• Journal of Korean Neurosurgical Society
• /
• v.58 no.1
• /
• pp.65-71
• /
• 2015

Objective : Lumbar spinal stenosis is conventionally treated with surgical decompression. However, bilateral decompression and laminectomy is more invasive and may not be necessary for lumbar stenosis patients with unilateral radiculopathy. We aimed to report the outcomes of unilateral laminectomy and bilateral pedicle screw fixation with fusion for patients with lumbar spinal stenosis and unilateral radiculopathy. Methods : Patients with lumbar spinal stenosis with unilateral lower extremity radiculopathy who received limited unilateral decompression and bilateral pedicle screw fixation were included and evaluated using visual analog scale (VAS) pain and the Oswestry Disability Index (ODI) scores preoperatively and at follow-up visits. Ligamentum flavum thickness of the involved segments was measured on axial magnetic resonance images. Results : Twenty-five patients were included. The mean preoperative VAS score was $6.6{\pm}1.6$ and $4.6{\pm}3.1$ for leg and back pain, respectively. Ligamentum flavum thickness was comparable between the symptomatic and asymptomatic side (p=0.554). The mean follow-up duration was 29.2 months. The pain in the symptomatic side lower extremity (VAS score, $1.32{\pm}1.2$) and the back (VAS score, $1.75{\pm}1.73$) significantly improved (p=0.000 vs. baseline for both). The ODI improved significantly postoperatively ($6.60{\pm}6.5$; p=0.000 vs. baseline). Significant improvement in VAS pain and ODI scores were observed in patients receiving single or multi-segment decompression fusion with fixation (p<0.01). Conclusion : Limited laminectomy and unilateral spinal decompression followed by bilateral pedicle screw fixation with fusion achieves satisfactory outcomes in patients with spinal stenosis and unilateral radiculopathy. This procedure is less damaging to structures that are important for maintaining posterior stability of the spine.

• The Journal of Korean Physical Therapy
• /
• v.20 no.4
• /
• pp.21-28
• /
• 2008

Purpose: We measured the Oswestry Low Back Pain Disability Index (OLBPDI) and related factors in patients with low back pain. Methods: The sample consisted of 50 patients who received physical therapy at the physical therapy units of the Andong Seoul Sintong Clinic, St. Luke Clinic, and Yeongju Seoul Sintong Clinic in Andong and Yeongju city from October, 2007, to February, 2008. The OLBPDI questionnaire was administered by 5 physical therapists as a cross-sectional study. Student's t-test and analysis of variance (ANOVA/Tukey and Scheffe) were used to analyze OLBPDI score differences. We also used nonparametric statistic analysis (Wilcoxon rank sum test, Median test). Pearson correlation analysis (Spearman correlation analysis) was used to analyze the relationship between OLBPDI and the visual analogue scale (VAS). Multiple regression analysis was performed to determine the effects of independent variables on pain scores as defined by the OLBPDI. Results: The average patient age was 37.1 years (range: 18$\sim$78 years old), and time from onset was 21.7 months (1$\sim$180). OLBPD and VAS scores were 12.70 (3.0$\sim$28.0) and 5.14 (1$\sim$8), respectively. OLBPDI scores were 14.4 in patients taking medicine and 11.57 in those who did not. There was a statistically significant relationship between OLBPDI and VAS (r=0.54, p=0.0001; r=0.55, p=0.0001 by Spearman coefficient). Gender ($\beta$=6.14, p=0.0124), age ($\beta$=-2.01, p=0.0324), weight ($\beta$=0.31, p=0.0222), time from onset ($\beta$=1.54, p=0.0044), and VAS score ($\beta$=1.59, p=0.0004) were significantly associated with OLBPD by multiple regression analysis. Conclusion: Variables associated with OLBPD were gender, age, weight, time from onset, and VAS score. Collecting information on the pain index using OLBPDI was acceptable to patients with low back pain. Further research should explore the pain index by using larger sample sizes and longer follow-up periods.

• Journal of Korean Foot and Ankle Society
• /
• v.15 no.1
• /
• pp.27-31
• /
• 2011

Purpose: This study evaluated the efficacy of an intra-articular injection of sodium hyaluronate in the treatment of early stage osteoarthritis of the ankle. Materials and Methods: Early stage ankle osteoarthritis (Takakura stage I and II) patients who received hyaluronic acid injection therapy were retrospectively reviewed. Patients underwent intra-articular injections of 2 mL of sodium hyaluronate for 3 consecutive weeks. Clinical evaluation and Visual Analogue Scale (VAS) scoring were performed at every three months after treatment. Results: Total 27 patients were involved and mean age was 55 year old (range 33 to 77 years). There were 13 male and 14 female patients. Mean follow up duration was 13 month and. Pre-intra-articular VAS score was $8.9{\pm}0.7$ and three month follow up score was $3.8{\pm}2.8$. VAS score of last follow up was $3.2{\pm}3.4$. The effect of hyaluronic acid continued about one year when analyzed the VAS score change of the patients followed for more than one year. Patients' satisfaction was "very satisfied" in nine, "satisfied" in 12, "fair" in one, and "not satisfied" in five patients. Overall satisfaction rate was 82%. There were no ankle osteoarthritis stage changes in serial follow up radiograph. Conclusion: Symptomatic relief of signs and symptoms of osteoarthritis of the ankle was achieved by injection of an intra-articular hyaluronate injection. Efficacy of Hyaluronate acid injection persisted more than 1 year in our study. Intra-articular hyaluronate injection to ankle osteoarthritis is safe and effective as knee joint and should be considered as a valid conservative treatment for ankle osteoarthritis.

• Journal of Acupuncture Research
• /
• v.22 no.6
• /
• pp.75-84
• /
• 2005

Objectives : Research on the effect and satisfaction between Acupuncture Treatment, Physical Treatment and contemporary Treatments of Acupuncture and Physical of lumbago patients Methods : We separated lumbago patients into three groups. A group with only Acupuncture Treatment and a group with only Physical Treatment and a group with contemporary treatments of Acupuncture and Physical. Questionnaire survey and score of Visual Analog Scale(VAS) and Oswestry Disability Index(ODI) were examined for comparison. Results & Conclusion : 1. Of the 54 patients Acupuncture Teatment group had 17 patients with similar ratio of gender and the average age was 39.5 years old. For the Physical Treatment group the ratio of male was 75% of the 8 patients and had the youngest average age which was 29.1 years old and the group with contemporary Treatments the ratio of female was 62% of 29 patients and had the oldest average age which was 46.7 years old. 2. The Acupuncture Treatment group had the shortest treatment period because of many acute stage caused by lumber sprain and the improvement score was the best. The group of contemporary treatments had the longest history day and treatment period by serious disease like HIVD and spinal stenosis but the improvement score of VAS and ODI was good similar to the Acupuncture Treatment group. For the Physical Treatment group there was many patients with degenerative change but not severe pain. The VAS, ODI and the improvement score was the lowest before and after the treatment.

• Journal of Korean Foot and Ankle Society
• /
• v.26 no.2
• /
• pp.71-77
• /
• 2022

Purpose: This study sought to investigate the appropriate indications for intra-articular injection of hyaluronic acid in ankle osteoarthritis, its efficacy at each stage of osteoarthritis and to compare the efficacy related differences at each stage. Materials and Methods: A retrospective study was conducted from January 2016 to September 2019 on 43 patients (50 cases) diagnosed with ankle arthritis and given intra-articular injection of hyaluronic acid. Patients were classified according to the modified Takakura ankle osteoarthritis stages. Stage 2 comprised 24 cases; stage 3A, 15 cases; stage 3B, 8 cases; and stage 4, 3 cases. The clinical evaluation was carried out using the visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) score, and the Foot and Ankle Outcome Score (FAOS). The patients' satisfaction with the injection was evaluated at 1 year after injection. A radiographic evaluation was performed to gauge the progression of osteoarthritis before and after the injection. Results: The VAS, AOFAS score, and FAOS at 3 months and 1 year after injection showed statistically significant improvements compared to those before the injection. There was a significant difference in the VAS for each stage over time; however, this was not the case with the AOFAS score and the FAOS. A significant improvement of the VAS after injection was seen only in stage 3A when compared with the other stages. The overall satisfaction rate with the injection was 90%. There were no ankle osteoarthritic stage changes in the serial follow-up radiograph. Conclusion: Intra-articular injection of hyaluronic acid resulted in a significant clinical improvement up to 1 year after the injection. Therefore, the intra-articular injection of hyaluronic acid could be a treatment option for ankle osteoarthritis.

• Clinics in Shoulder and Elbow
• /
• v.26 no.1
• /
• pp.71-81
• /
• 2023

Background: This study evaluated the clinical and radiologic outcomes of onlay patch augmentation in rotator cuff repair for moderate-to-large tears in elderly patients. Methods: We reviewed 24 patients who underwent onlay augmentation with dermal allograft after arthroscopic rotator cuff repair from January 2017 to March 2020. Inclusion criteria were patients aged >65 years with tears >2.5 cm, who were followed for >12 months after surgery, and patients who could raise their arms above 90° preoperatively. American Shoulder and Elbow Surgeons (ASES) score, Constant-Murley score, pain visual analog scale (VAS), and VAS for satisfaction were used as clinical outcomes. For the evaluation of cuff integrity, magnetic resonance imaging scans were performed every 3 months after surgery. The results were compared before and after surgery in all patients and between the retear and intact groups. Results: The average follow-up period was 16.38 months, and the mean age of patients was 71.05 years. All patients showed significant improvement in ASES score, Constant-Murley score, and pain VAS at the last evaluation. The average value of satisfaction VAS was 7.27/10. The retear rate was 25% (6/24) if Sugaya type 3 was categorized in the retear group, otherwise 16.7% (4/24), if Sugaya type 3 was categorized into the intact group. Irrespective of Sugaya type 3 being included in the retear group, there was no significant difference in outcome variables between the intact and retear groups during follow-up. Conclusions: In moderate-to-large rotator cuff tear in elderly patients, onlay patch augmentation improved clinical outcomes. Retear did not adversely affect clinical outcomes.

• The Korean Journal of Pain
• /
• v.23 no.2
• /
• pp.137-141
• /
• 2010

Background: Facet joint have been implicated as a source of chronic low back pain. Radiofrequency denervation has demonstrated the most solid evidence. To increase safety and efficacy of treatment, computed tomography (CT) guidance injection has been used in several disease. The purpose of this study was to evaluate the efficacy of CT-guided radiofrequency rhizotomy in the treatment of facet joint pain. Methods: A total of 40 patients were randomized to undergo radiofrequency facet joint denervation under CT guidance or C-arm guidance. All patients were examined visual analogue scale (VAS) score before treatment, 1 month, and 3 months after treatment. Results: The VAS in both groups showed significant improvement over the 1-month interval. No significant difference in the VAS score among the group was observed. Conclusions: In this study there was no significant difference between CT guidance lumbar rhizotomy and C-arm guidance lumbar rhizotomy. Therefore CT-guided radiofrequency denervation of the lumbar facet joint was a minimally invasive technique that appears effective.

• The Journal of Churna Manual Medicine for Spine and Nerves
• /
• v.2 no.1
• /
• pp.49-57
• /
• 2007

Objectives : This study was performed to evaluate the effect of Bee Venom Acupuncture Therapy on Lumbar Spinal Stenosis. Methods : The patient was diagnosed as Lumbar Spinal Stenosis through Lumbar spine MRI and treated with Bee Venom Acupuncture Therapy and so on and measured of VAS and ODI score to evaluate treatment effects. Results and Conclusions : ROM of Lumbar, Milgram test and sensory test has improved. VAS and ODI score were also decreased.

• The Journal of Churna Manual Medicine for Spine and Nerves
• /
• v.3 no.1
• /
• pp.9-18
• /
• 2008

Objective : The purpose of this study is to evaluate the conservative treatment for FBSS patient. Methods : We used Herbal medication, Acupuncture, burning Acupuncture, Physical Therapy for this patient. And we measured of VAS and ODI score to evaluate treatment effects. Results : Patient's sciatica and sensory test has improved. VAS and ODI score were also decreased.

• The Journal of Korea CHUNA Manual Medicine
• /
• v.6 no.1
• /
• pp.137-146
• /
• 2005

Objective : We got a good effect on one patient who was diagnosed Fibromyalgia. Method : We treated 1 case of Fibromyalgia with acupuncture, moxibustion, herbal medication, and iontophoresis. We measured the VAS(Visual Analog Scale) and ROM(Range of motion) of Lumbar. Results : Patient's met complain is low back pain, pain and hemiparesis of night lower limb, and Pantalgia After treatment, most symptoms decreased and ROM, ambulation improved. VAS score changed from 10 to 2 for 52 days. Conclusion : The Fibromyalgia were successfully treated by acupuncture, moxibustion, herbal medication, and iontophoresis.