• Title/Summary/Keyword: herniated disc

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The Usefulness of Intraoperative Myelography during Spinal Surgery (수술중 시행한 척수 조영술의 유용성)

  • Yoon, Sung-Hoon;Yi, Jin-Seok;Jang, Ha-Sung;Lee, Hung-Jin;Yang, Ji-Ho;Lee, Il-Woo;Kang, Joon-Ki
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup2
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    • pp.322-327
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    • 2001
  • Objectives : There are many kinds of method to evaluate neural decompression during operation. They are direct visual and manual inspection, intraoperative ultrasound, endoscope, intraoperative computed tomography and intraoperative myelography. We used intraoperative myelography to evaluate the proper decompression of neural elements during the decompressive surgery. Methods : We injected 10-20cc of nonionic water-soluble contrast materials through direct puncture site of exposed dura during operation or lower lumbar level or lumbar drain inserted preoperatively. 12 patients were included in this study. They were 7 patients of centrally herniated lumbar disc disease, 1 patient of multiple lumbar spinal stenosis, 2 patients of thoracic extradural tumor and 2 cervical fracture & dislocations. Results : 5 of 12 patients showed remained neural compression through intraoperative myelography, so they were operated further through other approach. Myelographic dye is heavier than CSF, so the dependent side of subarachnoid space was visualized only. In one case, CSF leakage through hemovac was detected, but it was treated only bed rest for 5 days after hemovac removal. Conclusion :Intraoperative myelography is an effective method to evaluate neural decompression during spinal surgery. This technique is easy and familiar to us, neurosurgeons.

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Surgical Treatment of a Chordoma Arising from the Second Thoracic Vertebral Body through the Modified Anterior Approach - Case Report - (전방 접근법으로 제거한 제2흉추 척삭종 - 증 례 보 고 -)

  • Lee, Jong-Won;Kim, Young-Baeg;Park, Seung-Won;Hwang, Sung-Nam;Choi, Duck-Young
    • Journal of Korean Neurosurgical Society
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    • v.29 no.4
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    • pp.574-579
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    • 2000
  • Chordomas are rare central nervous system tumors that are found predominantly in the sacrococcygeal(50%) and basiosphenoidal region(35%). Most of the remainder are related to the vertebral bodies and only 1 to 2% of them are known to occur in the thoracic vertebrae. A 15-year-old girl was admitted because of paraparesis. Three months prior to admission, she underwent a lumbar laminectomy at other hospital for the treatment of herniated lumbar disc but paraparesis became rather aggravated after the operation. At admission, MRI showed a low signal T1WI, high signal T2WI mass compressing the cord at T2 vertebral body. The tumor was subtotally removed via costotransversectomy but as the tumor was proven to be a chordoma, a second stage operation via anterior route was followed. At second operation, T2 corpectomy and T1-T3 plate fixation with autogeneous ileac bone graft was performed. Shortly after the operation, preoperative paraparesis disappeared completely and no evidence of tumor recurrence was noticed both clinically and radiologically for next 2 years. Spine surgery at cervicothoracic junction may be technically demanding due to anatomical complexity and hindering large vessels. The authers reviewed this case with special emphasis on the surgical procedure in this region.

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Graphic-based guidance point display system design for obtaining and improving lumbar exercise effect (요추 운동효과 향상을 위한 그래픽 기반 유도점 표시 시스템 설계)

  • Shin, Seong-Yoon;Lee, Hyun-Chang
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.25 no.2
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    • pp.208-213
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    • 2021
  • The use of computers has increased greatly, and services have been developed very much for the convenience of users. As the use of computers increases, human activity has declined, and symptoms of deterioration in health are increasing. As the time to sit and live increased, humans are more exposed to diseases of low back pain, and low back pain includes pain related to the lower back centering on the herniated disc. Most of the back pain is caused by abnormalities in the muscles and ligaments that support the spine and trunk. In this paper, we present an overall design for developing an app that can obtain lumbar exercise effects to reduce low back pain or help treatment. In order to use this effectively, we propose a plan to obtain lumbar exercise effect, and aim to present an app design that can help effectively treat low back pain by using graphic-based guidance points.

Case Report of Voiding Dysfunction Treated with Korean Medicine in a Hospitalized Patient with a Herniated Intervertebral Disc (한방병원에 입원한 배뇨장애를 동반한 추간판탈출증 환자에 대한 한방 치료 1례)

  • Kong, Geon-sik;Song, Jin-young;Kim, So-won;Park, Jin-hun;Wang, Yen-min;Kim, Sang-yoon;Park, Sung-hwan;Kang, Man-ho;Eom, Guk-hyeon;Lee, Hyung-chul
    • The Journal of Internal Korean Medicine
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    • v.42 no.2
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    • pp.86-94
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    • 2021
  • Objectives: The purpose of this study is to report on the efficacy of Korean medical treatment for voiding dysfunction. Methods: We treated a patient with voiding dysfunction using Korean medical treatments (herbal medicines, acupuncture, and herbal acupuncture therapy). To evaluate the results of this treatment, we measured the international prostate symptom score (IPSS) and the visual analog scale (VAS) for residual urination, dysuria, and miction pain. The general health status was evaluated with the European quality of life-5 dimensions (EQ-5d) scale. Results: We observed improvements in the IPSS and the EQ-5d scale after the treatments. Changes in the VAS reflected relief of residual urination and dysuria but not miction pain. Conclusions: This study suggests that Korean medicine may be effective to treat voiding dysfunction.

Correlation between Epidurographic Contrast Flow Patterns and Clinical Effectiveness in Chronic Lumbar Discogenic Radicular Pain Treated with Epidural Steroid Injections Via Different Approaches

  • Gupta, Ruchi;Singh, Saru;Kaur, Sukhdeep;Singh, Kulvinder;Aujla, Kuljeet
    • The Korean Journal of Pain
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    • v.27 no.4
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    • pp.353-359
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    • 2014
  • Background: Epidural steroid injections are an accepted procedure for the conservative management of chronic backache caused by lumbar disc pathology. The purpose of this study was to evaluate the epidurographic findings for the midline, transforaminal and parasagittal approaches in lumbar epidural steroid injections, and correlating them with the clinical improvement. Methods: Sixty chronic lower back pain patients with unilateral radiculitis from a herniated/degenerated disc were enrolled. After screening the patients according to the exclusion criteria and randomly allocating them to 3 groups of 20 patients, fluoroscopic contrast enhanced epidural steroids were injected via midline (group 1), transforaminal (group 2) and parasagittal interlaminar (group 3) approaches at the level of the pathology. The fluoroscopic patterns of the three groups were studied and correlated with the clinical improvement measured by the VAS over the next 3 months; any incidences of complications were recorded. Results: The transforaminal group presented better results in terms of VAS reduction than the midline and parasagittal approach groups (P < 0.05). The epidurography showed a better ventral spread for both the transforaminal (P < 0.001) and the paramedian approaches (P < 0.05), as compared to the midline approach. The nerve root filling was greater in the transforaminal group (P < 0.001) than in the other two groups. The ventral spread of the contrast agent was associated with improvement in the VAS score and this difference was statistically significant in group 1 (P < 0.05), and highly significant in groups 2 and 3 (P < 0.001). In all the groups, any complications observed were transient and minor. Conclusions: The midline and paramedian approaches are technically easier and statistically comparable, but clinically less efficacious than the transforaminal approach. The incidence of ventral spread and nerve root delineation show a definite correlation with clinical improvement. However, an longer follow-up period is advisable for a better evaluation of the actual outcom.

Statistical Study of the Ferguson's Angle, Lumbar Gravity Line and Lumbar Lordotic Angle in HIVD Patients. (요추간판탈출증 환자의 요천각, 요추중력중심선 및 요추전만각의 통계적 관찰)

  • Koh, Dong-Hyun;Hong, Soon-Sung;Lee, Jin-Ho;Jung, Sung-Yub;Shin, Joon-Shik
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.2 no.2
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    • pp.17-32
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    • 2007
  • Objectives : The lumbosacral joint is unstable area from an anatomical viewpoint, while it is also a very mobile area in ordinary life, so that clinically major causes of low back pain originate in this joint. The purpose of this study is to assess the difference of the Ferguson's angles, Lumbar gravity lines, Lumbar lordotic angles among Herniated of Intervertebral Disc(HIVD) patients. Methods : We analyzed the lateral view of lumbar spine checked at erect position on 88 patients who had been diagnosed as HIVD by Magnetic Resonance Imaging(MRI). We investigated the Ferguson's angle, Lumbar gravity line, Lumbar lordotic angle on X-ray film. Results and Conclusions : In the acute lumbago group the Ferguson's angle had a tendency to decrease, while in the chronic group it had a tendency to increase. In the acute lumbago group the Lumbar gravity line fell in front of the normal range(sacrum), while in the chronic group it fell behind the normal range(sacrum). In the acute lumbago group the Lumbar lordotic angle usually decreased, while in the chronic group it increased. The Ferguson's angle and the Lumbar gravity line, the Ferguson's angle and the Lumbar lordotic angle, the Lumbar gravity line and Lumbar lordotic angle each had a positive realtionship. The Ferguson's angle, the Lumbar gravity line and the Lumbar lordotic angle was less influenced by the level of HIVD and was more influenced by how long the patient had the pain. The correlationship between each factor was less in the chronic lumbago group than the acute group. In the chronic lumbago group the instability of the lumbosacral joint increased, while in the acute group the compression of the weight on the sacrum increased.

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Isokinetic Evaluation of Trunk Flexors and Trunk Extensors in Normal Adult Subjects and Patients with Post-operative Herniated Intervertebral Lumbar Disc (정상 성인남자와 요추간판탈출증 수술후 성인남자의 요추부 굴곡근 및 신전근의 등속성 근력평가)

  • Oh Seung-Kil
    • The Journal of Korean Physical Therapy
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    • v.10 no.1
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    • pp.81-98
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    • 1998
  • Isokinetic evaluation of trunk flexors and trunk extensors was performed at $60^{\circ}/sec\;and\;120^{\circ}/sec$ of angular velocity by using cybex 6000TEF Unit on 31 healthy male white workers and 15 post-operative HILD patients with no significant difference in mean age and mean body weight between two groups, and compared each other. The purpose of this study is to obtain the isokinetic normative strength values and endurance latins for Dunk extensors and trunk flexors, and is to provide a guideline for rehabilitation program of post-operative HILD patients. The collected data were analyzed by ANOVA, Duncan's Nyktuoke Range Test, and Pearson correlation coefficiency in PC-SAS program, The results obtained were as follow ; 1. Post-operative subjects has lower isokinetic values than normal subjects in peak torque, peak torque $\%$ by body weight, total work, total work $\%$ by body weight, average power, average power $\%$ by body weight, TAAE of trunk flexors and trunk extensors, and there are significant differences with statistic value in trunk extensors at $60^{\circ}/sec$ and in trunk flexors and trunk extensors at $120^{\circ}/sec$ between two groups(p<0.05). 2. Pest-ooperative subjects has lower values for angle of peak torque than normal subjects in trunk extensors, and there are significant differences with statistic value at $60^{\circ}/sec$ and $120^{\circ}/sec$ between two groups. 3. Post-operative subjects has higher values for endurance ratios than normal subjects in trunk extensors and flexors, but there are no significant differences with statistic value between two groups. 4. Post-operative subjects has higher values than normal subjects in peak torque ratios, total work ratios, average power ratios of trunk flexors to trunk extensors, and there are significant differences with statistic value between two groups(p<0.01). 5. There is significant positive-correlation with statistic valve between peak torque and height and body weight in normal subjects(p<0.05), but Thjere is significant negative-correlation between peak torque of trunk extensor at $120^{\circ}/sec$ and age (p<0.05). 6. There is significant positive-correlation with statistic value between peak torque of trunk flexors and body weight in post-operative subjects (p<0.05), but There is significant negative-correlation between peak torque of trunk extensor add age (p<0.05). In conclusion, post-operative subjects have greater weakness in trunk musculature than normal subjects, especially there is more significant weakness in trunk extensors than in trunk flexors

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Systematic Review of High Frequency of Acupuncture Point and Self Exercise Therapy for Lower Back Pain (요통 치료의 빈용 경혈과 자가 운동 요법에 대한 체계적 문헌 고찰)

  • Nam, Dae-Jin;Huh, Gun;Lee, Hyung-Eun;Choi, Bo-Mi;Lee, Jung-Min;Lee, Eun-Jung;Oh, Min-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.4
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    • pp.59-71
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    • 2013
  • Objectives The aim of this review is to figure out which acupoints are frequently used to treat low back pain and which exercises are effective to low back pain. Methods We searched the three electronic database (RISS, KISS, KTKP) and manually checked related Korean journals and reference lists up to June 2013. We investigated the frequency of acupoints for using treatment of low back pain. We Introduce exercise therapies we can do easily at home without professional skills for treatment low back pain. Results We included 72 articles in this study. The most frequently adopted acupoints were BL25, BL23, BL24, GB30, BL40, BL26, BL60, GB34, BL52, BL57, GB39. The most frequently adopted meridian pathways were BL, GB, GV, ST. The most frequently adopted disease causing low back pain were HIVD (Herniated intervertebral disc), Lumbar sprain, Spinal stenosis, Compression fracture, Cauda equina syndrome, Spondylolisthesis, Ankylosing spondylitis. There are many exercise therapies (Lumbar stabilizing exercise, Resistance exercise, Bareunmom physical exercise, Mckenzie exercise, Williams exercise, Emblass exercise, Swiss ball exercise, Thera band exercise, Yoga) for treatment low back pain. Conclusions These results suggest that most frequently adopted acupoints were foot taeyang urinary bladder channel acupoints. Beacuse foot taeyang urinary bladder channel is passes through the waist, it will be effective for treatment of low back pain. Also exercise therapy is effective for enhance Muscular strength. In order to treatment of low back pain, Acupuncture treatment is also important, as well as exercise therapy.

Narrative Review of Clinical Trial on Scolopendrid Pharmacopuncture in Korean Literature (국내 데이터 베이스 검색을 통한 오공 약침 시술에 대한 임상 논문고찰)

  • Jo, Dong-Chan;Lee, Jin-Hyun;Kim, Chang-Gon;Jung, Woo-Seok;Moon, Su-Jeong;Park, Tae-Yong;Lee, Jung-Han
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.4
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    • pp.73-82
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    • 2013
  • Objectives The purpose of this review is to investigate studies of Scolopendrid pharmacopuncture and the evidence of it's effects in order to suggest a better research method in the future. Methods We retrieved numbers of clinical studies about Scolopendrid pharmacopuncture from 7 Korean web databases, using key words such as 'Scolopendrid', 'Scolopendrid AND Pharmacopuncture'. This study had been conducted from 1st May 2013 to 31th July 2013. Controlled studies and case studies were only used for this study. Clinical studies that we picked from the databases were classified according to the diseases that those studies are about, and from these clinical studies, we are to research what has to be improved generally in clinical researches. Results 18 case studies, 4 controlled studies had been under research. Scolopendrid pharmacopuncture has a therapeutic effect mainly in musculoskeletal and neurological diseases such as herniated intervertebral disc, carpal tunnel syndrome, swollen leg, feeling of cold on legs, wrist ganglion, lateral epicondylitis, radial nerve palsy, cervical myelopathy, cauda equina syndrome, postauricular pain; as an early symptom of Bell's palsy, pain of popliteal part, gout, plantar fasciitis, cellulitis, frozen shoulder, pain of hip adductors. However objectivity and reliability of the Scolopendrid pharmacopuncture studies still remains controversial. Conclusions It has been suggested that there are positive effects of Scolopendrid pharmacopuncture therapy in treating specific diseases (especially neuromusculoskeletal diseases). However, this narrative review can't conclude and prove that the Scolopendrid pharmacopuncture has positive effectiveness on these diseases unlike systematic review. So, in order to put Scolopendrid pharmacopuncture therapy to use for many kinds of diseases in more reasonable ways, it is essential to build well-designed clinical research tools. In the future, abundant case studies, more follow-up trials and randomized controlled trials based on the korean medicine should be done to use Scolopendrid pharmacopuncture for a clinical purpose.

Radiological Findings of Relation Between Intercrestal Line and HIVD of Lumbar Spine (Intercrestal line 높이와 요추 추간판 탈출증의 상관관계에 대한 영상학적 연구)

  • Choo, Won-Jung;Kim, Min-Yeong;Seo, Min-Soo;Lee, Cha-Ro;Choi, Hee-Seung;Choi, Young-Il;Nam, Hang-Woo
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.6 no.2
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    • pp.53-60
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    • 2011
  • Objectives : The purpose of this study is to find out the relation between the height of intercrestal line, and HIVD(Herniated Intervertebral Disc)of Lumbar spine. Methods : We investigated 445 cases (208 male, 237 female) of patients who were diagnosed as HIVD of L-spine at either L4/5 or L5/S1 level. We analysed the relation between the height of intercrestal line and the level of HIVD. Results : 1. Among 445 cases, the level of intercrestal line with HIVD of L-spine at the specific location was different between male and female. In male, the intercrestal line is more likely to be located at L4 level, while in female more likely to be located at L5 level. 2. Among 445 cases, L5/S1 HIVD patients(272, 61.1%) were more than L4/5 HIVD patients(173, 38.9%). At L4 body area, L4/5 HIVD patients were more than L5/S1 HIVD patients, however, at L4/5 intervertebral area and L5 body area, L5/S1 HIVD patients were more than L4/5 HIVD patients. (p<0.01) 3. When the line is located at higher level, HIVD of L-spine tends to be occurred at L4/5 level. Contrastly, when the line is located at lower level, HIVD of L-spine tends to be occurred at L5/S1 level. (p<0.01) Conclusions : High intercrestal line leads to L4/5 HIVD, while low intercrestal line leads to L5/S1 HIVD. Possibly, it is caused by different length and thickness of the iliolumbar ligament.

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