• Title/Summary/Keyword: Lumbar disc

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Isokinetic Evaluation of Trunk Flexors and Trunk Extensors in Normal Adult Subjects and Patients with Post-operative Herniated Intervertebral Lumbar Disc (정상 성인남자와 요추간판탈출증 수술후 성인남자의 요추부 굴곡근 및 신전근의 등속성 근력평가)

  • Oh Seung-Kil
    • The Journal of Korean Physical Therapy
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    • v.10 no.1
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    • pp.81-98
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    • 1998
  • Isokinetic evaluation of trunk flexors and trunk extensors was performed at $60^{\circ}/sec\;and\;120^{\circ}/sec$ of angular velocity by using cybex 6000TEF Unit on 31 healthy male white workers and 15 post-operative HILD patients with no significant difference in mean age and mean body weight between two groups, and compared each other. The purpose of this study is to obtain the isokinetic normative strength values and endurance latins for Dunk extensors and trunk flexors, and is to provide a guideline for rehabilitation program of post-operative HILD patients. The collected data were analyzed by ANOVA, Duncan's Nyktuoke Range Test, and Pearson correlation coefficiency in PC-SAS program, The results obtained were as follow ; 1. Post-operative subjects has lower isokinetic values than normal subjects in peak torque, peak torque $\%$ by body weight, total work, total work $\%$ by body weight, average power, average power $\%$ by body weight, TAAE of trunk flexors and trunk extensors, and there are significant differences with statistic value in trunk extensors at $60^{\circ}/sec$ and in trunk flexors and trunk extensors at $120^{\circ}/sec$ between two groups(p<0.05). 2. Pest-ooperative subjects has lower values for angle of peak torque than normal subjects in trunk extensors, and there are significant differences with statistic value at $60^{\circ}/sec$ and $120^{\circ}/sec$ between two groups. 3. Post-operative subjects has higher values for endurance ratios than normal subjects in trunk extensors and flexors, but there are no significant differences with statistic value between two groups. 4. Post-operative subjects has higher values than normal subjects in peak torque ratios, total work ratios, average power ratios of trunk flexors to trunk extensors, and there are significant differences with statistic value between two groups(p<0.01). 5. There is significant positive-correlation with statistic valve between peak torque and height and body weight in normal subjects(p<0.05), but Thjere is significant negative-correlation between peak torque of trunk extensor at $120^{\circ}/sec$ and age (p<0.05). 6. There is significant positive-correlation with statistic value between peak torque of trunk flexors and body weight in post-operative subjects (p<0.05), but There is significant negative-correlation between peak torque of trunk extensor add age (p<0.05). In conclusion, post-operative subjects have greater weakness in trunk musculature than normal subjects, especially there is more significant weakness in trunk extensors than in trunk flexors

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Microbiology and Epidemiology of Infectious Spinal Disease

  • Jeong, Se-Jin;Choi, Seung-Won;Youm, Jin-Young;Kim, Hyun-Woo;Ha, Ho-Gyun;Yi, Jin-Seok
    • Journal of Korean Neurosurgical Society
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    • v.56 no.1
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    • pp.21-27
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    • 2014
  • Objective : Infectious spinal disease is regarded as an infection by a specific organism that affects the vertebral body, intervertebral disc and adjacent perivertebral soft tissue. Its incidence seems to be increasing as a result of larger proportion of the older patients with chronic debilitating disease, the rise of intravenous drug abuser, and the increase in spinal procedure and surgery. In Korea, studies assessing infectious spinal disease are rare and have not been addressed in recent times. The objectives of this study are to describe the epidemiology of all kind of spinal infectious disease and their clinical and microbiological characteristics as well as to assess the diagnostic methodology and the parameters related to the outcomes. Methods : A retrospective study was performed in all infectious spinal disease cases presenting from January 2005 to April 2010 to three tertiary teaching hospitals within a city of 1.5 million in Korea. Patient demographics, risk factors, clinical features, and outcomes were assessed. Risk factors entailed the presence of diabetes, chronic renal failure, liver cirrhosis, immunosuppressants, remote infection, underlying malignancy and previous spinal surgery or procedure. We comparatively analyzed the results between the groups of pyogenic and tuberculous spinal infection. SPSS version 14 statistical software was used to perform the analyses of the data. The threshold for statistical significance was established at p<0.05. Results : Ninety-two cases fulfilled the inclusion criteria and were reviewed. Overall, patients of tuberculous spinal infection (TSI) and pyogenic spinal infection (PSI) entailed 20 (21.7%) and 72 (78.3%) cases, respectively. A previous spinal surgery or procedure was the most commonly noted risk factor (39.1%), followed by diabetes (15.2%). The occurrence of both pyogenic and tuberculous spondylitis was predominant in the lumbar spine. Discs are more easily invaded in PSI. At initial presentation, white cell blood count and C-reactive protein levels were higher in PSI compared to TSI (p<0.05). Etiological agents were identified in 53.3%, and the most effective method for identification of etiological agents was tissue culture (50.0%). Staphyococcus aureus was the most commonly isolated infective agent associated with pyogenic spondylitis, followed by E. coli. Surgical treatment was performed in 31.5% of pyogenic spondylitis and in 35.0% of tuberculous spondylitis cases. Conclusion : Many previous studies in Korea usually reported that tuberculous spondylitis is the predominant infection. However, in our study, the number of pyogenic infection was 3 times greater than that of tuberculous spinal disease. Etiological agents were identified in a half of all infectious spinal disease. For better outcomes, we should try to identify the causative microorganism before antibiotic therapy and make every effort to improve the result of culture and biopsy.

Survey on practice behavior and model acceptance of traditional Korean medicine(TKM) doctors in order to develop health insurance payment model related with TKM clinical practice guidelines(CPGs). (한의임상진료지침 연계 건강보험 지불모형 개발을 위한 한의사 진료행태 및 모형 수용도 조사)

  • Kim, Dongsu;Lim, Byungmook;Han, Dongwoon;Park, Ji-eun;Jung, Hyoung-Sun
    • Journal of Society of Preventive Korean Medicine
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    • v.21 no.3
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    • pp.1-10
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    • 2017
  • Objectives : The purpose of this study is to investigate the practice patterns of traditional Korean medicine (TKM) doctors and the acceptance of payment model in order to develop a new TKM health insurance payment model linked with TKM clinical practice guidelines (CPGs). Methods : Lumbar herniated intervertebral disc (HIVD) and idiopathic facial palsy (IFP) were selected as a test diseases to develop a new TKM payment model. The level of benefit coverage in the National Health Insurance (NHI) was designed. The survey asked 228 TKM doctors about their practice patterns in HIVD and IFP patients and acceptance of new payment model. Results : Mean of medical cost for treatment of HIVD was 441,000 KW, mean of treatment period ranged from 4.9 to 17.5 weeks, and mean of number of treatment ranged from 14.6 to 50.4 HIVD patients. In the case of IFP, mean of medical cost for treatment of IFP was 468,000 KW, mean of treatment period was at least 4.2 and up to 15.9 weeks and mean of number of treatment ranged from 14.2 to 52 IFP patients. Conclusions : Current study suggests that mixed payment model of per-visit and episode-based model seem to be proper. The model 1 bundles both items which were covered and not covered by NHI in a rational way. The model 2 is based on the development and application of critical pathway. Lastly, model 3 suggests bundling of items covered by current NHI. Acceptance of TKM doctors is expected to be highest in the model 3.

The study of difference between HIVD group and simple low back pain group by Current Perception Threshold test (요추추간판탈출증군과 단순요통군간의 Current Perception Threshold상의 차이에 관한 연구)

  • Kim Cheol-Hong;Lee Byung-Hoon;Kwon Hye-Yeon;Lim Chun-Woo;Seo Jung-Chul;Youn Hyoun-Min;Song Choon-Ho;Jang Kyung-Jeon;Ahn Chang-Beohm
    • Journal of Acupuncture Research
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    • v.18 no.6
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    • pp.59-69
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    • 2001
  • Objective : The aim of this study is to assess the ability of the CPT test to dignosis radiculopathy in Korean with NeuvalTM CPT database. Method : Electrical stimulation(at 2000, 250, and 5Hz) using Neurometer was applied to the 19 patients who felt back and sciatic pain with herniated intervertevral disc(HIVD) of L-spine, dignosisd by lumbar CT or MRI, and the 33 patients who felt only back or hip or leg pain without HIVD, stenosis, spondylolisthesis which causing radiculopathy. The test sites were toe1, toe3 and toe5 related to L4, L5 and S1 nerve roots. Results : The mean values of the CPT of HIVD group was stiatically lower than LBP group at toe1-250Hz, toe3-2000Hz, 250Hz and toe5-250Hz, 5Hz. The grading CPT score of HIVD group was stastically higher than LBP group at the toe3(L5). The VAS of HIVD group was stastically higher than LBP group. Conclusion : These results suggest that the CPT test can be a valuable testing for diagnosing radiculopathy in Korean. In using CPT test further study is needed for the diagnosis and evaluation of sensory nerve dysfunction in the musculoskeletal disease.

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The Descriptive Analysis on the General Characteristics of the Inpatients with Occupational Injuries in an Oriental Medicine Hospital (한방병원에 입원한 산업재해 환자의 일반적 특성에 대한 기술적 분석)

  • Park, Tae-Yong;Lee, Jung-Han;Moon, Soo-Jeong;Ko, Ha-Neul;Ko, Yeon-Suk;Song, Young-Sun;Kwon, Kang-Beom
    • Journal of Society of Preventive Korean Medicine
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    • v.14 no.3
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    • pp.117-127
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    • 2010
  • Objectives : The purpose of this study was to find out the characteristics of patients who admitted due to industrial accident and to promote the superiority of oriental medical treatment on the sequelae of industrial accident. Methods : We analyzed the medical charts of 51 inpatients in a local oriental medicine hospital. The patients had been hospitalized from May 1, 2003 to October 31, 2010. Results : 1. By gender, males accounted for 78.4%, while females 21.6%. By age, most incidences occurred in the forties(29.4%), fifties(23.5%) and thirties(19.6%) in order. 2. Most causes of accident was carelessness(27.5%) and fall down(21.6%) was the next. 3. With regard to the interval from occurrence of accidents to hospitalization, 20 cases(39.2%) were found to be hospitalized 31~90 days after the accidents, followed by 11 cases(21.6%) in 91~180 days and 7 cases(13.7%) in 181~360 days. 4. Most cases turned out to be injuries with 40 patients from Sequelae of intracerebral hemorrhage (23.5%) and Lumbar and other intervertebral disc disorders with radiculopathy(13.7%). The mean duration of hospitalization was $209.03{\pm}346.04$ days. Inpatients of Organic brain syndrome NOS numbered the longest stay($676{\pm}86.26$days), Sequelae of intracerebral hemorrhage recorded $541.91{\pm}541.83$ days hospitalized. 5. Most of inpatients were treated with acupuncture(100%), herbal medication(98.0%), oriental physiological therapy(82.3%), and moxibustion(76.4%). Conclusions : This article will help the researchers related to Oriental medicine establish basic source of Oriental medicine approach for inpatients due to industrial accident.

Surgical Treatment for Common Iliac Arteriovenous Fistula after Lumbar Laminectomy (요추궁절제술 후에 발생한 총장골동맥의 동정맥루에 대한 수술)

  • Ryu, Kyoung-Min;Ryu, Jae-Wook;Park, Seong-Sik;Kim, Seok-Kon;Seo, Pil-Won
    • Journal of Chest Surgery
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    • v.40 no.6 s.275
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    • pp.455-458
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    • 2007
  • A 40 year-old male patient admitted for dyspnea and edema of the lower extremities. A pulsatile abdominal mass with a bruit was palpable in the right lower quadrant. Four months previously, he had underwent left partial lam-inectomy ($L4{\sim}5$) and discectomy at the L4 level due to disc protrusion, Computed tomography showed an ilio-iliac AV fistula with pseudoaneurysm at the L5 level. Because massive bleeding occurred when the aneurysm was entered, we closed the aneurysm and performed resection and suture of the aorta and both iliac arteries very near the aneurysm. After exclusion of the arterial side, we performed reduction angioplasty at the aneurysm and aorto-biiliac reconstruction with an artifcial graft. Twenty-four months after operation, he is doing well and hasn't had any complications on the follow-up.

A Descriptive Statistical Analysis of the Hospitalized Patients with Low Back Pain in Departments of Korean Rehabilitation Medicine of Korean Medicine Hospitals (한국의 5개 한의과대학 부속한방병원 재활의학과의 요통 입원 환자에 대한 후향적 기술통계분석 - 입원 기간, 상병명, 치료 방법을 중심으로 -)

  • Maeng, Tae-Ho;Kim, Jongyeon;Yi, Woon-Sup;Chung, Won-Seok;Ko, Youn-Seok;Lee, Jung-Han;Shin, Byung-Cheul;Cha, Yun-Yeop;Go, Ho-Yeon;Sun, Seong-Ho;Jeon, Chan-Yong;Jang, Bo-Hyoung;Song, Yun-Kyung;Ko, Seong-Gyu
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.4
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    • pp.213-223
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    • 2013
  • Objectives Low back pain (LBP) is one of the most common reason for people in Korea to visit Korean medical institutions. To assess actual amounts of use in the treatment of LBP in Korean medicine and to provide objective base line data for policy decision making, research regarding the current state of LBP patients' treatment in Korean medical institutions are in need. Methods The current study was designed as a retrospective chart review to investigate descriptive characteristics of LBP patients. The clinical records of 304 patients who were hospitalized for the treatment of LBP in Korean rehabilitation medicine inpatient clinics of five different Korean medicine hospitals were analyzed. The percentage of patient characteristics such as sex, age, average duration of admission, insurance type, diagnosed LBP related disease code, and rates of interventions applied were assessed. Results 1. The female sex was significantly predominant among patients with LBP : 105 patients (34.5%) were male and 199 patients (65.5%) were female. Percentage of the patients' age appeared as followed : 76 people (25.0%) were in their 50s, 64 people (21.1%) were in their 40s, 51 people (16.8%) were in their 30s, 37 people (12.2%) were in their 60s, and 33 people (10.9%) were in their 70s. Approximately half of the total LBP patients investigated were older than 50. 2. The average duration of admission was 16.2 days. Approximately one third (30.3%) of the patients were hospitalized for 8 to 14 days. 3. Female patients tended to stay admitted in hospitals slightly longer than male patients. Elderly (age 60~79) patients stayed in hospitals longer (17.8 days) compared to younger (age 20~39) patients (13.5 days). 4. More than half of the patients (171 cases, 56.3%) had their hospital bills covered with automobile insurance. 40.1% (122 cases) of the patients had medical insurance to cover their hospital bills. The average duration of admission of patients who had automobile insurance was 14.2 days, while that of the patients who had medical insurance was 18.4 days. 5. "Sprain and strain of the lumbar spine and pelvis" was the most commonly used (195 cases, 64.1%) disease code in patients with LBP. Patients diagnosed as "lumbar and other intervertebral disc disorders with radiculopathy" required the longest admission duration (22.1 days). 6. Herbal medication was applied to all of the patients during admission. Acupuncture was applied to all of the patients except one case diagnosed as spinal stenosis. Physical therapy, cupping therapy, moxibustion therapy, chuna therapy, and pharmacopuncture therapy were applied to 94.7, 92.8, 85.2, 83.9, and 49.7% of the patients, respectively. 7. There were certain differences among Korean medicine hospitals in terms of the LBP patients' duration of admission, type of insurance, frequency of the disease code use, type of intervention applied. Conclusions It is thought that the current study can be used as reference data in assessing the current state of LBP treatment in Korean rehabilitation medicine and a basis for future research. Provided improvements of certain limitations of the current study in future researches, such data would act as better base line data in policy decision making.

Relationship between Low Back Pain and Lumbar Paraspinal Muscles Fat Change in MRI (편측 요통을 호소하는 환자에 있어서 척추 주위 근육의 지방량과 통증과의 관계)

  • Kim, Ha-Neul;Kim, Kyoung-Hun;Kim, Joo-Won;Jin, Eun-Seok;Ha, In-Hyuk;Koh, Dong-Hyun;Hong, Soon-Sung;Kwon, Hyeok-Joon
    • Journal of Korean Medicine Rehabilitation
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    • v.19 no.1
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    • pp.135-143
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    • 2009
  • Objectives : Low back pain(LBP) is a common disabling disease in clinical practice and loss of working hours due to this condition is huge. The aim of this study was to determine if there was an association between fat deposit of paraspinal muscles as observed on MRI scans in patients presenting with unilateral LBP. Methods : 24 patients who visiting our hospital with a clinical presentation of unilateral LBP were recruited to the study. Patients were between 20 and 30 years and had a history of unilateral LBP within 12 months. After MRI scaning, the images were saved in DICOM file format for Picture Archiving and Communication System(PACS). The percentage of fat infiltrated area was measured using a pseudocoloring technique. Data were analyzed comparing the fat deposits of the muscles on the symptomatic and asymptomatic sides. Paired t-test was used to find the difference between the measurements of fat tissue in individual patients. Results : The amount of fat in the symptomatic side was $7.6{\pm}4.51%$, asymptomatic side was $6.7{\pm}4.29%$. There were increases, statistically significant, in the fat changes of the paraspinal muscles at the L4-5 disc level(P <0.05). Also, men were likely than women to have more fat deposit in symptomatic side(men $8.5{\pm}5.1%$, women $6.5{\pm}3.6%$). Conclusions : The amount of fat in the symptomatic side shows significantly increased than asymptomatic side in the paraspinal muscles at the L4-5 disc level. It suggested that fat infiltration in the muscles associated with LBP. Further studies will be needed to confirm the relationship between the muscle fatty changes and LBP in the large sample size. In addition, the correlation of pain severity with fat infiltration needs to be addressed.

Treatment by Injection-Acupuncture with Apitoxin and Apitoxin Combined by Chinese Herbal Medicine in Patients with Canine Bind Limb Paralysis : Case Report (후지마비견(後肢痲痺犬)에 대한 봉독(蜂毒) 약침(藥鍼) 및 봉독(蜂毒) 약침(藥鍼)과 한약제(漢藥劑)의 병용치료(倂用治療) : 증례보고(症例報告))

  • Jun, Hyung-Kyou;Park, Se-Kun;Kim, Duck-Hwan;Kim, Mun-Ho;Hsu, Chin-Yuan;Hsu, Chin-Ling;Liao, Jim-Cai;Chueh, Hao-Jen;Cheng, Han-Wen
    • Journal of Veterinary Clinics
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    • v.24 no.2
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    • pp.225-228
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    • 2007
  • The therapy by injection-acupuncture (AP) with bee-venom (apitoxin) and injection-AP with apitoxin combined by administration of Chinese herbal medicine was applied in 2 cases with canine intervertebral disc disease (IVDD). Case 1 was diagnosed as thoraco-lumbar IVDD (T11-T12, T12-T13, L3-L4 and L4-L5) and case 2 was diagnosed as IVDD at T10-T11 and T12-T13, respectively Injection-AP with apitoxin($Apitoxinc{(R)}$, total $200{\mu}g$ of apitoxin, 0.1 ml/acupoint) plus physical exercise (walking with gocart, TID/day) and aquatherapy (swimming treatment, BID/week) were given to each patient. The used acupoints were GV20 (Bai Hui), GB30 (Huan Tiao), ST36 (Zu San Li), GB34 (Yang Ling Quan), ST40 (Feng Long), ST41 (Jie Xi) and BL40 (Wei Zhong), the lesions, and trigger points. In addition, Chinese herbal medicine (Koda Pharmaceutical Co., Taiwan) including Zheng Gu Zi Jin Dan (正骨紫金丹 : 1 g), Shiuh Duann(續斷 : 0.2 g), Du Zhong(杜仲 : 0.2 g), Mo Yao(沒藥 : 0.2 g), Ru Xian(乳香 : 0.2 g) and Pyrite(自然銅 : 0.2 g) were orallly mdeicated BID for 0\9days in case 2. Walking was possible after session 11 for 4 weeks in case 1 and after session 6 for 2 weeks in case 2, respectively.