• Journal of International Academy of Physical Therapy Research
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• v.10 no.2
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• pp.1785-1790
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• 2019

Background: Lumbar disc herniation (LDH) causes neurological symptoms by compression of the dura mater and nerve roots. Due to the changed in proprioception inputs that can result in abnormal postural pattern, delayed reaction time, and changed in deep tendon reflex. Objective: To investigate the effects of lumbar stabilization exercises on motor neuron excitability and neurological symptoms in patients with LDH. Design: Randomized Controlled Trial (single blind) Methods: Thirty patients with LDH were recruited; they were randomly divided into the balance center stabilization resistance exercise group (n=15) and the Nordic walking group (n=15). Each group underwent their corresponding 20-minute intervention once a day, four times a week, for four weeks. Participants' motor neuron excitability and low back pain were assessed before and after the four-week intervention. Results: There were significant differences in all variables within each group (p<.05). There were significant differences between the experimental and control groups in the changes of upper motor neuron excitability and pain (p<.05), but not in the changes of lower motor neuron excitability and Korean Oswestry Disability Index. Conclusion: Lumbar stabilization exercises utilizing concurrent contraction of deep and superficial muscles improved low back function in patients with LDH by lowering upper motor neuron excitability than compared to exercises actively moving the limbs. Lumbar stabilization exercises without pain have a positive impact on improving motor neuron excitability.

• Korean Journal of Acupuncture
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• v.38 no.3
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• pp.189-195
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• 2021

Foot drop due to lumbar disc herniation is perceived to be an indication for surgery. A 44-year-old male presented with motor deficit in left ankle dorsiflexion along with radiating pain and paraesthesia. Motion Style Acupuncture Therapy (MSAT) was administered on the left side every other day. Acupuncture and Chuna were performed daily. Herbal medicine was taken 3 times a day. His symptoms rapidly improved throughout treatment, verified by decreased Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), increased 5-level EuroQol-5 Dimension (EQ-5D-5L) scores, and improved motor grades. We suggest that a combination of MSAT with traditional Korean medicine could be a favorable option for foot drop in LDH patients in terms of rapid pain reduction and the improvement of quality of life.

• Journal of Acupuncture Research
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• v.32 no.2
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• pp.23-33
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• 2015

Objectives : This study was designed to assess the general distribution and clinical effectiveness of Korean medical treatment on lumbar disc herniation. Methods : This is an observational study. 72 patients admitted to Daejeon Jaseng Hospital of Korean Medicine with a diagnosis of herniated intervertebral disc(HIVD) by lumbar-CT of lumbar-MRI were observed from July, 2014 to April, 2015. They were analyzed according to sex, age, the period of disease, causal factors, symptoms on admission, admission day, disc herniation type and treatment efficacy. All patients received a combination of treatments during hospitalization, including acupuncture, Chuna, herbal medicines and physical therapy. A zero to ten numerating rating scale(NRS) assessing pain, Oswestry disability index(ODI) and EuroQol-5 dimension(EQ-5D) was used before and after treatments. Results : Average admission duration was $28.00{\pm}12.85$ days in lumbar disc patients. For lumbar patients, lower back pain NRS decreased from $5.89{\pm}2.00$ to $3.42{\pm}1.87$(p<0.001) and radiating pain from $5.96{\pm}2.12$ to $3.38{\pm}1.83$(p<0.001). ODI decreased from $46.69{\pm}19.25$ to $35.69{\pm}16.67$(p<0.001), and EQ-5D index increased from $0.63{\pm}0.26$ to $0.71{\pm}0.20$(p<0.05) after treatment in lumbar disc patients. Conclusions : Korean medical combination treatment might be effective in reducing pain and improving quality of life for patients with lumbar disc herniation. This study further confirmed the efficacy of Korean medical treatment on HIVD.

• The Journal of Korean Physical Therapy
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• v.21 no.3
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• pp.9-16
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• 2009

Purpose: The purpose of this study was to investigate the effects of intermittent lumbar traction and manual traction on a $L_{4-5}$ herniated disc. Method: The subjects were randomly divided into the intermittent lumbar traction group (n=10) and the manual traction group (n=10). The intermittent traction group had traction-treatment applied for 12 times in the first two weeks, and then 6 times in the next two weeks. The time the traction was applied was for 30 minutes. The manual traction group had flexion-distraction therapy applied for 12 times in first two weeks, and for 6 times in next two weeks. The time the traction was applied was 3 to 6 minutes per treatment. Results: The change of the muscle test (MT), the disc herniation index (DHI) and the sagittal $T_2$ weighted MRI was measured at pretreatment and 4weeks and 12weeks after treatment. Conclusion: We found that intermittent lumbar traction and manual traction could improved the MT and DHI and this could improve the rehabilitation of patients with lumbar herniated disc.

• Journal of Korean Medicine Rehabilitation
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• v.18 no.1
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• pp.153-161
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• 2008

Objectives : To investigate therapeutic outcomes of back pain modalities in patients with disc hemiation; Korean medical treatments(Herbal medicine, chuna therapy, acupuncture, bee-venom acupuncture.). Methods : Operation(OP) recommended 20 patients with lumbar disc hemiation were treated with chuna therapy, acupuncture, bee-venom acupuncture one times a week and took herbal medicine after a meal two times daily. The patients' symptoms were assessed 1 week, 2 week, 4 week, 6 week, 8 week by Visual analogue scale(VAS), Oswestry disability index(ODI), 36-Item short-form health survey(SF-36). Results : 1. VAS(LBP and Sciatica) score was significantly improved after 8 weeks (P<0.05). 2. ODI, SF-36 score was significantly improved after 8 weeks (P<0.05). 3 There were significant changes in physical functioning(PF), bodily pain(BP), social functioning(SF), role emotinal(RE), mental health(MH) score of SF-36 after 8 weeks (P<0.05). Conclusions : This study suggests that Korean medical treatment(Herbal medicine, chuna therapy, acupuncture, bee-venom acupuncture) can be applicable to improve symptoms in patients with lumbar disc herniation.

• Journal of Korean Neurosurgical Society
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• v.59 no.2
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• pp.143-148
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• 2016

Objective : We evaluated postoperative outcomes in patients who have lumbar foraminal or extraforaminal disc herniation (FELDH) and suggested the risk factors for poor outcomes. Methods : A total of 234 patients were selected for this study. Pre- and post-operative Visual Analogue Scale (VAS) and Korean version Oswestry Disability Index (KODI) were evaluated and the changes of both score were calculated. Outcome was defined as excellent, good, fair, and poor based on Mcnab classification. The percentage of superior facetectomy was calculated by using the Maro-view 5.4 Picture Archiving Communication System (PACS). Results : Paramedian lumbar discectomy was performed in 180 patients and combined lumbar discectomy was performed in 54 patients. Paramedian lumbar discectomy group showed better outcome compared with combined discectomy group. p value of VAS change was 0.009 and KODI was 0.013. The average percentage of superior facetectomy was 33% (range, 0-79%) and it showed negative correlation with VAS and KODI changes (Pearson coefficient : -0.446 and -0.498, respectively). Excellent or good outcome cases (Group I) were 136 (58.1%) and fair or poor outcome cases (Group II) were 98 (41.9%). The percentage of superior facetectomy was 26.5% at Group I and 42.5% at Group II. There was significant difference in superior facetectomy percentage between Group I and II (p=0.000). Conclusion : This study demonstrated that paramedian lumbar discectomy with preservation of facet joints is an effective and good procedure for FELDH. At least 60% of facet should be preserved for excellent or good outcomes.

• Journal of Korean Neurosurgical Society
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• v.61 no.5
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• pp.600-607
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• 2018

Objective : It has been reported in recent studies that 50-80% of patients with cervical disc hernia have concomitant sleep disorders. The aim of this study was to evaluate the quality of sleep before and after surgical treatment in patients with cervical disc hernia and to assess the effects on treatment. Methods : The study included 32 patients performed discectomy and fusion with an intervertebral cage through the right anterior cervical approach. Oswestry Disability Index (ODI), Visual Analog Scale (VAS) and Pittsburgh Sleep Quality Index (PSQI) were applied to all patients preoperatively and at one month postoperatively. Results : The postoperative PSQI total points and all the PSQI subscale points, the ODI and VAS scores were significantly reduced compared to the preoperative values. A positive correlation was determined between the preoperative ODI points and the PSQI total points and sleep duration, sleep latency and daytime functional loss subscale points. A positive correlation was also found between preoperative ODI points and VAS points. A positive correlation was determined between the preoperative VAS points and and the PSQI total points and sleep duration, and sleep latency subscale points. A negative correlation was determined between the postoperative ODI and the daytime functional loss subscale points. Conclusion : The results of the study showed that in patients with cervical disc hernia, sleep quality and daytime functionality were negatively affected by severity of pain that limited daily activities. Bringing the pain under control with surgical treatment was observed to increase sleep quality. It can be concluded that when planning treatment for these patients, it should be taken into consideration that there could be a sleep disorder in addition to the complaints and symptoms such as pain, hypoestesia and loss of strength.

• The Korean Journal of Pain
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• v.31 no.2
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• pp.109-115
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• 2018

Background: Patients with lumbar disc herniation are treated with physiotherapy/medication and some with surgery. However, even after technically successful surgery some develop a failed back syndrome with persistent pain. Our aim was to evaluate the efficacy of epiduroscopy in patients who suffer chronic low back pain and/or radicular pain with or without surgery and the gender difference in outcome. Methods: A total of 88 patients were included with a mean age of 52 years (27-82), 54 women and 34 men. 66 of them were operated previously and 22 were non-operated. They all had persistent chronic back pain and radicular pain despite of medication and physical rehabilitation. Visual Analog Scale (VAS) for pain and Oswestry Disability Index (ODI) were evaluated preoperatively, after one month, six months and one-year after the epiduroscopy. Results: All patients, and also the subgroups (gender and operated/non-operated) improved significantly in pain (VAS) and disability (ODI) at one month. A significant improvement was also seen at one year. No differences were found between men and woman at the different follow-up times. A slight worsening in VAS and ODI was noticed over time except for the non-operated group. Conclusions: Epiduroscopy helps to improve the back and leg pain due to lumbar disc herniation in the early stage. At one year an improvement still exists, and the non-operated group seems to benefit most of the procedure.

• Journal of the Korean Data and Information Science Society
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• v.23 no.4
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• pp.727-738
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• 2012

The purpose of the present study was to determine the effect of a 4 week course of Cox distraction manipulation (CDM) combined with therapeutic modalities on the treatment of patients with L4-5 herniated nucleus pulposus (HNP). A total of 15 patients with L4-5 HNP (mean age, 37.76 years; age range 20-50years) participated in the study. A 4 week course of CDM combined with therapeutic modalities was delivered to the patients for 6 days per week for the first two weeks, and three times per week for two additional weeks. The entire treatment consisted of 18 visits over 4 week period. Comparisons of changes in the muscle strengthening (MS), straight leg raise (SLR), and oswestry disability index (ODI) at pre-intervention, after two weeks treatment sessions, and at discharge (after 18 treatment sessions) were analyzed. Comparisons of changes in the disc herniation index (DHI) at pre-intervention and at discharge were analyzed using the paired t-test. There were significant improvements in the outcome measures of MS Ibs, SLR test, and ODI score after 2 weeks and 4 weeks sessions of CDM combined with therapeutic modalities as compared with the pre-intervention. However, no significant different pre-test and post-test DHI. CDM combined with therapeutic modalities appears to be a safe and efficacious, noninvasive treatment modality for patients with L4-5 HNP.

• Journal of Acupuncture Research
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• v.21 no.5
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• pp.79-99
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• 2004

Objective : This study was designed to find out the effect of scolopendrid aquacupuncture classified by the type of HIVD(Herniation of Inter-Vertebral Disc) in lumbar spine. Methods : The 50 patients who had a diagnosis of HIVD by lumbar-CT or lumbar-MRI and admitted to Gwangju oriental medical hospital in wonkwang university from June 2003 to March 2004 were observed. The symptom of inpatients is low back pain with or without sciatica. We treated 50 patients by scolopendrid aquacupuncture besides the general consevative treatment of oriental medicine. Results and Conclusion : The scolopendrid aquacupuncture treatment led to improvement in the pain and symptom of HIVD as determined by all efficacy measures. After scolopendrid aquacupuncture treatment, there was improvement in VAS, oswestry disability index, ROM and SLRT. The improvement index of scolopendrid aquacupuncture treatment classified by the type of HIVD showed that the effects of scolopendrid aquacupuncture had correlation with the type of HIVD. The more the herniation of intervertebral disc decreased, the more the effect of scolopendrid aquacupuncture increased. This results suggest that scolopendrid aquacupuncture is good method for treatment of HIVD but we have to consider the clinical correlation with the degree of herniation.