• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.19 no.2
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• pp.19-22
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• 2013

Background: Excessive pronation of the feet can cause excessive inner rotation of the femur, followed by increased stress in the gluteus maximum, increased front slope of the pelvis, and lumbar lordosis, which leads to lumbar pain. The aim of the present study was to use the navicular drop test to examine foot pronation that can cause lumbar lordosis and to determine whether the navicular drop is lower in patients diagnosed with lumbar disc than in patients without this diagnosis. Methods: The Navicular Drop score was set by subtracting the navicular height at a standing position from the navicular height in a sitting position. The Navicular Drop measurements for college student with and without Lumbar Herniated Intervertebral Disc were compared using an independent t-test. Results: The control group were measured right $7.44{\pm}2.96$ and left $8.04{\pm}3.23$. The experimental group were measured right $2.12{\pm}1.33$ and left $2.80{\pm}1.29$. Therefore significant difference was found between the two groups (p<0.05). Conclusions: The navicular drop affected lumbar herniated intervertebral disc.

• The Journal of Korean Obstetrics and Gynecology
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• v.19 no.3
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• pp.203-213
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• 2006

Purpose : This study was carried out to evaluate correlation between Bone Mineral Density(BMD) and degenerative lumbar disease in postmenopausal low back pain patients. Methods : 69 postmenopausal patients with low back pain were examined. Magnetic resonance imaging was performed to evaluate degenerative lumbar disease and bone mineral density of lumbar spine was measured by Dual energy X-ray absorptiometry. Data were analyzed by Pearson's Linear Correlation Coefficient. Results : In postmenopausal patients with low back pain, BMD(T-score, Z-score) had negative correlation with the grade of intervertebral disc herniation and positive correlation with weight. Other lumbar diseases including Spinal stenosis, Spondylolisthesis and Facet joint arthrosis didn't have significant correlation with BMD. Conclusion : In postmenopausal patients with low back pain, BMD(T-score, Z-score) had inverse relationship with the grade of intervertebral disc herniation.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.14 no.1
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• pp.93-98
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• 2019

Objectives : This study aimed to introduce a new traction therapy and proposes that a new Chuna manual therapy technique could be implemented. Methods : The patient is placed in the prone position and their ankle is fixed to the fixing table. Next, clinicians contact on the vertebral spinal process above herniated disc region with the tissue pulled head part of scaphoid bone and the lower part of the pelvis is pulled horizontally to the foot. Conclusions : It was recently identified that traction while maintaining lumbar lordosis is more effective for lumbar disc herniation and is associated with fewer side effects. Chuna manual therapy also uses a technique of lumbar flexion-distraction manipulation to treat HIVD. further research is required.

• Journal of Acupuncture Research
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• v.17 no.3
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• pp.265-276
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• 2000

Objectives : The purpose of this study is to observe the clinical characteristics of 6 patients who were not improved after admitted conservative treatment in this 311 patients. Methods : We retrospectivety reviewed 311 patients of Herniated Lumbar Intervertebral Disc which undenvent admitted conservative treatment from November 1997 to June 2000. 311 patients were diagnosed by computed tomography or magnetic resonance imaging in addition to physical examination. Other complications were not detected in 311 patients with Hemiated Lumbar Intervertebral Disc. In case that the scoliosis appeared to caused by severe pain, we included this scoliosis patient with the object of survey. Results : 1. In 6 patients who were not improved, 4 patients were large herniation and 2 patients were medium herniation. 2. In all of 6 patients, the angle of straight leg raising test was low and was not imporved unril discharge. 3. X-ray findings showed straightening in all of 6 patients, disc space narrowing in 3 of 6 patients. 4. X-ray findings showed scoliosis in 3 of 4 patients who were severe pain. 5. The onset was relarively long from 30 days to 7 years. 6. The age was relatively young from 10's to 30's. 7. The adimission date was ralatively long from 32 days to 105 days. Conclusions : In 6 patients, there were observed much volume of disc herniation, low angle of straight leg raising test, young people in an age group, straightening of x-ray finding.

• The Korean Journal of Pain
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• v.28 no.2
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• pp.75-87
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• 2015

Background: Lumbar discogenic pain without pain mediated by a disc herniation, facet joints, or the sacroiliac joints, is common and often results in chronic, persistent pain and disability. After conservative treatment failure, injection therapy, such as an epidural injection, is frequently the next step considered in managing discogenic pain. The objective of this systematic review is to determine the efficacy of lumbar epidural injections in managing discogenic pain without radiculopathy, and compare this approach to lumbar fusion or disc arthroplasty surgery. Methods: A systematic review of randomized trials published from 1966 through October 2014 of all types of epidural injections and lumbar fusion or disc arthroplasty in managing lumbar discogenic pain was performed with methodological quality assessment and grading of evidence. The level of evidence was based on the grading of evidence criteria which, was conducted using 5 levels of evidence ranging from levels I to V. Results: Based on a qualitative assessment of the evidence for both approaches, there is Level II evidence for epidural injections, either caudal or lumbar interlaminar. Conclusions: The available evidence suggests fluoroscopically directed epidural injections provide long-term improvement in back and lower extremity pain for patients with lumbar discogenic pain. There is also limited evidence showing the potential effectiveness of surgical interventions compared to nonsurgical treatments.

• Journal of Korean Neurosurgical Society
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• v.46 no.1
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• pp.65-67
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• 2009

The authors report two cases of spontaneous regression of disc herniation at the level adjacent to the anterior lumbar interbody fusion (ALIF) level. This phenomenon may be due to the increased tension on the posterior longitudinal ligament (PLL) by appropriate restoration of the disc height and lumbar lordosis, which is a mechanism similar to ligamentotaxis applied to the thoracolumbar burst fracture.

• The Journal of Korean Physical Therapy
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• v.22 no.3
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• pp.71-77
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• 2010

Purpose: To determine whether upregulation of inducible nitric oxide synthase (iNOS) transcription and translation is related to radicular pain in a model of lumbar disc herniation. Also, to investigate the temporal changes of mRNA expression of iNOS and the identity of iNOS and transient receptor potential vanilloid (TRPV) 1 channel expression cells in dorsal root ganglion (DRG) of a model of lumbar disc herniation. Methods: A lumbar disc herniated rat model was developed by implantation of the autologous nucleus pulposus, harvested from the coccygeal vertebra of each tail, on the left L5 nerve root just proximal to the DRG. Rats were tested for mechanical allodynia of the plantar surface of both hind paws 2 days before surgery and 1, 5, 10, 20 and 30 days postoperatively. Reverse transcription polymerase chain reaction (RT-PCR) was used to follow iNOS mRNA expression. To stain iNOS and TRPV1 in DRG, an immunohistochemical study was done 10 days after surgery. Results: A significant drop in mechanical withdrawal threshold on the ipsilateral and contralateral hind paws was observed 1 day after surgery and was prolonged to 30 days in rats with lumbar disc herniation. The expression of mRNA for iNOS peaked at postoperative day 10 on both sides of the DRG. iNOS-positive sensory neurons in the DRG varied in size from large to small diameter cells. A majority of small and intermediate sensory neurons were TRPV1-positive cells. Double immunofluorescence staining for TRPV1 and iNOS revealed that most intermediate TRPV1-positive sensory neurons co-localized with iNOS-positive neurons. Conclusion: Nucleus pulposus-induced mechanical allodynia can be generated without mechanical compression. This pain is related to temporal changes in expression of iNOS mRNA in the DRG. Co-localization of TRPV1 and iNOS in intermediate neurons of the DRG is correlated with pain modality and intensity.

• Journal of Korean Neurosurgical Society
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• v.53 no.1
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• pp.31-38
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• 2013

Objective : Asymptomatic patients show high degeneration prevalence at lumbar disc in previous literatures. Unfortunately, there are few Korean data, so the authors attempted to analyze the prevalence of disc degeneration in highly selective asymptomatic Korean subjects using MRI. Methods : We performed 3 T MRI sagittal scans from T12 to S1 on 102 asymptomatic subjects (50 men and 52 women) who visited our hospital between the ages of 14 and 82 years (mean age 46.3 years). All images were read independently by three observers (two neurosurgeons and one neuroradiologist) who were not given any information about the subjects. We classified grading for lumbar disc herniation (HN), annular fissure (AF), and nucleus degeneration (ND), using disc degeneration classification. Results : The prevalence of HN, AF, and ND were 81.4%, 76.1%, and 75.8% respectively. Almost all levels showed an age-related proportional tendency with some exceptions. Conclusion : In asymptomatic Korean subjects, the abnormal findings showed high prevalence of AF, ND, and extrusion. Especially in young ages, the authors found that bulging, protrusion, and AF showed high prevalence at L4/5 and L5/S1. And ND showed high prevalence at L5/S1. So, all lumbar disc degenerations are not pathologic, especially in children and adolescents.

• Journal of Korean Neurosurgical Society
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• v.41 no.2
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• pp.137-140
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• 2007

HNP [Herniation of the necleus pulposus] generally occurs at ventral portion of lumbar thecal sac due to the anatomical position. We report two unusual cases of herniated dorsal portion of lumbar thecal sac causing diagnostic difficulties. Two patients with posteriorly migrated epidural disc fragments were evaluated with plain X-ray, and magnetic resonance imaging. These patients responded well to operation with complete relief of symptoms. Definite diagnosis of posteriorly located disc fragments is difficult because the radiological images of disc fragments may mimic those of other more common posterior epidural lesions.

• Journal of Acupuncture Research
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• v.18 no.4
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• pp.68-81
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• 2001

Herniated lumbar intervertebral disc(H.I.V.D) is the most common reason causing low back pain and leg radiating pain. Objective : The purpose of this report is to observe the effects of oriental medical conservative treatment in the different herniated type. Methods : We investigated 30 patients suffering from low back pain with sciatica which were admitted to Taejon Cheonan O. M. hospital from Nov 1, 2000 to Apr 30, 2001. 30 patients had a diagnosis of herniated lumbar interver tebral disc by Lumbar-C.T and Lumbar-M.R.I. we treated 30 patients by oriental medical conservative treatment (Ex: acupuncture, herb-med, physical theraphy, bed-rest, etc.) Results : 1. The mean hospitalization of patients was 21.1 days. that in the bulging type was l4days, protruded type 21days, mixed type 27days, extruded type 30days. that shows the less herniation of lumbar intervertebral disc, the mean hospitalization was more short. 2. In the distribution of the clinical symptoms admitted at that time, low back pain, leg radiating pain were showed in the all types(29patients, 96.6%). and sensory disorder, muscle powerlessness were showed least in the bulg ing type(0%, 37.5%), but that were showed most in the extruded type(50%,75%). 3. In the result of treatment due to clinical syptoms, bulging type was more execellent than any other other types. 4. The less herniation of lumbar intervertebral disc, angle of straight leg raising test was higher. In the result of treatment due to angle of straight leg raising test, bulging type was more execellent than any other other types. 5. In the distribution of physical. test, positive case in the Peyton sign, Ankle Dorsiflexion were showed least in the bulging type(25%, 12.5%), but that were showed most in the extruded type(100%, 75%). 6. In the result of treatment due to physical.test, bulging type was more exec ellent than any other other types. 7. The efficacy of total treatment was 90%(when we set a standard things more than fair), that in the bulging type was 100%, protruded 92%, mixedtype 80%, extruded type 75%. Bulging type had a more remakable effectsthan any other types. Conclusions : The less herniation of lumbar intervertebral disc, clinical syptoms were slighter, physical. test were better, and efficacy of oriental medical conservative treatme nt was remakable high.