• Title/Summary/Keyword: herniated lumbar disc patients

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Two Cases of Patients Visiting with Herniated Intervertebral Disc of Lumbar Spine Showing Symptoms Opposed to Radiological Findings (영상 의학적 소견과 상반된 증상으로 내원한 요추 추간판탈출증 환자 2례)

  • Kim, Eun-Seok;Han, Kyung-Wan;Lee, Han;Jung, Ho-Suk;Lee, Hyo-Eun;Cho, Jae-Hee;Kim, Chang-Youn
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.4 no.2
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    • pp.185-196
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    • 2009
  • Objective: The purpose of this study is to investigate the effects of oriental medicine conservative treatment on patients who show symptoms at the legion opposed to that shown in Magnetic Resonance Image(MRI) findings. Subject & Method: Oriental medicine treatment such as acupuncture and herbs was applied to two patients who were diagnosed as lateral herniated intervertebral disc of lumbar spine via MRI but whose pain and muscular force attenuation were shown at the opposed lower limb, for measuring its effects. Results: As for the two cases, the patients were favored in the Visual Analog Score (VAS) and the Straight leg Raising(SLR) test after the oriental medicine conservative treatment. In one case, the muscular force in the lower limb was favored. Conclusion: Based on the results in this study, oriental medicine conservative treatment might be effective on patients who show symptoms at the legion opposed to that shown in MRI findings.

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Transdural Nerve Rootlet Entrapment in the Intervertebral Disc Space through Minimal Dural Tear : Report of 4 Cases

  • Choi, Jeong Hoon;Kim, Jin-Sung;Jang, Jee-Soo;Lee, Dong Yeob
    • Journal of Korean Neurosurgical Society
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    • v.53 no.1
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    • pp.52-56
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    • 2013
  • Four patients underwent lumbar surgery. In all four patients, the dura was minimally torn during the operation. However, none exhibited signs of postoperative cerebrospinal fluid leakage. In each case, a few days after the operation, the patient suddenly experienced severe recurring pain in the leg. Repeat magnetic resonance imaging showed transdural nerve rootlets entrapped in the intervertebral disc space. On exploration, ventral dural tears and transdural nerve rootlet entrapment were confirmed. Midline durotomy, herniated rootlet repositioning, and ventral dural tear repair were performed, and patients' symptoms improved after rootlet repositioning. Even with minimal dural tearing, nerve rootlets may become entrapped, resulting in severe recurring symptoms. Therefore, the dural tear must be identified and repaired during the first operation.

The effects of lumbar extensors strengthening program on low back muscle power and mass, pain, return to work of patients who took laser operation for herniated lumbar disc (요부신전강화 운동프로그램이 단순추간판탈출증 수술환자의 요부근육 및 통증 그리고 사회복귀에 미치는 영향)

  • Hwang, Seong-Soo;Kim, Myung-Joon
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.10 no.2
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    • pp.45-56
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    • 2004
  • OBJECTIVE: The objective of this study was to know the effects of the postoperative lumbar extensor strengthening exercise program on back muscles strength and volume, pain, and the time of return to work. METHODS: A prospective controlled trial of lumbar extensor exercise program in patients who underwent microdiscectomy or percutaneous endoscopic discectomy for prolapsed lumbar intervertebral disc. Seventy-five patients were randomized into exercise group (20 male, 15 female) and non-exercise group (18 male, 22 female). Six weeks after surgery, patients in exercise group undertook a 12-week lumbar extension exercise (MedX) program. Assessment of spinal function was performed in all patients on postoperative 6 weeks, 18 weeks. The assessment included measures of lumbar extensor power, muscle mass of erector spinalis. All patients completed the visual analog scale (VAS) for evaluation of pain, and return to work. RESULTS: In muscle power, there were statistically significant improvements between pre and post test on muscle power in exercise group. But there were not statistically significant difference on muscle power in non-exercise group. In muscle mass, there were statistically significant difference between pre and post test on muscle mass in exercise group. But there were not statistically significant difference on muscle mass in non-exercise group. In the pain, there were statistically significant decrease between pre and post test on both group. But there were not statistically significant difference on fatty tissue and obesity in non-exercise group. The percentages of return to work in postoperative 4 months were significantly greater in the exercise group than in the non -exercise group. CONCLUSIONS: Postoperative lumbar extensor strengthening exercise program appears to be more beneficial to the patients who underwent operation for prolapsed lumbar intervertbral disc.

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The Effect of Transforaminal Epidural Block with Hyaluronidase and Triamcinolone (Hyaluronidase를 사용한 경추간공 경막외 차단의 효과)

  • Jo, Dae Hyun;Hong, Ji Hee;Kim, Myoung Hee
    • The Korean Journal of Pain
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    • v.18 no.2
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    • pp.176-180
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    • 2005
  • Background: Epidural steroid injections benefit certain patients with radicular pain, and often have only a limited duration. We compared the efficacy of hyaluronidase and triamcinolone and triamcinolone alone in patients with lumbar herniated disc disease treated with transforaminal epidural block. Methods: Forty patients who had undergone a transforaminal epidural injection were retrospectively reviewed. The T group received triamcinolone and local anesthetics; whereas, the HT group received hyaluronidase, triamcinolone and local anesthetics. We evaluated the improvement as being good, moderate, mild or no improvement, and in those where the improvement was good or moderate, also evaluated the duration of pain relief. Data were collected from the medical records of patients or via phone calls, which were analyzed using Student t- and chi-squared tests. A value of P < 0.05 was considered significant. Results: There were no significant differences in the degree of pain improvement or duration of pain relief between the two groups. Conclusions: A hyaluronidase and triamcinolone injection during transforaminal epidural block has on benefit with respect to the degree of pain improvement or its duration compared to a triamcinolone only injection.

Effects of Daoyin Exercise Therapy Combined with Korean Medicine Treatment on the Pain and Function Improvement of Low Back Pain Patients Diagnosed with Lumbar Disc Herniation : A Retrospective Observational Study (한방 복합치료를 병행한 도인운동요법이 요추추간판탈출증을 진단받은 요통 환자의 통증 및 기능 개선에 미치는 영향 : 후향적 관찰연구)

  • Kim, Yeon Hee;Lee, Jung Min;Lee, Eun Jung;Oh, Min Seok
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.31 no.4
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    • pp.238-245
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    • 2017
  • This retrospective observational study was aimed to evaluate that Daoyin Exercise therapy improves the symptoms related to lumbar disc herniation. We analyzed the medical records of 7 patients, who satisfied with inclusion and exclusion criteria. The subjects of the study were the patients who were prescribed Daoyin Exercise Therapy and Korean medical treatments for lumbar intervertebral disc herniation at Dunsan Korean Medicine Hospital of Daejeon University from July 25th, 2016 to March 31th, 2017. The effects of Daoyin Exercise Therapy was evaluated by comparing before and after taking Daoyin Exercise Therapy through 0-10 Numeric Rating Scale(NRS), Roland & Morris Disability Questionnaire(RMDQ), Trunk Extension Flexion(TEF) Program, EuroQol five Demension Questionnaire(EQ-5D, EQVAS) of the symptoms including lower back pain. The Daoyin Exercise Therapy combined with Korean medicine treatment reduced NRS($3.357{\pm}3.038$) and RMDQ($9.50{\pm}6.364$), and improved Muscle endurance($44.429{\pm}45.136$), EQ-5D($0.09{\pm}0.12$) and EQVAS($6.571{\pm}19.260$) of the 7 patients without side effects. These results implied that Daoyin Exercise Therapy might helps to improve symptoms of patients with lumbar disc herniation by reducing the symptoms of lower back pain and improving muscle endurance, quality of life, strength enhancement and core muscles.

A Case Report of Diabetes Mellitus with Herniated Intervertebral Lumbar Discs Improved by Korean Medicine Treatment (요추 추간판탈출증을 동반한 당뇨병 환자에 대한 한방 치험 1례)

  • Han, Dong-geun;Choi, A-ryun;Jung, You-jin;Kang, Ah-hyun;Seo, Hye-jin;Sung, Jae-yeon;Lee, Hyung-chul;Eom, Gook-hyun;Song, Woo-sub
    • The Journal of Internal Korean Medicine
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    • v.38 no.5
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    • pp.828-833
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    • 2017
  • Objective: The aim of this study was to evaluate the effects of traditional Korean medicine as a treatment for diabetes mellitus with herniated intervertebral lumbar discs. Method: The patients were treated with the herbal medicine Jungso-tang to reduce serum glucose (FBS/PP2hrs) and HbA1c to improve diabetes mellitus in parallel with lumbar herniated intervertebral disc treatment. Results: The treatment with Jungso-tang decreased the serum glucose (FBS/PP2hrs) and HbA1c levels. Conclusion: Korean medicine may be an effective treatment for diabetes mellitus with lumbar herniated intervertebral disc.

Effects of Shinchubogun-tang and Common Korean Medicine Treatment on Symptom Reduction in Patients with Intervertebral Lumbar Disc Herniation (신추보건탕 및 한방공통치료가 요추추간판탈출증 환자의 증상 호전에 미치는 영향)

  • Lee, Eun-Jung;Choi, Jeong June;Jang, Eunsu;Park, Yang-chun;Jung, In Chul
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.30 no.1
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    • pp.66-72
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    • 2016
  • This retrospective observational study was aimed to assess that Shinchubogun-tang (Shenzhuibujian-tang ; SBT) improves the symptoms related to lumbar disc herniation. We analyzed the medical records of 36 patients, who were satisfied with inclusion and exclusion criteria. The patients were diagnosed with lumbar disc herniation and prescribed with SBT in addition to Korean medical common treatments at Dunsan Korean Medicine Hospital of Daejeon University from January 1st, 2013 to November 30th, 2015. The effects of SBT was evaluated by comparing before and after taking SBT through 0-10 visual analogue scale(VAS) of the symptoms including lower back pain, radiating pain, and lower extremity numbness. The average period of common Korean medicine treatment before SBT prescription was 9.78 days and then the patients received SBT along with common Korean medicine treatment for 13.17 days on average. SBT plus common korean medicine treatment group significantly decreased VAS score of lower back pain from 5.40±1.62 to 3.28±1.70 (p<0.01), radiating pain from 5.60±1.42 to 2.35±1.79 (p<0.01), lower extremity numbness from 5.77±1.52 to 2.55±1.85(p<0.01). These results demonstrated that SBT might have a potential on improvement of lumbar disc herniation by reducing the symptoms of lower back pain, radiating pain, and lower extremity numbness.

Changes on Magnetic resonance imaging in lumbar disc herniations treated with oriental medicine (한의학적 치료법으로 호전된 요추 추간판 탈출증 환자의 영상의학적 변화)

  • Kim, Wu-Young;Han, Sang-Yup;Kim, Ki-Yuk;Kong, Duck-Hyun;Lee, Hyun-Jong;Kim, Chang-Youn;Nam, Hang-Woo
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.4 no.1
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    • pp.31-41
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    • 2009
  • Objectives: The aim of this study was to evaluate the evolution of lumbar disc herniation in patients treated with oriental medicine. Methods: 14patients(15 cases) with lumbar disc herniation proved at MRI(Magnetic resonance imaging) underwent a follow-up MRI study. Follow-up MRI was performed $4{\sim}14$months(mean 7 months) after initial MRI. Results & Conclusions: 1. 13 cases(87%) had reduction of disc herniation. 1 showed no change in amount of disc herniation. 1 had an increase in disc herniation. 2. Comparison initial MRI with follow-up MRI showed that 2 of the herniations decreased between 0% and 25%, 3 decreased between 25% and 50%, 5 decreased between 50% and 75%, 3 decreased between 75% and 100%. The size of the herniation decreased on average by 49% in 14patients(15 cases). 3. On axial images, the proportion of the cross-sectional area of the spinal canal occupied by the herniated disc was 54.41% on the average on the initial scan, 29.65% on the follow-up scan.

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Lumbar herniated disc: spontaneous regression

  • Altun, Idiris;Yuksel, Kasim Zafer
    • The Korean Journal of Pain
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    • v.30 no.1
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    • pp.44-50
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    • 2017
  • Background: Low back pain is a frequent condition that results in substantial disability and causes admission of patients to neurosurgery clinics. To evaluate and present the therapeutic outcomes in lumbar disc hernia (LDH) patients treated by means of a conservative approach, consisting of bed rest and medical therapy. Methods: This retrospective cohort was carried out in the neurosurgery departments of hospitals in KahramanmaraŞ city and 23 patients diagnosed with LDH at the levels of L3-L4, L4-L5 or L5-S1 were enrolled. Results: The average age was $38.4{\pm}8.0$ and the chief complaint was low back pain and sciatica radiating to one or both lower extremities. Conservative treatment was administered. Neurological examination findings, durations of treatment and intervals until symptomatic recovery were recorded. $Las{\grave{e}}gue$ tests and neurosensory examination revealed that mild neurological deficits existed in 16 of our patients. Previously, 5 patients had received physiotherapy and 7 patients had been on medical treatment. The number of patients with LDH at the level of L3-L4, L4-L5, and L5-S1 were 1, 13, and 9, respectively. All patients reported that they had benefit from medical treatment and bed rest, and radiologic improvement was observed simultaneously on MRI scans. The average duration until symptomatic recovery and/or regression of LDH symptoms was $13.6{\pm}5.4$ months (range: 5-22). Conclusions: It should be kept in mind that lumbar disc hernias could regress with medical treatment and rest without surgery, and there should be an awareness that these patients could recover radiologically. This condition must be taken into account during decision making for surgical intervention in LDH patients devoid of indications for emergent surgery.

A Modified Approach of Percutaneous Endoscopic Lumbar Discectomy (PELD) for Far Lateral Disc Herniation at L5-S1 with Foot Drop

  • Chun, Eun Hee;Park, Hahck Soo
    • The Korean Journal of Pain
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    • v.29 no.1
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    • pp.57-61
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    • 2016
  • Foraminal or extraforaminal Far Lateral Disc Herniations (FLDH) extending into or beyond the foraminal zone have been recognized as between 7-12% of all lumbosacral disc herniations. Conventional posterior laminectomy may not provide good access to a herniation that lies far lateral to the lateral margin of the pedicle. Use of the endoscopic technique through a percutaneous approach to treat such FLDH patients can decrease the surgical morbidity while achieving better outcomes. We made an effort to utilize the advantages of percutaneous endoscopic lumbar discectomy (PELD) and to determine the appropriate approach for FLDH at the level between the 5th Lumbar and first Sacral vertebrae(L5-S1). The authors present a case of an endoscopically resected lumbar extruded disc of the left extraforaminal zone with superior foraminal migration at the level of L5-S1, which had led to foot drop, while placing the endoscope in the anterior epidural space without facetectomy.