• Journal of Korean Neurosurgical Society
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• 제47권5호
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• pp.352-357
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• 2010

Objective : This retrospective study was performed to evaluate the clinical and radiological results of anterior lumbar interbody fusion (ALIF) using two different stand-alone cages in the treatment of lumbar intervertebral foraminal stenosis (IFS). Methods : A total of 28 patients who underwent ALIF at L5-S1 using stand-alone cage were studied [Stabilis$^{(R)}$ (Stryker, Kalamazoo, MI, USA); 13, SynFix-LR$^{(R)}$ (Synthes Bettlach, Switzerland); 15]. Mean follow-up period was 27.3 ${\pm}$ 4.9 months. Visual analogue pain scale (VAS) and Oswestry disability index (ODI) were assessed. Radiologically, the change of disc height, intervertebral foraminal (IVF) height and width at the operated segment were measured, and fusion status was defined. Results : Final mean VAS (back and leg) and ODI scores were significantly decreased from preoperative values (5.6 ${\pm}$ 2.3 ${\rightarrow}$ 2.3 ${\pm}$ 2.2, 6.3 ${\pm}$ 3.2 ${\rightarrow}$1.6 ${\pm}$ 1.6, and 53.7 ${\pm}$ 18.6 ${\rightarrow}$ 28.3 ${\pm}$ 13.1, respectively), which were not different between the two devices groups. In Stabilis$^{(R)}$ group, postoperative immediately increased disc and IVF heights (10.09 ${\pm}$ 4.15 mm ${\rightarrow}$ 14.99 ${\pm}$ 1.73 mm, 13.00 ${\pm}$ 2.44 mm ${\rightarrow}$ 16.28 ${\pm}$ 2.23 mm, respectively) were gradually decreased, and finally returned to preoperative value (11.29 ${\pm}$ 1.67 mm, 13.59 ${\pm}$ 2.01 mm, respectively). In SynFix-LR$^{(R)}$ group, immediately increased disc and IVF heights (9.60 ${\pm}$ 2.82 mm ${\rightarrow}$ 15.61 ${\pm}$ 0.62 mm, 14.01 ${\pm}$ 2.53 mm ${\rightarrow}$ 21.27 ${\pm}$ 1.93 mm, respectively) were maintained until the last follow up (13.72 ${\pm}$ 1.21 mm, 17.87 ${\pm}$ 2.02 mm, respectively). The changes of IVF width of each group was minimal pre- and postoperatively. Solid arthrodesis was observed in 11 patients in Stabilis group (11/13, 84.6%) and 13 in SynFix-LR$^{(R)}$ group (13/15, 86.7%). Conclusion : ALIF using stand-alone cage could assure good clinical results in the treatment of symptomatic lumbar IFS in the mid-term follow up. A degree of subsidence at the operated segment was different depending on the device type, which was higher in Stabilis$^{(R)}$ group.

• Journal of Acupuncture Research
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• 제28권1호
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• pp.65-75
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• 2011

Objectives : The purpose of this study was to evaluate the clinical effect of indirect moxibustion treatment for HIVD patients. Methods : From March 2010 to December 2010, 32 HIVD patients who admitted to Semyung oriental medical hospital were divided into two groups. Group I was treated by indirect moxibustion and general acupuncture, group II by general acupuncture. We evaluated the treatment effect of each group with the visual analog scale(VAS) and Oswestry disability index(ODI) by dividing three period(from admission day to third day after admission, from third day to sixth day after admission and from sixth day to ninth day after admission). Results : 1. Group I was more effective than group II in VAS score reducing rate at sixth day after admission and ninth day after admission but there was no statistical significance between two groups at third day after admission 2. Group I was more effective than group II in VAS improvement rate from third day to sixth day after admission but there was no statistical significance between two groups from admission day to third day after admission and sixth day to ninth day after admission. 3. Group I was more effective than group II in ODI score reducing rate at sixth day after admission and ninth day after admission but there was no statistical significance between two groups at third day after admission. 4. In ODI improvement rate group I was higher than group II, but there was no statistical significance. Conclusions : Through this research, Indirect moxibustion treatment is considered to be effective reducing pain for HIVD(Herniated intervertebral disc) patients.

• Journal of Korean Neurosurgical Society
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• 제52권4호
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• pp.359-364
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• 2012

Objective : Transpedicular screw fixation has some disadvantages such as postoperative back pain through wide muscle dissection, long operative time, and cephalad adjacent segmental degeneration (ASD). The purposes of this study are investigation and comparison of radiological and clinical results between interspinous fusion device (IFD) and pedicle screw. Methods : From Jan. 2008 to Aug. 2009, 40 patients underwent spinal fusion with IFD combined with posterior lumbar interbody fusion (PLIF). In same study period, 36 patients underwent spinal fusion with pedicle screw fixation as control group. Dynamic lateral radiographs, visual analogue scale (VAS), and Korean version of the Oswestry disability index (K-ODI) scores were evaluated in both groups. Results : The lumbar spine diseases in the IFD group were as followings; spinal stenosis in 26, degenerative spondylolisthesis in 12, and intervertebral disc herniation in 2. The mean follow up period was 14.24 months (range; 12 to 22 months) in the IFD group and 18.3 months (range; 12 to 28 months) in pedicle screw group. The mean VAS scores was preoperatively $7.16{\pm}2.1$ and $8.03{\pm}2.3$ in the IFD and pedicle screw groups, respectively, and improved postoperatively to $1.3{\pm}2.9$ and $1.2{\pm}3.2$ in 1-year follow ups (p<0.05). The K-ODI was decreased significantly in an equal amount in both groups one year postoperatively (p<0.05). The statistics revealed a higher incidence of ASD in pedicle screw group than the IFD group (p=0.029) Conclusion : Posterior IFD has several advantages over the pedicle screw fixation in terms of skin incision, muscle dissection and short operative time and less intraoperative estimated blood loss. The IFD with PLIF may be a favorable technique to replace the pedicle screw fixation in selective case.

• Journal of Korean Neurosurgical Society
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• 제63권5호
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• pp.623-630
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• 2020

Objective : A primary degenerative sagittal imbalance has been considered because of unique lifestyles such as the prolonged crouched posture during agricultural work and performing activities of daily living on the floor. Previous papers have reported that sagittal imbalance disease is often seen distinctly in the farming districts of "oriental" countries such as Korea and Japan. However, this finding was only evaluated with the use of X-ray, and other factors such as magnetic resonance imaging (MRI), muscle volume, compression fracture, and laboratory results were not considered. Thus, using these, we evaluate the agricultural work-associated factors for Korean elderly spinal sagittal imbalance. Methods : We recruited 103 Korean participants who had a sagittal vertical axis (SVA) of >5 cm in this Korean Elderly Sagittal Imbalance Cohort Study. The following were evaluated : radiological parameters, MRI, compression fracture, vitamin D, parathyroid hormone, C-terminal telopeptide, osteocalcin, bone mineral density and muscle fatty change, muscle volume, and health-related quality of life from patients' survey. Moreover, in this survey, the farmers' annual working hours were investigated. Subsequently, we analyzed the associated factors for spinal sagittal imbalance depending on occupation. Results : A total of 46 participants were farmers, and the others were housewives, sellers, and office workers. The farmer group had more SVA (141 vs. 99 mm, p=0.001) and pelvic tilt (31° vs. 24°, p=0.004) and lesser lumbar lordosis (20° vs. 30°, p=0.009) and thoracic kyphosis (24° vs. 33°, p=0.03) than non-farmer group. A significantly positive correlation was noted between the working hour and SVA in the farmer group (p=0.014). The visual analogue scale score for back pain (8.26 vs. 6.96, p=0.008) and Oswestry Disability Index (23.5 vs. 19.1, p=0.003) in the farmer group were higher than that in the non-farmer group, but the Short Form-36 score was not significantly different between the two groups. The Mini-Mental State Exam score was significantly lower in the farmer group than in the non-farmer group (24.85 vs. 26.98, p=0.002). Conclusion : The farmer group had more sagittal imbalance and back pain in proportion to the working hours even though the muscle and bone factors and general laboratory condition were not significantly different between the two groups. These results supported that the long hours spent in the crouched posture while performing agricultural work were a risk factor for severe sagittal imbalance.

• Journal of Acupuncture Research
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• 제33권1호
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• pp.103-116
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• 2016

Objectives : This study was performed to assess the effectiveness of conservative Korean traditional medical treatment on lumbar intervertebral disc herniation in 12 adolescents. Methods : Data were collected from adolescent patients diagnosed with lumbar intervertebral herniation by MRI, hospitalized at Jaseng Korean Medicine Hospital from January 1, 2014 to December 31, 2015. A total of 12 patients were included in the study. Patients were treated by acupuncture, pharmacopuncture, electroacupuncture, herbal medicine, chuna manual therapy, physical therapy during hospitalization period. To measure treatment outcomes, a verbal numerical rating scale (VNRS), Oswestry disability index (ODI), range of motion (ROM), Straight leg raising test (SLR), and EQ-5D were used. Results : The average age of the participants was $16.05{\pm}1.62$. The average of duration of symptom was $19.25{\pm}26.83(weeks)$ and the average length of hospitalization was $23.8{\pm}16.4(days)$. 2 patients (17 %) suffered from only lumbar pain, while 10 patients (83 %) suffered from lumbar and leg pain. No participant suffered from only leg pain. 8 patients (67 %) were diagnosed with disc herniation in one segment, and 4 patients (33 %) were diagnosed with disc herniation in multiple segments. A total of 17 disc segments (28 %) were herniated. The most herniated lumbar level was L4-5. 3 segments were diagnosed with bulging (17 %), 6 with protrusion (35 %), and 8 with extrusion (47 %). Extrusion was the most frequent herniated type. After treatment, the average VNRS of lumbar pain significantly decreased from $5.58{\pm}1.62$ to $2.91{\pm}1.56$ (p<0.001) and the average VNRS of leg pain significantly decreased from $5.16{\pm}2.51$ to $3.08{\pm}1.8$ (p<0.001). ODI significantly decreased from $48.87{\pm}18.72$ to $28.57{\pm}15.05$ (p<0.05), and EQ-5D significantly increased $0.58{\pm}0.31$ to $0.80{\pm}0.12$ (p<0.05). Range of flexion significantly improved from $61.25{\pm}32.62$ to $68.33{\pm}26.22$ (p<0.05). Conclusion : Conservative Korean Traditional Medical Treatment may be effective in the treatment of lumbar intervertebral disc herniation in adolescence. However, more case reports and clinical research are needed.

• 한방재활의학과학회지
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• 제24권4호
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• pp.41-48
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• 2014

Objectives The present study examines the domestic trend of Failed Back Surgery Syndrome (FBSS) in Korea. Methods The studies on FBSS were investigated via searching Korean web databases. As a result, 41 research papers were found and they were analyzed according to the year of publishment, the titles of journals which have the papers, the types of study, the definition of FBSS, employed treatment trials, and the instruments for assessment. Results The number of the research papers on FBSS published was increased since 2005. The studies on FBSS were mainly published in the Korean Journal of Pain. The most popular type of the studies were the case report and the most studies defined FBSS as persistent or recurring low back pain with or without sciatica after receiving spine surgeries. Various surgical and conservative treatments were employed in the studies and Visual Analogue Scale (VAS), Numeric Rating Scale (NRS), Oswestry Disability Index (ODI) were used as primary means of assessments. Conclusions Reviewing the domestic trends of studies on FBSS and examining the definition of FBSS is essential for the future studies because there is no clear criteria for making diagnosis of FBSS. Therefore, the further studies on FBSS need to be more elaborate with the definition of FBSS, and it is also necessary to apply more assessment tools for the better understanding of FBSS from various aspects. Ultimately, this review is anticipated to benefit the future in-depth study on FBSS.

• Journal of Acupuncture Research
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• 제32권4호
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• pp.203-211
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• 2015

Objectives : The purpose of this study was to assess the effectiveness of integrative Korean Medical treatments for patients with L-spine disk herniation that showed no response to Epidural Steroid Injections (ESI). Methods : In this study, we reviewed the medical records of ten patients who showed no improvement or relapsed after ESI. The patients each received more than three weeks of integrative treatments at Mokhuri Neck&Back Hospital. The Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) was measured before and after treatment. A statistical analysis to compare before and after treatments was assessed using paired t-test the SPSS 12.0 Windows program. Results : After three weeks of treatment, patients showed a significant decrease in VAS and ODI scores compared to before receiving treatment. VAS scores decreased from $5.3{\pm}1.25$ to $1.9{\pm}0.99$ (p<0.001), and ODI scores decreased from $59.8{\pm}22.2$ to $32.7{\pm}14.11$ (p<0.001). Conclusions : Complex Korean Medical treatment showed effectiveness in the treatment of L-spine HIVD patients that showed no response to ESI, and more objective research is needed.

• Journal of Acupuncture Research
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• 제32권4호
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• pp.157-165
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• 2015

Objectives : This study was designed to compare the effect of Shinbaro pharmacopuncture treatment and Jakyakgamcho Decoction pharmacopunture treatment in patients with low back pain caused by traffic accidents. Methods : This study was conducted on 64 cases of patients with low back pain caused by traffic accidents, who were admitted to Bucheon Jaseng Hospital of Korean Medicine from May 3rd, 2015 to October 31th, 2015. The patients were divided into two groups : Shinbaro pharmacopuncture treatment group and Jakyakgamcho Decoction pharmacopunture treatment group. We measured the efficacy of treatment with a numerical rating scale(NRS) and Oswestry disability index(ODI). The NRS which was checked at pre-tretment and after 4th and 8th treatments, and the ODI which was checked at pre-treatment and after 8th treatment were collected and analyzed. Results : In both Shinbaro and Jakyakgamcho Decoction group, NRS and ODI decreased significantly. However there was no statistically significant difference between the groups. At the 4th treatment, However, the Jakyakgamcho Decoction group showed a greater decrease in NRS with a statistically significant difference. Conclusions : In a short period of time, Jakyakgamcho Decoction Pharmacopuncture is more efficient than Shinbaro pharmacopuncture in reducing the pain of patients with low back pain caused by trafficic accidents, but in the end there is no statistically significant difference between the groups.

• 척추신경추나의학회지
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• 제7권2호
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• pp.53-61
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• 2012

Objectives : The Purpose of this study is to compare the effect of ShinBaro Pharmacopuncture Treatment and Bee Venom Pharmacopuncture Treatment of low back pain and radicular pain caused by spondylolisthesis. Methods : From January 1st,2012 to September 30th, 2012, 30 Low back pain and radicular pain patients with spondylolisthesis who were admitted to Bu-Cheon Jaseng Hospital of Oriental Medicine were divided into two groups. ShinBaro group was treated by ShinBaro Pharmacopuncture Treatment and Bee Venom group was treated by Bee Venom Pharmacopuncture Treatment. We evaluated the treatment effect of each group with numerical rating scale(NRS) and Oswestry disability index(ODI). The evaluations performed at admission day and 14th day after admission. Results : In both ShinBaro group and Bee Venom group, NRS and ODI decreased significantly in ststistics as treatment was perfomed. Though ShinBaro group showed a decreasing ODI score compared to BV group and BV group showed a decreasing NRS score compared to Shinbaro group, There is no statistical significance on NRS and ODI score after the treatment in both groups. Conclusions : The result sugguest that both ShinBaro pharmacopuncture treatment and Bee Venom pharmacopuncture treatment is considered to be effective and useful on low back pain and radicular pain caused by spondylolisthesis, although further study is needed.

• 척추신경추나의학회지
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• 제7권2호
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• pp.63-74
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• 2012

Objectives : The purpose of this study was to evaluate the effect of Oriental medical treatment in patients with Spondylolisthesis and lumbar Herniated Intervertebral Disc(HIVD). Methods : This clinical study was carried out on 39 patients with Spondylolisthesis and lumbar Herniated Intervertebral Disc(HIVD), who had been admitted from Jan. 2012 to Nov. 2012. All of 39 patients were treated with acupuncture, Chuna treatment and herbal medicine during the whole admission period. Verbal numerical rating scale(VNRS) and Oswestry disability index(ODI) were used to evaluated the effectiveness of the Oriental medical treatment. Results : 1. Significant improvement of the symptoms of low back pain and leg pain on 39 patients with Spondylolisthesis and lumbar Herniated Intervertebral Disc(HIVD) was seen when evaluated with VNRS and ODI. 2. There was no significant difference of improvement by herniated type when evaluated with VNRS and ODI.. 3. There was no significant difference of improvement by spondylolisthesis type(degenerative and spondylolytic) when evaluated with VNRS and ODI. Conclusions : These results suggest that in the case of low back pain and lower limb numbness caused by Spondylolisthesis and HIVD, conservative treatments can be considered as one of the options of treating the symptoms beside surgical way.