• The Korean Journal of Pain
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• v.18 no.2
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• pp.187-191
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• 2005

Background: Discogenic leg pain is a major cause of health problems, often due to herniation of the intervertebral disc, and has traditionally been treated conservatively or with an open surgical discectomy. Conventional open surgery has many complications, such as nerve root injury, discitis and a relatively high mortality rate; failure of conservative treatments is also common. Recently, the $Dekompressor^{(R)}$ Percutaneous Lumbar Discectomy probe was developed. Herein, we present the early results for a percutaneous lumbar discectomy in herniated lumbar disc disease. Methods: Eleven patients, including 8 men and 3 women, with ages ranging from 22 to 78 years, were enrolled in this study. Those patients with a previous history of back surgery were not excluded from the study. All patients were postoperatively evaluated for their clinical outcomes, such as visual analogue scale (VAS) for pain after 1 and 3 months, reduction in analgesics, functional improvement and overall satisfaction. Results: The percutaneous lumbar discectomy was completed in 11 patients (17 levels), with average reductions in pre-VAS of 61.3 and 60.2% at 1 and 3 months, respectively. Also, 72.7% of patients reported functional improvement, with 81.1% expressing overall satisfaction. There were no procedural related complications. Conclusions: We concluded that a percutaneous lumbar discectomy is a safe and effective treatment modality for a herniated lumbar disc.

• Journal of the Korean Society of Radiology
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• v.85 no.1
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• pp.3-23
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• 2024

Intervertebral disc herniation is frequently encountered in radiological practice. Sequestered disc herniation occurs when the disc material undergoes degeneration and completely loses continuity with the parent nucleus pulposus. Sequestered discs can reside within and outside the spinal canal, exerting a mass effect on adjacent structures, compressing nerve pathways, and eliciting a range of clinical symptoms. In particular, sequestered discs within the dura cannot be identified without durotomy. Therefore, precise preoperative localization is crucial for surgical planning. On MRI, the signal intensity of the sequestered disc may vary due to independent degeneration processes. Additionally, most sequestered disc fragments show varying degrees of peripheral enhancement depending on the degree of angiogenesis and granulation around the isolated tissue. In this article, we review various imaging findings and the location of the sequestered disc to provide patients with an accurate diagnosis and appropriate treatment direction.

• Journal of Acupuncture Research
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• v.21 no.5
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• pp.79-99
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• 2004

Objective : This study was designed to find out the effect of scolopendrid aquacupuncture classified by the type of HIVD(Herniation of Inter-Vertebral Disc) in lumbar spine. Methods : The 50 patients who had a diagnosis of HIVD by lumbar-CT or lumbar-MRI and admitted to Gwangju oriental medical hospital in wonkwang university from June 2003 to March 2004 were observed. The symptom of inpatients is low back pain with or without sciatica. We treated 50 patients by scolopendrid aquacupuncture besides the general consevative treatment of oriental medicine. Results and Conclusion : The scolopendrid aquacupuncture treatment led to improvement in the pain and symptom of HIVD as determined by all efficacy measures. After scolopendrid aquacupuncture treatment, there was improvement in VAS, oswestry disability index, ROM and SLRT. The improvement index of scolopendrid aquacupuncture treatment classified by the type of HIVD showed that the effects of scolopendrid aquacupuncture had correlation with the type of HIVD. The more the herniation of intervertebral disc decreased, the more the effect of scolopendrid aquacupuncture increased. This results suggest that scolopendrid aquacupuncture is good method for treatment of HIVD but we have to consider the clinical correlation with the degree of herniation.

• The Korean Journal of Pain
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• v.12 no.2
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• pp.258-262
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• 1999

Sacral meningeal cyst is usually asymtomatic, but may be responsible for sciatic pain syndromes and other clinical symptoms. Sacral meningeal cyst might be suspected when definite explanation for the clinical symptom, such as herniation of the intervertebral disc or spinal stenosis is not found. Plain films and CT may suggest the presence of sacral meningeal cyst, but MR is the current imaging study of choice. Evaluation of the correlation between the symptom and the cyst is as important as detection of it. We have experienced a case of sacral meningeal cyst detected during caudal epidural block. The patient complained of low back pain radiating to thigh. Plain films and lumbar spine CT showed no remarkable finding except disc bulging. During caudal epidural needle insertion, there was leakage of clear CSF, and intrasacral cystic shadow was visualized by dye injection. MR confirmed sacral meningeal cyst.

• The Journal of Internal Korean Medicine
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• v.40 no.5
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• pp.894-900
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• 2019

Objective: The aim of this study was to evaluate the effects of traditional Korean medicine as a treatment for a diabetic patient diagnosed with herniated intervertebral lumbar discs. Methods: We treated the patient with herbal medicines, acupuncture, herbal acupuncture therapy, and physical therapy. We measured the state and progress of this case with the Numerical Rating Scale (NRS) and Oswestry Disability Index (ODI). We also checked serum glucose levels (FBS/PP2hrs) regularly. Results: After treatment, the NRS score was decreased, the ODI score was improved, and the blood glucose level was stabilized. The overall symptoms of the patient showed positive improvement.

• The Korean Journal of Pain
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• v.27 no.2
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• pp.168-173
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• 2014

Background: Recently, there have been several case reports and retrospective studies about the incidence of intradiscal (ID) injection during transforaminal epidural steroid injection (TFESI). Inadvertent ID injection is not a rare complication, and it carries the risk of developing diskitis, although there has been no report of diskitis after TFESI. We prospectively evaluated the incidence of inadvertent ID injection during lumbar TFESI and analyzed the contributing factors. Methods: Ten patients received 2-level TFESI, and the remaining 229 patients received 1-level TFESI. When successful TFESI was performed, 2 ml of contrast dye was injected under real-time fluoroscopy to check for any inadvertent ID spread. A musculoskeletal radiologist analyzed all magnetic resonance images (MRIs) of patients who demonstrated inadvertent ID injection. When reviewing MRIs, the intervertebral foramen level where ID injection occurred was carefully examined, and any anatomical structure which narrowing the foramen was identified. Results: Among the 249 TFESI, we identified 6 ID injections; thus, there was an incidence of 2.4%. Four patients had isthmic spondylolisthesis, and the level of spondylolisthesis coincided with the level of ID injection. We further examined the right or left foramen of the spondylolisthesis level and identified the upward migrated disc material that was narrowing the foramen. Conclusions: Inadvertent ID injection during TFESI is not infrequent, and pain physicians must pay close attention to the type and location of disc herniation.

• Korean Journal of Acupuncture
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• v.35 no.4
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• pp.239-246
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• 2018

Objective : This case study reports the therapeutic effect of Korean Medicine (KM) treatments including CS(care special pain) and BV(bee venom) pharmacopuncture on herniated intervertebral disc(HIVD) of lumbar spine(L-spine). Methods : Two patients diagnosed with HIVD of L-spine were treated with CS and BV pharmacopuncture on GV3 and EX-B2, acupuncture, cupping, and herbal medicine. The Numeric Rating Scale(NRS), the Oswestry low back pain Disablility Index(ODI) and the Roland Morris Disability Questionnaire(RMDQ) scores were evaluated before and after treatment for comparison. Results : Low back pain(LBP) and radiating pain was improved with a decrease in patients' NRS, ODI and RMDQ scores. Conclusion : These results suggest that KM treatments including combined CS and BV pharmacopuncture could be an effective treatment on patients with HIVD of L-Spine.

• Journal of Korean Medicine Rehabilitation
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• v.28 no.4
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• pp.43-50
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• 2018

Objectives Upper lumbar disc herniation (LDH) (L1/2, L2/3) has specific anatomical characteristics and different outcome after conventional treatment compared to lower LDH (L3/4, L4/5, L5/S1). The purpose of this study was to compare the clinical features and effects of korean medical treatment of upper LDH between lower LDH. Methods We retrospectively reviewed the clinical data collected from 121 patients who was had admitted at the Haeundae Jaseng Hospital of Korean Medicine from June 1st, 2014 to August 31th, 2018. The patients who had treated at L1/2, L2/3 level LDH were grouped and compared with those treated at the L3/4, L4/5, L5/S1 level. We reviewed the patient characteristics such as age, the positive rate of Straight Leg Raise Test (SLR test), the presence or absence of previous lumbar surgery. Numeric Rating Scale (NRS) and Oswestry Disability Index (ODI) were evaluated at adimission and discharge. Results Mean age was significantly higher at upper LDH group and positive rate of SLR test was higher at lower LDH group. There was no significant difference of gender and previous lumbar surgery between two groups. Each group had a significant improvement of NRS, ODI scores. But between two groups, there was no significant difference of NRS, ODI scores. Conclusions Upper LDH group was older than lower LDH group. SLR test was useful tool to exclude upper LDH. Korean medical treatment was significantly effective to both upper and lower LDH groups. Further well designed prospective comparative studies are needed.

• Journal of Korean Neurosurgical Society
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• v.51 no.4
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• pp.208-214
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• 2012

Objective : Discal cyst is rare and causes indistinguishable symptoms from lumbar disc herniation. The clinical manifestations and pathological features of discal cyst have not yet been completely known. Discal cyst has been treated with surgery or with direct intervention such as computed tomography (CT) guided aspiration and steroid injection. The purpose of this study is to evaluate the safety and efficacy of the percutaneous endoscopic surgery for lumbar discal cyst over at least 6 months follow-up. Methods: All 8 cases of discal cyst with radiculopathy were treated by percutaneous endoscopic surgery by transforaminal approach. The involved levels include L5-S1 in 1 patient, L3-4 in 2, and L4-5 in 5. The preoperative magnetic resonance imaging and 3-dimensional CT with discogram images in all cases showed a connection between the cyst and the involved intervertebral disc. Over a 6-months period, self-reported measures were assessed using an outcome questionaire that incorporated total back-related medical resource utilization and improvement of leg pain [visual analogue scale (VAS) and Macnab's criteria]. Results : All 8 patients underwent endoscopic excision of the cyst with additional partial discectomy. Seven patients obtained immediate relief of symptoms after removal of the cyst by endoscopic approach. There were no recurrent lesions during follow-up period. The mean preoperative VAS for leg pain was $8.25{\pm}0.5$. At the last examination followed longer than 6 month, the mean VAS for leg pain was $2.25{\pm}2.21$. According to MacNab' criteria, 4 patients (50%) had excellent results, 3 patients (37.5%) had good results; thus, satisfactory results were achieved in 7 patients (87.5%). However, one case had unsatisfactory result with persistent leg pain and another paresthesia. Conclusion : The radicular symptoms were remarkably improved in most patients immediately after percutaneous endoscopic cystectomy by transforaminal approach.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.7 no.2
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• pp.83-90
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• 2012

Objectives : The perpose of this study was to observe the correlation between lumbar lordotic angle and radiological result. Methods : We randomly selected among the 150 patients with lumbar X-ray and MRI films who have visited Jaseng Hospital of Oriental Medicine with low back pain. Radiographic lumbar lordotic angle and lumbar HIVD were collected and stastically analyzed. Results : In this study, if the finding of a X-ray showed straightening of lumbar lordotic curve, based on MRI finding, the number of HIVD increased. Conclusions : There was a significant correlation between lumbar hypolordosis and HIVD, hypolordosis complained mare HIDVs.