• Journal of Korean Neurosurgical Society
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• v.60 no.5
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• pp.485-497
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• 2017

Surgical treatment of the degenerative disc disease has evolved from traditional open spine surgery to minimally invasive spine surgery including endoscopic spine surgery. Constant improvement in the imaging modality especially with introduction of the magnetic resonance imaging, it is possible to identify culprit degenerated disc segment and again with the discography it is possible to diagnose the pain generator and pathological degenerated disc very precisely and its treatment with minimally invasive approach. With improvements in the optics, high resolution camera, light source, high speed burr, irrigation pump etc, minimally invasive spine surgeries can be performed with various endoscopic techniques for lumbar, cervical and thoracic regions. Advantages of endoscopic spine surgeries are less tissue dissection and muscle trauma, reduced blood loss, less damage to the epidural blood supply and consequent epidural fibrosis and scarring, reduced hospital stay, early functional recovery and improvement in the quality of life & better cosmesis. With precise indication, proper diagnosis and good training, the endoscopic spine surgery can give equally good result as open spine surgery. Initially, endoscopic technique was restricted to the lumbar region but now it also can be used for cervical and thoracic disc herniations. Previously endoscopy was used for disc herniations which were contained without migration but now days it is used for highly up and down migrated disc herniations as well. Use of endoscopic technique in lumbar region was restricted to disc herniations but gradually it is also used for spinal canal stenosis and endoscopic assisted fusion surgeries. Endoscopic spine surgery can play important role in the treatment of adolescent disc herniations especially for the persons who engage in the competitive sports and the athletes where less tissue trauma, cosmesis and early functional recovery is desirable. From simple chemonucleolysis to current day endoscopic procedures the history of minimally invasive spine surgery is interesting. Appropriate indications, clear imaging prior to surgery and preplanning are keys to successful outcome. In this article basic procedures of percutaneous endoscopic lumbar discectomy through transforaminal and interlaminar routes, percutaneous endoscopic cervical discectomy, percutaneous endoscopic posterior cervical foraminotomy and percutaneous endoscopic thoracic discectomy are discussed.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.1 no.2
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• pp.73-80
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• 2006

This study is designed to evaluate the effect of flexion-distraction technique for the patient with thoracic & lumbar disc and scoliosis. After flexion-distraction technique the. results of VAS of lumbago, orthopedics tests, cobb's angle were improved significantly. It is suggested that flexion-distraction technique might be effective for the patient with Thoracic & Lumbar Disc and Scoliosis.

• The Journal of Korean Physical Therapy
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• v.2 no.1
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• pp.103-112
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• 1990

The intervertebral disc in the anterior portion of the function unit gives the spine its flexibility. The disc is attached closely to the vertebral endplates. Between these endplates and the annulus fibrosus, the nucleus pulposus of the lumbar disc is enclosed in a circle of unyielding tissues. Compressive pressure placed on the disc is dissipated circumferentially in a passive manner In response to the greater axial forced exerted on the lumbar spine in comparison to the cervical and thoracic spines, the nucleus pulposus has its greatest surface area in the lumbar spine. The intervertebral disc is not only structure that helps diss pate stresses placed on the spine. With flexion, extension, rotation, or shear stress, the load distribution on the function unit is shared by the intervertebral disc, anterior and posterior longitudinal ligaments, the facet joints and capsules, and other ligamentous structures like the ligamentum flavum, interspinous and supraspinous ligaments, which attach to the posterior elements of the functional unit.

• Journal of Chest Surgery
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• v.15 no.4
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• pp.428-431
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• 1982

A vascular complication caused by lumbar disc surgery is not infrequent till recently after the first report by Linton & White in 1945. In October 1980, we experienced one case of arteriovenous fistula following lumbar disc surgery in the department of thoracic surgery, CAFGH. The A-V fistula was situated between left common iliac artery and vein, which was confirmed by angiography easily. The A-V fistula was corrected surgically by Taylor`s method successfully without complication.

• Journal of Korean Neurosurgical Society
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• v.38 no.4
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• pp.320-322
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• 2005

A 45-year-old man presented with lower back pain and pain in the right leg of 3years duration. A plain radiographic examination revealed grade I isthmic spondylolisthesis, with instability at L4-5. Computed tomography and magnetic resonance imaging demonstrated bilateral foraminal stenosis, with soft foraminal disc herniation on the right side at the L4-5 level. He underwent anterior lumbar interbody fusion[ALIF] with percutaneous posterior fixation[PF] at the L4-5 level. Without removing the posterior bony structures, removal of foraminal disc herniation and reduction of spondylolisthesis were successfully performed using ALIF with percutaneous PF. When there is no hard disc herniation or lateral recess stenosis, ALIF with percutaneous PF can be one of the treatment options for isthmic spondylolisthesis, even in the presence of foraminal disc herniation, as in our case.

• Journal of Chest Surgery
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• v.17 no.2
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• pp.315-320
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• 1984

A vascular complication caused by lumbar disc surgery is not infrequent till recently after the report by Linton and White in 1945. Thereafter, many reports about the accidental injuries to the great vessels anterior to the lumbar area had been reported. In June, 1982, we experienced one case of arteriovenous fistula between right common lilac artery and inferior vena cava which was corrected surgically. The arteriovenous fistula caused by lumbar disc surgery and its review of the literature and presented.

• Journal of Chest Surgery
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• v.30 no.6
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• pp.621-624
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• 1997

Conventional surgery for lower lumbar disc herniation is a common practice and its vascular complications have been reported rarely. If the hypotension is severe or prolonged postoperatively, one should suspect vascular injury and perform urgent laparotomy. We experienced two cases of major vascular injuries following semi-laminectomy and discectomy.

• Journal of Korean Neurosurgical Society
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• v.38 no.5
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• pp.384-386
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• 2005

There have been several reports about abdominal pain due to discitis in children or thoracic disc herniation. However, none of them could verify causal relationship between disc disease and abdominal pain clearly. The authors report a patient with discogenic abdominal pain who had disc degeneration at lower lumbar level without definite protrusion or any evidence of inflammation. We could reproduce the abdominal pain by using discography. The patient was treated by percutaneous disc decompression successfully.

• Journal of the Korean Society of Physical Medicine
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• v.5 no.3
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• pp.363-373
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• 2010

Purpose : The purpose of this study was to compare differences in thoracolumbar ranges of motions by comparing ratios among 4 type diagnosis for patient with chronic low back pain. Methods : The subjects were 58 chronic low back pain patients. A motion analysis program (Global Postural System) was used after photography for posture measurement. To analyze differences in mobility percentages and ratios of thoracolumbar ranges of motion, one-way ANOVA was used. Results : Regional difference spinal posture and movement were found to diagnosis patients with chronic low back pain. Comparison of thoracolumbar ranges of motion revealed significant differences in the thoracic region during forward-bending of the trunk (p<.05). In the upper thoracic region, the herniated intervertebral lumbar disc (HILD) group was significantly larger than the spinal stenosis/herniated intervertebral lumbar disc (SS/HILD) group (p<.05). In the lower thoracic region, chronic sprains (CS) were significantly greater than in the spinal stenosis (SS) group and in the (SS/HJLD) group (p<.05). Comparative analysis of thoracic/lumbar mobility ratio showed the CS group's ratio during forward bending was largest: 1.66, while the HILD group's ratio was smallest: 84 a significant difference between the two groups (p<.01). Diagnosis was not associated with difference in thoracolumbar backward-bending range of motion (p>.05). Conclusion : Theses results indicate the clinical efficacy of diagnosing for chronic low back pain by evaluating spinal mobility.

• Journal of Korean Neurosurgical Society
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• v.38 no.5
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• pp.399-402
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• 2005

Direct anterior approach for lesions located anterior to the thecal sac is definitely superior to lateral or posterior approach in many respects. However, various anatomical obstacles and technical difficulties often hinder direct anterior approach. Thanks to ripe experience of retroperitoneal approach to the lumbar spine for anterior lumbar interbody fusion and total disc replacement, the authors could perform lumbar corpectomy and reconstruction by using midline retroperitoneal approach recently. During this approach, we repaired anterior longitudinal ligament also to reduce the risk of graft extrusion and to prevent erosion of vascular wall due to direct contact between metallic hardware, which was used for reconstruction of vertebral body, and major vessels.