• Title/Summary/Keyword: Lumbar disability

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The clinical study on treatment of HIVD of lumbar spine using Scolopendrid Herbal Acupuncture (요추간판탈출증(腰椎間板脫出症) 치료(治療)에 미치는 오공약침(蜈蚣藥針)에 대한 임상적(臨床的) 고찰(考察))

  • Park, So-Young;Choi, Hoi-Kang;So, Ki-Suk;Kang, Woo-Jung;Lee, Gun-Mok;Kim, Sung-Chul;Koh, Kang-Hun
    • Journal of Pharmacopuncture
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    • v.6 no.1
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    • pp.19-32
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    • 2003
  • Objective : This study is perfonned for the purpose of examining the efficacy of the scolopendrid (Scolopendra morsitans L.) which has been used to low back pain as a folk remedy. Methods & Results : Seventy patients with H.I.V.D. treated with the scolopendrid aquacupuncture and examined 4 tests; D.I.T.L., physical test, Oswestry disability index, and self-conscious pain rate were studied. There was $50{\sim}100\%$ of efficacy rate in each tests. Moreover, statistically valuable change in 5 to 7 D.I.T.I. points and in self-conscious pain rate was showed. Conclusion : The scolopendrid aquacupuncture is possible to be effective treating the H.I.V.D patients. So we suggest the possibility using this new remedy to the H.I.V.D. patients.

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.

Outcomes of Non-Operative Management for Pseudarthrosis after Pedicle Subtraction Osteotomies at Minimum 5 Years Follow-Up

  • Kim, Yong-Chan;Kim, Ki-Tack;Kim, Cheung-Kue;Hwang, Il-Yeong;Jin, Woo-Young;Lenke, Lawrence G.;Cha, Jae-Ryong
    • Journal of Korean Neurosurgical Society
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    • v.62 no.5
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    • pp.567-576
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    • 2019
  • Objective : Minimal data exist regarding non-operative management of suspected pseudarthrosis after pedicle subtraction osteotomy (PSO). This study reports radiographic and clinical outcomes of non-operative management for post-PSO pseudarthrosis at a minimum 5 years post-detection. Methods : Nineteen consecutive patients with implant breakage indicating probable pseudarthrosis after PSO surgery (13 women/six men; mean age at surgery, 58 years) without severe pain and disability were treated with non-operative management (mean follow-up, 5.8 years; range, 5-10 years). Non-operative management included medication, intermittent brace wearing and avoidance of excessive back strain. Radiographic and clinical outcomes analysis was performed. Results : Sagittal vertical axis (SVA), proximal junctional angle, thoracic kyphosis achieved by a PSO were maintained after detection of pseudarthrosis through ultimate follow-up. Lumbar lordosis and PSO angle decreased at final follow-up. There was no significant change in Oswestry Disability Index (ODI) scores and Scoliosis Research Society (SRS) total score, or subscales of pain, self-image, function, satisfaction and mental health between detection of pseudarthrosis and ultimate follow-up. SVA greater than 11 cm showed poorer ODI and SRS total score, as well as the pain, self-image, and function subscales (p<0.05). Conclusion : Non-operative management of implant failure of probable pseudarthrosis after PSO offers acceptable outcomes even at 5 years after detection of implant breakage, provided SVA is maintained. As SVA increased, outcome scores decreased in this patient population.

Correlation of responsiveness to pain intensity and functional status measurements after lumbar epidural steroid injection in patients with lower back pain

  • Park, Sun Kyung;Lee, Aeryoung;Cho, Suk Ju;Park, Sang Hyun;Yun, So Hui;Lee, Bang Won;Na, Changrock;Choi, Yun Suk
    • Journal of Medicine and Life Science
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    • v.19 no.1
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    • pp.20-25
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    • 2022
  • This study aimed to examine the changes in the Numerical Rating Scale (NRS), Oswestry Disability Index (ODI), and Roland Morris Disability Questionnaire (RMDQ) scores before and after epidural steroid injection (ESI) in patients with lower back pain, and the correlation between the three scales in patients with reduced scores on these scales. Patients completed the NRS, ODI, and RMDQ before and after receiving ESI. A paired t-test was performed to compare the mean scores obtained before and after ESI. The correlations between the scores were estimated by calculating the difference between the baseline and follow-up scores. Of the 49 patients, 37 completed both questionnaire assessments. Among them, 26 patients (70%) presented a post-ESI decrease in scores obtained on all three scales. The NRS score decreased from 6.81±1.91 points at baseline to 3.66±2.22 points at follow-up (P<0.0001); similarly, the ODI score decreased from 41.65±14.76 to 30.38±16.16 points (P=0.0025); and the RMDQ score decreased from 11.11±5.68 to 7.64±5.74 points (P=0.011). Of the 37 patients who completed the two questionnaires, 26 had reduced NRS, ODI, and RMDQ scores. The intraclass correlation coefficients between the NRS and ODI, NRS and RMDQ, and ODI and RMDQ scores were 0.7943, 0.6615, and 0.7182, respectively. The concordance correlation coefficients between the NRS and ODI, NRS and RMDQ, and ODI and RMDQ scores were 0.6020, 0.4938, and 0.5202, respectively. Among the measurements, the correlation between the NRS and ODI scores was the highest, and a moderate correlation was found between the scores obtained using the other instruments.

Effects of Equipment-Based Pilates Exercises on Visual Analogue Scale Scores, Oswestry Disability Index scores, and Core Muscle Thickness in Patients with Chronic Low Back Pain (기구 필라테스 운동이 만성 요통 환자의 통증 정도, 장애 지수, 복부근 두께에 미치는 영향)

  • O-Kook Kwon;Hyeon Choi;Chan-Ho Pack;Yeong-sik Yang;Dal-Yeong Yu
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.29 no.1
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    • pp.53-67
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    • 2023
  • Background: This study comparatively evaluated the effects of equipment-based pilates exercises (EPE) and lumbar stability exercises (LSE) in patients with chronic low back pain in terms of their Visual Analogue Scale(VAS), Oswestry Disability Index(ODI), and abdominal muscle thickness. Methods: A total of 30 participants were recruited and randomly assigned to either the EPE or the LSE. The VAS, ODI, and abdominal muscle thicknesses of the participants were measured before and after the intervention. Results: The EPE were more effective in terms of the duration of a sustained reduction in VAS scores. post hoc test revealed that EPE were more efficacious in terms of a sustained improvement in ODI scores. With respect to changes in abdominal muscle thickness, there was a significant difference in the thickness of internal oblique muscles(IO) and the external oblique muscles(EO) between the two groups. Conclusion: In this study, both types of exercise interventions resulted in improvements in the VAS, ODI scores, and abdominal muscle thickness in patients with chronic low back pain. However, EPE were found to be more effective than LPE in terms of longer sustained improvements in VAS and ODI scores. Also, with respect to abdominal muscle thickness, the thickness of EO and IO improved only in the EPE group.

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Risk Factors of Musculoskeletal System in Automobile Manufacturing Workers with Mlid Intellectual Disabilities: Focus on Neck and Lower Back Regions (경도 지적장애 자동차제조업 근로자의 근골격계 위험 요인 조사 -목과 허리 부위 중점으로-)

  • Young-In Hwang;Du-Jin Park
    • PNF and Movement
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    • v.22 no.1
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    • pp.129-137
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    • 2024
  • Purpose: The aim of this study was to investigate and compare the risk factors focusing on the neck and lower back between general workers (GW) and mild intellectual disability workers (MIDW) in the automobile manufacturing industry. Methods: A total of 32 participants were required for this study design to achieve 80% power, 0.9 effect size, and an alpha level of 0.05. Each group consisted of 16 subjects, including GW and MIDW. Pain levels in the neck and lower back were measured for all participants using the visual analog scale (VAS). A dual digital inclinometer was used to measure the range of motion (ROM) in the neck and lower back three times, and the average was used for analysis. The independent t-test was used to compare between the wo groups. Cohen's d effect analysis was employed to determine the effect size. The significant level was set at 0.05. Results: In the MIDW, neck pain was significantly higher, and left cervical flexion was significantly decreased compared with the GW. There was no significant difference in lower back pain between the MIDW and GW. However, both lumbar flexion and extension, as well as lateral flexion, were significantly reduced in the MIDW compared with the GW. Conclusion: This study reveals that MIDW working in the automobile manufacturing industry have a greater risk of neck pain, limitation in left cervical flexion, and overall restriction in the ROM of the lower back compared with GW.

Preservation of the Posterior Ligaments for Preventing Postoperative Spinal Instability in Posterior Decompression of Lumbar Spinal Stenosis: Comparative Study between Port-Hole Decompression and Subtotal Laminectomy (요추부 척추관 협착증의 후방 감압술에서 후방 인대의 보존 여부와 술 후 척추 불안정성과의 연관성: 포트홀(Port-Hole) 감압술과 후궁 아전절제술 간 비교 연구)

  • Jung, Yu-Hun;Na, Hwa-Yeop;Choe, Saehun;Kim, Jin;Lee, Joon-Ha
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.71-77
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    • 2020
  • Purpose: To determine if sparing the interspinous and supraspinous ligaments during posterior decompression for lumbar spinal stenosis is significant in preventing postoperative spinal instability. Materials and Methods: A total of 83 patients who underwent posterior decompression for lumbar spinal stenosis between March 2014 and March 2017 with a minimum one-year follow-up period, were studied retrospectively. The subjects were divided into two groups according to the type of surgery. Fifty-six patients who underwent posterior decompression by the port-hole technique were grouped as A, while 27 patients who underwent posterior decompression by a subtotal laminectomy grouped as B. To evaluate the clinical results, the Oswestry disability index (ODI), visual analogue scale (VAS) for both back pain (VAS-B) and radiating pain (VAS-R), and the walking distance of neurogenic intermittent claudication (NIC) were checked pre- and postoperatively, while simple radiographs of the lateral and flexion-extension view in the standing position were taken preoperatively and then every six months after to measure anteroposterior slippage (slip percentage), the difference in anteroposterior slippage between flexion and extension (dynamic slip percentage), angular displacement, and the difference in angular displacement between flexion and extension (dynamic angular displacement) to evaluate the radiological results. Results: The ODI (from 28.1 to 12.8 in group A, from 27.3 to 12.3 in group B), VAS-B (from 7.0 to 2.6 in group A, from 7.7 to 3.2 in group B), VAS-R (from 8.5 to 2.8 in group A, from 8.7 to 2.9 in group B), and walking distance of NIC (from 118.4 m to 1,496.2 m in group A, from 127.6 m to 1,481.6 m in group B) were improved in both groups. On the other hand, while the other radiologic results showed no differences, the dynamic angular displacement between both groups showed a significant difference postoperatively (group A from 6.2° to 6.7°, group B from 6.5° to 8.4°, p-value=0.019). Conclusion: Removal of the posterior ligaments, including the interspinous and supraspinous ligaments, during posterior decompression of lumbar spinal stenosis can cause a postoperative increase in dynamic angular displacement, which can be prevented by the port-hole technique, which spares these posterior ligaments.

The Effect of Postoperative Use of Teriparatide Reducing Screw Loosening in Osteoporotic Patients

  • Kim, Jae Wook;Park, Seung Won;Kim, Young Baeg;Ko, Myeong Jin
    • Journal of Korean Neurosurgical Society
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    • v.61 no.4
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    • pp.494-502
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    • 2018
  • Objective : The loosening of pedicle screws (PS) is one of the frequent problems of spinal surgery in the patients with osteoporosis. Previous studies had revealed that intermittent injection of teriparatide could reduce PS loosening by improving bone mass and quality when their patients took parathyroid hormone for a considerable duration before surgery. However, although the teriparatide is usually used after spine surgery in most clinical situations, there was no report on the efficacy of teriparatide treatment started after spine surgery. The purpose of this retrospective study was to examine the efficacy of teriparatide treatment started immediately after lumbar spinal surgery to prevent pedicle screw loosening in patients with osteoporosis. Methods : We included 84 patients with osteoporosis and degenerative lumbar disease who underwent transforaminal interbody fusion and PS fixation and received parathyroid hormone or bisphosphonate (BP) postoperatively. They were divided into teriparatide group (daily injection of $20{\mu}g$ of teriparatide for 6 months, 33 patients, 172 screws) and BP group (weekly oral administration of 35 mg of risedronate, 51 patients, 262 screws). Both groups received calcium (500 mg/day) and cholecalciferol (1000 IU/day) together. The screw loosening was evaluated with simple radiographic exams at 6 and 12 months after the surgery. We counted the number of patients with PS loosening and the number of loosened PS, and compared them between the two groups. Clinical outcomes were evaluated using visual analog scale (VAS) and Oswestry disability index (ODI) preoperatively, and at 12 months after surgery. Results : There was no significant difference in the age, sex, diabetes, smoking, bone mineral density, body mass index, and the number of fusion levels between the two groups. The number of PS loosening within 6 months after surgery did not show a significant difference between the teriparatide group (6.9%, 12/172) and the BP group (6.8%, 18/272). However, during 6-12 months after surgery, it was significantly lower in the teriparatide group (2.3%, 4/172) than the BP group (9.2%, 24/272) (p<0.05). There was no significant difference in the number of patients showing PS loosening between the teriparatide and BP groups. The teriparatide group showed a significantly higher degree of improvement of the bone mineral density (T-score) than that of BP group (p<0.05). There was no significant difference in the pre- and post-operative VAS and ODI between the groups. Conclusion : Our data suggest that the teriparatide treatment starting immediately after lumbar spinal fusion surgery could reduce PS loosening compared to BP.

A Clinical Study on Effect of Electro-acupuncture Treatment for Low Back Pain and Radicular Pain in Patients Diagnosed with Lumbar HIVD (요통과 하지방사통을 호소하는 요추 추간판 탈출증 환자의 전침 치료 효과 연구)

  • Lim, Su-Jin;Park, Sang-Won;Lee, Jun-Suk;Lee, Seul-Ji;Kim, Kie-Won;Nam, Ji-Hwan;Lee, Min-Jung;Jeon, Jae-Yoon;Song, Ju-Hyun
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.7 no.2
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    • pp.119-129
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    • 2012
  • Objectives : The purpose of this study was to evaluate the effect of electro-acupuncture treatment for low back pain and radicular pain in patients diagnosed with Lumbar HIVD. Methods : This clinical study was carried out on 92 patients with low back pain and radicular pain diagnosed with HIVD, who had been admitted from Mar. 2011 to Dec. 2011. 60 patients were divided into two groups, group A and group B, of 46 patients each. Group A was treated with electro-acupuncture treatment and general acupuncture treatment twice per day for more than 2 weeks. Group B was treated with general acupuncture treatment twice per day for more than 2 weeks. Verbal numerical rating scale(VNRS) and Oswestry disability index(ODI) were used to evaluated the effectiveness of the Oriental medical treatment. Results : In both two groups, VNRS, ODI, patient's condition grade decreased significantly in ststistics as treatment was perfomed. Between the two groups there was no significant difference in the VNRS, patient's condition grade. But there was significant difference in the ODI. Conclusions : These results suggest that both electro-acupuncture and general acupuncture were effective in reducing low back pain and radicular pain caused by HIVD. More systematic clinical stuty on electro-acupuncture is needed.

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Effect of The Daoyin Exercise Therapy Combined with Complex Korean Medicine Treatment on Pain and Function Improvement of Low Back Pain Patients : A Retrospective Observational Study (한방복합치료를 병행한 도인운동요법이 요통환자의 통증 및 기능 개선에 미치는 영향 : 후향적 관찰 연구)

  • Choi, Bong Seok;Lee, Eun Jung;Li, Yu Chen;Lee, Jung Min;Kim, Eun Seok;Song, Gwang Chan;Jung, In Chul;Oh, Min Seok
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.32 no.1
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    • pp.88-97
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    • 2018
  • This study was designed to prove the effect of the Daoyin exercise therapy combined with complex korean medicine treatment on pain and function improvement of low back pain patients. A retrospective observational study. 30 low back pain patients, checked numeric rating scale(NRS) over 5, were treated with the Daoyin exercise therapy combined with complex korean medicine treatment. NRS, roland & morris disability questionnaire(RMDQ), range of motion(ROM), isokinetic muscle strength, and euroqol five demension questionnaire(EQ-5D) were checked to evaluate patients. The Daoyin exercise therapy combined with complex korean medicine treatment reduced NRS $5.67{\pm}1.40$ to $3.73{\pm}1.72$, improved RMDQ $10.33{\pm}4.91$ to $8.17{\pm}5.40$, strengthened lumbar muscle's peak torque and improved EQ-5D $0.56{\pm}0.20$ to $0.63{\pm}0.15$ and euroqol visual analogue scale(EQVAS) $46.80{\pm}19.95$ to $57.50{\pm}19.93$ but had no effect on ROM. NRS decreased significantly as the number of trials increased. No one had serious adverse reactions. As described above, the Daoyin exercise therapy combined with complex korean medicine treatment can help reducing low back pain, improving lumbar function, strengthening lumbar muscle power and stamina and improving quality of life of low back pain patients.