• Title/Summary/Keyword: herniated nucleus pulposus

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Expression of MCP-1 in Spinal Dorsal Horn in a Rat Model of Lumbar Disc Herniation (추간판 탈출증 흰 쥐 모델에서 척수후각에서의 MCP-1의 발현)

  • Cho, Yun-Woo;Park, Hea-Woon;Kim, Su-Jeong;Seo, Jeong-Min;Do, Sung-Jin;Ahn, Sang-Ho
    • The Journal of Korean Physical Therapy
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    • v.21 no.3
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    • pp.95-102
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    • 2009
  • Purpose: This study evaluates MCP-1 expression in the dorsal horn of a rat model of lumbar disc herniation by an autograft of the nucleus pulposus to the spinal nerve. Methods: After a coccygeal nucleus pulposus graft to the left $5^{th}$ lumbar spinal nerve, proximal to dorsal root ganglion, mechanical allodynia and thermal hyperalgesia were assessed 1 day before surgery, and 1, 10, 20, 30 days after surgery. The mRNA of MCP-1 in the dorsal horn was assessed by real time PCR to compare the temporal pattern of neuropathic pain of the lumbar disc herniation model. Results: In the ipsilateral side of the lumbar disc herniation models, mechanical allodynia and thermal hyperalgesia reached a maximum at 10 days after surgery with significant difference from the control group. Pain was also provoked in the contralateral side of the lumbar disc herniation models with less intensity than the ipsilateral side. The level of MCP-1 mRNA expression in the dorsal horn reached a peak at 20 days after surgery. Conclusion: Mechanical allodynia and thermal hyperalgesia was induced by nucleus pulposus in a rat lumbar disc herniation model, similar to a previously reported peripheral nerve injury model. The level of MCP-1 expression was higher in the dorsal horn of the ipsilateral and contralateral sides. These results suggest that MCP-1 might play a role in the maintenance of neuropathic pain.

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The Spontaneous Regression of Lumbar Disc Herniation: 3 Cases Report (요추간판 탈출의 자연적 축소(3례 증례보고))

  • Kwon, Won-An;Kim, Han-Soo
    • The Journal of Korean Physical Therapy
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    • v.20 no.3
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    • pp.69-74
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    • 2008
  • Purpose: The majority of patients with radiculopathy caused by a herniated nucleus pulposus (HNP) heal spontaneously without surgery. The aim of this report is to describe the spontaneous regression of lumbar disc herniation and the results of clinical follow-up. Methods: Three patients with radiating low back pain presented with an extruded intervertebral disc on magnetic resonance imaging (MRI). We performed follow-up with conservative treatment (epidural injection, medication, physical therapy, exercise) and clinical assessments on the 6th, 10th and 22nd months. Results: The extruded intervertebral disc almost complete regressed, and correlated with clinical improvement and follow-up MRI. Conclusion: Conservative treatment can be an effective approach for a herniated lumbar discs if no neurological deficits are present.

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Treatment of the Herniated Nucleus Pulposus Syndrome by Chemonucleolysis with Chymopapain

  • Dabezies, Eugene J.
    • Journal of Biomedical Engineering Research
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    • v.5 no.2
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    • pp.111-120
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    • 1984
  • A new restoration method of chest X-ray image (dual project filter) was proposed to improve SNR (signal to noise ratio) characteristics. In this method, a priori information of system and anatomical structure and statistics of projected object are used in the design of filter. Dual projection filter varies its parameters, adapting to the local regions of chest(lungregion, mediasternum, subdiaphragm) and the structure of chest (bone, tissue, blood vessel, bronchia). The performance of Dual Projection Filter was 0.1-0.2dB better than Dual Sensor Wiener Filter, which was used for initial estimate of Dual Porjection Filter.

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Percutaneous Radiofrequency Facet Rhizotomy for Cervical Dorsal Ramus Syndrome

  • Cho, Tack-Geun;Hwang, Sung-Nam;Park, Seung-Won;Nam, Taek-Kyun;Hong, Hyun-Jong;Kim, Young-Baeg
    • Journal of Korean Neurosurgical Society
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    • v.40 no.6
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    • pp.419-422
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    • 2006
  • Objective : Radiofrequency facet rhizotomy[RFFR] has been widely performed for treatment of chronic neck pain caused by cervical dorsal ramus syndrome[CDRS]. To evaluate the therapeutic effectiveness of RFFR in the patients with CDRS, we analyzed patients with various cervical pathologic conditions. Methods : The therapeutic results in forty-four patients who underwent RFFR for CDRS from January, 2000 to December, 2002 were analyzed according to the underlying pathologic conditions causing CDRS. The pathologic conditions were sprain [33 cases], herniated nucleus pulposus [6], foraminal stenosis [4], and compression fracture [1]. The therapeutic results were evaluated one month after the operation and graded as excellent, good, fair of poor. Treatments were considered successful if the therapeutic results were graded as either excellent of good. Results : The overall success rate in all patients was 72.7%. The success fate for treatment of cases with cervical sprain was 87.9%, but treatment of cases with herniated nucleus pulposus, foraminal stenosis, and fracture showed unsatisfactory results [mean success rate was 27.3%]. Some patients complained of transient hypesthesia [4 cases] of transient dull pain at the electrode insertion sites [2 cases]. Conclusion : RFFR is an effective and safe treatment for CDRS caused by cervical sprain, regardless of the patient's age, the duration of the symptoms, and the presence of radiating pain.

Caudal Epidural Injection with a Guidewire-Reinforced Epidural Catheter in Patients with Herniated Nucleosus Pulpose (추간판 탈출증 환자에서 길잡이철사가 삽입된 경막외카테터를 이용한 미추경막외조영술)

  • Ko, Justin Sangwook;Lee, Seok Jin;Hwang, Hee Youn;Sim, Woo Seok;Choi, Soo Joo;Kim, Jie Ae;Kim, Chung Su;Hahm, Tae Soo;Kim, Gaab Soo;Cho, Hyun Sung;Kim, Tae Hyeong
    • The Korean Journal of Pain
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    • v.19 no.2
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    • pp.207-212
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    • 2006
  • Background: The epidural injection technique is a commonly used intervention in the management of chronic spinal pain, which has the advantage of delivering various drugs, such as local anesthetics or steroids, in higher concentrations to the inflamed nerve root. A guidewire-reinforced epidural catheter was introduced through a Tuohy needle during the caudal epidural procedure, with a catheter threaded into the affected nerve roots and the spread-pattern of contrast agents observed under fluoroscopy. Methods: Sixty-seven patients with low back pain, who showed evidence of a herniated nucleus pulposus on magnetic resonance imaging, were included. All patients received fluoroscopically guided caudal epidural injections, with the guidewire-reinforced epidural catheter introduced through a Tuohy needle and threaded either to the right or left side toward the target nerve roots. After confirming the catheter tip position at the affected nerve root, 2 ml increments of contrast agents (up to 6 ml) were injected, and their corresponding AP fluoroscopic views were obtained. Three radiologists reviewed all the radiographic findings and measured the proportion of the area of contrast spread at the side of target nerve roots. Results: Greater proportion of the area of contrast spread was observed at the side of the target nerve roots (P < 0.0001). At each level of contrast injection (2-⁣, 4- ⁣ and 6 ml), more than 70% of the spread of contrast dye was observed at the side of the target nerve roots in 85%, 70%, and 55% of cases, respectively. Conclusions: The combination of a caudal epidural injection and use of a guidewire-reinforced epidural catheter significantly enhances the target specificity, as revealed by the selective spread of contrast dye at the side of target nerves.

The effects of Cox distraction manipulation on functional assessment measures and disc herniation index in patients with L4-5 herniated disc (칵스 신연교정이 L4-5 추간판 탈출증 환자의 기능적 평가측정과 추간판탈출지수에 미치는 효과)

  • Kwon, Won-An;Ryu, Young-Sang;Ma, Sang-Yeol
    • 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.

The Body Deformity through LHNP Patients (요추부 추간판탈출중 환자의 신체변형에 관한 연구)

  • Moon, Sang-Eun
    • Journal of Korean Physical Therapy Science
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    • v.3 no.2
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    • pp.975-980
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    • 1996
  • The purpose of study was aimed at analysing the body deformity types through LHNP(lumbar herniated nucleus pulposus) patients without considering of lower extremity radiating pain. This study was proceeded in a time-series method through the ninety LHNP patients visited the hospital for the first time. The results were as follows. 1. Body type I : Deformity style of Lt shoulder & pelvis forward tilt 2. Body type II : Deformity style of Rt shoulder & pelvis forward tilt style 3. Body type III : Deformity style of Lt shoulder & Rt pelvis forward tilt style 4. Body type N : Deformity style of Rt shoulder & Lt pelvis forward tilt style.

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Intracranial Chronic Subdural Hematoma Presenting with Intractable Headache after Cervical Epidural Steroid Injection

  • Kim, Myungsoo;Park, Ki-Su
    • Journal of Korean Neurosurgical Society
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    • v.58 no.2
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    • pp.144-146
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    • 2015
  • Postdural punctural headache (PDPH) following spinal anesthesia is due to intracranial hypotension caused by cerebrospinal fluid (CSF) leakage, and it is occasionally accompanied by an intracranial hematoma. To the best of our knowledge, an intracranial chronic subdural hematoma (CSDH) presenting with an intractable headache after a cervical epidural steroid injection (ESI) has not been reported. A 39-year-old woman without any history of trauma underwent a cervical ESI for a herniated nucleus pulposus at the C5-6 level. One month later, she presented with a severe headache that was not relieved by analgesic medication, which changed in character from being positional to non-positional during the preceding month. Brain magnetic resonance imaging revealed a CSDH along the left convexity. Emergency burr-hole drainage was performed and the headache abated. This report indicates that an intracranial CSDH should be considered a possible complication after ESI. In addition, the event of an intractable and changing PDPH after ESI suggests further evaluation for diagnosis of an intracranial hematoma.

A Case Report of HNP at L-spine during Pregnancy (임신 중 요추간판 탈출증 환자에 대한 증례 보고)

  • Cho, Hye-Sook
    • The Journal of Korean Obstetrics and Gynecology
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    • v.25 no.4
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    • pp.161-170
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    • 2012
  • Purpose: This study was to report the effect and safety of oriental medical treament in the pregnant woman diagnosed to herniated of nucleus pulposus(HNP) at L-spine. Methods: The patient was diagnosed with HNP at L-spine during Pregnancy. She was treated by herb medicine, acupuncture and moxibustion. Their symptoms was disappeared. Results: After treatment, most symptoms decreased, VAS score changed 10 to 2, ODI changed 41 to 20. Conclusions: The oriental medical treament(herb medicine, acupuncture and moxibustion) relieves HNP at L-spine during Pregnancy.

The Effects of Self Sling Suspension on the Cervical Angle: Case Study (슬링현수 자가 운동이 경추각도에 미치는 영향: 사례연구)

  • Jeong, Seong-gwan;Kim, Yong-jin
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.25 no.1
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    • pp.77-81
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    • 2019
  • Background: The Purpose of this study was investigated the effects of the Self Sling Suspension on the numbness, radiated pain, visual analogue scale (VAS), Cobb's angle, Jochumsen's depth, neck disabliity index (NDI). Methods: This study was carried out with a 4 forward head posture (FHP) & 4 herniated nucleus pulposus (HNP) survivors. Outcomes such as the Numbness, Radiated Pain, VAS, Cobb's angle, Jochumsen's depth and NDI were measured pre- and post-intervention for both groups. Results: 2 HNP decrease was found numbness & radiated pain. After the intervention, was decreased VAS, NDI and was increased Cobb's angle, Jochumsen's depth. Conclusions: Applying Self Sling Suspension treatment to FHP & HNP patients proved to have a positive effect.