• The Journal of Korean Physical Therapy
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• 제21권3호
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• pp.95-102
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• 2009

Purpose: This study evaluates MCP-1 expression in the dorsal horn of a rat model of lumbar disc herniation by an autograft of the nucleus pulposus to the spinal nerve. Methods: After a coccygeal nucleus pulposus graft to the left $5^{th}$ lumbar spinal nerve, proximal to dorsal root ganglion, mechanical allodynia and thermal hyperalgesia were assessed 1 day before surgery, and 1, 10, 20, 30 days after surgery. The mRNA of MCP-1 in the dorsal horn was assessed by real time PCR to compare the temporal pattern of neuropathic pain of the lumbar disc herniation model. Results: In the ipsilateral side of the lumbar disc herniation models, mechanical allodynia and thermal hyperalgesia reached a maximum at 10 days after surgery with significant difference from the control group. Pain was also provoked in the contralateral side of the lumbar disc herniation models with less intensity than the ipsilateral side. The level of MCP-1 mRNA expression in the dorsal horn reached a peak at 20 days after surgery. Conclusion: Mechanical allodynia and thermal hyperalgesia was induced by nucleus pulposus in a rat lumbar disc herniation model, similar to a previously reported peripheral nerve injury model. The level of MCP-1 expression was higher in the dorsal horn of the ipsilateral and contralateral sides. These results suggest that MCP-1 might play a role in the maintenance of neuropathic pain.

• Journal of Acupuncture Research
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• 제32권3호
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• pp.107-115
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• 2015

Objectives : The aim of this study is to investigate the state of cervical disc herniation according to the degree of cervical lordosis and age. Methods : 67 records of inpatients who were diagnosed with herniated intervertebral disc(HIVD) of the cervical spine were analyzed. Cobb's method, Jochumsen method and the Ishihara index were used to measure the degree of cervical lordosis. The state of the cervical disc was identified using magnetic resonance imaging(MRI) of the cervical spine. Then correlations among cervical lordosis, age and cervical disc herniation were analyzed. Results : Disc bulging was associated with hypolordosis and disc protrusion was associated with hyperlordosis and age. Disc extrusion was not associated with either cervical lordosis or age. The number of disc herniations in the cervical spine was correlated with age significantly, but not with cervical lordosis. Conclusions : Cervical disc herniation had a tendency to correlate with age and cervical lordosis, although this is not definite. Future studies that analyze more radiographic images of patients with HIVD of the cervical spine might be necessary to identify the influence of cervical lordosis on cervical disc herniation.

• 대한정형도수물리치료학회지
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• 제22권2호
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• pp.9-14
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• 2016

Purpose: Many people are suffering from Low back pain due to HIVD and muscular problems, lack of joint functions on lumbar spine. In this study we compared the change of the herniation index, Oswestry LBP disability index (OLDI), visual analog scale (VAS), lumbar flexion range of motion (ROM) between the pre-experiment and after 4 weeks treatment by maitland manual therapy. Method: we selected and managed both the 15 people. They are $46.80{\pm}15.46$ years old people with HIVD and Stenosis. We treated for the people with HIVD and Stenosis by manual therapy(maitland manipulation method) during 4 weeks. And then we compared with pre-experiment and after 12 weeks through measuring the herniation index change by using computor themograpy (CT), LBP OLDI, VAS, lumbar flexion ROM. Results: The changes in the herniation index, Oswestry lumbar Disability Index, VAS, lumbar flexion ROM between the pre-experiment and after 4 weeks treatment by maitland manual therapy, there was a statistically significant difference. Although there was a significant difference after 4 weeks in OLDI, VAS, lumbar flexion ROM. But disc herniation index was no significant difference. Conclusion: Manual therapy is very effective for Lumbago due to the HIVD and spinap stenosis patients. OLDI, VAS and lumbar flexion ROM were increased. But disc herniation index was no significant difference. We suggest the combination treatment between manual exercise and spinal traction.

• 척추신경추나의학회지
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• 제6권2호
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• pp.33-44
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• 2011

양혈풍탕(養血風湯)을 처방하여 경추 추간판 탈출증으로 인한 극심한 통증 및 두통이 호전된 2례를 통하여 신경학적 결손이 없는 요추 방출성 골절에 대해 양혈풍탕(養血風湯)이 환자의 자각적인 증세 및 NRS, NDI 상으로 유효한 효과가 있었음을 확인하였다. 이에 저자는 두통이 동반된 경추 추간판 탈출증으로 입원하여 양혈풍탕(養血風湯)을 복용한 후 호전된 2케이스를 보고하는 바이다.

• The Korean Journal of Pain
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• 제28권1호
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• pp.11-21
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• 2015

Background: Epidural injections are performed utilizing 3 approaches in the lumbar spine: caudal, interlaminar, and transforaminal. The literature on the efficacy of epidural injections has been sporadic. There are few high-quality randomized trials performed under fluoroscopy in managing disc herniation that have a long-term follow-up and appropriate outcome parameters. There is also a lack of literature comparing the efficacy of these 3 approaches. Methods: This manuscript analyzes data from 3 randomized controlled trials that assessed a total of 360 patients with lumbar disc herniation. There were 120 patients per trial either receiving local anesthetic alone (60 patients) or local anesthetic with steroids (60 patients). Results: Analysis showed similar efficacy for caudal, interlaminar, and transforaminal approaches in managing chronic pain and disability from disc herniation. The analysis of caudal epidural injections showed the potential superiority of steroids compared with local anesthetic alone a 2-year follow-up, based on the average relief per procedure. In the interlaminar group, results were somewhat superior for pain relief in the steroid group at 6 months and functional status at 12 months. Interlaminar epidurals provided improvement in a significantly higher proportion of patients. The proportion of patients nonresponsive to initial injections was also lower in the group for local anesthetic with steroid in the interlaminar trial. Conclusions: The results of this assessment show significant improvement in patients suffering from chronic lumbar disc herniation with 3 lumbar epidural approaches with local anesthetic alone, or using steroids with long-term follow-up of up to 2 years, in a contemporary interventional pain management setting.

• 한방재활의학과학회지
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• 제21권2호
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• pp.253-263
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• 2011

Objectives : To analyze the therapeutic outcomes of back pain modalities in patients with disc herniation according to the change of magnetic imaging(MRI) at one year after conservative treatment. Methods : Clinical outcomes of 35 patients diagnosed with lumbar disc herniation by MRI examination, treated conservatively, were analyzed according to MRI follow-up change; improved, unchanged, worsened. Patients underwent MRI examination at baseline and after 24 week of treatment. After 1 year, we followed up 30 patients. The patients' clinical outcomes were assessed at baseline, 24 week, 1 year by visual analogue scale(VAS), oswestry disability index (ODI), and analyzed by each of it's correlation. Results : 1. VAS of sciatica and ODI of disability of daily activities showed significant decrease in patients after 1 year follow up(p<0.05). 2. VAS(low back pain and sciatica) and ODI of disability of daily activities showed significant decrease in "improved" group and VAS(sciatica) and ODI showed significant decrease in "unchanged" group. "worsened" group showed no statistic significance(p<0.05). 3. The 1 year follow-up of VAS(low back pain and sciatica) and ODI change showed relationship with MRI follow-up change(p<0.05). Conclusions : This study suggests that "improved" groups compared to "unchanged" and "worsened" group on MRI follow-up in patients with lumbar disc herniation were more effective at 1 year after conservative treatment. MRI follow-up change affect clinical changes in patients with lumbar disc herniation after 1 year.

• 한방재활의학과학회지
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• 제18권4호
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• pp.135-145
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• 2008

Objectives : To investigate therapeutic outcomes of back pain modalities in patients with disc herniation according to the duration by treated with herbal medicine, chuna, acupuncture, bee-venom acupuncture. Methods : We separated 36 patients with disc herniation into three group according to duration; acute patients within 4 week, subacute patients within 5-12 week, and chronic group within 13-24 week. 36 patients with lumbar disc herniation were treated with chuna therapy, acupuncture, bee-venom acupuncture one times a week and took herbal medicine after a meal two times daily. The patients' symptoms were assessed 1 week, 2 week, 4 week, 8 week by Visual analogue scale(VAS), Oswestry disability index(ODI), 36-Item short-form health survey(SF-36). Results : 1. ODI of disability of daily activities showed significantly decreased in acute stage group compared to subacute and chronic stage groups(P<0.05). 2. Physical functioning(PF), bodily pain(BP), social functioning(SF) score of SF-36 showed significantly increased in acute stage group compared to subacute and chronic stage groups(P<0.05). Conclusions : This study suggests that acute stage group compared to subacute and chronic stage groups in patients with lumbar disc herniation is the more effective to improve symptoms treated with herbal medicine, chuna therapy, acupuncture, bee-venom acupuncture.

• 대한미세수술학회:학술대회논문집
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• 대한미세수술학회 1997년도 제17차 학술대회
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• pp.127-127
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• 1997

• Journal of Acupuncture Research
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• 제33권2호
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• pp.11-20
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• 2016

Objectives : The purpose of this study is to investigate the clinical effectiveness of Korean medical combination treatment for cervical disc herniation. Methods : This is an observational study. 102 patients diagnosed with cervical disc herniation by MRI (Magnetic Resonance Imaging) were investigated from January, 2015 through to December, 2015 at Daejeon Jaseng Hospital of Korean Medicine. They were sorted according to the distribution of sex, age, causing factor, the period of disease, admission day and pain area. All patients were treated with acupuncture, Chuna treatment, and herbal therapy and physical therapy during the admission period. After treatment, NRS (Numeric Rating Scale), NDI (Neck Disability Index) and EQ-5D were assessed to evaluate the treatment efficacy. Results : There were more females than Males with a ratio of 1 : 1.37, the age of fifty was the most with 35.29 %, reason unknown was the most with 72.55 % and the subacute stage was the most with 38.24 %. According to disc herniation types, patients with protruded disc types were the most with 66.67 % and a lesion of C5/6 was the most with 41.18 %. For patients diagnosed with cervical disc herniation, neck and shoulder pain NRS decreased from $6.43{\pm}1.77$ to $3.96{\pm}1.96$(p<0.001) and radiating pain NRS decreased from $5.64{\pm}1.96$ to $3.57{\pm}1.88$ (p<0.001). NDI decreased from $41.72{\pm}14.04$ to $30.84{\pm}15.34$(p<0.001), and the EQ-5D index increased from $0.68{\pm}0.17$ to $0.79{\pm}0.14$(p<0.001) after treating cervical disc patients. Conclusion : Korean medical combination treatment might be effective in decreasing pain and raising the life quality of patients with cervical disc herniation.

• Journal of Acupuncture Research
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• 제33권1호
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• pp.103-116
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• 2016

Objectives : This study was performed to assess the effectiveness of conservative Korean traditional medical treatment on lumbar intervertebral disc herniation in 12 adolescents. Methods : Data were collected from adolescent patients diagnosed with lumbar intervertebral herniation by MRI, hospitalized at Jaseng Korean Medicine Hospital from January 1, 2014 to December 31, 2015. A total of 12 patients were included in the study. Patients were treated by acupuncture, pharmacopuncture, electroacupuncture, herbal medicine, chuna manual therapy, physical therapy during hospitalization period. To measure treatment outcomes, a verbal numerical rating scale (VNRS), Oswestry disability index (ODI), range of motion (ROM), Straight leg raising test (SLR), and EQ-5D were used. Results : The average age of the participants was $16.05{\pm}1.62$. The average of duration of symptom was $19.25{\pm}26.83(weeks)$ and the average length of hospitalization was $23.8{\pm}16.4(days)$. 2 patients (17 %) suffered from only lumbar pain, while 10 patients (83 %) suffered from lumbar and leg pain. No participant suffered from only leg pain. 8 patients (67 %) were diagnosed with disc herniation in one segment, and 4 patients (33 %) were diagnosed with disc herniation in multiple segments. A total of 17 disc segments (28 %) were herniated. The most herniated lumbar level was L4-5. 3 segments were diagnosed with bulging (17 %), 6 with protrusion (35 %), and 8 with extrusion (47 %). Extrusion was the most frequent herniated type. After treatment, the average VNRS of lumbar pain significantly decreased from $5.58{\pm}1.62$ to $2.91{\pm}1.56$ (p<0.001) and the average VNRS of leg pain significantly decreased from $5.16{\pm}2.51$ to $3.08{\pm}1.8$ (p<0.001). ODI significantly decreased from $48.87{\pm}18.72$ to $28.57{\pm}15.05$ (p<0.05), and EQ-5D significantly increased $0.58{\pm}0.31$ to $0.80{\pm}0.12$ (p<0.05). Range of flexion significantly improved from $61.25{\pm}32.62$ to $68.33{\pm}26.22$ (p<0.05). Conclusion : Conservative Korean Traditional Medical Treatment may be effective in the treatment of lumbar intervertebral disc herniation in adolescence. However, more case reports and clinical research are needed.