• The Korean Journal of Pain
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• 제29권1호
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• pp.57-61
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• 2016

Foraminal or extraforaminal Far Lateral Disc Herniations (FLDH) extending into or beyond the foraminal zone have been recognized as between 7-12% of all lumbosacral disc herniations. Conventional posterior laminectomy may not provide good access to a herniation that lies far lateral to the lateral margin of the pedicle. Use of the endoscopic technique through a percutaneous approach to treat such FLDH patients can decrease the surgical morbidity while achieving better outcomes. We made an effort to utilize the advantages of percutaneous endoscopic lumbar discectomy (PELD) and to determine the appropriate approach for FLDH at the level between the 5th Lumbar and first Sacral vertebrae(L5-S1). The authors present a case of an endoscopically resected lumbar extruded disc of the left extraforaminal zone with superior foraminal migration at the level of L5-S1, which had led to foot drop, while placing the endoscope in the anterior epidural space without facetectomy.

• Journal of Korean Neurosurgical Society
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• 제45권5호
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• pp.312-314
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• 2009

Brown-Sequard syndrome may be the result of penetrating injury to the spine, but many other etiologies have been described. This syndrome is most commonly seen with spinal trauma and extramedullary spinal neoplasm. A herniated cervical disc has been rarely reported as a cause of this syndrome. We present a case of a 28-year-old male patient diagnosed as large C3-C4 disc herniation with spinal cord compression. He presented with left hemiparesis and diminished sensation to pain and temperature in the right side below the C4 dermatome. Microdiscectomy and anterior cervical fusion with carbon fiber cage containing a core of granulated coralline hydroxyapatite was performed. After the surgery, rapid improvement of the neurologic deficits was noticed. We present a case of cervical disc herniation producing acute Brown-Sequard syndrome with review of pertinent literature.

• The Korean Journal of Pain
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• 제18권2호
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• pp.187-191
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• 2005

Background: Discogenic leg pain is a major cause of health problems, often due to herniation of the intervertebral disc, and has traditionally been treated conservatively or with an open surgical discectomy. Conventional open surgery has many complications, such as nerve root injury, discitis and a relatively high mortality rate; failure of conservative treatments is also common. Recently, the $Dekompressor^{(R)}$ Percutaneous Lumbar Discectomy probe was developed. Herein, we present the early results for a percutaneous lumbar discectomy in herniated lumbar disc disease. Methods: Eleven patients, including 8 men and 3 women, with ages ranging from 22 to 78 years, were enrolled in this study. Those patients with a previous history of back surgery were not excluded from the study. All patients were postoperatively evaluated for their clinical outcomes, such as visual analogue scale (VAS) for pain after 1 and 3 months, reduction in analgesics, functional improvement and overall satisfaction. Results: The percutaneous lumbar discectomy was completed in 11 patients (17 levels), with average reductions in pre-VAS of 61.3 and 60.2% at 1 and 3 months, respectively. Also, 72.7% of patients reported functional improvement, with 81.1% expressing overall satisfaction. There were no procedural related complications. Conclusions: We concluded that a percutaneous lumbar discectomy is a safe and effective treatment modality for a herniated lumbar disc.

• Journal of Acupuncture Research
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• 제37권4호
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• pp.259-269
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• 2020

Background: This study aims to statistically analyze and compare the curative effect and satisfaction level between typical traditional Korean medicine treatment and nonsurgical spinal decompression treatment. Methods: Of the patients who were diagnosed with the cervical or lumbar herniated intervertebral disc at the Department of Acupuncture and Moxibustion Medicine at the Daejeon Korean Medicine Hospital from April 14^th to August 25^th, 2019, this study retrospectively analyzed the medical records of 31 patients who underwent nonsurgical spinal decompression treatment and traditional Korean medicine (assigned to Group A) and another 31 patients who received typical traditional Korean medicine alone (assigned to Group B). The clinical data were analyzed using IBM SPSS Version 23.0. Results: No statistically significant differences appeared in terms of sociodemographic, condition, and therapeutic characteristics, except whether the patient received Western medicine treatment, before or after a treatment with traditional Korean medicine. Group A exhibited higher variations in numeric rating scale, EuroQol- 5 dimension and EuroQol visual analogue scale scores compared to Group B as determined by independent sample t test and analysis of covariance. In addition, the satisfaction score of Group A was higher than that of Group B The result of cross analysis revealed that desire for continued treatment in Group A was higher than that of Group B. Conclusion: This retrospective observational study showed that the patients with nonsurgical spinal decompression treatment reported a greater reduction in pain, improved quality of life and satisfaction than patients receiving typical traditional Korean medicine.

• The Korean Journal of Pain
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• 제20권2호
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• pp.181-185
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• 2007

Background: The first pain clinic opened in korea in 1973 at Yonsei University Hospital, however, since then the number of pain clinics has gradually increased, as has the number of patients visiting them. This increase in patient has caused concerns about the way in which pain is managed, therefore, we conducted a retrospective review of data according to the sex, age and disease in an attept to aid us in planning for the future of our pain clinic. Methods: We analyzed 1,282 new patients who had visited our pain clinic and 828 inpatients who were admitted to our pain clinic between March 2006 and February 2007. Results: The most frequent age group was in the sixties in outpatient and in the seventies in inpatient. In addition, the incidence of disease in new patients and inpatients was as follows: in new patients, lumbar herniated intervertebral disc 16.5%, hyperhidrosis 12.3%, cervical disc disorder 10.5%, acute herpes zoster 8.2%, postherpetic neuralgia 7.9%, and trigeminal neuralgia 7.0%; in admitted patients, acute herpes zoster 17.6%, trigeminal neuralgia 15.6%, lumbar herniated intervertebral disc 13.0%, postherpetic neuralgia 11.2%, hyperhidrosis 9.8%, and complex regional pain syndrome 7.0%. Conclusions: The patients visiting our pain clinic have presented with a wide variety of diseases. This improved care reflects an effort to expand our fields not only to the management of outpatients but also inpatients, as well as to the treatment of new fields of disease. In the future, We need to manage various pain patients not only in outpatients but also in inpatients to expand our field even through pain clinic is rapidly growing in Korea.

• 한방재활의학과학회지
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• 제31권3호
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• pp.125-131
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• 2021

This study reports the effectiveness of Korean medicine therapy by improving symptoms in patients with herniated lumbar disc (HLD) diagnosed with chronic overflow urinary incontinence (OUI). The patient was treated with two types of herbal medicine and electroacupuncture for 10 days. We used diary of voiding and incontinence, Overactive Bladder Symptom Score (OABSS), Bristol Female Lower Urinary Tract Symptoms questionnaire (BFLUTS) and numeral rating scale (NRS) to assess the symptoms. After treatment, the number of nocturia decreased from 5 to 2.5. OABSS decreased from 9 to 2 and BFLUTS decreased from 95 to 87. The NRS of back pain decreased from 7 to 3. This study may suggest that Korean medicine therapy can be effective therapy for OUI with HLD.

• 보험의학회지
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• 제27권2호
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• pp.96-106
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• 2008

다음은 위의 모든 결과를 바탕으로 디스크 질환의 입원기간이 길어지고 재발이 일어날 수 있는 나쁜 조건 (NEGATIVE)과 그 반대인 좋은 조건(Positive)을 table로 정리하였다. 좋은 조건은 같은 추간판 탈출 기왕력자라고 하더라도 예후에 긍정적인 가능성을 주는 조건이다. 따라서 심사할 때 table를 토대로 고지내용이 좋은 조건인지, 나쁜 조건인지 판단 할 수 있고 추가 질문사항을 요청하는데 도움이 될 수 있을 것이다. 만약 입원을 했더라도 며칠을 입원했는지. 재수술을 하였다면 어떻게 했는지, 직장인의 경우 현재 어떤 조건인지, 수술을 했다면 구체적으로 수술명이 무엇인지, 수술 후 술, 담배를 하였는지, 수술 후 현재 상태가 어떤지에 따라 인수 여부를 결정하는데 도움이 될 것이라고 생각한다.

• Journal of Acupuncture Research
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• 제15권2호
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• pp.301-310
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• 1998

Infrared thermographic imaging visualizes noninvasively various abnormal condition by detecting the skin temperature. As the imaging represents the objective condition by the changes in blood flow under the control of autonomic nervous system, it is used to diagnosis and monitor the lumboscral radiculopathy. And asymmetry is important in the diagnosis of disc herniation. The most common type of disc herniation occurs psoterolaterally. This frequently causes nerve root compression leading to a radiculopathy in the distribution of the involved nerve root, most of which also provoke the asymmetric changes in thermography. Central disc herniation, which accounts for 5% to 35% of disc herniation, is typically associated with low back pain. But radiculopathy is usually abscent unless central disc heriniaton is large enough to cause compression of the cauda equina. To evalute the diagnostic value of the thermographic imaging in the diagnosis of central disc herniation, the imaging of 15 normal subjects and 48 patients with central disc herniation documented by CT scan were analyzed. The patients had either bilateral radiculophathy or no radiculopathy. The imaging of patient group with non rediculopathy did not show any significant thermal difference to control. While bilateral radiculopathy group reveled hypothermic pattern compared twith control. Thermal difference between left and right side did not present any significance in non radiculopathy group but hypothermia in bilateral radiculopathy group. Large herniation group demonstrated hyperthemic pattern while the others showed no significant change. Cranial caudal thermal difference did not show any difference between experiment groups. These results shows that infrared thermographic imaging can be used central disc herniation with bilateral radiculopathy, while it seems to little useful on the diagnosis of non radiculopathic disc herniation.

• Journal of Acupuncture Research
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• 제25권3호
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• pp.127-138
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• 2008

Objectives : This study was designed to evaluate the general distribution and the efficacy of oriental medical treatment for Lumbar Disc Herniation. Subjects and Methods : The 137 patients who had a diagnosis of HIVD by Lumbar-CT of Lumbar-MRI and admitted to Dunsan oriental medical hospital in Daejon university from January 2005 to December 2007 were observed. They were analyzed according to the distribution of sex, age, the period of disease, causing factor, The patient-condition on admission, the symptom on admission, Admission day, Herniation type of the disc and the treatment efficacy was evaluated respectively. Results : 1. Male was more than female in the ratio of 1 : 1.174, and forties 28% the most, the acutest phase 48% the most, reason unknown 30% the most, Grade III 42% the most, Back and Leg radiate pain 65% the most, the day of 6-10 29% the most, protruded disc type 48% the most. 2. In the total treatment result, the good was 48%, the excellent 28%, the fair 15%, the poor 9% in order. 3. the "effective rate"(the percentage of positive effective treatment case) of each distribution, the thirties and fifties 100% the most, subacute phase 100% the most, exercise, traffic accident 100% the most respectively, Grade III 93% the most, only low back pain 97% the most, the day of 16-20 100% the most, Extruded disc 100% the most. Conclusions : Total effective rate was 91%. We have Known the efficacy of oriental medical treatment for HIVD, was good and early treatment was better than late treatment.

• Journal of Korean Neurosurgical Society
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• 제29권5호
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• pp.628-634
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• 2000

Objective : The introduction of MRI makes it easy to detect multiple lumbar disc herniation. However, MRI is not a physiologic test for detecting the symptomatic level. For the surgical plan, it is very important to determine the symtomatic level among the multiple lumbar disc herniation. In this regard, we studied diagnostic significance of discography on multiple lumbar disc herniation in determining the symptomatic level. Method and Material : We retrospectvely analyzed the discographic and clinical findings of 121 patients with multiple lumbar disc herniation for investigating the diagnostic availability of discography. All were surgically treated from January 1995 through May 1998. Result : Discography provocated the same pain as usual symptom in 99 out of 121 patients(81.8%). Compared with surgical findings, the diagnostic accuracy of the discography in multiple lumbar disc herniation was 75.6%, sensitivity was 64.6%, and specificity 87.2%. There was no correlation between the pain provocation of discography and the extent of annular degeneration on CT/discogram. The pain provocation showed good correlation with the extent of annular disruption on CT/discogram. The rate of same result(correlation rate) between the discography and D.I.T.I was 81.4% in multiple lumbar disc herniation patients with unilateral leg pain. Conclusion : These results indicate that in multiple lumbar disc herniation, the discography is considered useful diagnostic tool to determine the symptomatic level and to decide the surgical plan.