• Title/Summary/Keyword: lumbar disc

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Strategies for Noncontained Lumbar Disc Herniation by an Endoscopic Approach : Transforaminal Suprapedicular Approach, Semi-Rigid Flexible Curved Probe, and 3-Dimensional Reconstruction CT with Discogram

  • Chae, Ki-Hwan;Ju, Chang-Il;Lee, Seung-Myung;Kim, Byoung-Wook;Kim, Saeng-Youp;Kim, Hyeun-Sung
    • Journal of Korean Neurosurgical Society
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    • v.46 no.4
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    • pp.312-316
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    • 2009
  • Objective : The purpose of this study was to evaluate the efficacy of a transforaminal suprapedicular approach, semi-rigid flexible curved probe, and 3-dimensional reconstruction computed tomography (3D-CT) with discogram in the endoscopic treatment of non-contained lumbar disc herniations. Methods : The subjects were 153 patients with difficult, non-contained lumbar disc herniations undergoing endoscopic treatment. The types of herniation were as follows : extraforaminal, 17 patients; foraminal, 21 patients; high grade migration, 59 patients; and high canal compromise, 56 patients. To overcome the difficulties in endoscopic treatment, the anatomic structures were analyzed by 3D reconstruction CT and the high grade disc was extracted using a semi-rigid flexible curved probe and a transforaminal suprapedicular approach. Results : The mean follow-up was 18.3 months. The mean visual analogue scale (VAS) of the patients prior to surgery was 9.48, and the mean postoperative VAS was 1.63. According to Macnab's criteria, 145 patients had excellent and good results, and thus satisfactory results were obtained in 94.77% cases. Conclusion : In a posterolateral endoscopic lumbar discectomy, the difficult, non-contained disc is considered to be the most important factor impeding the success of surgery. By applying a semi-rigid flexible curved probe and using a transforaminal suprapedicular approach, good surgical results can be obtained, even in high grade, non-contained disc herniations.

A Clinical study on the Effect of Chuna to Herniated Lumbar Disc Patients (요추 추간판 탈출증 환자의 굴곡신연기법 치료효과에 대한 임상적 고찰)

  • Lee, Gil-Jae;Lee, Byeong-Yee;Jang, Gun;Song, Yun-Kyung;Lim, Hyung-Ho
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.2 no.2
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    • pp.79-88
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    • 2007
  • Objectives : This research is aimed to confirm the treating patients with herniated lumbar disc using Chuna treatment. Methods : Out of patients who were confirmed to have a herniated lumbar disc by MRI among the patients in oriental medical hospital of Kyungwon University from July 2005 to Dec 2006, we dived 15 people was treated common treatment, 15 people was treated both common treatment and Chuna treatment. We measured Visual Analog Scale(VAS) and symptom grade before and after treatment in each groups. Statistical analysis was performed by using SPSS program. Results : The result of the Visual Analog Scale(VAS) and symptom grade before and after treatment between two group, shows that the improvement of Back pain and Sciatica in common treatment with Chuna treatment group is more effective than that in only common treatment group.

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Incidental Diagnosis of Multiple Myeloma during Conservative Treatment for Lumbar Disc Herniation; -A Case Report- (요추 추간판 탈출증 치료 중 진단된 다발성 골수종 1례)

  • Lee, Kil-Joon;Kang, Ji-Hun;Park, Young-Hoi;Keum, Dong-Ho
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.1 no.2
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    • pp.41-47
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    • 2006
  • Objectives: The aim of this study is to notify incidental diagnosis of multiple myeloma during conservative treatment for lumbar disc herniation, caused by right flank pain. Methods: A 45-year-old female came to our hospital for the control of pain caused by lumbar disc hemiation L5-S1. After using Cox technique, she occured right flank pain and found out multiple fracture by bone scan. For further evaluation, she was diagnosed with multiple myeloma with bone marrow biopsy. Results and Conclusions: This case report suggests that clinicians should consider the possibility of multiple myeloma in the case of multiple fracture without trauma.

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A Case Report on the Thoracic & Lumbar Disc and Scoliosis Treated by Flexion-Distraction Technique (굴곡신연기법을 이용한 흉요추 추간판 탈출증과 척추 측만증의 치험 1례)

  • Kim, Se-Jong;Min, Boo-Ki;Yoon, Il-Ji;Oh, Min-Suck
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.1 no.2
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    • pp.73-80
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    • 2006
  • This study is designed to evaluate the effect of flexion-distraction technique for the patient with thoracic & lumbar disc and scoliosis. After flexion-distraction technique the. results of VAS of lumbago, orthopedics tests, cobb's angle were improved significantly. It is suggested that flexion-distraction technique might be effective for the patient with Thoracic & Lumbar Disc and Scoliosis.

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A Clinical Case Study of Low Back Pain Caused by the Herniated Lumbar Disc in Soeumin patient (요추(腰椎) 추간판(椎間板) 탈출증(脫出症)으로 인하여 발생한 소음인(少陰人) 요각통(腰脚痛) 치험 1례)

  • Kim, Hyun-Ho;Kim, Eun-Yi;Kim, Kyung-Sun;Lim, Eun-Chul;Jung, Kyung-Suk;Yoon, Hyoung-Seon
    • Journal of Sasang Constitutional Medicine
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    • v.16 no.3
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    • pp.108-113
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    • 2004
  • 1. Objectives The purpose of this study is to give an account of the effects of Korean herbal medicine therapy which is based on the Sasang Constitutional Medicine for the patient who has suffered from low back pain caused by the Herniated Lumbar Disc. 2. Methods Consulting her sungjeong(性情), Chehyungkisang(體形氣像) and QSCCII, we have diagnosed her as Soeumin(少陰人), and have prescribed Hyangbujapalmul-tang(香附子八物湯). 3. Results After the treatment, she felt her symptoms, low back pain, headache, and general condition, improved. 4. Conclusions This paper describes the process of management and changes of symptoms. We hope this paper useful to rehabilitatable treatment for low back pain caused by the Herniated Lumbar Disc through Sasang Constitutional Medicine.

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Analysis of Compression Behavior on Intervertebral Disc L4-5 in Pedicle Screw System Instrumented Lumbar Spine under Follower Load (척추경 나사못을 이용한 척추 유합술에서 고정범위에 따른 인접 추간판의 압축 거동 분석)

  • Ahn, Myun-Whan;Ahn, Jong-Chul;Lee, Su-Ho;Chung, Il-Sub;Lee, Choon-Yeol;Lee, Jang-Woo
    • Journal of Yeungnam Medical Science
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    • v.20 no.2
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    • pp.160-168
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    • 2003
  • Background: Confirm the stability of intervertebral disc sustaining each fused lumbar spine cases, comparing vertical compression, A-P shear force and rotational moment on intervertebral disc of instrumented lumbar spine with simple vertical compression load and follower load using finite element analysis. Materials and Methods: We analyze the stability of intervertebral disc L4-5 supporting fused lumbar spine segments. After performing finite element modelling about L1-L5 lumbar vertebral column and L1-L4 each fusion level pedicle screw system for fused lumbar spine fine element model. Intervertebral discs with complex structure and mechanical properties was modeled using spring element that compensate stiffness and tube-to-tube contact element was employed to give follower load. Performing geometrical non-linear analysis. Results: The differences of intervertebral disc L4-5 behavior under the follower compression load in comparision with vertical compression load are as follows. Conclusion: As a result of finite element interpretation of instrumented lumbar spine, the stability of L4-5 sustaining fused lumbar segment, the long level fused lumbar spine observed hing stability under follower load. This research method can be the basis tool of effects prediction for instrumentation, a invention of a more precious finite element interpretation model which consider the role of muscle around the spine is loaded.

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Magnetic Resonance Imaging for Each Type of Herniated Lumbar Intervertebral Disc (요추 추간판 탈출증의 유형별 자기공명영상 소견)

  • Kim, Ham-Gyum
    • Journal of radiological science and technology
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    • v.22 no.1
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    • pp.27-33
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    • 1999
  • The classification of herniated intervertebral lumbar disc type is clinically important, as treatment method may be slightly different according to the type of herniated intervertebral disc. When 450 patients who suffered from herniated intervertebral lumbar disc were tested with Magnetic Resonance Imaging (MRI) to find out the type of herniated disc, the following findings were given : 1. The age of the patients investigated ranged from 15 to 83, and their mean age was 40. 2. The male patients were twice as many as the female patients, since the ratio of males to females was 300 : 150. 3. 118 patients suffered from a single herniated disc, and 332 patients were attacked with multi-herniated disc. 4. The types of single herniated disc were a protrusion for 50 patients (40%) and an extrusion for 40 patients (34%). The part of being herniated was an intervertebral disc between $L_4-L_5$ for 95 patients(80%) and the same disc between $L_5-S_1$ for 22 patients(19%). 5. The types of multi : -herniated disc were an protrusion for 67 patients(20%) and an extrusion for 70 patients(21%). Besides, 90 patients (28%) were the case that protrusion and extrusion coexisted simultaneously. The parts of being herniated were $L_3-L_4,\;L_4-L_5$ and $L_5-S_1$ for 53 patients(16%), $L_3-L_4$ and $L_4-L_5$ for 57 patients(17%), and $L_4-L_5$ and $L_5-S_1$ for 139 patients(42%).

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Comparative Study of Effects on Intracutaneous Bee Venom Pharmacopuncture and Intramuscular Bee Venom Pharmacopuncture in Lumbar Disc Herniation (요추 추간판 탈출증에 대한 피내 봉약침과 근육내 봉약침의 치료 효과 비교)

  • Shin, Hwa-Young;Lee, Se-Min;Kim, Jee-Hyun;Kim, Sung-Jin;Choi, Yi-Jeong;Jung, Tae-Young;Kim, Jae-Su;Lim, Seong-Chul;Lee, Yun-Kyu;Lee, Bong-Hyo;Lee, Kyung-Min
    • Journal of Acupuncture Research
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    • v.28 no.3
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    • pp.1-11
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    • 2011
  • Objectives : This study is to compare effects on Intracutaneous Bee Venom pharmacopuncture and Intramuscular Bee Venom pharmacopuncture in Lumbar Disc Herniation. Methods : We investigated 34 cases of patients with lumbar disc herniation and devided into two groups. Group A were treated with intracutaneous bee venom pharmacupuncture and group B were treated with intramuscular bee venom pharmacopuncture. To evaluate the treatment effects of two groups, we used visual analog scale(VAS) and Aberdeen LBP scale. Results : In VAS and Aberdeen LBP scale, that of group A was further improved than that of group B, but there was no statistical significance. Conclusions : Intracutaneous bee venom pharmacupuncture and intramuscular bee venom pharmacopuncture were effective treatments for lumbar disc herniation, but there was no statistical significance.

The Effect of GCSB-5 a New Herbal Medicine on Changes in Pain Behavior and Neuroglial Activation in a Rat Model of Lumbar Disc Herniation

  • Cho, Hee Kyung;Kim, So-Yeon;Choi, Mi Jung;Baek, Seung Ok;Kwak, Sang Gyu;Ahn, Sang Ho
    • Journal of Korean Neurosurgical Society
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    • v.59 no.2
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    • pp.98-105
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    • 2016
  • Objective : Lumbar disc herniation can induce sciatica by mechanical compression and/or chemical irritation. The aim of this study was to compare the effects of GCSB-5 (Shinbaro$^{(R)}$) and NSAIDs on pain-related behavior and on the expressions of microglia, astrocytes, CGRP, TRPV1, IL-6, and CX3CL1 in a rat model of lumbar disc herniation. Methods : 112 male Sprague-Dawley rats underwent implantation of nucleus pulposus to a dorsal root ganglion (DRG). Rats were divided into five groups as follows; a saline group (the vehicle control group) (n=27), a 10 mg/kg aceclofenac group (the aceclofenac group) (n=22), and 100, 300 or 600 mg/kg GCSB-5 groups (the GCSB-5 100, 300, or 600 groups) (n=21 for each group). Rats were tested for mechanical allodynia at 3 days after surgery and at 1 day, 3 days, 7 days, 14 days, 21 days, 28 days, 35 days, 42 days, 49 days, and 56 days after treatment commencement. Immunohistochemical staining of microglia (Iba1), astrocytes (GFAP), CGRP, and TRPV1, and PCR for IL-6 and CX3CL1 were performed on spinal dorsal horns and DRGs at 56 days after medication commencement. Results : After 56 days of GCSB-5 300 administration, mechanical withdrawal thresholds were significantly increased (p<0.05), and immunohistochemical expressions of Iba1, GFAP, CGRP, and TRPV1 were reduced than other groups, but this difference was not statistically significant. Conclusion : These results indicate GCSB-5 reduces mechanical allodynia and downregulates neuroglial activity and the expressions of CGRP and TRPV1 in the spinal segments of a rat model of lumbar disc herniation.

A Clinical Study of 17 Cases of Patients with Big Toe Extensor Muscles Weakness Caused by Lumbar Disc Herniation (요추 추간판 탈출증으로 유발된 족무지 신전 근력약화 환자 17례의 임상적 고찰)

  • Kim, Wu-Young;Han, Sang-Yup;Kim, Ki-Yuk;Lee, Jae-Hoon;Lee, Hyun-Jong;Kim, Chang-Youn
    • Journal of Acupuncture Research
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    • v.26 no.4
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    • pp.19-27
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    • 2009
  • Objectives : To investigate the improvement rate of muscle weakness caused by lumbar disc herniation, 17 patients was treated with oriental medicine. Methods : To evaluate weakness of big toe extensor muscles caused by lumbar disc herniation, we measured the active range of motion(ROM) of big toe extension and muscle grading of big toe extensor muscles. We also measured numerical rating scale(NRS), oswestry disability index(ODI) and compared them with the active ROM of big toe extension. Results : 1. Progressive weakness of big toe extensor muscles was observed in 2 patients. Weakness of big toe extensor muscles were improved in 13 patients(76%). 2. Changes in manual muscle testing(MMT) scores corresponded with improvement rate of big toe extension. 3. Numerical rating scale(NRS) and oswestry disability index(ODI) improvement rate did not correspond with improvement rate of big toe extension. Conclusions : Muscle weakness caused by lumbar disc herniation can be treated with oriental medicine and progressive muscle weakness must be observed constantly.

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