• Title/Summary/Keyword: Herniation of lumbar intervertebral disc

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The Changes on MRI of the HIVD Patients after Oriental Medicine Treatment (MRI로 관찰한 요추 추간판탈출증 환자의 호전례 보고)

  • Lim, Myung-Jang;Song, Joo-Hyun;Moon, Ja-Young;Kang, In;Lee, Hyo-Eun;Cho, Jae-Hee;Wang, Wu-Hao;Jang, Hyoung-Seok
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.2 no.2
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    • pp.89-104
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    • 2007
  • Objectives : The purpose of this study is to report the image changes of four cases of Lumbar intervertebral disc Herniation after Oriental medicine Treatment Methods : We examined 4 patients with Lumbar intervertebral disc Herniation (HIVD of L-spine) who showed changes on MRI images before/after the treatment among HIVD of L-spine patients who visited Jaseng Hospital of Oriental Medicine from Jan. 2006 to Apr. 2007. Results & Conclusions : In this study, the first MRI examination of HIVD of L-spine patients was performed at the first visit and re-examination of MRI was done after the treatment. We assessed clinical symptoms by using Numerical rating scales(NRS). In each case, the size of the disc herniation was considerably reduced in MRI image. NRS was also reduced significantly.

A Rare Case of Lumbar Traumatic Intradiscal Hematoma Followed by Repeatative Occupation Related Minor Trauma

  • Kwon, Woo-Keun;Oh, Jong-Keon;Kwon, Taek-Hyun;Park, Youn-Kwan;Moon, Hong Joo;Kim, Joo-Han
    • Journal of Trauma and Injury
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    • v.31 no.1
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    • pp.38-42
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    • 2018
  • A case of surgically treated intervertebral disc extrusion with intraoperatively confirmed intradiscal hematoma in a 30-year-old physical trainer is presented. Preoperative magnetic resonance imaging revealed downward migrating disc herniation, without definite suggestive findings of intradiscal hematoma. Intervertebral disc herniation with concomitant intradiscal hematoma is extremely rare, but could occur in patients who have excessive axial stress to the spine occupationally. In our case, the patient was an occupational physical trainer who had repetitive minor trauma to the lumbar spine. Although the patient did not have any clear history of major trauma to the spine, the intraoperative findings revealed intradiscal hematoma, which is very rare. The presence of intradiscal hematoma is to be suspected even when preoperative imaging studies shows indefinite findings of hematoma, considering the change in signal intensity of hematoma by time.

Case Report of 6 Patients Not Improved after Conservative Treatment of Herniated Lumbar Intervertebral Disc (요추간판탈출증으로 보존적 치료후 호전되지 않는 환자 6 례 보고)

  • Lee, Sam-Ro;Kim, Hyun-Jung;Byun, Jae-Young;Ahn, Soo-Gi;Lee, Jong-Deok
    • Journal of Acupuncture Research
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    • v.17 no.3
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    • pp.265-276
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    • 2000
  • Objectives : The purpose of this study is to observe the clinical characteristics of 6 patients who were not improved after admitted conservative treatment in this 311 patients. Methods : We retrospectivety reviewed 311 patients of Herniated Lumbar Intervertebral Disc which undenvent admitted conservative treatment from November 1997 to June 2000. 311 patients were diagnosed by computed tomography or magnetic resonance imaging in addition to physical examination. Other complications were not detected in 311 patients with Hemiated Lumbar Intervertebral Disc. In case that the scoliosis appeared to caused by severe pain, we included this scoliosis patient with the object of survey. Results : 1. In 6 patients who were not improved, 4 patients were large herniation and 2 patients were medium herniation. 2. In all of 6 patients, the angle of straight leg raising test was low and was not imporved unril discharge. 3. X-ray findings showed straightening in all of 6 patients, disc space narrowing in 3 of 6 patients. 4. X-ray findings showed scoliosis in 3 of 4 patients who were severe pain. 5. The onset was relarively long from 30 days to 7 years. 6. The age was relatively young from 10's to 30's. 7. The adimission date was ralatively long from 32 days to 105 days. Conclusions : In 6 patients, there were observed much volume of disc herniation, low angle of straight leg raising test, young people in an age group, straightening of x-ray finding.

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The role of percutaneous neurolysis in lumbar disc herniation: systematic review and meta-analysis

  • Manchikanti, Laxmaiah;Knezevic, Emilija;Knezevic, Nebojsa Nick;Sanapati, Mahendra R.;Kaye, Alan D.;Thota, Srinivasa;Hirsch, Joshua A.
    • The Korean Journal of Pain
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    • v.34 no.3
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    • pp.346-368
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    • 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.

The Effect of Korean Medical Combination Treatment on 72 Cases of Herniated Intervertebral Lumbar Disc Patients: An Observational Study (요추 추간판탈출증 입원환자 72례에 대한 한의학적 복합치료 효과의 관찰 연구)

  • Kim, Sang Min;Lee, Sun Ho;Shin, You Bin;Choi, Ji Hoon;Koo, Ja Sung;Yoo, Hyung Jin;Lee, Dong Hyun
    • Journal of Acupuncture Research
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    • v.32 no.2
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    • pp.23-33
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    • 2015
  • Objectives : This study was designed to assess the general distribution and clinical effectiveness of Korean medical treatment on lumbar disc herniation. Methods : This is an observational study. 72 patients admitted to Daejeon Jaseng Hospital of Korean Medicine with a diagnosis of herniated intervertebral disc(HIVD) by lumbar-CT of lumbar-MRI were observed from July, 2014 to April, 2015. They were analyzed according to sex, age, the period of disease, causal factors, symptoms on admission, admission day, disc herniation type and treatment efficacy. All patients received a combination of treatments during hospitalization, including acupuncture, Chuna, herbal medicines and physical therapy. A zero to ten numerating rating scale(NRS) assessing pain, Oswestry disability index(ODI) and EuroQol-5 dimension(EQ-5D) was used before and after treatments. Results : Average admission duration was $28.00{\pm}12.85$ days in lumbar disc patients. For lumbar patients, lower back pain NRS decreased from $5.89{\pm}2.00$ to $3.42{\pm}1.87$(p<0.001) and radiating pain from $5.96{\pm}2.12$ to $3.38{\pm}1.83$(p<0.001). ODI decreased from $46.69{\pm}19.25$ to $35.69{\pm}16.67$(p<0.001), and EQ-5D index increased from $0.63{\pm}0.26$ to $0.71{\pm}0.20$(p<0.05) after treatment in lumbar disc patients. Conclusions : Korean medical combination treatment might be effective in reducing pain and improving quality of life for patients with lumbar disc herniation. This study further confirmed the efficacy of Korean medical treatment on HIVD.

A Case Report inculding Pharmacopuncture Therapy at Lumbar Facet joints for a Patient with Lumbar Disc Herniation with Lower Back Pain and Leg Radiating Pain that Worsen during Pregnancy (요추 후관절 약침 치료를 병행한 임신 중 요통 및 하지방사통이 악화된 요추 추간판 탈출증 환자 증례 보고)

  • Kim, Su-Jin;Kim, Sun-A;Kim, Min-Kyung;Lee, Si-Won;Kyung, Da-Hyun;Bae, Ji-Eun;Kwon, Yong-Su;Huh, Hyo-Seung
    • The Journal of Korean Obstetrics and Gynecology
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    • v.34 no.1
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    • pp.93-103
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    • 2021
  • Objectives: The purpose of this study was to report a case of a pregnant woman diagnosed with lumbar disc herniation that improved in lumbar pain and radiating leg pain through combined korean medical treatment including pharmacopuncture at lumbar facet joints in situations surgical and pharmacological treatment is limited due to pregnancy. Methods: A combination of treatment including pharmacopuncture at lumbar facet joints, acupuncture, cupping, and herbal medicine was provided for 1 month to a woman at 21 weeks pregnant who was diagnosed with lumbar disc herniation. Her progress was assessed with Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), EuroQol-5Dimension (EQ-5D) before and after treatment. Results: After the treatment, the pain decreased and the quality of life was enhanced. No adverse events were observed. Conclusions: The findings indicate that combined korean medical treatment including pharmacopuncture at lumbar facet joints can be safe and effective alternative to treat lumbar disc herniation during pregnancy.

Intradural Migration of a Sequestrated Lumbar Disc Fragment Masquerading as a Spinal Intradural Tumor

  • Kim, Hyeong-Suk;Eun, Jong-Pil;Park, Jung-Soo
    • Journal of Korean Neurosurgical Society
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    • v.52 no.2
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    • pp.156-158
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    • 2012
  • Intervertebral intradural lumbar disc herniation (ILDH) is a quite rare pathology, and isolated intradural lumbar disc herniation is even more rare. Magnetic resonance imaging (MRI) may not be able to reveal ILDHs, especially if MRI findings show an intact lumbar disc annulus and posterior longitudinal ligament. Here, we present an exceedingly rare case of an isolated IDLH that we initially misidentified as a spinal intradural tumor, in a 54-year-old man hospitalized with a 2-month history of back pain and right sciatica. Neurologic examination revealed a positive straight leg raise test on the right side, but he presented no other sensory, motor, or sphincter disturbances. A gadolinium-enhanced MRI revealed what we believed to be an intradural extramedullary tumor compressing the cauda equina leftward in the thecal sac, at the L2 vertebral level. The patient underwent total L2 laminectomy, and we extirpated the intradural mass under microscopic guidance. Histologic examination of the mass revealed a degenerated nucleus pulposus.

Clinical Reports on Correlation between the Different Herniated Type and Oriental Medical Treatment (요추(腰椎) 추간판(椎間板)의 탈출형태(脫出形態)와 한방치료(韓方治療)의 상관성(相關性)에 관한 임상보고(臨床報告))

  • Jang, Suk-Geun;Hwang, Kyu-Jung;Lee, Hyun;Lee, Byung-Ryul
    • Journal of Acupuncture Research
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    • v.18 no.4
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    • pp.68-81
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    • 2001
  • Herniated lumbar intervertebral disc(H.I.V.D) is the most common reason causing low back pain and leg radiating pain. Objective : The purpose of this report is to observe the effects of oriental medical conservative treatment in the different herniated type. Methods : We investigated 30 patients suffering from low back pain with sciatica which were admitted to Taejon Cheonan O. M. hospital from Nov 1, 2000 to Apr 30, 2001. 30 patients had a diagnosis of herniated lumbar interver tebral disc by Lumbar-C.T and Lumbar-M.R.I. we treated 30 patients by oriental medical conservative treatment (Ex: acupuncture, herb-med, physical theraphy, bed-rest, etc.) Results : 1. The mean hospitalization of patients was 21.1 days. that in the bulging type was l4days, protruded type 21days, mixed type 27days, extruded type 30days. that shows the less herniation of lumbar intervertebral disc, the mean hospitalization was more short. 2. In the distribution of the clinical symptoms admitted at that time, low back pain, leg radiating pain were showed in the all types(29patients, 96.6%). and sensory disorder, muscle powerlessness were showed least in the bulg ing type(0%, 37.5%), but that were showed most in the extruded type(50%,75%). 3. In the result of treatment due to clinical syptoms, bulging type was more execellent than any other other types. 4. The less herniation of lumbar intervertebral disc, angle of straight leg raising test was higher. In the result of treatment due to angle of straight leg raising test, bulging type was more execellent than any other other types. 5. In the distribution of physical. test, positive case in the Peyton sign, Ankle Dorsiflexion were showed least in the bulging type(25%, 12.5%), but that were showed most in the extruded type(100%, 75%). 6. In the result of treatment due to physical.test, bulging type was more exec ellent than any other other types. 7. The efficacy of total treatment was 90%(when we set a standard things more than fair), that in the bulging type was 100%, protruded 92%, mixedtype 80%, extruded type 75%. Bulging type had a more remakable effectsthan any other types. Conclusions : The less herniation of lumbar intervertebral disc, clinical syptoms were slighter, physical. test were better, and efficacy of oriental medical conservative treatme nt was remakable high.

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Correlation between Bone Mineral Density(BMD) and Degenerative Lumbar Disease in Postmenopausal Patients with Low Back Pain (폐경 후 요통환자에서 골밀도와 퇴행성 요추 병변과의 관계)

  • Park, Young-Eun;Kim, Chul-Soo;Kim, Kyu-Tae;Lee, Je-Kyun;Ahn, Gun-Sang;You, Hye-Kyung
    • The Journal of Korean Obstetrics and Gynecology
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    • v.19 no.3
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    • pp.203-213
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    • 2006
  • Purpose : This study was carried out to evaluate correlation between Bone Mineral Density(BMD) and degenerative lumbar disease in postmenopausal low back pain patients. Methods : 69 postmenopausal patients with low back pain were examined. Magnetic resonance imaging was performed to evaluate degenerative lumbar disease and bone mineral density of lumbar spine was measured by Dual energy X-ray absorptiometry. Data were analyzed by Pearson's Linear Correlation Coefficient. Results : In postmenopausal patients with low back pain, BMD(T-score, Z-score) had negative correlation with the grade of intervertebral disc herniation and positive correlation with weight. Other lumbar diseases including Spinal stenosis, Spondylolisthesis and Facet joint arthrosis didn't have significant correlation with BMD. Conclusion : In postmenopausal patients with low back pain, BMD(T-score, Z-score) had inverse relationship with the grade of intervertebral disc herniation.

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Intensive Korean Medicine Treatments for Low Back Pain and Decreased Living Function due to Herniation Intervertebral Discs in the Lumbar Spine: A Case Study (요추 추간판 탈출증으로 인한 요통 및 생활기능저하에 대한 한방 집중치료 치험 1례)

  • Choi, Ki-won;Kim, Tae-ju;Park, Han-bin;Yoo, Dong-hui;Kim, Ho;Lee, Sang-gun;Jo, Hyun-woo;Choi, Jae-yong
    • The Journal of Internal Korean Medicine
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    • v.41 no.2
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    • pp.283-292
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    • 2020
  • Background: This case study suggests the potential use of Korean medicine treatments as a conservative management for low back pain and decreased living function due to herniation of intervertebral discs in the lumbar spine. Case Summary: The patient suffered low back pain and decreased living function due to herniation of intervertebral discs of the lumbar spine. Korean medicine treatments, including herbal medicine, acupuncture performed on BL23, BL40, SP6, and GB39, and pharmacupuncture containing Sinbaro, were applied for eight days. The numeric rating scale (NRS) results for low back pain decreased from 6 to 2 and the Oswestry Disability Index (ODI) low back pain scores decreased from 75.56 to 31.11. Walking time also increased from less than one minute to 20 minutes, with an increase in range of motion (ROM) from "Uncheckable" to about normal motion range. Conclusion: Korean medicine treatment can be considered to be an effective conservative management option for pain and decreased living function in patients with herniation of intervertebral discs in the lumbar spine.