• Journal of International Academy of Physical Therapy Research
• /
• v.12 no.1
• /
• pp.2302-2307
• /
• 2021

Background: Patients with lumbar spinal stenosis show abnormal changes in muscle activity due to pain and limited range of motion of the lumbar spine. Excessive increased muscle tone and decreased muscle activity patterns threaten the patients' quality of life. However, there have been a few studies showing how to improve muscle performance in patients with lumbar spinal stenosis. Among these, joint mobilization is one way of improving muscle performance through pain relief and increasing the range of motion. Objectives: To investigate the effect of lumbar mobilization by orthopedic manual physical therapy on paravertebral muscle activity and tone in patients with lumbar spinal stenosis. Design: A randomized controlled trial. Methods: In this study, 24 patients with lumbar spinal stenosis were randomized (1:1 ratio) into two groups. The experimental group underwent lumbar posteroanterior mobilization, and the control group underwent conventional physical therapy (conventional transcutaneous electrical nerve stimulation) for 15 minutes each. For outcome measures, Myoton^®PRO was used to evaluate muscle tone when resting of the paravertebral muscle in the pain area. For muscle activity evaluation, the reference voluntary contraction of the paravertebral muscle was evaluated using surface electromyography. Results: Muscle tone and activity were significantly improved after intervention in both the experimental and control groups. In addition, the experimental group showed more significant decrease in muscle tone and activity than the control group. Conclusion: These results suggest that lumbar mobilization improving muscle performance in patients with lumbar spinal stenosis.

• Journal of International Academy of Physical Therapy Research
• /
• v.10 no.1
• /
• pp.1746-1749
• /
• 2019

Background: Surgery has been known as an inefficient approach to reduce back pain in patients with lumbar spinal stenosis; therefore, non-surgical treatments are necessary. However, there has been little research to analyze the effect of non-surgical treatments on lumbar spinal stenosis pain. Objective: To identify the effectiveness of 2 physiotherapeutic treatment approaches to relieve pain due to lumbar spinal stenosis. Design: Randomized controlled trial Methods: The participants were 36 lumbar spinal stenosis patients who were randomized in the joint mobilization group (JMG) and transcutaneous electrical nerve stimulation group (TENSG). Joint mobilization (JM) was conducted at the posteroanterior joint in the spinous process of the lumbar spine with stenosis. Transcutaneous electrical nerve stimulation (TENS) was applied on the lumbar spine with stenosis at a high frequency and intensity. Results: Visual analog scale (VAS) pain score significantly decreased in both groups, and the VAS value decreased more after JMG than that after TENSG. The pain thresholds of both groups also significantly increased, and that of JMG increased more compared to TENSG. In both the groups, significant improvements in VAS and pain thresholds were found, and JMG showed better results than TENSG. Conclusions: JM and TENS showed significant relief in both pain threshold and painpain, and JM showed more advanced relief compared to TENS.

• Journal of Korean Neurosurgical Society
• /
• v.42 no.1
• /
• pp.11-15
• /
• 2007

Objective : Lumbar foraminal stenosis is an important etiology of lumbar radicular symptomatology and frequent causes of remained symptoms after decompressive surgery. This study was conducted to determine the precise clinical and radiologic diagnosis of lumbar foraminal stenosis, and to demonstrate thorough treatment by decompressive surgery using a minimally invasive technique. Methods : Seven patients with established unilateral lumbar foraminal stenosis according to clinical and radiologic diagnosis were retrospectively studied. All patients underwent combined interlaminar and paraisthmic procedure with partial facetectomy. The outcome of surgery was evaluated and classified into excellent, good, fair and poor. Results : The results were excellent in four patients, good in two, and fair in one during the follow-up. There were no surgery-related complications. Conclusion : Minimally invasive combined interlaminar and paraisthmic approach provides good outcome in carefully selected patients with symptomatic lumbar foraminal stenosis.

• The Journal of Churna Manual Medicine for Spine and Nerves
• /
• v.13 no.2
• /
• pp.1-10
• /
• 2018

Objectives : To evaluate the evidence supporting the effectiveness and safety of Chuna manual therapy(CMT) for lumbar spinal stenosis Methods : We searched 10 electronic databases(Pubmed, EMBASE, Cochrane Library, CAJ, RISS, KISS, KISTI, KMBASE, DBpia, NDSL) and related 2 journals up to October 2018. We included randomized controlled trials(RCTs) of testing CMT for lumbar spinal stenosis patients. The methodological quality of RCTs related assessed by the Cochrane risk of bias tool 1.0. Results : Three RCTs were eligible in our inclusion criteria. The meta-analysis of 3 studies showed positive results for the using CMT for lumbar spinal stenosis. Conclusions : The review found favorable evidence of CMT for treating lumbar spinal stenosis with meta-analysis. However, our systematic review has limited evidence to support CMT for lumbar spinal stenosis because of low quality of original articles and further well-designed RCTs should be encouraged.

• Journal of Korean Neurosurgical Society
• /
• v.53 no.4
• /
• pp.245-248
• /
• 2013

Guillain-Barr$\acute{e}$ syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy. In typical cases, the first symptoms of GBS are pain, numbness, paresthesia, weakness in the limbs. Autonomic involvement is common and causes urinary retention and ileus. Much of these symptoms overlap with those of lumbar spinal stenosis. Therefore, correct diagnosis of GBS in a patient with symptomatic lumbar spinal stenosis or in a patient with atypical manifestations of GBS can be difficult, especially early in the course of GBS. Here, we report on a case of atypical GBS in a 74-year-old previously healthy patient with lumbar spinal stenosis and discuss the differential diagnosis of the GBS and lumbar spinal stenosis.

• Journal of Acupuncture Research
• /
• v.25 no.1
• /
• pp.97-106
• /
• 2008

Objectives : This study was designed to evaluate the effects of Bee Venom Pharmacopuncture therapy in patients with lumbar spinal stenosis. Methods : We investigated 16 patients with lumbar spinal stenosis. We divided patients into two groups : Bee Venom Pharmacopuncture was performed with acupuncture therapy for one group, and the other group received acupuncture therapy only. To evaluate the effectiveness of the treatment applied to the two groups, we used the Visual Analog Scale(VAS) and the Oswestry Low-back Pain Disability Index(ODI). We compared the VAS and ODI scores of the two groups statistically. Results : The Bee Venom Pharmacopuncture group received more effective relief than the acupunctureonly group as measured by decreasedpain and disability reported on the VAS and ODI by patients with lumbar spinal stenosis. Conclusions: Bee Venom Pharmacopuncture therapy can be used in addition to acupuncture therapy for highly effective treatment of patients with lumbar spinal stenosis. Further clinical studies are needed to verify these findings.

• The Journal of Churna Manual Medicine for Spine and Nerves
• /
• v.2 no.1
• /
• pp.49-57
• /
• 2007

Objectives : This study was performed to evaluate the effect of Bee Venom Acupuncture Therapy on Lumbar Spinal Stenosis. Methods : The patient was diagnosed as Lumbar Spinal Stenosis through Lumbar spine MRI and treated with Bee Venom Acupuncture Therapy and so on and measured of VAS and ODI score to evaluate treatment effects. Results and Conclusions : ROM of Lumbar, Milgram test and sensory test has improved. VAS and ODI score were also decreased.

• Journal of Korean Neurosurgical Society
• /
• v.60 no.4
• /
• pp.465-470
• /
• 2017

Objective : Magnetic resonance imaging (MRI) grading systems using sagittal images are useful for evaluation of lumbar foraminal stenosis. We evaluated whether such a grading system is useful as a diagnostic tool for surgery. Methods : Between July 2014 and June 2015, 99 consecutive patients underwent unilateral lumbar foraminotomy for lumbar foraminal stenosis. Surgically confirmed foraminal stenosis and the contralateral, asymptomatic neuroforamen were assessed based on a 4-point MRI grading system. Two experienced researchers independently evaluated the MR sagittal images. Interobserver agreement and intraobserver agreement were analyzed using ${\kappa}$ statistics. Results : The mean age of patients (54 women, 45 men) was 62.5 years. A total of 101 levels (202 neuroforamens) were evaluated. MRI grades for operated neuroforamens were as follows : Grade 0 in 0.99%, Grade 1 in 5.28%, Grade 2 in 14.85%, and Grade 3 in 78.88%. Interobserver agreement was moderate for operated neuroforamens (${\kappa}=0.511$) and good for asymptomatic neuroforamens (${\kappa}=0.696$). Intraobserver agreement by reader 1 for operated neuroforamens was good (${\kappa}=0.776$) and that for asymptomatic neuroforamens was very good (${\kappa}=0.831$). In terms of lumbar level, interobserver agreement for L5-S1 (${\kappa}=0.313$, fair) was relatively lower than the other level (${\kappa}=0.804$, very good). Conclusion : MRI grading system for lumbar foraminal stenosis is thought to be useful as a diagnostic tool for surgery in the lumbar spine; however, it is less reliable for symptomatic L5-S1 foraminal stenosis than for other levels. Thus, various clinical factors as well as the MRI grading system are required for surgical decision-making.

• Journal of Korean Neurosurgical Society
• /
• v.37 no.1
• /
• pp.76-78
• /
• 2005

We report a rare case of cauda equina syndrome due to bilateral lumbar facet cyst. A 62-year-old woman has developed both legs sciatica 3 months prior to her visit, but recently motor weakness and voiding difficulty occurred. Lumbar magnetic resonance image showed bilateral lumbar facet cyst compressing and surrounding both L5 nerve root and accompanying spinal stenosis. Urgent decompressive laminectomy and cyst removal was performed. Although sciatica was relieved and motor weakness was recovered usefully. Voiding difficulty and dysesthesia were not improved.

• Journal of Korean Medicine Rehabilitation
• /
• v.24 no.4
• /
• pp.129-136
• /
• 2014

Objectives The purpose of this study is to find out clinical and radiological correlation between lumbar lordotic angle, lumbar intervertebral disc angle and lumbar spinal stenosis. Methods Total 250 patients' who had visited Bu-Chun Jaseng Hospital of Korean Medicine lumbar lordotic angle, intervertebral disc angle of L4/5 and dural sac dimension of L4/5 were measured by X-ray and MRI films. We analysed correlation between lumbar lordotic angle, intervertebral disc angle of L4/5 and lumbar spinal stenosis in terms of clinical and radiological aspect. Results 1. The mean intervertebral disc angle of L4/5 were $10.72{\pm}3.98^{\circ}$, the mean lumbar lordotic angle were $41.97{\pm}11.73^{\circ}$ and the mean dural sac dimension of L4/5 were $133.18{\pm}45.46mm^2$. 2. This study shows that dural sac dimension of L4/5 was inversely reated to intervertebral disc angle of L4/5 by statistically (p<0.05). 3. There was visible difference regarding intervertebral disc angle of L4/5 between patients who had been diagnosed with lumbar spinal stenosis by clinically and patients who had not been diagnosed with lumbar spinal stenosis by clinically; The former's angle was relatively higher than the latter's (p<0.05). Conclusions There was a statistical significance between intervertebral disc angle of L4/5 and lumbar spinal stenosis in single-segment.