• Title/Summary/Keyword: Intervertebral disc

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A Clinical Study on Ruptured Intervertebral Lumbar Disc Patients Treated by Oriental Medicine Treatment in Parallel with Sling Exercise Therapy (슬링치료를 병행하여 한의학적 치료를 시행한 파열형 요추 추간판 탈출증 환자 5례에 대한 임상적 고찰)

  • Ryu, Mi-Seon;Wi, Jun;Bang, Sung-Pil;Lee, Ji-Eun;Chun, Hea-Sun;Kang, Sung-In;Lee, Joong-Chul;Yun, Yeo-Choong;Kim, Jae-Hong
    • Journal of Acupuncture Research
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    • v.26 no.5
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    • pp.171-181
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    • 2009
  • Objectives : A ruptured disc is a condition in which part or all of the nucleus pulposus is forced through a weakened part of the disc, resulting in back pain and leg pain caused by nerve root irritation. In this report, we investigated the effect of oriental medicine treatment in parallel with sling exercise therapy on ruptured intervertebral lumbar disc patients. Methods : The patients who have ruptured disc were treated by oriental medicine treatment in parallel with sling exercise therapy. The patients' symptoms were assessed by visual analogue scale(VAS) and revised oswestry disability questionnaire(RODQ) every week. Results : In all cases, chief complain such as lumbago, radicular pain and paresthesia were improved after above treatment. VAS score and RODQ score of all cases were decreased. Conclusions : There were usually thought to need operation in ruptured disc. But conservative treatment such as oriental medicine treatment in parallel with sling exercise therapy is helpful to improve the symptoms of the ruptured intervertebral lumbar disc except the emergency state.

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Case Report on 4 Patients with Lumbar Disc Herniation Treated with Concurrent Embedding Therapy under Conventional Korean Medical Treatments (매선요법을 병행한 요추 추간판 탈출증 환자 치험 4례)

  • Lee, Hyung Ggeol;Im, Jeong Gyun;Jung, Da Jung;Yook, Tae Han;Kim, Jong Uk
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.27 no.1
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    • pp.124-129
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    • 2013
  • Embedding Therapy keep the stimulation to acupoint. Recently, Embedding Therapy is used for various disease and also studied in many different fields especially in China. In Korea, Embedding Therapy is studied and used for dermatology, face-lift, obesity, facial palsy most frequently. Chinese studies shows us Embedding Therapy could help musculoskeletal system disorder, lumbar herniated intervertebral disc, sprain, spinal canal stenosis. In Korea study concerning lumbar herniated intervertebral disc treatment used Embedding Therapy is few. This study's purpose is to ensure effect of Embedding Therapy at lumbar herniated intervertebral disc treatment. Four lumbar disc herniation patients had been treated with Embedding Therapy were described in this article. The patients(n=4) had been suffering from chronic lower back and leg pain that continued for more than 6 months. All patients had been diagnosed as lumbar disc herniation by MRI or CT, and treated with Embedding Therapy at least 2 times(7 days interval). 2 patients had been treated with concurrent treatment of acupuncture therapy, and the other 2 patients with concurrent treatment of acupuncture and herbal therapy. We observed 4 patients for more than 2 weeks, and their symptoms and quality of daily life had been improved. This suggests that lumbar disc herniation can be successfully recovered with Concurrent Embedding Therapy under conventional Korean Medical Treatment without side effects.

Automated Pressure-Controlled Discography with Constant Injection Speed and Real-Time Pressure Measurement

  • Kim, Hyoung-Ihl;Shin, Dong-Ah
    • Journal of Korean Neurosurgical Society
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    • v.46 no.1
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    • pp.16-22
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    • 2009
  • Objective : This study was designed to investigate automated pressure-controlled discography (APCD) findings, to calculate the elastance of intervertebral discs, and to assess the relationship between the calculated elastance and disc degeneration. Methods : APCD was performed in 19 patients. There were a total of 49 intervertebral discs treated. Following intradiscal puncture, a dye was constantly injected and the intradiscal pressure was continuously measured. The elastance of the intervertebral disc was defined as unit change in intradiscal pressure per fractional change in injected dye volume. Disc degeneration was graded using a modified Dallas discogram scale. Results : The mean elastance was 43.0${\pm}$9.6 psi/mL in Grade 0, 39.5${\pm}$8.3 psi/mL in Grade 1, 30.5${\pm}$22.3 psi/mL in Grade 2, 30.5${\pm}$22.3 psi/mL in Grade 3, 13.2${\pm}$8.3 psi/mL in Grade 4 and 6.9${\pm}$3.8 psi/mL in Grade 5. The elastance showed significant negative correlation with the degree of degeneration ($R^2$=0.529, P=0.000). Conclusion: APCD liberates the examiner from the data acquisition process during discography. This will likely improve the quality of data and the reliability of discography. Elastance could be used as an indicator of disc degeneration.

A Rare Case of Lumbar Traumatic Intradiscal Hematoma Followed by Repeatative Occupation Related Minor Trauma

  • Kwon, Woo-Keun;Oh, Jong-Keon;Kwon, Taek-Hyun;Park, Youn-Kwan;Moon, Hong Joo;Kim, Joo-Han
    • Journal of Trauma and Injury
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    • v.31 no.1
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    • pp.38-42
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    • 2018
  • A case of surgically treated intervertebral disc extrusion with intraoperatively confirmed intradiscal hematoma in a 30-year-old physical trainer is presented. Preoperative magnetic resonance imaging revealed downward migrating disc herniation, without definite suggestive findings of intradiscal hematoma. Intervertebral disc herniation with concomitant intradiscal hematoma is extremely rare, but could occur in patients who have excessive axial stress to the spine occupationally. In our case, the patient was an occupational physical trainer who had repetitive minor trauma to the lumbar spine. Although the patient did not have any clear history of major trauma to the spine, the intraoperative findings revealed intradiscal hematoma, which is very rare. The presence of intradiscal hematoma is to be suspected even when preoperative imaging studies shows indefinite findings of hematoma, considering the change in signal intensity of hematoma by time.

Effect of Cervical Spinal Decompression on the Cervical Muscle Tone and Disc Height in Patients with Cervical Intervertebral Disc Herniation

  • Kang, Jeong il;Jeong, Dae Keun;Choi, Hyun
    • Journal of International Academy of Physical Therapy Research
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    • v.9 no.1
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    • pp.1420-1425
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    • 2018
  • The purpose of this study was to investigate the effect of traction and decompression therapies on the cervical muscle tone and disc height. The decompression group (n=16) received decompression therapy and Mckenzie exercises once a day and four times a week respectively, for three weeks. The traction group (n=15) also received traction therapy and Mckenzie exercises for the same period. Muscle tone was measured with a myotonometer, and the disk height was measured using magnetic resonance imaging (MRI), before the interventions. Three weeks later, we investigated the therapeutic effect by repeating these measurements. The difference in disk height between the two groups was not significant. There was a significant difference in the disk herniation index (p<.05). A significant difference was found only in the upper trapezius muscle after comparison of muscle tone and stiffness between the groups (p<.05). Findings from this study suggest that the decompression therapy is a more effective intervention for patients with cervical intervertebral disc herniation.

The Clinical Reports on 3 Case of the Patient of Extruded Disc Treated by Conservative Oriental Medical Treatment (L-spine MRI로 관찰한 Disc extrution환자의 디스크 흡수 3례 보고)

  • Lee, Jin-Hyuk;Min, Kwan-Sik;Kim, Su-Young
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.5 no.1
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    • pp.101-110
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    • 2010
  • Objectives: The propose of this study is to find out the clinical application of conservative treatment to 3 patients who has Disc Extrusion on L-spine MRI Methods: We examined 3 patients with Lumbar Intervertebral Disc Herniation (HIVD of L-spine) with Disc Extrusion who showed changes on MRI images before/after the treatment among HIVD of L-spine patients who visited Jaseng Hospital of Oriental Medicine. Results: In this study, the first MRI examination of HIVD of L-spine patients was performed at the first visit and re-examination of MRI was done after the treatment. In each case, the size of the extruded disc was considerably reduced in MRI image. Low back and leg pain was also reduced significantly after conervative oriental medical treatment. Conclusions: Conservative oriental medical treatment can be effective for improving symptoms of HIVD, decreasing pain, also decreasing the volume of herniated disc.

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Injectable Hydrogel as an Artificial Nucleus Pulposus in a Degenerative Intervertebral Disc (Injectable Hydrogel을 이용한 인공 Nucleus Pulposus의 제조)

  • Park, Jin-Hyun
    • Proceedings of the Korean Fiber Society Conference
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    • 2002.04a
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    • pp.13-16
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    • 2002
  • The Intervertebral disc is a composite structure made up of the nucleus pulposus (NP) core surrounded by the multi-layered fibers of the annulus fibrosis (AF)[1]. Water is drawn into the NP by the presence of hydrophilic proteins called proteoglycans [2]. The AF, with successive layers oriented in alternating directions, surrounds the NP. These layers are placed under tension as the NP absorbs water and swells [3]. (omitted)

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Effects of Conservative Korean Traditional Medical Treatment on Lumbar Intervertebral Disc Herniation in 12 Adolescents : A Retrospective Study (청소년기 요추간판탈출증에 대한 한방 보존적 치료 12례의 후향적 분석)

  • Kim, Hae Sol;Bae, Young Hyun;Kim, Ho Sun;Suh, Chang Yong;Kim, No Hyeon;Lee, Gi Bum;Yang, Kyu Jin
    • Journal of Acupuncture Research
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    • v.33 no.1
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    • pp.103-116
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    • 2016
  • Objectives : This study was performed to assess the effectiveness of conservative Korean traditional medical treatment on lumbar intervertebral disc herniation in 12 adolescents. Methods : Data were collected from adolescent patients diagnosed with lumbar intervertebral herniation by MRI, hospitalized at Jaseng Korean Medicine Hospital from January 1, 2014 to December 31, 2015. A total of 12 patients were included in the study. Patients were treated by acupuncture, pharmacopuncture, electroacupuncture, herbal medicine, chuna manual therapy, physical therapy during hospitalization period. To measure treatment outcomes, a verbal numerical rating scale (VNRS), Oswestry disability index (ODI), range of motion (ROM), Straight leg raising test (SLR), and EQ-5D were used. Results : The average age of the participants was $16.05{\pm}1.62$. The average of duration of symptom was $19.25{\pm}26.83(weeks)$ and the average length of hospitalization was $23.8{\pm}16.4(days)$. 2 patients (17 %) suffered from only lumbar pain, while 10 patients (83 %) suffered from lumbar and leg pain. No participant suffered from only leg pain. 8 patients (67 %) were diagnosed with disc herniation in one segment, and 4 patients (33 %) were diagnosed with disc herniation in multiple segments. A total of 17 disc segments (28 %) were herniated. The most herniated lumbar level was L4-5. 3 segments were diagnosed with bulging (17 %), 6 with protrusion (35 %), and 8 with extrusion (47 %). Extrusion was the most frequent herniated type. After treatment, the average VNRS of lumbar pain significantly decreased from $5.58{\pm}1.62$ to $2.91{\pm}1.56$ (p<0.001) and the average VNRS of leg pain significantly decreased from $5.16{\pm}2.51$ to $3.08{\pm}1.8$ (p<0.001). ODI significantly decreased from $48.87{\pm}18.72$ to $28.57{\pm}15.05$ (p<0.05), and EQ-5D significantly increased $0.58{\pm}0.31$ to $0.80{\pm}0.12$ (p<0.05). Range of flexion significantly improved from $61.25{\pm}32.62$ to $68.33{\pm}26.22$ (p<0.05). Conclusion : Conservative Korean Traditional Medical Treatment may be effective in the treatment of lumbar intervertebral disc herniation in adolescence. However, more case reports and clinical research are needed.

Evaluation of the Degenerative Changes of the Distal Intervertebral Discs after Internal Fixation Surgery in Adolescent Idiopathic Scoliosis

  • Dehnokhalaji, Morteza;Golbakhsh, Mohammad Reza;Siavashi, Babak;Talebian, Parham;Javidmehr, Sina;Bozorgmanesh, Mohammadreza
    • Asian Spine Journal
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    • v.12 no.6
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    • pp.1060-1068
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    • 2018
  • Study Design: Retrospective study. Purpose: Lumbar intervertebral disc degeneration is an important cause of low back pain. Overview of Literature: Spinal fusion is often reported to have a good course for adolescent idiopathic scoliosis (AIS). However, many studies have reported that adjacent segment degeneration is accelerated after lumbar spinal fusion. Radiography is a simple method used to evaluate the orientation of the vertebral column. magnetic resonance imaging (MRI) is the method most often used to specifically evaluate intervertebral disc degeneration. The Pfirrmann classification is a well-known method used to evaluate degenerative lumbar disease. After spinal fusion, an increase in stress, excess mobility, increased intra-disc pressure, and posterior displacement of the axis of motion have been observed in the adjacent segments. Methods: we retrospectively secured and analyzed the data of 15 patients (four boys and 11 girls) with AIS who underwent a spinal fusion surgery. We studied the full-length view of the spine (anterior-posterior and lateral) from the X-ray and MRI obtained from all patients before surgery. Postoperatively, another full-length spine X-ray and lumbosacral MRI were obtained from all participants. Then, pelvic tilt, sacral slope, curve correction, and fused and free segments before and after surgery were calculated based on X-ray studies. MRI images were used to estimate the degree to which intervertebral discs were degenerated using Pfirrmann grading system. Pfirrmann grade before and after surgery were compared with Wilcoxon signed rank test. While analyzing the contribution of potential risk factors for the post-spinal fusion Pfirrmann grade of disc degeneration, we used generalized linear models with robust standard error estimates to account for intraclass correlation that may have been present between discs of the same patient. Results: The mean age of the participant was 14 years, and the mean curvature before and after surgery were 67.8 and 23.8, respectively (p<0.05). During the median follow-up of 5 years, the mean degree of the disc degeneration significantly increased in all patients after surgery (p<0.05) with a Pfirrmann grade of 1 and 2.8 in the L2-L3 before and after surgery, respectively. The corresponding figures at L3-L4, L4-L5, and L5-S1 levels were 1.28 and 2.43, 1.07 and 2.35, and 1 and 2.33, respectively. The lower was the number of free discs below the fusion level, the higher was the Pfirrmann grade of degeneration (p<0.001). Conversely, the higher was the number of the discs fused together, the higher was the Pfirrmann grade. Conclusions: we observed that the disc degeneration aggravated after spinal fusion for scoliosis. While the degree of degeneration as measured by Pfirrmann grade was directly correlated by the number of fused segments, it was negatively correlated with the number of discs that remained free below the lowermost level of the fusion.

Report for Correlation between the Measurement of Thoracic Kyphosis and the Herniation of Cervical Intervertebral Disc of Neck Pain Patients who Visit Korean Medicine Hospital (한방 병원에 경추 통증으로 내원한 환자들의 흉추부 만곡 및 경추부 추간판탈출증의 상관 관계에 관한 보고)

  • Choi, Young-Jun;Yoo, Su-Bin;Moon, Byung-Heon;Chung, Jai-Hyeon;Yun, Yeong-Ung;Kim, Kil-Hwan;Nam, Hang-Woo;Lee, Cha-Ro
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.10 no.1
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    • pp.63-74
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    • 2015
  • Objectives : This study is planned to classify correlation between thoracic kyphosis angle and prevalence of cervical intervertebral disc. Methods : We Measured the thoracic kyphosis angel of the 110 men and 179 women patients with neck pain in 00 Korean Medicine Hospital. We use Cobb's angle method and Thoracic cage dimension method for measuring the thoracic kyphosis. And We use Magentic Resonance Imaging(MRI) for classifying the patient who has cervical intervertebral disc or not. Results : 1. There was statistical difference on the thoracic cage dimension with gender(P<0.001), while there was no statistical difference on Cobb's angle with gender(P=0.882). 2. Age and thoracic cage dimension(r=0.383) is statistically more correlative than age and cobb's angle(r=-0.59). Conclusions : 1. Thoracic cage dimension and gender, Thoracic cage dimension and age were statistically concerned on patient who has neck pain, while Cobb's angle had no statistical correlation with age and gender. 2. There was no statistical difference on the Cobb's angle and Thoracic cage Dimension between patient who has one or more cervical disc herniation(Protrusion disc, Extrusion disc) segment and patient who didn't have cervical disc herniation(Protrusion disc, Extrusion disc) segment.