• Title/Summary/Keyword: Lumbar Spine

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Non-operative Korean Medicine Treatment for Four Patients with Failed Back Surgery Syndrome after Spinal Fusion Surgery : A Retrospective Case Series

  • Seo, Young Hoon;Lee, Jeong Ryo;Lee, Sang Min;Kim, Min Chul;Kim, Yu Jong;Hong, Je Rak;Kim, She Young;Seo, Young Woo;Kim, Ji Su;Park, Han Sol;Lee, Min ho;Kim, Tae Hun;Kim, Kiok
    • The Journal of Korean Medicine
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    • v.37 no.2
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    • pp.93-103
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    • 2016
  • Objectives: The purpose of this study was to report Four cases of Failed Back Surgery Syndrome (FBSS) patients after spinal fusion surgery who showed significant improvement in pain and function with Complex Korean medical treatment. Methods: This study was a retrospective observational study. We reviewed medical records of Four patients with lumbar pain or radiating leg pain, who have received spinal fusion surgery in the past. All Four patients took complex treatments of Mokhuri Neck and Back hospital which involes Acupuncture, Pharmaco-acupuncture, Gangchuk herbal medicine, Chuna and Physical therapy during about four-week of admission treatment. Visual Analogue Scale (VAS), Oswestry disability index (ODI), Pain Free Walking Distance (PFWD) scores were assessed before and after treatments. Results: The average of hospitalization period was 28.5 days. Mean VAS scores decreased from 6.5 to 2.3, Oswestry Disability Index (ODI) scores decreased from 56.25 to 38.25 and Pain Free Walking Distance (PFWD) also improved from 10m to 166.6m. Conclusion: This study implies that a combination of Korean medical treatments might be effective in relieving pain, and improving the functional status of FBSS patients. Further studies are needed to fully understand the mechanisms underlying the effects.

Interventional Pain Management in Rheumatological Diseases - A Three Years Physiatric Experience in a Tertiary Medical College Hospital in Bangladesh

  • Siddiq, Md. Abu Bakar;Hasan, Suzon Al;Das, Gautam;Khan, Amin Uddin A.
    • The Korean Journal of Pain
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    • v.24 no.4
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    • pp.205-215
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    • 2011
  • Background: Interventional pain management (IPM) is a branch of medical science that deals with management of painful medical conditions using specially equipped X-ray machines and anatomical landmarks. Interventional physiatry is a branch of physical medicine and rehabilitation that treats painful conditions through intervention in peripheral joints, the spine, and soft tissues. Methods: A cross-sectional study was conducted using three years of hospital records (2006 to 2008) from the Physical Medicine and Rehabilitation Department at Chittagong Medical College Hospital in Bangladesh, with a view toward highlighting current interventional pain practice in a tertiary medical college hospital. Result: The maximum amount of intervention was done in degenerative peripheral joint disorders (600, 46.0%), followed by inflammatory joint diseases (300, 23.0%), soft tissue rheumatism (300, 23.0%), and radicular or referred lower back conditions (100, 8.0%). Of the peripheral joints, the knee was the most common site of intervention. Motor stimulation-guided intralesional injection of methylprednisolone into the piriformis muscle was given in 10 cases of piriformis syndrome refractory to both oral medications and therapeutic exercises. Soft tissue rheumatism of unknown etiology was most common in the form of adhesive capsulitis (90, 64.3%), and is discussed separately. Epidural steroid injection was practiced for various causes of lumbar radiculopathy, with the exception of infective discitis. Conclusion: All procedures were performed using anatomical landmarks, as there were no facilities for the C-arm/diagnostic ultrasound required for accurate and safe intervention. A dedicated IPM setup should be a requirement in all PMR departments, to provide better pain management and to reduce the burden on other specialties.

Can Abdominal Drawing-In Maneuver Using a Pressure Biofeedback Unit Change Muscle Recruitment Pattern During Prone Hip Extension?

  • Oh, Jae-Seop;Weon, Jong-Hyuck;Cynn, Heon-Seock;Kwon, Oh-Yun
    • Physical Therapy Korea
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    • v.13 no.4
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    • pp.56-63
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    • 2006
  • This study examined the effects of the abdominal drawing-in (ADI) maneuver using a pressure biofeedback on muscle recruitment pattern of erector spinae and hip extensors and anterior pelvic tilt during hip extension in the prone position. Fourteen able-bodied volunteers, who had no medical history of lower extremity or lumbar spine disease, were recruited for this study. The muscle onset time of erector spinae, gluteus maximus, and medial hamstring and angle of anterior pelvic tilt during hip extension in prone position were measured in two conditions: ADI maneuver condition and non-ADI maneuver condition. Muscle onset time was measured using a surface electromyography (EMG). Kinematic data for angle of anterior pelvic tilt were measured using a motion analysis system. The muscle onset time and angle of anterior pelvic tilt were compared using a paired t-test. The study showed that in ADI maneuver during hip extension in prone position, the muscle onset time for the erector spinae was delayed significantly by a mean of 43.20 ms (SD 43.12), and the onset time for the gluteus maximus preceded significantly by a mean of -4.83 ms (SD 14.10) compared to non-ADI maneuver condition (p<.05). The angle of anterior pelvic tilt was significantly lower in the ADI maneuver condition by a mean of 7.03 degrees (SD 2.59) compared to non-ADI maneuver condition (15.01 degrees) (p<.05). The findings of this study indicated that prone hip extension with the ADI maneuver was an effective method to recruit the gluteus maximus earlier than erector spinae and to decrease anterior pelvic tilting.

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Clinical Evaluation of Herniation of nucleus purposus patients treated by Bee venom therapy (봉약침으로 치료한 요추간판탈출증 환자의 임상적 평가)

  • Jun, Hyung-Joon;Hwang, Ook;Kim, Jung-Sin;Nam, Sang-Soo;Kim, Yong-Suk
    • Journal of Oriental Medical Thermology
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    • v.3 no.1
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    • pp.43-51
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    • 2004
  • Objective : The purposes of this study are to evaluate the efficacy of Bee Venom therapy(BV) on HNP(Herniation of Nucleus Purposus) of Lumbar spine by use of Visual Analog Scale(VAS), Pain Rating Scale(PRS) and Digital Infrared Thermographic Imaging(DITI), and to investigate their correlation. Methods : We researched 20 patients who were diagnosed by MRI as having a HNP, and treated them by Oriental medical therapy(including BV) for 4 weeks. The evaluation was peformed twice(admission day and after treatment for 4 weeks), and we compared the results. Results : 1. VAS, PRS and ${\Delta}t$(by DITI) were decreased after BV for 4 weeks significantly(p<0.01). 2. There was significant correlation between VAS and PRS(p<0.05). 3. There was significant correlation between PRS and ${\Delta}t$(p<0.05). 4. There was no significant correlation between VAS and ${\Delta}t$. Conclusions : BV improved HNP subjectively and objectively, and correlation was found between VAS and PRS and between PRS and ${\Delta}t$. Further study is needed for investigating their correlation.

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Case study of application on pelvic manipulation which low back pain patient in unilateral weight bearing due to pelvic imbalance (골반 불균형에 의한 편측체중지지 요통환자의 골반도수교정 적용사례)

  • Kim, Han-Il;Kim, Sang-Su;Kim, Gee-Sun;Park, Ji-Whan
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.15 no.1
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    • pp.72-78
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    • 2009
  • Purpose: to recognized that influence of decrease low back pain, change pelvic structure and balance control on unilateral weight bearing after application on pelvic manipulation which low back pain patient in unilateral weight bearing due to pelvic imbalance. Methods: The patient with low back pain in unilateral weight bearing due to pelvic imbalance was 39year female. one subject received intervention of pelvic manipulation on sidelying position and reaching exercise on sitting position which during 2 weak at the 3 time per a weak, each 30 minutes. outcomes measured were Facia l Action Coding System(FACS), Radiograph(Lumbar-Spine Anteroposterior AP.), Pressure Scan. Results: The results of this study were summarized below : 1. FACS score were Pre: min.4 - max.6 and Post: min.2 - max.4. 2. Radiograph measured Ilium width were Pre: Lt.14cm, Rt.12.7cm and Post: Lt.13.4cm, Rt.13cm which discrepancy of Ilium height were Pre: 1cm and Post: 0.2cm. 3. Pressure scan measured Pre: Lt. 36.8%, Rt.40.2% and Post: Lt.41.3%, Rt.36.2%. Conclusion: Pelvic manipulation applied a patient with low back pain in unilateral weight bearing due to pelvic imbalance suggest that can decrease low back pain, change pelvic structure and balance control on unilateral weight bearing.

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Osteoporotic Condition in Postmenopausal Women with Periodontitis (폐경후 여성의 치주질환 심도에 따른 골다공증 소견)

  • Kim, Kang-Moon;Kim, Young-Jun;Chung, Hyun-Ju
    • Journal of Periodontal and Implant Science
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    • v.32 no.1
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    • pp.225-234
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    • 2002
  • The purpose of this study was to evaluate the relationship between the osteoporotic condition and periodontal condition in postmenopausal women with periodontitis. Forty three female postmenopausal patients with no systemic disease were grouped into 3 groups by their periodontal conditions; 12 mild periodontitis, 11 moderate periodontitis and 20 advanced periodontitis. From each patient, age of menopause was taken, alkaline phosphatase(ALP) and osteocalcin (OC) in blood and deoxypyridinoline (DPD) in urine were measured. Bone mineral density (BMD) of lumbar spine (L2-L4) was measured by dual energy X-ray absorptiometry. Periodontal and osteoporotic parameters were compared among the groups and correlation coefficient between them was evaluated. The blood ALP and OC levels were similar among the groups with different periodontal condition, whereas the urine DPD level and BMD were significantly lower in advanced periodontitis group than the other groups(p<0.01). Probing depth was negatively related with BMD (r=-0.5, p<0.01) and positively related with patient age and the duration of menopause (r= 0.32 and 0.35 respectively, p<0.05). Clinical attachment loss was negatively related with BMD (r=-0.66, p<0.01), and positively related with urine DPD (r= 0.37, p<0.05). These results showed that postmenopausal women with advanced periodontitis had significantly decreased bone mineral density and suggests that decreased bone mineral density in postmenopausal women could be associated with periodontal tissue breakdown.

Effects of Tai Chi Exercise on Physical Fitness, Bone Mineral Density, and Fracture Risk in Institutionalized Elderly (저강도 타이치 운동이 시설거주노인의 체력, 골밀도 및 골절위험도에 미치는 효과)

  • Kim, Hyun-Li;So, Hee-Young;Song, Rha-Yun
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.17 no.3
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    • pp.334-342
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    • 2010
  • Purpose: The purpose of this study was to examine the effects of Tai Chi exercise on flexibility, balance, walking ability, muscle strength, bone mineral density, and fracture risk in institutionalized elders. Method: A quasi-experimental pretest-posttest design with a nonequivalent comparison group was utilized, and 53 older adults living in one institution were recruited and assigned to one of two groups, experimental group (18) or comparison (20). Both groups completed posttest measures at 6 months. There was a 31% rate of dropouts. Tai Chi exercise was provided twice a week for 24 weeks. Outcome measurements were conducted by a physiotherapist at a university hospital health promotion center who did not know the group assignment. Results: At 6 months, the experimental group had significantly greater grip strength(t=2.12, p=.04), back muscle strength (t=2.42, p=.02), balance (t=5.31, p<001), and flexibility (t=3.57, p<.001). They also showed significantly greater bone mineral density of lumbar spine and femur, and reduced fracture risk. Conclusion: Tai Chi exercise was safely and effectively used with institutionalized elders for 6 months and significantly improved physical fitness, bone mineral density along with a reduction in fracture risk. Whether Tai Chi exercise would lead to prevention of fall episodes and fall related fractures in this population will require further study.

Effects of the Hip Internal Rotation Gait on Gluteal and Erector Spinae Muscle Activity (고관절 내회전 보행이 둔부 근육과 척추 기립근의 근활성도에 미치는 영향)

  • Kwon, Oh-Yun;Won, Jong-Hyuck;Oh, Jae-Seop;Lee, Won-Hwee;Kim, Soo-Jung
    • Physical Therapy Korea
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    • v.13 no.1
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    • pp.24-31
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    • 2006
  • The purpose of this study was to identify the effect of the hip internal rotation on gluteal and erector spinae muscle electromyographic (EMG) activity during treadmill walking. Eleven healthy subjects were recruited. All subjects performed treadmill walking while maintaining the hip in neutral position (condition 1) and in internal rotation (condition 2). Surface EMG activity was recorded from four muscles (gluteus maximus (GM), gluteus medius (GMED), tensor fascia latae (TFL), and erector spinae (ES)) and the hip internal rotation angle was measured using a three dimensional motion analysis system. The gait cycle was determined with two foot switches, and stance phase was normalized as 100% stance phase (SP) for each condition using the MatLab 7.0 program. The normalized EMG activities according to the hip rotation (neutral or internal rotation) were compared using a paired t-test. During the entire SP of treadmill walking, the EMG activities of GM in condition 1 were significantly greater than in condition 2 (p<.05). The EMG activities of TFL and ES in condition 2 were significantly greater than in condition 1 (p<.05). The EMG activities of the GMED in condition 1 were significantly greater than in condition 1 (p>.05) except for 80~100% SP. Further studies need randomized control trials regarding the effect of hip internal rotation on the hip and lumbar spine muscle activity. Kinetic variables during gait or going up and down stairs are also needed.

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The Relationship between of Calcium Intake and BMD in Middle-aged Women (중년여성의 칼슘섭취 수준과 골밀도와의 관계)

  • Lee, Jong-Eun;Rhie, In-Sook;Kim, Soon-Lae
    • Research in Community and Public Health Nursing
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    • v.16 no.1
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    • pp.77-85
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    • 2005
  • Purpose: This study was to determine the effects of calcium intake on bone mineral density (BMD) in pre and post menopause women and to provide basic data for enhancing bone health of middle aged women. Methods: A total of 700 middle-aged women living in Seoul and Geonggi Province were interviewed during the period from June 2003 through January 2004 to investigate their social. demographic and physiological characteristics, health and daily activity performance, and their dietary patterns, and bone mineral density was measured. The survey of dietary intake was 24 hour recalls, and the individual calcium intake was calculated using food frequency. Data of 618 subjects was used for the analysis. Of the calcium intake levels, BMD values of the subjects of 20% of high level. 60% of middle level and 20% of low level were analyzed and compared. Results: The level of calcium intake according to general characteristics of the subjects was significantly related to age (p=0.001), education levels (p=.003) and marital status (p=.001). The BMD of the lumbar vertebrae and femur of the subjects taking a high level of calcium showed significantly higher than that of the subjects taking a middle level and low level of calcium. Femoral T-score was also significantly higher in subjects taking a high level of calcium than that of those taking a middle level and lower levels of calcium. Lumber spine T-score was higher in the high level group than that of the middle level group. Conclusion: The study revealed that women taking a high level of calcium had better bone health. Therefore. calcium intake is extremely important in daily dietary intake so that the intake of calcium-rich foods is highly recommended.

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A Meta Analysis on the Effects of Exercise on Bone Mineral Density among Middle-aged and Older Women (운동이 중년이후 여성의 골밀도에 미치는 효과에 대한 메타 분석)

  • Yoo, Ji-Soo;Park, Jee-Won;Lee, Suk-Jeong
    • Research in Community and Public Health Nursing
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    • v.20 no.3
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    • pp.285-295
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    • 2009
  • Purpose: This study was to examine the effectiveness of exercise for bone mineral density (BMD). Methods: Four investigators reviewed English articles from Pub Med and CINAHL, selecting randomized controlled trials on exercise programs for middle-aged and older women. Out of 25 studies identified, 14 that satisfied with the inclusion criteria were included in the meta-analysis. The quality of the studies was assessed using recognized methods and the effect size was calculated as a Hedges'g using Comprehensive Meta-analysis Version 2.0. Primary outcomes were changes in BMD at femoral neck, trochanter, and lumbar spine. Subgroup analysis included changes in BMD according to exercise style. Results: Weight bearing exercise was effective(Q=20.1, p>.05, ES=0.32), and resistance exercise was effective in case of comparing to pre and post intervention (Q=4.15, p=.98, ES=0.14). At the femoral neck, 9 study groups were homogeneous and the experimental groups demonstrated a positive effect on BMD (Q=19.5, p>.05, ES=0.33). In contrast, marked heterogeneity (Q=33.3, p<0.01) was apparent in 7 study groups evaluating trochanter. Conclusion: These findings suggest that weight bearing is effective for BMD of the femoral neck, and is relevant to the non-pharmacological treatment of bone loss for middle-aged and older women.

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