Objectives : The purpose of this study was to evaluate the effect of electro-acupuncture treatment for low back pain and radicular pain in patients diagnosed with Lumbar HIVD. Methods : This clinical study was carried out on 92 patients with low back pain and radicular pain diagnosed with HIVD, who had been admitted from Mar. 2011 to Dec. 2011. 60 patients were divided into two groups, group A and group B, of 46 patients each. Group A was treated with electro-acupuncture treatment and general acupuncture treatment twice per day for more than 2 weeks. Group B was treated with general acupuncture treatment twice per day for more than 2 weeks. Verbal numerical rating scale(VNRS) and Oswestry disability index(ODI) were used to evaluated the effectiveness of the Oriental medical treatment. Results : In both two groups, VNRS, ODI, patient's condition grade decreased significantly in ststistics as treatment was perfomed. Between the two groups there was no significant difference in the VNRS, patient's condition grade. But there was significant difference in the ODI. Conclusions : These results suggest that both electro-acupuncture and general acupuncture were effective in reducing low back pain and radicular pain caused by HIVD. More systematic clinical stuty on electro-acupuncture is needed.
Objectives: This research study aimed to determine the effect of Korean medicine treatments on a patient with lumbar disc herniation accompanying polycystic kidney disease. Methods: Acupuncture, herbal medicine, pharmacopuncture, spine decompression therapy, Motion Style Acupuncture Treatment (MSAT), and Chuna were preceded for treatment. We checked the patient's Oswestry Disability Index (ODI), numeric rating scale (NRS), and straight leg raise test (SLRT) on admission and discharge; we also used the NRS and SLRT to evaluate the patient's symptoms on every third day during the hospital stay. Because it is important to manage blood urea nitrogen (BUN), serum creatinine, and blood pressure during the early stage of polycystic kidney disease, BUN and serum creatinine levels were checked weekly while blood pressure was checked every morning. Results: Twelve days after admission, the NRS for lower back pain and right leg pain decreased from 7 to 3 and from 7 to 2, respectively. The ODI value also decreased from 56 to 20 while the SLRT value increased from 30/70 to 60/70. The BUN and serum creatinine levels and the blood pressure readings were all within normal range every time they were checked. Conclusions: The use of Korean medicine treatments resulted in improvements in NRS, ODI, and SLRT on a patient with a herniated lumbar disc herniated who had a past history of polycystic kidney disease; thus, the patient was able to maintaining kidney functioning. Herbal medicine, an alternative method of analgesic anti-inflammatory drugs that has been evaluated as relatively safe on liver and kidney function, could be suggested on a patient with a past history of polycystic kidney disease to maintain kidney function when renal function and blood pressure are monitored.
Objectives : Most of pains are important symptoms caused by cancer transpered to spine. Harpagophyti Radix Pharmacopuncture is highly effective in reducing fever, pain, inflammation but was never used to reduce pain from cancer transpered to spine. So I intended to use Harpagophyti Radix Pharmacopuncture to control pain. The purpose of this study is to evaluate the clinical application of Harpagophyti Radix Pharmacopuncture for Bone Metastasis of Breast Cancer and Spinal Stenosis. Methods : We examined patient with Bone Metastasis of Breast Cancer and Spinal Stenosis who admitted Jaseng Korean Medicine Hospital. The patient was treated by Korean Medicine treatment and Harpagophyti Radix Pharmacopuncture. This case was assessed by Numerical Rating Scale(NRS), Oswestry Low Back Pain Disability Index(ODI), Short-Form 36 Health Survey(SF-36), ROM(Range of Movement) and Special Test. Results : In this study, the patient's pain was controlled and NRS, ODI were decreased. I could identify the improvement in life quality from the positive change of SF-36 and also found out that treatment was successful from the improvement of ROM, Special test. Conclusions : Harpagophyti Radix Pharmacopuncture with Korean Medicine treatment for Bone Metastasis of Breast Cancer and Spinal Stenosis was proved to be useful to the pain relief and function recovery, but further research should take place for clear understanding of the exact amount of dosage and safety. Moreover it must be accompanied by long term follow up research.
Objective : The authors performed a retrospective study to assess the clinical and radiological outcome in symptomatic lumbar spondylolysis patients who underwent a direct pars repair surgery using two different surgical methods; pedicle screw with universal hook system (PSUH) and direct pars screw fixation (DPSF), and compared the results between two different treated groups. Methods : Forty-seven consecutive patients (PSUH; 23, DPSF; 15) with symptomatic lumbar spondylolysis who underwent a direct pars repair surgery were included. The average follow-up period was 37 months in the PSUH group, and 28 months in the DPSF group. The clinical outcome was measured using visual analogue pain scale (VAS) and Oswestry disability index (ODI). The length of operation time, the amount of blood loss, the duration of hospital stay, surgical complications, and fusion status were also assessed. Results : When compared to the DPSF group, the average preoperative VAS and ODI score of the PSUH group were less decreased at the last follow-up; (the PSUH group; back VAS : 4.9 vs. 3.0, leg VAS : 6.8 vs. 2.2, ODI : 50.6% vs. 24.6%, the DPSF group; back VAS : 5.7 vs. 1.1, leg VAS : 6.1 vs. 1.2, ODI : 57.4% vs. 18.2%). The average operation time was 174.9 minutes in the PSUH group, and 141.7 minutes in the DPSF group. The average blood loss during operation was 468.8 cc in the PSUH group, and 298.8 cc in the DPSF group. The average hospital stay after operation was 8.9 days in the PSUH group, and 7 days in the DPSF group. In the PSUH group, there was one case of a screw misplacement requiring revision surgery. In the DPSF group, one patient suffered from transient leg pain. The successful bone fusion rate was 78.3% in the PSUH group, and 93.3% in the DPSF group. Conclusion : The present study suggests that the technique using direct pars screw would be more effective than the method using pedicle screw with lamina hook system, in terms of decreased operation time, amount of blood loss, hospital stay, and increased fusion success rate, as well as better clinical outcome.
Kim, Bum-Joon;Kim, Se-Hoon;Lee, Haebin;Lee, Seung-Hwan;Kim, Won-Hyung;Jin, Sung-Won
Journal of Korean Neurosurgical Society
/
제60권2호
/
pp.225-231
/
2017
Objective : Solid bone fusion is an essential process in spinal stabilization surgery. Recently, as several minimally invasive spinal surgeries have developed, a need of artificial bone substitutes such as demineralized bone matrix (DBM), has arisen. We investigated the in vivo bone growth rate of DBM as a bone void filler compared to a local autologous bone grafts. Methods : From April 2014 to August 2015, 20 patients with a one or two-level spinal stenosis were included. A posterior lumbar interbody fusion using two cages and pedicle screw fixation was performed for every patient, and each cage was packed with autologous local bone and DBM. Clinical outcomes were assessed using the Numeric Rating Scale (NRS) of leg pain and back pain and the Korean Oswestry Disability Index (K-ODI). Clinical outcome parameters and range of motion (ROM) of the operated level were collected preoperatively and at 3 months, 6 months, and 1 year postoperatively. Computed tomography was performed 1 year after fusion surgery and bone growth of the autologous bone grafts and DBM were analyzed by ImageJ software. Results : Eighteen patients completed 1 year of follow-up, including 10 men and 8 women, and the mean age was 56.4 (32-71). The operated level ranged from L3/4 to L5/S1. Eleven patients had single level and 7 patients had two-level repairs. The mean back pain NRS improved from 4.61 to 2.78 (p=0.003) and the leg pain NRS improved from 6.89 to 2.39 (p<0.001). The mean K-ODI score also improved from 27.33 to 13.83 (p<0.001). The ROM decreased below 2.0 degrees at the 3-month assessment, and remained less than 2 degrees through the 1 year postoperative assessment. Every local autologous bone graft and DBM packed cage showed bone bridge formation. On the quantitative analysis of bone growth, the autologous bone grafts showed significantly higher bone growth compared to DBM on both coronal and sagittal images (p<0.001 and p=0.028, respectively). Osteoporotic patients showed less bone growth on sagittal images. Conclusion : Though DBM alone can induce favorable bone bridging in lumbar interbody fusion, it is still inferior to autologous bone grafts. Therefore, DBM is recommended as a bone graft extender rather than bone void filler, particularly in patients with osteoporosis.
Objectives: The purpose of this study is to report the effect of Postural Yinyang Correction of Temporomandibular Joint (Functional Cerebrospinal Therapy, FCST) on a patient with Osteoarthritis of the hip caused by Hip dysplasia and Lumbar spinal stenosis. Methods: A patient with Osteoarthritis of the hip caused by Hip dysplasia and Lumbar spinal stenosis was treated at Dept. of Acupuncture & Moxibustion, ○○ University Korean Medicine Hospital from Nov 8th, 2019 to Dec 6th, 2019 and received a Korean-Western medical treatment mainly managed with FCST. This study was measured with VAS (Visual Analogue Scale), ODI (Oswestry Disability Index) and questionnaire. Results: After treatment, the patient's pain was controlled and gait ability was improved, also VAS, ODI and questionnaire score were improved. Conclusions: Korean-Western Medical Treatment mainly managed with FCST may be helpful in controling pain with Osteoarthritis of the hip caused by Hip dysplasia and Lumbar spinal stenosis, but the further researches are needed.
Objectives : To report the clinical application and safety of Traditional Korean Medical treatment for patients with low back pain during pregnancy. Methods : Three patients who suffered from low back pain during pregnancy were treated with acupuncture, pharmacopuncture, moxibustion, and herbal medicine for 12 to 21 days. Numeric rating scale (NRS) of low back pain and Oswestry Disability Index (ODI) were checked to measure the outcome. A liver function and renal function test was carried out to identify any drug-induced liver or renal injury, and any adverse events were monitored thoroughly until delivery. Results : Low back pain reduced on NRS in all cases, and no serious adverse effects were found in the patients or infants. Conclusion : This study suggests that Traditional Korean Medical treatment is a candidate therapy for relieving low back pain during pregnancy, and also is safe for both patients and infants.
Objective : The aim of the present study was to assess the safety and efficacy of the dynamic stabilization system in the treatment of degenerative spinal diseases. Methods : The study population included 20 consecutive patients (13 females, 7 males) with a mean age of $61{\pm}6.98$ years (range 46-70) who underwent decompression and dynamic stabilization with the Dynesys system between January 2005 and August 2006. The diagnoses included spinal stenosis with degenerative spondylolisthesis (9/20, 45%), degenerative spinal stenosis (5/20, 25%), adjacent segmental disease after fusion (3/20, 15%), spinal stenosis with degenerative scoliosis (2/20, 10%) and recurrent intervertebral lumbar disc herniation (1/20, 5%). All of the patients completed the visual analogue scale (VAS) and the Korean version of the Oswestry Disability Index (ODI). The following radiologic parameters were measured in all patients : global lordotic angles and segmental lordotic angles (stabilized segments, above and below adjacent segments). The range of motion (ROM) was then calculated. Results : The mean follow-up period was $27.25{\pm}5.16$ months (range 16-35 months), and 19 patients (95%) were available for follow-up. One patient had to have the implant removed. There were 30 stabilized segments in 19 patients. Monosegmental stabilization was performed in 9 patients (47.3%), 9 patients (47.3%) underwent two segmental stabilizations and one patient (5.3%) underwent three segmental stabilizations. The most frequently treated segment was L4-5 (15/30, 50%), followed by L3-4 (12/30, 40%) and L5-S1 (3/30, 10%). The VAS decreased from $8.55{\pm}1.21$ to $2.20{\pm}1.70$ (p<0.001), and the patients' mean score on the Korean version of the ODI improved from $79.58%{\pm}15.93%$ to $22.17%{\pm}17.24%$ (p<0.001). No statistically significant changes were seen on the ROM at the stabilized segments (p=0.502) and adjacent segments (above segments, p=0.453, below segments, p=0.062). There were no patients with implant failure. Conclusion : The results of this study show that the Dynesys system could preserve the motion of stabilized segments and provide clinical improvement in patients with degenerative spinal stenosis with instability. Thus, dynamic stabilization systems with adequate decompression may be an alternative surgical option to conventional fusion in selected patients.
Park, Seong-Cheol;Yoon, Sang-Hoon;Hong, Yong-Pyo;Kim, Ki-Jeong;Chung, Sang-Ki;Kim, Hyun-Jib
Journal of Korean Neurosurgical Society
/
제46권4호
/
pp.292-299
/
2009
Objective : Clinical and radiological results of posterior dynamic stabilization using interspinous U (ISU, $Coflex^{TM}$, Paradigm Spine $Inc.^{(R)}$, NY, USA) were analyzed in comparison with posterior lumbar interbody fusion (PLIF) in degenerative lumbar spinal stenosis (LSS). Methods : A retrospective study was conducted for a consecutive series of 61 patients with degenerative LSS between May 2003 and December 2005. We included only the patients completed minimum 24 months follow up evaluation. Among them, 30 patients were treated with implantation of ISU after decompressive laminectomy (Group ISU) and 31 patients were treated with wide decompressive laminectomy and posterior lumbar interbody fusion (PLIF; Group PLIF). We evaluated visual analogue scale (VAS) and Oswestry Disability Index (ODI) for clinical outcomes (VAS, ODI), disc height ratio disc height (DH), disc height/vertebral body length ${\times}100$), static vertebral slip (VS) and depth of maximal radiolucent gap between ISU and spinous process) in preoperative, immediate postoperative and last follow up. Results : The mean age of group ISU ($66.2{\pm}6.7$ years) was 6.2 years older than the mean age of group PLIF ($60.4{\pm}8.1$ years; p=0.003). In both groups, clinical measures improved significantly than preoperative values (p<0.001). Operation time and blood loss was significantly shorter and lower in group ISU than group PLIF (p<0.001). In group ISU, the DH increased transiently in immediate postoperative period ($15.7{\pm}4.5%{\rightarrow}18.6{\pm}5.9%$), however decreased significantly in last follow up ($13.8{\pm}6.6%$, p=0.027). Vertebral slip (VS) of spondylolisthesis in group ISU increased during postoperative follow-up ($2.3{\pm}3.3{\rightarrow}8.7{\pm}6.2$, p=0.040). Meanwhile, the postoperatively improved DH and VS was maintained in group PLIF in last follow up. Conclusion : According to our result, implantation of ISU after decompressive laminectomy in degenerative LSS is less invasive and provides similar clinical outcome in comparison with the instrumented fusion. However, the device has only transient effect on the postoperative restoration of disc height and reduction of slip in spondylolisthesis. Therefore, in the biomechanical standpoint, it is hard to expect that use of Interspinous U in decompressive laminectomy for degenerative LSS had long term beneficial effect.
Objectives : The purpose of this study is to compare the effects of Pharmacopuncture Treatment with Chuna Treatments for Low Back Pain caused by Traffic accidents. Methods : This study was carried out on 81 patients with low back pain caused by Traffic accidents. The patients were divided into 2 group ; The pharmacopuncture(A) group was treated by pharmacopuncture treatment. The chuna(B) group was treated by chuna treatment. We measured Oswestry Disability Index(ODI) and Visual Analog Scale(VAS) on the patients before the treatment and on the 2nd, and 4th weeks after the treatments. Results : After being treated by our methods, the ODI and VAS score's were improved after the 4th weeks treatment in both groups. There is no significant difference on ODI and VAS score after the 4th weeks treatment in both groups. In the early stages(from pre to 2 weeks worth of treatment), Group A showed a decreasing VAS score compared to Group B. In the final stages(from 2 weeks to 4 weeks worth of treatment), Group B showed a higher decreasing amount compared to Group A in VAS score. Conclusions : The results suggest that both pharmacopuncture treatment and chuna treatment is considered to be effective and useful on low back pain caused by traffic accidents. There is no significant difference between pharmacopuncture treatment and chuna treatment for low back pain caused by traffic accidents, however the early stages of treatments(from pre to 2 weeks treatement) show that pharmocopouncture treatment is more effective than chuna treatment for low back pain by traffic accidents. In the final stages(from 2 weeks to 4 weeks treatment), chuna treatment is more effective than pharmacopuncture treatment for low back pain by traffic accident.
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