• Title/Summary/Keyword: Herniated disc

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Clinical Outcomes of Percutaneous Plasma Disc Coagulation Therapy for Lumbar Herniated Disc Diseases

  • Kim, Sang-Hyun;Kim, Sung-Chul;Cho, Ki-Hong
    • Journal of Korean Neurosurgical Society
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    • v.51 no.1
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    • pp.8-13
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    • 2012
  • Objective : This is prospective study of clinical outcomes of percutaneous plasma disc coagulation Therapy (PDCT) in patients with herniated lumbar disc disease (HLD) to evaluate the safety and efficacy in its clinical application and usefulness as a reliable alternative to microscopic discectomy. Methods : Forty-six patients were enrolled in this study from April 2006 to June 2010. All patients had one-level HLD. Disc degeneration was graded on routine T2-weighted magnetic resonance Image (MRI) using the Pfirrmann's grading system and all index levels were grade 3 and grade 4. Indications for surgery were radiculopathy caused by disc protrusion with soft consistency. MRI was done at one month after the procedure in all patients to check post-PDCT change. The clinical outcomes were evaluated using Visual Analog Scales (VAS) score and MacNab's criteria. Results : This study was approved by the Institutional Review Board of our institution. The age of the study population ranged from 16 to 59 years with a mean age of 37.2 years. There were 29 males and 17 females in this study. The mean period of clinical follow-up was 21 months. The average preoperative VAS score for radiculopathy was $7.4{\pm}1.4$, while the final follow-up VAS score was $1.4{\pm}0.7$ (p<0.001). In MacNab's criteria, 41 patients (89.1%) had achieved favorable improvement (excellent and good) until later follow-up. There were one patient from infection and two patients who needed to convert to open discectomy. Conclusion : PDCT is a safe and efficient treatment modality in a selective patient with HLD.

The Clinical Reports on 3 Case of the Patient of Extruded Disc Treated by Conservative Oriental Medical Treatment (L-spine MRI로 관찰한 Disc extrution환자의 디스크 흡수 3례 보고)

  • Lee, Jin-Hyuk;Min, Kwan-Sik;Kim, Su-Young
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.5 no.1
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    • pp.101-110
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    • 2010
  • Objectives: The propose of this study is to find out the clinical application of conservative treatment to 3 patients who has Disc Extrusion on L-spine MRI Methods: We examined 3 patients with Lumbar Intervertebral Disc Herniation (HIVD of L-spine) with Disc Extrusion who showed changes on MRI images before/after the treatment among HIVD of L-spine patients who visited Jaseng Hospital of Oriental Medicine. Results: In this study, the first MRI examination of HIVD of L-spine patients was performed at the first visit and re-examination of MRI was done after the treatment. In each case, the size of the extruded disc was considerably reduced in MRI image. Low back and leg pain was also reduced significantly after conervative oriental medical treatment. Conclusions: Conservative oriental medical treatment can be effective for improving symptoms of HIVD, decreasing pain, also decreasing the volume of herniated disc.

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Ultrasound-Guided Posterolateral Approach for Midline Calcified Thoracic Disc Herniation

  • Tan, Lee A.;Lopes, Demetrius K.;Fontes, Ricardo B.V.
    • Journal of Korean Neurosurgical Society
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    • v.55 no.6
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    • pp.383-386
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    • 2014
  • Objective : Symptomatic thoracic disc herniation often requires prompt surgical treatment to prevent neurological deterioration and permanent deficits. Anterior approaches offer direct visualization and access to the herniated disc and anterior dura but require access surgeons and are often associated with considerable postoperative pain and pulmonary complications. A disadvantage with using posterior approaches in the setting of central calcified thoracic disc herniation however, has been the limited visualization of anterior dura and difficulty to accurately assess the extent of decompression. Methods : We report our experience with intraoperative ultrasound (US) guidance during a modified posterior transpedicular approach for removal of a central calcified thoracic disc herniation with a review of pertinent literature. Results : The herniated thoracic disc was successfully removed with posterior approach with the aid of intraoperative US. The patient had significant neurological improvement at three months follow-up. Conclusion : Intraoperative ultrasound is a simple yet valuable tool for real-time imaging during transpedicular thoracic discectomy. Visualization provided by intraoperative US increases the safety profile of posterior approaches and may make thoracotomy unnecessary in a selected group of patients, especially when a patient has existing pulmonary disease or is otherwise not medically fit for the transthoracic approach.

The disc morphological changes on CT scan examinations after 5-7years, of acute HIVD patients who underwent oriental medical treatment (조기(早期) 한방치료(韓方治療)를 시행한 요추수핵탈출증(腰椎髓核脫出症) 환자(患者)의 C-T 상(上) 5-7년 후의 추간판(椎間板)의 변화(變化))

  • Mun, Hyung-Cheal;Hwang, Woo-Jun;Lee, Geon-Mok;Cho, Nam-Geun;Gang, Sung-Do;Cho, Jae-Woon;Chang, Byoung-Sun;Jin, Kyong-Son
    • Journal of Acupuncture Research
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    • v.18 no.4
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    • pp.1-12
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    • 2001
  • Study design : A retrospective study of lumbar disc herniations using results of follow-up computed tomographic scan examinations. Objective : Lumbar disc herniations is one of the cause low back pain and lower extremity pain. To clarify the lumbar disc herniations morphological changes over time(mean 5.3 years) in order to establish a strategy for treatment. Methods : Sixteen patients with lumbar disc herniations who underwent follow-up computed tomographic scan examinations were studied. The changes over time in herniated disc size(herniation ratio) were evaluated using this scan technique. The initial computed tomographic scan allowed classification of the herniations according to herniation ratio: small, medium and large. Results : Comparison with follow-up computed tomographic scans showed that of the 16 patients, in 14 patients(88%), the herniation ratio(HR) was decreased and among them, 8 patients had complet resolution of herniated disc. In 2 patients with small herniations, the HR of one case was increased, the other was decreased. In 8 patients with medium herniations, the HR of one case had no change, the others was decreased. In 6 patients with large herniation, the HR of all patients was decreased. Interestingly, 4 of the 16 patients showed calcification change of herniated disc. Conclusion : There is no doubt that herniated disc size is decreased over time. The largest herniations were those which had the greatest tendency to decrease in size. But in some cases, the HR was increased, or calcification change was showed.

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The Ligamentotactic Effect on a Herniated Disc at the Level Adjacent to the Anterior Lumbar Interbody Fusion : Report of Two Cases

  • Min, Jun-Hong;Jang, Jee-Soo;Kim, Seok-Kang;Maeng, Dae-Hyeon;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • v.46 no.1
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    • pp.65-67
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    • 2009
  • The authors report two cases of spontaneous regression of disc herniation at the level adjacent to the anterior lumbar interbody fusion (ALIF) level. This phenomenon may be due to the increased tension on the posterior longitudinal ligament (PLL) by appropriate restoration of the disc height and lumbar lordosis, which is a mechanism similar to ligamentotaxis applied to the thoracolumbar burst fracture.

Lateral Laminectomy in Thoracolumbar Disc Herniated Dogs (흉요추 추간원반탈출증 권에서의 편측 추궁절제술)

  • 엄기동;윤정회
    • Journal of Veterinary Clinics
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    • v.15 no.2
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    • pp.255-262
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    • 1998
  • Lateral laminectomy was performed far spinal decompression in 7 thoracolumbar disc herniated dogs. These dogs showed upper motor neurologic signs including kyphosisi urinary dysfunction, and paraplegia or paralysis in hindlimbs. The lesions were evaluated with myelographic findings and predominated in $T_{12}-T_{13}, T_{13}-L_{1} and L_{1}-L_{2}$ discs. Five dogs which were operated within 48 hours after the onset of paraplegia were recovered from kyphosis and sustained the normal gait and walkings furthermore normal urination and defecation were presented within 3 days of postoperation. One dog was expired with steroid induced intestinal bleeding. The other dog operated on 96 hours after the onset of paraplegia was not recovered from neurologic deficits. Spinal decompression technique was considered to be useful method fur improving neurological problems resulted firom thoracolumbar disc herniation, if dogs are operated on early stage of the onset of paraplegia.

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An Unexpected Improvement of the Symptom from Herniated Intervertebral Disc during Trial of Spinal Cord Stimulation for the Post-herpetic Neuralgia -A case report- (대상포진 후 신경통에 시행된 실험적 척수자극술시 예측치 못한 추간판 탈출증 증상의 개선 -증례 보고-)

  • Ahn, Jae-Seok;Han, Seok-Hee;Kim, Tae-Hyeong;Park, Hahck-Soo;Lim, Young-Jin;Lee, Sang-Chul
    • The Korean Journal of Pain
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    • v.14 no.1
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    • pp.110-113
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    • 2001
  • In controlling chronic intractable pains, the current therapeutic methods used are exercise, over the counter medication, cognitive-behavioral therapy, opioid medication, neural blockade, operation, etc., spinal cord stimulation being the last resort. Spinal cord stimulation was initiated when Shearly and others clinically tested the Gate control theory of Melzack and Wall. This had triggered the advancement of theoretic research on the mechanism and hardware necessary and has resulted in an accumulation of clinical experiences. This is known to be effective for treating sympathetic pain, arachnoiditis, failed back pain syndrome, radiculopathy, peripheral vascular disease, phantom limb syndrome, post-herpetic neuralgia, peripheral neuropathy, and angina pectoris. This report describes our experience in experimental spinal cord stimulation in patients with simultaneous post-herpetic neuralgia and herniated intervertebral disc. There wasn't any improvement in the post-herpetic neuralgia but the symptoms of a herniated intervertebral disc was much ameliorated. This was quite an unexpected result. The patient's back pain returned when the stimulation stopped.

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Filum Terminale Lipoma with Herniated Intervertebral Disc Treated with Traditional Korean Medicine: A Case Report

  • Kim, Sang-Gyun;Park, Ju-Hun;Park, Han-Bin;Yoo, Dong-Hwi;Jang, Won-Suk;Shin, Won-Bin;Choi, Kang-Eah;Cho, Hyun-Woo
    • Journal of Acupuncture Research
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    • v.37 no.4
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    • pp.281-284
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    • 2020
  • Filum terminale lipoma is an inherited lumbosacral abnormality that can cause tethered cord syndrome. This report describes an unusual case of lumbago and sciatica, pain suspected to be caused by a filum terminale lipoma where a herniated intervertebral disc had occurred. The patient was hospitalized for 43 days and received integrative Korean medicine treatment, including acupuncture, pharmacopuncture, Chuna therapy, cupping therapy, physiotherapy and herbal medicine. Treatment effectiveness was assessed using the numerical rating scale, Oswestry Disability Index, European Quality of Life 5-Dimensions, and patient symptoms. After inpatient treatment, the pain the patient suffered was significantly reduced, and the evaluation indices scores reflected this. Integrative Korean remedies may be an effective option for lower back pain and lower extremity symptoms which are caused by filum terminale lipoma where a herniated intervertebral disc has occurred. Additional clinical research is required to support this observation.

The Comparative Study on the Effect of Fire Needling Therapy and General Acupuncture with Other Korean Traditional Medical Treatment for the Patient with Lumbar Herniated Intervertebral Disc: A Randomized, Assessor Blinded, Two Arm Trial (요추 추간판 탈출증 환자에 대하여 기타 한방치료를 병행한 가열식 화침과 일반침의 효능 비교 연구: 무작위배정, 평가자 맹검, 평행군 설계)

  • Jung, Se Ho;Sung, Hee Jin;Lim, Su Ji;Lee, Eun Yong;Lee, Cham Kyul
    • Journal of Acupuncture Research
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    • v.32 no.4
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    • pp.29-36
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    • 2015
  • Objectives : The purpose of this study is to compare the efficacy of fire needling therapy and general acupuncture for the patient with lumbar herniated intervertebral disc. Methods : We observed 20 lumbar herniated intervertebral disc patients from March, 2014 to October, 2015. This study was randomized and assessor blinded. The patients were divided into two groups: one group(group A) was treated by general acupuncture only, and the other group(group B) was treated by fire needling therapy and general acupuncture. We evaluated the treatment effect experienced by each group using the visual analogue scale(VAS) and Oswestry disability index(ODI). Results : 1. In group A, VAS and ODI from before treatment to treatment 4, 8, 12, 16 were significantly improved in statistics. 2. In group B, VAS from before treatment to treatment 4, 8, 12, 16 was significantly improved, but ODI was significantly improved in statistics only from before treatment to treatment 12, not in treatment 4, 8, 16. 3. As a result of comparisons between group A and B, there were no statistical significance in VAS and ODI. Conclusions : This study was not able to determine statistical significance between the group treated by general acupuncture only and the group treated by fire needling therapy and general acupuncture, so further studies are required in the future.

The study on effective duration of conservative treatment on herniated intervertebral lumbar disc patients (요추 추간판탈출증 환자에 대한 보존적 치료의 효과적인 기간에 관한 연구)

  • Ghang, Goon-Yong;Kim, Young-Bae
    • Journal of Korean Physical Therapy Science
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    • v.12 no.3
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    • pp.13-26
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    • 2005
  • Low back pain is one of the most frequent problems treated in clinical feild. Eight out of ten people will experience significant low back pain sometime during their life. Most cases low back pain are not serious and respond to conservative treatment. It's pain is severe and not responding to conservative treatment or if it has significant leg pain. In these cases are may recommend surgery. The purpose of this study is to analyze the effective duration of treatment and degree of variable pain approached conservative treatment. The persons who diagnosed to herniated intervertebral lumbar disc were attended in this study. number of cases were 60cases. We evaluated their chart, X-ray and MRI. The result of the study were as follows; 1. The patients who treated for 33days were improved 100%, which was 3cases(5%). 2. The patients who treated for 45days were improved 90%, which was 13cases(22%). 3. The patients who treated for 43days were improved 80%, which was 28cases(47%). 4. The patients who treated for 39days were improved 70%, which was 6cases(10%). 5. The patients who treated for 28days were improved 60%, which was 5cases(28%). 6. The patients who treated for 22days were improved 50%, which was 4cases(7%). Conclusion ; In herniated intervertebral lumbar disc patients who had conservative treatment. The highest improve patients were 28 cases(47%), who treated for 43 days. The lowest improve patient was 1case(2%), who treated for 28 day. The Effective duration of conservative treatment was more than 43days. If they wants to be improving their symptoms, they should be treat for more than 43days.

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