• 제목/요약/키워드: Lumbar stenosis

검색결과 200건 처리시간 0.026초

기존치료법과 침도침 시술을 병행한 요추관협착증의 증례보고 및 분석 (Study and three Cases Report for Lumbar Spinal Stenosis Treatment Using a Combination of Acupotomy and Existing Treatments)

  • 정기용;서영찬;장우순;이지은;김경훈;신광순;한유식
    • 동의생리병리학회지
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    • 제26권1호
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    • pp.120-127
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    • 2012
  • This study reports the effect of acupotomy for patients diagnosed with lumbar spinal stenosis(LSS). We treated three patients diagnosed with LSS using acupotomy. We measured the Numerical Rating Scale(NRS), Oswestry Disability Index(ODI) scores and Odom's criteria before and after treatment to assess improvements in symptoms and functions. In all patients, NRS, ODI scores and Odom's criteria were improved. We found a beneficial effect with acupotomy for three patients diagnosed with LSS. Thus, these data suggest LSS may be treated successfully with acupotomy.

요추 척추관 협착증 환자의 양방향 경피적 내시경을 이용한 척추 수술 (Biportal Percutaneous Endoscopic Spinal Surgery for Lumbar Spinal Stenosis)

  • 강태욱;이순혁;박시영
    • 대한정형외과학회지
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    • 제54권3호
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    • pp.219-226
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    • 2019
  • 요추 척추관 협착증에서 다양한 방법으로 감압술을 시행하고 있으며, 최근 들어 고식적인 척추관 감압술의 여러 합병증을 최소화하기 위하여 최소 침습적 척추 수술이 시행되고 있다. 단방향 내시경을 이용한 감압술은 구조적으로 한계가 있어 그 사용이 제한적이기 때문에 양방향 내시경을 이용한 감압술을 시행하고 있다. 요추 척추관 협착증에서 양방향 내시경을 이용한 감압술은 안전하게 충분한 감압술을 시행할 수 있는 만족스러운 수술법이다.

Lateral Lumbar Interbody Fusion and in Situ Screw Fixation for Rostral Adjacent Segment Stenosis of the Lumbar Spine

  • Choi, Young Hoon;Kwon, Shin Won;Moon, Jung Hyeon;Kim, Chi Heon;Chung, Chun Kee;Park, Sung Bae;Heo, Won
    • Journal of Korean Neurosurgical Society
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    • 제60권6호
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    • pp.755-762
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    • 2017
  • Objective : The purpose of this study is to describe the detailed surgical technique and short-term clinical and radiological outcomes of lateral lumbar interbody fusion (LLIF) and in situ lateral screw fixation using a conventional minimally invasive screw fixation system (MISF) for revision surgery to treat rostral lumbar adjacent segment disease. Methods : The medical and radiological records were retrospectively reviewed. The surgery was indicated in 10 consecutive patients with rostral adjacent segment stenosis and instability. After the insertion of the interbody cage, lateral screws were inserted into the cranial and caudal vertebra using the MISF through the same LLIF trajectory. The radiological and clinical outcomes were assessed preoperatively and at 1, 3, 6, and 12 months postoperatively. Results : The median follow-up period was 13 months (range, 3-48 months). Transient sensory changes in the left anterior thigh occurred in 3 patients, and 1 patient experienced subjective weakness; however, these symptoms normalized within 1 week. Back and leg pain were significantly improved (p<0.05). In the radiological analysis, both the segmental angle at the operated segment and anterior disc height were significantly increased. At 6 months postoperatively, solid bony fusion was confirmed in 7 patients. Subsidence and mechanical failure did not occur in any patients. Conclusion : This study demonstrates that LLIF and in situ lateral screw fixation may be an alternative surgical option for rostral lumbar adjacent segment disease.

Isthmic Spondylolisthesis Associated with Foraminal Disc Herniation Treated by Anterior Lumbar Interbody Fusion

  • Lee, Dong-Yeob;Lee, Sang-Ho;Maeng, Dae-Hyeon;Jang, Jee-Soo
    • Journal of Korean Neurosurgical Society
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    • 제38권4호
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    • pp.320-322
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    • 2005
  • A 45-year-old man presented with lower back pain and pain in the right leg of 3years duration. A plain radiographic examination revealed grade I isthmic spondylolisthesis, with instability at L4-5. Computed tomography and magnetic resonance imaging demonstrated bilateral foraminal stenosis, with soft foraminal disc herniation on the right side at the L4-5 level. He underwent anterior lumbar interbody fusion[ALIF] with percutaneous posterior fixation[PF] at the L4-5 level. Without removing the posterior bony structures, removal of foraminal disc herniation and reduction of spondylolisthesis were successfully performed using ALIF with percutaneous PF. When there is no hard disc herniation or lateral recess stenosis, ALIF with percutaneous PF can be one of the treatment options for isthmic spondylolisthesis, even in the presence of foraminal disc herniation, as in our case.

요추 황색인대의 미세구조 ; 내층과 외층의 차이 (Ultrastructural Differences between Inner and Outer Layers of Human Lumbar Ligamentum Flavum)

  • 원유삼;이승민;최천식;주문배;어환;김종현;박윤관;서중근
    • Journal of Korean Neurosurgical Society
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    • 제29권5호
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    • pp.599-603
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    • 2000
  • Objectives : In lumbar spine surgery it is observed that the ligamentum flavum(LF) is bilayered, and the inner layers can be left in situ to prevent peridural adhesion in open lumbar disc surgeries. The purposes of this study are to investigate ultrastructural differences between the inner and outer layer of lumbar LF by electron microscopic examination, and to see whether these differences are, if present, more prominent in chronic degenerative lumbar spinal disorders as compared with acute lumbar disc diseases. Methods : Biopsy specimens of LF were obtained from nine patients undergoing lumbar spine surgery, five of them for degenerative spinal stenosis and four for acute disc herniation. During the surgery the outer layers of LF were carefully dissected from the inner layer, and four pieces($1{\times}1{\times}1-mm$) of biopsy samples were made from each layer. These were examined with electron microscope for the morphologies and the contents of the elastic and the collagen fibers. Results : The outer layer of LF showed elastic fiber degeneration as evidenced and decreased fiber content, while the inner layer was relatively preserved in both cases of degenerative spinal stenosis and acute disc herniation. The ultrastructural changes of the layers were more evident in the outer layer. Conclusion : With these observations the authors believe that the LF degeneration may occur mainly in the outer layer, and that this fact may aid in making the rationale for using the inner layer as physiologic barrier to prevent peridural adhesion in open lumbar disc surgeries.

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비구이형성증에 의한 고관절염과 요추 척추관 협착증 환자의 턱관절자세 음양교정술을 이용한 치험 1례 (A Case Report on a Patient with Osteoarthritis of the Hip Caused by Hip Dysplasia and Lumbar Spinal Stenosis, Treated by Postural Yinyang Correction of Temporomandibular Joint)

  • 임재은;김경민;장선희;박은진;이영준;홍누리;장영숙;양수현;최윤영;오다윤;이수진;김철홍
    • 턱관절균형의학회지
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    • 제9권1호
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    • pp.12-17
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    • 2019
  • Objectives: The purpose of this study is to report the effect of Postural Yinyang Correction of Temporomandibular Joint (Functional Cerebrospinal Therapy, FCST) on a patient with Osteoarthritis of the hip caused by Hip dysplasia and Lumbar spinal stenosis. Methods: A patient with Osteoarthritis of the hip caused by Hip dysplasia and Lumbar spinal stenosis was treated at Dept. of Acupuncture & Moxibustion, ○○ University Korean Medicine Hospital from Nov 8th, 2019 to Dec 6th, 2019 and received a Korean-Western medical treatment mainly managed with FCST. This study was measured with VAS (Visual Analogue Scale), ODI (Oswestry Disability Index) and questionnaire. Results: After treatment, the patient's pain was controlled and gait ability was improved, also VAS, ODI and questionnaire score were improved. Conclusions: Korean-Western Medical Treatment mainly managed with FCST may be helpful in controling pain with Osteoarthritis of the hip caused by Hip dysplasia and Lumbar spinal stenosis, but the further researches are needed.

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척주관협착증 환자의 Beck Depression Inventory 점수와 이와 관련된 요인들의 분석 (Beck Depression Inventory Score and Associated Factors in Korean Patients with Lumbar Spinal Stenosis)

  • 김애라;서보병;김진모;배정인;장영호;이용철;강철형;정성원;홍지희
    • The Korean Journal of Pain
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    • 제20권2호
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    • pp.138-142
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    • 2007
  • Background: Depression is a frequent comorbid disease of chronic pain patients. This study was conducted to evaluate the prevalence of depression and to correlate associated factors and depression in patients with lumbar spinal stenosis. Methods: The data of this survey was collected from 97 patients that visited our pain clinic for the management of lumbar spinal stenosis. Depression was examined by a self-reported survey using the Korean version of the Beck Depression Inventory (BDI). The Oswestry Disability Index (ODI) and the life satisfaction scale score were also obtained. Demographic and clinical characteristics (including spouse status, employment status, smoking status, the number of patients with multiple painful areas, the number of patients with combined disease, pain duration, visual analogue scale, Roland 5-point scale and walking distance) were obtained from an interview with the patient. The patients were divided into group N ($BDI{\leq}14$, n = 43) and group 0 (BDI > 14, n = 54) according to the BDI scale. Of the 97 patients, 55,7% had a high BDI score. Results: The patients in group N had a higher rate of employment (48.0%, P < 0.05) and had higher life satisfaction scale scores ($9.4{\pm}2.5$, P < 0.01) as compared to group D patients. The BDI score showed a close correlation with employment status and the life satisfaction scale. Conclusions: Many lumbar spinal stenosis patients had high BDI scores. Employment status and the life satisfaction scale were closely correlated with the BDI score.

동작 침법을 시행한 요추부 척추관 협착증 환자의 치험 2례 보고 (The Clinical Report on 3 cases of the patient of lumbar stenosis Treated with Motion Style Treatment)

  • 김기역;이기하;김우영;이현종;김창연
    • 척추신경추나의학회지
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    • 제3권1호
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    • pp.29-36
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    • 2008
  • Objectives : the purpose of this study is to report the improvement of stenosis patients, who treated by M.S.T.(Motion Style Treatment) Methods : the clinical study was done on 2 cases of patients with lumbar stenosis who admission in Jaseng Oriental Medicine hospital. We checked VNRS score after the treatment of M.S.T.(Motion Style Treatment) each day, and checked ODI score at admission and discharge. Results : VNRS score and ODI score decreased after the treatment of M.S.T.(Motion Style Treatment)

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The Effect of Lumbar Medial Branch Block on Low Back Pain

  • Kim, Kyoung-Tae;Park, Seung-Won;Kim, Young-Baeg;Hong, Hyun-Jong;Kwon, Jeong-Taik;Hwang, Sung-Nam
    • Journal of Korean Neurosurgical Society
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    • 제40권4호
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    • pp.256-261
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    • 2006
  • Objective : The goal of this study was to establish the benefit and prognostic factors of lumbar medial branch block[MBB] for low back pain. Methods : A retrospective analysis was based on the data obtained from 281 patients with low back pain, who visited our hospital between January 2001 and November 2004. Pain relief was evaluated at 2 weeks, 1 month and 3 months. The authors analyzed the results of MBB according to the patient's age, sex, symptom duration, pathologic condition, and presence of radiating pain. Results : Two hundred eighty one patients had sprain [151]. lumbar fracture [27], spinal stenosis [50], herniated lumbar disc [24] acute post-operative pain [8], and chronic post-operative pain [21] with success rate of 63.6%, 59.3%, 26.0%, 25.0%, 87.5% and 42.9%, respectively. The effects of MBB in sprain, lumbar fracture, and acute post-operative pain were significantly better than those in stenosis, herniated lumbar disc and chronic post-operative pain patients. The patients in young age group [<60 years], with short symptom duration [<6 months] and without radiating pain showed good response to lumbar MBB. Conclusion : The lumbar MBB appears to be safe and effective for low back pain in certain selected patients. Good prognostic factors were low back pain without surgical conditions and radiating pain, with short symptom duration [<6 months], and in relatively young age [<60 years] group.

자기공명영상 (Magnetic Resonance Image)을 통한 요통 환자의 다열근 위축에 대한 후향적 연구 (The Retrospective Study on the Correlation between the Multifidus Muscle Atrophy on Low Back Pain Patients and the Magnetic Resonance Images)

  • 이길준;박영회;금동호
    • 한방재활의학과학회지
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    • 제19권4호
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    • pp.151-163
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    • 2009
  • Objectives : In the assessment of the lumbar spine by magnetic resonance imaging (hereinafter, "MRI"), changes in the paraspinal muscles are overlooked. The purpose of our study is to examine the correlation between the multifidus muscle atrophy on MRI findings and the clinical findings in low back pain (hereinafter, "LBP") patients. Methods : The retrospective study on 38 LBP patients, presenting either with or without associated leg pains, was undertaken. The MRI findings on the patients were visually analysed to find out a lumbar multifidus muscle atrophy, disc herniation, disc degeneration, spinal stenosis and nerve root compressions. The clinical history in each case was obtained from their case notes and pain drawing charts. Results : The lumbar multifidus muscle atrophy has occurred from more than 80% of the patients with LBP. Most of lumbar multifidus muscle atrophies have increased from lower level of lumbar spine. It was bilateral in the majority of the cases. In addition, multifidus muscle atrophy was correlated to the patient's age, disc degenerations and spinal stenosis. On the contrary, gender, the duration of LBP, referred leg pain, disc herniation and nerve root compressions had no relevance to multifidus muscle atrophies. Therefore, when assessing the MRIs of the lumbar spine, we should have more attetion on multifidus muscle, because it has lot's of information about spinal neuropathy problems. Conclusions : Therefore, the examination of multifidus muscle atrophies should be considered when assessing the MRIs of the lumbar spine. In addition, it helps to evaluate and plan the treatment modalities of LBP. Moreover, it prevents from LBP by discovering the importance between the multifidus muscle and the spine stabilization exercise.