• 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.

• Korean Journal of Acupuncture
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• 제38권3호
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• pp.175-181
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• 2021

A 57-year-old female diagnosed with L5-S1 lumbar intervertebral disc herniation, suffering from severe pain despite taking tapentadol received combined Korean medicine treatment, including acupotomy, acupuncture, pharmacopuncture, and herbal therapies for 53 days. To assess pain, Numeric Rating Scale (NRS) and lumbar range of motion (ROM) were checked daily from the day of admission. Moreover, the Oswestry Disability Index (ODI) and European Quality of Life-5 Dimensions (EQ-5D) were used to evaluate function and quality of life. After combined Korean medicine treatment, reabsorptioin of intervertebral disc was confirmed by radiological examination; pain reduced from NRS 5~7 to NRS 1~2; lumbar ROM in extention increased from 20° to 30°; and function and quality of life improved. The results suggest the possibility that a combined Korean medical treatment, including acupotomy, can be used as an alternative to opioids for pain management of lumbar vertebral disc herniation.

• 한방재활의학과학회지
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• 제31권2호
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• pp.99-108
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• 2021

The study reports the clinical case of a patient with lower extremity weakness and gait disturbance treated with Korean medicine treatments including Chuna therapy. The patient suffered lower extremity weakness and gait disturbance with diagnosis of lumbar disk herniation and spinal stenosis. As a treatment, the doctor applied Chuna therapy, herbal medicine, acupuncture, pharmacopuncture, cupping and moxa. The effect of treatment was evaluated by numeral rating scale (NRS), self-walkable distance, functional independence measure (FIM), Oswestry disability index (ODI) and manual muscle test (MMT). NRS decreased from 6 to 4 at the leg. Self-walkable distance increased from 0 m to 10 m, FIM increased 85 to 96 points while ODI decreased 64% to 54%. MMT of hip flex and knee extension improved from grade 3+, grade 3 to grade 4, respectively. Korean medicine treatment can be effective for patients who suffer lower extremity weakness and gait disturbance due to lumbar disk herniation and spinal stenosis. Further clinical studies are required to verify these findings.

• Journal of Acupuncture Research
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• 제38권4호
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• pp.265-275
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• 2021

This review investigated the effectiveness and safety of acupotomy treatment for scoliosis. There were 7 online databases used in the search from inception to March 17, 2021, for randomized controlled trials of the use of acupotomy in patients with scoliosis. The Cochrane risk-of-bias tool was used to assess the methodological quality of the studies included (n = 12). A quantitative synthesis of the randomized controlled trials was performed using RevMan Version 5.3. The effect sizes of studies were presented as mean differences for continuous outcomes and risk ratios for dichotomous outcomes, with a 95% confidence interval. As part of combined therapy, acupotomy was reported to significantly improve Cobb's angle compared with other treatments. Likewise, the Visual Analog Scale score, the Oswestry Disability Index score, and pulmonary function were also reported to be improved following acupotomy combination therapy. Although 5 studies mentioned the criteria for reporting adverse events, only 1 study reported adverse events. In conclusion, acupotomy may be an effective treatment for scoliosis. However, the small number, and heterogeneity of the included studies, as well as the poor methodological quality, indicate that higher-quality studies should be conducted to verify the effectiveness and safety of acupotomy treatment for scoliosis.

• 대한한방내과학회지
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• 제40권5호
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• pp.938-947
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• 2019

Objective: This study was performed to report the changes in symptoms and radiological consequences of a patient diagnosed with spinal neurofibroma and complaining of lower back pain. Methods: The patient was diagnosed with a spinal neurofibroma after MRI examination and was treated with traditional Korean medicine, including traditional Korean medication and acupuncture. We measured the change in symptom severity using a numerical rating scale (NRS) and the Oswestry Disability Index (ODI). We also used the EQ-5D (EuroQoL-5D) scale to assess the patient's quality of life. In addition, we examined the change in the size of the cyst by MRI twice after discharge: at about 3 months after discharge and at about 8 months after discharge. Results: After about 6 weeks of treatment, most pathological symptoms had decreased. The patient showed a decline in NRS and ODI scores and showed an increase in quality of life. The two MRI examinations after the discharge revealed a decrease in the size of the cyst. Conclusions: Traditional Korean medicine can be a solution for patients with spinal neurofibroma causing neurological pain.

• 대한한방부인과학회지
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• 제34권1호
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• pp.93-103
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• 2021

Objectives: The purpose of this study was to report a case of a pregnant woman diagnosed with lumbar disc herniation that improved in lumbar pain and radiating leg pain through combined korean medical treatment including pharmacopuncture at lumbar facet joints in situations surgical and pharmacological treatment is limited due to pregnancy. Methods: A combination of treatment including pharmacopuncture at lumbar facet joints, acupuncture, cupping, and herbal medicine was provided for 1 month to a woman at 21 weeks pregnant who was diagnosed with lumbar disc herniation. Her progress was assessed with Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), EuroQol-5Dimension (EQ-5D) before and after treatment. Results: After the treatment, the pain decreased and the quality of life was enhanced. No adverse events were observed. Conclusions: The findings indicate that combined korean medical treatment including pharmacopuncture at lumbar facet joints can be safe and effective alternative to treat lumbar disc herniation during pregnancy.

• 대한물리의학회지
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• 제16권1호
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• pp.49-61
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• 2021

PURPOSE: Hamstring muscle shortening is related to low back pain, and it is important to check the hamstring muscle flexibility and pelvic mobility to analyze the effects of the intervention. This study examined the effects of hamstring muscle shortening on flexibility and pelvic mobility according to the method of stretching the hamstring muscle in patients with low back pain. METHODS: Forty Low Back Pain Patients participated. The subjects performed the Visual Analogue Scale (VAS), Fear Avoidance Belief Questionnaire (FABQ), Korean version of Oswestry Disability Index (KODI), Myovision, and sensbalance therapy cushion (pelvic mobility, proprioception). The subjects were divided into two groups to perform the passive and active stretching protocol. The intervention was conducted three times a week for four weeks. RESULTS: Hamstring muscle flexibility was increased significantly in both groups (p < .05), and there was no difference between the groups. VAS, FABQ was decreased significantly in both groups (p < .01), and there was no difference between the groups. The left lower back muscle impedance was decreased significantly in both groups (p < .05). The passive stretching group showed a significant increase in the pelvic anterior, posterior, and left tilt ROM (p < .05). The active stretching group showed a significant increase in the pelvic anterior, posterior tilt ROM (p < .05). CONCLUSION: Both stretching methods may be useful intervention methods for pelvic mobility and pain recovery and can assess back pain recovery.

• 대한정형도수물리치료학회지
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• 제27권3호
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• pp.79-87
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• 2021

Objective: To compare the effects of lumbar dysfunction and balance when office workers with chronic back pain performed the abdominal drawing-in maneuver. Methods: A total of 16 office workers with chronic low back pain were included in this study. The participants were randomly divided into two groups: the general and abdominal drawing-in maneuver groups. The intervention was applied for 6 weeks, 3 times a week, 70 min per day. Participants in the general exercise group(n=8) performed the general physical therapy and lumbar flexibility exercise, whereas those in the abdominal drawing-in maneuver group(n=8) performed the general physical therapy and lumbar stabilization exercise using abdominal drawing-in maneuver(3 times/week for 6 weeks). All tests, were the Korean Oswestry disability index (KODI) and balance ability, were completed pre and post-intervention. Results: Significant improvements in the KODI and balance ability test were observed in the abdominal drawing-in exercise group (p<.05), whereas no significant changes (p>.05) were observed in the general exercise group. Conclusion: This study revealed that abdominal drawing-in maneuver can effectively improve the lumbar dysfunction and balance ability of office workers with chronic back pain.

• 대한물리치료과학회지
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• 제28권3호
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• pp.66-75
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• 2021

Background: The purpose of this study is to investigate the effect of muscle energy technique and stretching on pain and pressure pain fear-avoidance beliefs questionnaire in patients with chronic back pain aged 30~40 years. Design: Pretest-Posttest design: single blind. Methods: The subjects of this study were 30, 22 males and 8 females between the ages of 30 and 40 with chronic back pain. Each group consists of three groups of 10 people. Changes in back pain were observed using Korean version of Oswestry Disability Index (K-ODI), visual analogue scale (VAS), and fear-avoidance beliefs questionnaire (FABQ). And the change in tenderness was observed using digital pressure statistics. Changes between groups after 3 weeks were compared with those before the experiment using one way ANOVA to determine the changes after 3 weeks. And the change within the group was investigated using the paired t-test. Results: As a result of the experiment, there were significant differences in the group changes in K-ODI, VAS, FABQ, and pressure pain (p<0.05). And there was a significant difference in all items after 3 weeks compared to before the experiment (p<0.05). Conclusion: In patients with chronic back pain, the muscle energy technique and stretching gave a significant difference in pain and pressure pain, fear-avoidance beliefs questionnaire changes. And this result suggests the possibility of providing basic data for future research and clinical physiotherapy intervention.