• The Korean Journal of Pain
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• 제34권4호
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• pp.454-462
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• 2021

Background: This study was performed to reveal the relationships between the cross-sectional areas (CSAs) of the paraspinal muscles and the severity of low back pain (LBP), including the level of disability. Methods: This single-center cross-sectional study was conducted on 164 patients with chronic LBP. The effects of demographic characteristics, posture, level of physical activity, disc herniation type, and sarcopenia risk on the CSAs of paraspinal muscles were evaluated along with the relationship between the CSAs and severity of pain and disability in all patients. The CSAs of paraspinal muscles were evaluated using the software program Image J 1.53. Results: A negative significant correlation was found between age and the paraspinal muscle's CSA (P < 0.05), whereas a positive correlation was present between the level of physical activity and the CSA of the paraspinal muscle at the L2-3 and L3-4 levels. The CSAs of paraspinal muscles in patients with sarcopenia risk was significantly lower than those in patients without sarcopenia risk (P < 0.05). The CSAs of paraspinal muscles at the L2-3 and L3-4 levels in obese patients were significantly higher than those in overweight patients (P = 0.028, P = 0.026, respectively). There was no relationship between the CSAs of paraspinal muscles and pain intensity or disability. Conclusions: Although this study did not find a relationship between paraspinal CSAs and pain or disability, treatment regimens for preventing paraspinal muscles from atrophy may aid pain physicians in relieving pain, restoring function, and preventing recurrence in patients with chronic LBP.

• 한국운동역학회지
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• 제29권1호
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• pp.23-32
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• 2019

Objective: The aim of this study was to provide kinematic data on the characteristics of spinal disease patients by comparing and analyzing kinematic variables related to foot balance and gait pattern of spinal disease. Method: The subjects of the study included 40 adult men and 60 adult women who visited the hospital in Busan. Patients who were diagnosed with spinal disease by a physician through X-ray examination were selected as subjects for the diagnosis of vertebral disc herniation, spinal stenosis, spinal disease diagnosed with spinal disease and the general public. Left and right foot pressure and contact area were checked by Gaitview pro meter. X-ray photographs were taken with a Zen-2090 mobile fluoroscopy under physicians' direct participation. One-way ANOVA was performed to compare the differences between the kinematic variables and post-hoc was performed by the Duncan method. Results: The difference in contact area between the left foot and the right foot was $115.30{\pm}14.15cm^2$ in the left side and $124.25{\pm}13.65cm^2$ in the left side in the spinal disease patients. The difference in pressure between the left and right side of the spinal disease patients was wider than that of the general people. Especially, the right side of the spinal disease patients showed a larger area of left foot contact than the general population. Conclusion: Spinal disease patients have wider contact area of the left foot than those of the general population. In the case of right spinal disease, the left foot support area is widened due to pain. In the gait, women showed slightly more posterior body center than men, and the upper body muscle imbalance and immobilization due to the spinal disease caused imbalance of the muscles moving to the lower limb, It was analyzed to inhibit movement.

• 대한한방내과학회지
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• 제42권5호
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• pp.767-776
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• 2021

Objective: This study examined a case in which insomnia and pain due to herniated intervertebral disks were improved by treatment with an oriental herbal and the administration of Uhwangchungsim-won. Case Summary: Three patients with insomnia diagnosed with herniated intervertebral disks were treated with a series of Korean medical therapies, including the herbal medication Uhwangchungsim-won, acupuncture, herbal acupuncture, and physical therapy. We used the Numerical Rating Scale (NRS) to measure subjective sleep states and the European Quality of Life Five Dimensions (EQ-5d) Scale to evaluate the therapeutic effect. Following treatment, subjective sleep states and the overall scores for pain had improved. Conclusion: The results indicate that Korean medical therapies with Uhwangchungsim-won have beneficial effects on insomnia for patients with herniated intervertebral disks.

• Journal of Acupuncture Research
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• 제38권2호
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• pp.146-158
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• 2021

Background: This study was designed to statistically analyze the year, gender, age, insurance type, and condition/disease of patients who were admitted to the Department of Acupuncture and Moxibustion Medicine at DaeJeon Korean Medicine Hospital over a 5-year period (2015-2020). Methods: Patients who visited the Department of Acupuncture and Moxibustion Medicine at DaeJeon Korean Medicine Hospital were classified according to year, gender, age, insurance type, and condition/disease. The statistical analysis was performed using IBM SPSS 23.0. Results: There is an increasing number of patients attending the Department of Acupuncture and Moxibustion Medicine year-on-year over the 5-year period, with a higher frequency of females than males each year. The largest age groups represented in these patients were those aged in their 50s, followed by those aged in their 40s, and 60s. Furthermore, the number of patients using health insurance was greater than those using automobile insurance each year. Of the 5,061 patients, the most common group was the patients (n = 991) who reported sprain and strain of cervical spine, followed by lumbar spine, lumbar herniation of the intervertebral disc, and facial paralysis. Conclusion: The number of patients seeking traditional Korean medicine treatment continues to increase, particularly in the 40s to 60s age group, with a larger proportion using health insurance and sprain or strain of the cervical spine. The results of this study may be used as a local (Daejeon) reference to develop Korean medicine policies, such as setting up medical benefits for patients using Korean medicine hospitals.

• Journal of Trauma and Injury
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• 제35권1호
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• pp.56-60
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• 2022

The most common cause of foot drop is lumbar degenerative disc herniation, particularly at L4/5. We present a rare case of spinal cord injury accompanied by a thoracolumbar lesion that presented with bilateral foot drop. A 69-year-old male patient presented with sudden-onset severe bilateral leg pain and bilateral foot drop. Radiologic findings revealed T12 spondylitis compressing the conus medullaris. He had undergone vertebroplasty for a T12 compression fracture after a fall 6 months before. A physical examination showed bilateral foot drop, paresthesia of both L5 dermatomes, increased deep tendon reflex, and a positive Babinski sign. An acute bilateral L5 root lesion and a conus medullaris lesion were suspected based on electromyography. A surgical procedure was done for decompression and reconstruction. After the operation, bilateral lower extremity muscle strength recovered to a good grade from the trace grade, and the patient could walk without a cane. The current case is a very rare report of bilateral foot drop associated with T12 infectious spondylitis after vertebroplasty. It is essential to keep in mind that lesions of the thoracolumbar junction can cause atypical neurological symptoms. Furthermore, understanding the conus medullaris and nerve root anatomy at the T12-L1 level will be helpful for treating patients with atypical neurological symptoms.

• 디지털정책학회지
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• 제3권1호
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• pp.21-25
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• 2024

본 연구는 엉치엉덩관절의 불안정성에 초점을 맞춘 테이핑 방법이 요통에 도움이 될 수 있는 잠재 중재 방법인지에 대해 고려해 보고자 한 사례연구이다. 해당 사례는 58세 과거 디스크탈출증 및 협착증으로 인해 허리 수술 병력이 있는 남성이 지속적인 통증 감소를 위해 참여한 테이핑 교육 세션에서 나타난 주목할 만한 결과를 사례로 정리하였다. 중재 방법으로 테잎을 엉치뼈 2~4사이에 가시결절로부터 양쪽으로 80%< 장력으로 늘려 엉치엉덩관절을 지나게 붙이고 이후 끝 쪽은 양쪽 약 45° 방향으로 올려 중간볼기근(gluteus medius m.) 쪽으로 향하게 붙였다. 그 다음 엉덩뼈능선(iliac crest)로부터 척추기립근을 따라 10번째 갈비뼈 수준까지 이르는 양쪽 테이핑 방법이 적용되었다. 해당 중재를 통해 VAS와 ODI 두 검사도구로부터 VAS는 5에서 0, 장애지수는 13에서 0으로 각각 기록되는 긍정적 사례 결과를 관찰할 수 있었다.

• 대한정형외과 초음파학회지
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• 제7권2호
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• pp.113-119
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• 2014

목적: 제 1천추 신경근 증상을 호소하는 추간판 탈출증 환자 및 척추 협착증 환자에서 초음파를 이용한 선택적 신경근 차단술을 실시하여 고식적인 방사선 영상 증폭기를 이용한 방법과 비교하여 그 결과 및 정확성에 대해 알아보고자 하였다. 대상 및 방법: 2012년 2월부터 2013년 12월까지 요추 추간판 탈출증이나 척추 협착증으로 발생한 하지 방사통을 주소로 내원한 환자 중 제1 천추 신경근 차단술을 시술 받은 38명을 대상으로 후향적으로 평가하였다. 초음파를 이용하여 시행한 18명(A군)과 방사선 영상 증폭기를 이용한 20명(B군)을 1개월 추시 관찰하였다. 효과 판정은 통증의 변화를 평가하기 위한 도구로 시각통증척도(VAS, Visual Analogue Scale)와 기능을 평가하기 위한 도구로 요통 기능장애척도(K-MODI, Korean Modified Oswestry Disability Index)를 이용하였으며, 각 시술 소요 시간을 확인하였다. 결과: VAS 점수는 A군에서 시술 전 $7.40{\pm}0.85$, 시술 1개월 후 $4.7{\pm}1.43$로 나타났고, B군에서 시술 전 $7.39{\pm}1.02$, 시술 1개월 후 $4.36{\pm}1.64$로 두 군 모두 유의한 감소를 보였다. 소요 시간은 A군이 $477.53{\pm}115.02$초, B군이 $492.47{\pm}144.38$초로 유의한 차이를 보이지 않았다. K-MODI는 A군에서 시술 전 $72.8{\pm}12.3$에서 시술 1개월 후 $43.3{\pm}10.3$로 나타났고, B군에서 시술 전 $73.8{\pm}11.5$에서 시술 1개월 후 $44.1{\pm}11.2$로 두 군 모두 유의한 감소를 보였다. 그러나 두 군 사이에서 VAS 점수 및 K-MODI 비교는 유의한 차이는 없었다. 결론: 초음파를 이용한 제 1천추 신경근 차단술은 방사선 영상 증폭기를 이용한 고식적인 방법에 비해 임상 결과 및 소요 시간에 차이는 없으나, 외래에서 간단히 시술 할 수 있는 장점이 있어 추간판 탈출증이나 척추 협착증 환자에서 유용한 시술 방법으로 사료된다.

• 동의생리병리학회지
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• 제27권3호
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• pp.280-288
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• 2013

Hua-Tuo(145-208) created five "WuQinXi" exercise by imitating the movements of a tiger, a deer, a bear, a monkey and a bird. The "WuQinXi" exercise, one of the medical Qi-gongs, is an exercise maximizing human's self healing power and has been effective significantly at several modern researches. There are many exercise therapies in western medcine, such as Willamss flexion exercise, Mckenzie's extension exercise, vertebral stabilization exercise and so on. However, there isn't a special exercise therapy which can be applied for medical practice in oriental medicine. So We selected some motions from "WuQinXi" exercise, which are suitable for lumbar spinal disease, and analyzed them. After that, We assorted them by kinds of lumbar spinal disease. First, We selected 22 motions which are related with lumbar movements from 3 type "WuQinXi" exercises ; 10 mode, 15 mode, 18 mode. And then, We classified them according to lumbar movements as flexion, extention, lateral bending and rotation, and also functions as stabilization and rubbing. Next, with these classifications, We assorted those motions by kinds of lumbar spinal disease as HIVD(herniation of intervertebral disc), spinal stenosis, spondylolysis and spondylolisthesis, facet joint syndrome, compression fracture and spondylosis. We expect that trying "WuQinXi" exercise at clinic in this way, the particular exercise therapy of oriental medicine, "WuQinXi" exercise will become more popular. And Oriental medical doctors will be able to teach patients "WuQinXi" exercise's motions easily at clinic, depending on kinds of lumbar spinal disease each patient suffers from. We plan to study more about 20 mode, 30 mode, 40 mode and the effect of "WuQinXi" exercise by comparing patients who do the "WuQinXi" exercise with the patients who do the western medical exercise therapy.

• Journal of Korean Neurosurgical Society
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• 제52권4호
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• pp.359-364
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• 2012

Objective : Transpedicular screw fixation has some disadvantages such as postoperative back pain through wide muscle dissection, long operative time, and cephalad adjacent segmental degeneration (ASD). The purposes of this study are investigation and comparison of radiological and clinical results between interspinous fusion device (IFD) and pedicle screw. Methods : From Jan. 2008 to Aug. 2009, 40 patients underwent spinal fusion with IFD combined with posterior lumbar interbody fusion (PLIF). In same study period, 36 patients underwent spinal fusion with pedicle screw fixation as control group. Dynamic lateral radiographs, visual analogue scale (VAS), and Korean version of the Oswestry disability index (K-ODI) scores were evaluated in both groups. Results : The lumbar spine diseases in the IFD group were as followings; spinal stenosis in 26, degenerative spondylolisthesis in 12, and intervertebral disc herniation in 2. The mean follow up period was 14.24 months (range; 12 to 22 months) in the IFD group and 18.3 months (range; 12 to 28 months) in pedicle screw group. The mean VAS scores was preoperatively $7.16{\pm}2.1$ and $8.03{\pm}2.3$ in the IFD and pedicle screw groups, respectively, and improved postoperatively to $1.3{\pm}2.9$ and $1.2{\pm}3.2$ in 1-year follow ups (p<0.05). The K-ODI was decreased significantly in an equal amount in both groups one year postoperatively (p<0.05). The statistics revealed a higher incidence of ASD in pedicle screw group than the IFD group (p=0.029) Conclusion : Posterior IFD has several advantages over the pedicle screw fixation in terms of skin incision, muscle dissection and short operative time and less intraoperative estimated blood loss. The IFD with PLIF may be a favorable technique to replace the pedicle screw fixation in selective case.

• Journal of Korean Neurosurgical Society
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• 제63권6호
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• pp.806-813
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• 2020

Objective : Lumbar disc herniation (LDH) is a common disease, and lumbar discectomy (LD) is a common neurosurgical procedure. However, there is little previous data on return to work (RTW) after LD. This study investigated the period until the RTW after LD prospectively. Clinically, the pain state at the time of RTW also checked. RTW failure rate 6 months after surgery also investigated. Methods : Patients with daily/regular jobs undergoing LD between September 2014 and December 2018 were enrolled. Pain was assessed by the Oswestri Disability Index (ODI) and the Numeric Rate Scale (NRS). Employment type was divided into self-employed, regular and contracted. Monthly telephone interviews were conducted to check RTW status and self-estimated work capability after surgery. Results : Sixty-seven patients enrolled in this study. Three patients failed to RTW, and three others resigned within 6 months after surgery. The preoperative NRS and ODI were 7.2±1.2 and 22.1±7.9, respectively. The average time to RTW was 5.1±6.0 weeks. At RTW, NRS was 1.5±1.8 and ODI was 6.3±3.9. Amongst patients that successfully returned to work were 16 self-employed workers, 42 regular employees, and three contracted workers. The time to RTW of self-employed, regular, and contracted workers were 5.9±8.8, 4.2±4.3 and 13.3±2.3 weeks, respectively (p=0.011). Thirty-six of the patients that returned to work self-reported a 22.8±15.6% reduction in work capability at 6 months. Conclusion : RTW may vary depending on the employment status. In this study, we found that while employment type may affect the length to RTW, most patients were able to RTW and >40% of patients reported no loss of work capabilities 6 months postoperatively, hopefully alleviating some patient hesitation towards LD.