• Journal of Korean Neurosurgical Society
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• v.29 no.5
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• pp.628-634
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• 2000

Objective : The introduction of MRI makes it easy to detect multiple lumbar disc herniation. However, MRI is not a physiologic test for detecting the symptomatic level. For the surgical plan, it is very important to determine the symtomatic level among the multiple lumbar disc herniation. In this regard, we studied diagnostic significance of discography on multiple lumbar disc herniation in determining the symptomatic level. Method and Material : We retrospectvely analyzed the discographic and clinical findings of 121 patients with multiple lumbar disc herniation for investigating the diagnostic availability of discography. All were surgically treated from January 1995 through May 1998. Result : Discography provocated the same pain as usual symptom in 99 out of 121 patients(81.8%). Compared with surgical findings, the diagnostic accuracy of the discography in multiple lumbar disc herniation was 75.6%, sensitivity was 64.6%, and specificity 87.2%. There was no correlation between the pain provocation of discography and the extent of annular degeneration on CT/discogram. The pain provocation showed good correlation with the extent of annular disruption on CT/discogram. The rate of same result(correlation rate) between the discography and D.I.T.I was 81.4% in multiple lumbar disc herniation patients with unilateral leg pain. Conclusion : These results indicate that in multiple lumbar disc herniation, the discography is considered useful diagnostic tool to determine the symptomatic level and to decide the surgical plan.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.11 no.2
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• pp.57-64
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• 2016

This is a case report about left leg radiating pain treated with complex traditional Korean medical intervention, while the case did not responded to prolotherapy and extracorporeal shock wave treatment for lumbar herniated intervertebral disc (HIVD). The patient was diagnosed with a piriformis problem after a physical examination and was treated with lumbar and piriformis muscle treatment. After 9 sessions of treatment for 33 days, Numeric Rating Scale (NRS) for pain has been decreased from 8 to 3. Further studies with more cases and longer observation period should be conducted to provide evidence for optimum acupuncture procedure considering its effectiveness, safety and patients' compliance altogether.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.15 no.1
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• pp.121-134
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• 2020

Objectives : This case report describes the management of five patients suffering from nonstructural scoliosis with lumbar herniated intervertebral disc all treated with complex Korean medicine treatment. Methods : Five patients were hospitalized and treated with herbal medicine, acupuncture, pharmacopuncture, cupping, and Chuna manual therapy. Patients were assessed for Numerical Rating Scale (NRS), Oswestry Disability Index (ODI), EuroQol-FiveDimensions (EQ-5D), and Cobb's angle. Results : In all patients, NRS, ODI, and Cobb's angle decreased, while the EQ-5D score increased. Conclusions : As seen in these five cases, complex Korean medicine treatment with Chuna manual therapy has effects on the management of nonstructural scoliosis.

• Journal of Korean Neurosurgical Society
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• v.48 no.6
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• pp.501-505
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• 2010

Objective : This study was undertaken to compare the diagnostic performances of magnetic resonance imaging (MRI), MR myelography (MRM) and myelography in young soldiers with a herniated lumbar disc (HLD). Methods : Sixty-five male soldiers with HLD comprised the study cohort. A visual analogue scale for low back pain (VAS-LBP), VAS for leg radiating pain (VAS-LP), and Oswestry disability index (ODI) were applied. Lumbar MR, MRM, and myelographic findings were checked and evaluated by four independent radiologists, respectively. Each radiologist was asked to score (1 to 5) the degree of disc protrusion and nerve root compression using modified grading systems devised by the North American Spine Society and Pfirrmann and the physical examination rules for conscription in the Republic of Korea. Correlated coefficients between clinical and radiological factors were calculated. Interpretational reproducibility between MRI and myelography by four bases were calculated and compared. Results : Mean patient age was $20.5{\pm}1.1$. Mean VAS-LBP and VAS-LP were $6.7{\pm}1.6$ and $7.4{\pm}1.7$, respectively. Mean ODI was $48.0{\pm}16.2%$. Mean MRI, MRM, and myelography scores were $3.3{\pm}0.9$, $3.5{\pm}1.0$, and $3.9{\pm}1.1$, respectively. All scores of diagnostic performances were significantly correlated (p < 0.05). However, none of these scores reflected the severity of patients' symptoms. There was no statistical difference of interpretational reproducibility between MRI and myelography. Conclusion : Although MRI and myelography are based on different principles, they produce similar interpretational reproducibility in young soldiers with a HLD. However, these modalities do not reflect the severity of symptoms.

• Journal of Korean Neurosurgical Society
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• v.40 no.4
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• pp.256-261
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• 2006

Objective : The goal of this study was to establish the benefit and prognostic factors of lumbar medial branch block[MBB] for low back pain. Methods : A retrospective analysis was based on the data obtained from 281 patients with low back pain, who visited our hospital between January 2001 and November 2004. Pain relief was evaluated at 2 weeks, 1 month and 3 months. The authors analyzed the results of MBB according to the patient's age, sex, symptom duration, pathologic condition, and presence of radiating pain. Results : Two hundred eighty one patients had sprain [151]. lumbar fracture [27], spinal stenosis [50], herniated lumbar disc [24] acute post-operative pain [8], and chronic post-operative pain [21] with success rate of 63.6%, 59.3%, 26.0%, 25.0%, 87.5% and 42.9%, respectively. The effects of MBB in sprain, lumbar fracture, and acute post-operative pain were significantly better than those in stenosis, herniated lumbar disc and chronic post-operative pain patients. The patients in young age group [<60 years], with short symptom duration [<6 months] and without radiating pain showed good response to lumbar MBB. Conclusion : The lumbar MBB appears to be safe and effective for low back pain in certain selected patients. Good prognostic factors were low back pain without surgical conditions and radiating pain, with short symptom duration [<6 months], and in relatively young age [<60 years] group.

• Journal of Korean Neurosurgical Society
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• v.62 no.6
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• pp.691-699
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• 2019

Objective : Lumbar discectomy is an effective treatment for lumbar disc herniation (LDH); however, up to 2-18% of patients with LDH have experienced recurrent disc herniation. The purpose of this study was to evaluate the efficacy of a novel annular closure device (ACD) for preventing LDH recurrence and re-operation compared with that of conventional lumbar discectomy (CLD). Methods : In this prospective randomized controlled trial, we compared CLD with discectomy utilizing the $Barricaid^{(R)}$ (Intrinsic Therapeutics, Inc., Woburn, MA, USA) ACD. Primary radiologic outcomes included disc height, percentage of preoperative disc height maintained, and re-herniation rates. Additional clinical outcomes included visual analog scale (VAS) scores for back and leg pain, Oswestry Disability Index (ODI) scores, and 12-item short-form health survey (SF-12) quality of life scores. Outcomes were measured at preoperation and at 1 week, 1, 3, 6, 12, and 24 months postoperation. Results : Sixty patients (30 CLD, 30 ACD) were enrolled in this study. At 24-month follow-up, the disc height in the ACD group was significantly greater than that in the CLD group ($11.4{\pm}1.5$ vs. $10.2{\pm}1.2mm$, p=0.006). Re-herniation occurred in one patient in the ACD group versus six patients in the CLD group (${\chi}^2=4.04$, p=0.044). Back and leg VAS scores, ODI scores, and SF-12 scores improved significantly in both groups compared with preoperative scores in the first 7 days following surgery and remained at significantly improved levels at a 24-month follow-up. However, no statistical difference was found between the two groups. Conclusion : Lumbar discectomy with the $Barricaid^{(R)}$ (Intrinsic Therapeutics, Inc.) ACD is more effective at maintaining disc height and preventing re-herniation compared with conventional discectomy. Our results suggest that adoption of ACD in lumbar discectomy can help improve the treatment outcome.

• The Journal of Internal Korean Medicine
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• v.21 no.1
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• pp.1-6
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• 2000

Objectives : Herniated lumbar intervertebral disc (HIVD) is one of the cause of low back pain and radiculopathy. To evaluate the efficiency of simultaneous administration of herb medicine and non-steroid-anti-inflamatory drugs (NSAIDs), we investigated 48 HIVD patients confirmed by CT or MRI and treated with acupuncture, bed rest, herb medicine, physical therapy and NSAIDs. Methods : The patients were divided into four groups as follows : The A group were 11 cases treated with only herb medicine A. The A+W group were 14 cases treated with herb medicine A and NSAIDs. The B group were 11 cases treated with herb medicine B. The B+W group were 12 cases treated with herb medicine Band NSAIDs. We evaluated the pain degree by visual analog scale (VAS). Results : The mean VAS was reduced to $4.89{\pm}2.62$ after 2 weeks therapy and pain decrease was the most prominent in the group having within a week duration ($3.25{\pm}2.49$). Pain scale was decreased to $4.57{\pm}2.95$ in A+W group, $4.91{\pm}1.97$ in A group, $4.72{\pm}2.68$ in B group, and $5.41{\pm}2.67$ in B+W group after 2 weeks therapy. Conclusions : These results indicate that oriental medical theraphy is useful enough to treat the HIVD patients and herb medicine decrease the pain of the HIVD effectively. Therefore, the more research about herb medicine for pain killing drugs should be done.

• The Journal of Korea CHUNA Manual Medicine
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• v.2 no.1
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• pp.93-109
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• 2001

Objectives : The aim of present study is to estimate clinical outcome of Chuna treatment and Chuna medicine treatment for patients with H.I.V.D(Herniated Intervertebral Disc) of lumbar spine according to the character of patients and the steps of Chuna therapy, and therefore suggest a prospective, desirable Chuna treatment and patient guidance. Methods : We investigated the 258 cases of outpatients who were diagnosed as the H.I.V.D. on lumbar C.T. or MRI and were treated more than seven times with chuna treatment and more than one time with Chuna medicine treatment In Jaseng Oriental Medicine Hospital from September 1, 1999 to December 31, 2000. We evaluated the subjective symptoms by Hudgin's classification. For the sake of the more objective evaluation for before and after treatment, we calculated the Improvement index and ratio of the four parts to estimate the pain and functional disorder In before and after treatment by Macnab's criteria. Results & Conclusion : The improvement index and ratio showed that the conservative therapy with Chuna therapy improved the symptom of H.I.V.D. much effectively, and especially in the patient groups of male, 30-39 years, standing Job, duration of symptom within one week, the 4th step of chuna treatment, the first step of chuna medicine treatment, and the excellent satisfactory assessment of Chuna treatment. Therefore, it is supposed that the conservative therapy with Chuna therapy and patient guidance should be much actively continued.

• Journal of Korean Neurosurgical Society
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• v.60 no.2
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• pp.220-224
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• 2017

Objective : This study aimed to unravel the putative mechanism underlying the neurologic deficits contralateral to the side with lumbar disc herniation (LDH) and to elucidate the treatment for this condition. Methods : From January 2009 to June 2015, 8 patients with LDH with predominantly contralateral neurologic deficits underwent surgical treatment on the side with LDH with or without decompressing the symptomatic side. A retrospective review of charts and radiological records of these 8 patients was performed. The putative mechanisms underlying the associated contralateral neurological deficits, magnetic resonance imaging (MRI), electromyography (EMG), and the adequate surgical approach are discussed here. Results : MRI revealed a similar laterally skewed paramedian disc herniation, with the apex deviated from the symptomatic side rather than directly compressing the nerve root; this condition may generate a contralateral traction force. EMG revealed radiculopathies in both sides of 6 patients and in the herniated side of 2 patients. Based on EMG findings and the existence of suspicious lateral recess stenosis of the symptomatic side, 6 patients underwent bilateral decompression of nerve roots and 2 were subjected to a microscopic discectomy to treat the asymptomatic disc herniation. No specific conditions such as venous congestion, nerve root anomaly or epidural lipomatosis were observed, which may be considered the putative pathomechanism causing the contralateral neurological deficits. The symptoms resolved significantly after surgery. Conclusion : The traction force generated on the contralateral side and lateral recess stenosis, rather than direct compression, may cause the contralateral neurologic deficits observed in LDH.

• Journal of Acupuncture Research
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• v.27 no.3
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• pp.25-33
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• 2010

Objectives : The purpose of this study is to investigate the difference of treatment effect between Oriental Medical Treatment and Oriental-Western Combination Treatment on Herniated Lumbar Disc. Methods : From 1st November, 2008 to 31th August, 2009, 18 Herniated Lumbar Disc patients who admitted the Department of Acupuncture & Moxibustion, college of Oriental medicine, Dae-gu Hanny University were divided into two groups. Group A was treated with oriental medical theraphy (Acupuncture, Moxibustion, Herb, Cupping, Physical theraphy) and Group B with both oriental medical theraphy and western medical theraphy(Acupuncture, Moxibustion, Herb, Cupping, Physical theraphy, Intramuscular injection of Dexamethasone and Dicknol 2ml). We evaluated the treatment effect of each group with the Visual Analog Scale(VAS) and Pain Rating Scale(PRS), deviding two period(From first day to fourth day after Admission and From first day to ninth day after Admission). Results : Improvement Degree of Group A and Group B was significantly improvement (p<0.05) according to the VAS & PRS. Group B showed better performance compared with Group A. Conclusions : These results proved that combination treatment of oriental and western medicine was more effective than just oriental medical treatment of Herniated Lumbar Disc. And the difference between the two groups were significant according to PRS.