• 제목/요약/키워드: Disc herniation

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Bladder Recovery Patterns in Patients with Complete Cauda Equina Syndrome: A Single-Center Study

  • Reddy, Ashok Pedabelle;Mahajan, Rajat;Rustagi, Tarush;Chhabra, Harvinder Singh
    • Asian Spine Journal
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    • 제12권6호
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    • pp.981-986
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    • 2018
  • Study Design: Retrospective case series. Purpose: Cauda equina syndrome (CES) is associated with etiologies such as lumbar disc herniation (LDH) and lumbar canal stenosis (LCS). CES has a prevalence of 2% among patients with LDH and exhibits variable outcomes, even with early surgery. Few studies have explored the factors influencing the prognosis in terms of bladder function. Therefore, we aimed to assess the factors contributing to bladder recovery and propose a simplified bladder recovery classification. Overview of Literature: Few reports have described the prognostic clinical factors for bladder recovery following CES. Moreover, limited data are available regarding a meaningful bladder recovery status classification useful in clinical settings. Methods: A single-center retrospective study was conducted (April 2012 to April 2015). Patients with CES secondary to LDH or LCS were included. The retrieved data were evaluated for variables such as demographics, symptom duration, neurological symptoms, bladder symptoms, and surgery duration. The variable bladder function outcome during discharge and at follow-up was recorded. All subjects were followed up for at least 2 years. A simplified bladder recovery classification was proposed. Statistical analyses were performed to study the correlation between patient variables and bladder function outcome. Results: Overall, 39 patients were included in the study. Majority of the subjects were males (79.8%) with an average age of 44.4 years. CES secondary to LDH was most commonly seen (89.7%). Perianal sensation (PAS) showed a significant correlation with neurological recovery. In the absence of PAS, bladder function did not recover. Voluntary anal contraction (VAC) was affected in all study subjects. Conclusions: Intactness of PAS was the only significant prognostic variable. Decreased or absent VAC was the most sensitive diagnostic marker of CES. We also proposed a simplified bladder recovery classification for recovery prognosis.

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

  • 황지혜;김덕현
    • Korean Journal of Acupuncture
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    • 제35권4호
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    • pp.239-246
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    • 2018
  • 2017년 12월 29일부터 2018년 7월27일까지 가천대 부속 길한방병원에서 MRI상 요추 추간판탈출증 진단 받고 보존적 치료위해 내원하신 요추 추간판탈출증 환자 중에서 요통 및 하지방사통에 대하여 CS약침과 봉약침의 상호보완 치료를 포함한 한의학적 복합치료를 시행한 2건의 증례에 있어서, NRS, ODI, RMDQ의 호전양상을 확인하였다. 그리고 개인마다 차이가 있었지만, CS약침으로 방사통을 유발하는 치료를 통한 요각통에 대한 강한 진통효과를 확인할 수 있었고, 봉약침은 자입시 통증이 거의 없고 제반증상 호전 및 치료후기 관리에 좋은 것으로 사료되었다. 약침반응은 CS약침의 경우 시술시의 뻐근한 느낌, 봉약침의 경우 시술초기 가려움 및 발진 등의 반응이 간헐적으로 발생되었으며, 대부분 수시간~2일 이내에 소실되었다.

추나 시술 부작용에 대한 국내 현황 보고 (A report of present situation about the adverse reactions of chuna manipulation in Korea)

  • 이병이;장건;이길재;송윤경;임형호
    • 척추신경추나의학회지
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    • 제2권2호
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    • pp.161-170
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    • 2007
  • Objectives : This report was performed to report the present situation of the adverse reactions of chuna manipulation in Korea. Methods : Searches were conducted on Internet based field. We investigated the cases reported from Korea Consumer Agency and the "Minwon Baekseo" published by Korean Oriental Medicine Society. Results & Conclusions : The relevant cases and papers were of small number. The most adverse reaction of chuna manipulation was disc herniation. The serious adverse reactions were Cauda equina syndrome(CES) and Cerebral infarction. Most of serious adverse reaction cases were performed by non proffesional therapist. We should give chuna treatment to patients after sufficient education. We expect more case reports and systemic studies about adverse reaction and effect of chuna manipulation.

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적외선체열촬영을 통한 편측 경항상지통환자의 임상적 고찰 (Analysis about DITI of the Patients having a Neck and Upper Extremity Pain on One Side)

  • 박민정;이경윤;조원영;박쾌환
    • Journal of Acupuncture Research
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    • 제21권2호
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    • pp.301-314
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    • 2004
  • Objectives : We studied to discover the patterns of DITI of the patients having a both neck and upper extremity pain on one side without any nerve root compression sign and the history of cervical disc herniation. Method : We selected 26 patients as an experimental group, who had visited for a both neck and upper extremity pain on one side without any nerve root compression sign, at the department of acupunture and moxibustion in Conmaul oriental medical hospital, during 2001. 01. - 2003. 09. And 31 normal adults were selected as a control group, not having any neck or arm pain and any history of cervical disease. We analyzed the segmental temperature statistically with t-test. Results & Conclusion : There was a significant change of temperatures in the scapula, posterior brachium, lateral forearm and dorsal hand area. And the experimental group showed cold spot and disruption of normal thermographic shape that were usually shown on the cervical sprain.

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적외선체열촬영을 통한 편측 경항상지통환자의 임상적 고찰 (Analysis about DITI of the Patients having a Neck and Upper Extremity Pain on One Side)

  • 이경윤;조원영;박쾌환;박민정
    • 대한한방체열의학회지
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    • 제4권1호
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    • pp.61-69
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    • 2005
  • Objectives : We studied to discover the patterns of DITI of the patients having a both neck and upper extremity pain on one side without any nerve root compression sign and the history of cervical disc herniation. Method : We selected 26 patients as an experimental group, who had visited for a both neck and upper extremity pain on one side without any nerve root compression sign, at the department of acupunture and moxibustion in Conmaul oriental medical hospital, during 2001. 01. - 2003. 09. And 31 normal adults were selected as a control group, not having any neck or arm pain and any history of cervical disease. We analyzed the segmental temperature statistically with t-test. Results & Conclusion : There was a significant change of temperatures in the scapula, posterior brachium, lateral forearm and dorsal hand area. And the experimental group showed cold spot and disruption of normal thermographic shape that were usually shown on the cervical sprain.

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Demographic and Clinical Characteristics of Patients with Restless Legs Syndrome in Spine Clinic

  • Yang, Jin Seo;Cho, Yong Jun;Kang, Suk Hyung;Choi, Hyuk Jai
    • Journal of Korean Neurosurgical Society
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    • 제55권2호
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    • pp.83-88
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    • 2014
  • Objective : The restless legs syndrome (RLS) is a common disorder affecting up to 5% to 15% of the general population, in which the incidence increases with age, and includes paresthesia in the legs. The purpose of this study is to investigate the incidence of RLS in spine center and to review clinical manifestations of this syndrome and its current treatments. Methods : Over a period of a year, retrospective medical record review and lumbar magnetic resonance images were performed on 32 patients with RLS in spine clinic who were diagnosed by National Institutes of Health criteria. Affected limbs were classified as five. Two grading systems were used in the evaluation of neural compromises. Results : The incidence of RLS was 5.00% (32/639). There were 16 males (50%) and 16 females (50%). The median age at diagnosis was 55.4 years (range, 25-93 years). There are no correlation between the affected limbs of RLS and neural compromises on the lumbar spine. Conclusion : The RLS is a clearly common neurologic disorder of the limbs, usually the legs. The awareness of this syndrome can help reduce diagnostic error; thereby, avoiding the morbidity and expense associated with unnecessary studies or inappropriate treatments in RLS patients.

봉약침요법으로 치료한 요추부 척수강내 낭종 1례에 대한 증례보고 (Case Report of spinal meningeal cyst patient treated with by bee venom therapy)

  • 황욱;김정신;전형준;남상수;김용석
    • Journal of Acupuncture Research
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    • 제20권3호
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    • pp.217-228
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    • 2003
  • Objective : Spinal meningeal cysts can be the cause of the low back pain and sciatica. We tried to manage the low back pain and sciatica caused by other disease besides intervertebral disc herniation. Methods : We treated the patient who diagnosed as spinal meningeal cyst and hospitalized. And we investigate the progress of physical condition, VAS, modified VAS, PRS by treatment and MRI before and after treatment. Results : There was remarkable improvement in condition of the patient who has spinal meningeal cyst after bee venom therapy. We found the size of cyst decreased in MRI and also progress in VAS modified VAS PRS physical view improved. Conclusions : We think that the result of this case can be a pilot study that proves the effect of bee venom therapy the low back pain and sciatica caused by variable disease.

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Spondylodiscitis after Cervical Nucleoplasty without Any Abnormal Laboratory Findings

  • Lee, Seung Jun;Choi, Eun Joo;Nahm, Francis Sahngun
    • The Korean Journal of Pain
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    • 제26권2호
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    • pp.181-185
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    • 2013
  • Infective spondylodiscitis is a rare complication that can occur after interventional spinal procedures, of which symptoms are usually back pain and fever. Early diagnosis of infective spondylodiscitis is critical to start antibiotics and to improve prognosis. Laboratory examinations including complet blood cell count (CBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) are conventional tools for the early detection of infectious spondylitis. However, we experienced infective spondylodiscitis after cervical nucleoplasty which did not display any laboratory abnormalities, but was diagnosed through an MRI. A patient with cervical disc herniation received nucleoplasty at C5/6 and C6/7. One month later, the patient complained of aggravated pain. There were neither signs of chill nor fever, and the laboratory results appeared normal. However, the MRI findings were compatible with infectious spondylodiscitis at the nucleoplasty site. In conclusion, infectious spondylodiscitis can develop after cervical nucleoplasty without any laboratory abnormalities. Therefore, an MRI should be taken when there is a clinical suspicion for infection in order to not miss complications after interventional procedures, even if the laboratory findings are normal.

Radiofrequency Facet Denervation for Low Back Pain after Microscopic Discectomy

  • Kim, Seok-Won;Lee, Seung-Myung;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • 제38권6호
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    • pp.442-444
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    • 2005
  • Objective : There were few reports about statistically significant factor which contribute to low back pain[LBP] after microscopic discectomy. We analyzed the result of percutaneous radiofrequency neurotomy[PRN] for low back pain after microscopic discectomy in lumbar disc herniation. Methods : Forty four patients with LBP after microscopic discectomy who were treated by one level microscopic discectomy from January 2003 to March 2004 were included in this study. They were divided into two groups by the presence of preoperative LBP into preoperative back pain group [group I] and postoperative back pain group [group II]. Radiofrequency procedures were performed in the usual manner, targetting the medial branch of L4, L5 and Sl. Pain relief was estimated at 1 week, 1 month and 6 months following the procedure, using the visual analogue scale. Above 50% pain relief was defined as the positive response. Results : Positive responders were 16 patients [73%] at 1 week, 12 patients [55%] at 1 month, and 7 patients [32%] at 6 months after PRN in group I. In Group II, 18 patients, 15 patients and 13 patients responded positively after 1 week, 1 month and 6 months after PRN, respectively. Conclusion : PRN is an effective treatment for newly developed low back pain after microscopic discectomy. There was no morbidity in our series, but long-term follow up is necessary.

Management of Irq-Un-Nasa (Sciatica) by Fasd (Venesection): A Case Report

  • Khan, Fatima;Nayab, Mohd;Ansari, Abdul Nasir
    • 셀메드
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    • 제12권2호
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    • pp.6.1-6.5
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    • 2022
  • Objectives: Sciatica is a musculoskeletal pain sensed in the leg along with the distribution of the sciatic nerve, which is sometimes accompanied by low back pain and is most commonly caused by a disc herniation. In the Unani system of Medicine, Irq-un-Nasa (Sciatica) is defined as the pain which starts from the hip joint and descends towards the foot. It is a type of Waja-ul-Mafasil which is developed due to the accumulation of Khilt-e-Dam or Khilt-e-Balgham ghaleez in the hip joint. The conventional system of Medicine offers several medications and surgeries to manage sciatica with limited clinical evidence of effectiveness. These cases aim to provide insight into the effects of Fasd (Venesection) in Irq-un-Nasa. Case Presentation: Fasd was performed in the saphena minor vein of two clinically diagnosed patients with sciatica after the initial assessment. Two sittings of Fasd, once a week in each patient, were performed, followed by telephonic assessments for two months. The intensity of sciatic pain reduced with subsequent sittings of Fasd, and there was no recurrence of any symptoms and signs again during complete follow-up. Conclusion: Based on the results of the present case report, it appears that such cases of Irq-un-Nasa can be managed with Fasd, and the quality of life of such patients can also be improved.