• Korean Journal of Acupuncture
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• v.38 no.3
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• pp.189-195
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• 2021

Foot drop due to lumbar disc herniation is perceived to be an indication for surgery. A 44-year-old male presented with motor deficit in left ankle dorsiflexion along with radiating pain and paraesthesia. Motion Style Acupuncture Therapy (MSAT) was administered on the left side every other day. Acupuncture and Chuna were performed daily. Herbal medicine was taken 3 times a day. His symptoms rapidly improved throughout treatment, verified by decreased Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), increased 5-level EuroQol-5 Dimension (EQ-5D-5L) scores, and improved motor grades. We suggest that a combination of MSAT with traditional Korean medicine could be a favorable option for foot drop in LDH patients in terms of rapid pain reduction and the improvement of quality of life.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.12 no.2
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• pp.33-41
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• 2006

This study planed to analyze durability of effect and result that the Medx and Sling exercise gets to the strength of lumbar extensors. 15 patients who had enforce the minimal invasive lumbar surgery were executed 3 times per week for 8 weeks. The purpose of this study was to identify the influence of the mixed exercises of the Medx and Sling program on lumbar trunk muscles and to present basic data for the proper exercise prescription for lumbar patients. The results were as follows: 1) Left: Patients by lumbar hernia operation of trunk muscle strength by Sling-exercise: 0, 45, 90, 135, 180 (degree) treatment periods (P<0.05). 2) Right: Patients by lumbar hernia operation of trunk muscle strength by Sling-Exercise: 0, 45, 90, 135, 180 (degree) treatment periods (P<0.05). Medx treatment, a muscle strengthening lumbar extension exercise program, was now being used at local hospitals. In addition, Sling exercise, which is designed to develop lumbar muscle by way of reducing gravity in a new way so that it can accelerate the growth of muscles and ligaments in-depth in the patients, also has begun to be introduced gradually. In this study, therefore, the new mixed program (Sling and Medx training)can used as an exercise program that can reduce pain and increase lumbar muscles, not only for disk disease patients but also for all those who have undergone surgery or who haven't undergone surgery, who have chronic pain, and it also can be utilized as basic data for the new method of exercise.

• Journal of Korean Neurosurgical Society
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• v.66 no.1
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• pp.33-43
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• 2023

Objective : To compare the outcomes of anterior lumbar interbody fusion (ALIF), oblique lumbar interbody fusion (OLIF), and transforaminal lumbar interbody fusion (TLIF) in terms of global sagittal alignment. Methods : From January 2007 to December 2019, 141 adult patients who underwent multilevel interbody fusion for lumbar degenerative disorders were enrolled. Regarding the approach, patients were divided into the ALIF (n=23), OLIF (n=60), and TLIF (n=58) groups. Outcomes, including local radiographic parameters and global sagittal alignment, were then compared between the treatment groups. Results : Regarding local radiographic parameters, ALIF and OLIF were superior to TLIF in terms of the change in the anterior disc height (7.6±4.5 mm vs. 6.9±3.2 mm vs. 4.7±2.9 mm, p<0.001), disc angle (-10.0°±6.3° vs. -9.2°±5.2° vs. -5.1°±5.1°, p<0.001), and fused segment lordosis (-14.5°±11.3° vs. -13.8°±7.5° vs. -7.4°±9.1°, p<0.001). However, regarding global sagittal alignment, postoperative lumbar lordosis (-42.5°±9.6° vs. -44.4°±11.6° vs. -40.6°±12.3°, p=0.210), pelvic incidence-lumbar lordosis mismatch (7.9°±11.3° vs. 6.7°±11.6° vs. 11.5°±13.0°, p=0.089), and the sagittal vertical axis (24.3±28.5 mm vs. 24.5±34.0 mm vs. 25.2±36.6 mm, p=0.990) did not differ between the groups. Conclusion : Although the anterior approaches were superior in terms of local radiographic parameters, TLIF achieved adequate global sagittal alignment, comparable to the anterior approaches.

• Journal of Korean Physical Therapy Science
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• v.12 no.3
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• pp.13-26
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• 2005

Low back pain is one of the most frequent problems treated in clinical feild. Eight out of ten people will experience significant low back pain sometime during their life. Most cases low back pain are not serious and respond to conservative treatment. It's pain is severe and not responding to conservative treatment or if it has significant leg pain. In these cases are may recommend surgery. The purpose of this study is to analyze the effective duration of treatment and degree of variable pain approached conservative treatment. The persons who diagnosed to herniated intervertebral lumbar disc were attended in this study. number of cases were 60cases. We evaluated their chart, X-ray and MRI. The result of the study were as follows; 1. The patients who treated for 33days were improved 100%, which was 3cases(5%). 2. The patients who treated for 45days were improved 90%, which was 13cases(22%). 3. The patients who treated for 43days were improved 80%, which was 28cases(47%). 4. The patients who treated for 39days were improved 70%, which was 6cases(10%). 5. The patients who treated for 28days were improved 60%, which was 5cases(28%). 6. The patients who treated for 22days were improved 50%, which was 4cases(7%). Conclusion ; In herniated intervertebral lumbar disc patients who had conservative treatment. The highest improve patients were 28 cases(47%), who treated for 43 days. The lowest improve patient was 1case(2%), who treated for 28 day. The Effective duration of conservative treatment was more than 43days. If they wants to be improving their symptoms, they should be treat for more than 43days.

• Journal of Korean Neurosurgical Society
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• v.67 no.2
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• pp.209-216
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• 2024

Objective : Some patients with disc herniation who underwent discectomy complain of back pain after surgery and are unsatisfied with the surgical results. This study aimed to evaluate the relationship between preoperative disc height (DH), postoperative DH, and pain score 12 months after surgery in patients who underwent microdiscectomy for herniated lumbar disc. Methods : This study enrolled patients who underwent microdiscectomy at a medical center between January 2012 and December 2020. Patients with X-ray or computed tomography and pain score assessment (visual analog scale score) prior to surgery, immediately post-op, and at 1, 6, and 12 months after surgery were included. The DH index was defined as DH/overlying vertebral width. The DH ratio was defined as the postoperative DH/preoperative DH. Simple linear regression and multivariate linear regression analyses were applied to assess the correlation between DHs and leg pain scores 12 months after surgery. Results : A total of 118 patients who underwent microdiscectomy were included. DH decreased up to 12 months after surgery. The DH ratio at 1, 6, and 12 months after discectomy showed a significant positive correlation with the pain scores at 12 months after discectomy (1 month : p=0.045, B=0.52; 6 months : p=0.008, B=0.78; 12 months : p=0.005, B=0.69). Multivariate linear regression analysis revealed that the level of surgery, sex, age, and body mass index had no significant relationship with back pain scores after 12 months. Conclusion : In patients who underwent microdiscectomy, the DH ratios at 1, 6, and 12 months after surgery were prognostic factors for back pain scores at 12 months after surgery. Aggressive discectomy is recommended for lower postoperative DH ratios and Visual analog scale scores, leading to improved patient satisfaction.

• Journal of Korean Neurosurgical Society
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• v.29 no.1
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• pp.35-43
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• 2000

Objective : Percutaneous lumbar approaches such as arthroscopic discectomy, laser discectomy, and nucleotome remain controversial and have technical limitations to free fragment disc, bony pathology and access to L5-S1, The purpose of this study was to determine efficacy of this new endoscopic system and to report techniques and tactics. Methods : From July 1997 to May 1998, we treated 40 consecutive patients(43 levels) with the MED system. Mean age was 32 years(range ; 18 to 62). There were 30 males and 10 females. All patients had sciatica with SLRT limitation. There were 23 patients with disc herniation at L4-5 and 14 patients at L5-S1. Three patients had 2 level disc herniations. There was one far lateral disc herniation at L4-5. Results : Using modified MacNab criteria, there were 37 excellent results and 3 good result. Most patients were discharged within 3-4 days except 2 patients with dural tearing. There were no other complications. Mean operation time was 1.5 hours(range : 40 minutes to 2.5 hours). Conclusion : The MED system is a reliable approach to lumbar disc herniations. This system combines the advantages of conventional open surgery and a minimally invasive technique. As tactics for the doctors who wish to attempt, "palpate" the lamina by first dilator, identification of interlaminar space by removal of overlying soft tissue and confirmation of the shoulder portion of nerve root before discectomy are important to this procedure. We conclude that lumbar disc herniations can be successfully treated with MED approach.

• Journal of Korean Neurosurgical Society
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• v.38 no.5
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• pp.399-402
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• 2005

Direct anterior approach for lesions located anterior to the thecal sac is definitely superior to lateral or posterior approach in many respects. However, various anatomical obstacles and technical difficulties often hinder direct anterior approach. Thanks to ripe experience of retroperitoneal approach to the lumbar spine for anterior lumbar interbody fusion and total disc replacement, the authors could perform lumbar corpectomy and reconstruction by using midline retroperitoneal approach recently. During this approach, we repaired anterior longitudinal ligament also to reduce the risk of graft extrusion and to prevent erosion of vascular wall due to direct contact between metallic hardware, which was used for reconstruction of vertebral body, and major vessels.

• Journal of Korean Neurosurgical Society
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• v.42 no.4
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• pp.251-257
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• 2007

Objective : This multi-center clinical study was designed to determine the long-term results of patients who received a one-level posterior lumbar interbody fusion with expandable cage ($Tyche^{(R)}$ cage) for degenerative spinal diseases during the same period in each hospital. Methods : Fifty-seven patients with low back pain who had a one-level posterior lumbar interbody fusion using a newly designed expandable cage were enrolled in this study at five centers from June 2003 to December 2004 and followed up for 24 months. Pain improvement was checked with a Visual Analogue Scale (VAS) and their disability was evaluated with the Oswestry Disability Index. Radiographs were obtained before and after surgery. At the final follow-up, dynamic stability, quality of bone fusion, interveretebral disc height, and lumbar lordosis were assessed. In some cases, a lumbar computed tomography scan was also obtained. Results : The mean VAS score of back pain was improved from 6.44 points preoperatively to 0.44 at the final visit and the score of sciatica was reduced from 4.84 to 0.26. Also, the Oswestry Disability Index was improved from 32.62 points preoperatively to 18.25 at the final visit. The fusion rate was 92.5%. Intervertebral disc height, recorded as $9.94{\pm}2.69\;mm$ before surgery was increased to $12.23{\pm}3.31\;mm$ at postoperative 1 month and was stabilized at $11.43{\pm}2.23\;mm$ on final visit. The segmental angle of lordosis was changed significantly from $3.54{\pm}3.70^{\circ}$ before surgery to $6.37{\pm}3.97^{\circ}$ by 24 months postoperative, and total lumbar lordosis was $20.37{\pm}11.30^{\circ}$ preoperatively and $24.71{\pm}11.70^{\circ}$ at 24 months postoperative. Conclusion : There have been no special complications regarding the expandable cage during the follow-up period and the results of this study demonstrates a high fusion rate and clinical success.

• The Korean Journal of Pain
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• v.34 no.3
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• pp.371-371
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• 2021

• Journal of Korean Neurosurgical Society
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• v.40 no.2
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• pp.84-89
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• 2006

Objective : The purpose of this study is to compare the outcomes of two methods for stabilization and fusion : Postero-Lateral Fusion [PLF, pedicle screw fixation with bone graft] and Posterior Lumbar Interbody Fusion [PLIF, cage insertion] for spinal stenosis and recurred disc herniation except degenerative spondylolisthesis. Methods : Seventy one patients who underwent PLF [n=36] or PLIF [n=35] between 1997 and 2001 were evaluated prospectively. These two groups were compared for the change of interbody space, the range of segmental angle, the angle of lumbar motion, and clinical outcomes by Prolo scale. Results : The mean follow-up period was 32.6 months. The PLIF group showed statistically significant increase of the interbody space after surgery. However, the difference in the change of interbody space between two groups was insignificant [P value=0.05]. The range of segmental angle was better in the PLIF group, but the difference in the change of segmental angle was not statistically significant [P value=0.0l7]. Angle of lumbar motion was similar in the two groups. Changes of Prolo economic scale were not statistically significant [P value=0.193]. The PLIF group showed statistically significant improvement in Prolo functional scale [P value=0.003]. In Prolo economic and functional scale, there were statistically significant relationships between follow-up duration [P value<0.001]. change of interbody space [P value<0.001], and range of segmental angle [P value<0.001]. Conclusion : Results of this study indicate that PLIF is superior to PLF in interbody space augmentation and clinical outcomes by Prolo functional scale. Analysis of clinical outcomes showed significant relationships among various factors [fusion type, follow-up duration, change of interbody space, and range of segmental angle]. Therefore, the authors recommend instrumented PLIF to offer better clinical outcomes in patients who needed instrumented lumbar fusion for spinal stenosis and recurred disc herniation.