• The Korean Journal of Pain
• /
• v.34 no.3
• /
• pp.346-368
• /
• 2021

Background: Recalcitrant disc herniation may result in chronic lumbar radiculopathy or sciatica. Fluoroscopically directed epidural injections and other conservative modalities may provide inadequate improvement in some patients. In these cases, percutaneous neurolysis with targeted delivery of medications is often the next step in pain management. Methods: An evidence-based system of methodologic assessment, namely, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used. Multiple databases were searched from 1966 to January 2021. Principles of the best evidence synthesis were incorporated into qualitative evidence synthesis. The primary outcome measure was the proportion of patients with significant pain relief and functional improvement (≥ 50%). Duration of relief was categorized as short-term (< 6 months) and long-term (≥ 6 months). Results: This assessment identified one high-quality randomized controlled trial (RCT) and 5 moderate-quality non-randomized studies with an application of percutaneous neurolysis in disc herniation. Overall, the results were positive, with level II evidence. Conclusions: Based on the present systematic review, with one RCT and 5 non-randomized studies, the evidence level is II for percutaneous neurolysis in managing lumbar disc herniation.

• Journal of Acupuncture Research
• /
• v.28 no.3
• /
• pp.1-11
• /
• 2011

Objectives : This study is to compare effects on Intracutaneous Bee Venom pharmacopuncture and Intramuscular Bee Venom pharmacopuncture in Lumbar Disc Herniation. Methods : We investigated 34 cases of patients with lumbar disc herniation and devided into two groups. Group A were treated with intracutaneous bee venom pharmacupuncture and group B were treated with intramuscular bee venom pharmacopuncture. To evaluate the treatment effects of two groups, we used visual analog scale(VAS) and Aberdeen LBP scale. Results : In VAS and Aberdeen LBP scale, that of group A was further improved than that of group B, but there was no statistical significance. Conclusions : Intracutaneous bee venom pharmacupuncture and intramuscular bee venom pharmacopuncture were effective treatments for lumbar disc herniation, but there was no statistical significance.

• Journal of Korean Neurosurgical Society
• /
• v.59 no.2
• /
• pp.98-105
• /
• 2016

Objective : Lumbar disc herniation can induce sciatica by mechanical compression and/or chemical irritation. The aim of this study was to compare the effects of GCSB-5 (Shinbaro$^{(R)}$) and NSAIDs on pain-related behavior and on the expressions of microglia, astrocytes, CGRP, TRPV1, IL-6, and CX3CL1 in a rat model of lumbar disc herniation. Methods : 112 male Sprague-Dawley rats underwent implantation of nucleus pulposus to a dorsal root ganglion (DRG). Rats were divided into five groups as follows; a saline group (the vehicle control group) (n=27), a 10 mg/kg aceclofenac group (the aceclofenac group) (n=22), and 100, 300 or 600 mg/kg GCSB-5 groups (the GCSB-5 100, 300, or 600 groups) (n=21 for each group). Rats were tested for mechanical allodynia at 3 days after surgery and at 1 day, 3 days, 7 days, 14 days, 21 days, 28 days, 35 days, 42 days, 49 days, and 56 days after treatment commencement. Immunohistochemical staining of microglia (Iba1), astrocytes (GFAP), CGRP, and TRPV1, and PCR for IL-6 and CX3CL1 were performed on spinal dorsal horns and DRGs at 56 days after medication commencement. Results : After 56 days of GCSB-5 300 administration, mechanical withdrawal thresholds were significantly increased (p<0.05), and immunohistochemical expressions of Iba1, GFAP, CGRP, and TRPV1 were reduced than other groups, but this difference was not statistically significant. Conclusion : These results indicate GCSB-5 reduces mechanical allodynia and downregulates neuroglial activity and the expressions of CGRP and TRPV1 in the spinal segments of a rat model of lumbar disc herniation.

• Journal of Acupuncture Research
• /
• v.26 no.4
• /
• pp.71-77
• /
• 2009

Objectives : The aim of this study is to investigate radiological changes in cervical disc herniation after oriental medical treatment. Methods : 9 patient diagnosed as cervical disc herniation by MRI were treated with oriental medical treatment and underwent a follow up MRI study. Results & Conclusions : Comparison of initial MRI with follow-up MRI showed that 2 of the herniations dimensions decreased between 1% and 25%, 1 decreased between 26% and 50%, 5 decreased between 50% and 75%. The mean disc herniation dimensions decrease was 40% in 9 patients. Comparison of initial MRI with follow-up MRI showed that 4 of the herniations diameter decreased between 1% and 25%, 2 decreased between 26% and 50%, 3 decreased between 50% and 75%. The mean disc herniation diameter decrease was 36% in 9 patients.

• Journal of Acupuncture Research
• /
• v.26 no.4
• /
• pp.19-27
• /
• 2009

Objectives : To investigate the improvement rate of muscle weakness caused by lumbar disc herniation, 17 patients was treated with oriental medicine. Methods : To evaluate weakness of big toe extensor muscles caused by lumbar disc herniation, we measured the active range of motion(ROM) of big toe extension and muscle grading of big toe extensor muscles. We also measured numerical rating scale(NRS), oswestry disability index(ODI) and compared them with the active ROM of big toe extension. Results : 1. Progressive weakness of big toe extensor muscles was observed in 2 patients. Weakness of big toe extensor muscles were improved in 13 patients(76%). 2. Changes in manual muscle testing(MMT) scores corresponded with improvement rate of big toe extension. 3. Numerical rating scale(NRS) and oswestry disability index(ODI) improvement rate did not correspond with improvement rate of big toe extension. Conclusions : Muscle weakness caused by lumbar disc herniation can be treated with oriental medicine and progressive muscle weakness must be observed constantly.

• Journal of Acupuncture Research
• /
• v.30 no.5
• /
• pp.41-50
• /
• 2013

Objectives : This study was performed to compare the effects of Shinbaro pharmacopuncture therapy and bee venom pharmacopuncture therapy in lumbar disc herniation Methods : We compared treatment efficacy of 12 patients with Shinbaro pharmacopuncture therapy and 10 patients with bee venom pharmacopuncture therapy, all of whom were diagnosed with lumbar disc herniation using computed tomography(CT) or magnetic resonance imaging(MRI). We performed a retrospective comparison and analysis during the course of 21 days since admission. To evaluate the treatment efficacy, we recorded the temperatures of the opposite back, hip, and legs with visual analog scale(VAS, back and legs), pain rating scale(PRS), Oswestry disability index(ODI) and digital infrared thermal imaging(DITI) based on patients' medical records. Results : Both treatments were effective in reducing pain and improving functions for lumbar disc herniation patients in terms of VAS, PRS, ODI, DITI. Shinbaro pharmacopuncture group showed slightly better results than the bee venom pharmacopuncture group, but the difference was not significant. Conclusions : For the treatment of lumbar disc herniation, it is suggested that Shinbaro pharmacopuncture therapy is thought to be as effective as bee venom pharmacopuncture therapy without side effects, although further study would be necessary.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.27 no.1
• /
• pp.124-129
• /
• 2013

Embedding Therapy keep the stimulation to acupoint. Recently, Embedding Therapy is used for various disease and also studied in many different fields especially in China. In Korea, Embedding Therapy is studied and used for dermatology, face-lift, obesity, facial palsy most frequently. Chinese studies shows us Embedding Therapy could help musculoskeletal system disorder, lumbar herniated intervertebral disc, sprain, spinal canal stenosis. In Korea study concerning lumbar herniated intervertebral disc treatment used Embedding Therapy is few. This study's purpose is to ensure effect of Embedding Therapy at lumbar herniated intervertebral disc treatment. Four lumbar disc herniation patients had been treated with Embedding Therapy were described in this article. The patients(n=4) had been suffering from chronic lower back and leg pain that continued for more than 6 months. All patients had been diagnosed as lumbar disc herniation by MRI or CT, and treated with Embedding Therapy at least 2 times(7 days interval). 2 patients had been treated with concurrent treatment of acupuncture therapy, and the other 2 patients with concurrent treatment of acupuncture and herbal therapy. We observed 4 patients for more than 2 weeks, and their symptoms and quality of daily life had been improved. This suggests that lumbar disc herniation can be successfully recovered with Concurrent Embedding Therapy under conventional Korean Medical Treatment without side effects.

• Journal of Korean Neurosurgical Society
• /
• v.54 no.3
• /
• pp.183-188
• /
• 2013

Objective : The aim of this study is to assess outcomes during first one year for patients with severe motor weakness caused by lumbar disc herniation that underwent surgical or nonsurgical treatment. Methods : The 46 patients with motor weakness because of lumbar disc herniation who were treated at neurosurgical department and rehabilitation in our hospital from 2006 to 2010, retrospectively. Each group had 26 surgical treatments and 20 conservative treatments. We followed up 1, 3, 6 months and 12 month and monitored a Visual Analogue rating Scale (VAS) of back and leg pain, Oswestry Disability Index (ODI) and degree of motor weakness. We analyzed the differences between surgical and nonsurgical groups using Mann-Whitney U test and repeat measure ANOVA in each follow-up periods. Results : In the recovery of motor weakness, surgical treatment uncovered a rapid functional recovery in the early periods (p=0.003) and no difference between groups at the end of follow-up period was found (p>0.05). In VAS of back and leg, the interaction between time and group was not found (p>0.05) and there was no difference between groups (p>0.05). In ODI, the interaction between time and group was not found (p>0.05) and there was no difference between groups (p>0.05). Conclusion : Surgical treatment for motor weakness caused by herniated intervertebral disc resulted in a rapid recovery in the short-term period, especially 1 month. We think early and proper surgical treatment in a case of motor weakness from disc herniation could be a good way for providing a chance for rapid alleviation.

• Journal of Korean Neurosurgical Society
• /
• v.29 no.5
• /
• pp.623-627
• /
• 2000

Objective : Spontaneous lumbar epidural hematoma is a rare entity, although the precipitating factors such as anticoagulation therapy frequently precede it. The authors report four cases of surgically confirmed spontaneous epidural hematoma mimicking lumbar disc herniation. Methods : Between 1995 and 1998, four patients with spontaneous lumbar epidural hematoma were diagnosed. The clinical findings which are identical to that of acute disc herniation are included in this study. The operative findings and radiological characteristics are also included. Results : The magnetic resonance(MR) image findings demonstrated epidural lesions of intermediate to low signal intensity equivalent to those of normal discs on $T_1$-weighted images, and epidural lesions of high signal intensity higher than these normal discs on a $T_2$-weighted image. The image findings also showed rim enhanced pattern of the gadolinium-enhanced $T_1$-weighted MR images. All of the hematomas was associated with a small concomitant disc herniation or underlying annular tear. Conclusion : The authors speculate that spontaneous lumbar epidural hematoma results from tearing of the fragile penetrating vein caused by underlying disc or annulus disruption between Batson' plexus and vertebral body.

• Journal of Korean Neurosurgical Society
• /
• v.40 no.2
• /
• pp.79-83
• /
• 2006

Objective : The purpose of this study was to describe a surgical technique of axillary approach of percutaneous endoscopic interlaminar discectomy for L5-S1 disc herniation and its preliminary results. Methods : From July 2002 to September 2003, 101 patients with lumbar radiculopathy due to L5-S1 disc herniation, who were treated by percutaneous interlaminar endoscopic discectomy, were retrospectively reviewed. There were 57 males and 44 females with a mean age of 44.8 years [range, 18 to 62 years]. The surgery consisted of needle insertion into the epidural space via the interlaminar space, sequential dilatation, and endoscopic discectomy through the axillary area of the S1 root. Results : The mean follow-up period was 14.5 months and the average surgical time was 41 min. According to the modified Macnab criteria, 44 patients [43.6%] had excellent outcomes, 49 [48.5%] had good results and only 8 [78%] had fair or poor outcomes. Four patients had a revision microdiscectomy due to incomplete removal of disc fragment. There were no major complications related to this surgical approach. Conclusion : Axillary approach of percutaneous endoscopic interlaminar discectomy is safe and effective procedure for the treatment of L5-Sl disc herniation. It combines the advantages of MED and conventional percutaneous endoscopic discectomy.