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

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Effects of Nonsurgical Spinal Decompression Treatment on the Level of Pain and Quality of Life in Patients with Cervical or Lumbar Disc Herniation: A Retrospective Observational Study

  • Kim, Beom Seok;Lee, Ye Ji;Kim, Hyo Bin;Sung, Ki Jung;Jeon, Ju Hyun;Kim, Eun Seok;Kim, Young Il
    • Journal of Acupuncture Research
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    • v.37 no.4
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    • pp.259-269
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    • 2020
  • Background: This study aims to statistically analyze and compare the curative effect and satisfaction level between typical traditional Korean medicine treatment and nonsurgical spinal decompression treatment. Methods: Of the patients who were diagnosed with the cervical or lumbar herniated intervertebral disc at the Department of Acupuncture and Moxibustion Medicine at the Daejeon Korean Medicine Hospital from April 14th to August 25th, 2019, this study retrospectively analyzed the medical records of 31 patients who underwent nonsurgical spinal decompression treatment and traditional Korean medicine (assigned to Group A) and another 31 patients who received typical traditional Korean medicine alone (assigned to Group B). The clinical data were analyzed using IBM SPSS Version 23.0. Results: No statistically significant differences appeared in terms of sociodemographic, condition, and therapeutic characteristics, except whether the patient received Western medicine treatment, before or after a treatment with traditional Korean medicine. Group A exhibited higher variations in numeric rating scale, EuroQol- 5 dimension and EuroQol visual analogue scale scores compared to Group B as determined by independent sample t test and analysis of covariance. In addition, the satisfaction score of Group A was higher than that of Group B The result of cross analysis revealed that desire for continued treatment in Group A was higher than that of Group B. Conclusion: This retrospective observational study showed that the patients with nonsurgical spinal decompression treatment reported a greater reduction in pain, improved quality of life and satisfaction than patients receiving typical traditional Korean medicine.

Comparative Study on the Clinical Trial of Acupotomy Treatment for Lumbar Disk Herniation

  • Beom Seok Kim;Ju Hyun Jeon;Tae Yong Park;Hong Kyoung Kim;Young Il Kim
    • Journal of Acupuncture Research
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    • v.40 no.3
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    • pp.252-264
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    • 2023
  • Background: The primary aim of this study is to statistically analyze and compare the difference in treatment outcomes based on the frequency and duration of acupotomy treatment for lumbar disk herniation. Methods: The evaluation of efficacy and safety involved using visual analog scale (VAS), numeric rating scale (NRS), Roland Morris disability questionnaire (RMDQ), EuroQol 5-dimention (EQ-5D), and similar parameters. This was achieved through the establishment of a comparable cohort using propensity score matching. Group A comprised 46 patients who underwent 4 sessions of acupotomy treatment for 2 weeks, while Group B consisted of 15 patients who received 6 acupotomy sessions for 3 weeks. Results: For Group A, the average amount of change in VAS values at weeks 4 and 6 was significantly decreased. However, the average amount of change in RMDQ values was not significant. Notably, the average amount of change of EQ-5D values at week 6 increased significantly. As for Group B, the average amount of change of NRS values in weeks 2 and 3 was significantly decreased. Conversely, the average amount of change in RMDQ and EQ-5D values was not significant. In comparing the 2 groups at the final follow-up, the average amount of change in all evaluation values was not significant. Further, no significant interaction effect was observed in the changes over time in all evaluation values between the 2 groups. Conclusion: This study establishes that there was no statistically significant difference in pain reduction, functional impairment, and quality of life improvement between 2 group.

Correlation between the Head Forward Posture and the Site of Herniation of Single Level Cervical Intervertebral Disc (두부 전방 정도와 경추 추간판 탈출증 발생 부위의 상관성 분석)

  • Kim, Shin-Woong;Kim, Se-Jun;Son, Seol-Ki;Dong, Sang-Oak;Lee, Jae-Chul;Shin, Dong-Jae
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.8 no.2
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    • pp.31-38
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    • 2013
  • Objectives : The present study examines the domestic trend of Chuna treatments on lumbar spinal disorder in Korea. Methods : We investigated the studies on Chuna treatments for lumbar spinal disorder via searching 10 Korean web databases. As a result, 63 research papers were found to be analyzed according to their published year, the titles of journals, the types of study, the techniques of Chuna, the instruments for assessment, the Chuna technique and the number of the treatment trials by the cases of lumbar spinal disorder and ethical approvals. Results : The number of the research papers published tends to increase every year. The studies on Chuna treatments were mainly published in The Journal of Korea CHUNA Manual Medicine for Spine & Nerves. The most frequently adopted technique of Chuna in the examined studies was Cox flexion & distraction technique. Visual analogue scale(VAS), oswestry disability questionnaire(ODI) were used as primary means of assessments. The ethical problems of the examined studies needed to be improved. Conclusion : Reviewing the domestic trend of studies on Chuna treatments for lumbar spinal disorder and examining the strong and weak points of those treatments are essential for the future studies. It is anticipated that this review benefits the future in-depth study on the treatments for Chuna in Korean medicine.

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Correlations of Cross-sectional Areas of Psoas and Paraspinal Muscles in Patients with Lumbar Disc Herniation According to the Age Groups (연령대별 요추 추간판탈출증 환자의 요근과 척추주위근 단면적에 대한 분석)

  • Kong, Deok-Hyun;Bae, Kwang-Ho;Go, Ho-Yeon;Kang, Myung-Jin;Kim, Jun-Su;Yang, Kee-Young;Lee, Jae-Hoon;Eun, Young-Jun
    • Journal of Korean Medicine Rehabilitation
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    • v.20 no.4
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    • pp.159-169
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    • 2010
  • Objectives : This study was designed to evaluate the correlation of the cross-sectional areas(CSA) of paraspinalis(iliocostalis lumborum, multifidus, longissimus thoracis parts lumborum) and psoas muscle and sex, age, change of the VAS(visual analogue scale) and past history of chronic low back pain in patients suffering from HIVD(herniation of intervertebral disc). Methods : Medical records of 140 subjects with HIVD were retrospectively reviewed. The MRI(magnetic resonance imaging) findings on the patients were scanned and analyzed by PiView program to find the paraspinal and psoas muscle CSA and were evaluated by the correlation of sex, age, change of the VAS, and past history of chronic low back pain. Results : There was significant difference between groups in male and female, young-adults age and middle age, middle age and old age, young-adults age and old age. But the correlation of the paraspinal and psoas muscle CSA and past history of chronic low back pain were partially significant. On the other hand, the correlation of the paraspinal and psoas muscle CSA and change of the VAS were not significant. Conclusions : These results suggest that the cross-sectional areas(CSA) of paraspinalis and psoas muscle have relevance to sex and age.

Changes in Disc Height as a Prognostic Factor in Patients Undergoing Microscopic Discectomy

  • Myeonggeon Kweon;Koang-Hum Bak;Hyeong-Joong Yi;Kyu-Sun Choi;Myung-Hoon Han;Min-Kyun Na;Hyoung-Joon Chun
    • Journal of Korean Neurosurgical Society
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    • v.67 no.2
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    • pp.209-216
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    • 2024
  • Objective : Some patients with disc herniation who underwent discectomy complain of back pain after surgery and are unsatisfied with the surgical results. This study aimed to evaluate the relationship between preoperative disc height (DH), postoperative DH, and pain score 12 months after surgery in patients who underwent microdiscectomy for herniated lumbar disc. Methods : This study enrolled patients who underwent microdiscectomy at a medical center between January 2012 and December 2020. Patients with X-ray or computed tomography and pain score assessment (visual analog scale score) prior to surgery, immediately post-op, and at 1, 6, and 12 months after surgery were included. The DH index was defined as DH/overlying vertebral width. The DH ratio was defined as the postoperative DH/preoperative DH. Simple linear regression and multivariate linear regression analyses were applied to assess the correlation between DHs and leg pain scores 12 months after surgery. Results : A total of 118 patients who underwent microdiscectomy were included. DH decreased up to 12 months after surgery. The DH ratio at 1, 6, and 12 months after discectomy showed a significant positive correlation with the pain scores at 12 months after discectomy (1 month : p=0.045, B=0.52; 6 months : p=0.008, B=0.78; 12 months : p=0.005, B=0.69). Multivariate linear regression analysis revealed that the level of surgery, sex, age, and body mass index had no significant relationship with back pain scores after 12 months. Conclusion : In patients who underwent microdiscectomy, the DH ratios at 1, 6, and 12 months after surgery were prognostic factors for back pain scores at 12 months after surgery. Aggressive discectomy is recommended for lower postoperative DH ratios and Visual analog scale scores, leading to improved patient satisfaction.

Statistical Analysis of Patients Attending the Department of Acupuncture and Moxibustion Medicine at DaeJeon Korean Medicine Hospital: from March 2015 to February 2020

  • Sung, Ki Jung;Lee, Ye Ji;Kim, Hyo Bin;Kim, Beom Seok;Jeon, Ju Hyun;Kim, Eun Seok;Kim, Young Il
    • Journal of Acupuncture Research
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    • v.38 no.2
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    • pp.146-158
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    • 2021
  • Background: This study was designed to statistically analyze the year, gender, age, insurance type, and condition/disease of patients who were admitted to the Department of Acupuncture and Moxibustion Medicine at DaeJeon Korean Medicine Hospital over a 5-year period (2015-2020). Methods: Patients who visited the Department of Acupuncture and Moxibustion Medicine at DaeJeon Korean Medicine Hospital were classified according to year, gender, age, insurance type, and condition/disease. The statistical analysis was performed using IBM SPSS 23.0. Results: There is an increasing number of patients attending the Department of Acupuncture and Moxibustion Medicine year-on-year over the 5-year period, with a higher frequency of females than males each year. The largest age groups represented in these patients were those aged in their 50s, followed by those aged in their 40s, and 60s. Furthermore, the number of patients using health insurance was greater than those using automobile insurance each year. Of the 5,061 patients, the most common group was the patients (n = 991) who reported sprain and strain of cervical spine, followed by lumbar spine, lumbar herniation of the intervertebral disc, and facial paralysis. Conclusion: The number of patients seeking traditional Korean medicine treatment continues to increase, particularly in the 40s to 60s age group, with a larger proportion using health insurance and sprain or strain of the cervical spine. The results of this study may be used as a local (Daejeon) reference to develop Korean medicine policies, such as setting up medical benefits for patients using Korean medicine hospitals.

A Clinical Case Report Treated by Megadose Pharmacoacupuncture and Korean Medical treatments for the three Patients with HIVD of L-Spine and one Patient with HIVD of C-Spine (대용량약침 및 한방치료를 적용한 요추 추간판 탈출증 환자 치험 3례, 경추 추간판 탈출증 환자 치험 1례)

  • Ju, Yeong-Guk;Kim, Tae-Ho;Lee, So-Jin;Ahn, Sang-Min;Sin, Su-Ji;Kwon, Ok-Jun;Kim, Joo-Won;Yoon, Moon-Sik
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.10 no.2
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    • pp.61-71
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    • 2015
  • Objective : To report cases of HIVD of C&L-Spine successfully treated with conservative Korean Traditional Medicine treatment with Megadose Pharmacoacupuncture. Methods : Four patients diagnosed with HIVD of C&L-Spine were treated with Megadose Pharmacopuncture, acupuncture and herbal medicine. Numeric Rating Scale(NRS), Neck Disablility Index(NDI) and Oswestry low back pain Disablility Index(ODI) scores were collected before and after treatment for comparison. Results : There was a significant decrease in NRS, NDI and ODI scores. The mean NRS score decresed from 9 to 2.25, NDI from 45 to 14 and ODI from 46.66 to 11.33. Conclusion : The result suggests Megadose Pharmacoacupuncture can be an effective treatment on patients with HIVD of C&L-Spine.

Study on the Movement of New Qi-gong "WuQinXi" Exercise for Lumbar Spinal Disease : Based on 10 Mode, 15 Mode, 18 Mode (요추 질환에 대한 신기공 오금희의 동작연구 -10식, 15식, 18식을 중심으로-)

  • You, Kyung Gon;Yeom, Seung Ryong;Lee, Sang Yeong;Kwon, Young Dal;Jeong, Hyun Woo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.27 no.3
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    • pp.280-288
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    • 2013
  • Hua-Tuo(145-208) created five "WuQinXi" exercise by imitating the movements of a tiger, a deer, a bear, a monkey and a bird. The "WuQinXi" exercise, one of the medical Qi-gongs, is an exercise maximizing human's self healing power and has been effective significantly at several modern researches. There are many exercise therapies in western medcine, such as Willamss flexion exercise, Mckenzie's extension exercise, vertebral stabilization exercise and so on. However, there isn't a special exercise therapy which can be applied for medical practice in oriental medicine. So We selected some motions from "WuQinXi" exercise, which are suitable for lumbar spinal disease, and analyzed them. After that, We assorted them by kinds of lumbar spinal disease. First, We selected 22 motions which are related with lumbar movements from 3 type "WuQinXi" exercises ; 10 mode, 15 mode, 18 mode. And then, We classified them according to lumbar movements as flexion, extention, lateral bending and rotation, and also functions as stabilization and rubbing. Next, with these classifications, We assorted those motions by kinds of lumbar spinal disease as HIVD(herniation of intervertebral disc), spinal stenosis, spondylolysis and spondylolisthesis, facet joint syndrome, compression fracture and spondylosis. We expect that trying "WuQinXi" exercise at clinic in this way, the particular exercise therapy of oriental medicine, "WuQinXi" exercise will become more popular. And Oriental medical doctors will be able to teach patients "WuQinXi" exercise's motions easily at clinic, depending on kinds of lumbar spinal disease each patient suffers from. We plan to study more about 20 mode, 30 mode, 40 mode and the effect of "WuQinXi" exercise by comparing patients who do the "WuQinXi" exercise with the patients who do the western medical exercise therapy.

Posterior Interspinous Fusion Device for One-Level Fusion in Degenerative Lumbar Spine Disease : Comparison with Pedicle Screw Fixation - Preliminary Report of at Least One Year Follow Up

  • Kim, Ho Jung;Bak, Koang Hum;Chun, Hyoung Joon;Oh, Suck Jun;Kang, Tae Hoon;Yang, Moon Sool
    • Journal of Korean Neurosurgical Society
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    • v.52 no.4
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    • pp.359-364
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    • 2012
  • Objective : Transpedicular screw fixation has some disadvantages such as postoperative back pain through wide muscle dissection, long operative time, and cephalad adjacent segmental degeneration (ASD). The purposes of this study are investigation and comparison of radiological and clinical results between interspinous fusion device (IFD) and pedicle screw. Methods : From Jan. 2008 to Aug. 2009, 40 patients underwent spinal fusion with IFD combined with posterior lumbar interbody fusion (PLIF). In same study period, 36 patients underwent spinal fusion with pedicle screw fixation as control group. Dynamic lateral radiographs, visual analogue scale (VAS), and Korean version of the Oswestry disability index (K-ODI) scores were evaluated in both groups. Results : The lumbar spine diseases in the IFD group were as followings; spinal stenosis in 26, degenerative spondylolisthesis in 12, and intervertebral disc herniation in 2. The mean follow up period was 14.24 months (range; 12 to 22 months) in the IFD group and 18.3 months (range; 12 to 28 months) in pedicle screw group. The mean VAS scores was preoperatively $7.16{\pm}2.1$ and $8.03{\pm}2.3$ in the IFD and pedicle screw groups, respectively, and improved postoperatively to $1.3{\pm}2.9$ and $1.2{\pm}3.2$ in 1-year follow ups (p<0.05). The K-ODI was decreased significantly in an equal amount in both groups one year postoperatively (p<0.05). The statistics revealed a higher incidence of ASD in pedicle screw group than the IFD group (p=0.029) Conclusion : Posterior IFD has several advantages over the pedicle screw fixation in terms of skin incision, muscle dissection and short operative time and less intraoperative estimated blood loss. The IFD with PLIF may be a favorable technique to replace the pedicle screw fixation in selective case.

Clinical Experience of the Dynamic Stabilization System for the Degenerative Spine Disease

  • Lee, Soo-Eon;Park, Sung-Bae;Jahng, Tae-Ahn;Chung, Chun-Kee;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.43 no.5
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    • pp.221-226
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    • 2008
  • Objective : The aim of the present study was to assess the safety and efficacy of the dynamic stabilization system in the treatment of degenerative spinal diseases. Methods : The study population included 20 consecutive patients (13 females, 7 males) with a mean age of $61{\pm}6.98$ years (range 46-70) who underwent decompression and dynamic stabilization with the Dynesys system between January 2005 and August 2006. The diagnoses included spinal stenosis with degenerative spondylolisthesis (9/20, 45%), degenerative spinal stenosis (5/20, 25%), adjacent segmental disease after fusion (3/20, 15%), spinal stenosis with degenerative scoliosis (2/20, 10%) and recurrent intervertebral lumbar disc herniation (1/20, 5%). All of the patients completed the visual analogue scale (VAS) and the Korean version of the Oswestry Disability Index (ODI). The following radiologic parameters were measured in all patients : global lordotic angles and segmental lordotic angles (stabilized segments, above and below adjacent segments). The range of motion (ROM) was then calculated. Results : The mean follow-up period was $27.25{\pm}5.16$ months (range 16-35 months), and 19 patients (95%) were available for follow-up. One patient had to have the implant removed. There were 30 stabilized segments in 19 patients. Monosegmental stabilization was performed in 9 patients (47.3%), 9 patients (47.3%) underwent two segmental stabilizations and one patient (5.3%) underwent three segmental stabilizations. The most frequently treated segment was L4-5 (15/30, 50%), followed by L3-4 (12/30, 40%) and L5-S1 (3/30, 10%). The VAS decreased from $8.55{\pm}1.21$ to $2.20{\pm}1.70$ (p<0.001), and the patients' mean score on the Korean version of the ODI improved from $79.58%{\pm}15.93%$ to $22.17%{\pm}17.24%$ (p<0.001). No statistically significant changes were seen on the ROM at the stabilized segments (p=0.502) and adjacent segments (above segments, p=0.453, below segments, p=0.062). There were no patients with implant failure. Conclusion : The results of this study show that the Dynesys system could preserve the motion of stabilized segments and provide clinical improvement in patients with degenerative spinal stenosis with instability. Thus, dynamic stabilization systems with adequate decompression may be an alternative surgical option to conventional fusion in selected patients.