• Title/Summary/Keyword: Lumbar stenosis

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A Study on Effect by Lumbar Extension Exercise (요부신전운동에 의한 효과에 관한 연구)

  • Lee, Suk-Min;Lee, Myeong-Hee
    • Journal of Korean Physical Therapy Science
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    • v.9 no.2
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    • pp.37-48
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    • 2002
  • The purpose of this study is to improve the effect of Lumbar extensor exercise program and develop the Lumbar extensor exercise program which will be suitable to the patients characteristics. In this study the experimental group was made up of 38 subjects. They are the patients with low back pain using the Lumbar extension exercise program in C hospital. The lumbar extension exercise program was given two times a week for 8 weeks. The results were estimated by Lumbar extensor strength by diagnosis agent. The results were measured three times, one time pre-treatment and two times post-treatment at 4weeks and 8weeks by lumbar extensor curve angle(0, 12, 24, 36, 48, 60, 72). The results were compared at pre-test 4weeks and 8weeks. The muscle strength measured at both 4weeks and 8weeks with the greater strength was shown at 4weeks. The muscle strength of patients with M.strain, Laminectomy and HNP was increased at all angles except for patients with stenosis. The results of this study indicated that diagnosis influenced the muscle strength in Lumbar extensor exercise program.

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The Effect of spinal manipulation on the Lumbar Spine with LBP patients (척추도수교정이 요통에 미치는 영향)

  • Oh, Kang-o;Kim, Chi-hyok;Choi, Su-hong
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.22 no.2
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    • pp.9-14
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    • 2016
  • Purpose: Many people are suffering from Low back pain due to HIVD and muscular problems, lack of joint functions on lumbar spine. In this study we compared the change of the herniation index, Oswestry LBP disability index (OLDI), visual analog scale (VAS), lumbar flexion range of motion (ROM) between the pre-experiment and after 4 weeks treatment by maitland manual therapy. Method: we selected and managed both the 15 people. They are $46.80{\pm}15.46$ years old people with HIVD and Stenosis. We treated for the people with HIVD and Stenosis by manual therapy(maitland manipulation method) during 4 weeks. And then we compared with pre-experiment and after 12 weeks through measuring the herniation index change by using computor themograpy (CT), LBP OLDI, VAS, lumbar flexion ROM. Results: The changes in the herniation index, Oswestry lumbar Disability Index, VAS, lumbar flexion ROM between the pre-experiment and after 4 weeks treatment by maitland manual therapy, there was a statistically significant difference. Although there was a significant difference after 4 weeks in OLDI, VAS, lumbar flexion ROM. But disc herniation index was no significant difference. Conclusion: Manual therapy is very effective for Lumbago due to the HIVD and spinap stenosis patients. OLDI, VAS and lumbar flexion ROM were increased. But disc herniation index was no significant difference. We suggest the combination treatment between manual exercise and spinal traction.

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Clinical Observation on 119 Patients with Lumbar Spinal Stenosis Treated with Bee Venom Pharmacopuncture Therapy (봉약침 병행치료한 요추관 협착증 환자 119례에 대한 임상고찰)

  • Han, Kyung-Wan;Kim, Eun-Seok;Woo, Jae-Hyuk;Lee, Seul-Ji;Lee, Joon-Seok;Nam, Ji-Hwan;Kim, Kie-Won;Koh, Kang-Hoon;Yoo, In-Sik
    • Journal of Acupuncture Research
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    • v.28 no.3
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    • pp.21-31
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    • 2011
  • Objectives : The purpose of this study was to evaluate the effect of bee venom pharmacopuncture therapy in patients with lumbar spinal stenosis. Methods : This clinical study was carried out on 119 patients with lumbar spinal stenosis, who had been admitted from May, 2009 to March, 2011. Patients were sorted into two groups ; One group(bee venom pharmacopuncture group) was treated with bee venom pharmacopuncture and acupuncture therapy, the other(non-bee venom pharmacopuncture group) with acupuncture therapy only. Verbal numerical rating scale(VNRS) and Oswestry disability index(ODI) were used to evaluate the effectiveness of the treatment in both groups. VNRS and ODI scores of the two groups were statistically compared. Results : The bee venom pharmacopuncture group demonstrated a more significant improvement than non-bee venom pharmacopuncture group when evaluated with VNRS and ODI. Conclusions : In the case of the patients with spinal stenosis, it was found that treatment with combination of bee venom pharmacopuncture and acupuncture was more effective in improving the conditions of the patients (subsidence of the symptoms) than the acupuncture treatment only.

Surgical Treatment of Lumbar Spinal Stenosis in Geriatric Population : Is It Risky?

  • Kim, Dong-Won;Kim, Sung-Bum;Kim, Young-Soo;Ko, Yong;Oh, Seong-Hoon;Oh, Suck-Jun
    • Journal of Korean Neurosurgical Society
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    • v.38 no.2
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    • pp.107-110
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    • 2005
  • Objective : Lumbar spinal stenosis is increasingly recognized as a common cause of low back pain in elderly patients. Conservative treatment has been initially applied to elderly patients, however, surgical treatment is sometimes indispensable to relieve severe pain. We retrospectively examine the age-related effects on the surgical risk, and results following general anesthesia and operative procedure in geriatric patients for two different age groups of at least 65years old. Methods : Consecutive 51 patients [${\ge}$ 65years], who underwent open surgical procedure for degenerative lumbar spinal stenosis, were selected in the study. Patients were divided into two groups. Group A included all patients who were between 65 and 69years of age at the time of surgery. Group B included all patients who were at least 70years of age at the time of surgery. We reviewed medical history including preoperative American Society of Anesthesiologists[ASA] classification of physical status, anesthetic risk factor, operative time, estimated blood loss, transfusion requirements, hospital stay, operated level, and clinical outcome to look for comparisons between two age groups [$65{\sim}69$ and over 70years]. Results : In preoperative evaluation, mean anesthetic risk factor of patients was numerically similar between the groups. The American Society of Anesthesiologists classification of physical status was similar between two groups. There was no difference in operated level, operative time, estimated blood loss, hospital stay, and anesthetic risk factor between the two groups. The clinical successful outcome showed 82.7% for Group A and 81.8% for group B. The overall postoperative complication rates were similar for both group A and B. Conclusion : We conclude that advanced age per se, did not increase the associated morbidity and mortality in surgical decompression for spinal stenosis.

Clinical Comparison of Posterolateral Fusion with Posterior Lumbar Interbody Fusion

  • Kim, Chang-Hyun;Gill, Seung-Bae;Jung, Myeng-Hun;Jang, Yeun-Kyu;Kim, Seong-Su
    • 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.

Investigation of High-Sensitivity C-reactive Protein and Erythrocyte Sedimentation Rate in Low Back Pain Patients

  • Park, Chan-Hong;Lee, Sang-Ho
    • The Korean Journal of Pain
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    • v.23 no.2
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    • pp.147-150
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    • 2010
  • Background: Chronic low back pain can be a manifestation of lumbar degenerative disease, herniation of intervertebral discs, arthritis, or lumbar stenosis. When nerve roots are compromised, low back pain, with or without lower extremity involvement, may occur. Local inflammatory processes play an important role in patients with acute lumbosciatic pain. The purpose of this study was to assess the value of erythrocyte sedimentation rate (ESR) and high sensitivity C-reactive protein (hsCRP) measurements in patients with chronic low back pain or radiculopathy. Methods: ESR and hsCRP were measured in 273 blood samples from male and female subjects with low back pain and/or radiculopathy due to herniated lumbar disc, spinal stenosis, facet syndrome, and other diseases. The hsCRP and ESR were measured prior to lumbar epidural steroid injection. Results: The mean ESR was 18.8 mm/h and mean hsCRP was 1.1 mg/L. ESR had a correlation with age. Conclusions: A significant systemic inflammatory reaction did not appear to arise in patients with chronic low back pain.

Efficacy of Unilateral Laminectomy for Bilateral Decompression in Elderly Lumbar Spinal Stenosis

  • Ji, Yong-Cheol;Kim, Young-Baeg;Hwang, Sung-Nam;Park, Seung-Won;Kwon, Jeong-Taik;Min, Byung-Kook
    • Journal of Korean Neurosurgical Society
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    • v.37 no.6
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    • pp.410-415
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    • 2005
  • Objective: The aim of our study is to evaluate the effectiveness of unilateral hemilaminectomy for bilateral decompression in elderly patients with degenerative spinal stenosis. For this purpose, we studied the co-morbid condition and clinical outcome of patients who underwent decompressive surgery using the unilateral approach technique. Methods: Thirty-four patients over 65years of age who underwent unilateral partial laminectomy for bilateral decompression from January 2000 to October 2003 were analyzed. These patients were studied for preoperative co-morbid condition and physical status according to the American Society of Anesthesiologists(ASA) classification, postoperative morphometrical change, and clinical outcomes, including visual analogue scale(VAS) score. The mean follow-up was 23months (range 6 - 48months). Results: A patient's physical status was recorded as class I, II, or III by ASA classification, which correlated to 41.2%, 44.1%, and 14.7% of patients, respectively. The cross-sectional area of the pre- and postoperative dural sac at the level of the stenosis was $52.5{\pm}19.9mm^2$ and $110.6{\pm}18.2mm^2$, respectively. The outcome was excellent in 8.8%, good in 58.8%, fair in 23.6%, and poor in 8.8% of the patients. The VAS was changed postoperatively to $3.1{\pm}1.2$. There was no operation-related transfusion yet there was no evidence of postoperative instability at the follow-up examination. Conclusion: Unilateral laminectomy for bilateral decompression, in spite of the limited exposure, can result in satisfactory decompression of the lumbar spinal stenosis and tolerable clinical outcome. This approach is thought to be appropriate for elderly patients who have a greater surgical burden.

Effectiveness of percutaneous epidural neuroplasty using a balloon catheter in patients with chronic spinal stenosis accompanying mild spondylolisthesis: a longitudinal cohort study

  • Myong-Hwan Karm;Chan-Sik Kim;Doo-Hwan Kim;Dongreul Lee;Youngmu Kim;Jin-Woo Shin;Seong-Soo Choi
    • The Korean Journal of Pain
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    • v.36 no.2
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    • pp.184-194
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    • 2023
  • Background: Degenerative lumbar spondylolisthesis (DLS) is frequently associated with lumbar spinal stenosis (LSS) and conservative treatments such as epidural steroid injection do not have long-term benefits in LSS patients with DLS. This study evaluated the effectiveness of percutaneous epidural neuroplasty using a balloon catheter in patients with LSS and DLS. Methods: Patients' sex, age, body mass index, diabetes, hypertension, stenosis grading, pain duration, location, pain intensity, and medications were retrieved from electronic medical records. At 1, 3, and 6 months following the procedure, data on pain severity, medication usage, and physical functional status were analyzed. A generalized estimating equations model was used at the six-month follow-up. Patients were divided into those with DLS (the spondylolisthesis group) and those without DLS (the no spondylolisthesis group) to evaluate whether the effects of percutaneous epidural neuroplasty using a balloon catheter were different. Results: A total of 826 patients were included (spondylolisthesis: 433 patients, 52.4%; no spondylolisthesis: 393 patients, 47.6%). Age, body mass index, hypertension, pain location, and stenosis grading were statistically different between the two groups. The generalized estimating equations analyses with unadjusted and adjusted estimation revealed a significant improvement in the estimated mean numerical rating scale of pain intensities compared to that at baseline in both groups (P < 0.001). Any adverse events that occurred were minor and temporary. Conclusions: Percutaneous epidural neuroplasty using a balloon catheter may be an alternative treatment option for patients with chronic LSS, regardless of accompanying DLS, who have had failed conservative management.

Design of the Interspinous Process Fixator Using Biomechanical Analysis for the Treament of Degenerative Lumbar Spinal Stenosis (퇴행성 요추부 척추관 협착증 치료를 위한 극돌기간 고정기구의 설계 및 생체역학적 분석)

  • Heo S.;Son K.;Lee S.J.;Moon B.Y.
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2005.06a
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    • pp.1963-1966
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    • 2005
  • Degenerative lumbar spinal stenosis(DLSS) is a disease inducing low back pain, leg pain, convulsion, numbness, and neurogenic claudication from compression of nerve root. Intervertebra fixation was reported to increase the degenerative of neighbor region after treatment. Recently, a new surgical technique of inserting a fixator between interspinous processes has been introduced. The purpose of this study is to design of the interspinous process fixator with flexibility to complement the trouble of using fixator in DLSS. This study evaluated the existing fixator through the mechanical test and modified fixators using the finite element analysis(FEA). Displacement, stiffness and Von-Mises stress were found to have similar values to those obtained from the mechanical test and the FEA in the biomechanical loading condition. Effects of variation in length and thickness were investigated to design an optimal fixator.

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Effect of Bergamot Essential Oil-Inhalation on Chronic Pain after Surgery for Lumbar Spinal Stenosis (버가못 에센셜 오일 향흡입이 요추관협착증 환자의 수술 후 만성통증에 미치는 효과)

  • Seol, Geun-Hee;Jung, Myung-Hee
    • Journal of Korean Biological Nursing Science
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    • v.13 no.2
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    • pp.156-163
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    • 2011
  • Purpose: The purpose of this study was to examine the effects of a bergamot essential oil-inhalation on chronic pain after surgery for lumbar spinal stenosis. Methods: Fifty-two subjects were randomly assigned to the experimental (bergamot essential oil-inhalation) and control (almond oil-inhalation) group. All patients understood the purpose of this study and a written informed consent for the study was obtained. Results: Bergamot essential oil-inhalation was conducted during twenty minutes. Visual analog scale, blood pressure, heart rate, and respiratory rate were measured before and after treatment in the two groups. The visual analog scale score, heart rate, and respiratory rate in bergamot essential oil-inhalation group were significantly lower than those in almond oil-inhalation group. However, there was no significant difference in systolic and diastolic blood pressure between the two groups. Conclusion: Therefore, bergamot essential oil-inhalation is effective in alleviating pain, heart rate, and respiratory rate. These results suggest that bergamot essential oil-inhalation can be a useful method for the relief of chronic pain during the treatment after spinal surgery.