• 제목/요약/키워드: Lumbar Spinal Stenosis

검색결과 174건 처리시간 0.024초

퇴행성 요추질환 영상의 고찰 (Consideration of Imaging Studies for Degenerative Spine Disease)

  • 신정섭;김재헌
    • 대한물리의학회지
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    • 제2권1호
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    • pp.93-99
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    • 2007
  • Purpose : The aim of this study is to consider degenerative spine disease theoretically and compare plain radiography which is a basic study for low back pain with MRI in cases of degenerative lumbar spine disease to find out whether the abnormalities agree with each other. Methods : In 4 cases of lumbar degenerative disease, we studied the relation of the abnormalities such as disc space narrowing, spinal space narrowing, loss of lordosis and osteophytes on plain radiography with those on MRI of HIVD, spinal stenosis and spondylolisthesis. Results : Many abnormalities such as disc space narrowing, spinal space narrowing, loss of lordosis, osteophytes and change of cortex & bone marrow on plain radiography suggest HIVD, spinal stenosis, spondylolysis or spondylolisthesis on MRI. Conclusion : For low back pain patients, plain radiography is a basic study in diagnosis of HIVD, spinal stenosis, spondylolysis or spondylolisthesis but MRI or CT scan is necessary to develop(build) a treatment plan like an operation.

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쿠션인솔이 요추 척추관협착증 환자의 유연성 및 운동능력에 미치는 영향 (The Effect of Cushion Insole on the Flexibility and Exercise Ability of Lumbar Spinal Stenosis)

  • 김현택;문상호;김경철;권병안
    • 디지털융복합연구
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    • 제17권1호
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    • pp.423-432
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    • 2019
  • 본 연구의 목적은 요추 척추관협착증 환자에게 쿠션 인솔을 착용하게 하여서 요추의 유연성과 운동능력에 미치는 영향에 대하여 연구하는 것이다. 요추 척추관협착증이 있는 26명의 환자를 실험군 13명과 대조군 13명으로 무작위로 배치하였다. 참가자들은 6 주간 하루 2 시간 동안 쿠션인솔을 착용하게 하였다. 실험군은 8mm, 대조군은 4mm 쿠션인솔을 맹검법으로 착용하도록 하였다. 실험군의 굴곡능력 검사에서 $3.38{\pm}3.12$의 유의미한 증가(p<0.05)를 보였으나 다른 검사에서는 통계적으로 유의미하지 않았다(p>0.05). 결론적으로 쿠션인솔은 요추 척추관협착증 치료를 위한 중재의 방법으로 적합하지 않았다. 차후에 인솔의 높이나 재질을 다르게 하여 더 연구할 필요성이 있다.

A Comparison of the Clinical Outcomes of Decompression Alone and Fusion in Elderly Patients with Two-Level or More Lumbar Spinal Stenosis

  • Son, Seong;Kim, Woo Kyung;Lee, Sang Gu;Park, Chan Woo;Lee, Keun
    • Journal of Korean Neurosurgical Society
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    • 제53권1호
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    • pp.19-25
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    • 2013
  • Objective : We compared the results of two surgical techniques by retrospective study of 60 elderly patients (65 years or older) who underwent either decompression alone or fusion for the treatment of two-level or more lumbar spinal stenosis. Methods : During the period of 2003 and 2008, two-level or more decompression alone or fusion was performed for lumbar spinal stenosis by three surgeons at our institution. Patients were allocated to two groups by surgical modality, namely, to a decompression group (31 patients) or a fusion group (29 patients). Overall mean age was 71.1 years (range, 65-84) and mean follow-up was 5.5 years (range, 3-9). A retrospective review of clinical, radiological, and surgical data was conducted. Results : No significant difference between the two groups was found with respect to age, follow-up period, surgical levels, or preoperative condition. At the last follow-up, correction of lumbar lordotic angle (determined radiologically) was better in the fusion group. However, clinical outcomes including visual analogue scale, Oswestry Disability Index, and the Odom's criteria were not significantly different in the two groups. On the other hand, surgical outcomes, such as, operation time, estimated blood loss, and surgical complications were significantly better in the decompression alone group. Conclusion : Our findings suggest that decompressive laminectomy alone achieves good outcomes in patients with two-level or more lumbar spinal stenosis, associated with an advanced age, poor general condition, or osteoporosis.

Randomized Controlled Trials of Miniscalpel Acupuncture for Lumbar Spinal Stenosis Cited in the China National Knowledge Infrastructure Database

  • Yoon, Sang Hoon;Kim, Yoon Sik;Kwon, Min Goo;Kwon, Chan Young
    • Journal of Acupuncture Research
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    • 제34권3호
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    • pp.59-69
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    • 2017
  • Objectives : This study analyzed the current status of randomized controlled trials (RCTs) of miniscalpel acupuncture for lumbar spinal stenosis (LSS) in China. Methods : A literature search was performed using the China National Knowledge Infrastructure (CNKI) database. All studies up to June 7th, 2017 were searched. The quality of included RCTs was assessed with the Jadad scale. Results : Five RCTs were finally included in this review. The overall quality of the RCTs was assessed as low. All articles evaluated miniscalpel acupuncture as monotherapy or in combination with filiform needle therapy, drug injection therapy, Tuina treatment, thermal coagulation therapy, or spinal decompression. Miniscalpel acupuncture as monotherapy or adjunctive therapy showed greater therapeutic effect and fewer adverse effects. Conclusion : Miniscalpel acupuncture is a safe and effective nonpharmacological treatment for LSS. However, high-quality studies with consistent treatment protocols are needed to confirm these findings.

감수말 공하법을 병행한 한방치료로 호전된 요추 척추관 협착증 환자의 증례보고 (A Case Report of Lumbar Spinal Stenosis Improved with Diarrhea-Inducing Treatment by Gamsui-mal and Korean Medicine Treatment)

  • 남수현;김동후;최현민;강준혁;현민경
    • 한방재활의학과학회지
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    • 제27권1호
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    • pp.67-75
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    • 2017
  • The purpose of this study is to report the effectiveness of diarrhea-inducing treatment by Gamsui-mal for lumbar spinal stenosis. During hospitalization four patients with lumbar spinal stenosis were treated with diarrhea-inducing treatment by Gamsui-mal and acupuncture, herbal medicine, moxibustion, cupping treatment, Bee-venom pharmacopuncture. Before treatment, we explained in detail about diarrhea-inducing treatment by Gamsui-mal and patients agreed with treatment. The symptoms appeared in patients of diarrhea, abdominal pain, and vomiting in the treatment process. We evaluated the degree of improvement by visual analogue scale (VAS), oswestry disability index (ODI). After treatment, we found that pain was reduced and patient's symptoms were improved by visual analogue scale (VAS), oswestry disability index (ODI) score. The results show that diarrhea-inducing treatment by Gamsui-mal was rapidly improving symptoms. Further studies are needed to clarify the effect of diarrhea-inducing treatment by Gamsui-mal.

요추 추간판 탈출증과 척주관 협착에 의한 통증 치료에 Triamcinolone 시술 횟수와 용량에 따른 경막외 스테로이드 주입법의 효과 비교 (A Comparison of the Efficacy of Epidural Steroid Injections in Terms of the Dosages and Frequency of Triancinolone Injections for the Pain Related to Lumbar Spinal Stenosis or Herniated Disks)

  • 황병문;황범상
    • The Korean Journal of Pain
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    • 제19권1호
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    • pp.72-76
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    • 2006
  • Background: The objective of this study was to describe the extent of pain relief after an epidural steroid injection in the patients suffering from chronic low back pain from herniated disks or lumbar spinal stenosis. Methods: The study was prospectively designed for patients suffering with lumbar spinal stenosis (LSS) and herniated disks (HD) who were referred to a hospital-based pain clinic for epidural steroid injections (ESI). The pain was assessed with using a visual analog scale at baseline, two weeks after the first ESI and two weeks after the third ESI. Results: Eighty patients were enrolled, and all of them provided pain ratings before and after the injections. The LSS patients seemed to improve less than did the HD patients. The results showed no significant differences in the triamcinolone dosage and the frequency of injections for determining the efficacy of ESI. Conclusions: The LSS patients tended to have a less effective respond to ESIs than did the HD patients. The unsatisfactory response to ESI by the LSS patients underscores the need for randomized controlled trials of performing ESI in this population.

사례관리를 위한 Critical Pathway 개발 : 요추협착증 환자의 융합술 (Development of Case Management using Critical Pathway of Posterolateral Fusion for Lumbar Spinal Stenosis)

  • 박혜옥;노유자
    • 성인간호학회지
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    • 제12권4호
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    • pp.727-740
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    • 2000
  • It is well recognized that case management is required to survive in the rapidly changing medical environment. One of the case management is the critical pathway(CP) which is assumed to increase the quality of care and at the same time to decrease the length of stay in hospital. The purpose of the study was to develop a CP for the management of patients with postero-lateral fusion for lumbar spinal stenosis. Through review of literature and medical records of patients with spinal stenosis, a pilot CP was designed, including 8 different care components such as medication, laboratory tests, assessment etc., from one day before surgery to 6 days of postoperative care. Every item of the pilot CP was evaluated by a panel of experts to test the content validity. The items not agreed on by more than 4 out of 6 experts were deleted or modified to be integrated in the CP. To apply the modified CP to a clinical environment, the items reflecting treatment, medication and lab work were entered into an order communication system(OCS), and doctors and nurses were taught to use the CP. Finally, the development of CP for the patients with posterolateral lumbar fusion was completed after the application and variance analysis of the CP.

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FCST의 음양균형장치를 활용한 요추 척추관 협착증의 증례보고 (Lumbar Spinal Stenosis Cases Managed by Yinyang Balance Appliance of FCST, a TMJ Therapy for the Balance of Meridian and Neurological System)

  • 이상배;박상길;오세창;이영준;인창식
    • 턱관절균형의학회지
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    • 제5권sup호
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    • pp.25-30
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    • 2015
  • 본 증례에서는 MRI상 극심한 요추 척추관 협착증 소견을 받고 요통과 하지 방사통으로 일상생활이 어려워 수술적 치료를 예정 받은 환자에게서 음양균형장치를 포함한 PBT, 침치료 등 구조적 치료를 통해서도 유의한 치료변화가 나타남을 관찰하였고 자각적 통증 및 보행 시간의 호전이 있어 이를 보고하는 바이다.

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Comparison of Sagittal Spinopelvic Alignment between Lumbar Degenerative Spondylolisthesis and Degenerative Spinal Stenosis

  • Lim, Jae Kwan;Kim, Sung Min
    • Journal of Korean Neurosurgical Society
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    • 제55권6호
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    • pp.331-336
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    • 2014
  • Objective : The purpose of this study was to evaluate the differences in sagittal spinopelvic alignment between lumbar degenerative spondylolisthesis (DSPL) and degenerative spinal stenosis (DSS). Methods : Seventy patients with DSPL and 72 patients with DSS who were treated with lumbar interbody fusion surgery were included in this study. The following spinopelvic parameters were measured on whole spine lateral radiographs in a standing position : pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis angle (LL), L4-S1 segmental lumbar angle (SLL), thoracic kyphosis (TK), and sagittal vertical axis from the C7 plumb line (SVA). Two groups were subdivided by SVA value, respectively. Normal SVA subgroup and positive SVA subgroup were divided as SVA value (<50 mm and ${\geq}50mm$). Spinopelvic parameters/PI ratios were assessed and compared between the groups. Results : The PI of DSPL was significantly greater than that of DSS (p=0.000). The SVA of DSPL was significantly greater than that of DSS (p=0.001). In sub-group analysis between the positive (34.3%) and normal SVA (65.7%), there were significant differences in LL/PI and SLL/PI (p<0.05) in the DSPL group. In sub-group analysis between the positive (12.5%) and normal SVA (87.5%), there were significant differences in PT/PI, SS/PI, LL/PI and SLL/PI ratios (p<0.05) in the DSS group. Conclusion : Patients with lumbar degenerative spondylolisthesis have the propensity for sagittal imbalance and higher pelvic incidence compared with those with degenerative spinal stenosis. Sagittal imbalance in patients with DSPL is significantly correlated with the loss of lumbar lordosis, especially loss of segmental lumbar lordosis.

요추 척추관 협착증 환자 118례에 대한 임상적 고찰 (The Clinical Study on Spinal Stenosis of Lumbar Spine)

  • 조재희;이효은;문자영;임명장;강인;이한;정호석;김지형
    • 척추신경추나의학회지
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    • 제3권2호
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    • pp.77-85
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    • 2008
  • Object : These studies are designed to make a survey of the effectiveness of the non surgical oriental medicine treatment with Chuna on spinal stenosis of lumbar spine. Methods : The clinical study was done on 118 cases of patients with spinal stenosis of lumbar spine diagnosed by M.R.I, symptoms and physical test who was in the admission in Ja-Seng Oriental Medcine Hospital from October 2006 to October 2008. after treatment we checked VNRS score to estimate the efficacy of treatment. Results : 1. As a Objectivity treatment record, they test excellent 17%, good 69%, fair 8%, poor 6%. 2. The mean NRS score decreased about 3.26 after the treatment. Conclusions : Non surgical oriental medicine treatment with Chuna has on useful effect on spinal stenosis of lumbar spine.

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