• Journal of Pharmacopuncture
• /
• v.7 no.2
• /
• pp.109-119
• /
• 2004

Objective : To broaden our understanding on occupational disease of market workers and to evaluate the effect of TKM treatment focusing on acupuncture and herb medicine and to promote base studies and clinical trials on occupational disease. Materials and Methods : Analysis was done on 33 Ga-Rak market workers' chart which had been selected through investigation of 1508 outpatient's chart of Kyung Won University Hospital from Jun. 1st, 2002 to May. 31th, 2003. Results : 1. Out of 33 patients, Men had more occupational diseases than women had and Most people were in their forties. 2. Major cause of the disease include repetitve bending, heavy weight lifting and overwork. 3. Past History of patients mostly include frequent lumbar sprain, periarthritis of shoulder, lumbar HNP 4. The patients with occupational disease were diagnosed as lumbar sprain, periarthritis of shoulder, lumbar HNP, degenerative spondylosis, spinal stenosis and their chief complaints were low back pain, omalgia, back pain with radicular pain. 5. The duration of treatment was mostly within a week. 6. Acupuncture, Bee Venom Acupuncture, moxibustion, Herb-medicine, extract, taping therapy, physical therapy were used as treatment methods. 7. Applied herb medicine were composed of 8 kinds of prescriptions and extract were made up of 6 prescriptions 8. Applied acupoints belonged mainly to 14 meridians 9. The treatment of herb medicine combined with acupuncture proved effective in treating the ocupational disease. Conclusion : The occupational disease of patients working in Ga-Rak market were closely related with overwork, especially with repetitive bending and heavy weight lifting and TKM treatment focusing on acupuncture combined with herb medicine was effective in treating occupational disease.

• Journal of Acupuncture Research
• /
• v.22 no.6
• /
• pp.75-84
• /
• 2005

Objectives : Research on the effect and satisfaction between Acupuncture Treatment, Physical Treatment and contemporary Treatments of Acupuncture and Physical of lumbago patients Methods : We separated lumbago patients into three groups. A group with only Acupuncture Treatment and a group with only Physical Treatment and a group with contemporary treatments of Acupuncture and Physical. Questionnaire survey and score of Visual Analog Scale(VAS) and Oswestry Disability Index(ODI) were examined for comparison. Results & Conclusion : 1. Of the 54 patients Acupuncture Teatment group had 17 patients with similar ratio of gender and the average age was 39.5 years old. For the Physical Treatment group the ratio of male was 75% of the 8 patients and had the youngest average age which was 29.1 years old and the group with contemporary Treatments the ratio of female was 62% of 29 patients and had the oldest average age which was 46.7 years old. 2. The Acupuncture Treatment group had the shortest treatment period because of many acute stage caused by lumber sprain and the improvement score was the best. The group of contemporary treatments had the longest history day and treatment period by serious disease like HIVD and spinal stenosis but the improvement score of VAS and ODI was good similar to the Acupuncture Treatment group. For the Physical Treatment group there was many patients with degenerative change but not severe pain. The VAS, ODI and the improvement score was the lowest before and after the treatment.

• Journal of Korean Neurosurgical Society
• /
• v.60 no.5
• /
• pp.485-497
• /
• 2017

Surgical treatment of the degenerative disc disease has evolved from traditional open spine surgery to minimally invasive spine surgery including endoscopic spine surgery. Constant improvement in the imaging modality especially with introduction of the magnetic resonance imaging, it is possible to identify culprit degenerated disc segment and again with the discography it is possible to diagnose the pain generator and pathological degenerated disc very precisely and its treatment with minimally invasive approach. With improvements in the optics, high resolution camera, light source, high speed burr, irrigation pump etc, minimally invasive spine surgeries can be performed with various endoscopic techniques for lumbar, cervical and thoracic regions. Advantages of endoscopic spine surgeries are less tissue dissection and muscle trauma, reduced blood loss, less damage to the epidural blood supply and consequent epidural fibrosis and scarring, reduced hospital stay, early functional recovery and improvement in the quality of life & better cosmesis. With precise indication, proper diagnosis and good training, the endoscopic spine surgery can give equally good result as open spine surgery. Initially, endoscopic technique was restricted to the lumbar region but now it also can be used for cervical and thoracic disc herniations. Previously endoscopy was used for disc herniations which were contained without migration but now days it is used for highly up and down migrated disc herniations as well. Use of endoscopic technique in lumbar region was restricted to disc herniations but gradually it is also used for spinal canal stenosis and endoscopic assisted fusion surgeries. Endoscopic spine surgery can play important role in the treatment of adolescent disc herniations especially for the persons who engage in the competitive sports and the athletes where less tissue trauma, cosmesis and early functional recovery is desirable. From simple chemonucleolysis to current day endoscopic procedures the history of minimally invasive spine surgery is interesting. Appropriate indications, clear imaging prior to surgery and preplanning are keys to successful outcome. In this article basic procedures of percutaneous endoscopic lumbar discectomy through transforaminal and interlaminar routes, percutaneous endoscopic cervical discectomy, percutaneous endoscopic posterior cervical foraminotomy and percutaneous endoscopic thoracic discectomy are discussed.

• Asian Spine Journal
• /
• v.12 no.6
• /
• pp.1043-1052
• /
• 2018

Study Design: Level III retrospective cross-sectional study. Purpose: To define and characterize the presentation, symptom duration, and patient/surgical risk factors associated with 'post-decompressive neuropathy (PDN).' Overview of Literature: PDN is characterized by lower extremity radicular pain that is 'different' from pre-surgical radiculopathy or claudication pain. Although it is a common constellation of postoperative symptoms, PDN is incompletely characterized and poorly understood. We hypothesize that PDN is caused by an intraoperative neuropraxic event and may develop early (within 30 days following the procedure) or late (after 30 days following the procedure) within the postoperative period. Methods: Patients who consented to undergo lumbar laminectomy with or without an instrumented fusion for degenerative lumbar spine disease were followed up prospectively from July 2013 to December 2014. Relevant data were extracted from the charts of the eligible patients. Patient demographics and surgical factors were identified. Patients completed postoperative questionnaires 3 weeks, 3 months, 6 months, and 1 year postoperatively. Questions were designed to characterize the postoperative pain that differed from preoperative pain. A diagnosis of PDN was established if the patient exhibited the following characteristics: pain different from preoperative pain, leg pain worse than back pain, a non-dermatomal pain pattern, and nocturnal pain that often disrupted sleep. A Visual Analog Scale was used to monitor the pain, and patients documented the effectiveness of the prescribed pain management modalities. Patients for whom more than one follow-up survey was missed were excluded from analysis. Results: Of the 164 eligible patients, 118 (72.0%) completed at least one follow-up survey at each time interval. Of these eligible patients, 91 (77.1%) described symptoms consistent with PDN. Additionally, 75 patients (82.4%) described early-onset symptoms, whereas 16 reported symptoms consistent with late-onset PDN. Significantly more female patients reported PDN symptoms (87% vs. 69%, p=0.03). Patients with both early and late development of PDN described their leg pain as an intermittent, constant, burning, sharp/stabbing, or dull ache. Early PDN was categorized more commonly as a dull ache than late-onset PDN (60% vs. 31%, p=0.052); however, the difference did not reach statistical significance. Opioids were significantly more effective for patients with early-onset PDN than for those with late-onset PDN (85% vs. 44%, p=0.001). Gabapentin was most commonly prescribed to patients who cited no resolution of symptoms (70% vs. 31%, p=0.003). Time to symptom resolution ranged from within 1 month to 1 year. Patients' symptoms were considered unresolved if symptoms persisted for more than 1 year postoperatively. In total, 81% of the patients with early-onset PDN reported complete symptom resolution 1 year postoperatively compared with 63% of patients with late-onset PDN (p=0.11). Conclusions: PDN is a discrete postoperative pain phenomenon that occurred in 77% of the patients who underwent lumbar laminectomy with or without instrumented fusion. Attention must be paid to the constellation and natural history of symptoms unique to PDN to effectively manage a self-limiting postoperative issue.

• Journal of Korean Neurosurgical Society
• /
• v.62 no.4
• /
• pp.450-457
• /
• 2019

Objective : Anterior cervical discectomy and fusion (ACDF) is commonly used surgical procedure for cervical degenerative disease. Among the various intervertebral spacers, the use of allografts is increasing due to its advantages such as no harvest site complications and low rate of subsidence. Although subsidence is a rare complication, graft collapse is often observed in the follow-up period. Graft collapse is defined as a significant graft height loss without subsidence, which can lead to clinical deterioration due to foraminal re-stenosis or segmental kyphosis. However, studies about the collapse of allografts are very limited. In this study, we evaluated risk factors associated with graft collapse. Methods : We retrospectively reviewed 33 patients who underwent two level ACDF with anterior plating using allogenous bone graft from January 2013 to June 2017. Various factors related to cervical sagittal alignment were measured preoperatively (PRE), postoperatively (POST), and last follow-up. The collapse was defined as the ratio of decrement from POST disc height to follow-up disc height. We also defined significant collapses as disc heights that were decreased by 30% or more after surgery. The intraoperative distraction was defined as the ratio of increment from PRE disc height to POST disc height. Results : The subsidence rate was 4.5% and graft collapse rate was 28.8%. The pseudarthrosis rate was 16.7% and there was no association between pseudarthrosis and graft collapse. Among the collapse-related risk factors, pre-operative segmental angle (p=0.047) and intra-operative distraction (p=0.003) were significantly related to allograft collapse. The cut-off value of intraoperative distraction ${\geq}37.3%$ was significantly associated with collapse (p=0.009; odds ratio, 4.622; 95% confidence interval, 1.470-14.531). The average time of events were as follows: collapse, $5.8{\pm}5.7months$; subsidence, $0.99{\pm}0.50months$; and instrument failure, $9.13{\pm}0.50months$. Conclusion : We experienced a higher frequency rate of collapse than subsidence in ACDF using an allograft. Of the various preoperative factors, intra-operative distraction was the most predictable factor of the allograft collapse. This was especially true when the intraoperative distraction was more than 37%, in which case the occurrence of graft collapse increased 4.6 times. We also found that instrument failure occurs only after the allograft collapse.