• 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.

• 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.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.16 no.2
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• pp.55-67
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• 2021

Objectives This review aimed to investigate studies of Chuna manual therapy (CMT) for low back pain and the evidence of their effects in order to suggest a better research method in the future. Methods We investigated studies on CMT for low back pain by searching Korean web databases from 2020 to 2021. As a result, 72 research papers were analyzed according to their published year, the titles of journals, the types of studies, the techniques of Chuna, and the instruments used for assessment. Results The results were as follows: 1. There were three papers published initially in 2000. this number showed a steady increase, and a total of 72 papers were published that year. 2. Studies on CMT were mainly published in the Journal of Korea Chuna Manual Medicine for Spine and Nerves. 3. When categorized according to the methods of studies, a simple case report was used more often than the sum of randomized controlled trials (RCTs) and non-RCTs. 4. The most frequently adopted technique of Chuna in the examined studies was the COX flexion and distraction technique. 5. The Visual Analog Scale and Oswestry Disability Index were used as primary means of assessment. Conclusions Based on the analysis, it was observed that this review provided limited evidence of CMT use in patients with LBP. Therefore, further investigation using well-designed RCTs is required to obtain higher evidence.

• The Journal of Internal Korean Medicine
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• v.40 no.5
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• pp.841-850
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• 2019

Objective: The aim of this study was to report the effects of traditional Korean medicine as a treatment for the pain of a compression fracture in a patient with metastatic prostate cancer. Methods: A 60-year-old male patient with a compression fracture was treated with herbal medicines, acupuncture, and pharmacopuncture for 25 days. His chief complaints were severe low back pain, pain and numbness in both legs, and right groin pain. The effect of treatment was evaluated by the numerical rating scale (NRS) score for pain, the Oswestry Disability Index (ODI) score, and blood test results (CBC-diff count, CRP, ESR, etc.). Results: After 25 days of inpatient treatment, the patient's pain was controlled. The NRS and ODI scores were lower and most pathological symptoms had decreased. Conclusions: Traditional Korean medicine can be a solution for patients with compression fractures arising from metastasis of prostate cancer to the spine.

• Journal of Korean Medicine Rehabilitation
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• v.20 no.4
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• pp.231-239
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• 2010

Objectives : This study was performed to report the effect and safety of oriental medical treatment in the pregnant woman diagnosed to herniation of nuclues pulposus(HNP) at L5-S1 with central protrusion and left S1 nerve root. Methods : A 32-year old pregnant woman diagnosed HNP at L5-S1 at local hospital was admitted with low back pain and left leg rad pain. We treated her by acupuncture, a herbal medicine, cupping treatment and measured visual analogue scale(VAS), Oswestry disability index(ODI) and Roland-Morris disability qustionnaire(RMDQ) from 5th March 2010 to 26th March 2010. Results : After treatment, most symptoms decreased, VAS score changed 10 to 2, ODI changed 388, RMDQ changed 13 to 6. Conclusions : In this study, oriental medical treatment was effective and safe in pregnant woman with HNP at L-spine. But the rigorous studies will be needed to define clearly that oriental medical treatment is effective and safe in pregnant women with HNP at L-spine.

• Journal of Korean Medicine Rehabilitation
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• v.23 no.4
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• pp.95-115
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• 2013

Objectives The aim of this review is to provide fundamental data for low back pain scales which can be used in clinical trial. Methods We investigated the latest studies on chronic low back pain via PubMed. And we also investigated domestic studies through "http://oasis.kiom.re.kr". 95 research papers were analyzed. Scales were classified into pain scale, function scale, generic health status scale and psychological scale. Results 1) According to foreign clinical studies, Visual Analog Scale (VAS) and Numerical Rating Scale (NRS) were used 18 times as pain scale. Oswestry Disability Index (ODI) was used 20 times as function scale, Roland-Morris Disability Questionnaire (RMDQ) was 17, and Hannover Functional Ability Questionnaire (HFAQ) was used 3 times. 36-item Short Form Health Survey (SF-36) was used 13 times as generic health status scale, Euroqol-5 Dimentions Questionnaire (EQ-5D) was 11, and 12-item Short Form Health Survey (SF-12) was used 3 times. Fear-Avoidance Beliefs Questionnaire (FABQ) was used 9 times as psychological scale, Pain Catastrophizing Scale (PCS) and Tampa Scale for Kinesiophobia (TSK-R) both were used 3 times. 2) According to domestic clinical studies, VAS was used 37 times as pain scale, NRS was 11, and Short Form McGill Pain Questionnaire (SF-MPQ) was used 6 times. ODI was used 30 times as function scale, RMDQ was 2 times only. SF-36 was used once as generic health status scale and Beck's Depression Inventory (BDI) was used 3 times as psychological scale. Conclusions We recommend VAS or NRS as a measure to evaluate pain, and ODI as a measure to evaluate functional disability. And we also recommend SF-36 or SF-12 and EQ-5D as a measure to evaluate generic health status. Finally, we recommend FABQ for use in measuring psychological scale.