• Title/Summary/Keyword: Sciatica

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Epidural Steroid Injection in the Treatment of Cervical Radiculopathy (Cervical Radiculopathy에 대한 경막외 Steroid 주입에 관하여)

  • Choe, Huhn;Han, Young-Jin;Baek, Hae-Jung;Kim, Dong-Chan
    • The Korean Journal of Pain
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    • v.4 no.2
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    • pp.152-156
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    • 1991
  • Cervical radiculopathy has been recognized as a common cause of neck, shoulder, and arm pain. It was conventionally treated with rest, traction, cervical collars, manipulation, transcutaneous electrical nerve stimulation, and nonsteroidal anti-inflammatory drugs with varying results. Surgery has not always been successful so the idea of epidural steroid injection was developed as in the case of lumbar epidural injections, for the treatment of low back pain and sciatica. Thirty one patients with evidence of cervical radiculopathy were treated with injections of triamcinolone acetate into the cervical epidural space. The effect of the steroid injection could be evaluated in twenty one patients who received epidural injections more than twice. No improvement was seen in 6 patients and 15 patients showed good to excellent pain relief for a week to over 6 months. Epidural steroid injection seems to have a positive role in the treatment of cervical radiculopathy.

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Clinical Implication of Prostaglandin E2 Content in Lumbar Disc Disease (추간판내 Prostaglandin E2 양의 임상적 의의)

  • Kim, Hyung Seok;Cho, Ki Hong;Kim, Ki Young;Ahn, Young Hwan;Ahn, Young Min;Yoon, Soo Han;Cho, Kyung Gi
    • Journal of Korean Neurosurgical Society
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    • v.29 no.10
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    • pp.1340-1344
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    • 2000
  • Objective : A prospective biochemical assay of prostaglandin $E_2$ content in symptomatic lumbar disc materials was done in order to clarify the pathogenesis of lumbar radiculopathy. Patients and Methods : Forty-eight disc specimens were purified by a standard solid-phase extraction procedure and analyzed by an enzymelinked immunosorbent assay for prostaglandin $E_2$. Clinical and anatomic correlations were evaluated with analysis of variance and t-test. Results : Acute herniated lumbar disc diseases tended to be associated with a higher prostaglandin $E_2$ content than degenerative lumbar disc disease. Sequestered discs tended to be associated with a higher prostaglandin $E_2$ content than extruded discs, which also showed higher prostaglandin $E_2$ content than protruded ones. A sciatica and positive straight leg raising test appeared to be associated with a higher prostaglandin $E_2$ content than a negative test. Conclusion : This result suggests that the level of prostaglandin $E_2$ would be correlated with clinical symptom and sign in the inflammatory process of lumbar disc herniation.

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Lumbar herniated disc: spontaneous regression

  • Altun, Idiris;Yuksel, Kasim Zafer
    • The Korean Journal of Pain
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    • v.30 no.1
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    • pp.44-50
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    • 2017
  • Background: Low back pain is a frequent condition that results in substantial disability and causes admission of patients to neurosurgery clinics. To evaluate and present the therapeutic outcomes in lumbar disc hernia (LDH) patients treated by means of a conservative approach, consisting of bed rest and medical therapy. Methods: This retrospective cohort was carried out in the neurosurgery departments of hospitals in KahramanmaraŞ city and 23 patients diagnosed with LDH at the levels of L3-L4, L4-L5 or L5-S1 were enrolled. Results: The average age was $38.4{\pm}8.0$ and the chief complaint was low back pain and sciatica radiating to one or both lower extremities. Conservative treatment was administered. Neurological examination findings, durations of treatment and intervals until symptomatic recovery were recorded. $Las{\grave{e}}gue$ tests and neurosensory examination revealed that mild neurological deficits existed in 16 of our patients. Previously, 5 patients had received physiotherapy and 7 patients had been on medical treatment. The number of patients with LDH at the level of L3-L4, L4-L5, and L5-S1 were 1, 13, and 9, respectively. All patients reported that they had benefit from medical treatment and bed rest, and radiologic improvement was observed simultaneously on MRI scans. The average duration until symptomatic recovery and/or regression of LDH symptoms was $13.6{\pm}5.4$ months (range: 5-22). Conclusions: It should be kept in mind that lumbar disc hernias could regress with medical treatment and rest without surgery, and there should be an awareness that these patients could recover radiologically. This condition must be taken into account during decision making for surgical intervention in LDH patients devoid of indications for emergent surgery.

Health related Behavior and Food Intake Frequency According to Self-rated Health of Older Adults in Agricultural and Fishery Areas (농.어촌지역 65세 이상 노인들의 주관적 건강평가에 따른 건강관련행동 및 음식섭취빈도)

  • Kim, Wan-Soo;Han, Young-Hee
    • Korean Journal of Human Ecology
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    • v.18 no.5
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    • pp.1123-1133
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    • 2009
  • This study attempted to analyze the general and physical characteristics, the status of physical function, the type and number of current diagnosis and self-reported symptoms, healthy life mode and food preference according to self-rated health (SRH) of older adults (135 men and 270 women). It also attempted to assess the factors affecting the SRH standards in agricultural and fishery areas located in southwestern Korea. The subjects considered themselves as being 'good'(57.6%), 'normal'(29.6%) or 'poor'(12.85) SRH, meaning positive self-rating of health and it was found that the correlation between factors such as the gender, current marriage status, monthly wage, the reception of the government's livelihood subsidy and subjective economical status and the SRH were significant. Regardless of the categories of obesity, a large number of the participants rated themselves as 'healthy', but not statistically significant. The subjects who reported poor ADL and IADL capacities, indicators of the status of physical function, were significantly more classified to the 'poor' health category and vice versa (P<0.001). The reported chronic diseases in this study that have lasted more than three months, were lumbago, sciatica, arthritis, high blood pressure and peptic ulcer. The current ratios of smoking, drinking and exercise were 85.3, 39.0 and 18.6%, respectively. The less drinking and exercising there was, the higher the 'good' SRH categories obtained (P<0.05). The respondents who had less chance of eating sour and hot foods estimated their health status as being better.

A Clinical Observation on the case of Cauda equina syndrome with bladder incontinence using Korean Bee-Venom Acupuncture (봉약침료법(蜂藥鍼療法)을 중심으로 한 복합치료가 배뇨곤란(排尿困難)이 주증(主證)인 마미증후군(馬尾症候群) 환자(患者) 1례(例)에 미치는 영향)

  • Byun, Im-jeung;Lee, Seong-no;Ahn, Koang-hyun;Song, Won-sub;Kwon, Soon-jung;Kang, Mi-suk;Song, Ho-sueb;Kim, Kee-hyun
    • Journal of Acupuncture Research
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    • v.19 no.6
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    • pp.205-213
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    • 2002
  • Objective : This study was to investigate on the Korean Bee-Venon acupuncture of Cauda equina syndrome which has been described as complex of low back pain, bilateral sciatica, saddle anesthesia and motor weakness in the lower extremity that progress to paraplegia with bladder and bowel incontinence. Methods : Clinical observation was done on Cauda equina syndrome in the Department of Acupuncture & Moxibustion, Kyungwon Inchon Oriental Medical Hospital from may 25 to June 24. The patients was treated with Korean Bee-Venon acupuncture at Samchosu(B22), Shinsu(B23), Taejangsu(B25), Pang-gwangsu(B28) and Yo-yang-gwan(Gv3) with oriental medicine treatment. We evaluated the bladder incontinence, duration of urination and area of anesthesia before and after treatment. Conclusions : 1. At the early time, gait disturbance was treated well, but discomfort bladder incontinence was remained. 2. The symptoms of Cauda equina syndrome especially bladder incontinence was recurred in short duration by Korean Bee-Venon acupuncture and oriental medicine treatment. 3. There was no significant changes in GOT/GPT before and after treatment.

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The Role of Computed Tomography in the Presurgical Diagnosis of Foraminal Entrapment of Lumbosacral Junction

  • Moon, Ki-Hyoung;Jang, Jee-Soo;Lee, Sang-Ho;Lee, Su-Chan;Lee, Ho-Yeon
    • Journal of Korean Neurosurgical Society
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    • v.47 no.1
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    • pp.1-6
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    • 2010
  • Objective: On the basis of preoperative computed tomography (CT) scans, we studied the change of the size of anterior primary division (APD) of the L5 spinal root in the presence of foraminal/extraforaminal entrapment of the L5 spinal root. Methods: Two independent radiologists retrospectively reviewed the preoperative CT scans of 27 patients treated surgically and compared the sizes of the APDs on bilateral L5 spinal roots. If one side APO size was larger than the other side APD size, it was described as left or right "dominancy" and regarded this as "consensus (C)" in case that there was a consensus between the larger APD and the location of sciatica, and regarded as "non-consensus (NC)" in case that there was not a consensus. Oswestry Disability Index (ODI) scores were used for preoperative and postoperative evaluation. Results: On CT scans, twenty-one (77%) of 27 patients were the consensus group (APD swelling) and 6 (22%) were a non-consensus group (APD no swelling). In 9 patients with acute foraminal disc herniations, asymmetric enlargement of the APD on L5 spinal root was detected in all cases (100%) and detected in 11 (64%) of 17 patients with stenosis. Preoperative ODI score was 75-93 (mean 83) and postoperative 001 scores were improved to 13-36 (mean 21). The mean follow-up period was 6 months (range, 3-11 months). Conclusion: An asymmetric enlargement of the APD on L5 spinal root on CT scans is meaningfully associated with a foraminal or extraforaminal entrapment of the L5 spinal root on the lumbosacral junction.

A Clinical study carried out common acupuncture therapy and Bee-Venom Acupuncture on HNP of L-spine (봉독약침병행치료(峰毒藥鍼竝行治療)한 요추간판탈출증환자(腰椎間板脫出症患者)의 임상고찰(臨床考察))

  • Bae, Eun-Jeong;Cho, Hyun-Yeul;Jin, Jae-Do;Shin, Min-Kyu;Han, Sang-Gyun;Yang, Gi-Young;Hwang, Kyu-Jung;Shin, Young-Il;Lee, Hyun;Lee, Byung-Ryul
    • Journal of Acupuncture Research
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    • v.19 no.1
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    • pp.54-64
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    • 2002
  • Objective : The one of the main cause in back pain & sciatica is HNP of L-spine. This study is for taking data for the clinical application of Bee-Venom Acupuncture on HNP of L-spine. Methods : This clinical study was carried out 24 patients with HNP of L-spine, who had been admitted from March, 2001 to November, 2001. We devided the patients into two groups; One was an experimental group, treated by 2 methods-common acupuncture therapy and Bee-Venom Acupuncture. The other was an control group, treated only by common acupuncture therapy. Results and Conclusion : In an experimental group, there were 4 excellent cases (33.33%) and 5 good cases(41.67%). In an control group, there were 2 excellent cases (16.67%) and 5 good cases (41.67%). We thought that it needed to prove effects of Bee- Venom Acupuncture for efficient application by more clinical data from now.

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Effectiveness of Electroacupuncture for Patients with Failed Back Surgery Syndrome: A Systematic Review and Meta-analysis

  • Shin, Donghoon;Shin, Kyungmoon;Jeong, Hwejoon;Kang, Deok;Yang, Jaewoo;Oh, Jihoon;Lim, Jinwoong
    • Journal of Acupuncture Research
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    • v.39 no.3
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    • pp.159-169
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    • 2022
  • Failed back surgery syndrome (FBSS) is a term that applies to symptoms such as persistent or recurring low back pain, paresthesia, sciatica, or numbness after spine surgery. Electroacupuncture (EA) has been reported to have excellent analgesic effects although there have been no systematic reviews on the effects of EA on FBSS. Therefore, a systematic review and meta-analysis of the effectiveness of EA on FBSS was conducted. Eight databases were searched for studies that used EA for FBSS and 7 randomized controlled trials (RCTs) were included. RCTs of EA as combination therapy for FBSS compared with conventional treatment demonstrated improvement in the level of pain, lumbar functional scale scores, and quality of life. However, meta-analysis showed that reduction in pain was not statistically significant, while evaluation of lumbar function significantly improved, although the quality of evidence in the RCTs was generally low. RCTs comparing EA alone with conventional treatment demonstrated an improved level of pain, lumbar function, and effective rate of treatment. Meta-analysis showed that pain was significantly decreased in the EA alone group compared with the control group, although the quality of evidence was low. To improve the quality of evidence, high-quality RCTs are required in the future.

Role of MR Neurography for Evaluation of the Lumbosacral Plexus: A Scoping Review (요천추 신경총에 대한 자기공명신경조영술의 역할: 주제 범위 문헌고찰)

  • Seon Gyeong Kim;Joon-Yong Jung
    • Journal of the Korean Society of Radiology
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    • v.83 no.6
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    • pp.1273-1285
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    • 2022
  • Purpose MR neurography (MRN) is an imaging technique optimized to visualize the peripheral nerves. This review aimed to discover an optimized protocol for MRN of the lumbosacral plexus (LSP) and identify evidence for the clinical benefit of lumbosacral plexopathies. Materials and Methods We performed a systematic search of the two medical databases until September 2021. 'Magnetic resonance imaging', 'lumbosacral plexus', 'neurologic disease', or equivalent terms were used to search the literature. We extracted information on indications, MRN protocols for LSP, and clinical efficacy from 55 studies among those searched. Results MRN of the LSP is useful for displaying the distribution of peripheral nerve disease, guiding perineural injections, and assessing extraspinal causes of sciatica. Three-dimensional short-tau inversion recovery turbo spin-echo combined with vascular suppression is the mainstay of MRN. Conclusion Future work on the MRN of LSP should be directed to technical maturation and clinical validation of efficacy.

Clinical Reports on Correlation between the Different Herniated Type and Oriental Medical Treatment (요추(腰椎) 추간판(椎間板)의 탈출형태(脫出形態)와 한방치료(韓方治療)의 상관성(相關性)에 관한 임상보고(臨床報告))

  • Jang, Suk-Geun;Hwang, Kyu-Jung;Lee, Hyun;Lee, Byung-Ryul
    • Journal of Acupuncture Research
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    • v.18 no.4
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    • pp.68-81
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    • 2001
  • Herniated lumbar intervertebral disc(H.I.V.D) is the most common reason causing low back pain and leg radiating pain. Objective : The purpose of this report is to observe the effects of oriental medical conservative treatment in the different herniated type. Methods : We investigated 30 patients suffering from low back pain with sciatica which were admitted to Taejon Cheonan O. M. hospital from Nov 1, 2000 to Apr 30, 2001. 30 patients had a diagnosis of herniated lumbar interver tebral disc by Lumbar-C.T and Lumbar-M.R.I. we treated 30 patients by oriental medical conservative treatment (Ex: acupuncture, herb-med, physical theraphy, bed-rest, etc.) Results : 1. The mean hospitalization of patients was 21.1 days. that in the bulging type was l4days, protruded type 21days, mixed type 27days, extruded type 30days. that shows the less herniation of lumbar intervertebral disc, the mean hospitalization was more short. 2. In the distribution of the clinical symptoms admitted at that time, low back pain, leg radiating pain were showed in the all types(29patients, 96.6%). and sensory disorder, muscle powerlessness were showed least in the bulg ing type(0%, 37.5%), but that were showed most in the extruded type(50%,75%). 3. In the result of treatment due to clinical syptoms, bulging type was more execellent than any other other types. 4. The less herniation of lumbar intervertebral disc, angle of straight leg raising test was higher. In the result of treatment due to angle of straight leg raising test, bulging type was more execellent than any other other types. 5. In the distribution of physical. test, positive case in the Peyton sign, Ankle Dorsiflexion were showed least in the bulging type(25%, 12.5%), but that were showed most in the extruded type(100%, 75%). 6. In the result of treatment due to physical.test, bulging type was more exec ellent than any other other types. 7. The efficacy of total treatment was 90%(when we set a standard things more than fair), that in the bulging type was 100%, protruded 92%, mixedtype 80%, extruded type 75%. Bulging type had a more remakable effectsthan any other types. Conclusions : The less herniation of lumbar intervertebral disc, clinical syptoms were slighter, physical. test were better, and efficacy of oriental medical conservative treatme nt was remakable high.

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