• Title/Summary/Keyword: Intervertebral Disc

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The Effect of Flexion-distraction Technique and Drop Technique on Pain and Sacral Angle of Patients with Lumbar Spine Herniated Intervertebral Disc (굴곡-신연기법과 낙차 교정법이 허리 척추사이원반 탈출증 환자의 시각적 상사 척도 및 엉치뼈 각에 미치는 영향)

  • Oh, Hyun-Ju;Choi, Seok-Joo;Lee, Kwan-Sub;Choi, Ji-Oun
    • Journal of Korean Physical Therapy Science
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    • v.25 no.3
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    • pp.9-16
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    • 2018
  • Background: In order to find out the effect of therapy methods through Flexion-distraction technique and drop technique on pain, sacral angle of patients with lumbar herniated intervertebral disc targeting patients with lumbar herniated intervertebral disc due to L5-S1. Method: This study was to present the directivity of the therapy method for lumbar herniated intervertebral disc by comparing and analyzing the spinal decompression therapy and provide an effective treatment method to patients with lumbar herniated intervertebral disc by identifying the therapeutic effect of Flexion-distraction technique and drop technique. The research period is March 1, 2018 to June 30, 2018 and subjects are the patients diagnosed as lumbar herniated intervertebral disc due to L5-S1 by their doctor through clinical findings and medical equipment such as X-ray, CT, MRI etc. Among patients who visited and hospitalized in S Orthopaedics located in Daegu and 30 female patients with sacral angle of more than $30^{\circ}$ were randomly classified into 15 people and we carried out treatment three times a week for 8 weeks for 15 people in the experimental group applying Flexion-distraction technique and drop technique and 15 people in the control group applying spinal decompression therapy to compare and analyze the changes in pain, sacral angle of patients with lumbar herniated intervertebral disc. Result: According to the results of this study, changes in the Visual Analogue Scale showed statistically significant differences in both the experimental group and control group(p<.05), while there was statistically significant difference in the comparison between groups before and after measurement of experimental group (p<.05). In the comparison within two groups of sacral angle, both groups showed statistically significant difference(p<.05) but there was no statistically significant difference in the comparison of scores between groups before and after measurement of each group(p>.05). Discussion: All those results the above proved that we need to confirm various benefits of the therapy with the flexion-distraction technique and drop technique, and the findings of the concerned study will possibly become useful information when doctors actually work on a therapy to treat patients with the lumbar herniated intervertebral disc.

Preliminary study of presumptive intradural-intramedullary intervertebral disc extrusion in 20 dogs

  • Kim, Jaehwan;Kim, Hyoju;Hwang, Jeongyeon;Eom, Kidong
    • Journal of Veterinary Science
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    • v.21 no.4
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    • pp.52.1-52.11
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    • 2020
  • Background: Intradural-intramedullary intervertebral disc extrusion (IIVDE) is a rare condition of intervertebral disc disease. However, the diagnosis of IIVDE is challenging because the prognosis and imaging characteristics are poorly characterized. Objectives: We aimed to describe the clinical and imaging characteristics of tentatively diagnosed IIVDE in dogs to assess the prognostic utility of neurological grade and magnetic resonance imaging (MRI) findings. Methods: Twenty dogs were included in this retrospective cohort study. Results: Nonchondrodystrophic breeds (n = 16) were more predisposed than chondrodystrophic breeds. Most dogs showed acute onset of clinical signs. Neurological examination at admission showed predominant non-ambulatory paraparesis (n = 9); paresis (n = 16) was confirmed more frequently than paralysis (n = 4). Follow-up neurological examination results were only available for 11 dogs, ten of whom showed neurological improvement and 8 showed successful outcomes at 1 month. The characteristic MRI findings include thoracic vertebra (T)2 hyperintense, T1 hypointense, intramedullary linear tracts with reduced disc volume, and cleft of the annulus fibrosus. None of the MRI measurements were significantly correlated with neurological grade at admission. Neurological grade did not differ according to the presence of parenchymal hemorrhage, parenchymal contrast enhancement, and meningeal contrast enhancement. Neurological grades at admission showed a statistical correlation with those observed at the 1-month follow-up (r = 0.814, p = 0.02). Conclusions: IIVDE is a rare form of disc extrusion commonly experienced after physical activity or trauma and most frequently affects the cranial-cervical and thoracolumbar regions of nonchondrodystrophic dog breeds. Neurological score at admission emerged as a more useful prognostic indicator than MRI findings in dogs with suspected IIVDE.

Comparison of Anthropometric Method & Medical Image Method in the Lumbar Intervertebral Disc Size (신체계측 추정식과 의료영상 실계측 방법의 요추부 추간판 크기 비교)

  • Kim, Jong-Soon;Kim, Chang-Soo
    • Journal of radiological science and technology
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    • v.30 no.2
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    • pp.121-127
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    • 2007
  • The purpose of this study was to examine the indirect estimation of the lumbar intervertebral disc size by two anthropometric methods(Colombini's method and Turk and Celan's method), in order to compare these indirect methods with the direct analysis by computed tomography(CT). The wrist, elbow, knee and ankle joint(right side) diameters were measured in 52 normal volunteers and intervertebral disc sizes were measured in 50 normal subjects by CT. Then the intervertebral disc sizes were calculated using two anthropometric formula. The data were analysed with ANOVA to differentiation between indirect and direct estimation of the lumbar intervertebral disc sizes. This study shows that male subjects have significantly larger L4-5 and L5-S1 intervertebral disc sizes than female subjects. In addition, disc sizes calculated by Colombini's formula were significantly larger than Turk & Celan's formula but there was no significant differences in the compared Turk & Celan's estimation with CT values. The indirect estimation of the intervertebral disc size by Turk & Celan's formula can be considered as a clinically useful method. However, further study should be conducted to compare anthropometric values according to age.

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A Case Study of Spinal Cord Stimulation Acupuncture for Lower Limb Numbness Induced by Lumbar Herniated Intervertebral Disc (하지 비증을 주소증으로 한 요추 추간판 탈출증 환자에 대한 척수 자극 침술의 임상 증례 보고)

  • Seo, Ha-Ra;Park, Jung-Oh;Lee, Han-Gil
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.10 no.2
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    • pp.87-95
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    • 2015
  • Objectives : The purpose of this study was to evaluate the effects of spinal cord stimulation acupuncture therapy for lower limb numbness resulting from lumbar herniated intervertebral disc(HlVD). Methods : From 8th August, 2015 to 30th October, 2015, 1 male patient diagnosed as herniated intervertebral disc at L5/S1(Diffuse bulging disc with smooth ventral thecal sac indentation at L5-S1) was treated with spinal cord stimulation acupuncture and general Korean medicine therapy(acupuncture, herbal injection). Numerical Rating Scale(NRS) and Oswestry Disability Index(ODI) were recorded during the treatment. Results : 1. The patient's chief complaints were remarkably improved - Rt. lower limb numbness remained 15% compared before treatment, Rt. lower limb paresthesia and gait disturbance almost disappeared after 25 times of treatment during 3 months. 2. NRS score decreased from 7 to 3, ODI decreased from 16 to 7. Conclusions : This study demonstrates that spinal cord stimulation acupuncture therapy with Korean medicine treatment has notable effect in improving lower limb numbness induced by lumbar HlVD.

Magnetic Resonance Imaging for Each Type of Herniated Cervical Intervertebral Disc (경추 추간판 탈출증의 유형별 자기공명영상 소견)

  • Kim, Ham-Gyum
    • Journal of radiological science and technology
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    • v.23 no.2
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    • pp.21-26
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    • 2000
  • The classification of herniated intervertebral cervical disc types are clinically important, as treatment methods would be slightly different according to the specific type of the herniated disc. 423 patients who suffered from herniated intervertebral cervical discs were tested with Magnetic Resonance Imaging (MRI), to distinguish the type of the herniated discs. The followings are the results ; 1) The age of the patients tested ranged from 16 to 75 years old and the mean age of the patients was 41.4 years of age. 2) There were twice as many male patients, with a ratio of 288 : 135 men to women. 3) 101 patients suffered from single herniated discs, while 322 patients suffered from multi-herniated discs. 4) Of single herniated disc injuries, 52 patients had protruded discs (52%), while 25 patients had extruded discs (25%). 21 Patients (21%) had herniated intervertebral discs between $C_4{\sim}C_5$, and 51 patients (50%), and had the same injury between $C_5$ and $C_6$. 5) Of multi-herniated disc injuries, 140 patients had protruded discs(44%). while 45 patients had extruded discs (14%). 54 patients had both protruded and extruded discs(17%). 36 patients(11%), herniated discs $C_3{\sim}C_6$ ; 69 patients (21%), herniated discs $C_3{\sim}C_7$ ; 47 patients(15%) herniated discs $C_4{\sim}C_6$ and 67 patients(20%) herniated discs $C_5{\sim}C_7$.

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Role of Matrix Metalloproteinases in Degenerative Lumbar Disc; Molecular and Immunohistochemical Study

  • Ryu, Kyeong-Sik;Cho, Sung-Jin;Park, Chun-Kun
    • Journal of Korean Neurosurgical Society
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    • v.40 no.5
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    • pp.363-368
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    • 2006
  • Objective : Little is known about the comprehensive molecular and biological mechanism on the development of the degeneration of the intervertebral disc. Many kinds of matrix metalloproteinase[MMP] initiate the degradation of the extracellular matrix including several kinds of collagens and proteoglycans. We compared molecular and immunohistochemical features of degenerated intervertebral disc and normal counterparts in order to investigate the role of MMP-1, 2, 3, 9. Methods : We have evaluated MMP-1, 2, 3, 9 expression in 30 surgically resected lumbar disc from degenerative disc disease patients and 5 normal control cases. RT-PCR[reverse transcriptase-polymerase chain reaction] and immunohistochemistry were performed. Results : By RT-PCR, normal tissue samples showed merely scant expression of MMP-1, 2, 3, 9 mRNA, but degenerated disc samples revealed more pronounced expression. mRNA amplifications were detected in 60%, 63.3%, 70%, 53.3% cases By immunohistochemistry, normal tissue samples showed minimal protein expression of MMP-1, 2, 3, 9, but degenerated disc samples revealed more pronounced expression. Protein expressions were detected in 73.3%, 63.3%, 76.7%, 63.3% cases. Both the mRNA amplification and protein overexpression rates were significantly higher in degenerated disc than in the normal tissue. Concordance between both the mRNA amplification and protein expressions of MMP-1, 3, 9 were not observed, but there is well correlation in MMP-2 expression. Conclusion : We concluded that the over-expressions of the MMP-1, 2, 3, 9 may contribute to the development of degeneration of the intervertebral disc.

Immediate Effect of Flexion-Distraction Spinal Manipulation on Intervertebral Height, Pain, and Spine Mobility in Patients with Lumbar Degenerative Disc Disease

  • Pi, Taejin;Chung, Yijung
    • Physical Therapy Rehabilitation Science
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    • v.10 no.2
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    • pp.235-243
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    • 2021
  • Objective: This study aimed to investigate the short-term effects of flexion-distraction spinal manipulation on intervertebral height, pain, spine mobility in patients with lumbar degenerative disc disease. Design: Randomized controlled trial with a pretest-posttest control group design Methods: A total of 96 participants with degenerative disc disease participated in the study and were randomly divided into two groups. Both groups received intervention for 3-5 minutes a day. The experimental group (n=48) underwent flexion-distraction spinal manipulation for 3-5 minutes, and the control group (n=48) was maintained in the same position as the experimental group for 5 minutes without any intervention. The intervertebral height was measured by computed tomography, pain was assessed using visual analog scale, and the spine in flexion mobility was measured using the finger-to-floor distance test and passive straight leg raise test. Pre-test and post-test measurements were obtained. Results: The experimental group showed significant improvement in intervertebral height, degree of pain, and spinal mobility (p<0.05). The intervertebral height increased from 6.32±1.90 to 6.93±1.85 mm (p<0.05), lower back pain decreased from 69.17±13.35 mm to 48.48±12.20 mm (p<0.05), lumbar spine mobility changed from 17.37±4.49 to 12.69±4.34 cm (p<0.05), and passive straight leg raise test range increased from 46.94±13.05° to 56.01±12.20° (p<0.05). Conclusions: This study suggests that flexion-distraction spinal manipulation could be an effective treatment for decreasing pain and improving function in patients with degenerative disc disease.

Development of the body of axis and 1st cervical intervertebral disc in the korean native cattle fetus (한우태자의 축추골 몸통과 첫째 척추사이 원반의 발달)

  • Lee, Hye-ran;Ahn, Dong-choon;Kim, In-shik;Yang, Hong-hyun;Paik, Young-ki
    • Korean Journal of Veterinary Research
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    • v.37 no.1
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    • pp.59-69
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    • 1997
  • The histological and histochemical study of the body of axis and 1st intervertebral disc in the Korean native cattle fetus was attempted to early developmental process. The experimental animals used in this study were collected from fetus of the Korean native cattle ranging from 50mm to 180mm in Crown-Rump length(CR-length). The results were summerized as follows: 1. The ossification centers appeared centrum 1 and centrum 2 of the axis in 110mm CR-length fetus of the Korean native cattle. The centrum 2 was formed little earlier than the centrum 1. 2. The histochemical reactions for collagenous fibers in the axis revealed negative in 50mm CR-length, mild positive in 90mm CR-length, and strong positive in 110mm CR-length, respectively. 3. Dense collagenous fibers were observed in the notochord through the centrum 2, and intervertebral disc developed into cuneiform dorsoventrally, It's contour looks like an annual ring. These fiber bundle arranged lamellar formation. 4. The intervertabral disc of 50mm CR-length fetus was composed mainly mesenchymal cells, and these cell showed aggregation in the central portion. The intervertebral disc of 110mm CR-length fetus was consisted of pricipally fibroblast, and notochordal sheath formed with two layers in the center.

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Study on Diagnostic Value of Straight Leg Raising Test between Traffic Accident Patients Group and Non-Traffic Accident Patients Group in Diagnosing Herniated Lumbar Intervertebral Disc (요추간판탈출증 진단에 있어 교통사고 환자와 비교통사고 환자의 하지직거상 검사상 진단적 가치 비교 연구)

  • Song, Mi-Young;Lee, Kang-Su;Lee, Myung-Jong
    • Journal of Korean Medicine Rehabilitation
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    • v.15 no.2
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    • pp.67-75
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    • 2005
  • Objectives : Straight leg raising test(SLR) is useful clinical test to diagnose herniated lumbar intervertebral disc. The purpose of this study is to analyse diagnostic value of straight leg raising test between traffic accident patients group and non-traffic accident patients group. Methods : The study involved 26 traffic accident patients group and 45 non-traffic accident patients group with low back pain or radiating pain into the leg. All had a result of straight leg raising test and lumbar computed tomography(CT) or magnetic resonance imaging(MRI). The associations between straight leg raising test and herniated lumbar intervertebral disc were analysed. Results and Conclusions : 1. There is not significant associations between straight leg raising test and herniated lumbar intervertebral disc in traffic accident patients group. 2. There is significant associations between straight leg raising test and herniated lumbar intervertebral disc in non-traffic accident patients group. 3. In traffic accident patients group, and negative predictive value are higher than non-traffic accident patients group. 4. In non-traffic accident patients group, sensitivity, positive predictive value and odds ratios are higher than traffic accident patients-group.

Change of the Intervertebral Foraminal Pressure after Removal of the Disc Material (디스크 제거 후 추간공내 압력의 변화)

  • Hong, Chang Kie;Park, Chong Oon;Hyun, Dong Keun;Ha, Young Soo
    • Journal of Korean Neurosurgical Society
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    • v.30 no.2
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    • pp.144-149
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    • 2001
  • Objective : Spinal nerve root compression occurs commonly in conditions, such as herniated nucleus pulposus, spinal stenosis, intervertebral foraminal stenosis, and trauma. However, the pathophysiolosy of the symptoms and signs related to spinal nerve root compression is poorly understood. The purpose of the present study was to assess and compare the changes of various pressures of intervertebral foraminal pressure before and after decompression. Method : After laminetomy without foraminotomy was performed, pressure sensor tip of Camino parenchymal type was located at the middle-central portion of the intervertebral foramen and anterior portion of nerve root for the foraminal pressure before decompression of the intervertebral foramen. After laminectomy with foraminotomy, the same method was used for the foraminal pressure after decompression. The authors studied 40 consecutive patients (57 disc spaces) with severe constant root pain to the lower leg, pain unrelived by bed rest, and minimal tension signs, diagnosed by MRI. Results : In patients with intervertebral foraminal stenosis, the intraforaminal pressure was decreased from $86{\pm}2.23mmHg$ to $17.1{\pm}1.51mmHg$ and in patients without stenosis, from $55.9{\pm}1.08mmHg$ to $11.9{\pm}1.25mmHg$. All patients below 20mmHg after decompression showed good outcome, but 4 cases who showed poor outcome had foraminal stenosis, posterolateral type of the herniated disc, and above 30mmHg of foraminal pressure after decompression. Conclusion : These findings suggest that if the foraminal pressure falls below 20mmHg after decompression, good outcome can be anticipated. Central type of the herniated disc shows better outcome compared to the posterolateral type.

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