• Korean Journal of Adult Nursing
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• v.12 no.4
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• pp.727-740
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• 2000

It is well recognized that case management is required to survive in the rapidly changing medical environment. One of the case management is the critical pathway(CP) which is assumed to increase the quality of care and at the same time to decrease the length of stay in hospital. The purpose of the study was to develop a CP for the management of patients with postero-lateral fusion for lumbar spinal stenosis. Through review of literature and medical records of patients with spinal stenosis, a pilot CP was designed, including 8 different care components such as medication, laboratory tests, assessment etc., from one day before surgery to 6 days of postoperative care. Every item of the pilot CP was evaluated by a panel of experts to test the content validity. The items not agreed on by more than 4 out of 6 experts were deleted or modified to be integrated in the CP. To apply the modified CP to a clinical environment, the items reflecting treatment, medication and lab work were entered into an order communication system(OCS), and doctors and nurses were taught to use the CP. Finally, the development of CP for the patients with posterolateral lumbar fusion was completed after the application and variance analysis of the CP.

• Journal of TMJ Balancing Medicine
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• v.5 no.sup
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• pp.25-30
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• 2015

Therapeutic effect of Yinyang Balancing Appliance of functional cerebrospinal therapy (FCST) for meridian and neurologic yinyang balance was observed in a lumbar spinal stenosis case. One lumbar spinal stenosis case was managed with the Yinyang Balancing Appliance on temporomandibular joint (TMJ), combined with acupuncture. Clinical outcome measurement was based on subjective measures and clinical observations. The patient showed positive changes even after the initial treatment and this effect maintained over the follow-up period. further clinical and biological research on FCST is expected.

• The Korean Journal of Pain
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• v.25 no.1
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• pp.55-59
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• 2012

Lumbar spinal stenosis is a commonly treated with epidural injections of local anesthetics and corticosteroids, however, these therapies may relieve leg pain for weeks to months but do not influence functional status. Furthermore, the majority of patients report no substantial symptom change over the repeated treatment. Utilizing balloon catheters, we successfully treated with three patients who complained persistent symptoms despite repeated conventional steroid injections. Our results suggest that transforaminal decompression using a balloon catheter may have potential in the nonsurgical treatment of spinal stenosis by modifying the underlying pathophysiology.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.4 no.1
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• pp.85-94
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• 2009

Objects : This study was to report a clinical effect of Korean Treatment for a patient diagnosed by Computed Tomography as Cervical Spinal Stenosis with Ossification of posterior Longitudinal Ligament. Methods : In order to alleviate left shoulder pain and neck stiffness, the patient was treated by acupuncture therapy, herbal medicine, distilled herbal injection, cervical traction technique of Chuna treatment and conservative managements. To evaluate the effect of the treatment, Recovery rate of Hirabayashi, VAS(Visual Anlaogue Scale), NDI and ROM(Range of Motion) were used. Lhermitte's sign, Valsalva test, Distraction test, Compression test and Spurling test were carried out. Results : VAS, NDI and ROM were improved and Recovery rate was 100%. Conclusions : Korean Treatment can be effectively used for a patient with Cervical Spinal Stenosis with OPLL. Further clinical studies are needed to verify the findings.

• Journal of Acupuncture Research
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• v.28 no.3
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• pp.21-31
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• 2011

Objectives : The purpose of this study was to evaluate the effect of bee venom pharmacopuncture therapy in patients with lumbar spinal stenosis. Methods : This clinical study was carried out on 119 patients with lumbar spinal stenosis, who had been admitted from May, 2009 to March, 2011. Patients were sorted into two groups ; One group(bee venom pharmacopuncture group) was treated with bee venom pharmacopuncture and acupuncture therapy, the other(non-bee venom pharmacopuncture group) with acupuncture therapy only. Verbal numerical rating scale(VNRS) and Oswestry disability index(ODI) were used to evaluate the effectiveness of the treatment in both groups. VNRS and ODI scores of the two groups were statistically compared. Results : The bee venom pharmacopuncture group demonstrated a more significant improvement than non-bee venom pharmacopuncture group when evaluated with VNRS and ODI. Conclusions : In the case of the patients with spinal stenosis, it was found that treatment with combination of bee venom pharmacopuncture and acupuncture was more effective in improving the conditions of the patients (subsidence of the symptoms) than the acupuncture treatment only.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.3 no.2
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• pp.77-85
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• 2008

Object : These studies are designed to make a survey of the effectiveness of the non surgical oriental medicine treatment with Chuna on spinal stenosis of lumbar spine. Methods : The clinical study was done on 118 cases of patients with spinal stenosis of lumbar spine diagnosed by M.R.I, symptoms and physical test who was in the admission in Ja-Seng Oriental Medcine Hospital from October 2006 to October 2008. after treatment we checked VNRS score to estimate the efficacy of treatment. Results : 1. As a Objectivity treatment record, they test excellent 17%, good 69%, fair 8%, poor 6%. 2. The mean NRS score decreased about 3.26 after the treatment. Conclusions : Non surgical oriental medicine treatment with Chuna has on useful effect on spinal stenosis of lumbar spine.

• Journal of Korean Neurosurgical Society
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• v.38 no.2
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• pp.107-110
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• 2005

Objective : Lumbar spinal stenosis is increasingly recognized as a common cause of low back pain in elderly patients. Conservative treatment has been initially applied to elderly patients, however, surgical treatment is sometimes indispensable to relieve severe pain. We retrospectively examine the age-related effects on the surgical risk, and results following general anesthesia and operative procedure in geriatric patients for two different age groups of at least 65years old. Methods : Consecutive 51 patients [${\ge}$ 65years], who underwent open surgical procedure for degenerative lumbar spinal stenosis, were selected in the study. Patients were divided into two groups. Group A included all patients who were between 65 and 69years of age at the time of surgery. Group B included all patients who were at least 70years of age at the time of surgery. We reviewed medical history including preoperative American Society of Anesthesiologists[ASA] classification of physical status, anesthetic risk factor, operative time, estimated blood loss, transfusion requirements, hospital stay, operated level, and clinical outcome to look for comparisons between two age groups [$65{\sim}69$ and over 70years]. Results : In preoperative evaluation, mean anesthetic risk factor of patients was numerically similar between the groups. The American Society of Anesthesiologists classification of physical status was similar between two groups. There was no difference in operated level, operative time, estimated blood loss, hospital stay, and anesthetic risk factor between the two groups. The clinical successful outcome showed 82.7% for Group A and 81.8% for group B. The overall postoperative complication rates were similar for both group A and B. Conclusion : We conclude that advanced age per se, did not increase the associated morbidity and mortality in surgical decompression for spinal stenosis.

• Journal of Acupuncture Research
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• v.35 no.4
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• pp.226-237
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• 2018

Background: This study examined the characteristics and prognosis of patients admitted to the Dunsan Korean medicine hospital for treatment of herniated intervertebral disc (HIVD) or spinal stenosis with Miniscalpel needle therapy (MSN). Methods: Patients were admitted to the Dunsan Korean medicine hospital from January 01, 2016 to September 30, 2017 for the treatment of HIVD or spinal stenosis with MSN. Crossover analysis, Independent sample t test, one-way ANOVA, multiple linear regression analysis, and binary logistic regression analysis were performed. Results: Crossover analysis showed statistically significant differences in treatment methods according to gender, current pain according to the disease duration, satisfaction of MSN according to disease duration, treatment methods, and intention of re-treatment with MSN according to treatment methods. Independent t test and one-way ANOVA showed that there was a difference in current Numeric Rating Scale (NRS) according to disease duration, and difference between discharge and current NRS, and number of MSN according to disease. Multiple linear regression analysis showed that age, disease duration, and number of MSN affect discharge NRS, disease duration, and number of MSN affect current NRS, and Western medical treatment after MSN, discharge NRS, and current NRS affect satisfaction of MSN. Binary logistic regression analysis showed that discharge NRS affects current pain, and gender, discharge NRS, and treatment methods affect intention of re-treatment with MSN. Conclusion: Characteristics, prognosis, satisfaction and variables affecting prognosis of MSN were statistically significant, indicating that more systematic studies are required to further examine the effects of MSN on HIVD or spinal stenosis.

• Journal of Korean Medicine Rehabilitation
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• v.26 no.3
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• pp.109-117
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• 2016

Objectives The purpose of this study was to investigate the correlation between walking ability of lumbar spinal stenosis patients and the cross-sectional area (CSA) of lumbar paraspinal muscles. Methods This study was carried out on 62 lumbar spinal stenosis patients who had limited walking abilities because of neurogenic claudication (NC). All patients received more than 2 weeks of complex treatment at Mokhuri Neck&Back Hospital. CSA of lumbar paraspinal muscles was measured from axial T2-weighted MRI and divided by CSA of adjacent vertebral body to avoid influence of body statues (RCSA-Relative CSA). Pain Free Walking Distance and Numerical Rating Scale (NRS) was measured before and after treatment. Results The Pain Free Walking Distance had significantly increased in patients who had bigger RCSA of psoas muscle (r=0.313, p<0.05). Conclusions The psoas muscle can be a predictive factor for restoring walking ability of lumbar spinal stenosis patients who have limitations walking.

• The Journal of Internal Korean Medicine
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• v.40 no.2
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• pp.165-172
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• 2019

Background: To suggest potential of Korean medicine treatments as a conservative management for neurogenic claudication and lower extremity weakness due to spinal stenosis. Case Summary: The patient suffered weakness, pain and numbness of the right leg and difficulty walking with diagnosis of spinal stenosis due to herniated lumbar intervertebral disc. Korean medicine treatments, including herbal medicine, acupuncture, pharmacopuncture and Chuna manual therapy were applied. The Numeric Rating Scale (NRS) of pain and numbness in the right leg decreased from 7 to 4, with an increase in strength of the right leg from 60% to 95% compared to the strength of left leg. Walking duration also increased from less than one minute to more than five minutes. Conclusion: Korean medicine treatment may be considered as an effective conservative management for symptoms of spinal stenosis.