• 대한한방내과학회지
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• 제40권5호
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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.

• The Journal of Korean Physical Therapy
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• 제33권5호
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• pp.238-244
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• 2021

Purpose: Menstruation is associated with menstrual symptoms like pain and balance problems which have an impact on the quality of life. Pilates increases pelvic stability and reduces menstrual pain by inducing abdominal muscle contraction. This study was done to evaluate the effects of Pilates on menstrual pain, symptoms, balance, and quality of life when compared to aerobic exercise. Methods: Thirty-nine women with menstrual pain were randomly divided into the Pilates group (n=13), aerobics group (n=13), and control group (n=13). The Pilates group performed lumbar-pelvic stabilization exercises, while the aerobic group ran on a treadmill. The control group did not undergo any intervention. The experimental groups exercised for four weeks (12 sessions) and did not exercise during menstruation. The Y-balance test was performed on the second day of menstruation to evaluate dynamic balance. The questionnaires administered immediately after menstruation were the visual analog scale (VAS), Korea Oswestry Disability Index (ODI), and the modified Menstrual Distress Questionnaire (MDQ). The paired t-test was used to compare the effect of exercise within the three groups and a oneway analysis of variance was used to compare between groups. Results: VAS and MEDI-Q scores significantly decreased in the Pilates group after 4 weeks compared with those in the aerobic and control groups. Moreover, ODI and Y-balance scores increased in the Pilates group compared with those in the aerobic and control groups (p<0.05). Conclusion: The Pilates stabilization exercises are effective and help in improving menstrual pain, balance and other menstrual symptoms assessed through ODI, and MEDI-Q, compared to aerobic exercises.

• 대한한방내과학회지
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• 제42권5호
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• pp.1027-1034
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• 2021

Objectives: This study aimed to determine the effects of Korean medical treatment on a patient with compression fractures. Methods: The patient was treated with herbal medicine and acupuncture for 51 days. Symptom changes were measured using the Numerical Rating Scale (NRS), Range of Motion (ROM), Oswestry Disability Index (ODI), and European Quality of Life Five Dimensions (EQ-5D) Scale. Results: The NRS score for lower back pain decreased from 7 to 3, and the ODI score decreased from 51.11 to 22.22. Range of motion (ROM) increased meaningfully in flexion(from 30 to 60), Left/Right lateral bending(from 10/30 to 30/45), Left/Right rotation (from 10/30 to 30/45), and the EQ-5D score also increased from 0.506 to 0.677. Conclusion: The results indicate that Korean medical treatment may be effective for managing patients' acute compression fractures.

• Annals of Rehabilitation Medicine
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• 제42권6호
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• pp.804-813
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• 2018

Objective To elucidate the effect of a 12-week horizontal vibration exercise (HVE) in chronic low back pain (CLBP) patients as compared to vertical vibration exercise (VVE). Methods Twenty-eight CLBP patients were randomly assigned to either the HVE or VVE group. All participants performed the exercise for 30 minutes each day, three times a week, for a total of 12 weeks. Altered pain and functional ability were evaluated using the visual analog scale (VAS) and Oswestry Disability Index (ODI), respectively. Changes in lumbar muscle strength, transverse abdominis (TrA) and multifidus muscle thicknesses, and standing balance were measured using an isokinetic dynamometer, ultrasonography, and balance parameters, respectively. These assessments were evaluated prior to treatment, 6 weeks and 12 weeks after the first treatment, and 4 weeks after the end of treatment (that is, 16 weeks after the first treatment). Results According to the repeated-measures analysis of variance, there were significant improvements with time on VAS, ODI, standing balance score, lumbar flexor, and extensor muscle strength (all p<0.001 in both groups) without any significant changes in TrA (p=0.153 in HVE, p=0.561 in VVE group) or multifidus (p=0.737 in HVE, p=0.380 in VVE group) muscle thickness. Further, there were no significant differences between groups according to time in any of the assessments. No adverse events were noticed during treatment in either group. Conclusion HVE is as effective as VVE in reducing pain, strengthening the lumbar muscle, and improving the balance and functional abilities of CLBP patients. Vibrational exercise increases muscle strength without inducing muscle hypertrophy.

• Asian Spine Journal
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• 제12권6호
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• pp.1017-1027
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• 2018

Study Design: This retrospective study was conducted including 18 patients who underwent posterior-only stabilization and fusion procedure for pseudoarthrosis in the ankylosed spine from October 2007 to May 2015. Purpose: This study aimed to describe the treatment outcomes in 18 patients with Andersson lesion (AL) who were managed using the posterior-only approach. Literature Review: AL is an unstable, localized, vertebral, or discovertebral lesion of the spine. It is observed in patients with ankylosing spondylitis. The exact etiology of this disorder remains unclear, and the treatment guidelines are not clearly described. Methods: We analyzed 18 patients with AL who were treated with posterior long segment spinal fusion without any anterior interbody grafting or posterior osteotomy. Pre- and postoperative radiography, computed tomography, and recent follow-up images were examined. The pre- and postoperative Visual Analog Scale score and the Oswestry Disability Index score were evaluated for all patients. Whiteclouds' outcome analysis criteria were applied at the follow-up. Moreover, at study completion, patient feedback was collected; all the patients were asked to provide their opinion regarding the surgery and were asked whether they would recommend this procedure to other patients and them self undergo the same procedure again if required. Results: The most common site was the thoracolumbar junction. The symptom duration ranged from 1 month to 10 years preoperatively. Most patients experienced fusion by the end of 1 year, and the fusion mass could be observed as early as 4 months. Pseudoarthrosis void of up to 2.5 cm was noted to be healed in subsequent imaging. In addition, clinically, the patients reported good symptomatic relief. No patient required revision surgery. Whiteclouds' outcome analysis score at the latest follow-up revealed goodto-excellent outcomes in all patients. Conclusions: ALs can be treated using the posterior-only approach with long segment fixation and posterior spinal fusion. This is a safe, simple, and quick procedure that prevents the morbidity of anterior surgery.

• The Korean Journal of Pain
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• 제32권3호
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• pp.196-205
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• 2019

Background: Hypertonic saline (HS) injections for decompressive neuroplasty (DN) can cause pain. We assessed whether a continuous infusion of HS through an infusion pump would reduce injection-related pain compared with repeated bolus administrations. Methods: Fifty patients scheduled for DN were randomized to either the bolus injection or the continuous infusion group. After appropriately placing the epidural catheter, 4 mL of 5% NaCl was injected as four boluses of 1 mL each at 15-minute intervals or infused over 1 hour using an infusion pump. The severity of pain induced by HS injection, as measured by the 11-point numerical rating scale (NRS), was the primary outcome. The severity of low back or lower extremity pain, as measured by the 11-point NRS and Oswestry Disability Index (ODI), 3 months following the procedure, was the secondary outcome. Results: Data from 21 patients in the bolus group and 23 in the continuous infusion group were analyzed. No statistically significant difference in injection-related pain was identified between the two groups during the initial HS administration (P = 0.846). However, there was a statistically significant reduction in injection-related pain in the continuous infusion group compared to the bolus injection group from the second assessment onwards (P = 0.001, < 0.001, and < 0.001, respectively). No significant between-group differences in the NRS and ODI scores 3 months post-procedure were noted (P = 0.614 and 0.949, respectively). Conclusions: Our study suggests that administering HS through a continuous infusion is a useful modality for reducing HS injection-related pain during DN.

• 대한한방내과학회지
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• 제39권6호
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• pp.1321-1328
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• 2018

Objective: This study was performed to report on the effects of traditional Korean Medicine as a treatment for a patient with Charcot-Marie-Tooth disease, with lower limb pain as the chief complaint. Methods: We treated this patient with traditional Korean medicine and measured symptom severity using the Visual Analogue Scale (VAS), and the Oswestry Disability Index (ODI) as well as measuring the length of the patient's self-exercising time. Results: After about 7 weeks of treatment, most pathological symptoms had decreased. There was a gradual decline in the VAS and a gradual increase in the length of the self-exercising time. Although there was an increase in the ODI scale during the first 2 weeks, it eventually showed a decline in the rest of the period. Conclusions: Traditional Korean medicine can be a solution for the patients with Charcot-Marie-Tooth disease suffering from peripheral neurological symptoms.

• Korean Journal of Acupuncture
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• 제35권4호
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• pp.239-246
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• 2018

2017년 12월 29일부터 2018년 7월27일까지 가천대 부속 길한방병원에서 MRI상 요추 추간판탈출증 진단 받고 보존적 치료위해 내원하신 요추 추간판탈출증 환자 중에서 요통 및 하지방사통에 대하여 CS약침과 봉약침의 상호보완 치료를 포함한 한의학적 복합치료를 시행한 2건의 증례에 있어서, NRS, ODI, RMDQ의 호전양상을 확인하였다. 그리고 개인마다 차이가 있었지만, CS약침으로 방사통을 유발하는 치료를 통한 요각통에 대한 강한 진통효과를 확인할 수 있었고, 봉약침은 자입시 통증이 거의 없고 제반증상 호전 및 치료후기 관리에 좋은 것으로 사료되었다. 약침반응은 CS약침의 경우 시술시의 뻐근한 느낌, 봉약침의 경우 시술초기 가려움 및 발진 등의 반응이 간헐적으로 발생되었으며, 대부분 수시간~2일 이내에 소실되었다.

• Journal of Korean Neurosurgical Society
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• 제62권6호
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• pp.700-711
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• 2019

Objective : The treatment of multiple thoracolumbar spine fractures according to fracture continuity has rarely been reported. Herein we evaluate the clinical features and outcomes of multiple thoracolumbar fractures depending on continuous or noncontinuous status. Methods : From January 2010 to January 2016, 48 patients with acute thoracic and lumbar multiple fractures who underwent posterior fusion surgery were evaluated. Patients were divided into two groups (group A : continuous; group B : noncontinuous). We investigated the causes of the injuries, the locations of the injuries, the range of fusion levels, and the functional outcomes based on the patients' general characteristics. Results : A total of 48 patients were enrolled (group A : 25 patients; group B : 23 patients). Both groups had similar pre-surgical clinical and radiologic features. The fusion level included three segments (group A : 4; group B : 5) or four segments (group A : 19; group B : 5). Group B required more instrumented segments than did group A. Group A scored 23.5 and group B scored 33.4 on the Korean Oswestry Disability Index (KODI) at the time of last follow-up. In both groups, longer fusion was associated with worse KODI score. Conclusion : In this study, due to the assumption of similar initial clinical and radiologic features in both group, the mechanism of multiple fractures is presumed to be the same between continuous and noncontinuous fractures. The noncontinuous fracture group had worse KODI scores in long-term follow-up, thought to be due to long fusion level. Therefore, we recommend minimizing the number of segments that are fused in multiple thoracolumbar and lumbar fractures when decompression is not necessary.

• Journal of Korean Neurosurgical Society
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• 제62권6호
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• pp.691-699
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• 2019

Objective : Lumbar discectomy is an effective treatment for lumbar disc herniation (LDH); however, up to 2-18% of patients with LDH have experienced recurrent disc herniation. The purpose of this study was to evaluate the efficacy of a novel annular closure device (ACD) for preventing LDH recurrence and re-operation compared with that of conventional lumbar discectomy (CLD). Methods : In this prospective randomized controlled trial, we compared CLD with discectomy utilizing the $Barricaid^{(R)}$ (Intrinsic Therapeutics, Inc., Woburn, MA, USA) ACD. Primary radiologic outcomes included disc height, percentage of preoperative disc height maintained, and re-herniation rates. Additional clinical outcomes included visual analog scale (VAS) scores for back and leg pain, Oswestry Disability Index (ODI) scores, and 12-item short-form health survey (SF-12) quality of life scores. Outcomes were measured at preoperation and at 1 week, 1, 3, 6, 12, and 24 months postoperation. Results : Sixty patients (30 CLD, 30 ACD) were enrolled in this study. At 24-month follow-up, the disc height in the ACD group was significantly greater than that in the CLD group ($11.4{\pm}1.5$ vs. $10.2{\pm}1.2mm$, p=0.006). Re-herniation occurred in one patient in the ACD group versus six patients in the CLD group (${\chi}^2=4.04$, p=0.044). Back and leg VAS scores, ODI scores, and SF-12 scores improved significantly in both groups compared with preoperative scores in the first 7 days following surgery and remained at significantly improved levels at a 24-month follow-up. However, no statistical difference was found between the two groups. Conclusion : Lumbar discectomy with the $Barricaid^{(R)}$ (Intrinsic Therapeutics, Inc.) ACD is more effective at maintaining disc height and preventing re-herniation compared with conventional discectomy. Our results suggest that adoption of ACD in lumbar discectomy can help improve the treatment outcome.