• Journal of radiological science and technology
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• v.23 no.2
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• pp.21-26
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• 2000

The classification of herniated intervertebral cervical disc types are clinically important, as treatment methods would be slightly different according to the specific type of the herniated disc. 423 patients who suffered from herniated intervertebral cervical discs were tested with Magnetic Resonance Imaging (MRI), to distinguish the type of the herniated discs. The followings are the results ; 1) The age of the patients tested ranged from 16 to 75 years old and the mean age of the patients was 41.4 years of age. 2) There were twice as many male patients, with a ratio of 288 : 135 men to women. 3) 101 patients suffered from single herniated discs, while 322 patients suffered from multi-herniated discs. 4) Of single herniated disc injuries, 52 patients had protruded discs (52%), while 25 patients had extruded discs (25%). 21 Patients (21%) had herniated intervertebral discs between $C_4{\sim}C_5$, and 51 patients (50%), and had the same injury between $C_5$ and $C_6$. 5) Of multi-herniated disc injuries, 140 patients had protruded discs(44%). while 45 patients had extruded discs (14%). 54 patients had both protruded and extruded discs(17%). 36 patients(11%), herniated discs $C_3{\sim}C_6$ ; 69 patients (21%), herniated discs $C_3{\sim}C_7$ ; 47 patients(15%) herniated discs $C_4{\sim}C_6$ and 67 patients(20%) herniated discs $C_5{\sim}C_7$.

• Journal of radiological science and technology
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• v.22 no.1
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• pp.27-33
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• 1999

The classification of herniated intervertebral lumbar disc type is clinically important, as treatment method may be slightly different according to the type of herniated intervertebral disc. When 450 patients who suffered from herniated intervertebral lumbar disc were tested with Magnetic Resonance Imaging (MRI) to find out the type of herniated disc, the following findings were given : 1. The age of the patients investigated ranged from 15 to 83, and their mean age was 40. 2. The male patients were twice as many as the female patients, since the ratio of males to females was 300 : 150. 3. 118 patients suffered from a single herniated disc, and 332 patients were attacked with multi-herniated disc. 4. The types of single herniated disc were a protrusion for 50 patients (40%) and an extrusion for 40 patients (34%). The part of being herniated was an intervertebral disc between $L_4-L_5$ for 95 patients(80%) and the same disc between $L_5-S_1$ for 22 patients(19%). 5. The types of multi : -herniated disc were an protrusion for 67 patients(20%) and an extrusion for 70 patients(21%). Besides, 90 patients (28%) were the case that protrusion and extrusion coexisted simultaneously. The parts of being herniated were $L_3-L_4,\;L_4-L_5$ and $L_5-S_1$ for 53 patients(16%), $L_3-L_4$ and $L_4-L_5$ for 57 patients(17%), and $L_4-L_5$ and $L_5-S_1$ for 139 patients(42%).

• Journal of Acupuncture Research
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• v.18 no.4
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• pp.68-81
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• 2001

Herniated lumbar intervertebral disc(H.I.V.D) is the most common reason causing low back pain and leg radiating pain. Objective : The purpose of this report is to observe the effects of oriental medical conservative treatment in the different herniated type. Methods : We investigated 30 patients suffering from low back pain with sciatica which were admitted to Taejon Cheonan O. M. hospital from Nov 1, 2000 to Apr 30, 2001. 30 patients had a diagnosis of herniated lumbar interver tebral disc by Lumbar-C.T and Lumbar-M.R.I. we treated 30 patients by oriental medical conservative treatment (Ex: acupuncture, herb-med, physical theraphy, bed-rest, etc.) Results : 1. The mean hospitalization of patients was 21.1 days. that in the bulging type was l4days, protruded type 21days, mixed type 27days, extruded type 30days. that shows the less herniation of lumbar intervertebral disc, the mean hospitalization was more short. 2. In the distribution of the clinical symptoms admitted at that time, low back pain, leg radiating pain were showed in the all types(29patients, 96.6%). and sensory disorder, muscle powerlessness were showed least in the bulg ing type(0%, 37.5%), but that were showed most in the extruded type(50%,75%). 3. In the result of treatment due to clinical syptoms, bulging type was more execellent than any other other types. 4. The less herniation of lumbar intervertebral disc, angle of straight leg raising test was higher. In the result of treatment due to angle of straight leg raising test, bulging type was more execellent than any other other types. 5. In the distribution of physical. test, positive case in the Peyton sign, Ankle Dorsiflexion were showed least in the bulging type(25%, 12.5%), but that were showed most in the extruded type(100%, 75%). 6. In the result of treatment due to physical.test, bulging type was more exec ellent than any other other types. 7. The efficacy of total treatment was 90%(when we set a standard things more than fair), that in the bulging type was 100%, protruded 92%, mixedtype 80%, extruded type 75%. Bulging type had a more remakable effectsthan any other types. Conclusions : The less herniation of lumbar intervertebral disc, clinical syptoms were slighter, physical. test were better, and efficacy of oriental medical conservative treatme nt was remakable high.

• Journal of Korean Neurosurgical Society
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• v.47 no.1
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• pp.26-29
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• 2010

Objective: Recurrent lumbar disc herniation has been reported to occur in 5% to 15% of surgically treated primary lumbar disc herniation cases. We investigated the molecular biologic characteristics of primary herniated discs and recurrent discs to see whether the recurrent discs has the similar biological features with primary herniated discs. Methods: Primary hemiated disc and recurrent disc cells were obtained by discectomy of lumbar disc patients and cells were isolated and then taken through monolayer cultures. We compared chondrogenic and osteogenic mRNA gene expression, and western blot between the two groups. Results: The mRNA gene expression of recurrent disc cells were increased 1.47* times for aggrecan, 1.38 times for type I collagen, 2.04 times for type II collagen, 1.22 times for both Sox-9 and osteocalcin, and 1.31 times for alkaline phosphatase, respectively, compared with the primary herniated lumbar disc cells (*indicates p < 0.05). Westem blot results for each aggrecan, type I collagen, type II collagen, Sox-9, osteocalcin, and alkaline phosphatase were similar between the primary herniated disc cells and recurrent disc cells. Conclusion: These results indicate that the recurrent disc cells have similar chondrogenic and osteogenic gene expression compared to primary herniated disc cells. Therefore, we assumed that the regeneration of remaining discs could fill the previous discectomy space and also it could be one of the factors for disc recurrence especially in the molecular biologic field.

• The Journal of Korea CHUNA Manual Medicine
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• v.3 no.1
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• pp.43-53
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• 2002

Objectives : The object is to study a clinical effect regarding the conservative treatment of the patient who was diagnosed as the herniated Intervertebral lumbar disc(HIVD) and hospitalized in the oriental medical hospital and clinical study about the type of the HIVD. Methods. The clinical studies were done on 65 cases (hospitalized in Dept. of Oriental Rehabilitation Medicine, jaseng on oriental medical hospital from June 2001 to May 2002) who complained of low back pain or sciatica and diagnosed as HIVD on CT(computerized tomography) or MRI(magnetic resonance imaging). They were given both oriental conservative treatment and exercise during the hospitalization period. We investigated and observed 20 items about sex, age, weight, height, occupation, smoking. obesity, duration of disease, clinical symptom and treatment duration in basis of medical recording which was drawn up at patient hospitalization. We classified HIVD with 4 types(Bulging. Protruded. Extruded, Sequestered) and decided the case which simultaneously had 2 overs with Mixed type. The treatment evaluation standard was classified with 4 branches; Excellent. Good, Fair and Poor. Results & Conclusions : The treatment result of over 'fair' is bulging type 85%, protruded type 92.7%, extruded type 100% and the mixed type was 85.1 %. The effect was good in order of bulging, mixed, protruded and extruded type. It appeared most plentifully with 30 people in L4-5 and L5-S 1 disc herniation type.

• Journal of Korean Neurosurgical Society
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• v.29 no.2
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• pp.180-187
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• 2000

Objective : A number of evidence have suggested a pivotal role of matrix metalloproteinases(MMP) on the degeneration of intervertebral disc. Proteins of intervertebral disc mainly consist of collagen and proteoglycan. These proteins can be destructed by MMP, resulting in changes of main collagen type and degeneration of matrix proteins. The present study was to determine the different effects of MMP-1 and MMP-2 on the degenerative spinal diseases, resulting from aging process. Clinical Materials & Methods : Thirty-one patients were randomly selected among 350 patients whose discs were resected during operation from March 1997 to February 1999. Patients were divided into two groups: group I with spinal stenosis and group II with herniated intervertebral disc. Group II was subdivided into the ruptured(Group Iia) and unruptured(Group Iib). Increases in MMP-1 immunopositive cells were observed in both groups, as evidenced by immunocytochemical staining. However, in marked contrast, the number of MMP-2 immunopositive cells were only seen in group II. There was no significant difference between Group IIa and Group IIb. The MMP-2 immunopositive cells were increased in the anulus fibrosus of ruptured(Group Iia) more than unruptured(Group Iib), but statistically it was not significant. In addition, the immunopositivity of MMP-1 and MMP-2 was proportional to patients's age. Conclusion : These results strongly suggests the possible involvement of MMP-2, but not MMP-1 in progressive herniated intervertevral disc.

• The Korean Journal of Pain
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• v.23 no.1
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• pp.28-34
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• 2010

Background: An independent medical examination (IME) is a critical process for awarding reparation for injury. However, conducting an IME in pain medicine is very difficult, not only because pain is a subjective symptom, but also because there are no proper objective methods to demonstrate it. This study was conducted to compare IME reports and the court decisions on the disability status of the patients. Methods: We analyzed 79 IME reports and 25 corresponding court decisions on the disability status of patients. The diagnoses, causal relationships between the patients' status and the trauma, McBride's degree of disability, the American Medical Association's impairment ratings, the estimated annual cost for future treatment, and the necessity of care-giving were compared and analyzed. Results: The diagnoses in the 79 cases were complex regional pain syndrome (CRPS) type I (58 cases), CRPS type II (7 cases), peripheral neuropathy (5 cases), myofascial pain syndrome (4 cases), herniated intervertebral disc (2 cases), and fibromyalgia (1 case). The types of accidents were road traffic accidents (50 cases), military injuries (14 cases), industrial accidents (11 cases), and others (4 cases). The IME reports and the court decisions stated considerably different McBride's degrees of disability (P = 0.014). However, there was no significant difference in the estimated cost for future treatment between the IME reports and the court decisions (P = 0.912). Conclusions: IME reports should be accurate, fair, and based on objective findings. Feedback on IMEs from the court decisions is helpful for reference use.