• Title/Summary/Keyword: Lumbar Disc Herniation

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A Case Report of Patient with Muscles Weakness Caused by Chronic Lumbar Disc Herniation (하지 근력 저하를 동반한 만성기 요추 추간판 탈출증 환자 치험 1례)

  • Kim, Jee-Yong;Kim, Sun-Min;Kim, Tae-Hun;Park, Byong-Yoon;Jun, Byung-Chul;Choi, Woo-Sung
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.5 no.2
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    • pp.159-168
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    • 2010
  • Objectives : The object of this study is to report a clinical effect of oriental medical treatments lot chronic muscle weakness caused by herniated intervertbral lumbar disc. Methods : The patient was diagnosed as lumbar disc herniation, and was treated by conservative treatments including acupunture, herbal mixture, pharmacopuncture. And we measured Visual Analog Score(VAS), Walking time and Manual Muscle testing(MMT). Results : After treatments, Visual Analog Score, Walking time and Manual Muscle testing(MMT) were improved in case. Conclusions : Chronic Muscle weakness caused by lumbar disc herniation can be improved by conservative maneuver as to oriental medical method.

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Comparison of Percutaneous Endoscopic Lumbar Discectomy and Open Lumbar Microdiscectomy for Recurrent Disc Herniation

  • Lee, Dong-Yeob;Shim, Chan-Shik;Ahn, Yong;Choi, Young-Geun;Kim, Ho-Jin;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • v.46 no.6
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    • pp.515-521
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    • 2009
  • Objective : The purpose of this study was to compare clinical and radiological outcomes of percutaneous endoscopic lumbar discectomy (PELD) and open lumbar microdiscectomy (OLM) for recurrent disc herniation. Methods : Fifty-four patients, who underwent surgery, either PELD (25 patients) or repeated OLM (29 patients), due to recurrent disc herniation at L4-5 level, were divided into two groups according to the surgical methods. Excluded were patients with sequestrated disc, calcified disc, severe neurological deficit, or instability. Clinical outcomes were assessed using Visual Analogue Scale (VAS) score and Oswestry Disability Index (ODI). Radiological variables were assessed using plain radiography and/or magnetic resonance imaging. Results : Mean operating time and hospital stay were significantly shorter in PELD group (45.8 minutes and 0.9 day, respectively) than OLM group (73.8 minutes and 3.8 days, respectively) (p < 0.001). Complications occurred in 4% in PELD group and 10.3% in OLM group in the perioperative period. At a mean follow-up duration of 34.2 months, the mean improvements of back pain, leg pain, and functional improvement were 4.0, 5.5, and 40.9% for PELD group and 2.3, 5.1, and 45.0% for OLM group, respectively. Second recurrence occurred in 4% after PELD and 10.3% after OLM. Disc height did not change after PELD, but significantly decreased after OLM (p = 0.0001). Neither sagittal rotation angle nor volume of multifidus muscle changed significantly in both groups. Conclusion : Both PELD and repeated OLM showed favorable outcomes for recurrent disc herniation, but PELD had advantages in terms of shorter operating time, hospital stay, and disc height preservation.

Comparative Study of Effects on Intracutaneous Bee Venom Pharmacopuncture and Intramuscular Bee Venom Pharmacopuncture in Lumbar Disc Herniation (요추 추간판 탈출증에 대한 피내 봉약침과 근육내 봉약침의 치료 효과 비교)

  • Shin, Hwa-Young;Lee, Se-Min;Kim, Jee-Hyun;Kim, Sung-Jin;Choi, Yi-Jeong;Jung, Tae-Young;Kim, Jae-Su;Lim, Seong-Chul;Lee, Yun-Kyu;Lee, Bong-Hyo;Lee, Kyung-Min
    • Journal of Acupuncture Research
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    • v.28 no.3
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    • pp.1-11
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    • 2011
  • Objectives : This study is to compare effects on Intracutaneous Bee Venom pharmacopuncture and Intramuscular Bee Venom pharmacopuncture in Lumbar Disc Herniation. Methods : We investigated 34 cases of patients with lumbar disc herniation and devided into two groups. Group A were treated with intracutaneous bee venom pharmacupuncture and group B were treated with intramuscular bee venom pharmacopuncture. To evaluate the treatment effects of two groups, we used visual analog scale(VAS) and Aberdeen LBP scale. Results : In VAS and Aberdeen LBP scale, that of group A was further improved than that of group B, but there was no statistical significance. Conclusions : Intracutaneous bee venom pharmacupuncture and intramuscular bee venom pharmacopuncture were effective treatments for lumbar disc herniation, but there was no statistical significance.

The Effect of GCSB-5 a New Herbal Medicine on Changes in Pain Behavior and Neuroglial Activation in a Rat Model of Lumbar Disc Herniation

  • Cho, Hee Kyung;Kim, So-Yeon;Choi, Mi Jung;Baek, Seung Ok;Kwak, Sang Gyu;Ahn, Sang Ho
    • Journal of Korean Neurosurgical Society
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    • v.59 no.2
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    • pp.98-105
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    • 2016
  • Objective : Lumbar disc herniation can induce sciatica by mechanical compression and/or chemical irritation. The aim of this study was to compare the effects of GCSB-5 (Shinbaro$^{(R)}$) and NSAIDs on pain-related behavior and on the expressions of microglia, astrocytes, CGRP, TRPV1, IL-6, and CX3CL1 in a rat model of lumbar disc herniation. Methods : 112 male Sprague-Dawley rats underwent implantation of nucleus pulposus to a dorsal root ganglion (DRG). Rats were divided into five groups as follows; a saline group (the vehicle control group) (n=27), a 10 mg/kg aceclofenac group (the aceclofenac group) (n=22), and 100, 300 or 600 mg/kg GCSB-5 groups (the GCSB-5 100, 300, or 600 groups) (n=21 for each group). Rats were tested for mechanical allodynia at 3 days after surgery and at 1 day, 3 days, 7 days, 14 days, 21 days, 28 days, 35 days, 42 days, 49 days, and 56 days after treatment commencement. Immunohistochemical staining of microglia (Iba1), astrocytes (GFAP), CGRP, and TRPV1, and PCR for IL-6 and CX3CL1 were performed on spinal dorsal horns and DRGs at 56 days after medication commencement. Results : After 56 days of GCSB-5 300 administration, mechanical withdrawal thresholds were significantly increased (p<0.05), and immunohistochemical expressions of Iba1, GFAP, CGRP, and TRPV1 were reduced than other groups, but this difference was not statistically significant. Conclusion : These results indicate GCSB-5 reduces mechanical allodynia and downregulates neuroglial activity and the expressions of CGRP and TRPV1 in the spinal segments of a rat model of lumbar disc herniation.

A Clinical Study of 17 Cases of Patients with Big Toe Extensor Muscles Weakness Caused by Lumbar Disc Herniation (요추 추간판 탈출증으로 유발된 족무지 신전 근력약화 환자 17례의 임상적 고찰)

  • Kim, Wu-Young;Han, Sang-Yup;Kim, Ki-Yuk;Lee, Jae-Hoon;Lee, Hyun-Jong;Kim, Chang-Youn
    • Journal of Acupuncture Research
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    • v.26 no.4
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    • pp.19-27
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    • 2009
  • Objectives : To investigate the improvement rate of muscle weakness caused by lumbar disc herniation, 17 patients was treated with oriental medicine. Methods : To evaluate weakness of big toe extensor muscles caused by lumbar disc herniation, we measured the active range of motion(ROM) of big toe extension and muscle grading of big toe extensor muscles. We also measured numerical rating scale(NRS), oswestry disability index(ODI) and compared them with the active ROM of big toe extension. Results : 1. Progressive weakness of big toe extensor muscles was observed in 2 patients. Weakness of big toe extensor muscles were improved in 13 patients(76%). 2. Changes in manual muscle testing(MMT) scores corresponded with improvement rate of big toe extension. 3. Numerical rating scale(NRS) and oswestry disability index(ODI) improvement rate did not correspond with improvement rate of big toe extension. Conclusions : Muscle weakness caused by lumbar disc herniation can be treated with oriental medicine and progressive muscle weakness must be observed constantly.

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A Study of Improvement on Low Back Pain Caused by Lumbar Disc Herniation Depending on Female Inpatient's Bone Mineral Density(BMD), Body Mass Index(BMI), Age, Pain Duration (여성의 골밀도가 요추 추간판 탈출증으로 인한 요통 호전도에 미치는 영향 및 골밀도와 비만도, 연령, 병력 기간의 관계에 관한 연구)

  • Bae, Sang-Eun;Lee, Sung-Chul;Kim, In-Joong
    • The Journal of Korean Obstetrics and Gynecology
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    • v.25 no.1
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    • pp.93-105
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    • 2012
  • Objectives: This study explored the relationships between Bone Mineral Density (BMD), Body Mass Index(BMI), Age, pain duration outcomes of treatment for Low Back Pain(LBP) in 3 groups(normal,osteopenia,osteoporosis) of female patients. Methods: We evaluated 32 cases of normal, 30 cases of osteopenia and 38 cases of osteoporosis based on BMD, BMI, Age, pain duration among the female inpatients with LBP caused by lumbar disc herniation, admitted at Jaseng Hospital of Oriental Medicine from January 2010 to December 2011. And we measured VNRS(Verbal Numeric Rating Scale) to evaluate the conservative treatment effects. Results: In improvement of female LBP caused by lumbar disc herniation, BMD(T-score), BMI had not proved correlation(P-value>0.05). Female patients' age was negatively correlated with T-score. In pain improvement, BMD normal group showed more reduction of NRS(numeric rating scale) than osteoporosis group, but that had not proved correlation(p-value=0.893). Conclusions: Statically, among the female inpatients with LBP caused by lumbar disc herniation, had no significant differences between the normal group, osteopenia group and osteoporosis group's improvement rate, depending on treating period.

Effects of Lumbar Stabilization Exercise on Motor Neuron Excitability and Pain in Patients with Lumbar Disc Herniation

  • Kang, Jeongil;Jeong, Daekeun;Choi, Hyunho
    • Journal of International Academy of Physical Therapy Research
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    • v.10 no.2
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    • pp.1785-1790
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    • 2019
  • Background: Lumbar disc herniation (LDH) causes neurological symptoms by compression of the dura mater and nerve roots. Due to the changed in proprioception inputs that can result in abnormal postural pattern, delayed reaction time, and changed in deep tendon reflex. Objective: To investigate the effects of lumbar stabilization exercises on motor neuron excitability and neurological symptoms in patients with LDH. Design: Randomized Controlled Trial (single blind) Methods: Thirty patients with LDH were recruited; they were randomly divided into the balance center stabilization resistance exercise group (n=15) and the Nordic walking group (n=15). Each group underwent their corresponding 20-minute intervention once a day, four times a week, for four weeks. Participants' motor neuron excitability and low back pain were assessed before and after the four-week intervention. Results: There were significant differences in all variables within each group (p<.05). There were significant differences between the experimental and control groups in the changes of upper motor neuron excitability and pain (p<.05), but not in the changes of lower motor neuron excitability and Korean Oswestry Disability Index. Conclusion: Lumbar stabilization exercises utilizing concurrent contraction of deep and superficial muscles improved low back function in patients with LDH by lowering upper motor neuron excitability than compared to exercises actively moving the limbs. Lumbar stabilization exercises without pain have a positive impact on improving motor neuron excitability.

The role of percutaneous neurolysis in lumbar disc herniation: systematic review and meta-analysis

  • Manchikanti, Laxmaiah;Knezevic, Emilija;Knezevic, Nebojsa Nick;Sanapati, Mahendra R.;Kaye, Alan D.;Thota, Srinivasa;Hirsch, Joshua A.
    • 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.

Herniated Lumbar Disc in a Patient Undergoing Lumbar Chuna Manipulation Treatment: A Case Report (요추 추나치료 후 악화된 요추 추간판 탈출증 1례 보고)

  • Jang, Gun;Cho, Tae-Young;Lee, Byeong-Yee;Lee, Jong-Soo;Lim, Hyung-Ho
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.1 no.2
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    • pp.137-141
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    • 2006
  • Cauda equina syndrome(CES) and disc hemiation have been implicated as a potential complication of Chuna Manipulation Treatment. We reported a man who developed sudden complication alter lumbar Chuna Manipulation Treatment. It is supposed that this patient suffered a disc herniation secondarily due to a lumbar Chuna Manipulation Treatment. Therefore, doctors should be aware that neurological complication may occur as a result of lumbar Chuna Manipulation Treatment.

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The Spontaneous Regression of Lumbar Disc Herniation: 3 Cases Report (요추간판 탈출의 자연적 축소(3례 증례보고))

  • Kwon, Won-An;Kim, Han-Soo
    • The Journal of Korean Physical Therapy
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    • v.20 no.3
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    • pp.69-74
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    • 2008
  • Purpose: The majority of patients with radiculopathy caused by a herniated nucleus pulposus (HNP) heal spontaneously without surgery. The aim of this report is to describe the spontaneous regression of lumbar disc herniation and the results of clinical follow-up. Methods: Three patients with radiating low back pain presented with an extruded intervertebral disc on magnetic resonance imaging (MRI). We performed follow-up with conservative treatment (epidural injection, medication, physical therapy, exercise) and clinical assessments on the 6th, 10th and 22nd months. Results: The extruded intervertebral disc almost complete regressed, and correlated with clinical improvement and follow-up MRI. Conclusion: Conservative treatment can be an effective approach for a herniated lumbar discs if no neurological deficits are present.

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