• 보건의료산업학회지
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• 제8권1호
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• pp.151-164
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• 2014

This study was conducted to investigate the effect of timing of surgery on outcomes of spine operated patients for lumbar herniated intervertebral disc. The research design was cohort study and based on the data of claims for the medical expenses of health insurance. 21,475 cases who had primary spine surgery between January 1, and December 31, 2003, observed to conservative treatment period in the past two years from preoperative primary diagnosis to timing of primary surgery. According to one and five year follow up monitoring, the probability of occurrence of reoperation was not statistically significant with preoperative duration of symptom. Also one year follow up, the probability of occurrence of complication, was not statistically significant with preoperative duration of symptom. But five year follow up, groups who had one to two month preoperative duration of symptom decreased complication rate than less than a month(95%CI:0.594-0.927). Thus, from the onset of symptoms of back pain before primary surgery with enough and adequate time observation is required. Also, medical consumers or providers to choose surgery in determining prudence is required.

• Journal of Acupuncture Research
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• 제17권3호
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• pp.265-276
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• 2000

1997년 11월 1일부터 2000년 6월30일까지 원광대 부속 광주 한방병원 침구과에 요추 추간판 탈출증으로 진단받고 다른 합병증이 발견되지 않은 311례의 입원치료한 환자를 대상으로 보존적 치료를 하였으나, 전혀 호전되지 않았거나 통증만 약간 감소하였던 환자 6례를 분석 검토한 결과, 다음과 같은 결론을 얻었다. 1. 4례에서 large herination이고 2례에서 medium herniation으로 대부분 탈출량이 많았다. 2. 6례 모두에서 하지직거상검사의 각도가 낮았으며 퇴원시까지 호전되지 않았다. 3. X-ray상, 6례 모두에서 straightening되어 있었고, 6례중 3례에서 disc space가 좁아져 있었다. 4. 통증이 심한 4례중 3례에서 측만증이 동반되었다. 발병일이 최소 30일부터 최고 7년까지로 오래되었다. 6. 환자들은 10대에서 30대까지로 연령층이 젊은 편이었다. 7. 입원기간이 최소 32일부터 최대 105일까지로 긴 편이었다. 총괄하면, 상기 6례는 디스크 탈출량이 많았고, 하지직거상검사상 각도가 낮았으며, 연령층이 젊었고, x-ray상 straightening되어 있었다.

• The Korean Journal of Pain
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• 제22권1호
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• pp.99-103
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• 2009

We studied the historical changes of intervertebral disc displacement using magnetic resonance imaging. The phenomenon of the spontaneous regression of herniated discs is well known. The case of a 40-years-old male presenting with a large disc herniation at L5-S1, experiencing severe sciatic pain, and having the straight leg raising test positive at 25 degrees is presented. The extruded disc was documented by clinical examination. He was treated conservatively with epidural steroid injection (ESI), medication, physical therapy and self-exercise and reevaluated in 10 weeks later, 30 and 1 year. Large extruded disc can be treated successfully by physical therapy with ESI. However, the degeneration and the dehydration of disc result in decrease of disc height. Consequently, the regression of extruded disc might have been due to the resorption and the dehydration.

• 대한한방내과학회지
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• 제39권5호
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• pp.994-1003
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• 2018

Objective: The aim of this study was to report a clinical case suggesting the potential effects of traditional Korean medicine for the treatment of sporadic spinocerebellar ataxia in a patient with herniated intervertebral lumbar discs. Methods: The patient was treated with a series of Korean medicine treatments including the herbal medicine Zhenganxifeng-tang-gagam, acupuncture, pharmacoacupuncture, and electroacupuncture along with herniated intervertebral lumbar disc treatments. Results: Improvements of Numeric rating scale (NRS) and European Quality of Life-5 Dimensions (EQ-5D) score were observed after the treatment. Conclusion: Traditional Korean medicine has potential benefits for sporadic spinocerebellar ataxia patients with herniated intervertebral lumbar discs.

• 척추신경추나의학회지
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• 제5권2호
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• pp.127-134
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• 2010

요추부 한 분절 유합술 이후 발생한 추간판 탈출증으로 내원한 외래 환자 1례에 한방치료를 적용하여 요통 및 하지방사통 통증 감소와 요추부 관절가동범위(ROM) 증가에 유의한 효과를 보였기에 보고하는 바이다.

• Journal of Acupuncture Research
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• 제32권2호
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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 Korean Journal of Pain
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• 제19권2호
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• pp.278-281
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• 2006

The diagnosis of pyomyositis in the pelvic region is difficult, as its incidence is relatively, with symptoms that mimic those of discogenic pain. Sciatica is a common presentation of a prolapsed lumbar disc. Less common causes, such as spinal stenosis, pelvic tumors or even primary nerve tumors can also cause these symptoms. Magnetic resonance imaging (MRI) is a useful diagnostic tool. Herein, the case of a patient with an acute pyogenic infection in the iliopsoas muscle, presenting with sciatica, is reported. This is a rare infective disease, which if promptly treated with intravenous antibiotics, can be completely resolved; otherwise, it can result in deep abscess formation, sepsis and death.

• Journal of Korean Neurosurgical Society
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• 제53권1호
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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.

• 척추신경추나의학회지
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• 제4권2호
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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.

• Journal of Korean Neurosurgical Society
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• 제60권1호
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• pp.40-46
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• 2017

Objective: To assess role of some inflammatory mediators in patients with primary and recurrent lumbar disc herniation. Expression of IL-6, transforming growth factor (TGF)-1, insulin-like growth factor (IGF)-1, and Bcl-2-associated X protein (BAX) have been shown to be more intense in the primary group than the recurrent goup, but this mediators may be important aspects prognostic. Methods: 19 patients underwent primary and revision operations between June 1, 2009 and June 1, 2014, and they were included in this study. The 19 patients' intervertebral disc specimens obtained from the primary procedures and reoperations were evaluated. Expression of IL-6, TGF-1, IGF-1, and BAX were examined immunohistochemically in the 38 biopsy tissues obtained from the primary and recurrent herniated intervertebral discs during the operation. Results: For IL-6 expression in the intervertebral disc specimens, there was no difference between the groups. The immunohistochemical study showed that the intervertebral disc specimens in the primary group were stained intensely by TGF-1 compared with the recurrent group. Expression of IGF-1 in the primary group was found moderate. In contrast, in the recurrent group of patients was mild expression of IGF-1. The primary group intervertebral disc specimens were stained moderately by BAX compared with the recurrent group. Conclusion: The results of our prognostic evaluation of patients in the recurrent group who were operated due to disc herniation suggest that mediators may be important parameters.