.4%), normal(10.4%), poor(0.5%), it suggests that most patients(89%) satisfied with the treatment.

• Journal of Acupuncture Research
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• 제32권2호
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• pp.87-96
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• 2015

Objectives : The purpose of this study was to investigate the clinical effects of Dong-qi acupuncture on piriformis for herniated intervertebral disc(HIVD) of lumbar spine patients with piriformis muscles tenderness. Methods : This research was carried out on the 60 inpatients who received treatment for their HIVD of lumbar spine from January 1 to May 31, 2014 in DaeJeon Jaseng Hospital of Korean Medicine. We divided them into two groups ; group A(n=30) : common treatment on HIVD of L-spine without Dong-qi acupuncture on piriformis(acupuncture, pharmacopuncture, herb medication, Chuna and physiotherapy), and group B(n=30) : common treatment on HIVD of L-spine with Dong-qi acupuncture on piriformis. We evaluated the treatment effect of each group on tenderness(checked by Algometer pressure), and with a numeric rating scale(NRS), and oswestry disability index(ODI). The evaluations of tenderness were performed 8 times : admission day, and on the 3rd, 6th, 9th, 12th, 15th, 18th and 21st day after admission. The evaluations of NRS and ODI were performed 3 times : admission day, and on the 12th and 21st day after admission. The statistical significance was evaluated by SPSS 18.0 for Windows. Results : In group B, tenderness was significantly decreased compared with group A. The difference of tenderness from admission day to the 12th day showed significant reduction compared with group A. Conclusions : Dong-qi acupuncture is more effective in reducing piriformis muscle tenderness in the early stages of treatment. We expect that patients who receive Dong-qi acupuncture will be satisfied with Korean medical treatment and trust their doctor.

• Journal of Acupuncture Research
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• 제31권1호
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• pp.43-50
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• 2014

Objectives : The purpose of this study is to compare the effect of Shinbaro pharmacopuncture treatment and bee venom pharmacopuncture treatment on cervical disc herniation and whiplash injury induced by traffic accident. Methods : This study was carried out on the 59 patients with whiplash injury by traffic accident and diagnosed as cervical disc herniation. The patients were divided into 2 groups ; Shinbaro pharmacopuncture group was treated with Shinbaro pharmacopuncture along with herbal medicine and general acupuncture. Bee venom pharmacopuncture group was treated with bee venom pharmacopuncture along with herbal medicine and general acupuncture. We measured verbal numerical rating scale(VNRS) and neck disability index(NDI) before the treatment and 1, 2, 3 weeks afterwards. Results : Shinbaro pharmacopuncture group and Bee venom pharmacopuncture both showed significant decrease in VNRS and NDI. Shinbaro pharmacopuncture group showed significant decrease over Bee venom pharmacopuncture group in VNRS decrement in the first week, while Bee venom pharmacopuncture group showed significant decrease over Shinbaro pharmacopuncture group in the secone week of treatment. Conclusion : According to the result of this study, it is suggested that Shinbaro pharmacopuncture group is more effective in reducing pain in the earlier period of treatment. Also suggests that further study on the effect of Shinbaro pharmacopuncture on patients diagnosed as cervical disc herniation after traffic accident for longer period of treatment.

• Journal of Acupuncture Research
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• 제30권4호
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• pp.139-149
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• 2013

Objectives : The aim of this study was to observe the effect of balanced acupuncture on herniated intervertebral disc of lumbar spine patients. Methods : We investigated 23 cases of in-patients with acute & subacute herniated intervertebral disc of lumbar spine in oriental hospital, and divided patients into two groups. We treated one group(12 people) by complex oriental medical treatment with Balanced acupuncture, and the other group(11 people) by complex oriental medical treatment without Balanced acupuncture. To evaluate the effectiveness of treatment applied for two groups, we used visual analog scale(VAS) and rating scale for low back pain at admission and discharge. Results : 1. In balanced acupuncture group and control group, compared with baseline and final. VAS was significantly improved. 2. In Balanced acupuncture group and control group, compared with baseline and final. Rating scale for low back pain was significantly improved. 3. VAS and rating scale for low back pain improvement rate in balanced acupuncture group were no statistical significance compared with control group. Conclusions : Balanced acupuncture might be used for relieving symptoms related with herniated intervertebral disc of lumbar spine, but it's no statistical significance.

• 한방재활의학과학회지
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• 제28권4호
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• pp.43-50
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• 2018

Objectives Upper lumbar disc herniation (LDH) (L1/2, L2/3) has specific anatomical characteristics and different outcome after conventional treatment compared to lower LDH (L3/4, L4/5, L5/S1). The purpose of this study was to compare the clinical features and effects of korean medical treatment of upper LDH between lower LDH. Methods We retrospectively reviewed the clinical data collected from 121 patients who was had admitted at the Haeundae Jaseng Hospital of Korean Medicine from June 1st, 2014 to August 31th, 2018. The patients who had treated at L1/2, L2/3 level LDH were grouped and compared with those treated at the L3/4, L4/5, L5/S1 level. We reviewed the patient characteristics such as age, the positive rate of Straight Leg Raise Test (SLR test), the presence or absence of previous lumbar surgery. Numeric Rating Scale (NRS) and Oswestry Disability Index (ODI) were evaluated at adimission and discharge. Results Mean age was significantly higher at upper LDH group and positive rate of SLR test was higher at lower LDH group. There was no significant difference of gender and previous lumbar surgery between two groups. Each group had a significant improvement of NRS, ODI scores. But between two groups, there was no significant difference of NRS, ODI scores. Conclusions Upper LDH group was older than lower LDH group. SLR test was useful tool to exclude upper LDH. Korean medical treatment was significantly effective to both upper and lower LDH groups. Further well designed prospective comparative studies are needed.

• 한방재활의학과학회지
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• 제28권4호
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• pp.33-41
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• 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.