• Archives of Orthopedic and Sports Physical Therapy
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• v.14 no.2
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• pp.73-80
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• 2018

Purpose: This study was evaluated the effects of nucleoplasty and chemonucleolysis, as interventional treatments for herniated intervertebral disc disease, on spinal tissues. Methods: Nucleoplasty using plasma beam and chemonucleolysis with collagenase were conducted on the spinal motion segments that were dissected from of human cadaver spine under fluoroscopic guidance. After the procedure, the intervertebral discs were transected, and the changes in gross findings were examined. Subsequently, the influence of the procedure on the nucleus pulposus, annuls fibrosus, and endplate was analyzed through a pathologic examination. Results: Nucleoplasty was confirmed to eliminate the local range of tissues in nucleus pulposus according to the procedure tract and to not affect other tissues. In chemonucleolysis, we found that collagenase diffused from the surgical site within the nucleus pulposus and was not present in the annulus fibrosus and endplate. Conclusions: The clinically-used interventional treatments that were investigated here were not found to do not cause additional damage to areas other than those targeted.

• The Journal of the Korea Contents Association
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• v.22 no.9
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• pp.570-582
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• 2022

Nucleoplasty is a type of percutaneous disc decompression that has been developed to treat herniated intervertebral discs. Currently, in some clinics, researchers have also applied this procedure to patients with internal disc disruption, apart from the originally intended usage on herniated intervertebral discs. The purpose of this study is to evaluate the feasibility of this extended use based on medical logic. To achieve this, the author analyzed case studies on performing nucleoplasty on patients with internal disc disruption. The main points of the analysis are, first, the validity of the treatment evidence presented by the researchers and, second, the relevance of the patient selection criteria. As a result, it is judged that the therapeutic rationale of existing papers applying nucleoplasty to the treatment of internal disc disruption is unclear or inconsistent with general medical logic, and in the process of patient screening, discs that may be deemed inappropriate for percutaneous decompression are included. Therefore, the author believes that existing studies applying nucleoplasty to the treatment of internal disc disruption have the nature of somewhat adventurous experiments that are unnecessary or can cause potential side effects. In order to uphold patients' rights and improve the completeness of the study in the research process on this topic, the author thinks that it is essential to establish clearer therapeutic evidence than the current level of understanding and to have an elaborate patient screening process based on it.

• Journal of Acupuncture Research
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• v.38 no.1
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• pp.1-7
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• 2021

This review of national and international randomized controlled trials of Salviae miltiorrhizae radix pharmacopuncture for lumbar herniated intervertebral discs was performed to assess its clinical efficacy. There were 5 online databases (PubMed, EMBASE, CNKI, NDSL, OASIS, and RISS) searched on June 1st, 2020. Studies were selected according to the inclusion and exclusion criteria and were reviewed by risk of bias assessment. This review included 14 Chinese studies. The sample sizes ranged from 50 to 100. The numbers of treatments ranged from 20 to 30, with most patients receiving 20 treatments. The longest treatment periods were 10-15 and 15-20 days, of which each accounted for 29% of the studies. The most frequently used evaluation indices were the Japanese Orthopedic Association and the Visual Analog Scale scoring method. The most frequently used acupoints were EX18 and BL25, which accounted for 31% of the total number of acupoints. In 50% of the studies, the pharmacopuncture injection volume was 2 mL. Acupuncture treatment was the most common control group. Eleven studies reported that the intervention group had significantly improved symptoms. However, most of the included studies were of low quality.

• The Korean Journal of Pain
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• v.23 no.2
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• pp.147-150
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• 2010

Background: Chronic low back pain can be a manifestation of lumbar degenerative disease, herniation of intervertebral discs, arthritis, or lumbar stenosis. When nerve roots are compromised, low back pain, with or without lower extremity involvement, may occur. Local inflammatory processes play an important role in patients with acute lumbosciatic pain. The purpose of this study was to assess the value of erythrocyte sedimentation rate (ESR) and high sensitivity C-reactive protein (hsCRP) measurements in patients with chronic low back pain or radiculopathy. Methods: ESR and hsCRP were measured in 273 blood samples from male and female subjects with low back pain and/or radiculopathy due to herniated lumbar disc, spinal stenosis, facet syndrome, and other diseases. The hsCRP and ESR were measured prior to lumbar epidural steroid injection. Results: The mean ESR was 18.8 mm/h and mean hsCRP was 1.1 mg/L. ESR had a correlation with age. Conclusions: A significant systemic inflammatory reaction did not appear to arise in patients with chronic low back pain.

• Journal of Korean Neurosurgical Society
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• v.42 no.4
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• pp.245-250
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• 2007

Tubular retractor system as a minimally invasive surgery (MIS) technique has many advantages over other conventional MIS techniques. It offers direct visualization of the operative field, anatomical familiarity to spine surgeons, and minimizing tissue trauma. With technical advancement, many spinal pathologies are being treated using this system. Namely, herniated discs, lumbar and cervical stenosis, synovial cysts, lumbar instability, trauma, and even some intraspinal tumors have all been treated through tubular retractor system. Flexible arm and easy change of the tube direction are particularly useful in contralateral spinal decompression from an ipsilateral approach. Careful attention to surgical technique through narrow space will ensure that complications are minimized and will provide improved outcomes. However, understanding detailed anatomies and keeping precise surgical orientation are essential for this technique. Authors present the technical feasibility and initial results of use a tubular retractor system as a minimally invasive technique for variaties of spinal disorders with a review of literature.

• The Korean Journal of Pain
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• v.22 no.1
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• pp.99-103
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• 2009

We studied the historical changes of intervertebral disc displacement using magnetic resonance imaging. The phenomenon of the spontaneous regression of herniated discs is well known. The case of a 40-years-old male presenting with a large disc herniation at L5-S1, experiencing severe sciatic pain, and having the straight leg raising test positive at 25 degrees is presented. The extruded disc was documented by clinical examination. He was treated conservatively with epidural steroid injection (ESI), medication, physical therapy and self-exercise and reevaluated in 10 weeks later, 30 and 1 year. Large extruded disc can be treated successfully by physical therapy with ESI. However, the degeneration and the dehydration of disc result in decrease of disc height. Consequently, the regression of extruded disc might have been due to the resorption and the dehydration.

• The Korean Journal of Pain
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• v.29 no.1
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• pp.40-47
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• 2016

Background: Neuropathic pain, including paresthesia/dysesthesia in the lower extremities, always develops and remains for at least one month, to variable degrees, after percutaneous endoscopic lumbar discectomy (PELD). The recently discovered dual analgesic mechanisms of action, similar to those of antidepressants and anticonvulsants, enable nefopam (NFP) to treat neuropathic pain. This study was performed to determine whether NFP might reduce the neuropathic pain component of postoperative pain. Methods: Eighty patients, who underwent PELD due to herniated nucleus pulposus (HNP) at L4-L5, were randomly divided into two equal groups, one receiving NFP (with a mixture of morphine and ketorolac) and the other normal saline (NS) with the same mixture. The number of bolus infusions and the infused volume for 3 days were compared in both groups. The adverse reactions (ADRs) in both groups were recorded and compared. The neuropathic pain symptom inventory (NPSI) score was compared in both groups on postoperative days 1, 3, 7, 30, 60, and 90. Results: The mean attempted number of bolus infusions, and effective infused bolus volume for 3 days was lower in the NFP group for 3 days. The most commonly reported ADRs were nausea, dizziness, and somnolence, in order of frequency in the NFP group. The median NPSI score, and all 5 median sub-scores in the NFP group, were significantly lower than that of the NS group until postoperative day 30. Conclusions: NFP significantly reduced the neuropathic pain component, including paresthesia/dysesthesia until 1 month after PELD. The common ADRs were nausea, dizziness, somnolence, and ataxia.

• Journal of the Korean Society of Clothing and Textiles
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• v.40 no.3
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• pp.516-525
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• 2016

Lumbar discs are one of the first parts of the musculoskeletal system to age in the human body. Lumbar disc for females start to age at twenty years of age and completely age between fifty and sixty. The number of lumbar herniated intervertebral disc patients are increasing rapidly; however, studies on protective inner wear are insufficient. This study was conducted to develop protective inner wear equipment that retains an aesthetic appreciation of the body. The methods and procedures of this study are as follows. First, foreign and domestic lumbar pads were researched and analyzed by visiting medical shops and internet shopping malls that sell lumbar pads. Second, the survey was conducted on forty patients with disc disease in hospitals located in Seoul and surrounding suburbs. The following are the study results and observations. First, the lumbar pads selling on the market had a variety of designs, textiles, and fabrics. The result of the research was to develop additional inner protective equipment for lumbar herniated intervertebral disc patients. Second, the survey results of the forty patients with disc disease were that housewives were the most vulnerable. All patients had experience purchasing lumbar pads. The prevention of pain and stress were the most selected responses for the motivation to buy lumbar pads. Most individuals said that they used lumbar pads for less than 1 year. Dissatisfaction came from fabric, activity and design. 'Being uncomfortable to wear' was the most common complaint. 'Protection and how easy the clothes were to wear' were the most selected for the necessity of developments. The Inner wear shape was the most selected in shape. Except for six respondents, all favored the lumbar protective inner wear design.

• Journal of Acupuncture Research
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• v.34 no.2
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• pp.19-38
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• 2017

Objectives : This is a retrospective statistical analysis of the demographic and therapeutic characteristics influencing the continued improvement of symptoms in patients treated in 2014 for herniated lumbar discs at a Korean medicine hospital; thereby, providing clinical data to further improve medical services of Korean medicine. Methods : We investigated the demographic and therapeutic variables of all patients who were diagnosed with a herniated lumbar intervertebral disc and were hospitalized for more than 1 night at Dunsan Korean medicine hospital from January 1, 2014, to December 31, 2014. IBM SPSS 21.0 was used to conduct a logistic multiple regression analysis and a covariance analysis (ANCOVA) of the demographic and therapeutic variables collected from the electronic medical records and telephone surveys. Results : 1. A longer duration of hospitalization was significantly better for the maintenance of pain relief or a decrease in the pain after discharge. 2. Younger patients were significantly less likely to be treated with a Western medical treatment after discharge. 3. Most of the demographic and therapeutic variables were not statistically significant in regards to treatment for lower back pain since discharge. Conclusion : Some of the demographic and therapeutic variables had a positive effect on the prognosis at one year or greater in patients who received integrative Korean medical treatment for lumbar disc herniation. Continued and systematic research will be needed.

• The Journal of Internal Korean Medicine
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• v.40 no.5
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• pp.894-900
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• 2019

Objective: The aim of this study was to evaluate the effects of traditional Korean medicine as a treatment for a diabetic patient diagnosed with herniated intervertebral lumbar discs. Methods: We treated the patient with herbal medicines, acupuncture, herbal acupuncture therapy, and physical therapy. We measured the state and progress of this case with the Numerical Rating Scale (NRS) and Oswestry Disability Index (ODI). We also checked serum glucose levels (FBS/PP2hrs) regularly. Results: After treatment, the NRS score was decreased, the ODI score was improved, and the blood glucose level was stabilized. The overall symptoms of the patient showed positive improvement.