• 동의생리병리학회지
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• 제25권4호
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• pp.702-707
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• 2011

Patients with lumbar disc herniation are faced with lowered quality of life. For this reason, we investigated the effects of Oriental Intensive Therapy (OIT) including acupuncture, pharmacopuncture, manual therapy and herbal medicine on patients with lumbar disc herniation. Ten patients, diagnosed with lumbar disc herniation by MRI in hospital, were treated with OIT for 12 weeks. Symptoms of the patients were assessed using Verbal Numerical Rating Scale (VNRS) and Oswestry Disability Index (ODI). All patients were investigated every a week. In our results, intensity of pain was reduced after 4 weeks treatment significantly by VNRS, Quality of life has also improved after 4 weeks treatment by ODI. In conclusion, this study suggests that OIT may be effective to treat patients with lumbar disc herniation.

• 한방재활의학과학회지
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• 제33권4호
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• pp.185-193
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• 2023

Objectives This study was conducted to find out the correlation between lumbar malposition and lumbar disc herniation. Methods Among the patients who visited Gwangju Jaseng Hospital of Korean Medicine from January 2019 to January 2021, taking 92 patients under age 60 who had the records of X-rays and magnetic resonance imaging (MRI) images as the research subjects, Cobb's angle was measured in anterior-posterior (AP) view and lateral (LAT) view, the number of displacements was scored by listing categories defined by The Korean Society of Chuna Manual Medicine for Spine and Nerves. The degree of lumbar intervertebral disc herniation was expressed as a percentage according to the method of Kato, etc., and the correlation between each factor was analyzed. Results AP curvature and MRI herniation index showed significant positive correlation in L4-L5 level but there was no significant difference in L5-S1 level. LAT curvature and MRI herniation index had no correlation in L4-L5 level, but there was a significant negative correlation in L5-S1 level. Malposition score and MRI herniation index had a significant positive correlation in L5-S1 level, whereas there was no correlation in L4-L5. Conclusions As a result of the study, AP curvature and MRI herniation index showed a significant positive tendency in L4-L5 lumbar spine, and LAT curvature and MRI herniation index showed a significant negative tendency in L5-S1 lumbar spine. Malposition score and MRI herniation index were found to have a significant positive tendency in L5-S1 lumbar spine.

• Journal of Korean Neurosurgical Society
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• 제53권3호
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• pp.145-149
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• 2013

Objective : We analyzed the clinical and radiologic features of posterior apophyseal ring separation (PARS) with lumbar disc herniation and suggest the proper management options according to the PARS characteristics. Methods : We reviewed case series of patients with PARS who underwent surgery of lumbar disc herniation. Preoperative symptoms, neurologic status, Body Mass Index, preoperative and postoperative Visual Analogue Scale (VAS) and Korean-Oswestry Disability Index (K-ODI) scores, operation types were obtained. PARS size, locations, the degree of resection were assessed. Results : PARS was diagnosed in 109 (7.5%) patients among 1448 patients given surgical treatment for single level lumbar disc herniation. There were 55 (50.5%) small PARS and 54 (49.5%) large PARS. Among the large PARS group, 15 (27.8%) had lower endplate PARS of upper vertebra at the level of disc herniation. Thirty-nine (72.2%) were upper endplate PARS of lower vertebra. Among the group with upper endplate PARS of lower vertebra, unresected PARS was diagnosed in 12 (30.8%) cases and resected PARS was diagnosed in 27 (69.2%) cases. VAS and K-ODI scores changes were $3.6{\pm}2.9$ and $5.4{\pm}6.4$ in the unresected PARS group, $5.8{\pm}2.1$ and $11.3{\pm}7.1$ in the resected PARS group. The group with upper endplate PARS of lower vertebra showed significant difference of VAS (p=0.01) and K-ODI (p=0.013) score changes between unresected and resected PARS groups. Conclusion : The large PARS of upper endplate in lower vertebra should be removed during the surgery of lumbar disc herniation. High level or bilateral side of PARS should be widely decompressed and arthrodesis procedures are necessary if there is a possibility of secondary instability.

• 한방재활의학과학회지
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• 제26권3호
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• pp.97-108
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• 2016

Objectives This study is planned to classify effectiveness of Korean medicine treatment on lumbar intervertebral Disc herniation patients' fear-avoidance belief. Methods We measured 84 patients with lumbar intervertebral disc herniation in Jaseng Korean Medicine Hospital. We used numeric rating scale, oswestry disability index, fear-avoidance belief questionaire for evaluating effectiveness of oriental medicine treatment on lumbar intervertebral disc herniation. And We used Magentic Resonance Imaging(MRI) for classifying the patient who has lumbar intervertebral disc or not. Results 1. There was statistical effectiveness of korean medicine treatment on lumbar intervertebral disc herniation patients' fear-avoidance belief (p<0.01). ${\Delta}NRS$ and ${\Delta}ODI$ (r=0.587) was Most statistically correlative. ${\Delta}ODI$ and ${\Delta}FABQ$ had a little of statistically correlation (r=0.313). ${\Delta}NRS$ and ${\Delta}FABQ$ has no statistically correlation (r=0.145). Conclusions This study suggests that screening for the korean medicine treatment reduces fears and negative belief of patients with the lumbar disc herniation and prevents chronic physical symptoms that come from them so that it can be a great help to controlling patients' pain clinically.

• 척추신경추나의학회지
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• 제4권1호
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• pp.31-41
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• 2009

Objectives: The aim of this study was to evaluate the evolution of lumbar disc herniation in patients treated with oriental medicine. Methods: 14patients(15 cases) with lumbar disc herniation proved at MRI(Magnetic resonance imaging) underwent a follow-up MRI study. Follow-up MRI was performed $4{\sim}14$months(mean 7 months) after initial MRI. Results & Conclusions: 1. 13 cases(87%) had reduction of disc herniation. 1 showed no change in amount of disc herniation. 1 had an increase in disc herniation. 2. Comparison initial MRI with follow-up MRI showed that 2 of the herniations decreased between 0% and 25%, 3 decreased between 25% and 50%, 5 decreased between 50% and 75%, 3 decreased between 75% and 100%. The size of the herniation decreased on average by 49% in 14patients(15 cases). 3. On axial images, the proportion of the cross-sectional area of the spinal canal occupied by the herniated disc was 54.41% on the average on the initial scan, 29.65% on the follow-up scan.

• 한국한의학연구원논문집
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• 제16권2호
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• pp.119-124
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• 2010

Cervical disc herniations can press on the spinal cord and cause a problem called cervical myelopathy. The most common symptom of cervical disc herniation is neck pain that spreads down to the upper limb in various locations. There can also be associated with weakness and movement disorders of upper limb. In Oriental medicine, cervical disc herniation is treated with herb-med, physical therapy, acupuncture, Chuna, etc, but the Bee Venom therapy is the most common and effective. In this case, we used the Bee Venom therapy at cervical hyeopcheokhyeol for about 2 months to a patient who was diagnosed with disc herniation at Cervical 5-6, 6-7 and appealed weakness, limited elevation and abduction of the left upper limb. As a result, left upper limb disability was improved. Using the Bee Venom therapy at cervical hyeopcheokhyeol that are effective on movement disorders and neurological diseases of upper limb is an effective treatment to upper limb disability diagnosed with cervical disc herniation, and suggests the direction of the treatment to upper limb weakness and movement disorders diagnosed with cervical disc herniation.

• Journal of Korean Neurosurgical Society
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• 제55권6호
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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.

• Journal of Korean Neurosurgical Society
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• 제37권4호
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• pp.300-302
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• 2005

The authors report a case of hyperacute, massive hemorrhage in the left basal ganglia with severe midline shift that was treated successfully by the ultrasound-monitored free hand aspiration technique. Every effort was made to shorten time until removal of considerable amount of the hematoma and minimize duration of cerebral herniation, avoiding additional irreversible neurological deficit. A burr hole aspiration technique was preferred to standard craniotomy procedure, and any time-consuming procedures such as stereotactic frame application were abandoned. A burr hole was localized on the basis of computed tomography images simply and quickly with a ruler, and safety of the aspiration procedure was augmented by real-time ultrasound monitoring. Such minimally invasive technique relieved cerebral herniation successfully while avoiding time consumption and the morbidity of major craniotomy procedure. Early resuscitation of the patient with cerebral herniation in this case resulted in excellent recovery of the patient's neurological deficit. The patient's mentality started to improve rapidly and was clear six months after the surgery.

• Journal of Korean Neurosurgical Society
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• 제30권10호
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• pp.1237-1240
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• 2001

Spontaneous herniation of the spinal cord is a very rare. It's clinical symptom presents with progressive myelopathy. A 42-year old male patient who presented the progressive left leg weakness and Brown-Seqaurd syndrome is presented. MRI showed a typical finding of dural defect and herniation of the cord on the level of T3-4. Repair of dural defect using an artificial dura and reposition of cord herniation were undertaken after three level laminectomies with SSEP monitoring. Postoperatively, symptoms were improved rapidly. In our knowledgement, this is first case being reported in Korea. This entity, although rare, should be considered in the differential diagnosis of myelopathy in the absence of a mass lesion.

• Journal of Korean Neurosurgical Society
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• 제44권1호
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• pp.19-25
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• 2008

Objective : To analyze the relationship of concomitant foraminallumbar disc herniation (FLDH) with postoperative leg pain after microdecompression for extraforaminallumbar disc herniation (EFLDH) at the L5-S1 level. Methods : Sixty-five patients who underwent microdecompression for symptomatic EFLDH at the L5-S1 level were enrolled, According to the severity of accompanying FLDH, EFLDH was classified into four categories (Class I : no FLDH; Class II : mild to moderate FLDH confined within a lateral foraminal zone; Class III : severe FLDH extending to a medial foraminal zone; Class IV : Class III with intracanalicular disc herniation). The incidence of postoperative leg pain, dysesthesia, analgesic medication, epidural block, and requirement for revision surgery due to leg pain were evaluated and compared at three months after initial surgery. Results : The incidences of postoperative leg pain and dysesthesia were 36.9% and 26.1%, respectively. Pain medication and epidural block was performed on 40% and 41.5%, respectively, Revision surgery was recommended in six patients (9.2%) due to persistent leg pain, The incidences of leg pain, dysesthesia, and requirement for epidural block were higher in Class III/IV, compared with Class I/II. The incidence of requirement for analgesic medication was significantly higher in Class III/IV, compared with Class I/II (p=0,02, odds ratio=9,82). All patients who required revision surgery due to persistent leg pain were included in Class III/IV. Conclusion : Concomitant FLDH seems related to postoperative residual leg pain after microdecompression for EFLDH at the L5-S1 level.