• 한방재활의학과학회지
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• 제26권4호
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• pp.117-126
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• 2016

Objectives The purpose of this study is to report the effect of Megadose Pharmacoacupuncture combined with conservative Korean medicine treatment on Herniated InterVertebral Disc (HIVD) of lumbar spine patient diagnosed by Magnetic Resonance Imaging (MRI). Methods This study includes 41 patients whose Lumbar Disc Herniations were by MRIbetween 1st Aprill 2011 and 31th March 2016. All of the patients were treated with Megadose Pharmacoacupuncture combined with Korean medicine treatment. The MRI examination was performed on two or more occasions (minimally, pre-treatment and post-treatment). The volume of each herniated disc was measured. For each patient, age, sex, disc migration, morphology, initial LDH size, herniated disc resorption rate were analysed. Results The mean volumes of herniated discs at pre-treatment and post-treatment were $1321.62{\pm}467.53mm^3$ and $648.72{\pm}313.38mm^3$. The volumes of all patients were decreased. The resorption means of each class of the extent of LDH were significantly different (p=0.041). On the other hand, no difference was found in sex, age, level, herniated disc grade. Conclusions The MRI results suggest that Megadose Pharmacoacupuncture combined with Korean medicine treatment can help treat lumbar herniated disc.

• 정형스포츠물리치료학회지
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• 제14권2호
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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.

• 한국콘텐츠학회논문지
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• 제22권9호
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• pp.570-582
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• 2022

수핵성형술은 경피적 디스크 감압술의 한 종류로 디스크 탈출증의 치료를 위해 개발된 시술법이다. 현재 몇몇 임상 현장에선 이 기술을 원래의 적응증인 디스크 탈출증을 지닌 환자들에 대해서 뿐 아니라, 디스크 내장증을 지닌 환자들에게도 사용하고 있다. 이 연구의 목적은 이와 같은 임상 현장에서의 수핵성형술의 적응증의 확대가 타당한 의학적 논리 위에서 수행된 것인지 평가하는 것이다. 그것을 위해 논자는 수핵성형술을 디스크 내장증 환자들에게 적용한 논문들을 분석하였다. 분석의 요점은 첫째, 연구자들이 제시하는 치료 근거의 타당성과 둘째, 환자 선별 기준의 적절성이다. 그 결과 수핵성형술을 디스크 내장증의 치료에 적용한 기존 논문들이 제시하는 치료 근거는 불분명하거나 일반적인 의학의 논리에 부합하지 않는 측면이 있는 것으로 판단되며, 환자 선별의 과정에선 경피적 감압술이 기능을 발휘할 수 있는 조건을 지닌 디스크를 찾기 위한 절차를 엄밀히 수행하지 않거나 경피적 감압술에 부적합한 것으로 판단될 수 있는 디스크도 시술 대상에 포함시킨 것으로 평가된다. 따라서 논자는 수핵성형술을 디스크 내장증 치료에 적용한 기존 연구들은 불필요하거나 잠재적 부작용을 발생시킬 수 있는 다소 모험적인 실험의 성격을 갖고 있다고 판단한다. 이 주제에 대한 연구과정에서 환자의 권익을 지키고 연구의 완성도를 높이기 위해선 현재의 이해 수준보다 선명한 치료적 근거의 확립과 이에 기반한 정교한 환자 선별 과정이 필수적으로 갖추어져야 할 것이라 생각한다.

• Journal of Acupuncture Research
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• 제38권1호
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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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• 제23권2호
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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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• 제42권4호
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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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• 제22권1호
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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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• 제29권1호
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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.

• 한국의류학회지
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• 제40권3호
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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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• 제34권2호
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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.