• Title/Summary/Keyword: Disc herniation

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Statistical Analysis of Patients Attending the Department of Acupuncture and Moxibustion Medicine at DaeJeon Korean Medicine Hospital: from March 2015 to February 2020

  • Sung, Ki Jung;Lee, Ye Ji;Kim, Hyo Bin;Kim, Beom Seok;Jeon, Ju Hyun;Kim, Eun Seok;Kim, Young Il
    • Journal of Acupuncture Research
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    • v.38 no.2
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    • pp.146-158
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    • 2021
  • Background: This study was designed to statistically analyze the year, gender, age, insurance type, and condition/disease of patients who were admitted to the Department of Acupuncture and Moxibustion Medicine at DaeJeon Korean Medicine Hospital over a 5-year period (2015-2020). Methods: Patients who visited the Department of Acupuncture and Moxibustion Medicine at DaeJeon Korean Medicine Hospital were classified according to year, gender, age, insurance type, and condition/disease. The statistical analysis was performed using IBM SPSS 23.0. Results: There is an increasing number of patients attending the Department of Acupuncture and Moxibustion Medicine year-on-year over the 5-year period, with a higher frequency of females than males each year. The largest age groups represented in these patients were those aged in their 50s, followed by those aged in their 40s, and 60s. Furthermore, the number of patients using health insurance was greater than those using automobile insurance each year. Of the 5,061 patients, the most common group was the patients (n = 991) who reported sprain and strain of cervical spine, followed by lumbar spine, lumbar herniation of the intervertebral disc, and facial paralysis. Conclusion: The number of patients seeking traditional Korean medicine treatment continues to increase, particularly in the 40s to 60s age group, with a larger proportion using health insurance and sprain or strain of the cervical spine. The results of this study may be used as a local (Daejeon) reference to develop Korean medicine policies, such as setting up medical benefits for patients using Korean medicine hospitals.

Bilateral foot drop caused by T12 infectious spondylitis after vertebroplasty: a case report

  • Kim, Dong Hwan;Shin, Yong Beom;Ha, Mahnjeong;Kim, Byung Chul;Han, In Ho;Nam, Kyoung Hyup
    • Journal of Trauma and Injury
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    • v.35 no.1
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    • pp.56-60
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    • 2022
  • The most common cause of foot drop is lumbar degenerative disc herniation, particularly at L4/5. We present a rare case of spinal cord injury accompanied by a thoracolumbar lesion that presented with bilateral foot drop. A 69-year-old male patient presented with sudden-onset severe bilateral leg pain and bilateral foot drop. Radiologic findings revealed T12 spondylitis compressing the conus medullaris. He had undergone vertebroplasty for a T12 compression fracture after a fall 6 months before. A physical examination showed bilateral foot drop, paresthesia of both L5 dermatomes, increased deep tendon reflex, and a positive Babinski sign. An acute bilateral L5 root lesion and a conus medullaris lesion were suspected based on electromyography. A surgical procedure was done for decompression and reconstruction. After the operation, bilateral lower extremity muscle strength recovered to a good grade from the trace grade, and the patient could walk without a cane. The current case is a very rare report of bilateral foot drop associated with T12 infectious spondylitis after vertebroplasty. It is essential to keep in mind that lesions of the thoracolumbar junction can cause atypical neurological symptoms. Furthermore, understanding the conus medullaris and nerve root anatomy at the T12-L1 level will be helpful for treating patients with atypical neurological symptoms.

The effect of Modified Sacroiliac Joint Taping on Back pain_A case report (변형된 엉치엉덩관절 테이핑의 요통 효과 사례보고)

  • Il-Young Cho
    • Journal of Digital Policy
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    • v.3 no.1
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    • pp.21-25
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    • 2024
  • This is a case study that sought to consider whether taping, which focuses on instability of the sacroiliac joint, is a potential intervention method that may be helpful for low back pain. In the case of a 58-year-old participant, we summarized the notable results from a taping training session that a man with a history of back surgery due to disc herniation and stenosis participated in to reduce ongoing pain. As an intervention method, tape was applied between the 2nd and 4th sacrum on both sides from the spinous tuberosity. It was stretched to a tension of 80% and attached past the sacroiliac joint, and then the ends were raised at about 45° on both sides and attached toward the gluteus medius muscle. Then, along the erector spinae muscle from the iliac crest. Bilateral taping up to the level of the 10th rib was applied. Through this intervention, positive case results were observed from both VAS and ODI test tools, with VAS recorded as 5 to 0 and disability index recorded as 13 to 0, respectively.

The Efficacy of Ultrasonography-guided S1 Selective Nerve Root Block (초음파를 이용한 제 1천추 선택적 신경근 차단술의 유용성)

  • Jeon, Young Dae;Kim, Tae Gyun;Shim, Dae Moo;Kim, Chang Su
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.7 no.2
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    • pp.113-119
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    • 2014
  • Purpose: This study was to evaluate effect and efficiency of S1 selective nerve root block using ultrasonography-guided compared with fluoroscopy-guided for lumbar disc herniation or spinal stenosis patients. Materials and Methods: Between February 2012 and December 2013, 38 patients who were with lower leg radiating pain for more than 1months and underwent S1 selective spinal nerve root block in our institution, were reviewed. They divided into two groups: Group A included 18 patients with ultrasonography-guided and Group B included 20 patients with fluoroscopy-guided. Treatment effectiveness was assessed using a visual analogue scale (VAS) and the Korea Modified Oswestry Disability Index (K-MODI). They were evaluated its preoperatively, postoperatively and 1 month later. We were recorded whole procedure time. Results: VAS was improved from 7.4 to 4.7 at 1 month in group A and from 7.39 to 4.36 at 1month in group B. K-MODI was improved from 72.8 to 43.3 at 1month in group A and from 73.8 to 44.1 at 1month in group B. Whole procedure time were $477.53{\pm}115.02s$, $492.47{\pm}144.38s$ in group A, group B, respectively. But there was no significant difference in VAS and K-MODI between two groups. Conclusion: Ultrasonography-guided sacral nerve root block is effective and accurate method in sacral radiating pain.

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Study on the Movement of New Qi-gong "WuQinXi" Exercise for Lumbar Spinal Disease : Based on 10 Mode, 15 Mode, 18 Mode (요추 질환에 대한 신기공 오금희의 동작연구 -10식, 15식, 18식을 중심으로-)

  • You, Kyung Gon;Yeom, Seung Ryong;Lee, Sang Yeong;Kwon, Young Dal;Jeong, Hyun Woo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.27 no.3
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    • pp.280-288
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    • 2013
  • Hua-Tuo(145-208) created five "WuQinXi" exercise by imitating the movements of a tiger, a deer, a bear, a monkey and a bird. The "WuQinXi" exercise, one of the medical Qi-gongs, is an exercise maximizing human's self healing power and has been effective significantly at several modern researches. There are many exercise therapies in western medcine, such as Willamss flexion exercise, Mckenzie's extension exercise, vertebral stabilization exercise and so on. However, there isn't a special exercise therapy which can be applied for medical practice in oriental medicine. So We selected some motions from "WuQinXi" exercise, which are suitable for lumbar spinal disease, and analyzed them. After that, We assorted them by kinds of lumbar spinal disease. First, We selected 22 motions which are related with lumbar movements from 3 type "WuQinXi" exercises ; 10 mode, 15 mode, 18 mode. And then, We classified them according to lumbar movements as flexion, extention, lateral bending and rotation, and also functions as stabilization and rubbing. Next, with these classifications, We assorted those motions by kinds of lumbar spinal disease as HIVD(herniation of intervertebral disc), spinal stenosis, spondylolysis and spondylolisthesis, facet joint syndrome, compression fracture and spondylosis. We expect that trying "WuQinXi" exercise at clinic in this way, the particular exercise therapy of oriental medicine, "WuQinXi" exercise will become more popular. And Oriental medical doctors will be able to teach patients "WuQinXi" exercise's motions easily at clinic, depending on kinds of lumbar spinal disease each patient suffers from. We plan to study more about 20 mode, 30 mode, 40 mode and the effect of "WuQinXi" exercise by comparing patients who do the "WuQinXi" exercise with the patients who do the western medical exercise therapy.

Posterior Interspinous Fusion Device for One-Level Fusion in Degenerative Lumbar Spine Disease : Comparison with Pedicle Screw Fixation - Preliminary Report of at Least One Year Follow Up

  • Kim, Ho Jung;Bak, Koang Hum;Chun, Hyoung Joon;Oh, Suck Jun;Kang, Tae Hoon;Yang, Moon Sool
    • Journal of Korean Neurosurgical Society
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    • v.52 no.4
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    • pp.359-364
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    • 2012
  • Objective : Transpedicular screw fixation has some disadvantages such as postoperative back pain through wide muscle dissection, long operative time, and cephalad adjacent segmental degeneration (ASD). The purposes of this study are investigation and comparison of radiological and clinical results between interspinous fusion device (IFD) and pedicle screw. Methods : From Jan. 2008 to Aug. 2009, 40 patients underwent spinal fusion with IFD combined with posterior lumbar interbody fusion (PLIF). In same study period, 36 patients underwent spinal fusion with pedicle screw fixation as control group. Dynamic lateral radiographs, visual analogue scale (VAS), and Korean version of the Oswestry disability index (K-ODI) scores were evaluated in both groups. Results : The lumbar spine diseases in the IFD group were as followings; spinal stenosis in 26, degenerative spondylolisthesis in 12, and intervertebral disc herniation in 2. The mean follow up period was 14.24 months (range; 12 to 22 months) in the IFD group and 18.3 months (range; 12 to 28 months) in pedicle screw group. The mean VAS scores was preoperatively $7.16{\pm}2.1$ and $8.03{\pm}2.3$ in the IFD and pedicle screw groups, respectively, and improved postoperatively to $1.3{\pm}2.9$ and $1.2{\pm}3.2$ in 1-year follow ups (p<0.05). The K-ODI was decreased significantly in an equal amount in both groups one year postoperatively (p<0.05). The statistics revealed a higher incidence of ASD in pedicle screw group than the IFD group (p=0.029) Conclusion : Posterior IFD has several advantages over the pedicle screw fixation in terms of skin incision, muscle dissection and short operative time and less intraoperative estimated blood loss. The IFD with PLIF may be a favorable technique to replace the pedicle screw fixation in selective case.

A Prospective Observational Study of Return to Work after Single Level Lumbar Discectomy

  • Kang, Suk-Hyung;Seo Yang, Jin;Cho, Steve Sungwon;Cho, Yong-Jun;Jeon, Jin Pyeong;Choi, Hyuk Jai
    • Journal of Korean Neurosurgical Society
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    • v.63 no.6
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    • pp.806-813
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    • 2020
  • Objective : Lumbar disc herniation (LDH) is a common disease, and lumbar discectomy (LD) is a common neurosurgical procedure. However, there is little previous data on return to work (RTW) after LD. This study investigated the period until the RTW after LD prospectively. Clinically, the pain state at the time of RTW also checked. RTW failure rate 6 months after surgery also investigated. Methods : Patients with daily/regular jobs undergoing LD between September 2014 and December 2018 were enrolled. Pain was assessed by the Oswestri Disability Index (ODI) and the Numeric Rate Scale (NRS). Employment type was divided into self-employed, regular and contracted. Monthly telephone interviews were conducted to check RTW status and self-estimated work capability after surgery. Results : Sixty-seven patients enrolled in this study. Three patients failed to RTW, and three others resigned within 6 months after surgery. The preoperative NRS and ODI were 7.2±1.2 and 22.1±7.9, respectively. The average time to RTW was 5.1±6.0 weeks. At RTW, NRS was 1.5±1.8 and ODI was 6.3±3.9. Amongst patients that successfully returned to work were 16 self-employed workers, 42 regular employees, and three contracted workers. The time to RTW of self-employed, regular, and contracted workers were 5.9±8.8, 4.2±4.3 and 13.3±2.3 weeks, respectively (p=0.011). Thirty-six of the patients that returned to work self-reported a 22.8±15.6% reduction in work capability at 6 months. Conclusion : RTW may vary depending on the employment status. In this study, we found that while employment type may affect the length to RTW, most patients were able to RTW and >40% of patients reported no loss of work capabilities 6 months postoperatively, hopefully alleviating some patient hesitation towards LD.

Clinical Experience of the Dynamic Stabilization System for the Degenerative Spine Disease

  • Lee, Soo-Eon;Park, Sung-Bae;Jahng, Tae-Ahn;Chung, Chun-Kee;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.43 no.5
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    • pp.221-226
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    • 2008
  • Objective : The aim of the present study was to assess the safety and efficacy of the dynamic stabilization system in the treatment of degenerative spinal diseases. Methods : The study population included 20 consecutive patients (13 females, 7 males) with a mean age of $61{\pm}6.98$ years (range 46-70) who underwent decompression and dynamic stabilization with the Dynesys system between January 2005 and August 2006. The diagnoses included spinal stenosis with degenerative spondylolisthesis (9/20, 45%), degenerative spinal stenosis (5/20, 25%), adjacent segmental disease after fusion (3/20, 15%), spinal stenosis with degenerative scoliosis (2/20, 10%) and recurrent intervertebral lumbar disc herniation (1/20, 5%). All of the patients completed the visual analogue scale (VAS) and the Korean version of the Oswestry Disability Index (ODI). The following radiologic parameters were measured in all patients : global lordotic angles and segmental lordotic angles (stabilized segments, above and below adjacent segments). The range of motion (ROM) was then calculated. Results : The mean follow-up period was $27.25{\pm}5.16$ months (range 16-35 months), and 19 patients (95%) were available for follow-up. One patient had to have the implant removed. There were 30 stabilized segments in 19 patients. Monosegmental stabilization was performed in 9 patients (47.3%), 9 patients (47.3%) underwent two segmental stabilizations and one patient (5.3%) underwent three segmental stabilizations. The most frequently treated segment was L4-5 (15/30, 50%), followed by L3-4 (12/30, 40%) and L5-S1 (3/30, 10%). The VAS decreased from $8.55{\pm}1.21$ to $2.20{\pm}1.70$ (p<0.001), and the patients' mean score on the Korean version of the ODI improved from $79.58%{\pm}15.93%$ to $22.17%{\pm}17.24%$ (p<0.001). No statistically significant changes were seen on the ROM at the stabilized segments (p=0.502) and adjacent segments (above segments, p=0.453, below segments, p=0.062). There were no patients with implant failure. Conclusion : The results of this study show that the Dynesys system could preserve the motion of stabilized segments and provide clinical improvement in patients with degenerative spinal stenosis with instability. Thus, dynamic stabilization systems with adequate decompression may be an alternative surgical option to conventional fusion in selected patients.

Clinical Study on 2 Cases of Patients of Common Peroneal Nerve Palsy(Foot Drop) Improved by Motion Style Treatment (Motion Style Treatment로 호전된 족하수 환자 2례 보고)

  • Lee, Jin-Ho;Park, Jong-Min;Jung, Sung-Yup;Kim, Sung-Yong;Shin, Joon-Shik;Park, Won-Sang
    • The Journal of Korea CHUNA Manual Medicine
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    • v.6 no.1
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    • pp.119-126
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    • 2005
  • The purpose of this study is to report the patients with common peroneal nerve palsy, who improved by motion style treatment.(M.S.T.) The clinical study on 2 case of patients with herniation of nucleus pulposus, L4-5, L5-S1 combined foot drop, who had been hospitalized in Ja-Seng Oriental Hospital. We checked the motor grade and subjective improvement at interval of 3days under the treatment of M.S.T. After 2-3 weeks of treatment, the movement and power of ankle joint improved to nearly normal range. The subjective improvement was 70% compared with Rt. ankle and range of active motion increased from Gr.1-2 to Gr.4

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Diagnostic and Therapeutic Utility of Ultrasonography-guided Facet Joint Block in Chronic Cervical Spinal Pain (만성 경추 동통 환자에서 초음파를 이용한 후관절 차단술의 진단 및 치료적 유용성)

  • Kim, Tae Kyun;Shim, Dae Moo;Oh, Sung Kyun;Choi, Byong San;Han, Sang Su
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.3 no.2
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    • pp.54-58
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    • 2010
  • Purpose: In patients with chronic cervical pain, the facet joint is the source of the majority. Due to the difficulty of identifying the exact location of the joint that causes these symptoms, the possibility of complications and the placebo effect brings clinical application into question. In this study, we assessed the prevalence of patients with chronic cervical pain and report the diagnostic and therapeutic usefulness of ultrasonography - guided facet joint block therapy. Materials and Methods: Patients with nonspecific chronic cervical pain for more than 6 months were selected. Patients with disc herniation, sciatica-related pain were excluded from the study and 160 patients who failed in conservative treatment (physical therapy, chiropractic therapy, medication) were included in the study. Diagnostic Ultrasonography-guided facet joint block was performed with 1% lidocaine, and after two weeks, Bupivacaine 0.25% was used in patients who tested positive for lidocaine. Patients with more than 75% pain reduction during movement after facet joint block were considered positive. Results: Among the 160 patients with chronic cervical pain, 96 patients(60%) had a positive reaction after facet block using lidocaine. Among the 64 patients with a negative reaction to lidocaine, 48 patients(75%) had a positive reaction to bupivacaine. There were 48 false positive patients(50%) who showed a positive reaction to lidocaine but a negative reaction to bupivacaine. The mean VAS of the total 160 patients before blocks was 8.5, after 2 weeks follow up it decreased to 2.7 (p = 0.001) and after 4weeks 3.6 (p = 0.001). The 8 patients as an initial improvement of symptoms are not satisfied with the procedure and the 3 patients had been worsened during observation, were showed pain relief after additional ultrasonography-guided facet joint block at 4th week. Conclusion: A single ultrasonography-guided block to chronic cervical pain patients has relatively low diagnostic value since high false positive rate. The twice facet joint blocks is thought to be a useful method for interventional pain management of patients with chronic cervical pain.

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