• Title/Summary/Keyword: 추간판 탈출증

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Fistula Formation Between the Disc and Dura after Percutaneous Endoscopic Lumbar Discectomy - A Case Report - (경피적 내시경 요추 추간판 절제술 후 발생한 추간판과 경막 사이의 누공 형성 - 증례 보고 -)

  • Kim, Hak Sun;Kim, Hyoung Bok;Chung, Hoon-Jae;Yang, Jea Ho
    • Journal of Korean Society of Spine Surgery
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    • v.25 no.4
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    • pp.180-184
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    • 2018
  • Study Design: Case report Objectives: To document fistula formation between the disc and dura by an unrecognized dural tear after percutaneous endoscopic lumbar discectomy (PELD). Summary of Literature Review: The risk of durotomy is relatively low with PELD, but cases of unrecognized durotomies have been reported. An effective diagnostic tool for such situations has not yet been identified. Materials and Methods: A patient twice underwent transforaminal PELD under the diagnosis of a herniated lumbar disc at L4-5. She still complained of intractable pain and motor weakness around the left lower extremity at 6 months postoperatively. Magnetic resonance imaging showed no specific findings suggestive of violation of the nerve root. However, L5 and S1 nerve root injury was noted on electromyography. An exploratory operation was planned to characterize damage to the neural structures. Results: In the exploration, a dural tear was found at the previous operative site, along with a fistula between the disc and dura was also found at the dural tear site. The durotomy site was located on the ventrolateral side of the dura and measured approximately 5 mm. The durotomy site was repaired with Nylon 5-0 and adhesive sealants. The patient's preoperative symptoms diminished considerably. Conclusions: Fistula formation between the disc and dura can be caused by an unrecognized dural tear after PELD. Discography is a reliable diagnostic tool for fistulas formed by an unrecognized durotomy.

A Clinical Case Report Treated by Megadose Pharmacoacupuncture and Korean Medical treatments for the three Patients with HIVD of L-Spine and one Patient with HIVD of C-Spine (대용량약침 및 한방치료를 적용한 요추 추간판 탈출증 환자 치험 3례, 경추 추간판 탈출증 환자 치험 1례)

  • Ju, Yeong-Guk;Kim, Tae-Ho;Lee, So-Jin;Ahn, Sang-Min;Sin, Su-Ji;Kwon, Ok-Jun;Kim, Joo-Won;Yoon, Moon-Sik
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.10 no.2
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    • pp.61-71
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    • 2015
  • Objective : To report cases of HIVD of C&L-Spine successfully treated with conservative Korean Traditional Medicine treatment with Megadose Pharmacoacupuncture. Methods : Four patients diagnosed with HIVD of C&L-Spine were treated with Megadose Pharmacopuncture, acupuncture and herbal medicine. Numeric Rating Scale(NRS), Neck Disablility Index(NDI) and Oswestry low back pain Disablility Index(ODI) scores were collected before and after treatment for comparison. Results : There was a significant decrease in NRS, NDI and ODI scores. The mean NRS score decresed from 9 to 2.25, NDI from 45 to 14 and ODI from 46.66 to 11.33. Conclusion : The result suggests Megadose Pharmacoacupuncture can be an effective treatment on patients with HIVD of C&L-Spine.

A Clinical Case of Oriental Medical Treatment on Failed Back Surgery Syndrome (요추 추간판 탈출증으로 3차례 수술적 처치를 시행한 수술 실패 증후군 환자에 대한 보존적 치료 치험 1례)

  • Lim, Gwang-Mook;Moon, Su-Jeong;Jun, Kyu-Sang;Shin, Hong-Kyun;Ko, Youn-Seok
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.6 no.2
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    • pp.23-32
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    • 2011
  • Objectives : This study was performed to report the effect of oriental medical treatment for the failed back surgery syndrome(FBSS) patient after three times surgical operation treatment on herniated nuclues pulposus(HNP) L5-S1. Methods : A 70-year old patient after three times surgical operation treatment was admitted with low back pain and left leg radiation pain. We treated her by oriental medical treatment and measured McGill Pain Questionnaire-Short Form(SF-MPQ), visual analogue scale(VAS) and Oswestry disability index(ODI). Results : After treatment, most symptoms decreased, SF-MPQ changed 36 to 17, VAS score changed 9 to 4, ODI changed 39 to 27. Conclusions : In this study, oriental medical treatment was effective in failed back surgery syndrome patient. But the rigorous studies will be needed to define clearly that oriental medical treatment is effective in failed back surgery syndrome.

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Case Report of Two Cases on Effect of Combined Bee Venom and CS Pharmacopuncture with Koream Medicine Treatment on HIVD of L-spine (요추 추간판탈출증 환자에 대한 봉약침과 CS약침을 병행한 한의학적 복합치료 효과에 대한 증례보고)

  • Hwang, Ji Hye;Kim, Deok-Hyun
    • Korean Journal of Acupuncture
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    • v.35 no.4
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    • pp.239-246
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    • 2018
  • Objective : This case study reports the therapeutic effect of Korean Medicine (KM) treatments including CS(care special pain) and BV(bee venom) pharmacopuncture on herniated intervertebral disc(HIVD) of lumbar spine(L-spine). Methods : Two patients diagnosed with HIVD of L-spine were treated with CS and BV pharmacopuncture on GV3 and EX-B2, acupuncture, cupping, and herbal medicine. The Numeric Rating Scale(NRS), the Oswestry low back pain Disablility Index(ODI) and the Roland Morris Disability Questionnaire(RMDQ) scores were evaluated before and after treatment for comparison. Results : Low back pain(LBP) and radiating pain was improved with a decrease in patients' NRS, ODI and RMDQ scores. Conclusion : These results suggest that KM treatments including combined CS and BV pharmacopuncture could be an effective treatment on patients with HIVD of L-Spine.

Lumbar Facet Joint Injection in Low Back Pain and Sciatica Caused by Lumbar Facet Joint Arthropathy (후관절 관절증으로 인한 요통 및 좌골신경통에 대한 후관절강내 차단)

  • Ban, Jong-Seok;Go, Jeon-Seock;Min, Byng-Woo
    • The Korean Journal of Pain
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    • v.2 no.2
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    • pp.174-180
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    • 1989
  • An intra-articular lumbar facet joint block with a local anesthetic and asteroid is a reliable method of diagnosis and therapy for low back pain and/or sciatica caused by lumbar facet arthropathy under fluoroscopy. We injected 40 mg of methylperdnisolone acetate and 1 ml of 0.5% bupivacaine into each lumbar facet joint to 14 patients. The results are as follows: 1) Excellent pain relief in 2 patients (14.29%) 2) Good pain relief in 6 patients (42.85%) 3) Fair pain relief in 4 patients (28.57%) 4) Non effective pain relief in 2 patients (14.29%).

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Clinical Application of Mesenchymal Stem Cells in a Dog with Intervertebral Disc Disease (추간판 탈출증이 발생한 개에서 동종의 지방유래 줄기세포의 임상적 적용)

  • Kim, Young-Ki;Lee, Seung-Yong;Park, Se-Jin;Lee, Scott-S.;Kim, Jin-Hyun;Lee, Hee-Chun;Chang, Hong-Hee;Lee, Hyo-Jong;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
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    • v.28 no.1
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    • pp.122-127
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    • 2011
  • A 5-year old, intact male, Cocker spaniel dog was referred with paraplegia and loss of deep pain perception. Physical, neurological examinations, radiography, and computed tomography were evaluated. Based on the clinical examinations, the dog was diagnosed with severe disc herniation ($L_2$ to $L_3$ intervertebral disc space). On the next day of presentation (6 days after loss of deep pain perception), hemilaminectomy was performed. After decompression of spinal cord and removal of herniated disc materials, $1{\times}10^6$ canine allogenic adipose tissue-derived mesenchymal stem cells (MSCs) diluted by $50{\mu}l$ saline were directly applied to the injured site of the spinal cord. Ten weeks of follow-up after surgery, full recovery of deep pain perception and motor function were evaluated in both hind limbs. Based on the result, we suggest that the transplantation of allogenic adipose tissue-derived MSCs to dogs with spinal cord injuries could be a considerable method to expect better clinical outcomes in veterinary practice.

Magnetic Resonance Imaging Follow-Up Case Study on Changes in a Lumbar Herniated Intervertebral Disc Treated with Korean Conservative Treatment (보존적 한방치료를 진행한 요추 추간판 탈출증 환자의 시간에 따른 영상의학적 추간판 크기 변화 1례)

  • Roh, Ji-ae;Lee, Ji-won;Jang, Jae-won;Jeong, Wu-jin;Noh, Je-heon
    • The Journal of Internal Korean Medicine
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    • v.39 no.5
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    • pp.879-885
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    • 2018
  • Background: A herniated intervertebral disc (HIVD) triggers low back pain (LBP). Korean conservative treatment can decrease the herniated disc size without traditional surgery, but detailed prognosis is unclear. Case summary: One patient presented with LBP and bilateral sciatica. She was diagnosed with lumbar HIVD by magnetic resonance imaging (MRI) and treated by Korean medicine (acupuncture, decoction, and physical therapy). For 6 months, MRI follow-up exams showed the aggravation and migration of L5-S1 followed by distinct improvement of the same lumbar vertebra. Conclusion: The disc size in a patient with lumbar HIVD was reduced by Korean conservative treatment, and periodic radiologic examination showed the previously unrecognized process of absorbing the disc.

The Effects of Distraction Manipulation on the Pain and Intervertebral Disc Angle in Patients With Herniated Intervertebral lumbar Disc (신연교정치료가 요추 추간판 탈출증 환자의 통증 및 추간판 각도에 미치는 효과)

  • Ma, Sang-Yeol;Lee, Hyeon-Hee;Kim, Seong-Hak;Lee, Moon-Hwan
    • The Journal of Korean Physical Therapy
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    • v.19 no.3
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    • pp.31-39
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    • 2007
  • Purpose: This study was conducted to investigate the effect of distraction manipulation on the pain and. intervertebral disc angle in patients with herniated intervertebral lumbar discs. Methods: 30 patients who visited to receive the treatments of the physical therapy in W pain clinic in Daejeon. All subjects had been treated with flexion-distraction manipulation for 30 minutes per day and three times a week during 12 weeks period from June 10 to 19 August 2006. They were randomly divided into two groups: lumbar 4 and lumbar 5 group. Results: Pain of L4 and L5 group was significantly reduced after than before treatment(p<0.05). The intervertebral lumbar disc angle was significantly improved after than before treatment(p<0.05). Conclusion: These results indicated that distraction manipulation has a effectiveness in patients with herniated lumbar disc.

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Causalgia After Cervical Discectomy (경추 추궁절제술후 발생한 Causalgia)

  • Choe, Huhn;Kim, Dong-Chan;Han, Young-Jin
    • The Korean Journal of Pain
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    • v.5 no.1
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    • pp.80-84
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    • 1992
  • 49세 여자 환자가 경부 추간판 탈출증의 치료를 받기위하여 전신 마취하에 우측의 추궁 절제술과 전방 추체간 접합술을 받고난 즉시 회복실에서 부터 양측 상지에 작열통이 발생하였다. 환자는 양측 상지에 전형적인 작열통의 증상인 allodynia, 통각 과민(hyperalgesia), 통각 이상 과민증 (hyperpathia)을 보였으며 특히 우측 상지에는 심한 부종을 보이고 있었다. 환자는 일련의 성상 신경절 차단과 disposable $Daymate^{TM}$ portable elastomeric infusor를 이용한 연속적 상완신경총 차단으로 작열통이 완치되었다.

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