• The Journal of Korean Medicine
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• v.16 no.2 s.30
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• pp.62-78
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• 1995

In industrialized countries, low back pam is very common, with up to 60 to 80% of the population being affected at some time in their lives. Herniated lumbar intervertebral disc is one of principal cause of low back pain and radiculopathy. The therapy of the disease is classified into conservative treatment or surgical intervention. The majority of these cases successfully heal with conservative managemant, even though it was claimed that the henirated disc material would not resolved spontaneously without surgical removal. It was reported that there was no significant difference in outcome and cost effectiveness between conservative and surgical therapy group. Also after conservative therapy the resorption of herniated disc with satisfactory improvement of symptom was reported. Conservative treatment includes bed rest, heat, drug therapy, therapeutic exercises, physical therapy such as traction and manipulation, and acupuncture. These managements show favorable outcome in the patients with herniated lumbar intervertebral disc. So conservative management should be applied in the therapy of herniated intervertebral disc, unless there exist aggravation during the first 3 weeks of treatment or apparent surgical care indication. And further investigation to improve effectiveness of conservative therapy should be ensued.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.5 no.2
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• pp.127-134
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• 2010

Objectives: The purpose of this study is the evaluation of conservative medical treatment on the herniation of intervertebral disc(HIVD) patient after the fusion surgery of a lumbar segment. Methods: We used acupuncture, herbal medication, and manipulation for this patient. And we measured of VNRS score and SLR test result to evaluate effect of conservative medical treatment. Results & Conclusions: Patient's low back and left leg pain VNRS is decreased, and the SLR test result is improved.

• The Journal of Korean Physical Therapy
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• v.16 no.1
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• pp.157-182
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• 2004

The purpose of this study was to evaluate effects of lumbar stabilizing exercise on the functional recovery and the range of motion of low back pain patients. The subjects were consisted of sixty patients who had non specific chronic low back pain(32 females. 28 males; mean aged 37.3) from 19 to 65 years of age(mean age : 37.3). All subjects randomly assigned to the lumbar stabilizing exercise group, the modalities treatment group, the manual treatment group. Lumbar stabilizing exercise group received manual treatment with lumbar stabilizing exercise for 30minutes, modalities treatment group received hot pack used thermal therapy for 20minutes and ICT used electrical therapy for 20minutes and US or MWD used deep thermal therapy for 15minutes, manual treatment group received modalities treatment with therapeutic massage for 10minutes and joint mobilization or manipulation for 10minutes per day and three times a week during 4 weeks period. The Multilevel Roland-Morris Disability Questionnaire(MR-MDQ) was used to measure functional disability level. Visual Analogue Scale(VAS) was used to measure subjective pain level. Remodified Schober test(RST) was used to measure forward flexion range of motion of lumbar segment. Finger-to-Floor test(F-T-FT) was used to measure forward flexion range of motion of full spine of low back pain patients. All measurements of each patients were measured at pre-treatment and 4 week post-treatment. The results of this study were summarized as follows : 1. The MR-MDQ of lumbar stabilizing exercise group, modalities treatment group, and manual treatment group was significantly reduced between pre-treatment and post-treatment(p<.05). 2. The VAS of lumbar stabilizing exercise group, modalities treatment group, and manual treatment group was significantly reduced between pre-treatment and post-treatment(p<.05). 3. The RST of lumbar stabilizing exercise group, modalities treatment group, and manual treatment group was significantly reduced between pre-treatment and post-treatment(p<.05). 4. The F-T-FT of lumbar stabilizing exercise group, modalities treatment group, and manual treatment group was significantly reduced between pre-treatment and post-treatment(p<.05). 5. The results of analyzed effects of MR-MDQ, RST, F-T-FT were significantly reduced (p<.05), but VAS wasn't significantly reduced(p>.05) between treatment type of lumbar stabilizing exercise group and modalities treatment group and manual treatment group according to pre-treatment and post-treatment. 6. The results of LSD post-hoc to find difference between treatment type of lumbar stabilizing exercise group and modalities treatment group and manual treatment group according to pre-treatment and post-treatment that MR-MDQ was significantly reduced stabilizing exercise group than modalities treatment group(p<.05), and VAS wasn't significantly reduced all treatment group(p>.05), and RST was significantly reduced stabilizing exercise group than modalities treatment group(p<.05), and F-T-FT was significantly reduced stabilizing exercise group than modalities treatment group and manual treatment group (p<.05).

• Journal of Korean Neurosurgical Society
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• v.51 no.3
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• pp.182-186
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• 2012

In conventional percutaneous disc surgery, introducing instruments into disc space starts by inserting a guide needle into the triangular working zone. However, landing the guide needle tip on the annular window is a challenging step in endoscopic discectomy. Surgeons tend to repeat the needling procedure to reach an optimal position on the annular target. Obturator guiding technique is a modification of standard endoscopic lumbar discectomy, in which, obturator is used to access triangular working zone instead of a guide needle. Obturator guiding technique provides more vivid feedback and easy manipulation. This technique decreases the steps of inserting instruments and takes safer route from the peritoneum.

• The Journal of Korea CHUNA Manual Medicine
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• v.2 no.1
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• pp.111-120
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• 2001

We reviewed literatures of western and oriental medicine about postoperative management of spine. Traditionally, with orthoses and bed rest, many physicians restricted activity of daily life and back exercises of patients who had taken spine surgery. More aggressive early mobilization, however, such as strengthening exercise and stretching after 4 weeks of surgery gets grounds nowadays. Physical therapies including manipulation, TENS, MENS, ultrasound and cryotherapy are being used as helpful treatment modalities of postoperative pain and swelling. Failed back surgery syndrome occurs due to wrong patient, diagnosis and surgery and is managed with conservative treatment or reoperation. In oriental medicine, treatments of musculoskeletal injuries including surgical wound are based on the balance of chi(氣) and blood(血).

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.15 no.1
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• pp.72-78
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• 2009

Purpose: to recognized that influence of decrease low back pain, change pelvic structure and balance control on unilateral weight bearing after application on pelvic manipulation which low back pain patient in unilateral weight bearing due to pelvic imbalance. Methods: The patient with low back pain in unilateral weight bearing due to pelvic imbalance was 39year female. one subject received intervention of pelvic manipulation on sidelying position and reaching exercise on sitting position which during 2 weak at the 3 time per a weak, each 30 minutes. outcomes measured were Facia l Action Coding System(FACS), Radiograph(Lumbar-Spine Anteroposterior AP.), Pressure Scan. Results: The results of this study were summarized below : 1. FACS score were Pre: min.4 - max.6 and Post: min.2 - max.4. 2. Radiograph measured Ilium width were Pre: Lt.14cm, Rt.12.7cm and Post: Lt.13.4cm, Rt.13cm which discrepancy of Ilium height were Pre: 1cm and Post: 0.2cm. 3. Pressure scan measured Pre: Lt. 36.8%, Rt.40.2% and Post: Lt.41.3%, Rt.36.2%. Conclusion: Pelvic manipulation applied a patient with low back pain in unilateral weight bearing due to pelvic imbalance suggest that can decrease low back pain, change pelvic structure and balance control on unilateral weight bearing.

• Journal of Korean Physical Therapy Science
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• v.29 no.2
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• pp.38-47
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• 2022

Background: The purpose of this study was to investigate the effect of the combined application of manipulation and stabilization exercises on pain and spinal curvature in patients with chronic back pain. Design: Randomized controlled trial Methods: The research subjects included 24 women in their 40s and 50s who have chronic back pain. The sample was evenly divided into an experimental group, which received the combined application of manipulation and stabilization exercises, and a control group, which received stabilization exercises only. The 30-minute intervention was applied five times a week for eight weeks. A bivariate repeated measures analysis of variances was conducted to identify the differences between the two groups before the experiment, after the fourth week, and at the end of the eight-week experiment. The level of statistical significance was set at.05. This analysis examined the within-group changes and the between-group changes using a paired t-test and an independent t-test, respectively. Results: Changes in pain differed significantly depending on the time of the measurement, the interaction between the time of the measurement and each group, and between the two groups (p<.05). Changes in the curvature of the bones of the neck, the bones of the back, and the lumbar vertebrae differed significantly depending on the time of the measurement and the interaction between the time of the measurement and each group (p<.05). Conclusion: The combined application of manipulation and stabilization exercises demonstrated a positive effect on changes in pain and spinal curvature, and the method is expected to be a useful intervention for reducing pain and improving spinal curvature in patients with back pain.

• Physical Therapy Rehabilitation Science
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• v.12 no.2
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• pp.92-104
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• 2023

Objective: The purpose of this study was to investigate the effect of spinal mobilization with leg movement (SMWLM) and neural mobilization (NM) in patients with lumbar disc herniation (LDH) accompanied by radiating pain. Design: Three-group pre-test-post-test control group design. Methods: We enrolled 48 participants, whom we randomly assigned to three groups. The SMWLM group (n=16) underwent 20 min of conventional physical therapy (CT) and 20 min of SMWLM. The NM group (n=16) underwent 20 min of CT and 20 min of NM. The control group (n=16) underwent 20 min of CT. These interventions in all the groups were performed three times a week for 4 weeks. Numeric pain rating score (NPRS), body grid chart score (BGCS), passive straight leg raise (PSLR), active lumbar flexion range of motion (ALFROM), korean version oswestry disability index (KODI), and korean version fear avoidance beliefs questionnaire (KFABQ) were measured pre- and post-intervention. Results: In all three groups, the NPRS, PSLR, KODI, and KFABQ scores were significantly different pre- and post-intervention (p<0.05). Significant differences were observed in BGCS and ALFROM in the SMWLM and NM groups pre- and post-intervention (p<0.05). The SMWLM group showed more improvement in the NPRS of leg pain, ALFROM, and KFABQ score than that exhibited by the NM and control groups (p<0.05). Conclusions: Both SMWLM and NM were effective for improving back and leg pain, centralization of symptoms, mechanical sensitivity, lumbar mobility, lumbar functional disability, and psychosocial functioning in patients with LDH with radiating pain.

• Journal of Korean Neurosurgical Society
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• v.58 no.4
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• pp.350-356
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• 2015

Objective : Cases of contralateral radiculopathy after a transforaminal lumbar interbody fusion with a single cage (unilateral TLIF) had been reported, but the phenomenon has not been explained satisfactorily. The purpose of this study was to determine its incidence, causes, and risk factors. Methods : We did retrospective study with 546 patients who underwent a unilateral TLIF, and used CT and MRI to study the causes of contralateral radicular symptoms that appeared within a week postoperatively. Clinical and radiological results were compared by dividing the patients into the symptomatic group and asymptomatic group. Results : Contralateral symptoms occurred in 32 (5.9%) of the patients underwent unilateral TLIF. The most common cause of contralateral symptoms was a contralateral foraminal stenosis in 22 (68.8%), screw malposition in 4 (12.5%), newly developed herniated nucleus pulposus in 3 (9.3%), hematoma in 1 (3.1%), and unknown origin in 2 patients (6.3%). 16 (50.0%) of the 32 patients received revision surgery. There was no difference in visual analogue scale and Oswestry disability index between the two groups at discharge. Both preoperative and postoperative contralateral foraminal areas were significantly smaller, and postoperative segmental angle was significantly greater in the symptomatic group comparing to those of the asymptomatic group (p<0.05). Conclusion : The incidence rate is not likely to be small (5.9%). If unilateral TLIF is performed for cases when preoperative contralateral foraminal stenosis already exists or when a large restoration of segmental lordosis is required, the probability of developing contralateral radiculopathy is increased and caution from the surgeon is needed.

• Journal of Korean Medicine Rehabilitation
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• v.23 no.1
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• pp.77-86
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• 2013

This study was introduced the short-term effectiveness of Oriental medicine treatment for lumbar disc herniation inpatients. We selected 208 inpatients with a magnetic resonance imaging(MRI)-confirmed lumbar disc herniation since June 2012 until August 2012. Their demographics characterisitics, numeric rating scale(NRS) and Oswestry back-related disability index(ODI) for low or leg pain, lumbar flexion and extension angle were assessed at baseline and when discharged from the hospital. When it measured the straight leg raisingscale(SLR), the low side of the angle was examined. Treatment every patient has received as follow; herbal medicine, bee venom, acupuncture and physical examination, spinal manipulation. NRS of low back pain and leg pain and ODI is $5.6{\pm}2.3$, $4.9{\pm}2.8$ and $45.5{\pm}20.0$, respectively at baseline and $2.8{\pm}1.8$, $2.7{\pm}1.9$ and $27.2{\pm}14.1$, respectively when discharged from the hospital. range of motion(ROM) of lumbar flexion and extension angle and SLR is $70.0{\pm}27.1$, $15.4{\pm}7.2$ and $61.3{\pm}23.0$ respectively at baseline and $80.5{\pm}16.9$, $18.25{\pm}4.1$ and $73.2{\pm}14.0$, respectively when discharged from the hospital. It shows that statistically significant improved(P<0.001). Furthermore, regarding patient satisfaction with the treatment, excellent(33.7%), good(55.4%), normal(10.4%), poor(0.5%), it suggests that most patients(89%) satisfied with the treatment.