• Journal of Yeungnam Medical Science
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• v.8 no.1
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• pp.238-245
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• 1991

The disc internal disruption syndrome is not well known to us, but the following hypothesis is widely accepted in clinical practice. The disc internal disruption syndrome may develop intractable back pain with aggrevated of pain, loss of spinal motion with any physical exercise, leg pain, loss of energy, marked weight loss, and profound depression. The patient with this syndrome will be found to have normal plain roentgenograms, myelograms, CT scans, results of blood examination and neurologic findings. For these reasons, this syndrome was frequently diagnosed by abnormal discographic findings. We had experience with two cases of disc internal disruption syndrome with clinical, roentgenographic and discographic evaluations. Thus We present these cases with a brief review of the concerned literature.

• The Journal of the Korea Contents Association
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• v.22 no.9
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• pp.570-582
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• 2022

Nucleoplasty is a type of percutaneous disc decompression that has been developed to treat herniated intervertebral discs. Currently, in some clinics, researchers have also applied this procedure to patients with internal disc disruption, apart from the originally intended usage on herniated intervertebral discs. The purpose of this study is to evaluate the feasibility of this extended use based on medical logic. To achieve this, the author analyzed case studies on performing nucleoplasty on patients with internal disc disruption. The main points of the analysis are, first, the validity of the treatment evidence presented by the researchers and, second, the relevance of the patient selection criteria. As a result, it is judged that the therapeutic rationale of existing papers applying nucleoplasty to the treatment of internal disc disruption is unclear or inconsistent with general medical logic, and in the process of patient screening, discs that may be deemed inappropriate for percutaneous decompression are included. Therefore, the author believes that existing studies applying nucleoplasty to the treatment of internal disc disruption have the nature of somewhat adventurous experiments that are unnecessary or can cause potential side effects. In order to uphold patients' rights and improve the completeness of the study in the research process on this topic, the author thinks that it is essential to establish clearer therapeutic evidence than the current level of understanding and to have an elaborate patient screening process based on it.

• Journal of Korean Neurosurgical Society
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• v.29 no.7
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• pp.935-939
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• 2000

Objective : Traumatic disc lesion is a lesion with tremendous controversies. The causal relationships of this lesion are not established along with pathogenesis, diagnostic criteria, methods of treatment and the outcome. However, a significant number of patients with back pain after a trauma underwent spinal operations under the diagnosis of traumatic disc lesions. Such an ill-directed operation eventually produce a person with an iatrogenic disability. We present two illustrative cases, and tried to make a preventive method. Methods : We examined the path from mild trauma after a road traffic accident into the iatrogenic disability in two illustrative cases, who requested disability assessment and medical appraisement. We evaluated the reason and background for such an unwanted outcome and tried to find a method to reduce or prevent it by a literature review. Results : These two patients were admitted to the hospital with the diagnosis of lumbar sprain after a road traffic accidents. They eventually underwent spinal surgery under another diagnosis such as traumatic disc herniation or internal disc disruption. They stayed at the hospital for more than six months and finally lost their jobs. They became the disabled at last. Although they complained back pain, they never insisted by themselves that their symptoms were due to the traumatic disc lesion. To prevent such an iatrogenic disability, the doctors should assist them to go-back to the workplace promptly instead of a reckless extension of the treatment period. It may be necessary to evaluate the certificates to extend the treatment period with an additional diagnosis by a medical expert. To reduce the unnecessary long-term admission, a new billing system such as a partial share for the high cost of the treatment by the patients may be needed. Conclusion : It is not the patient but the doctors, who has the responsibility to avoid the unnecessary operations. All treating doctors should try to reduce or prevent such an iatrogenic complication caused by ourselves before we are forced to do so.