• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.2
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• pp.212-220
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• 2020

This study examines the effects on isometric lumbar extension strength, dynamic balance ability, and range of motion, after administering 8 weeks SEBT exercise (dynamic balance exercise) and Lumbar Stabilizing exercise, to open laser lumbar microdiscectomy patients. Totally, 14 patients who underwent preservation treatment for 6 weeks after undergoing open laser lumbar microdiscectomy, were enrolled for the study. Patients were randomly assigned to the Lumbar Stabilizing Exercise Group (LSG, n=7) and SEBT Exercise + Lumbar Stabilizing Exercise Group (SGLS, n=7). Results indicate that isometric lumbar extension strength ratio significantly decreases after 8 weeks rehabilitation exercise in both the LSG (p=0.007) as well as SLSG (p=0.024) groups. Normalized reach distance of the three directions in the Y-balance test to examine the dynamic balance capability showed a significant increase in both groups. The dynamic balance capability showed significant increase to the left (LSG, p=0.010; SLSG, p=0.002) and right (LSG, p=0.002; SLSG, p=0.002). Moreover, significant increase was also obtained in the range of joint operation, in both LSG (p=0.006) and SLSG (p=0.017) groups. These results indicate that both groups of rehabilitation exercise achieve positive outcomes on the isometric lumbar extension strength, range of motion, and dynamic balance ability. However, some results suggest that the SEBT program is likely to have a better efficacy.

• Journal of Korean Neurosurgical Society
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• v.46 no.6
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• pp.515-521
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• 2009

Objective : The purpose of this study was to compare clinical and radiological outcomes of percutaneous endoscopic lumbar discectomy (PELD) and open lumbar microdiscectomy (OLM) for recurrent disc herniation. Methods : Fifty-four patients, who underwent surgery, either PELD (25 patients) or repeated OLM (29 patients), due to recurrent disc herniation at L4-5 level, were divided into two groups according to the surgical methods. Excluded were patients with sequestrated disc, calcified disc, severe neurological deficit, or instability. Clinical outcomes were assessed using Visual Analogue Scale (VAS) score and Oswestry Disability Index (ODI). Radiological variables were assessed using plain radiography and/or magnetic resonance imaging. Results : Mean operating time and hospital stay were significantly shorter in PELD group (45.8 minutes and 0.9 day, respectively) than OLM group (73.8 minutes and 3.8 days, respectively) (p < 0.001). Complications occurred in 4% in PELD group and 10.3% in OLM group in the perioperative period. At a mean follow-up duration of 34.2 months, the mean improvements of back pain, leg pain, and functional improvement were 4.0, 5.5, and 40.9% for PELD group and 2.3, 5.1, and 45.0% for OLM group, respectively. Second recurrence occurred in 4% after PELD and 10.3% after OLM. Disc height did not change after PELD, but significantly decreased after OLM (p = 0.0001). Neither sagittal rotation angle nor volume of multifidus muscle changed significantly in both groups. Conclusion : Both PELD and repeated OLM showed favorable outcomes for recurrent disc herniation, but PELD had advantages in terms of shorter operating time, hospital stay, and disc height preservation.

• PNF and Movement
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• v.10 no.2
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• pp.25-31
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• 2012

Purpose : The purpose of this study is to figure out the effects of Open Laser Microdiscectomy(OLM) on deep muscles by comparing multifidus and longissimus muscle size (cross section area; CSA) of pre and post operation. Methods : The subjects consisted of forty patients who had OLM. The data were analyzed with paired t-test comparing left and right deep muscle CSA of pre and post-operation, and both the deep muscle CSA of pre and post-operation, using SPSS ver. 15.0 program. Results : The results of this study showed a significant difference in deep muscle size (CSA) between pre and post operation (p<.05). Although there was not a meaningful difference between right and left deep muscle size (CSA) in pre operation (p>.05), there was a significant difference between both of them in post operation (p<.05). Conclusion : Therefore we made the conclusion that the operation causes decrease of muscle tone in deep muscles and muscle imbalance by causing muscle atrophy in the lumbar deep muscle after the operation.

• Journal of Korean Neurosurgical Society
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• v.39 no.6
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• pp.413-418
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• 2006

Objective : The objective of this study is to evaluate and compare the clinical results between classical open surgery and percutaneous endoscopic lumbar discectomy[PELD] in cases of extraforaminal lumbar disc herniation. Methods : We obtained the clinical data from 47 patients with extraforaminal lumbar disc herniations who underwent the open paramedian muscle-splitting approach or percutaneous endoscopic lumbar discectomy[PELD] between January 2001 and February 2004. This study consisted of patients with soft disc extraforaminal herniations. The patients were assessed with the visual analogue scale[VAS] and MacNab's criteria before surgery, just before discharge, and postoperative 1 year. Results : There were 25 cases in the open surgery group and 22 cases in the PELD group. The average operating time was $78{\pm}36.71\;min$ in the PELD group and $110{\pm}29.68\;min$ in the open surgery group. The mean hospital stay was $2.73{\pm}2.62$ days in the PELD group and $7.68{\pm}2.59$ days in the open surgery group. VAS decreased from $8.34{\pm}0.66$ to $1.29{\pm}2.27$ in the PELD group and from $8.40{\pm}1.40$ to $1.70{\pm}1.72$ in the open surgery group at the one-year follow-up. The success rate of PELD was 86.4%, compared with 80.0% for open surgery. However, there were no statistically significant difference between two groups for success rate and VAS. Conclusion : Although the success rates were similar in both groups, PELD is less invasive, faster, and safe procedure than open surgery for extraforaminal disc herniation in selected patients.

• Journal of Korean Neurosurgical Society
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• v.44 no.5
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• pp.320-326
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• 2008

Objective : To evaluate the risk factors that may be responsible for the development of contralateral reherniations from ipsilateral ones after open lumbar microdiscectomy (OLM), and to compare surgical outcomes of revision OLM for contralateral reherniations with those for ipsilateral ones. Methods: Seventeen patients who underwent revision OLM for contralateral reherniation were enrolled into Group I, and 35 patients who underwent revision OLM for ipsilateral reherniation were enrolled into Group II. Using medical charts and imaging study results, the differences in the clinical and radiological factors were evaluated between the two groups. Clinical outcomes of each group were compared between the two groups. Results: Significant differences were found in the interval to reherniation from initial surgery (33 months for Group I and 18.6 months for Group II, p=0.009), as well as in the incidences of both protruded disc (35.3% for Group I and 8.6% for Group II, p=0.045) and mild disc degeneration (29.4% for Group I and 5.7% for Group II, p=0.031) at initial surgery. On binary multi-logistic regression analysis, significant differences were found in the interval to reherniation (p=0.027, Odds ratio=1.051) and incidence of mild disc degeneration (p=0.025, Odds ratio= 12.03) between the two groups. There were no significant differences in the improvement of clinical outcomes after revision OLM between the two groups. Conclusion: The interval to reherniation from initial surgery and the grade of disc degeneration at initial surgery were key factors that distinguished the development of contralateral reherniations from ipsilateral ones. Surgical outcomes of revision OLM were similar in both groups.

• Journal of Korean Neurosurgical Society
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• v.48 no.6
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• pp.547-550
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• 2010

Spinal cysticercosis is a very uncommon manifestation of neurocysticercosis which is caused by the larvae of Taenia solium. However, it can develop as a primary infection through blood stream or direct larval migration. It can result in high recurrence and severe neurologic morbidity if not treated appropriately. We report the case of a 43-year-old woman who presented with severe lower back pain and left leg radiating pain in recent 2 weeks. Magnetic resonance image (MRI) of lumbar spine demonstrated extruded disc at the L5-S1 level combined with intradural extramedullary cystic lesion. We performed the open lumbar microdiscectomy (OLM) at L5-S1 on the left with total excision of cystic mass. After surgery, the patient showed an improvement of previous symptoms. Diagnosis was confirmed by histopathological examination as intradural extramedullary cysticercosis. We discuss clinical features, diagnostic screening, and treatment options of spinal cysticercosis.

• Journal of Korean Neurosurgical Society
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• v.50 no.3
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• pp.201-204
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• 2011

Objective : To quantitatively evaluate the asymmetry of the multifidus and psoas muscles in unilateral sciatica caused by lumbar disc herniation using magnetic resonance imaging (MRI). Methods : Seventy-six patients who underwent open microdiscectomy for unilateral L5 radiculopathy caused by disc herniation at the L4-5 level were enrolled, of which 39 patients (51.3%) had a symptom duration of 1 month or less (group A), and 37 (48.7%) had a symptom duration of 3 months or more (group B). The cross-sectional areas (CSAs) of the multifidus and psoas muscles were measured at the mid-portion of the L4-5 disc level on axial MRI, and compared between the diseased and normal sides in each group. Results : The mean symptom duration was $0.6{\pm}0.4$ months and $5.4{\pm}2.7$ months for groups A and B, respectively (p<0.001). There were no differences in the demographics between the 2 groups. There was a significant difference in the CSA of the multifidus muscle between the diseased and normal sides (p<0.01) in group B. In contrast, no significant multifidus muscle asymmetry was found in group A. The CSA of the psoas muscle was not affected by disc herniation in either group. Conclusion : The CSA of the multifidus muscle was reduced by lumbar disc herniation when symptom duration was 3 months or more.

• Journal of Korean Neurosurgical Society
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• v.41 no.4
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• pp.241-245
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• 2007

Objective : So called "minimally invasive procedures" have evolved from chemonucleolysis, automated percutaneous discectomy, arthroscopic microdiscectomy that are mainly working within the confines of intradiscal space to transforaminal endoscopic technique to remove herniated epidural disc materials directly. The purpose of this study is to assess the result of endoscopic spinal surgery and favorable indication in the thoracolumbar spine. Methods : The records of 71 patients, 73 endoscopic procedures, were retrospectively analysed. Yeung Endoscopic Spine Surgery system with 7 mm working sleeve and $25^{\circ}$ viewing angle was used. The mean follow up period was 6 months [range, 3-9]. Results : Operated levels were from T12-L1 disc down to L5-L6 of S1 disc. Of 71 cases, 2 patients underwent transforaminal endoscopic surgery twice due to recurrence after initial operation. MacNab's criteria was used to assess the outcome. Favorable outcome, excellent of good, was seen in 78% [57 procedures] of the patients. Among 11 fair outcomes, only 1 procedure was followed by secondary open procedure, laminectomy with discectomy. Two of 5 poor outcomes were operated again by same procedure which resulted in fair outcomes. One patient with aggravated cauda equina syndrome remained poor and a lumbar fusion procedure was performed in other patient with poor outcome. There were 2 postoperative discitis that were treated with conservative care in one and anterior lumbar interbody fusion in the other. Conclusion : Evolving technology of mechanical, visual instrument enables minimal invasive procedure possible and effective. The transforaminal endoscopic spinal surgery can reach as high as T12-L1 disc level. The rate of favorable outcome is mid-range among reported endoscopic lumbar surgery series. Authors believe that the outcome will be better as cases accumulate and will be able to reach the fate of standard open microsurgery.