• The Journal of Korean Physical Therapy
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• v.23 no.5
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• pp.15-21
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• 2011

Purpose: The purpose of this study was to describe the influence of respiration on the segmental motion of the lumbar spine in the lying position. Methods: Twelve healthy females without a history of low back pain participated. Lumbosacral lordosis, intervertebral body angles, intervertebral body displacements, and anterior heights of the intervertebral disc of the lumbar spine were measured at inspiration, expiration and forced expiration in the supine and prone positions via fluoroscopy. Results: The results of lumbar kinematic analysis in the supine position according to respiration pattern were as follows. The L4/5 intervertebral body angle was significantly higher at forced expiration than at expiration (p<0.05). The L3/4 anterior height of the intervertebral disc was significantly higher at expiration than at forced inspiration and the L5/S1 anterior height of the intervertebral disc was significantly higher at inspiration than at forced expiration (p<0.05). There were no significant differences in the intervertebral body displacements and lumbosacral lordosis in the supine position (p>0.05). The results of lumbar kinematic analysis in the prone position according to respiration pattern were as follows. The L5/S1 anterior height of the intervertebral disc was significantly higher at inspiration than at forced expiration (p<0.05). However, there was no significant difference in the intervertebral body angle, the intervertebral body displacements, and the lumbosacral lordosis (p>0.05). Conclusion: These findings suggested that respiration can affect the intervertebral body angle and anterior height of the intervertebral disc in some segments. The results from this study serve as a step in the development of guidelines for lumbar kinematic analysis for lumbar breathing training.

• The Journal of Korean Physical Therapy
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• v.19 no.1
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• pp.23-31
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• 2007

Purpose: As a preliminary study, the purpose of this study was to examine the indirect estimation of the lumbar intervertebral disc size by two anthropometric methods, in order to compare these indirect methods with the direct analysis by radiological imaging. Methods: The wrist, elbow, knee, and ankle joint (both right and left) diameters were measured in 52 volunteers, and then intervertebral disc size was calculated using two anthropometric methods (Colombini and modified Colombini). The data were analysed with independent t-test to assess clinical usefulness. Results: When using right and left joint diameter, there was no significant difference in the estimation value of the L4-5 and L5-S1 intervetebral disc sizes. However, the study has shown that male subjects have significantly larger L4-5 and L5-S1 intervertebral disc sizes, compared with those of female subjects. In addition, disc sizes calculated by Colombini's formula were significantly larger than modified Colombini's formula. Conclusion: The indirect estimation of the intervertebral disc size by anthropometric method can be considered as a clinically useful method. However, further study should be conducted to compare anthropometric values with other radiological imaging.

• Journal of Acupuncture Research
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• v.26 no.1
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• pp.67-79
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• 2009

Objectives : The study on Acupotomy therapy has recently become a popular academic field as proven to be an great alternative to the limitation of Western medical treatment. However, there has been little study examining acupotomy therapy on treating Cervical Herniated Intervertebral Disc. Thus, this study aims to investigate the sense of improvement and satisfaction from the Cervical Herniated Intervertebral Disc patients treated with acupotomy therapy. Methods : A total of 23 subjects that consists of Cervical Herniated Intervertebral Disc patients were participated in this study. They were treated with acupotomy therapy and acupuncture. All the subjects were asked to answer Odom's degree, VAS(visual analogue scale), NDI(neck disability index) and JOA score before and after the treatment. Results : The results of the Odom's degree, VAS, NDI and JOA score of analysis groups, show that the improvement of neck pain in acupotomy and acupuncture treatment group is significantly effective. Conclusions : It is suggested that acupotomy therapy has development-effectiveness on Cervical Herniated Intervertebral Disc.

• The Journal of Korean Physical Therapy
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• v.19 no.3
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• pp.31-39
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• 2007

Purpose: This study was conducted to investigate the effect of distraction manipulation on the pain and. intervertebral disc angle in patients with herniated intervertebral lumbar discs. Methods: 30 patients who visited to receive the treatments of the physical therapy in W pain clinic in Daejeon. All subjects had been treated with flexion-distraction manipulation for 30 minutes per day and three times a week during 12 weeks period from June 10 to 19 August 2006. They were randomly divided into two groups: lumbar 4 and lumbar 5 group. Results: Pain of L4 and L5 group was significantly reduced after than before treatment(p<0.05). The intervertebral lumbar disc angle was significantly improved after than before treatment(p<0.05). Conclusion: These results indicated that distraction manipulation has a effectiveness in patients with herniated lumbar disc.

• Journal of Korean Neurosurgical Society
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• v.43 no.3
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• pp.149-154
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• 2008

Objective: The aim of this study is to elucidate the effects of transforming growth factor-${\beta}$ (TGF-${\beta}$)1 and L-ascorbic acid on proteoglycan synthesis, and the relationship between Sox9, proteoglycan, and TGF-${\beta}1$ in intervertebral disc cells. Methods: Human intervertebral disc tissue was sequentially digested to 0.2% pronase and 0.025% collagenase in DMEM/F-12 media and extracted cells were cultured in $37^{\circ}C$, 5% $CO_2$ incubator. When intervertebral disc cells were cultured with TGF-${\beta}1$ or L-ascorbic acid, the production level of sulfated glycosaminoglycan (sGAG) was estimated by dimethyl methyleneblue (DMMB) assay. The changes of Sox9 mRNA and protein levels via TGF-${\beta}1$ were detected by RT-PCR and Western blot analysis in each. Results: The amount of sGAG was increased with the lapse of time during incubation, and sGAG content of pellet cultured cells was much larger than monolayer culture. When primary cultured intervertebral disc cells in monolayer and pellet cultures were treated by TGF-${\beta}1$ 20 ng, sGAG content of experimental group was increased significantly compared to control group in both cultures. L-Ascorbic acid of serial concentrations (50-300 ug/ml) increased sGAG content of mono layer cultured intervertebral disc cells significantly in statistics. The co-treatment of TGF-${\beta}1$ and L-ascorbic acid increased more sGAG production than respective treatment. After treating with TGF-${\beta}1$, Sox9 mRNA and protein expression rates were significantly increased in disc cells compared with the control group. Conclusion: This study suggests that TGF-${\beta}1$ would increase sulfated glycosaminoglycan (sGAG) and other proteoglycans such as versican by elevating Sox9 mRNA and protein expressions in order.

• The Journal of Korean Medicine
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• v.16 no.2 s.30
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• pp.62-78
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• 1995

In industrialized countries, low back pam is very common, with up to 60 to 80% of the population being affected at some time in their lives. Herniated lumbar intervertebral disc is one of principal cause of low back pain and radiculopathy. The therapy of the disease is classified into conservative treatment or surgical intervention. The majority of these cases successfully heal with conservative managemant, even though it was claimed that the henirated disc material would not resolved spontaneously without surgical removal. It was reported that there was no significant difference in outcome and cost effectiveness between conservative and surgical therapy group. Also after conservative therapy the resorption of herniated disc with satisfactory improvement of symptom was reported. Conservative treatment includes bed rest, heat, drug therapy, therapeutic exercises, physical therapy such as traction and manipulation, and acupuncture. These managements show favorable outcome in the patients with herniated lumbar intervertebral disc. So conservative management should be applied in the therapy of herniated intervertebral disc, unless there exist aggravation during the first 3 weeks of treatment or apparent surgical care indication. And further investigation to improve effectiveness of conservative therapy should be ensued.

• The Korean Journal of Pain
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• v.27 no.1
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• pp.86-89
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• 2014

Discal cyst is an intraspinal cyst with a distinct communication with the corresponding intervertebral disc. It is a rare condition and could present with radiculopathy similar to that caused by lumbar disc herniation. We present a patient with a large discal cyst in the ventrolateral epidural space of the $5^{th}$ lumbar vertebral (L5) level that communicated with the adjacent $4^{th}$ lumbar and $5^{th}$ lumbar intervertebral disc, causing L5 radiculopathy. We alleviated the radiating pain with selective transforaminal epidural blocks.

• Investigative Magnetic Resonance Imaging
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• v.21 no.2
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• pp.109-113
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• 2017

A 55-year-old male presented with dysesthesia of the right anteromedial thigh. A magnetic resonance image revealed a globular mass at the right extraforaminal area of the L3/4 level. Based on the diagnosis of neurogenic tumor, surgical excision was performed. The surgical impression and pathology confirmed extrusion of intervertebral disc. In a retrospective review of the magnetic resonance image, we noticed a fibrillary pattern directed from the intervertebral disc space to the lesion, and disrupted annulus fibrosus and indentation caused by the ring apophysis. We suggest aforementioned features, indicative of intervertebral disc lesions, to be checked when interpreting mass lesions around the intervertebral foramen.

• Korean Journal of Acupuncture
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• v.27 no.4
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• pp.5-13
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• 2010

Objectives : Herniated lumbar intervertebral disc is common reason causing back pain. Lumbar stabilization exercise prevent back pain recurrence by strengthening lumbar muscles. Sling Exercise Therapy(SET) is a system for spinal muscle stabilization and strengthening using fixed string and mobile band. The purpose of this study is to investigate and measure the effectiveness of SET and oriental medicine for Herniated lumbar intervertebral disc. Methods : The subjects for this study are 40 patients suffering from Herniated lumbar intervertebral disc in our clinic. They were measured and compared by Visual Analogue Scale(VAS), 4 grades of recovery degree and sex, age, period of disease, disc herniation type, times of exercise. Results : In the above index, the score(VAS, 4 grades of recovery degree) improved after treatments. But they make no difference between sex, age, period of disease, disc herniation type and times of exercise. Conclusions : These results suggest that SET may be used for Herniated lumbar intervertebral disc for pain management and muscle strengthening as an essential treatment regardless of sex, age, period of disease and disc herniation type.

• The Korean Journal of Pain
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• v.22 no.1
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• pp.99-103
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• 2009

We studied the historical changes of intervertebral disc displacement using magnetic resonance imaging. The phenomenon of the spontaneous regression of herniated discs is well known. The case of a 40-years-old male presenting with a large disc herniation at L5-S1, experiencing severe sciatic pain, and having the straight leg raising test positive at 25 degrees is presented. The extruded disc was documented by clinical examination. He was treated conservatively with epidural steroid injection (ESI), medication, physical therapy and self-exercise and reevaluated in 10 weeks later, 30 and 1 year. Large extruded disc can be treated successfully by physical therapy with ESI. However, the degeneration and the dehydration of disc result in decrease of disc height. Consequently, the regression of extruded disc might have been due to the resorption and the dehydration.