• Journal of Korean Medicine Rehabilitation
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• v.31 no.4
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• pp.203-210
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• 2021

Bertolotti's syndrome is a rare spinal disease and it is known to cause low back pain due to a lumbosacral transitional vertebra. There has been rare study of Bertolotti's syndrome. This study reports the effects of Korean medicine treatment on the patient who was diagnosed on Bertolotti's syndrome. The patient was treated with Korean medicine treatment including acupuncture, pharmacopuncture, herbal medicine, and Chuna manual therapy during 40 days. Numerical rating scale (NRS), Euroqol five dimension (EQ-5D) index, Oswestry disability index (ODI), lumbar range of motion were used for assessment. After treatment, low back pain NRS decreased from 3 to 2, and low limb pain NRS decreased from 5 to 2. EQ-5D index, ODI and lumbar range of motion also were improved. This study shows Korean medicine treatment can be an effective care for Bertolotti's syndrome.

• Journal of Acupuncture Research
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• v.28 no.6
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• pp.149-157
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• 2011

Objectives : The purpose of this study is to investigate the effect of mixed pharmacopuncture of $Jungsongouhyul$ and $Cervi$ $Pantotrichum$ $Cornu$ on low back pain patients. Methods : 83 patients with Low back pain who were treated in Dept. of Acupuncture and Moxibusion, Dongshin University Hospital in Suncheon from Sep. 1st, 2010 to August 31th, 2011, were divided into two groups. One group (52 patients) was treated with conservative treatments (acupuncture, herb med, cupping therapy and physical therapy) and mixed pharmacopuncture of $Jungsongouhyul$ and $Cervi$ $Pantotrichum$ $Cornu$ theraphy (PG) and the other group (31 patients) was treated with conservative treatments alone(NPG). To estimate the effects of treatments, visual analog scale(VAS) and Oswestry disability index(ODI) were checked. Results : 1. In VAS, both of PG and NPG shows statistically significant improvement rate after 3rd treatment and 5th treatment. 2. In ODI, both of PG and NPG shows statistically significant improvement rate after 3rd treatment and 5th treatment. 3. In comparing VAS of PG and NPG, there was more significant improvement in PG than NPG after 3rd treatment and 5th treatment. 4. In comparing ODI of PG and NPG, there was more significant improvement in PG than NPG after 3rd treatment but no significant improvement between PG and NPG after 5th treatment. Conclusions : According to the study, it is thought that mixed pharmacopuncture of $Jungsongouhyul$ and $Cervi$ $Pantotrichum$ $Cornu$ theraphy is effective to low back pain patients, and further study is needed for the confirmation of the effect of mixed pharmacopuncture of $Jungsongouhyul$ and $Cervi$ $Pantotrichum$ $Cornu$.

• Physical Therapy Korea
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• v.12 no.2
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• pp.44-57
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• 2005

The objectives of this study were to examine the relative efficacy of three active exercise programs for work-related, chronic low back pain, and to observe to what extent the programs affected the mechanical stability of the lumbar region. The subjects were 64 employees who were randomly divided into three groups to match the three active exercise programs which were performed 3 times a week for 6 months. All subjects were assessed with the same measurements at a pre-study examination, and then were reassessed at 2 weeks, 3months and 6 months after the study. The pain intensity didn't show any significant difference among the three groups. However, the Oswestry Disability Index showed significant differences among the three groups at 6 months and the lumbar and thoracic exercise groups showed significant decreases compared to the general physiotherapy group (p<.05). Maximal stretching with both hands in the overhead direction showed a significant difference among the three groups at 3 months and 6 months, and the thoracic exercise group at 6 months showed a significant increase in overhead stretching compared to the lumbar exercise and general physiotherapy groups (p<.05). The group that performed maximal stretching with both hands in the overhead direction showed the most significant among the 3 months and 6 months. At 6 months, the thoracic exercise group showed a significant increase in overhead stretching compared to the lumbar exercise and general physiotherapy groups (p<.05). The lumbar region angle of inclination showed significant differences among the three groups at 2 weeks 3 months, and 6 months, with the thoracic exercise group being decreased more significantly at 6 months than the lumbar exercise and general physiotherapy groups (p<.05). Exercise aimed at increasing thoracic mobility has an effect on lumbar stability. Furthermore, it is far more effective for lumbar stabilization than general physiotherapy and deep muscle strengthening lumbar exercise.

• Journal of Korean Neurosurgical Society
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• v.45 no.2
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• pp.74-80
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• 2009

Objective : To evaluate clinical and radiological results of two different fusion techniques in adult low-grade isthmic spondylolisthesis. Methods : Between November 2003 and December 2004, 46 consecutive patients underwent instrumented mini-transforaminal lumbar interbody fusion (mini-TLIF) (group I) at Wooridul Spine Hospital, Seoul, Korea. Between February 2003 and October 2006, 32 consecutive patients underwent instrumented circumferential fusion (group II) at Leon Wiltse Memorial Hospital, Suwon, Korea. The mean follow-up periods were 29.7 and 26.1 months, respectively. Results : Mean visual analog scale (VAS) scores for back and leg pain decreased, respectively, from 6.98 and 6.33 to 2.3 and 2.2 in group I and from 7.38 and 6.00 to 1.7 and 1.0 in group II. Mean Oswestry disability index (ODI) improved from 51.85% to 14.4% in group I and from 60% to 9.1% in group II. In both groups, VAS and ODI scores significantly changed from pre- to postoperatively (p<0.001), but postoperative outcome between groups was statistically not significant. Radiologic evidence of fusion was noted in 95.7% and 100% of the patients in group I and II, respectively. In both groups, changes in disc height, segmental lordosis, degree of listhesis, and whole lumbar lordosis between the pre- and postoperative periods were significant except whole lumbar lordosis in both groups. Conclusion : Clinical and functional outcomes demonstrate no significant differences between groups in treating back and leg pain of adult patients with low-grade isthmic spondylolisthesis. However, in terms of operative data (i.e. operation time and hospital stay), instrumented mini-TLIF demonstrated better results.

• The Korean Journal of Pain
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• v.33 no.3
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• pp.226-233
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• 2020

Background: We aimed to compare interlaminar epidural steroid injections (ILESI) and bilateral transforaminal epidural steroid injections (TFESI) on pain intensity, functional status, depression, walking distance, and the neuropathic component in patients with lumbar central spinal stenosis (LCSS). Methods: The patients were divided into either the ILESI or the bilateral TFESI groups. Prime outcome measures include the numerical rating scale (NRS), Oswestry disability index (ODI), Beck depression inventory (BDI), and pain-free walking distance. The douleur neuropathique en 4 questions score was used as a secondary outcome measure. Results: A total of 72 patients were finally included. NRS, ODI, and BDI scores showed a significant decline in both groups in all follow-ups. Third-month NRS scores were significantly lower in the ILESI group (P = 0.047). The percentages of decrease in the ODI and BDI scores between the baseline and the third week and third month were significantly higher in the ILESI group (P = 0.017, P = 0.001 and P = 0.048, P = 0.030, respectively). Pain-free walking distance percentages from the baseline to the third week and third month were significantly higher in the ILESI group (P = 0.036, P < 0.001). The proportion of patients with neuropathic pain in the bilateral TFESI group significantly decreased in the third week compared to the baseline (P = 0.020). Conclusions: Both ILESI and TFESI are reliable treatment options for LCSS. ILESI might be preferred because of easier application and more effectiveness. However, TFESI might be a better option in patients with more prominent neuropathic pain.

• Journal of Korean Medicine Rehabilitation
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• v.21 no.4
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• pp.227-239
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• 2011

Objectives: This study was performed to report the case of oriental medical treatment for the left lower limb monoplegia after herniated intervertebral disc(HIVD) operation at lumbar(L)-spine. Methods: A 38-year-old man who underwent lumbar HIVD operation at a hospital admitted with motor weakness of left lower limb, a little decreased left leg radiation pain and low back pain. We treated him by acupuncture, herbal medicine, bee venom injection moxibustion, cupping treatment physical therapy and measured with visual analogue scale(VAS), Oswestry disability index(ODI), Roland-Morris disability questionnaire(RMDO) and manual muscle test(MMT) from 8th February to 4th May 2011. Results: After treatment most symptoms decreased, VAS score changed from 10 to 3, ODI changed 71% to 37% RMDQ changed 13 to 8 and MMT changed from 3 to 5. Conclusions: Our study suggested that oriental medical treatments are significantly applicable to the monoplegia and pain after lumbar HIVD operation. And further studies ire required to identify underlying mechanism of the treatment.

• Physical Therapy Rehabilitation Science
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• v.12 no.4
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• pp.547-553
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• 2023

Objective: This case report was to investigate the effects of lumbar stabilization exercises using a traction force sensor on the flexibility of the spine, dynamic balance, pain intensity, and ODI in patients with chronic low back pain. Design: A Case study Methods: The participant underwent lumbar stabilization exercises using a traction force sensor twice a week for a total of 10 sessions over a period of 5 weeks. Outcome measures included lumbar flexibility using the Schober test, changes in functional performance in daily life assessed by ODI, overall pain intensity and frequency measured by the VAS, and the Y balance test.The participant underwent lumbar stabilization exercises using a traction force sensor twice a week for a total of 10 sessions over a period of 5 weeks. Outcome measures included lumbar flexibility using the Schober test, changes in functional performance in daily life assessed by ODI, overall pain intensity and frequency measured by the VAS, and the Y balance test. Results: After the intervention, the participant's lumbar flexibility increased from 12.5 cm to 16 cm, indicating an improvement in lumbar flexibility. The pain score decreased from 8 points before the intervention to 0 points after the intervention. Additionally, the ODI score decreased from 4 points to 0 points. Dynamic balance also improved, with the measurements increasing from 55 cm anterior, 48 cm left, and 47 cm right before the intervention to 65 cm anterior, 60 cm left, and 57 cm right after the intervention. Conclusions: The patient positively responded to lumbar stabilization exercises using a traction force sensor, showing increased lumbar flexibility, improved daily functioning, reduced pain, and enhanced dynamic balance. These results suggest that the application of lumbar stabilization exercises with a traction force sensor may be considered positively for patients with chronic low back pain.

• Journal of Acupuncture Research
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• v.34 no.4
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• pp.172-179
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• 2017

Background: This study was designed to evaluate the clinical effectiveness of traditional Korean medicine treatment for lumbar spinal stenosis as assessed by radiological criteria. Methods: This was an observational study of 122 patients who were diagnosed with lumbar spinal stenosis and admitted to Jaseng Hospital between January 2016 and June 2017. They were analyzed according to sex, age, cause of disease, disease stage, length of admission, type of stenosis, morphological grade, and dural sac cross-sectional area. All patients were treated with traditional Korean medicine. Patients were assessed with the Numeric Rating Scale (NRS), Oswestry Disability Index (ODI) and EQ-5D before and after treatment. Results: Regarding the distribution of the factors analyzed, these were of note: more females than males (1:3.52); and highest proportions were age more than 70 years (37.70%), cause of lumbar spinal stenosis unknown (67.21%), and subacute stage (42.62%). Comparing before and after treatment, the NRS score for low back and pelvic pain decreased from $6.14{\pm}1.71$ to $4.28{\pm}1.91$ (p < 0.001), and the NRS score for radiating pain and numbness decreased from $6.27{\pm}1.61$ to $2.02{\pm}1.54$ (p < 0.001). ODI decreased from $46.86{\pm}19.40$ to $33.63{\pm}18.66$ (p < 0.001), and gait-related ODI decreased from $3.34{\pm}1.23$ to $2.80{\pm}1.11$ (p < 0.001). There were no statistically significant differences in improvement of the NRS, ODI, gait-related ODI, and EQ-5D for morphological grade and dural sac cross-sectional area. Conclusion: Traditional Korean medicine is effective treatment for patients with lumbar spinal stenosis. Even in patients with severe radiological findings, it is possible to reduce pain and improve quality of life.

• Journal of Acupuncture Research
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• v.21 no.5
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• pp.79-99
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• 2004

Objective : This study was designed to find out the effect of scolopendrid aquacupuncture classified by the type of HIVD(Herniation of Inter-Vertebral Disc) in lumbar spine. Methods : The 50 patients who had a diagnosis of HIVD by lumbar-CT or lumbar-MRI and admitted to Gwangju oriental medical hospital in wonkwang university from June 2003 to March 2004 were observed. The symptom of inpatients is low back pain with or without sciatica. We treated 50 patients by scolopendrid aquacupuncture besides the general consevative treatment of oriental medicine. Results and Conclusion : The scolopendrid aquacupuncture treatment led to improvement in the pain and symptom of HIVD as determined by all efficacy measures. After scolopendrid aquacupuncture treatment, there was improvement in VAS, oswestry disability index, ROM and SLRT. The improvement index of scolopendrid aquacupuncture treatment classified by the type of HIVD showed that the effects of scolopendrid aquacupuncture had correlation with the type of HIVD. The more the herniation of intervertebral disc decreased, the more the effect of scolopendrid aquacupuncture increased. This results suggest that scolopendrid aquacupuncture is good method for treatment of HIVD but we have to consider the clinical correlation with the degree of herniation.

• Journal of Korean Neurosurgical Society
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• v.65 no.4
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• pp.539-548
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• 2022

Objective : Although full-endoscopic lumbar interbody fusion (Endo-LIF) has been tried as the latest alternative technique to minimally invasive transforaminal lumbar interobody fusion (MIS-TLIF) since mid-2010, the evidence is still lacking. We compared the clinical outcome and safety of Endo-LIF to MIS-TLIF for lumbar degenerative disease. Methods : We systematically searched electronic databases, including PubMed, EMBASE, and Cochrane Library to find literature comparing Endo-LIF to MIS-TLIF. The results retrieved were last updated on December 11, 2020. The perioperative outcome included the operation time, blood loss, complication, and hospital stay. The clinical outcomes included Visual analog scale (VAS) of low back pain and leg pain and Oswestry disability index (ODI), and the radiological outcome included pseudoarthosis rate with 12-month minimum follow-up. Results : Four retrospective observational studies and one prospective observational study comprising 423 patients (183 Endo-LIF and 241 MIS-TLIF) were included, and the pooled data analysis revealed low heterogeneity between studies in our review. Baseline characteristics including age and sex were not different between the two groups. Operation time was significantly longer in Endo-LIF (mean difference [MD], 23.220 minutes; 95% confidence interval [CI], 10.669-35.771; p=0.001). However, Endo-LIF resulted in less perioperative blood loss (MD, -144.710 mL; 95% CI, 247.941-41.478; p=0.023). Although VAS back pain at final (MD, -0.120; p=0.586), leg pain within 2 weeks (MD, 0.005; p=0.293), VAS leg pain at final (MD, 0.099; p=0.099), ODI at final (MD, 0.141; p=0.093) were not different, VAS back pain within 2 weeks was more favorable in the Endo-LIF (MD, -1.538; 95% CI, -2.044 to -1.032; p<0.001). On the other hand, no statistically significant group difference in complication rate (relative risk [RR], 0.709; p=0.774), hospital stay (MD, -2.399; p=0.151), and pseudoarthrosis rate (RR, 1.284; p=0.736) were found. Conclusion : Relative to MIS-TLIF, immediate outcomes were favorable in Endo-LIF in terms of blood loss and immediate VAS back pain, although complication rate, mid-term clinical outcomes, and fusion rate were not different. However, the challenges for Endo-LIF include longer operation time which means a difficult learning curve and limited surgical indication which means patient selection bias. Larger-scale, well-designed study with long-term follow-up and randomized controlled trials are needed to confirm and update the results of this systematic review.