• Title/Summary/Keyword: Lumbar disability

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A Case Report on a Patient with Osteoarthritis of the Hip Caused by Hip Dysplasia and Lumbar Spinal Stenosis, Treated by Postural Yinyang Correction of Temporomandibular Joint (비구이형성증에 의한 고관절염과 요추 척추관 협착증 환자의 턱관절자세 음양교정술을 이용한 치험 1례)

  • Lim, Jae-Eun;Kim, Kyoung-Min;Jang, Sun-Hee;Park, Eun-Jin;Lee, Young-Jun;Hong, Noo-Ri;Jang, Yeong-Suk;Yang, Su-Hyeon;Choi, Yun-Young;Oh, Da-Yoon;Lee, Soo-Jin;Kim, Cheol-Hong
    • Journal of TMJ Balancing Medicine
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    • v.9 no.1
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    • pp.12-17
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    • 2019
  • Objectives: The purpose of this study is to report the effect of Postural Yinyang Correction of Temporomandibular Joint (Functional Cerebrospinal Therapy, FCST) on a patient with Osteoarthritis of the hip caused by Hip dysplasia and Lumbar spinal stenosis. Methods: A patient with Osteoarthritis of the hip caused by Hip dysplasia and Lumbar spinal stenosis was treated at Dept. of Acupuncture & Moxibustion, ○○ University Korean Medicine Hospital from Nov 8th, 2019 to Dec 6th, 2019 and received a Korean-Western medical treatment mainly managed with FCST. This study was measured with VAS (Visual Analogue Scale), ODI (Oswestry Disability Index) and questionnaire. Results: After treatment, the patient's pain was controlled and gait ability was improved, also VAS, ODI and questionnaire score were improved. Conclusions: Korean-Western Medical Treatment mainly managed with FCST may be helpful in controling pain with Osteoarthritis of the hip caused by Hip dysplasia and Lumbar spinal stenosis, but the further researches are needed.

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Minimum 2-Year Follow-Up Result of Degenerative Spinal Stenosis Treated with Interspinous U ($Coflex^{TM}$)

  • Park, Seong-Cheol;Yoon, Sang-Hoon;Hong, Yong-Pyo;Kim, Ki-Jeong;Chung, Sang-Ki;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.46 no.4
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    • pp.292-299
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    • 2009
  • Objective : Clinical and radiological results of posterior dynamic stabilization using interspinous U (ISU, $Coflex^{TM}$, Paradigm Spine $Inc.^{(R)}$, NY, USA) were analyzed in comparison with posterior lumbar interbody fusion (PLIF) in degenerative lumbar spinal stenosis (LSS). Methods : A retrospective study was conducted for a consecutive series of 61 patients with degenerative LSS between May 2003 and December 2005. We included only the patients completed minimum 24 months follow up evaluation. Among them, 30 patients were treated with implantation of ISU after decompressive laminectomy (Group ISU) and 31 patients were treated with wide decompressive laminectomy and posterior lumbar interbody fusion (PLIF; Group PLIF). We evaluated visual analogue scale (VAS) and Oswestry Disability Index (ODI) for clinical outcomes (VAS, ODI), disc height ratio disc height (DH), disc height/vertebral body length ${\times}100$), static vertebral slip (VS) and depth of maximal radiolucent gap between ISU and spinous process) in preoperative, immediate postoperative and last follow up. Results : The mean age of group ISU ($66.2{\pm}6.7$ years) was 6.2 years older than the mean age of group PLIF ($60.4{\pm}8.1$ years; p=0.003). In both groups, clinical measures improved significantly than preoperative values (p<0.001). Operation time and blood loss was significantly shorter and lower in group ISU than group PLIF (p<0.001). In group ISU, the DH increased transiently in immediate postoperative period ($15.7{\pm}4.5%{\rightarrow}18.6{\pm}5.9%$), however decreased significantly in last follow up ($13.8{\pm}6.6%$, p=0.027). Vertebral slip (VS) of spondylolisthesis in group ISU increased during postoperative follow-up ($2.3{\pm}3.3{\rightarrow}8.7{\pm}6.2$, p=0.040). Meanwhile, the postoperatively improved DH and VS was maintained in group PLIF in last follow up. Conclusion : According to our result, implantation of ISU after decompressive laminectomy in degenerative LSS is less invasive and provides similar clinical outcome in comparison with the instrumented fusion. However, the device has only transient effect on the postoperative restoration of disc height and reduction of slip in spondylolisthesis. Therefore, in the biomechanical standpoint, it is hard to expect that use of Interspinous U in decompressive laminectomy for degenerative LSS had long term beneficial effect.

The Study on Effectiveness of Oriental Medicine Treatment for Lumbar Disc Herniation Inpatients on 208 Cases (요추 추간판 탈출증 입원환자 208례를 통한 한방치료의 효과 연구)

  • Jung, Jae-Hoon;Kim, Won-Woo;Seong, Ik-Hyun;Lee, Kap-Soo;Cho, Chang-Young;Kum, Chang-Jun;Kim, Hee-Jung;Ha, In-Hyuk
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.1
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    • pp.77-86
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    • 2013
  • This study was introduced the short-term effectiveness of Oriental medicine treatment for lumbar disc herniation inpatients. We selected 208 inpatients with a magnetic resonance imaging(MRI)-confirmed lumbar disc herniation since June 2012 until August 2012. Their demographics characterisitics, numeric rating scale(NRS) and Oswestry back-related disability index(ODI) for low or leg pain, lumbar flexion and extension angle were assessed at baseline and when discharged from the hospital. When it measured the straight leg raisingscale(SLR), the low side of the angle was examined. Treatment every patient has received as follow; herbal medicine, bee venom, acupuncture and physical examination, spinal manipulation. NRS of low back pain and leg pain and ODI is $5.6{\pm}2.3$, $4.9{\pm}2.8$ and $45.5{\pm}20.0$, respectively at baseline and $2.8{\pm}1.8$, $2.7{\pm}1.9$ and $27.2{\pm}14.1$, respectively when discharged from the hospital. range of motion(ROM) of lumbar flexion and extension angle and SLR is $70.0{\pm}27.1$, $15.4{\pm}7.2$ and $61.3{\pm}23.0$ respectively at baseline and $80.5{\pm}16.9$, $18.25{\pm}4.1$ and $73.2{\pm}14.0$, respectively when discharged from the hospital. It shows that statistically significant improved(P<0.001). Furthermore, regarding patient satisfaction with the treatment, excellent(33.7%), good(55.4%), normal(10.4%), poor(0.5%), it suggests that most patients(89%) satisfied with the treatment.

Comparative Study on the Clinical Characteristics and Effects of Korean Medical Treatment between the Upper and Lower Lumbar Single Level Disc Herniation (상부요추와 하부요추 단분절 추간판 탈출증 환자의 임상적 특성과 한방치료 효과 비교연구)

  • Lee, Ju-Young;Kim, Yong-Hyeon;Kim, Kwang-Hwi;Kim, Tae-Yeon;Lee, Tae-Geol;Lee, Sang-Woon;Chu, Hui-Yeong;Jung, Hui-Kyeong;Jung, Bum-Hwan
    • Journal of Korean Medicine Rehabilitation
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    • v.28 no.4
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    • pp.43-50
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    • 2018
  • Objectives Upper lumbar disc herniation (LDH) (L1/2, L2/3) has specific anatomical characteristics and different outcome after conventional treatment compared to lower LDH (L3/4, L4/5, L5/S1). The purpose of this study was to compare the clinical features and effects of korean medical treatment of upper LDH between lower LDH. Methods We retrospectively reviewed the clinical data collected from 121 patients who was had admitted at the Haeundae Jaseng Hospital of Korean Medicine from June 1st, 2014 to August 31th, 2018. The patients who had treated at L1/2, L2/3 level LDH were grouped and compared with those treated at the L3/4, L4/5, L5/S1 level. We reviewed the patient characteristics such as age, the positive rate of Straight Leg Raise Test (SLR test), the presence or absence of previous lumbar surgery. Numeric Rating Scale (NRS) and Oswestry Disability Index (ODI) were evaluated at adimission and discharge. Results Mean age was significantly higher at upper LDH group and positive rate of SLR test was higher at lower LDH group. There was no significant difference of gender and previous lumbar surgery between two groups. Each group had a significant improvement of NRS, ODI scores. But between two groups, there was no significant difference of NRS, ODI scores. Conclusions Upper LDH group was older than lower LDH group. SLR test was useful tool to exclude upper LDH. Korean medical treatment was significantly effective to both upper and lower LDH groups. Further well designed prospective comparative studies are needed.

Comparative Analysis of ABM/P-15, Bone Morphogenic Protein and Demineralized Bone Matrix after Instrumented Lumbar Interbody Fusion

  • Sathe, Ashwin;Lee, Sang-Ho;Kim, Shin-Jae;Eun, Sang Soo;Choi, Yong Soo;Lee, Shih-min;Seuk, Ju-Wan;Lee, Yoon Sun;Shin, Sang-Ha;Bae, Junseok
    • Journal of Korean Neurosurgical Society
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    • v.65 no.6
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    • pp.825-833
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    • 2022
  • Objective : ABM/P-15 (anorganic bone matrix/15-amino acid peptide fragment) is a commercially available synthetically manufactured P-15 collagen peptide fragment, that is adsorbed on ABM. This study was done to investigate the efficacy of ABM/P-15 in achieving fusion in the lumbar spine and comparing it with that of recombinant bone morphogenic protein-2 (rhBMP-2) and demineralized bone matrix (DBM). Methods : A retrospective observational study of prospectively collected data of 140 patients who underwent lumbar spinal fusion surgeries in a single specialty spine hospital between 2016 and 2020, with a minimum 6-month follow-up was conducted. Based on the material used for the augmentation of the bone graft at the fusion site, the patients were divided into three categories namely ABM/P-15, rhBMP-2, and DBM group. Results : ABM/P-15, rhBMP-2, and DBM were used in 46, 44, and 50 patients, respectively. Patient characteristics like age, gender, bone mineral density, smoking history, and presence of diabetes mellitus were comparable amongst the three groups. Average follow-up was 16.0±5.2, 17.9±9.8, and 26.2±14.9 months, respectively in ABM/P-15, rhBMP-2, and DBM groups. The fusion was achieved in 97.9%, 93.2%, and 98% patients while the average time-to-union was 4.05±2.01, 10±4.28, and 9.44±3.49 months (p<0.001), respectively for ABM/P-15, rhBMP-2, and DBM groups. The average pre-operative Visual analogue scale score was 6.93±2.42, 7.14±1.97, 7.01±2.14 (p=0.900) for ABM/P-15, rhBMP-2 and DBM groups, respectively, which reduced to 1.02±0.80, 1.21±0.96, and 0.54±0.70 (p=0.112), respectively at the last follow up. Pre-operative Oswestry disability index scores were 52.7±18.02, 55.4±16.8, and 53.56±19.6 (p=0.751) in ABM/P-15, rhBMP-2, and DBM groups, which post-operatively reduced to 33.77±15.52, 39.42±16.47, and 38.3±15.89 (p=0.412) and further to 15.74±8.3, 17.41±10.45, and 16.76±9.81 (p=0.603), respectively at the last follow-up. Conclusion : ABM/P-15 appears to achieve union significantly earlier than rhBMP-2 and DBM in lumbar spinal fusion cases while maintaining a comparable clinical and complication profile.

Treatment of Thigh Injuries (대퇴부 손상의 치료)

  • Park Jai-Hyung;Kim Hyoung-Soo;Kim Hyun-Chul;Ji Jeong-Min
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.3 no.2
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    • pp.100-106
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    • 2004
  • Thigh injuries are relatively uncommon sports injuries. But the incidence is increasing as many kinds of sports activity develops. And the prompt recognition and treatment of these injuries are critical to prevent prolonged disability. Also, despite the simple anatomic structure of the thigh, this region is finely tuned muscular mechanism with both anterior and posterior muscles crossing two joints. So the contracture of thigh muscle can result in not only decreased range of motion of the knee and hip joint, but also painful lumbar spine. So we reviewed recent literatures about the type of thigh injuries, diagnosis, treatment and rehabilitation.

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The Effect of Exercise Program on Chronic Low Back Pain in Female Teachers of Elementary School (만성요통 여교사에 대한 운동프로그램의 효과 - 근력, 근지구력, 유연성, 통증, 기능장애, 우울 및 생활만족도를 중심으로 -)

  • Choi, Soon-Young
    • Women's Health Nursing
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    • v.7 no.2
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    • pp.169-187
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    • 2001
  • This study was performed to probe the effect of exercise program on muscle strength, endurance, flexibility, pain, disability level and life satisfaction in female teachers of elementary school who complain of low back pain. For this study, 44 female teachers aged 30-50 years with mechanical low back pain of 6 months' duration, who had the structural normalities in the lumbar spine, were recruited from April 1 to July 10 1999. Twenty three out of them were assigned to the experimental group and twenty one to the control group. The exercise program consisted of education on right postures, the etiology and diagnosis of low back pain, and exercise intervention such as muscle relaxation, elongation and strengthening. With 8 weeks program, the subjects received two sessions of education and six sessions of group exercise in the 1st week, while three sessions of group exercise and four sessions of individual exercise weekly and two sessions of education during the later 7 weeks. The muscle strength and endurance were measured by Cybex 770, the flexibility by flexibility measurement machine, the intensity of pain by Visual Analogue Scale (VAS), the level of disability by Oswestry low back pain disability scale, depression by Beck depression inventory (BDI), and life satisfaction by Life satisfaction index-Z. Study measurements were taken before and after 8 weeks exercise program. Data were analyzed using paired t-test, t-test, and ANCOVA. The results were as follows ; 1. The flexors and extensors peak torque and flexors peak torque per body weight of experimental group were significantly increased at test velocities $30^{\circ}$/sec, $60^{\circ}$/sec compared with those of control group. There was no significant difference in extensors peak torque per flexors peak torque at $30^{\circ}/sec$, $60^{\circ}/sec$ between experimental and control group. 2. The flexors and extensors total work and flexors total work per body weight of experimental group were significantly increased at $120^{\circ}/sec$, compared with those of control group. 3.The flexibility of lumbar spine in experimental group was significantly increased compared with that of control group. The pains in anterior, posterior, left lateral and right lateral bending and in rotation of experimental group were significantly increased compared with those of control group. 4. The Oswestry disability scores of experimental and control group were significantly decreased, and there was no difference in the Oswestry disability score change between experimental and control group. 5. The scores of BDI of experimental group were significantly decreased compared with those of control group. Life satisfaction index-Z scores of experimental group were not changed, but those of control group were significantly decreased. There was no difference in the score change of Life satisfaction index-Z between experimental and control group. 6. ANCOVA analysis for the data variables of inhomogeneous baseline represented that there was no significant difference in extensors peak torque and extensors total work at $120^{\circ}/sec$ and extensor total work per body weight at $120^{\circ}/sec$ change between experimental group and control group. These findings indicate that the exercise program could be effective in increasing the muscle strength, endurance, flexibility and decreasing pain, improving depression in female teachers of elementary school with chronic low back pain. It is suggested that the exercise program could be an essential factor for the effective nursing intervention to the patients suffered from chronic low back pain.

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Posterior Interspinous Fusion Device for One-Level Fusion in Degenerative Lumbar Spine Disease : Comparison with Pedicle Screw Fixation - Preliminary Report of at Least One Year Follow Up

  • Kim, Ho Jung;Bak, Koang Hum;Chun, Hyoung Joon;Oh, Suck Jun;Kang, Tae Hoon;Yang, Moon Sool
    • Journal of Korean Neurosurgical Society
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    • v.52 no.4
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    • pp.359-364
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    • 2012
  • Objective : Transpedicular screw fixation has some disadvantages such as postoperative back pain through wide muscle dissection, long operative time, and cephalad adjacent segmental degeneration (ASD). The purposes of this study are investigation and comparison of radiological and clinical results between interspinous fusion device (IFD) and pedicle screw. Methods : From Jan. 2008 to Aug. 2009, 40 patients underwent spinal fusion with IFD combined with posterior lumbar interbody fusion (PLIF). In same study period, 36 patients underwent spinal fusion with pedicle screw fixation as control group. Dynamic lateral radiographs, visual analogue scale (VAS), and Korean version of the Oswestry disability index (K-ODI) scores were evaluated in both groups. Results : The lumbar spine diseases in the IFD group were as followings; spinal stenosis in 26, degenerative spondylolisthesis in 12, and intervertebral disc herniation in 2. The mean follow up period was 14.24 months (range; 12 to 22 months) in the IFD group and 18.3 months (range; 12 to 28 months) in pedicle screw group. The mean VAS scores was preoperatively $7.16{\pm}2.1$ and $8.03{\pm}2.3$ in the IFD and pedicle screw groups, respectively, and improved postoperatively to $1.3{\pm}2.9$ and $1.2{\pm}3.2$ in 1-year follow ups (p<0.05). The K-ODI was decreased significantly in an equal amount in both groups one year postoperatively (p<0.05). The statistics revealed a higher incidence of ASD in pedicle screw group than the IFD group (p=0.029) Conclusion : Posterior IFD has several advantages over the pedicle screw fixation in terms of skin incision, muscle dissection and short operative time and less intraoperative estimated blood loss. The IFD with PLIF may be a favorable technique to replace the pedicle screw fixation in selective case.

A Case Report of Lumbar HIVD Treated with Korean Medicine on a Polycystic Kidney Patient (다낭신 환자의 요추 추간판탈출증에 대한 통합한방치료 1례)

  • Ju, Ah-ra;Ryu, Gwang-hyun;Park, Mi-so;Choi, Yo-sup;Choo, Won-jung;Chae, Ji-won
    • The Journal of Internal Korean Medicine
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    • v.41 no.2
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    • pp.132-140
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    • 2020
  • Objectives: This research study aimed to determine the effect of Korean medicine treatments on a patient with lumbar disc herniation accompanying polycystic kidney disease. Methods: Acupuncture, herbal medicine, pharmacopuncture, spine decompression therapy, Motion Style Acupuncture Treatment (MSAT), and Chuna were preceded for treatment. We checked the patient's Oswestry Disability Index (ODI), numeric rating scale (NRS), and straight leg raise test (SLRT) on admission and discharge; we also used the NRS and SLRT to evaluate the patient's symptoms on every third day during the hospital stay. Because it is important to manage blood urea nitrogen (BUN), serum creatinine, and blood pressure during the early stage of polycystic kidney disease, BUN and serum creatinine levels were checked weekly while blood pressure was checked every morning. Results: Twelve days after admission, the NRS for lower back pain and right leg pain decreased from 7 to 3 and from 7 to 2, respectively. The ODI value also decreased from 56 to 20 while the SLRT value increased from 30/70 to 60/70. The BUN and serum creatinine levels and the blood pressure readings were all within normal range every time they were checked. Conclusions: The use of Korean medicine treatments resulted in improvements in NRS, ODI, and SLRT on a patient with a herniated lumbar disc herniated who had a past history of polycystic kidney disease; thus, the patient was able to maintaining kidney functioning. Herbal medicine, an alternative method of analgesic anti-inflammatory drugs that has been evaluated as relatively safe on liver and kidney function, could be suggested on a patient with a past history of polycystic kidney disease to maintain kidney function when renal function and blood pressure are monitored.

Direct Pars Repair Surgery Using Two Different Surgical Methods : Pedicle Screw with Universal Hook System and Direct Pars Screw Fixation in Symptomatic Lumbar Spondylosis Patients

  • Shin, Myung-Hoon;Ryu, Kyeong-Sik;Rathi, Nitesh Kumar;Park, Chun-Kun
    • Journal of Korean Neurosurgical Society
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    • v.51 no.1
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    • pp.14-19
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    • 2012
  • Objective : The authors performed a retrospective study to assess the clinical and radiological outcome in symptomatic lumbar spondylolysis patients who underwent a direct pars repair surgery using two different surgical methods; pedicle screw with universal hook system (PSUH) and direct pars screw fixation (DPSF), and compared the results between two different treated groups. Methods : Forty-seven consecutive patients (PSUH; 23, DPSF; 15) with symptomatic lumbar spondylolysis who underwent a direct pars repair surgery were included. The average follow-up period was 37 months in the PSUH group, and 28 months in the DPSF group. The clinical outcome was measured using visual analogue pain scale (VAS) and Oswestry disability index (ODI). The length of operation time, the amount of blood loss, the duration of hospital stay, surgical complications, and fusion status were also assessed. Results : When compared to the DPSF group, the average preoperative VAS and ODI score of the PSUH group were less decreased at the last follow-up; (the PSUH group; back VAS : 4.9 vs. 3.0, leg VAS : 6.8 vs. 2.2, ODI : 50.6% vs. 24.6%, the DPSF group; back VAS : 5.7 vs. 1.1, leg VAS : 6.1 vs. 1.2, ODI : 57.4% vs. 18.2%). The average operation time was 174.9 minutes in the PSUH group, and 141.7 minutes in the DPSF group. The average blood loss during operation was 468.8 cc in the PSUH group, and 298.8 cc in the DPSF group. The average hospital stay after operation was 8.9 days in the PSUH group, and 7 days in the DPSF group. In the PSUH group, there was one case of a screw misplacement requiring revision surgery. In the DPSF group, one patient suffered from transient leg pain. The successful bone fusion rate was 78.3% in the PSUH group, and 93.3% in the DPSF group. Conclusion : The present study suggests that the technique using direct pars screw would be more effective than the method using pedicle screw with lamina hook system, in terms of decreased operation time, amount of blood loss, hospital stay, and increased fusion success rate, as well as better clinical outcome.