• Title/Summary/Keyword: Herniated discs

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Magnetic Resonance Imaging for Each Type of Herniated Cervical Intervertebral Disc (경추 추간판 탈출증의 유형별 자기공명영상 소견)

  • Kim, Ham-Gyum
    • Journal of radiological science and technology
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    • v.23 no.2
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    • pp.21-26
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    • 2000
  • The classification of herniated intervertebral cervical disc types are clinically important, as treatment methods would be slightly different according to the specific type of the herniated disc. 423 patients who suffered from herniated intervertebral cervical discs were tested with Magnetic Resonance Imaging (MRI), to distinguish the type of the herniated discs. The followings are the results ; 1) The age of the patients tested ranged from 16 to 75 years old and the mean age of the patients was 41.4 years of age. 2) There were twice as many male patients, with a ratio of 288 : 135 men to women. 3) 101 patients suffered from single herniated discs, while 322 patients suffered from multi-herniated discs. 4) Of single herniated disc injuries, 52 patients had protruded discs (52%), while 25 patients had extruded discs (25%). 21 Patients (21%) had herniated intervertebral discs between $C_4{\sim}C_5$, and 51 patients (50%), and had the same injury between $C_5$ and $C_6$. 5) Of multi-herniated disc injuries, 140 patients had protruded discs(44%). while 45 patients had extruded discs (14%). 54 patients had both protruded and extruded discs(17%). 36 patients(11%), herniated discs $C_3{\sim}C_6$ ; 69 patients (21%), herniated discs $C_3{\sim}C_7$ ; 47 patients(15%) herniated discs $C_4{\sim}C_6$ and 67 patients(20%) herniated discs $C_5{\sim}C_7$.

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Different Expression of Extracellular Matrix Genes: Primary vs. Recurrent Disc Herniation

  • Kuh, Sung-Uk;Kwon, Young-Min;Chin, Dong-Kyu;Kim, Keun-Su;Jin, Byung-Ho;Cho, Yong-Eun
    • Journal of Korean Neurosurgical Society
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    • v.47 no.1
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    • pp.26-29
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    • 2010
  • Objective: Recurrent lumbar disc herniation has been reported to occur in 5% to 15% of surgically treated primary lumbar disc herniation cases. We investigated the molecular biologic characteristics of primary herniated discs and recurrent discs to see whether the recurrent discs has the similar biological features with primary herniated discs. Methods: Primary hemiated disc and recurrent disc cells were obtained by discectomy of lumbar disc patients and cells were isolated and then taken through monolayer cultures. We compared chondrogenic and osteogenic mRNA gene expression, and western blot between the two groups. Results: The mRNA gene expression of recurrent disc cells were increased 1.47* times for aggrecan, 1.38 times for type I collagen, 2.04 times for type II collagen, 1.22 times for both Sox-9 and osteocalcin, and 1.31 times for alkaline phosphatase, respectively, compared with the primary herniated lumbar disc cells (*indicates p < 0.05). Westem blot results for each aggrecan, type I collagen, type II collagen, Sox-9, osteocalcin, and alkaline phosphatase were similar between the primary herniated disc cells and recurrent disc cells. Conclusion: These results indicate that the recurrent disc cells have similar chondrogenic and osteogenic gene expression compared to primary herniated disc cells. Therefore, we assumed that the regeneration of remaining discs could fill the previous discectomy space and also it could be one of the factors for disc recurrence especially in the molecular biologic field.

Spontaneous Regression of a Radiculopathic Cervical Herniated Disc following Non-surgical Treatment -3 case reports- (비수술적 치료 후 자연소실된 경추추간판탈출증 -증례보고-)

  • Kim, Hyeun Sung;Jo, Dae Hyun;Park, In Ho;Rhu, Jae Kwang;Sun, Kwang Jin;Lim, Kyung Joon
    • The Korean Journal of Pain
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    • v.21 no.1
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    • pp.84-88
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    • 2008
  • The spontaneous regression of herniated cervical discs is not a well established phenomenon. However, we encountered the 3 cases of spontaneous regression of severe radiculopathic herniated cervical discs that were treated using a non-surgical method. Each of the patients were treated with a combination of manipulation, dry needling and analgesics. In each case, the symptoms improved within 12 months of treatment and magnetic resonance imaging (MRI) conducted at that time revealed marked regression of the herniated disc in all cases. These cases provide additional examples of spontaneous regression of herniated cervical discs documented by MRI following non-surgical treatment.

Thoracoscopic Discectomy of the Herniated Thoracic Discs (흉추 추간판 탈출증에서 흉강경하 흉추간판 절제술)

  • Lee, Sang Ho;Lim, Sang Rak;Lee, Ho Yeon;Jeon, Sang Hyeop;Han, Young Mi;Jung, Byung Joo
    • Journal of Korean Neurosurgical Society
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    • v.29 no.12
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    • pp.1577-1583
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    • 2000
  • Objectives : Among the various types of minimally invasive spine surgeries, thoracoscopic surgery is becoming more widely accepted and increasingly utilized. This report delineates our clinical experience using thoracoscopy to resect herniated thoracic discs in 16 patients who suffered from myelopathy or intolerable radiculopathy. Patients and Methods : Between Mar. 1997 and Sep. 1999, 16 consecutive patients underwent thoracoscopic discectomy for treatment of herniated thoracic discs. There were 12 men and 4 women(mean age 43.5 years ; range 18-61 years). Eleven patients presented with myelopathic signs and symptoms from spinal cord compression and 5 patients had incapacitating thoracic radicular pain without myelopathy. The surgical level was varied between T3 and T12. The pathology of specimen were 11 hard discs and 5 soft discs herniations. Thoracoscopic techniques were performed with long narrow spine instruments and high speed drill through 3 or 4 ports under one lung ventilated general anesthesia. During the operation three patients were converted to open thoracotomy due to intolerable one lung ventilation, excessive bleeding and inadequate operation field. The mean operation time was 264min.(range : 100-420min.), and postoperative mean admission period was 11 days. Results : Clinical and neurological outcomes were good in all patients(mean follow-up period 20 months). Among the eleven myelopathic patients, 8 improved neurologically, and 3 stabilized. Among the five radiculopathic patients, 4 recovered completely and no patient had worsened. Postoperative complications were pleural effusion in one case, intercostal neuralgia in one, delayed hemopneumothorax in one, prolonged air leakage in one and pneumonia in one case. Conclusions : Thoracoscopic discectomy needs a steep learning curve to be familiar to anatomical space and handling of endoscopic instruments. However, it is technically feasible and can be effectively performed with acceptable results.

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An Analysis of the Outcome of Transforaminal Epidural Steroid Injections in Patients with Spinal Stenosis or Herniated Intervertebral Discs (요척주관 협착증 혹은 추간판 탈출증 환자에서 실시한 경추간공 경막외 스테로이드 주입의 결과에 관한 분석)

  • Hong, Ji Hee;Lee, Yong Chul;Lee, Han Min;Kang, Chul Hyung
    • The Korean Journal of Pain
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    • v.21 no.1
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    • pp.38-43
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    • 2008
  • Background: Spinal stenosis and herniated intervertebral discs are the principal causes of lumbosacral radiculopathy. This study was conducted to compare the therapeutic value and duration of pain relief of fluoroscopic guided transforaminal epidural steroid injections (TFESIs) in patients with refractory radicular leg pain. Methods: Between August 2006 and March 2007, 87 patients (H group: patients with herniated intervertebral disc, S group: patients with spinal stenosis) who met the inclusion criteria were treated with fluoroscopic guided TFESIs. Prior to treatment, the VAS and ODI scores were determine to evaluate the degree of pain and level of disability. The degree of pain relief was then assessed 1 month after treatment with the TFESIs and graded as excellent (no residual pain), good (improvement of pain symptoms by more than 50%), fair (improvement of pain symptoms by less than 50%) and Poor (no improvement of pain). In addition, the duration of pain relief was evaluated by regular outpatient visits for 6 months, and by telephone interviews after 6 months. Results: The H and S group both had excellet results at 1 month after treatment with TFESIs showing improvements of 44.1% and 20.8% respectively. However this difference was not significant between groups. In addition, a duration of pain relief greater than 6 months was achieved in 32.4% of the patients in the H group and 37.7% of those in the S group. Conclusions: TFESIs had a similar degree of therapeutic effectiveness and duration of pain relief in patients with spinal stenosis and herniated intervertebral discs.

A Case Report of a Sporadic Spinocerebellar Ataxia Patient with Herniated Intervertebral Lumbar Discs Treated with Traditional Korean Medicine (요추 추간판 탈출증을 동반한 산발성 소뇌 운동실조 환자에 대한 한방치험 증례보고 1례)

  • Seo, Hye-jin;Kang, Ah-hyun;Han, Dong-geun;Sung, Jae-yeon;Oh, Ju-hyun;Lee, Yu-ra;Kang, Man-ho;Lee, Hyung-chul;Eom, Guk-hyeon;Song, Woo-sub
    • The Journal of Internal Korean Medicine
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    • v.39 no.5
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    • pp.994-1003
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    • 2018
  • Objective: The aim of this study was to report a clinical case suggesting the potential effects of traditional Korean medicine for the treatment of sporadic spinocerebellar ataxia in a patient with herniated intervertebral lumbar discs. Methods: The patient was treated with a series of Korean medicine treatments including the herbal medicine Zhenganxifeng-tang-gagam, acupuncture, pharmacoacupuncture, and electroacupuncture along with herniated intervertebral lumbar disc treatments. Results: Improvements of Numeric rating scale (NRS) and European Quality of Life-5 Dimensions (EQ-5D) score were observed after the treatment. Conclusion: Traditional Korean medicine has potential benefits for sporadic spinocerebellar ataxia patients with herniated intervertebral lumbar discs.

Effect of Traditional Korean Medicine Treatment Including Acupotomy on the Level of Pain and Quality of Life of Patients with Cervical Herniated Intervertebral Disc: A Retrospective Observational Study

  • Kim, Beom Seok;Sung, Ki Jung;Lee, Ye Ji;Jeon, Ju Hyun;Kim, Young Il
    • Journal of Acupuncture Research
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    • v.38 no.3
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    • pp.227-232
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    • 2021
  • Background: The purpose of this study was to statistically analyze the treatment effect and patient satisfaction of traditional Korean medicine, including acupotomy treatment of cervical herniated intervertebral disc. Methods: This was a retrospective study of 22 patients who received traditional Korean medicine including acupotomy treatment amongst all patients diagnosed with cervical herniated intervertebral discs at the Korean Medicine hospital in Daejeon, Korean, from January 01, 2020 to April 30, 2021. The clinical data from patient medical records were statistically analyzed. Results: The Numeric Rating Scale, the European Quality of Life 5 Dimensions, and the European Quality of Life Visual Analogue Scale questionnaire scores were each compared before and after traditional Korean medicine treatment, including acupotomy, showed significantly improved scores after treatment (p < 0.001). Out of a total of 22 patients, 11 rated the treatment "very satisfactory" (50%), 5 "satisfactory" (22.7%), 5 "indifferent" (22.7%), 1 "unsatisfactory" (4.5%), and 0 "very unsatisfactory" (0%). Of the total 22 patients, 17 patients (77.3%) were willing to have further treatment, and 5 patients (22.7%) were not willing. Conclusion: Traditional Korean medicine treatment including acupotomy was an effective treatment for cervical herniated intervertebral discs. To determine the effect of an individual application (e.g., acupotomy) of traditional Korean medicine treatment for cervical herniated intervertebral disc, a prospective, controlled study is needed.

A Case Report of Diabetes Mellitus with Herniated Intervertebral Lumbar Discs Improved by Korean Medicine Treatment (요추 추간판탈출증을 동반한 당뇨병 환자에 대한 한방 치험 1례)

  • Han, Dong-geun;Choi, A-ryun;Jung, You-jin;Kang, Ah-hyun;Seo, Hye-jin;Sung, Jae-yeon;Lee, Hyung-chul;Eom, Gook-hyun;Song, Woo-sub
    • The Journal of Internal Korean Medicine
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    • v.38 no.5
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    • pp.828-833
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    • 2017
  • Objective: The aim of this study was to evaluate the effects of traditional Korean medicine as a treatment for diabetes mellitus with herniated intervertebral lumbar discs. Method: The patients were treated with the herbal medicine Jungso-tang to reduce serum glucose (FBS/PP2hrs) and HbA1c to improve diabetes mellitus in parallel with lumbar herniated intervertebral disc treatment. Results: The treatment with Jungso-tang decreased the serum glucose (FBS/PP2hrs) and HbA1c levels. Conclusion: Korean medicine may be an effective treatment for diabetes mellitus with lumbar herniated intervertebral disc.

Acupuncture and Spontaneous Regression of a Radiculopathic Cervical Herniated Disc

  • Kim, Sung-Ha;Park, Man-Young;Lee, Sang-Mi;Jung, Ho-Hyun;Kim, Jae-Kyoun;Lee, Jong-Deok;Kim, Dong-Woung;Yeom, Seung-Ryong;Lim, Jin-Young;Park, Min-Jung;Park, Se-Woon;Kim, Sung-Chul
    • Journal of Pharmacopuncture
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    • v.15 no.2
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    • pp.36-39
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    • 2012
  • The spontaneous regression of herniated cervical discs is not a well-established phenomenon. However, we encountered a case of a spontaneous regression of a severe radiculopathic herniated cervical disc that was treated with acupuncture, pharmacopuncture, and herb medicine. The symptoms were improved within 12 months of treatment. Magnetic resonance imaging (MRI) conducted at that time revealed marked regression of the herniated disc. This case provides an additional example of spontaneous regression of a herniated cervical disc documented by MRI following non-surgical treatment.

Loss of Disc Height after Spontaneous Regression of a Herniated Lumbar Disc - A Case Report - (탈출된 요추 추간판 자연 소실 후 발생한 추간판 간격 감소 - 증례 보고 -)

  • Kim, Hyoung Bok;Chung, Hoon-Jae
    • Journal of Korean Society of Spine Surgery
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    • v.25 no.4
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    • pp.175-179
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    • 2018
  • Study Design: Case report. Objectives: We report 3 cases of loss of disc height after spontaneous regression of a herniated lumbar disc. Summary of Literature Review: Reports of spontaneous regression of a herniated lumbar disc were identified. Materials and Methods: We conservatively treated 3 patients who were diagnosed with a herniated lumbar disc. During outpatient follow-up, radiating pain improved in all patients, but they complained of chronic lower back pain. Magnetic resonance imaging (MRI) was performed for diagnostic purposes. Results: On MRI, spontaneous regression of the herniated lumbar discs was observed, but loss of disc height was also found. Conclusions: A herniated lumbar disc may be a risk factor for loss of disc height. It is important to recognize that a patient with a herniated lumbar disc can struggle with chronic lower back pain even if spontaneous regression of the herniated lumbar disc occurs.