• Journal of Acupuncture Research
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• v.37 no.3
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• pp.177-180
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• 2020

Background: The aim of this study was to examine whether the effects of acupotomy therapy were beneficial for the treatment of protrusion of lumbar intervertebral disc. Methods: The number of patients (n = 80) were equally assigned into treatment group and control group. Treatment group was given acupotomy therapy twice a week, and control group was given acupuncture 3 times a week, for 4 weeks. The beneficial effect and changes in score of the Japan Orthopedic Association (JOA) for low back pain were observed. Results: Among 40 cases in the treatment group, there were 25 (62.5%) with an excellent effect, 13 (32.5%) with good effect, 1 (2.5%) with a medium effect and 1 (2.5%) with poor effect, with the total experiencing an excellent/good effect of 95.0%. Among 40 cases in the control group, there were 11 (27.5%) with an excellent effect, 17 (42.5%) with good effect, 10 (25.0%) with a medium effect, and 2 (5.0%) with poor effect, with an excellent/good rate of 70.0%. The result of the rank sum test showed Z = -4.923, p < 0.05 in the comparison, indicating a significantly better outcome following acupotomy compared with acupuncture. JOA scores increased in both groups after treatment (p < 0.05), which was more significant in the acupotomy treatment group (p < 0.05). Conclusion: Acupotomy therapy has a beneficial effect on protrusion of lumbar intervertebral disc.

• The Journal of Korean Physical Therapy
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• v.12 no.3
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• pp.455-467
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• 2000

The purpose of this study was to analyse the effects of disc degeneration on the biomechanical behaviors of the intervertebral disc in term of axial displacement, intradiscal pressure. disc bulge at the 1.4-1.5 functional spinal unit(FSU). The degeneration is divided 4 grade by initial intradiscal pressure: normal: 135kPa. mild: 107kPa. moderate: 47kPa, severe: 15kPa, The predicted results were follows: 1. The magnitude of the bulge is found to be maximum at the anterior, minimum at the postero-lateral portion. The bulge of lateral, postero-lateral is found to be maximum in severe grade. followed by moderate. mild, normal grade. 2. Tho displacement was increased with increasing compressive load in all four grades.'rho stiffness of disc was found to be reduced by progressing from normal to severe grade. 3. The intradiscal pressure was increased nearly linearly with increasing compressive load in normal and mild grade. But the increasing rate in moderate and severe grade was showed apparently different from nomal and mild grade. Specially, it was increased very slightly in severe grade. In conclusion, decreased intradiscal pressure resulted in increase of axial displacement and disc bulge with compressive load increasing. these may compromise the nerve root impingement or irritation. Therefore posture and activities must be focus to reduce compressive load applied on the back or disc.

• 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.

• Journal of Acupuncture Research
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• v.33 no.4
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• pp.65-72
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• 2016

Objectives : While neck pain is highly prevalent in Korea, studies examining its Korean medical treatment are currently lacking. The aim of this study was to assess current Korean medical treatment practice patterns for neck pain. Methods : A preliminary questionnaire was developed to investigate current practice patterns of neck pain and cervical intervertebral disc displacement (IDD) treatment, and underwent further revision through external review. The final questionnaire was distributed as a web-based survey to 18,289 potential respondents by email. Results : The response rate was 3.34 %. Most participants replied that they received multiple Korean medicine interventions for neck pain treatment consisting of such methods as acupuncture, wet cupping, interferential current therapy and electroacupuncture. A total of 378 respondents acknowledged that diagnostic testing was needed for neck pain treatment. The most commonly used Korean Standard Classification of Diseases (KCD) principal diagnosis code for neck pain was M542, and for cervical IDD was M501. Conclusion : This survey study helps determine current practice patterns of neck pain, and recognizes the need for use of diagnostic devices in neck pain treatment. These results are further anticipated to provide basic data for clinical practice guidelines (CPGs) and future studies using Korean National Health Insurance and Health Insurance Review & Assessment Service data.

• 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.

• Journal of Korean Medicine Rehabilitation
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• v.29 no.3
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• pp.1-13
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• 2019

Objectives This review aims to analyze the current research trend in the usage of bee venom (BV) acupuncture for spinal diseases. Methods We collected 80 articles on BV acupuncture clinical study for spinal diseases by searching Korean web databases 'Journal of Korean Medicine Rehabilitation', 'Oriental Medicine Advanced Searching Integrated System', 'Korean Traditional Knowledge Portal' from 1999 to 2018. Results We summarized the most frequent clinical treatment methods of BV acupuncture. 1. Herniated intervertebral disc was treated for 40% and the treated spinal diseases were various. 2. '1:10,000' in the type of BV was chosen for 21%. 3. 29% of studies used 6-7 acupoints per session and 23% of studies used 'BL' as the injection site. 3. The highest volume of injected BV into each acupoint was 0.1 cc for 34% and the highest total volume of injected BV was 1.0 cc for 39%. Conclusions We found the limited evidence on the lack of consensus and detailed description in the reported experimental design. The results in this review suggest that future works should focus on more consistent and systematic study for the reproducible and standardized treatment methods.

• The Journal of Internal Korean Medicine
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• v.40 no.2
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• pp.165-172
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• 2019

Background: To suggest potential of Korean medicine treatments as a conservative management for neurogenic claudication and lower extremity weakness due to spinal stenosis. Case Summary: The patient suffered weakness, pain and numbness of the right leg and difficulty walking with diagnosis of spinal stenosis due to herniated lumbar intervertebral disc. Korean medicine treatments, including herbal medicine, acupuncture, pharmacopuncture and Chuna manual therapy were applied. The Numeric Rating Scale (NRS) of pain and numbness in the right leg decreased from 7 to 4, with an increase in strength of the right leg from 60% to 95% compared to the strength of left leg. Walking duration also increased from less than one minute to more than five minutes. Conclusion: Korean medicine treatment may be considered as an effective conservative management for symptoms of spinal stenosis.

• Journal of Korean Medicine Rehabilitation
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• v.33 no.4
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• pp.185-193
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• 2023

Objectives This study was conducted to find out the correlation between lumbar malposition and lumbar disc herniation. Methods Among the patients who visited Gwangju Jaseng Hospital of Korean Medicine from January 2019 to January 2021, taking 92 patients under age 60 who had the records of X-rays and magnetic resonance imaging (MRI) images as the research subjects, Cobb's angle was measured in anterior-posterior (AP) view and lateral (LAT) view, the number of displacements was scored by listing categories defined by The Korean Society of Chuna Manual Medicine for Spine and Nerves. The degree of lumbar intervertebral disc herniation was expressed as a percentage according to the method of Kato, etc., and the correlation between each factor was analyzed. Results AP curvature and MRI herniation index showed significant positive correlation in L4-L5 level but there was no significant difference in L5-S1 level. LAT curvature and MRI herniation index had no correlation in L4-L5 level, but there was a significant negative correlation in L5-S1 level. Malposition score and MRI herniation index had a significant positive correlation in L5-S1 level, whereas there was no correlation in L4-L5. Conclusions As a result of the study, AP curvature and MRI herniation index showed a significant positive tendency in L4-L5 lumbar spine, and LAT curvature and MRI herniation index showed a significant negative tendency in L5-S1 lumbar spine. Malposition score and MRI herniation index were found to have a significant positive tendency in L5-S1 lumbar spine.

• 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.

• The Korean Journal of Pain
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• v.31 no.2
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• pp.109-115
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• 2018

Background: Patients with lumbar disc herniation are treated with physiotherapy/medication and some with surgery. However, even after technically successful surgery some develop a failed back syndrome with persistent pain. Our aim was to evaluate the efficacy of epiduroscopy in patients who suffer chronic low back pain and/or radicular pain with or without surgery and the gender difference in outcome. Methods: A total of 88 patients were included with a mean age of 52 years (27-82), 54 women and 34 men. 66 of them were operated previously and 22 were non-operated. They all had persistent chronic back pain and radicular pain despite of medication and physical rehabilitation. Visual Analog Scale (VAS) for pain and Oswestry Disability Index (ODI) were evaluated preoperatively, after one month, six months and one-year after the epiduroscopy. Results: All patients, and also the subgroups (gender and operated/non-operated) improved significantly in pain (VAS) and disability (ODI) at one month. A significant improvement was also seen at one year. No differences were found between men and woman at the different follow-up times. A slight worsening in VAS and ODI was noticed over time except for the non-operated group. Conclusions: Epiduroscopy helps to improve the back and leg pain due to lumbar disc herniation in the early stage. At one year an improvement still exists, and the non-operated group seems to benefit most of the procedure.