Object : This study is designed to evaluate the correlation between the data of DITI(Digital Infrared Thermographic Imaging)examination and the changes of clinical symptom after the therapy of acupuncture in the patients with herniated cervical intervertebral disc. Content : The conservative therapy with acupuncture was performed during $4{\sim}5$ weeks, The acupuncture points of SI3, B62, TE3, G34, LI4, S36, GV26, G21, SII5 were used. In the pre- and post therapy, DITI examinations were performed in patients who had HIVD and were treated by acupuncture simultaneously, and then tried to correlate the results of clinical symptoms with the difference of thermographic findings at pre-acupuncture and post-acupuncture. Setting : The standard routine thermoghaphic examinations were performed with thermography(DITI) in the 15 patients with lumbar disc herniations at pre- and post acupuncture. Patient : Thermographic imaging of 15 cases were analyzed. They has disc herniations in X-ray, CT scan and MRI and they were treated by acupuncture theraphy in our hospital from March, 1994 to January, 1995. Result : 1) The causes were trauma(60%), retention of phlegm and fluid(8.7%) and cold & moisture(33.3%) 2) Levels of herniated cervical disc are C2/3(1 case). C3/4(2 cases), C5/6 & C6/7 (2 cases), C6/7(4 cases), Normal(6 cases). 3) Classifications of thermographic pattern are radiculopathy(80%), spot(13.3%), and nonspecific(6.7%) in order. 4) In evaluation Results of clinical symptom are Excellent(80%), Good(6.7%), and Poor(6.7%). Data of DITI are Excellent(80%), Good(6.7%), Fair(6.7%), and Poor(6.7%). Conclusion ; Acupuncture showed good results over 86.7% in clinical evaluation and 86.7% in DITI. Thermographic examination was valuable in the evaluation of therapeutic effect of acupuncture treatment.
Percutaneous laser discectomy has potential advantages over conservative therapy and classical open surgery as a minimally invasive procedure, although clinical experiences are limited. We experienced a patient treated with herniated lumbar discs using Nd:YAG laser. A 55-year-old woman complained of severe back pain with sciatica on L4/5 and L5/S1 dermatome for several months. The MRI finding showed bulging discs at L4/5 and L5/S1. Epidural, transsacral and root block treatments were attempted without effect. Under fluoroscopic guidance, a 14 G biopsy needle was inserted into the L4/5 and L5/S1 disc spaces to the margin of the nucleus pulposus. Laser irradiation for vaporization of tissue was performed at 20 W/second to 1200 J. A laser fiber ($600{\mu}m$) was advanced 1 cm from the tip of the needle. At the end of the procedure, the patient began to feel relief of pain (VAS changed from 9 to 4) and was discharged the same day after staying 2 hours in the recovery room. Antibiotics were administered for prevention of discitis. She had no complaints of pain until the 1-month follow up visit. Percutaneous laser discetomy technique has the disadvantages of expensive equipment, high temperature and amount of vaporing disc tissue is empirical. However, this technique, as one of the therapeutic modalities for disc herniation, provides faster relief from acute attack than conservative management techniques in carefully selected patients with sciatica due to disc prolapse.
Objective : In treatment of lumbar spine herniation of nucleus pulpous, the different result in accordance with difference of sex, age, medical history, part, or type. Methods : After 49 patients who were diagnosed as HNP of L-spine were grouped by sex, age, medical history, part, or type, they were compared and analyzed on the basis of difference between measuring VAS and ODI as they were hospitalized and as they were discharged. Results : 1. In terms of differences by gender, males' average degree of VAS improvement was 63.92 and females' average degree of VAS improvement was 59.8. Also, Males' average ODI improvement index was 12.36 and females' average ODI improvement index was 12.5. 2. In terms of differences by age, Teens recorded highest degree of VAS improvement and ODI improvement index. 3. In terms of differences by medical history, Most acute or acute patients showed higher degree of VAS improvement and ODI improvement index than subacute or chronic patients. 4. There were no significant distinguishing markscomparing between one diseased part and other. 5. As the research that focused on different type, Extrusion type had better improvement by medical treatment than Protrusion type. Conclusion : This research drew the result as above, but recognizable statistical relation could not be found in the result. Therefore there needs much sustainable research to deduce meaningful result.
Objectives : This study was designed to evaluate the general distribution and the efficacy of oriental medical treatment for Lumbar Disc Herniation. Subjects and Methods : The 137 patients who had a diagnosis of HIVD by Lumbar-CT of Lumbar-MRI and admitted to Dunsan oriental medical hospital in Daejon university from January 2005 to December 2007 were observed. They were analyzed according to the distribution of sex, age, the period of disease, causing factor, The patient-condition on admission, the symptom on admission, Admission day, Herniation type of the disc and the treatment efficacy was evaluated respectively. Results : 1. Male was more than female in the ratio of 1 : 1.174, and forties 28% the most, the acutest phase 48% the most, reason unknown 30% the most, Grade III 42% the most, Back and Leg radiate pain 65% the most, the day of 6-10 29% the most, protruded disc type 48% the most. 2. In the total treatment result, the good was 48%, the excellent 28%, the fair 15%, the poor 9% in order. 3. the "effective rate"(the percentage of positive effective treatment case) of each distribution, the thirties and fifties 100% the most, subacute phase 100% the most, exercise, traffic accident 100% the most respectively, Grade III 93% the most, only low back pain 97% the most, the day of 16-20 100% the most, Extruded disc 100% the most. Conclusions : Total effective rate was 91%. We have Known the efficacy of oriental medical treatment for HIVD, was good and early treatment was better than late treatment.
Objectives : The purpose of this study is to investigate the clinical effectiveness of Korean medical combination treatment for cervical disc herniation. Methods : This is an observational study. 102 patients diagnosed with cervical disc herniation by MRI (Magnetic Resonance Imaging) were investigated from January, 2015 through to December, 2015 at Daejeon Jaseng Hospital of Korean Medicine. They were sorted according to the distribution of sex, age, causing factor, the period of disease, admission day and pain area. All patients were treated with acupuncture, Chuna treatment, and herbal therapy and physical therapy during the admission period. After treatment, NRS (Numeric Rating Scale), NDI (Neck Disability Index) and EQ-5D were assessed to evaluate the treatment efficacy. Results : There were more females than Males with a ratio of 1 : 1.37, the age of fifty was the most with 35.29 %, reason unknown was the most with 72.55 % and the subacute stage was the most with 38.24 %. According to disc herniation types, patients with protruded disc types were the most with 66.67 % and a lesion of C5/6 was the most with 41.18 %. For patients diagnosed with cervical disc herniation, neck and shoulder pain NRS decreased from $6.43{\pm}1.77$ to $3.96{\pm}1.96$(p<0.001) and radiating pain NRS decreased from $5.64{\pm}1.96$ to $3.57{\pm}1.88$ (p<0.001). NDI decreased from $41.72{\pm}14.04$ to $30.84{\pm}15.34$(p<0.001), and the EQ-5D index increased from $0.68{\pm}0.17$ to $0.79{\pm}0.14$(p<0.001) after treating cervical disc patients. Conclusion : Korean medical combination treatment might be effective in decreasing pain and raising the life quality of patients with cervical disc herniation.
Objectives The purpose of this study was to compare the effects of MSAT (Mostion style acuputure treatment) on piriformis muscle regarding leg radiating pain with HIVD of L-SPINE. Methods Forty patients who received inpatient treatment from Febuarary 1 to March 31, 2014 in the Daejon-Jaseng oriental medicine hospital were divided into 2 groups by blocked randomization : Group A (n=20)=routine treatment on HIVD of L-SPINE with MSAT on piriformis muscle and Group B (n=20)=routine treatment on HIVD of L-SPINE (acupuncture, Shinbaro pharmacopuncture, herb medication, chuna treatment and physiotherapy). The MSAT (Mostion style acuputure treatment) on piriformis muscle 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 18.0 for windows. Results Compared to before treatment, 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 dischanre (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), 7day (ODI) (p=0.000) but there was no significant difference between the two groups at 7 days (NRS) and before discharge (p>0.05). Conclusions Compared to just routine treatment, the MSAT (Mostion style acuputure treatment) on piriformis muscle 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 Leg radiating pain with HIVD of L-SPINE, the MSAT (Mostion style acuputure treatment) on piriformisat the early stage will be clinically helpful to patients.
The purpose of this study was to evaluate changes of static lumbar lordosis by different heel heights in normal adults and patients with herniation of nucleus pulposus(HNP). The lumbar lordosis was examined while standing on barefoot, on heel support with 4cm heel, and with 8cm heel in 10 normal adults and 10patients with HNP. Standing lumbar lateral view was performed by 20 minutes adaptation with corresponding shoe types. The angle of lumbar lordosis was taken with Wiltse and Winter's method(angles between upper margin of 1 st lumbar body and upper margin of 5th lumbar body). The results of this study were as follow: 1. Significant statistical decrease in lumbar lordosis was observed as heel heights were increased from barefoot to 8cm high heel in normal adults(p<0.05). 2. There were no significant differences in lumbar lordosis according to three different heel heights in patients with HNP(p>0.05). 3. In comparison of barefoot, There were statistically significant decrease in HNP patients compared with normal adults in terms of lumbar lordosis(p<0.05).
Objectives The purpose of this study is to find out the relationship between the hip internal rotation angle and the site of herniation of single level lumbar intervertebral disc. Methods This study was carried out to 418 patients with lumbar disc herniation diagnosed by M.R.I, who visited Bu-Chun Jaseng Hospital of Korean Medicine with low back pain. Researchers measured their hip internal rotation angle and analyzed the relationship between the hip internal rotation angle and the site of herniation of single level lumbar intervertebral disc. Results 1. Excessive right internal rotation of hip joint increases risk of L5/S1 HIVD. 2. Limited left internal rotation of hip joint decreases risk of L4/L5 HIVD. 3. In cases of L4/L5 HIVD level, there was evidence that the prevalence of HNP in men was 1.85 times as higher than that in women. 4. In cases of L5/S1 HIVD level, there was the evidence that the prevalence of HNP in men was 0.64 times as lower than that in women. Conclusions In single-segment lumbar HIVD patients, limited left internal rotation of hip joint decreases risk of HIVD of L4/5 and excessive right internal rotation of hip joint mainly leads to L5/S1 HIVD.
Objectives : The purpose of this study was to assess the effectiveness of integrative Korean Medical treatments for patients with L-spine disk herniation that showed no response to Epidural Steroid Injections (ESI). Methods : In this study, we reviewed the medical records of ten patients who showed no improvement or relapsed after ESI. The patients each received more than three weeks of integrative treatments at Mokhuri Neck&Back Hospital. The Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) was measured before and after treatment. A statistical analysis to compare before and after treatments was assessed using paired t-test the SPSS 12.0 Windows program. Results : After three weeks of treatment, patients showed a significant decrease in VAS and ODI scores compared to before receiving treatment. VAS scores decreased from $5.3{\pm}1.25$ to $1.9{\pm}0.99$ (p<0.001), and ODI scores decreased from $59.8{\pm}22.2$ to $32.7{\pm}14.11$ (p<0.001). Conclusions : Complex Korean Medical treatment showed effectiveness in the treatment of L-spine HIVD patients that showed no response to ESI, and more objective research is needed.
Objectives : The purpose of this study was to evaluate the effect of electro-acupuncture treatment for low back pain and radicular pain in patients diagnosed with Lumbar HIVD. Methods : This clinical study was carried out on 92 patients with low back pain and radicular pain diagnosed with HIVD, who had been admitted from Mar. 2011 to Dec. 2011. 60 patients were divided into two groups, group A and group B, of 46 patients each. Group A was treated with electro-acupuncture treatment and general acupuncture treatment twice per day for more than 2 weeks. Group B was treated with general acupuncture treatment twice per day for more than 2 weeks. Verbal numerical rating scale(VNRS) and Oswestry disability index(ODI) were used to evaluated the effectiveness of the Oriental medical treatment. Results : In both two groups, VNRS, ODI, patient's condition grade decreased significantly in ststistics as treatment was perfomed. Between the two groups there was no significant difference in the VNRS, patient's condition grade. But there was significant difference in the ODI. Conclusions : These results suggest that both electro-acupuncture and general acupuncture were effective in reducing low back pain and radicular pain caused by HIVD. More systematic clinical stuty on electro-acupuncture is needed.
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