• Title/Summary/Keyword: Lumbar Herniated Disc

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Clinical Analysis of Chemonucleolysis for Treatment of Lumbar Disc Herniation (요추간판 탈출증치료에서 화학적 수핵용해술의 임상적 고찰)

  • Ihm, Jowa-Hyuk;Baek, Seung-Chan;Ko, Sam-Kyu;Chi, Yong-Chul;Choi, Byung-Yeran;Moon, Choong-Bae;Cho, Soo-Ho
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.171-177
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    • 1986
  • During last 48 months, in our department 51 patients with single or multiple herniated lumbar discs have received chemonucleolysis. Forty-one of 51 cases have single level herniation and remaining cases have multiple level. Age distribution were from 19 to 59 years old. Over 4 months(longest case: 18 months) follow up revealed as follows: 40 cases(78%) revealed excellent results: 4 cases(7.8%) received discectomy 3-6 months after chemonucleolysis because of recurred symtoms : no anaphylaxis and no major complications were noted.

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Idiopathic Hypertrophic Spinal Pachymeningitis : Report of Two Cases and Review of the Literature

  • Kim, Jee-Hee;Park, Young-Mok;Chin, Dong-Kyu
    • Journal of Korean Neurosurgical Society
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    • v.50 no.4
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    • pp.392-395
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    • 2011
  • Idiopathic hypertrophic spinal pachymeningitis (IHSP) is a rare inflammatory disease characterized by hypertrophic inflammation of the dura mater and various clinical courses that are from myelopathy. Although many associated diseases have been suggested, the etiology of IHSP is not well understood. The ideal treatment is controversial. In the first case, a 55-year-old woman presented back pain, progressive paraparesis, both leg numbness, and voiding difficulty. Initial magnetic resonance imaging (MRI) demonstrated an anterior epidural mass lesion involving from C6 to mid-thoracic spine area with low signal intensity on T1 and T2 weighted images. We performed decompressive laminectomy and lesional biopsy. After operation, she was subsequently treated with steroid and could walk unaided. In the second case, a 45-year-old woman presented with fever and quadriplegia after a spine fusion operation due to lumbar spinal stenosis and degenerative herniated lumbar disc. Initial MRI showed anterior and posterior epidural mass lesion from foramen magnum to C4 level. She underwent decompressive laminectomy and durotomy followed by steroid therapy. However, her conditions deteriorated gradually and medical complications occurred. In our cases, etiology was not found despite through investigations. Initial MRI showed dural thickening with mixed signal intensity on T1- and T2-weighted images. Pathologic examination revealed chronic nonspecific inflammation in both patients. Although one patient developed several complications, the other showed slow improvement of neurological symptoms with decompressive surgery and steroid therapy. In case of chronic compressive myelopathy due to the dural hypertrophic change, decompressive surgery such as laminectomy or laminoplasty may be helpful as well as postoperative steroid therapy.

Surgical Treatment of a Chordoma Arising from the Second Thoracic Vertebral Body through the Modified Anterior Approach - Case Report - (전방 접근법으로 제거한 제2흉추 척삭종 - 증 례 보 고 -)

  • Lee, Jong-Won;Kim, Young-Baeg;Park, Seung-Won;Hwang, Sung-Nam;Choi, Duck-Young
    • Journal of Korean Neurosurgical Society
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    • v.29 no.4
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    • pp.574-579
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    • 2000
  • Chordomas are rare central nervous system tumors that are found predominantly in the sacrococcygeal(50%) and basiosphenoidal region(35%). Most of the remainder are related to the vertebral bodies and only 1 to 2% of them are known to occur in the thoracic vertebrae. A 15-year-old girl was admitted because of paraparesis. Three months prior to admission, she underwent a lumbar laminectomy at other hospital for the treatment of herniated lumbar disc but paraparesis became rather aggravated after the operation. At admission, MRI showed a low signal T1WI, high signal T2WI mass compressing the cord at T2 vertebral body. The tumor was subtotally removed via costotransversectomy but as the tumor was proven to be a chordoma, a second stage operation via anterior route was followed. At second operation, T2 corpectomy and T1-T3 plate fixation with autogeneous ileac bone graft was performed. Shortly after the operation, preoperative paraparesis disappeared completely and no evidence of tumor recurrence was noticed both clinically and radiologically for next 2 years. Spine surgery at cervicothoracic junction may be technically demanding due to anatomical complexity and hindering large vessels. The authers reviewed this case with special emphasis on the surgical procedure in this region.

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A Case of Combination of Korean Medicine Treatments in Neurogenic Claudication and Lower Extremity Weakness due to Spinal Stenosis (척추관 협착으로 인한 신경원성 파행 및 하지 근력 저하에 대한 한방복합치료 치험 1례)

  • Choi, Ki-hoon;Kim, Tae-ju;Choi, Ki-won;Heo, Seung-jin;Kwon, Oh-hoon;Kim, Kwang-hwi;Kim, Tae-yeon;Lee, Tae-geol;Choi, Kang-eah
    • 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.

The Analysis of Research Trend about Management of Low Back Pain (요통관리에 관한 연구동향 분석)

  • Hyun, Kyung-Sun
    • The Korean Journal of Rehabilitation Nursing
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    • v.1 no.1
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    • pp.51-60
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    • 1998
  • The result of studying papers about management of lower back pain published in domestic and foreign nursing and medical magazines in these 10 years is as follows ; 1. General characteristic of lower back pain ; 1) In sex distribution, there were more men than women in 5 papers and more women than men in 4 papers among 9 papers surveryed. 2) In age distribution, thirties to forties of patients had more lower back pain as surveyed by general hospitals and fifties to sixties of patients had more lower back pain as surveyed by oriental medical hospitals. 3) In cause factor, there were 50 to 65% of sprain, 32 to 44% of herniated intervertebral disc and 13 to 29% of degenerative changes. 4) In symtom distribution, there were 26 to 57% of lower back pain, 42 to 65% of lower back pain with radiating pain and 34 to 99% of paravertevral muscle spasm. 5) In period of pain management distribution, 18 to 40% of patients experienced pain for less than 6 months and 59 to 82% of them experienced pain for more than 6 months in 3 papers among 4 papers. 6) In surveying the treatment, 66 to 88% of patients had conservative treatment and there were treatments of general hospital, oriental medicine, self remedy and traditional practice in conservative treatment. 7) In job distribution, 12 to 50% of them were housekeepers, 23 to 31% office workers, 4.6 to 36% blue color workers and 11 to 15% students. 2. As psychological character lower back pain paients had anxiety, depression, anger-hostility, phobic anxiety, neurasthenia, hypochondriasis, and interpersonal sensitivity. 3. To distinguish the cause of lower back pain, plain lumbar roentgenogram, straight leg rasing test, eletromyelogic findings, somatosensory evoked potentials CT and MRI were performed. 4. To relieve lower back pain. epidural adhesiolysis, epidulal injection of local anesthetic in mixture with steroid, lumbar spinal root block, low level laser therapy, acupuncture like transcutaneous nerve stimulation(AL TENS), topical capsaicin and lumbar orthotics were used in medical field, and relaxation technique was used in nursing field. 5. Mckenzie's extension exercise and William's flexsion exercise for lower back pain were used in medical field and Yoga exercise was applied in nursing field. 6. The more school education and self efficacy were high, the better they had active coping lower back pain positively and the less self efficacy was the more they had serious pain. As a result of studying the paper there have been very little research for lower back pain in nursing fields of Korea and foreign countries. Because 60 to 80% of population expeience lower back pain at least more than once, it is necessary to develop the study and clinical practice for management of lower back pain.

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A clinical study about painful manifestation on lumbar with regard to movement change of trunk (체간의 움직임 변화에 따른 요추부 근육의 통증 발현에 대한 임상적 고찰)

  • Kim, Sung-Ryul;Lee, Suk-Min;Song, Chang-Ho
    • The Journal of Korean Physical Therapy
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    • v.16 no.3
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    • pp.86-96
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    • 2004
  • A clinical study about painful manifestation on lumbar with regard to movement change of trunk The purpose of this study is to present the basis of low back pain therapy which is close examined of back muscle that is the main reason for that case of back pain when trunk rotation, flexion and extension. Therefore this study, which is based on literature review and clinical experience, has tried to figure out that back pain which is considered to be significant for the most increasing time, posture, motion, painful area, involved muscle have any influence on trunk rotation, flexion and extension This study has done with the patients in oriental rehabilitation clinic, K-oriental hospital, from Jan, 2003 to Dec, 2003. Total cases were 145(male:$39\%$-52 patients, female:$64.1\%$-93 patients) those who complained lumbosacral pain with radiating that makes patient unable to bending or extending the trunk. And they were surveyed retrospect way, checking the medical record and that of therapist. Results are as followings. 1. For sprain patient, $34.5\%$ complained pain on extension, and among them, the most remarkably, patients who did right rotation extension pattern were $20\%$. Herniated disc patient shows greater limit on flexion when trunk moves bending route, but right rotation with extension pattern shows the most limitation on flexion-extension according to the rotation of trunk 2. Cases of morning back pain($60.5\%$) showed high value on right rotation extension pattern($18.6\%$), right rotation flexion pattern($16.3\%$) but did not show big difference on left flexion and extension pattern 3. Patients those who complain pain on sitting position showed highest value each left, right $14.6\%$ of left and right rotation extension pattern 4. Among extension painful patient, there showed highest value of each $32.5\%$ on right rotation extension pattern, and $20.0\%$ on right rotation flexion pattern. 5. Tenderness distribution of quadratus lumborum showed $34.5\%$ on right rotation extension pattern, $20.7\%$ on left rotation extension pattern, and that of iliopsoas muscle at right rotation flexion pattern showed right muscle $20.0\%$, left $50.0\%$ Derived from the results of survey above, for sprain and HIVD patient showed greatest pain on right rotation pattern, for pain plus patient on right rotation extension among those who has extreme pain on sitting in the morning described tenderness on right quadratus lumborum, and those who complain pain on left rotation extension described tenderness on left lumborum the most Decisively, it is possible to figure out the problem muscle that involved when I found the time, position, motion that aggravating and painful area. Therefore this study would be expected to be able to be a useful clinical materials on diagnosis and therapy of low back pain.

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Angioleiomyosarcoma Arising from the Deep Femoral Vein - A report of one case - (심부 대퇴정맥에 발생한 혈관 평활근육종 - 1예 보고 -)

  • Hwang, Seong-Wook;Gok, Nak-Soo;Jung, Ho-Joong;Sohn, Dong-Suep;Cho, Dai-Yun
    • Journal of Chest Surgery
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    • v.41 no.3
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    • pp.381-385
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    • 2008
  • A 69-year-old man was admitted to our hospital for deep vein thrombosis, and he had experienced two episodes of left leg swelling: one happened after an 11 hour-air trip from Europe in June 2007, and the other developed 3 days after an operation for a herniated lumbar disc in July 2007. We treated him for a deep vein thrombosis of the deep femoral vein after admission. However, we arrived at the final diagnosis of angioleiomyosarcoma after the operation for the tentative diagnosis of deep vein thrombosis. We removed the firmly engorged deep femoral vein on the second operation. We report here on a case of angioleiomyosarcoma that arose from the deep femoral vein.

The Clinical Effects of Non Sugical Spinal Decompression Treatment on HIVD (요추추간판탈출증환자 15예의 척추감압치료 병용에 대한 임상적 고찰)

  • Won, Jae-Kyun;Park, Darn-Seo;Pi, Chien-Hsin;Song, Yong-Sun;Kwon, Young-Mi;Park, Tae-Yong
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.2 no.2
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    • pp.41-48
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    • 2007
  • Objectives : These studies are designed to make a survey of the effectiveness of the non surgical decompression treatment. Methods : These studies 15 cases of L-spine herniated lumbar intervertebral disc(HIVD) which was treated with non surgical spinal decompression and other medicine treatment(acupuncture, cupping, interferential current therapy, ultra-sound therapy and hot poultice). Each patient has been treated with spine decompression and other medicine treatment. And degree of improvement has been evaluated by Visual Analogue Scale and the Roland-Morris Disability Questionnaire score for low back pain. Results and Conclusions : Through the results, the medical treatment proved to have valid effect for L-spine HIDV. And further clinical studies comparing non surgical spinal decompression treatment and other medicine treatment is necessary.

The Clinical Effects of Acupuncture and Acupotomy Therapy for HIVD (요추 추간판 탈출증 환자의 침도요법의 효과에 대한 임상적 고찰)

  • Yun, Joo-Young;Kim, Do-Ho;Kim, Hyun-Wook;Kim, Sung-Soo;Park, Se-Woon;Kim, Eon-Kuk;Lee, Geon-Hui;Lee, Geon-Mok
    • Journal of Acupuncture Research
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    • v.27 no.4
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    • pp.85-97
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    • 2010
  • 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 HIVD. Thus, this study aims to investigate the sense of improvement and satisfaction from the HIVD patients treated with acupotomy therapy. Methods : A total of 63 subjects that consists of HIVD patients were participated in this study. The experimental group(33subjects) was treated with acupotomy therapy and acupuncture, and the control group (30subjects) was treated with acupuncture. All the subjects were asked to answer VAS(visual analogue scale) and ODI(Oswestry disability index) before and after the treatment. Results : The results of the VAS and ODI of comparison analysis between two groups, show that the improvement of HIVD in acupotomy and acupuncture treatment group is more effective than that in acupuncture treatment group

A Case Report of 2 Failed Back Surgery Syndrome Patients Treated by Chuna Cranio-Sacral Therapy with Korean medical treatments (두개천골추나요법을 한의학적 치료에 병행하여 호전된 척추수술실패증후군 환자 치험 2례)

  • Lee, Jong-Hoon;Chang, Dong-Ho;Kim, Jung-Sup;Kim, Dong-Eun;Park, Sang-Eun;Cho, Sung-Woo
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.10 no.2
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    • pp.37-49
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    • 2015
  • Objectives : The purpose of this study is to show the effectiveness of Chuna Cranio-Sacral Therapy for remaining pain and muscle strength decrease after herniated intervertebral disc surgery. Methods : Two patients with Failed Back Surgery Syndrome(FBSS) were hospitalized and treated by Korean medical treatments with Chuna Cranio-Sacral Therapy. The Range of Motion(ROM) of the lumbar spine and Manual Muscle Test(MMT) were adopted to measure the resulting motor recovery after treatment. And the Numerical Rating Scale(NRS) was adopted to measure changes of pain level. Two patients both had Chuna Cranio-Sacral Therapy category III disorder with short right leg. We applied category III blocking technique everyday for 20 minutes with Korean medical treatments. Results : In both cases, the range of motions were improved and the pain level decreased. And in case 1, muscle strength also showed improvements. Conclusions : We suggest Chuna Cranio-Sacral Therapy is effective for pain decrease and motor recovery of FBSS patients. Further studies are needed to set up an Korean medical protocol for FBSS.