• The Journal of the Korean bone and joint tumor society
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• v.17 no.2
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• pp.106-110
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• 2011

In the patient who has intradural mass associated with spinal stenosis, if the operation for spinal stenosis is performed alone, the symptom may remain. We report with literature review that we achieved the successful outcome after simultaneous decompression of spinal stenosis and space occupying mass removal in the case of intradural and extradural compression. A 71-year-old female patient suffering from low back pain and radiating pain of both lower extremities admitted. In magnetic resonance imaging, spinal stenosis on L4-5 and spondylolisthesis on L5-S1 compressed dural sac and intradural space occupying mass on L4 level compressed. By posterior approach, decompression and interbody fusion were carried out. Then mass was removed with median durotomy. Pathologic diagnosis was schwannoma and the symptom was improved remarkably.

• Journal of the Korean Society of Physical Medicine
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• v.2 no.1
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• pp.93-99
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• 2007

Purpose : The aim of this study is to consider degenerative spine disease theoretically and compare plain radiography which is a basic study for low back pain with MRI in cases of degenerative lumbar spine disease to find out whether the abnormalities agree with each other. Methods : In 4 cases of lumbar degenerative disease, we studied the relation of the abnormalities such as disc space narrowing, spinal space narrowing, loss of lordosis and osteophytes on plain radiography with those on MRI of HIVD, spinal stenosis and spondylolisthesis. Results : Many abnormalities such as disc space narrowing, spinal space narrowing, loss of lordosis, osteophytes and change of cortex & bone marrow on plain radiography suggest HIVD, spinal stenosis, spondylolysis or spondylolisthesis on MRI. Conclusion : For low back pain patients, plain radiography is a basic study in diagnosis of HIVD, spinal stenosis, spondylolysis or spondylolisthesis but MRI or CT scan is necessary to develop(build) a treatment plan like an operation.

• Journal of Korean Neurosurgical Society
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• v.41 no.3
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• pp.157-160
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• 2007

Objective : The purpose of this study was to evaluate the efficacy and safety of the surgical treatment for lumbar spinal stenosis in elderly patients. Methods : The authors reviewed the medical records of 49 patients older than 65 years of age with lumbar spinal stenosis who underwent surgical treatment from January 2002 to December 2004 in our institute. Results : Average age of patients was 70 years old [32 women, 17 men]. Twenty-four patients had chronic medical disorders. All patients were operated under the general anesthesia of these, 29 patients underwent decompressive laminectomy and decompressive laminectomy with instrumentation and fusion in 20 patients. The mean operation time was 193.5 minutes, mean estimated blood loss was 378cc and mean postoperative hospital stay length was 15.3 days. The mean follow-up duration was 11.9 months. The evaluation of outcome was assessed by Macnab classification. At first month after operation, the outcome showed excellent in 7 [14.3%]. good in 35 [71.4%], fair in 5 [10.2%], and poor in 2 [4.1%]. And at 6 months after operation, 17 patients were lost in follow-up, the outcome showed excellent in 4 [12.5%], good in 25 [78.1%], fair in 3 [9.4%], and no poor cases. There was no significant difference between outcome of laminectomy alone and that of laminectomy with fusion. Six patients [12.2%] experienced postoperative complications which included wound infection [3], nerve root injury [1], disc herniation [1], and reoperation due to insufficient decompression [1]. There were no deaths related to operation. Conclusion : We conclude that the surgical treatment for lumbar spinal stenosis in elderly patients can provide good results with acceptable morbidity when carefully selected. In addition, decision on lumbar spinal fusion should not be against solely on advanced age.

• Journal of Korean Neurosurgical Society
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• v.53 no.1
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• pp.19-25
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• 2013

Objective : We compared the results of two surgical techniques by retrospective study of 60 elderly patients (65 years or older) who underwent either decompression alone or fusion for the treatment of two-level or more lumbar spinal stenosis. Methods : During the period of 2003 and 2008, two-level or more decompression alone or fusion was performed for lumbar spinal stenosis by three surgeons at our institution. Patients were allocated to two groups by surgical modality, namely, to a decompression group (31 patients) or a fusion group (29 patients). Overall mean age was 71.1 years (range, 65-84) and mean follow-up was 5.5 years (range, 3-9). A retrospective review of clinical, radiological, and surgical data was conducted. Results : No significant difference between the two groups was found with respect to age, follow-up period, surgical levels, or preoperative condition. At the last follow-up, correction of lumbar lordotic angle (determined radiologically) was better in the fusion group. However, clinical outcomes including visual analogue scale, Oswestry Disability Index, and the Odom's criteria were not significantly different in the two groups. On the other hand, surgical outcomes, such as, operation time, estimated blood loss, and surgical complications were significantly better in the decompression alone group. Conclusion : Our findings suggest that decompressive laminectomy alone achieves good outcomes in patients with two-level or more lumbar spinal stenosis, associated with an advanced age, poor general condition, or osteoporosis.

• Journal of Korean Medicine Rehabilitation
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• v.31 no.3
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• pp.115-123
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• 2021

This study reports the effects of Korean medicine treatments including Chuna manual therapy (CMT) and exercise treatment for a patient suffering with cervical spinal stenosis. We treated patient diagnosed with cervical spinal stenosis. The patient was treated with CMT once a day for 26 days. Manual muscle testing (MMT), ratio and degree of numbness, numerical rating scale (NRS) were used as tools for evaluating the patient's progress. MMT was increased from 3+ to 5, ratio and degree of numbness were decreased from grade (Gr.) 9 to Gr. 4, NRS was decreased from 5 to 3. This study suggests that CMT and self-exercise can be considered as effective treatment for cervical spinal stenosis.

• Journal of Acupuncture Research
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• v.34 no.3
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• pp.59-69
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• 2017

Objectives : This study analyzed the current status of randomized controlled trials (RCTs) of miniscalpel acupuncture for lumbar spinal stenosis (LSS) in China. Methods : A literature search was performed using the China National Knowledge Infrastructure (CNKI) database. All studies up to June 7th, 2017 were searched. The quality of included RCTs was assessed with the Jadad scale. Results : Five RCTs were finally included in this review. The overall quality of the RCTs was assessed as low. All articles evaluated miniscalpel acupuncture as monotherapy or in combination with filiform needle therapy, drug injection therapy, Tuina treatment, thermal coagulation therapy, or spinal decompression. Miniscalpel acupuncture as monotherapy or adjunctive therapy showed greater therapeutic effect and fewer adverse effects. Conclusion : Miniscalpel acupuncture is a safe and effective nonpharmacological treatment for LSS. However, high-quality studies with consistent treatment protocols are needed to confirm these findings.

• The Korean Journal of Pain
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• v.27 no.3
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• pp.219-228
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• 2014

Background: A lipo-prostaglandin E1 agonist is effective for the treatment of neurological symptoms of spinal stenosis when administered by an oral or intravenous route. we would like to reveal the therapeutic effect of an epidural injection of lipo-prostaglandin E1 on hyperalgesia in foraminal stenosis. Methods: A total of 40 male Sprague-Dawley rats were included. A small stainless steel rod was inserted into the L5/L6 intervertebral foramen to produce intervertebral foraminal stenosis and chronic compression of the dorsal root ganglia (DRG). The rats were divided into three groups: epidural PGE1 (EP) (n = 15), saline (n = 15), and control (n = 10). In the EP group, $0.15{\mu}g{\cdot}kg-1$ of a lipo-PGE1 agonist was injected daily via an epidural catheter for 10 days from postoperative day 3. In the saline group, saline was injected. Behavioral tests for mechanical hyperalgesia were performed for 3 weeks. Then, the target DRG was analyzed for the degree of chromatolysis, chronic inflammation, and fibrosis in light microscopic images. Results: From the fifth day after lipo-PGE1 agonist injection, the EP group showed significant recovery from mechanical hyperalgesia, which was maintained for 3 weeks (P < 0.05). Microscopic analysis showed much less chromatolysis in the EP group than in the saline or control groups. Conclusions: An epidurally administered lipo-PGE1 agonist relieved neuropathic pain, such as mechanical hyperalgesia, in a rat foraminal stenosis model, with decreasing chromatolysis in target DRG. We suggest that epidurally administered lipo-PGE1 may be a useful therapeutic candidate for patients with spinal stenosis.

• Journal of Korean Medicine Rehabilitation
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• v.20 no.4
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• pp.131-138
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• 2010

Objectives : Recently work-related musculoskeletal disorders have increased in various workplaces and many reports have been confirming this, but a comparative study on incidence of spinal disease by occupation has not been established yet. So this study was designed to clarify the distinction on incidence of spinal disease between white and blue collar workers. Methods : The subjects who visited with spinal disease to Ja-Seng oriental hospital from January to April in 2020 were selected and divided into white collar workers(n=844) and blue collar workers(n=333). We counted the number of patients with each spinal disease in both groups and carried out comparative analysis in five items(herniated nucleus pulposus(HNP), stenosis, spondylosis, sprain, etc). All data were analyzed by chi-square test. Results and Conclusions : Whit collar workers had higher incidence in HNP(p=0.030), sprain(p=0.016),etc(p=0.035) than blue collar workers, while blue collar workers had higher incidence in stenosis(p=0.002). But we think that the confidence is low in stenosis because the number of cases are very small. There were no significance between two groups with spondylosis.

• Journal of Korean Medicine Rehabilitation
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• v.24 no.4
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• pp.129-136
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• 2014

Objectives The purpose of this study is to find out clinical and radiological correlation between lumbar lordotic angle, lumbar intervertebral disc angle and lumbar spinal stenosis. Methods Total 250 patients' who had visited Bu-Chun Jaseng Hospital of Korean Medicine lumbar lordotic angle, intervertebral disc angle of L4/5 and dural sac dimension of L4/5 were measured by X-ray and MRI films. We analysed correlation between lumbar lordotic angle, intervertebral disc angle of L4/5 and lumbar spinal stenosis in terms of clinical and radiological aspect. Results 1. The mean intervertebral disc angle of L4/5 were $10.72{\pm}3.98^{\circ}$, the mean lumbar lordotic angle were $41.97{\pm}11.73^{\circ}$ and the mean dural sac dimension of L4/5 were $133.18{\pm}45.46mm^2$. 2. This study shows that dural sac dimension of L4/5 was inversely reated to intervertebral disc angle of L4/5 by statistically (p<0.05). 3. There was visible difference regarding intervertebral disc angle of L4/5 between patients who had been diagnosed with lumbar spinal stenosis by clinically and patients who had not been diagnosed with lumbar spinal stenosis by clinically; The former's angle was relatively higher than the latter's (p<0.05). Conclusions There was a statistical significance between intervertebral disc angle of L4/5 and lumbar spinal stenosis in single-segment.

• Journal of Korean Medicine Rehabilitation
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• v.27 no.1
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• pp.67-75
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• 2017

The purpose of this study is to report the effectiveness of diarrhea-inducing treatment by Gamsui-mal for lumbar spinal stenosis. During hospitalization four patients with lumbar spinal stenosis were treated with diarrhea-inducing treatment by Gamsui-mal and acupuncture, herbal medicine, moxibustion, cupping treatment, Bee-venom pharmacopuncture. Before treatment, we explained in detail about diarrhea-inducing treatment by Gamsui-mal and patients agreed with treatment. The symptoms appeared in patients of diarrhea, abdominal pain, and vomiting in the treatment process. We evaluated the degree of improvement by visual analogue scale (VAS), oswestry disability index (ODI). After treatment, we found that pain was reduced and patient's symptoms were improved by visual analogue scale (VAS), oswestry disability index (ODI) score. The results show that diarrhea-inducing treatment by Gamsui-mal was rapidly improving symptoms. Further studies are needed to clarify the effect of diarrhea-inducing treatment by Gamsui-mal.