• Title/Summary/Keyword: Herniation

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Effects of Conservative Korean Traditional Medical Treatment on Lumbar Intervertebral Disc Herniation in 12 Adolescents : A Retrospective Study (청소년기 요추간판탈출증에 대한 한방 보존적 치료 12례의 후향적 분석)

  • Kim, Hae Sol;Bae, Young Hyun;Kim, Ho Sun;Suh, Chang Yong;Kim, No Hyeon;Lee, Gi Bum;Yang, Kyu Jin
    • Journal of Acupuncture Research
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    • v.33 no.1
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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.

Correlation Analysis Between Lumbar Scoliosis of X-ray and HIVD of L-spine MRI in LBP Patients who Visit Korean Medicine Hospital (한방병원에 요통으로 내원한 환자에서 X-ray상 요추측만과 MRI상 HIVD와의 연관성 분석)

  • Kim, Kil-Hwan;Choi, Young-Jun;Kwon, Ok-Jun;Joo, Young-Kuk;Song, Seung-Bae;Song, Gwang-Chan;Seo, Ji-Yeon;Choo, Won-Jung
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.11 no.1
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    • pp.41-51
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    • 2016
  • Objectives : This study is planned to classify Correlation between Cobbs Angle of Lumbar scoliosis and prevalence of Lumbar Intervertebral Disc. Methods : We Measured the lumbar scoliosis angle of the 114men and 91 women patients with lumbar pain in Bucheon Jaseng Korean Medicine Hospital. We use Cobb's angle method for measuring the lumbar scoliosis. And We use Magentic Resonance Imaging(MRI) for classifying the patient who has lumbar intervertebral disc or not. Results : 1.There was no statistical relation between the Cobbs angle and gender(P>0.05) 2.There was no statistical relation between the Cobbs angle and age(P>0.05) 3.There was significant relation between the direction of lumbar scoliosis and the direction of disc herniation(P<0.05) 4.There was no statistical relation between on the Cobbs angle and disc herniation. The more severe of lumbar scoliosis has not tendency of disc herniation. 5.There was no statistical relation between lumbar scoliosis Cobbs Angle on HIVD of L-spine patient and direction of disc herniation on horizontal plane. Conclusions : The direction of disc herniation has tendency of the opposite direction of lumbar scoliosis. When disc herniation, opposite side bending broad intervertebral foramen and reduce pressure.

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Clinical Study on Soft Cervical Disc Herniation (연성 경추 추간판 탈출증에 대한 임상적 고찰)

  • Lee, Ok-ja;Kim, Hong-hun;So, Ki-suk;Kim, Sung-nam;Cho, Nam-geun
    • Journal of Acupuncture Research
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    • v.21 no.4
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    • pp.85-92
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    • 2004
  • Objective : We studied the effect and possibility of the oriental medical conservative treatment on soft cervical disc herniation. Methods : From October.2001 to July. 2003, we observed 16 patients hospitalized because of soft cervical disc herniation diagnosed by Cervical M.R.I, symptoms and physical test. After treatment a standard of valuation was according to criteria of Robinson et al. Results : The clinical results were satisfactory as excellent in 4 case, good in 10 case, fair in 2 case. 87.5% of all were improved above good state. Conclusions : We considered that oriental medical conservative treatment has on useful effect on soft soft cervical disc herniation patient's treatment and recovery.

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Myelopathy Caused by Soft Cervical Disc Herniation : Surgical Results and Prognostic Factors

  • Kim, Young-Jin;Oh, Seong-Hoon;Yi, Hyeong-Joong;Kim, Young-Soo;Ko, Yong;Oh, Suck-Jun
    • Journal of Korean Neurosurgical Society
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    • v.42 no.6
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    • pp.441-445
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    • 2007
  • Objective : The purpose of this study was to investigate the surgical results and prognostic factors for patients with soft cervical disc herniation with myelopathy. Methods : During the last 7 years, 26 patients with cervical discogenic myelopathy were undertaken anterior discectomy and fusion. Clinical and radiographic features were reviewed to evaluate the surgical results and prognostic factors. The clinical outcome was judged using two grading systems (Herkowitz's scale and Nurick's grade). Results : Male were predominant (4:1), and C5-6 was the most frequently involved level. Gait disturbance, variable degree of spasticity, discomfort in chest and abdomen, hand numbness were the most obvious signs. Magnetic resonance(MR) images showed that central disc herniation was revealed in 16 cases, and accompanying cord signal changes in 4. Postoperatively, 23 patients showed favorable results (excellent, good and fair) according to Herkowitz's scale. Conclusion : Anterior cervical discectomy and fusion effectively reduced myelopathic symptoms due to soft cervical disc herniation. The authors assured that the shorter duration of clinical attention, the lesser the degree of myelopathy and better outcome in discogenic myelopathy.

Simultaneous Paraspinal and Midline Approach for Upper Lumbar Disc Herniation : Technique to Prevent Lamina Fracture

  • Kim, Seok-Won;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.38 no.2
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    • pp.111-115
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    • 2005
  • Objective : Upper lumbar disc herniation is rare disease, compared with lower. The lamina of this high level lumbar vertebra is narrower than that of low level, and this have taken surgeon into important consideration for surgical methods because partial removal of lamina for discectomy weakens the base of the articular process and may result in fracture. The authors an accurate preoperative diagnosis that enables the surgeon to operative approach for preserving the facet joint. Methods : Thirteen patients with upper lumbar disc herniation have underone surgical procedure by midline approach for removal of ruptured disc fragment and paraspinal approach for removal of residual disc materials simultaneously without instrumentation. All patients who underwent surgery were analyzed and long-term follow-up was conducted. Results : At a mean follow-up of 24months, there were complete resolution of presenting radiating leg pain in 85% of the patients, 7.5% were left with minimal residual discomfort, and 7.5% derived little or no benefit from surgery. The follow-up radiologic findings of all patients shows that lamina and facet joint have preserved safely and no instability. Conclusion : Simultaneously, paraspinal with midline approach provides highly satisfactory operating methods by simplifying exposure and greatly limiting the risk of complications. This provides the basis for a planned surgical approach in which destruction of the facet joint can be avoided.

Cervical Disc Herniation Producing Acute Brown-Sequard Syndrome

  • Kim, Jong-Tae;Bong, Ho-Jin;Chung, Dong-Sup;Park, Young-Sup
    • Journal of Korean Neurosurgical Society
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    • v.45 no.5
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    • pp.312-314
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    • 2009
  • Brown-Sequard syndrome may be the result of penetrating injury to the spine, but many other etiologies have been described. This syndrome is most commonly seen with spinal trauma and extramedullary spinal neoplasm. A herniated cervical disc has been rarely reported as a cause of this syndrome. We present a case of a 28-year-old male patient diagnosed as large C3-C4 disc herniation with spinal cord compression. He presented with left hemiparesis and diminished sensation to pain and temperature in the right side below the C4 dermatome. Microdiscectomy and anterior cervical fusion with carbon fiber cage containing a core of granulated coralline hydroxyapatite was performed. After the surgery, rapid improvement of the neurologic deficits was noticed. We present a case of cervical disc herniation producing acute Brown-Sequard syndrome with review of pertinent literature.

An Unappreciated Correlation : Surgical Treatment of Lumbosacral Disc Disease and Erectile Dysfunction

  • Kulaksizoglu, Haluk;Kaptan, Hulagu
    • Journal of Korean Neurosurgical Society
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    • v.47 no.4
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    • pp.282-286
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    • 2010
  • Objective : The aim of the present study was to assess the effect of lumbar disc herniation surgery for low back pain on the erectile functioning. Methods : Thirty-eight patients, with age ranging from 22 to 56 years, who had presented with pain due to herniated lumbar discs were included in the study. International Index of Erectile Function (IIEF) Short Form questionnaire was used to evaluate the erectile functioning. Patient visits on the 1st week,1st month and 3rd month postoperatively were analyzed. Pain scores were also noted together with side effects and the complications of the surgery. Results : Of the 38 patients, 18 patients had reported erectile dysfunction; 10 patients mild and 8 patients moderate erectile dysfunction. Twenty patients did not report erectile problems. The herniation levels mostly were L5-S1 in 12 (31.6%). Overall, erectile dysfunction rates have improved in 31.7% of those previously with erectile dysfunction in a 3 month period after the surgery. Best results were obtained in those patients with mild erectile dysfunction preoperatively. Conclusion : Mild erectile dysfunction together with radiculopathy tends to improve after lumbosacral disc surgery. Moderate and severe erectile dysfunction may be related to a more severe nerve injury or to vascular and/or psychiatric factors. An evaluation of erectile functioning should routinely be performed in patients with lumbosacral disc disease both for data accumulation and for medico legal causes since the documentation of the correlation between erectile dysfunction and lumbosacral disc disease is still lacking.

Clinical Study on a Case of Herniation(Herniated) of Nucleus Pulposus with Sacro-Occipital Technique (Sacro-Occipital Technique를 통한 추간판 탈출증 환자 치험 1례에 대한 임상적 고찰)

  • Park, Min-Jie;Sung, Su-Min;Hwang, Min-Seop;Yun, Chong-Hwa;Park, Min-Jung;Kim, Jung-Uk
    • The Journal of Korea CHUNA Manual Medicine
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    • v.6 no.1
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    • pp.189-196
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    • 2005
  • Objectives : This report intended to estimate effect taken by using Sacro-Occipital Technique on the patient with Herniation of Nucleus Pulposus(Central type). Method : From 11 May, 2005 to 30 June, 2005. The patient recived Sacro-Occipital Technique and Acupuncture therapy. Result : After being hospitalized for 50 days. the patient's Motor Grade, ODI, VAS, ROM were improved each from IV to IV+. from 26 to 20, from 10 to 2, and ROM with flexion/entension, rotation were improved each from 70'/0' to 90'/12', from 30'/40' to 45'/55'. Conclusion : We considered Sacro-Occipital Technique has an useful effect on Herniation of Nucleus Pulposus

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Case Report: Changes in Magnetic Resonance Imaging in Lumbar Disc Herniation Treated with Korean Medicine (한의원에서 도침치료로 영상의학적 소견을 호전시킨 요추 추간판 탈출증 증례 1례)

  • Park, Sang-kyu;Kim, Yoon-sik;Jo, Hyun-kyung;Yoo, Ho-ryong;Seol, In-chan
    • The Journal of Internal Korean Medicine
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    • v.39 no.5
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    • pp.863-869
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    • 2018
  • Objectives: The purpose of this case study was to report the effectiveness of Korean medicine treatment on severe lumbar disc herniation patient diagnosed by magnetic resonance imaging (MRI). Methods: The patient was treated with complex Korean medicine treatment, including acupuncture, pharmacopuncture, acupotomy, and Chu-na treatment. The treatment effect was evaluated by a Numerical Rating Scale (NRS), and MRI. Results: After the treatment, the NRS score of pain intensity was reduced from severe to mild degree. The volume of extruded disc in MRI images was clearly reduced. Conclusion: Korean medicine treatment might be effective in patients with lumbar disc herniation.

Effects of Therapeutic Exercise on Pain, Physical Function, and Magnetic Resonance Imaging Findings in a Patient with Multilevel Lumbar Disc Herniation: A Case Report

  • Kim, Ahram;Lee, Hoseong
    • Journal of International Academy of Physical Therapy Research
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    • v.10 no.1
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    • pp.1725-1733
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    • 2019
  • Background: In some clinical guidelines followed in clinical practice, nonsurgical treatments are recommended as the primary intervention for patients with lumbar disc herniation (LDH). However, the effect of a therapeutic exercise program based on stabilization of the lumbar spine for treatment of multilevel LDH has not been evaluated thoroughly. Objective: To investigate the effects of therapeutic exercise on pain, physical function, and magnetic resonance imaging (MRI) findings in a patient with multilevel LDH. Design: Case Report Methods: A 43-year-old female presented with low back pain, radicular pain and multilevel LDH (L3-L4, L4-L5, L5-S1). The therapeutic exercise program was conducted. in 40-min sessions, three times a week, for 12 weeks. Low back and radicular pain, lumbar disability, and physical function were measured before and after 6 and 12 weeks of the exercise program. MRI was performed before and after 12 weeks of the program. Results: After 6 and 12 weeks of the therapeutic exercise, low back and radicular pain and lumbar disability had decreased, and lumbar range of motion (ROM) was improved bilaterally, compared with the initial values. Also improved at 6 and 12 weeks were isometric lumbar strength and endurance, and the functional movement screen score. The size of disc herniations was decreased on MRI obtained after 12 weeks of therapeutic exercise than on the pre-exercise images. Conclusions: We observed that therapeutic exercise program improved spinal ROM, muscle strength, functional capacity, and size of disc herniation in LDH patient.