• Journal of Korean Neurosurgical Society
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• v.41 no.2
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• pp.137-140
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• 2007

HNP [Herniation of the necleus pulposus] generally occurs at ventral portion of lumbar thecal sac due to the anatomical position. We report two unusual cases of herniated dorsal portion of lumbar thecal sac causing diagnostic difficulties. Two patients with posteriorly migrated epidural disc fragments were evaluated with plain X-ray, and magnetic resonance imaging. These patients responded well to operation with complete relief of symptoms. Definite diagnosis of posteriorly located disc fragments is difficult because the radiological images of disc fragments may mimic those of other more common posterior epidural lesions.

• The Journal of Korean Medicine
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• v.18 no.2
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• pp.33-42
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• 1997

The authors studied the natural evaluation of lumbar soft disc herniation in 20 patients with lumbar radiculopathy that was successfully treated with conservative theraphy only. The first computed tomography (CT) examination was performed during the acute phase of the radiculopathy, and the second performed from 3 to 24 months after healing. The initial CT allowed classification of the herniations according to size: ten were considered small. ten medium. Comparison with follow-up scans showed that 18 of Herniations decreased between 0 and 25%, two decreased between 75 and 100%.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.11 no.1
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• pp.37-48
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• 2005

Objects: This study is designed to analysis improvement and maintaince of trunk stability targeting patients who need post operative rehabilitation exercise after undergoing opened microscopic laser discectomy(OMLD) due to HNP. Method: Between March 2004 and February 2005 a total sixty patients who underwent OMLD due to $L_4/L_5$, $L_5/S_1$ HNP and who agreed to the experiment were subject for this study. Experimental group consisted of 18 subjects, and they underwent 45 minutes dynamic lumbar stabilization exercise And control group consisted of 18 subjects who conducted conservative physical therapy based on the use of physical modality for 45 minutes except to exercise. Results: Experimental group that was lumbar extensor's isometric peak torque, weight distribution of both leg, trunk muscle balance and Oswestry LBP disability index increased during 12 weeks in a statistically significant manner compared to before exercise (p<.05). When re-test was tried, isometric peak torque (p>.05) and Oswestry LBP disability index(p<.05) maintained 12th week level or improved. Weight distribution rate of both leg and trunk muscle balance maintained the level of 8th week of exercise execution(p<.05). Control group that was lumbar extensor's isometric peak torque, weight distribution rate of both leg and trunk muscle balance aggravated during 12 weeks compared to pre-test(p>.05) But, Oswestry LBP disability index increased in a statistically significant level compared to pre-test(p<.05). When re-test was tried, isometric peak torque increased slightly compared to pre-test, but decreased when at least $60^{\circ}$ flexion angle(p>.05). Weight distribution rate of both leg and trunk muscle balance also aggravated compared to pre-test(p>.05), and Oswestry LBP disability index was similar to the 4th week of physical therapy execution(p>.05). Conclusion: Successive postoperative Especially, Application of dynamic lumbar stabilization exercise program is important than traditional lumbar strengthening exercise program in the maintaince of spinal stability.

• Journal of Korean Medicine Rehabilitation
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• v.24 no.4
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• pp.117-127
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• 2014

Objectives The purpose of this study is to find out the relationship between the hip internal rotation angle and the site of herniation of single level lumbar intervertebral disc. Methods This study was carried out to 418 patients with lumbar disc herniation diagnosed by M.R.I, who visited Bu-Chun Jaseng Hospital of Korean Medicine with low back pain. Researchers measured their hip internal rotation angle and analyzed the relationship between the hip internal rotation angle and the site of herniation of single level lumbar intervertebral disc. Results 1. Excessive right internal rotation of hip joint increases risk of L5/S1 HIVD. 2. Limited left internal rotation of hip joint decreases risk of L4/L5 HIVD. 3. In cases of L4/L5 HIVD level, there was evidence that the prevalence of HNP in men was 1.85 times as higher than that in women. 4. In cases of L5/S1 HIVD level, there was the evidence that the prevalence of HNP in men was 0.64 times as lower than that in women. Conclusions In single-segment lumbar HIVD patients, limited left internal rotation of hip joint decreases risk of HIVD of L4/5 and excessive right internal rotation of hip joint mainly leads to L5/S1 HIVD.

• Journal of Acupuncture Research
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• v.26 no.1
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• pp.59-66
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• 2009

Objectives : This study was designed to evaluate clinical effects of Hua-Tuo-Jia-Ji-Xue acupuncture to the patients with herniation of nucleus pulposus(HNP) of lumbar. Methods : Total of 40 patients with HNP of lumbar were participated in this study. We divided them into two group; A group using conventional acupuncture and B group using conventional acupuncture and Hua-Tuo-Jia-Ji-Xue acupuncture at the same time. All the subjects were asked to complete the VAS(visual analogue scale) and ODI(Oswestry disability index) before and after treatment. Results : Both A and B group represented effective improvement in VAS and ODI. And, B group is more effective than A group statistically. Conclusions : A comparision of VAS and ODI results of the two groups show that Hua-Tuo-Jia-Ji-Xue acupuncture trement can give be more effective method on lumbago patients, if it is added conventional acupuncture. Further clinical studies are needed to verify these findings.

• The Journal of Korea CHUNA Manual Medicine
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• v.1 no.1
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• pp.55-65
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• 2000

The present study retrospectively investigated clinical outcome at patients with low back pain or sciatica during Chuna treatment (flexion-distraction technique). The study population consisted of 29 patients. Discogenic group consisted of 21 patients who were already diagnosed as HNP of lumbar spine with serial MRIs(magnetic resonance imaging) or CTs(computerized tomography). Simple LBP group consisted of 8 patients with low back pain & sciatica who were non-specific disorder on radiologic examination. All patients were treated with flexion-distraction technique, one of Chuna technique, under analysis of Moire Topography. And the evaluation of clinical outcome was done twice during this study by Moire Topography Analytic Point and Low Back Pain Assesment, Visual Analogue Scale. The results were summarized as follows; Total improvement rate of Moire Topography was $25.8{\pm}17.8%$, and the rate of Low Back Pain Assesment was $56.5{\pm}23.0%$, Visual Analogue Scale of post-treatment was $32.6{\pm}22.5$ Between Improvement rate of Moire Topography and improvement rate of Low Back Pain Assesment, significant correlation was proved(Person's coefficient was 0.381, p<0.05). After all, it is certain improvement of Moire Topography represents symptom's improvement.

• Journal of Acupuncture Research
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• v.20 no.5
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• pp.63-72
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• 2003

Objective : he purposes of this study are to evaluate the efficacy of Bee Venom therapy(BV) on HNP(Herniation of Nucleus Purposus) of Lumbar spine by use of Visual Analog Scale(VAS), Pain Rating Scale(PRS) and Digital Infrared Thermographic Imaging(DITI), and to investigate their correlation. Methods : We researched 20 patients who were diagnosed by MRI as having a HNP, and treated them by Oriental medical therapy(including BV) for 4 weeks. The evaluation was peformed twice(admission day and after treatment for 4 weeks), and we compared the results. Results : 1. VAS, PRS and ${\Delta}t$(by DITI) were decreased after BV for 4 weeks significantly(p<0.01). 2. There was significant correlation between VAS and PRS(p<0.05). 3. There was significant correlation between PRS and ${\Delta}t$(p<0.05). 4. There was no significant correlation between VAS and ${\Delta}t$. Conclusions : BV improved HNP subjectively and objectively, and correlation was found between VAS and PRS and between PRS and ${\Delta}t$. Further study is needed for investigating their correlation.

• Journal of Oriental Medical Thermology
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• v.3 no.1
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• pp.43-51
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• 2004

Objective : The purposes of this study are to evaluate the efficacy of Bee Venom therapy(BV) on HNP(Herniation of Nucleus Purposus) of Lumbar spine by use of Visual Analog Scale(VAS), Pain Rating Scale(PRS) and Digital Infrared Thermographic Imaging(DITI), and to investigate their correlation. Methods : We researched 20 patients who were diagnosed by MRI as having a HNP, and treated them by Oriental medical therapy(including BV) for 4 weeks. The evaluation was peformed twice(admission day and after treatment for 4 weeks), and we compared the results. Results : 1. VAS, PRS and ${\Delta}t$(by DITI) were decreased after BV for 4 weeks significantly(p<0.01). 2. There was significant correlation between VAS and PRS(p<0.05). 3. There was significant correlation between PRS and ${\Delta}t$(p<0.05). 4. There was no significant correlation between VAS and ${\Delta}t$. Conclusions : BV improved HNP subjectively and objectively, and correlation was found between VAS and PRS and between PRS and ${\Delta}t$. Further study is needed for investigating their correlation.

• The Korean Journal of Pain
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• v.11 no.2
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• pp.288-293
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• 1998

We had retrospective analysis of 421 patients who were consulted from other departments. From 1994 to 1997, these patients received nerve blocks, intravenous lidocaine infusion, lasers and so on for their pain. From these results, we are gathering information and making some recommandations. The largest percentage of patients were in their fifties with a distribution of 32.8% male and 55.1% female. The most common condition requiring treatment was low back pain 44.6%, followed by cancer pain 19.2%, cervical pain 7.4%, and shoulder pain 4.3%. In case of low back pain, the largest portion was HNP(27%), followed by spinal stenosis(16%), sprain(11%), and postlaminectomy(10%). The most common cacer was colorectal(28.4%) and the next was stomach(19.7%). The most commonly done nerve block was stellate ganglion block 32.3%, followed by lumbar epidural block 24.5% and caudal block 7.2%.

• The Korean Journal of Pain
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• v.27 no.1
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• pp.3-15
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• 2014

As our population ages and the rate of spine surgery continues to rise, the use epidural lysis of adhesions (LOA) has emerged as a popular treatment to treat spinal stenosis and failed back surgery syndrome. There is moderate evidence that percutaneous LOA is more effective than conventional ESI for both failed back surgery syndrome, spinal stenosis, and lumbar radiculopathy. For cervical HNP, cervical stenosis and mechanical pain not associated with nerve root involvement, the evidence is anecdotal. The benefits of LOA stem from a combination of factors to include the high volumes administered and the use of hypertonic saline. Hyaluronidase has been shown in most, but not all studies to improve treatment outcomes. Although infrequent, complications are more likely to occur after epidural LOA than after conventional epidural steroid injections.