• Title/Summary/Keyword: Sciatica

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Intradural Extramedullary Spinal Metastasis - A Case Report - (경막하 수외로 전이된 척수암 1례 - 증 례 보 고 -)

  • Shin, Il-Young;Doh, Jae-Won;Yoon, Seok-Mann;Lee, Kyeong-Seok;Bae, Hack-Gun;Yun, Il-Gyu;Choi, Soon-Kwan;Byun, Bark-Jang
    • Journal of Korean Neurosurgical Society
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    • v.29 no.8
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    • pp.1085-1088
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    • 2000
  • Spinal intradural extramedullary metastasis are very rare. The authors report a case of spinal metastasis at the T5 level in the intradural extramedullary space in a 76-year-old man who presented with paraparesis and sciatica. Preoper-ative neuroradiologic imaging studies were highly suggestive of intradural mass lesion with compressive myelopathy. Pathology revealed metastatic squamous cell carcinoma. We describle the mechanism of tumor spread in intradural spinal metastasis.

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An Analysis on Present Condition of the Cooperative Medical Care Using the Episode of Care : Claims Data of HEALTH INSURANCE REVIEW & ASSESSMENT SERVICE (진료 에피소드를 이용한 협진 의료이용 현황 분석 : 건강보험심사평가원 청구자료를 중심으로)

  • Uhm, TaeWoong;Kim, Nam-Kwen;Kim, Sina
    • Journal of Society of Preventive Korean Medicine
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    • v.19 no.2
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    • pp.51-56
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    • 2015
  • Objective : We analyzed present condition of cooperative medical care using claims data of HEALTH INSURANCE REVIEW & ASSESSMENT SERVICE form patients treated by Korean-Western cooperative medicine. The study aimed to offer guidelines in selecting disease-related research in developing Korean-Western convergence technology. Method : Based on the patients using Korean medical service, we analyzed claims data of patients using Korean medical service and western medical service from January 2012 to December 2013. We were assigned to the server remotely. With the concept of 'episode of care', we rebuilt claims data and analyzed present condition of cooperative medical usage. Results : We analyzed present condition of cooperative medical care per episode of care. Among outpatients, Low back pain, lumbar region(M5456) was the highest number. Among inpatients, Sciatica due to intervertebral disc disorder(M511) was the highest number. Conclusion : Based on the claims data provided by HEALTH INSURANCE REVIEW & ASSESSMENT SERVICE, we have derived a list of multy frequently disease frequently treated by cooperative medical care by analyzing present condition.

Spinal Intramedullary Lipoma without Dysraphism

  • So, Wan-Soo;Lee, Woo-Jong;Choi, Ha-Young;Eun, Jong-Pil
    • Journal of Korean Neurosurgical Society
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    • v.42 no.1
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    • pp.42-45
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    • 2007
  • Spinal cord lipomas are commonly associated with spinal dysraphism. The lipomas without spinal dysraphism have been reported to be only 1% of all spinal cord lipomas. We report two cases of patients with spinal intramedullary lipomas without dysraphism. One patient was a 57-year-old man who had lower back pain and right-sided sciatica for 20 years. Magnetic resonance imaging (MRI) of the spine demonstrated an intradural mass occupying L1 to L2. The other patient was a 27-year-old woman who had back pain and gait disturbance for 5 months. MRI of the spine showed an elongated intradural mass occupying T7 to T9. Total laminectomy with partial resection of the lesions was performed on both patients. Pathological studies confirmed the diagnosis of spinal cord lipoma. They exhibited no dysraphism. Postoperatively, neurological symptoms improved in both patients.

Intradural Migration of a Sequestrated Lumbar Disc Fragment Masquerading as a Spinal Intradural Tumor

  • Kim, Hyeong-Suk;Eun, Jong-Pil;Park, Jung-Soo
    • Journal of Korean Neurosurgical Society
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    • v.52 no.2
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    • pp.156-158
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    • 2012
  • Intervertebral intradural lumbar disc herniation (ILDH) is a quite rare pathology, and isolated intradural lumbar disc herniation is even more rare. Magnetic resonance imaging (MRI) may not be able to reveal ILDHs, especially if MRI findings show an intact lumbar disc annulus and posterior longitudinal ligament. Here, we present an exceedingly rare case of an isolated IDLH that we initially misidentified as a spinal intradural tumor, in a 54-year-old man hospitalized with a 2-month history of back pain and right sciatica. Neurologic examination revealed a positive straight leg raise test on the right side, but he presented no other sensory, motor, or sphincter disturbances. A gadolinium-enhanced MRI revealed what we believed to be an intradural extramedullary tumor compressing the cauda equina leftward in the thecal sac, at the L2 vertebral level. The patient underwent total L2 laminectomy, and we extirpated the intradural mass under microscopic guidance. Histologic examination of the mass revealed a degenerated nucleus pulposus.

Hepatoprotective activity of Nyctanthes arbor-tristis (l.)

  • Wagh, A.E.;Yeotkar, U.S.;Nimbhorker, M.G.;Deshmukh, T.A.;Patil, V.R.
    • Advances in Traditional Medicine
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    • v.10 no.2
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    • pp.111-115
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    • 2010
  • The flowers of Nyctanthes arbor-tristis Linn. of Oleaceae widely used in Ayurvedic system of medicine for the treatment of diuresis, liver disorder, spleen enlargement sciatica, bitter, stomachic, carminative and tonic to hair. The aim of the present study was to evaluate the alcoholic and aqueous extracts of the flowers of Nyctanthes arbor-tristis for hepatoprotective effect against carbontetrachloride induced liver damage in rats. Administration of alcoholic and aqueous extracts of the leaves of Nyctanthes arbor-tristis protect the liver from toxic effects of carbontetrachloride by reducing the elevated levels of Serum glutamate pyruvate transaminase, Serum glutamate oxaloacetate transaminase, Alkaline phosphatase and serum bilirubin. Results revealed that both the alcoholic and aqueous extracts showed significant hepatoprotective activity by reducing the elevated levels of biochemical parameters at a dose of 200 mg/kg body weight. The results were supported by histopathological studies of liver samples which showed regeneration of hepatocytes by the extracts.

Analysis of Patients with Cervical Epidural Steroid Injection and Nerve Block (경부 경막외 Steroid 주입 및 차단술을 받은 환자의 분석)

  • Chung, Sung-Won;Cheun, Jae-Kyu
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.98-101
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    • 1996
  • Background: Lumbar epidural steroid injection for relief of low back pain and sciatica has become a popular procedure. further, cervical epidural steroid injection with nerve block (CESNB) is known to be effective for the management of acute and chronic pain of neck, shoulder and arm. However, many anesthesiologists are not familiar with CESNB. Methods: Charts of 34 patients who had undergone 60 cervical epidural steroid injections over a three year period, 1993 to 1995, were reviewed. We studied the followings: initial visit and department, injected interspaces, personal characteristics, indications for injection and complications. Results: Patients' first visits were mainly to orthopaedics (11 patients) and neurosurgery (10 patients). Epidural injection sites were: C7-T1 interspace (29 patients) and C6-C7 interspace (6 patients). Mean age of patients were 50.1 years. range 21~73 years. There were twenty male and fourteen female patients. Complications varied from dizziness after CESNB (1 patient). loss of consciousness with transient apnea (2 patients), and local infection with suspicious meningitis (1 patient). Conclusion: We conclude from the above data that CESNB is a good, safe and conservative form of therapeutic procedure in the management of patients suffering from cervical radiculopathy, and neck and shoulder pain.

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Effectiveness of ShinBaro Pharmacopuncture on Lumbar Spinal Herniated Intervertebral Disc : A Randomized Controlled Trial (요추추간판탈출증에 대한 신바로약침의 효과 : 무작위 대조군 시험)

  • Jun, Byung-Chul;Kim, Eun-Soo;Kim, Dong-Sub;Kim, Tae-Hun;Kim, Jee-Yong
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.6 no.2
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    • pp.109-119
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    • 2011
  • Objective : The aim of this study is to investigate the effectiveness of ShinBaro Pharmacopuncture in the treatment of patients with Lumbar spine Herniated Nucleus Pulposus. Methods : We investigated 20 cases of patients with lumbar disc herniation and devided into two groups. Experimental group were treated with ShinBaro Pharmacopuncture with integrated package treatment and control group were treated the same therapies without ShinBaro Pharmacopuncture. To evaluate the treatment effects of two groups, we used numeric rating scale(NRS), oswestry disability index(ODI). Results : In NRS of lumbar and sciatica pain and ODI, that of experimental group was much more improved than control group, and decrement of NRS of lumbar pain showed statistical significance along with the duration of treatment. Conclusions : ShinBaro Pharmacopuncture was thought to be effective for relieving symptoms of lumbar spine herniated nucleus pulposus, although further study is needed.

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Magnetic Resonance Imaging Follow-Up Case Study on Changes in a Lumbar Herniated Intervertebral Disc Treated with Korean Conservative Treatment (보존적 한방치료를 진행한 요추 추간판 탈출증 환자의 시간에 따른 영상의학적 추간판 크기 변화 1례)

  • Roh, Ji-ae;Lee, Ji-won;Jang, Jae-won;Jeong, Wu-jin;Noh, Je-heon
    • The Journal of Internal Korean Medicine
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    • v.39 no.5
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    • pp.879-885
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    • 2018
  • Background: A herniated intervertebral disc (HIVD) triggers low back pain (LBP). Korean conservative treatment can decrease the herniated disc size without traditional surgery, but detailed prognosis is unclear. Case summary: One patient presented with LBP and bilateral sciatica. She was diagnosed with lumbar HIVD by magnetic resonance imaging (MRI) and treated by Korean medicine (acupuncture, decoction, and physical therapy). For 6 months, MRI follow-up exams showed the aggravation and migration of L5-S1 followed by distinct improvement of the same lumbar vertebra. Conclusion: The disc size in a patient with lumbar HIVD was reduced by Korean conservative treatment, and periodic radiologic examination showed the previously unrecognized process of absorbing the disc.

Treatment of Radiculopathy with Flexible Fiberoptic Epiduroscope Inserted through the Sacral Canal -A case report- (천골열공을 통하여 삽입된 Flexible Fiberoptic Epiduroscope을 이용한 신경근병증 환자의 치험 -증례 보고-)

  • Park, Jong-Wan;Lee, Jung-Soon;Lee, Ju-Chul;Kim, Yong-Ik;Hwang, Kyoung-Ho;Park, Wook
    • The Korean Journal of Pain
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    • v.10 no.2
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    • pp.270-273
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    • 1997
  • Caudal epiduroscopy has been introduced as an alternative technique for direct injection of epidural steroid and lysis of adhesion. Futher, it gives a better understanding of the role of epidural adhesion in recurrence of sciatica and low back disorder after surgery. We experienced a clinical application of flexible fiberoptic epiduroscope inserted through the sacral canal. A 37-year-old woman was suffering from right lumbar radiculopathy after an operation for a herniated disc. A series of volumetric caudal steroid injections and physical therapy had little effect on her symptoms. Patient was thought to be a good candidate for epiduroscopy. Flexible flberoptic epiduroscopy was as follows: 60 ml of normal saline irrigation and epidurogram, 40 mg of triamcinolone in 10m1 of normal saline was directed around right L5 nerve root. The following morning, patient reported reduced pain in her leg.

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Pain Management for low back Pain and Lumbosacral Radiculopathy (요통에 대한 통증관리)

  • Kang, Keung-Mo;Ban, Jong-Seok;Min, Byung-Woo
    • The Korean Journal of Pain
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    • v.1 no.2
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    • pp.181-187
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    • 1988
  • Since the introduction of epidural corticosteroid injections for the management of sciatica, lumbosacral radiculopathy has become one of the most common pain problems encountered by anesthesiologists. In order to function effectively, anesthesiologists should be able to: (1) recognize those syndromes which may respond to nerve block; (2) understand the pathophysiology of the conditions being treated and (3) be familiar with alternate therapeutic pathways for patients not responding to merre block. There are many etiologic factors of low back pain and lumbosacral radiculopathy. Particularly, Nerve root compression caused by a protruding disc, a osteophyte or tumors are usually responsible for pain. Neural inflammation, therefore, is considered to play a major role in pain production. The use of local anesthetics in mixture with steroids is believed to break down neural inflammation. Steroids and local anesthetics were injected lumbar or caudal epidmal to 106 patients for the purpose of relieving low back pain and lumbosacral radiculopathy. The results are as follows: Excellent pain relieved group: 27 patients (25.5%) Good pain relieved group: 49 patients (46.1%) Fair pain relieved group: 15 patients(14.2%) Not effective group: 15 patients(14.2%).

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