• Title/Summary/Keyword: Herniated disc

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The Clinical Case Report on a Patient with HIVD(Herniated Intervertebral Disc) and Schwannoma, Treated by Conservative Oriental Medical Treatment (요추 추간판 탈출증과 신경초종을 동반한 요각통 환자를 대상으로 한 한방 보존적 치료 치험 1례)

  • Woo, Jae-Hyuk;Lee, Han;Jung, Ho-Suk;Kim, Eun-Seok;Han, Kyung-Wan;Lee, Jun-Suk;Kim, Chang-Youn
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.5 no.1
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    • pp.111-124
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    • 2010
  • Objectives: The purpose of this study is to report clinical effects of oriental medicine w~h conservative treatments including acupuncture, Chuna treatment and herbal medicine on a patient with low back pain and lower limb numbness caused by HIVD and schwannoma. Methods: The patient was diagnosed with HIVD and schwannoma through the MRI scan. This case was treated with acupuncture, Chuna treatment and herbal medicine during the whole admission period. We evaluated the progress of the symptoms with objective criteria such as NRS(Numerical Rating Scale), SLRT(Straight Leg Raising Test), ODI(Oswestry Disability Index) score and MMT(Manual Muscle Testing). Results and Conclusions: After weeks of conducting conservative treatment on patient with low back pain and lower limb numbness caused by HIVD and schwannoma occurred at the lumbar spine, significant improvements of the symptoms were seen. These results suggest that in the case of low back pain and lower limb numbness caused by HIVD and schwannoma, conservative treatments can be considered as one of the options of treating the symptoms beside surgical way.

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Collaborative Study of Oriental-Western Medicine on HIVD (요추추간판탈출증의 동·서의학적 협진연구)

  • Lee, geon-mok;Lee, kang-chang;Hwang, yoo-jin
    • Journal of Acupuncture Research
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    • v.17 no.2
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    • pp.1-10
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    • 2000
  • Herniated lumbar intervertebral disc(HIVD) is the most common reason causing low back pain and leg radiating pain. The purpose of this study is to see the good of Oriental-Western medicine on HIVD. In order to this syudy, HIVD patients divided into two groups: Group with Oriental medicine(GOM) and Group with Oriental-Westem medicine(GOWM). The results of treatments were summarized as follows. 1. If We investigate a state of patients, GrIII type is 17 cases in GOM and is 16 cases in GOWM. In the GOM, Gr II shows better than the others and in the GOWM, GrI, III shows better than the others. 2. The results of treatments in GOM and GOWM is the good in a general way. It shows excellent type at 10 cases in the GOM, and shows excellent type at 14 cases in GOWM. 3. In Acute stage(in one month), subacute stage(one month~six months) and chronic stage(over six months), the therapic point of GOM and GOWM is 2.9~3.5 on the average. 4. If we notice the effect point of HIVD, in GOM, the point of bulging type is 3, protruded type is 3.5 extruded type is 3. But in GOWM, the point of bulging type is 3.7, protruded type is 3.5 extruded type is 2.7.

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The Usefulness of Intraoperative Myelography during Spinal Surgery (수술중 시행한 척수 조영술의 유용성)

  • Yoon, Sung-Hoon;Yi, Jin-Seok;Jang, Ha-Sung;Lee, Hung-Jin;Yang, Ji-Ho;Lee, Il-Woo;Kang, Joon-Ki
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup2
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    • pp.322-327
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    • 2001
  • Objectives : There are many kinds of method to evaluate neural decompression during operation. They are direct visual and manual inspection, intraoperative ultrasound, endoscope, intraoperative computed tomography and intraoperative myelography. We used intraoperative myelography to evaluate the proper decompression of neural elements during the decompressive surgery. Methods : We injected 10-20cc of nonionic water-soluble contrast materials through direct puncture site of exposed dura during operation or lower lumbar level or lumbar drain inserted preoperatively. 12 patients were included in this study. They were 7 patients of centrally herniated lumbar disc disease, 1 patient of multiple lumbar spinal stenosis, 2 patients of thoracic extradural tumor and 2 cervical fracture & dislocations. Results : 5 of 12 patients showed remained neural compression through intraoperative myelography, so they were operated further through other approach. Myelographic dye is heavier than CSF, so the dependent side of subarachnoid space was visualized only. In one case, CSF leakage through hemovac was detected, but it was treated only bed rest for 5 days after hemovac removal. Conclusion :Intraoperative myelography is an effective method to evaluate neural decompression during spinal surgery. This technique is easy and familiar to us, neurosurgeons.

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Surgical Treatment of a Chordoma Arising from the Second Thoracic Vertebral Body through the Modified Anterior Approach - Case Report - (전방 접근법으로 제거한 제2흉추 척삭종 - 증 례 보 고 -)

  • Lee, Jong-Won;Kim, Young-Baeg;Park, Seung-Won;Hwang, Sung-Nam;Choi, Duck-Young
    • Journal of Korean Neurosurgical Society
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    • v.29 no.4
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    • pp.574-579
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    • 2000
  • Chordomas are rare central nervous system tumors that are found predominantly in the sacrococcygeal(50%) and basiosphenoidal region(35%). Most of the remainder are related to the vertebral bodies and only 1 to 2% of them are known to occur in the thoracic vertebrae. A 15-year-old girl was admitted because of paraparesis. Three months prior to admission, she underwent a lumbar laminectomy at other hospital for the treatment of herniated lumbar disc but paraparesis became rather aggravated after the operation. At admission, MRI showed a low signal T1WI, high signal T2WI mass compressing the cord at T2 vertebral body. The tumor was subtotally removed via costotransversectomy but as the tumor was proven to be a chordoma, a second stage operation via anterior route was followed. At second operation, T2 corpectomy and T1-T3 plate fixation with autogeneous ileac bone graft was performed. Shortly after the operation, preoperative paraparesis disappeared completely and no evidence of tumor recurrence was noticed both clinically and radiologically for next 2 years. Spine surgery at cervicothoracic junction may be technically demanding due to anatomical complexity and hindering large vessels. The authers reviewed this case with special emphasis on the surgical procedure in this region.

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Graphic-based guidance point display system design for obtaining and improving lumbar exercise effect (요추 운동효과 향상을 위한 그래픽 기반 유도점 표시 시스템 설계)

  • Shin, Seong-Yoon;Lee, Hyun-Chang
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.25 no.2
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    • pp.208-213
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    • 2021
  • The use of computers has increased greatly, and services have been developed very much for the convenience of users. As the use of computers increases, human activity has declined, and symptoms of deterioration in health are increasing. As the time to sit and live increased, humans are more exposed to diseases of low back pain, and low back pain includes pain related to the lower back centering on the herniated disc. Most of the back pain is caused by abnormalities in the muscles and ligaments that support the spine and trunk. In this paper, we present an overall design for developing an app that can obtain lumbar exercise effects to reduce low back pain or help treatment. In order to use this effectively, we propose a plan to obtain lumbar exercise effect, and aim to present an app design that can help effectively treat low back pain by using graphic-based guidance points.

Case Report of Voiding Dysfunction Treated with Korean Medicine in a Hospitalized Patient with a Herniated Intervertebral Disc (한방병원에 입원한 배뇨장애를 동반한 추간판탈출증 환자에 대한 한방 치료 1례)

  • Kong, Geon-sik;Song, Jin-young;Kim, So-won;Park, Jin-hun;Wang, Yen-min;Kim, Sang-yoon;Park, Sung-hwan;Kang, Man-ho;Eom, Guk-hyeon;Lee, Hyung-chul
    • The Journal of Internal Korean Medicine
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    • v.42 no.2
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    • pp.86-94
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    • 2021
  • Objectives: The purpose of this study is to report on the efficacy of Korean medical treatment for voiding dysfunction. Methods: We treated a patient with voiding dysfunction using Korean medical treatments (herbal medicines, acupuncture, and herbal acupuncture therapy). To evaluate the results of this treatment, we measured the international prostate symptom score (IPSS) and the visual analog scale (VAS) for residual urination, dysuria, and miction pain. The general health status was evaluated with the European quality of life-5 dimensions (EQ-5d) scale. Results: We observed improvements in the IPSS and the EQ-5d scale after the treatments. Changes in the VAS reflected relief of residual urination and dysuria but not miction pain. Conclusions: This study suggests that Korean medicine may be effective to treat voiding dysfunction.

Lumbar Facet Joint Injection: A Review of Efficacy and Safety (요추 후관절 주사: 임상적 유용성과 안전성에 대한 고찰)

  • Yoonah Do;Eugene Lee;Choong Guen Chee;Joon Woo Lee
    • Journal of the Korean Society of Radiology
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    • v.85 no.1
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    • pp.54-76
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    • 2024
  • Facet joint arthrosis is a progressive degenerative disease that is frequently associated with other spinal degenerative disorders such as degenerative disc disease or spinal stenosis. Lumbar facet joint arthrosis can induce pain in the proximal lower extremities. However, symptoms and imaging findings of "facet joint syndrome" are not specific as they mimic the pain from herniated discs or nerve root compression. Currently, evidence for therapeutic intra-articular lumbar facet joint injections is still considered low, with a weak recommendation strength. Nevertheless, some studies have reported therapeutic effectiveness of facet joint injections. Moreover, the use of therapeutic facet joint injections in clinical practice has increased. This review article includes opinions based on the authors' experience with facet joint injections. This review primarily aimed to investigate the efficacy of lumbar facet joint injections and consider their associated safety aspects.

Correlation between Epidurographic Contrast Flow Patterns and Clinical Effectiveness in Chronic Lumbar Discogenic Radicular Pain Treated with Epidural Steroid Injections Via Different Approaches

  • Gupta, Ruchi;Singh, Saru;Kaur, Sukhdeep;Singh, Kulvinder;Aujla, Kuljeet
    • The Korean Journal of Pain
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    • v.27 no.4
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    • pp.353-359
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    • 2014
  • Background: Epidural steroid injections are an accepted procedure for the conservative management of chronic backache caused by lumbar disc pathology. The purpose of this study was to evaluate the epidurographic findings for the midline, transforaminal and parasagittal approaches in lumbar epidural steroid injections, and correlating them with the clinical improvement. Methods: Sixty chronic lower back pain patients with unilateral radiculitis from a herniated/degenerated disc were enrolled. After screening the patients according to the exclusion criteria and randomly allocating them to 3 groups of 20 patients, fluoroscopic contrast enhanced epidural steroids were injected via midline (group 1), transforaminal (group 2) and parasagittal interlaminar (group 3) approaches at the level of the pathology. The fluoroscopic patterns of the three groups were studied and correlated with the clinical improvement measured by the VAS over the next 3 months; any incidences of complications were recorded. Results: The transforaminal group presented better results in terms of VAS reduction than the midline and parasagittal approach groups (P < 0.05). The epidurography showed a better ventral spread for both the transforaminal (P < 0.001) and the paramedian approaches (P < 0.05), as compared to the midline approach. The nerve root filling was greater in the transforaminal group (P < 0.001) than in the other two groups. The ventral spread of the contrast agent was associated with improvement in the VAS score and this difference was statistically significant in group 1 (P < 0.05), and highly significant in groups 2 and 3 (P < 0.001). In all the groups, any complications observed were transient and minor. Conclusions: The midline and paramedian approaches are technically easier and statistically comparable, but clinically less efficacious than the transforaminal approach. The incidence of ventral spread and nerve root delineation show a definite correlation with clinical improvement. However, an longer follow-up period is advisable for a better evaluation of the actual outcom.

Statistical Study of the Ferguson's Angle, Lumbar Gravity Line and Lumbar Lordotic Angle in HIVD Patients. (요추간판탈출증 환자의 요천각, 요추중력중심선 및 요추전만각의 통계적 관찰)

  • Koh, Dong-Hyun;Hong, Soon-Sung;Lee, Jin-Ho;Jung, Sung-Yub;Shin, Joon-Shik
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.2 no.2
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    • pp.17-32
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    • 2007
  • Objectives : The lumbosacral joint is unstable area from an anatomical viewpoint, while it is also a very mobile area in ordinary life, so that clinically major causes of low back pain originate in this joint. The purpose of this study is to assess the difference of the Ferguson's angles, Lumbar gravity lines, Lumbar lordotic angles among Herniated of Intervertebral Disc(HIVD) patients. Methods : We analyzed the lateral view of lumbar spine checked at erect position on 88 patients who had been diagnosed as HIVD by Magnetic Resonance Imaging(MRI). We investigated the Ferguson's angle, Lumbar gravity line, Lumbar lordotic angle on X-ray film. Results and Conclusions : In the acute lumbago group the Ferguson's angle had a tendency to decrease, while in the chronic group it had a tendency to increase. In the acute lumbago group the Lumbar gravity line fell in front of the normal range(sacrum), while in the chronic group it fell behind the normal range(sacrum). In the acute lumbago group the Lumbar lordotic angle usually decreased, while in the chronic group it increased. The Ferguson's angle and the Lumbar gravity line, the Ferguson's angle and the Lumbar lordotic angle, the Lumbar gravity line and Lumbar lordotic angle each had a positive realtionship. The Ferguson's angle, the Lumbar gravity line and the Lumbar lordotic angle was less influenced by the level of HIVD and was more influenced by how long the patient had the pain. The correlationship between each factor was less in the chronic lumbago group than the acute group. In the chronic lumbago group the instability of the lumbosacral joint increased, while in the acute group the compression of the weight on the sacrum increased.

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Isokinetic Evaluation of Trunk Flexors and Trunk Extensors in Normal Adult Subjects and Patients with Post-operative Herniated Intervertebral Lumbar Disc (정상 성인남자와 요추간판탈출증 수술후 성인남자의 요추부 굴곡근 및 신전근의 등속성 근력평가)

  • Oh Seung-Kil
    • The Journal of Korean Physical Therapy
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    • v.10 no.1
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    • pp.81-98
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    • 1998
  • Isokinetic evaluation of trunk flexors and trunk extensors was performed at $60^{\circ}/sec\;and\;120^{\circ}/sec$ of angular velocity by using cybex 6000TEF Unit on 31 healthy male white workers and 15 post-operative HILD patients with no significant difference in mean age and mean body weight between two groups, and compared each other. The purpose of this study is to obtain the isokinetic normative strength values and endurance latins for Dunk extensors and trunk flexors, and is to provide a guideline for rehabilitation program of post-operative HILD patients. The collected data were analyzed by ANOVA, Duncan's Nyktuoke Range Test, and Pearson correlation coefficiency in PC-SAS program, The results obtained were as follow ; 1. Post-operative subjects has lower isokinetic values than normal subjects in peak torque, peak torque $\%$ by body weight, total work, total work $\%$ by body weight, average power, average power $\%$ by body weight, TAAE of trunk flexors and trunk extensors, and there are significant differences with statistic value in trunk extensors at $60^{\circ}/sec$ and in trunk flexors and trunk extensors at $120^{\circ}/sec$ between two groups(p<0.05). 2. Pest-ooperative subjects has lower values for angle of peak torque than normal subjects in trunk extensors, and there are significant differences with statistic value at $60^{\circ}/sec$ and $120^{\circ}/sec$ between two groups. 3. Post-operative subjects has higher values for endurance ratios than normal subjects in trunk extensors and flexors, but there are no significant differences with statistic value between two groups. 4. Post-operative subjects has higher values than normal subjects in peak torque ratios, total work ratios, average power ratios of trunk flexors to trunk extensors, and there are significant differences with statistic value between two groups(p<0.01). 5. There is significant positive-correlation with statistic valve between peak torque and height and body weight in normal subjects(p<0.05), but Thjere is significant negative-correlation between peak torque of trunk extensor at $120^{\circ}/sec$ and age (p<0.05). 6. There is significant positive-correlation with statistic value between peak torque of trunk flexors and body weight in post-operative subjects (p<0.05), but There is significant negative-correlation between peak torque of trunk extensor add age (p<0.05). In conclusion, post-operative subjects have greater weakness in trunk musculature than normal subjects, especially there is more significant weakness in trunk extensors than in trunk flexors

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