• 제목/요약/키워드: Lumbar disc disease patients

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요추 추간판 탈출증의 한의학적 치료와 슬링운동 병행 치료 효과 (Effects of Treatment of Oriental Medicine and Sling Exercise Therapy on Herniated Lumbar Intervertebral Disc)

  • 양미성;강대희;기영범;박수곤;조희근;최진봉;설재욱;김선종
    • Korean Journal of Acupuncture
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    • 제27권4호
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    • pp.5-13
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    • 2010
  • Objectives : Herniated lumbar intervertebral disc is common reason causing back pain. Lumbar stabilization exercise prevent back pain recurrence by strengthening lumbar muscles. Sling Exercise Therapy(SET) is a system for spinal muscle stabilization and strengthening using fixed string and mobile band. The purpose of this study is to investigate and measure the effectiveness of SET and oriental medicine for Herniated lumbar intervertebral disc. Methods : The subjects for this study are 40 patients suffering from Herniated lumbar intervertebral disc in our clinic. They were measured and compared by Visual Analogue Scale(VAS), 4 grades of recovery degree and sex, age, period of disease, disc herniation type, times of exercise. Results : In the above index, the score(VAS, 4 grades of recovery degree) improved after treatments. But they make no difference between sex, age, period of disease, disc herniation type and times of exercise. Conclusions : These results suggest that SET may be used for Herniated lumbar intervertebral disc for pain management and muscle strengthening as an essential treatment regardless of sex, age, period of disease and disc herniation type.

Efficacy of a Novel Annular Closure Device after Lumbar Discectomy in Korean Patients : A 24-Month Follow-Up of a Randomized Controlled Trial

  • Cho, Pyung Goo;Shin, Dong Ah;Park, Sang Hyuk;Ji, Gyu Yeul
    • Journal of Korean Neurosurgical Society
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    • 제62권6호
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    • pp.691-699
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    • 2019
  • Objective : Lumbar discectomy is an effective treatment for lumbar disc herniation (LDH); however, up to 2-18% of patients with LDH have experienced recurrent disc herniation. The purpose of this study was to evaluate the efficacy of a novel annular closure device (ACD) for preventing LDH recurrence and re-operation compared with that of conventional lumbar discectomy (CLD). Methods : In this prospective randomized controlled trial, we compared CLD with discectomy utilizing the $Barricaid^{(R)}$ (Intrinsic Therapeutics, Inc., Woburn, MA, USA) ACD. Primary radiologic outcomes included disc height, percentage of preoperative disc height maintained, and re-herniation rates. Additional clinical outcomes included visual analog scale (VAS) scores for back and leg pain, Oswestry Disability Index (ODI) scores, and 12-item short-form health survey (SF-12) quality of life scores. Outcomes were measured at preoperation and at 1 week, 1, 3, 6, 12, and 24 months postoperation. Results : Sixty patients (30 CLD, 30 ACD) were enrolled in this study. At 24-month follow-up, the disc height in the ACD group was significantly greater than that in the CLD group ($11.4{\pm}1.5$ vs. $10.2{\pm}1.2mm$, p=0.006). Re-herniation occurred in one patient in the ACD group versus six patients in the CLD group (${\chi}^2=4.04$, p=0.044). Back and leg VAS scores, ODI scores, and SF-12 scores improved significantly in both groups compared with preoperative scores in the first 7 days following surgery and remained at significantly improved levels at a 24-month follow-up. However, no statistical difference was found between the two groups. Conclusion : Lumbar discectomy with the $Barricaid^{(R)}$ (Intrinsic Therapeutics, Inc.) ACD is more effective at maintaining disc height and preventing re-herniation compared with conventional discectomy. Our results suggest that adoption of ACD in lumbar discectomy can help improve the treatment outcome.

Immediate Effect of Flexion-Distraction Spinal Manipulation on Intervertebral Height, Pain, and Spine Mobility in Patients with Lumbar Degenerative Disc Disease

  • Pi, Taejin;Chung, Yijung
    • Physical Therapy Rehabilitation Science
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    • 제10권2호
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    • pp.235-243
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    • 2021
  • Objective: This study aimed to investigate the short-term effects of flexion-distraction spinal manipulation on intervertebral height, pain, spine mobility in patients with lumbar degenerative disc disease. Design: Randomized controlled trial with a pretest-posttest control group design Methods: A total of 96 participants with degenerative disc disease participated in the study and were randomly divided into two groups. Both groups received intervention for 3-5 minutes a day. The experimental group (n=48) underwent flexion-distraction spinal manipulation for 3-5 minutes, and the control group (n=48) was maintained in the same position as the experimental group for 5 minutes without any intervention. The intervertebral height was measured by computed tomography, pain was assessed using visual analog scale, and the spine in flexion mobility was measured using the finger-to-floor distance test and passive straight leg raise test. Pre-test and post-test measurements were obtained. Results: The experimental group showed significant improvement in intervertebral height, degree of pain, and spinal mobility (p<0.05). The intervertebral height increased from 6.32±1.90 to 6.93±1.85 mm (p<0.05), lower back pain decreased from 69.17±13.35 mm to 48.48±12.20 mm (p<0.05), lumbar spine mobility changed from 17.37±4.49 to 12.69±4.34 cm (p<0.05), and passive straight leg raise test range increased from 46.94±13.05° to 56.01±12.20° (p<0.05). Conclusions: This study suggests that flexion-distraction spinal manipulation could be an effective treatment for decreasing pain and improving function in patients with degenerative disc disease.

요추 추간판탈출증 입원환자 72례에 대한 한의학적 복합치료 효과의 관찰 연구 (The Effect of Korean Medical Combination Treatment on 72 Cases of Herniated Intervertebral Lumbar Disc Patients: An Observational Study)

  • 김상민;이순호;신유빈;최지훈;구자성;유형진;이동현
    • Journal of Acupuncture Research
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    • 제32권2호
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    • pp.23-33
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    • 2015
  • Objectives : This study was designed to assess the general distribution and clinical effectiveness of Korean medical treatment on lumbar disc herniation. Methods : This is an observational study. 72 patients admitted to Daejeon Jaseng Hospital of Korean Medicine with a diagnosis of herniated intervertebral disc(HIVD) by lumbar-CT of lumbar-MRI were observed from July, 2014 to April, 2015. They were analyzed according to sex, age, the period of disease, causal factors, symptoms on admission, admission day, disc herniation type and treatment efficacy. All patients received a combination of treatments during hospitalization, including acupuncture, Chuna, herbal medicines and physical therapy. A zero to ten numerating rating scale(NRS) assessing pain, Oswestry disability index(ODI) and EuroQol-5 dimension(EQ-5D) was used before and after treatments. Results : Average admission duration was $28.00{\pm}12.85$ days in lumbar disc patients. For lumbar patients, lower back pain NRS decreased from $5.89{\pm}2.00$ to $3.42{\pm}1.87$(p<0.001) and radiating pain from $5.96{\pm}2.12$ to $3.38{\pm}1.83$(p<0.001). ODI decreased from $46.69{\pm}19.25$ to $35.69{\pm}16.67$(p<0.001), and EQ-5D index increased from $0.63{\pm}0.26$ to $0.71{\pm}0.20$(p<0.05) after treatment in lumbar disc patients. Conclusions : Korean medical combination treatment might be effective in reducing pain and improving quality of life for patients with lumbar disc herniation. This study further confirmed the efficacy of Korean medical treatment on HIVD.

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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추간판내 Prostaglandin E2 양의 임상적 의의 (Clinical Implication of Prostaglandin E2 Content in Lumbar Disc Disease)

  • 김형석;조기홍;김기용;안영환;안영민;윤수한;조경기
    • Journal of Korean Neurosurgical Society
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    • 제29권10호
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    • pp.1340-1344
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    • 2000
  • Objective : A prospective biochemical assay of prostaglandin $E_2$ content in symptomatic lumbar disc materials was done in order to clarify the pathogenesis of lumbar radiculopathy. Patients and Methods : Forty-eight disc specimens were purified by a standard solid-phase extraction procedure and analyzed by an enzymelinked immunosorbent assay for prostaglandin $E_2$. Clinical and anatomic correlations were evaluated with analysis of variance and t-test. Results : Acute herniated lumbar disc diseases tended to be associated with a higher prostaglandin $E_2$ content than degenerative lumbar disc disease. Sequestered discs tended to be associated with a higher prostaglandin $E_2$ content than extruded discs, which also showed higher prostaglandin $E_2$ content than protruded ones. A sciatica and positive straight leg raising test appeared to be associated with a higher prostaglandin $E_2$ content than a negative test. Conclusion : This result suggests that the level of prostaglandin $E_2$ would be correlated with clinical symptom and sign in the inflammatory process of lumbar disc herniation.

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Clinical Outcomes of Percutaneous Plasma Disc Coagulation Therapy for Lumbar Herniated Disc Diseases

  • Kim, Sang-Hyun;Kim, Sung-Chul;Cho, Ki-Hong
    • Journal of Korean Neurosurgical Society
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    • 제51권1호
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    • pp.8-13
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    • 2012
  • Objective : This is prospective study of clinical outcomes of percutaneous plasma disc coagulation Therapy (PDCT) in patients with herniated lumbar disc disease (HLD) to evaluate the safety and efficacy in its clinical application and usefulness as a reliable alternative to microscopic discectomy. Methods : Forty-six patients were enrolled in this study from April 2006 to June 2010. All patients had one-level HLD. Disc degeneration was graded on routine T2-weighted magnetic resonance Image (MRI) using the Pfirrmann's grading system and all index levels were grade 3 and grade 4. Indications for surgery were radiculopathy caused by disc protrusion with soft consistency. MRI was done at one month after the procedure in all patients to check post-PDCT change. The clinical outcomes were evaluated using Visual Analog Scales (VAS) score and MacNab's criteria. Results : This study was approved by the Institutional Review Board of our institution. The age of the study population ranged from 16 to 59 years with a mean age of 37.2 years. There were 29 males and 17 females in this study. The mean period of clinical follow-up was 21 months. The average preoperative VAS score for radiculopathy was $7.4{\pm}1.4$, while the final follow-up VAS score was $1.4{\pm}0.7$ (p<0.001). In MacNab's criteria, 41 patients (89.1%) had achieved favorable improvement (excellent and good) until later follow-up. There were one patient from infection and two patients who needed to convert to open discectomy. Conclusion : PDCT is a safe and efficient treatment modality in a selective patient with HLD.

디스크 수술환자의 재활운동 프로그램 적용 후 비만이 요부신전근력 향상 및 요통완화에 미치는 영향 (Effects of Obesity on Lumber Strength and Visual Analogue of Back Pain in Disc Surgical Operated Patients after Rehabilitation)

  • 이창진;임영태
    • 한국운동역학회지
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    • 제15권2호
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    • pp.147-153
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    • 2005
  • The purpose of this study were to compare the differences of isometric lumber extension strength and subjective pain degrees between obesity patients group and normal body fat group in disc surgical operated patients. The research purposed to indicate how isometric lumbar extension exercise for 12 weeks affected to lumbar strength and visual analogue scale of patients suffered by chronic back pain. The subjects were 65 low back pain patients(male 30, female 35)who had disease on lumbar in W hospital. The lumbar extension strength was measured at seven degrees of angles, which were $0^{\circ}$ $12^{\circ}$ $24^{\circ}$ $36^{\circ}$ $48^{\circ}$ $60^{\circ}$ and $72^{\circ}$ before and after the exercise program. We got the results of subjective pain degree using the modified visual analogue scale(VAS) of Lawlis et al(1989) and measured the maximal isometric lumbar strength of all subjects using MedX lumbar extension machine. Results were as follows; After the exercise, the lumbar extension strength of normal body fat patients groups included males and female were greater than that of the obesity patients groups in all angles(p<.05). The visual analogue scale of chronic back pain patients was decreased significantly after the exercise(p<.05). The results showed the significance between the lumbar extension strength and the visual analogue scale of chronic back pain patients and showed that the isometric lumbar extension exercise decreased the subjective pain degrees of visual analogue scale with and increased lumbar extension strength. The correlation between the visual analogue scale and the %body fat of chronic back pain patients was no significant after exercise. Therefore, the lumbar extension strength exercise is needed for improvement of back strength, decrease of %body fat.

요추부 추간판 탈출증 환자에 대한 고전압 미세전류치료의 누적치료효과 (Cumulative Therapeutic Effect of High-Voltage Microcurrent Therapy in Patients with Herniated Lumbar Disc)

  • 윤왕현;박진영;김도영;박중현
    • Clinical Pain
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    • 제18권2호
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    • pp.65-69
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    • 2019
  • Objective: This study aims to evaluate the efficacy of high-voltage microcurrent therapy in patients with herniated lumbar disc (HLD) presenting radicular or back pain. Method: This is a retrospective study with 33 patients who are complaining pain with HLD findings on magnetic resonance image. Microcurrent therapy was applied to leg or paralumbar area. Treatment was conducted for seven minutes with 250~1000 uA intensity as high as the patients could tolerate via stimulating probe with roller type and the frequency was 60 Hz with a sine wave pulse. The visual analogue scale (VAS) was measured just before and after the treatment. Results: The degree of pain reduction (△VAS) was 1.6 points after treatment on average. The △VAS according to the diagnosis, stenosis, dermatome area, medication, pain site and caudal epidural block was not statistically significant. However, the △VAS according to the number of treatments (< 3, ≥ 3 times) showed a statistically significant difference (p=0.04). Conclusion: High-voltage microcurrent therapy may help reduce lumbar or lumbosacral radiating pain after the procedure. The effect was better when microcurrent was applied three times or more. This result suggests that the microcurrent would have cumulative effect on reducing radicular or back pain in patients with HLD.

Dekompressor(R)를 이용한 요부의 경피적 추간판 감압술의 임상 결과 (Clinical Outcomes of Percutaneous Lumbar Discectomy Using Dekompressor(R))

  • 한선숙;심성은;김양현;이은형;조주연;김지영;이상철
    • The Korean Journal of Pain
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    • 제18권2호
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    • pp.187-191
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    • 2005
  • Background: Discogenic leg pain is a major cause of health problems, often due to herniation of the intervertebral disc, and has traditionally been treated conservatively or with an open surgical discectomy. Conventional open surgery has many complications, such as nerve root injury, discitis and a relatively high mortality rate; failure of conservative treatments is also common. Recently, the $Dekompressor^{(R)}$ Percutaneous Lumbar Discectomy probe was developed. Herein, we present the early results for a percutaneous lumbar discectomy in herniated lumbar disc disease. Methods: Eleven patients, including 8 men and 3 women, with ages ranging from 22 to 78 years, were enrolled in this study. Those patients with a previous history of back surgery were not excluded from the study. All patients were postoperatively evaluated for their clinical outcomes, such as visual analogue scale (VAS) for pain after 1 and 3 months, reduction in analgesics, functional improvement and overall satisfaction. Results: The percutaneous lumbar discectomy was completed in 11 patients (17 levels), with average reductions in pre-VAS of 61.3 and 60.2% at 1 and 3 months, respectively. Also, 72.7% of patients reported functional improvement, with 81.1% expressing overall satisfaction. There were no procedural related complications. Conclusions: We concluded that a percutaneous lumbar discectomy is a safe and effective treatment modality for a herniated lumbar disc.