• Title/Summary/Keyword: lumbar diseases

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The Effect of Korean Medicinal Admission Treatment and Radiological Characteristics on 25 Cases of Spondylolysis (척추분리증 환자 25예의 한방 입원치료 효과와 영상의학적 특성)

  • Lee, Sang-Won;Kim, Yang-Sun;Kim, Yong-Wha;Kim, Yu-Gon;Park, Han-Sol;Lee, Ji-Eun;Lim, Jin-Woong;Jeong, Hyeon-Gyo;Choi, In-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.30 no.1
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    • pp.95-103
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    • 2020
  • Objectives The purpose of this study is to assess the effect of korean medicinal admission treatment for degenerative lumbar diseases with spondylolysis and analyze their radiological findings. Methods This study was performed on 25 cases' medical records of spondylolysis patients with both X-rays and MRI images. Their general characteristics, morphologies of intervertebral discs, grades of spondylolisthesis, grades of intervertebral foraminal stenosis were analyzed. The efficacy of treatment was evaluated by numeric pain rating scale (NPRS) changes and statistically assessed by paired t-test using program R Studio. Results After admission treatment, NPRS scores significantly decreased from 6.76±2.07 to 2.38±1.22 (p<0.01). Spondylolysis was associated with degenerative disc change and intervertebral foraminal stenosis at the same or adjacent vertebral level. In spondylolisthesis cases (76%), forward slippage occurred at the same level of spondylolysis in every case. Conclusions Spondylolysis could play a key role in the lumbar degenerative mechanism and korean medicinal admission treatment is effective on pain relief of degenerative lumbar diseases with spondylolysis.

Comparison of Root Images between Post-Myelographic Computed Tomography and Magnetic Resonance Imaging in Patients with Lumbar Radiculopathy

  • Park, Chun-Kun;Lee, Hong-Jae;Ryu, Kyeong-Sik
    • Journal of Korean Neurosurgical Society
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    • v.60 no.5
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    • pp.540-549
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    • 2017
  • Objective : To evaluate the diagnostic value of computed tomography-myelography (CTM) compared to that of magnetic resonance imaging (MRI) in patients with lumbar radiculopathy. Methods : The study included 91 patients presenting with radicular leg pain caused by herniated nucleus pulposus or lateral recess stenosis in the lumbar spine. The degree of nerve root compression on MRI and CTM was classified into four grades. The results of each imaging modality as assessed by two different observers were compared. Visual analog scale score for pain and electromyography result were the clinical parameters used to evaluate the relationships between clinical features and nerve root compression grades on both MRI and CTM. These relationships were quantified by calculating the receiver-operating characteristic curves, and the degree of relationship was compared between MRI and CTM. Results : McNemar's test revealed that the two diagnostic modalities did not show diagnostic concurrence (p<0.0001). Electromyography results did not correlate with grades on either MRI or CTM. The visual analog pain scale score results were correlated better with changes of the grades on CTM than those on MRI (p=0.0007). Conclusion : The present study demonstrates that CTM could better define the pathology of degenerative lumbar spine diseases with radiculopathy than MRI. CTM can be considered as a useful confirmative diagnostic tool when the exact cause of radicular pain in a patient with lumbar radiculopathy cannot be identified by using MRI. However, the invasiveness and potential complications of CTM are still considered to be pending questions to settle.

The Risk of Applying Moving Cupping Therapy to A Patient with Chronic Lumbar Pain Previously Treated with Gold Thread Therapy

  • Yeonhak, Kim;Yoona, Oh;Jihun, Kim;Eunseok, Kim;Gi Young, Yang;Byung Ryul, Lee
    • Journal of Acupuncture Research
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    • v.39 no.4
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    • pp.317-322
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    • 2022
  • Gold thread therapy (GTT) continuously stimulates acupoints and is used to treat chronic conditions/diseases such as chronic lumbar pain. During the procedure gold thread is embedded into the skin and although gold thread is medically pure, GTT is an irreversible treatment where there is limited evidence on its safety. Here, we report a case of a 79-year-old woman being treated for low back pain who developed side effects following moving cupping therapy at a site of GTT (performed in the 1970s). Adverse reactions causing radiating pain persisted more than at least 9 days following moving cupping therapy. The symptoms of pain were evaluated using the numerical rating scale, and changes in tenderness and the state of bruising was recorded. Low back pain improved but the radiating low leg pain did not improve. This case highlights the need for caution when performing moving cupping therapy where GTT has been previously performed.

A Multi-center Clinical Study of Posterior Lumbar Interbody Fusion with the Expandable Stand-alone Cage($Tyche^{(R)}$ Cage) for Degenerative Lumbar Spinal Disorders

  • Kim, Jin-Wook;Park, Hyung-Chun;Yoon, Seung-Hwan;Oh, Seong-Hoon;Roh, Sung-Woo;Rim, Dae-Cheol;Kim, Tae-Sung
    • Journal of Korean Neurosurgical Society
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    • v.42 no.4
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    • pp.251-257
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    • 2007
  • Objective : This multi-center clinical study was designed to determine the long-term results of patients who received a one-level posterior lumbar interbody fusion with expandable cage ($Tyche^{(R)}$ cage) for degenerative spinal diseases during the same period in each hospital. Methods : Fifty-seven patients with low back pain who had a one-level posterior lumbar interbody fusion using a newly designed expandable cage were enrolled in this study at five centers from June 2003 to December 2004 and followed up for 24 months. Pain improvement was checked with a Visual Analogue Scale (VAS) and their disability was evaluated with the Oswestry Disability Index. Radiographs were obtained before and after surgery. At the final follow-up, dynamic stability, quality of bone fusion, interveretebral disc height, and lumbar lordosis were assessed. In some cases, a lumbar computed tomography scan was also obtained. Results : The mean VAS score of back pain was improved from 6.44 points preoperatively to 0.44 at the final visit and the score of sciatica was reduced from 4.84 to 0.26. Also, the Oswestry Disability Index was improved from 32.62 points preoperatively to 18.25 at the final visit. The fusion rate was 92.5%. Intervertebral disc height, recorded as $9.94{\pm}2.69\;mm$ before surgery was increased to $12.23{\pm}3.31\;mm$ at postoperative 1 month and was stabilized at $11.43{\pm}2.23\;mm$ on final visit. The segmental angle of lordosis was changed significantly from $3.54{\pm}3.70^{\circ}$ before surgery to $6.37{\pm}3.97^{\circ}$ by 24 months postoperative, and total lumbar lordosis was $20.37{\pm}11.30^{\circ}$ preoperatively and $24.71{\pm}11.70^{\circ}$ at 24 months postoperative. Conclusion : There have been no special complications regarding the expandable cage during the follow-up period and the results of this study demonstrates a high fusion rate and clinical success.

A Review of Trends for Acupotomy (도침요법의 연구동향 고찰)

  • Yuk, Dong Il;Kim, Kyung Min;Jeon, Ju Hyun;Kim, Young Il;Kim, Jung Ho
    • Journal of Acupuncture Research
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    • v.31 no.3
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    • pp.35-43
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    • 2014
  • Objectives : The purpose of this review is to overview and evaluate the current state of the usage of acupotomy. Methods : Eight electronic databases(Science direct, Pubmed, five Korean databases, CKNI) were searched for relevant articles and data from January 1999 to May 2014. Results : Thirty-nine articles were included. Acupotomy were used in musculoskeletal diseases(n=34) and other diseases(n=5). Among musculoskeletal diseases, lumbar spine(n=12) neck(n=5) and shoulder(n=3) diseases were mostly often used. Most studies(n=21) had small sample size(under 10 people) and combined with other therapies(acupuncture, herbal medicine, physical therapy, etc.). Conclusion : Acupotomy appears to be effective and useful for musculoskeletal diseases and some other diseases. But there were a few clinical studies for acupotomy and had many limitations to judge its effectiveness. Further modified studies are required.

Neurogenic muscle hypertrophy: a case report

  • Shin, Hyun Ho;Jeon, Young Hoon;Jang, Seung Won;Kim, Sae Young
    • The Korean Journal of Pain
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    • v.29 no.4
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    • pp.270-273
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    • 2016
  • Muscular hypertrophy is caused mainly due to myopathic disorder. But, it is also rarely produced by neurogenic disorder. A 74-year-old woman complained of right calf pain with hypertrophy for several years. Recent lumbar spine magnetic resonance imaging (MRI) showed central and lateral canal narrowing at the L4-L5 intervertebral space. Lower extremity MRI revealed fatty change of right medial head of the gastrocnemius and soleus, causing right calf hypertrophy. Electrodiagnostic examinations including electromyography and nerve conduction velocity testing demonstrated $5^{th}$ lumbar and $1^{st}$ sacral polyradiculopathy. Integrating all the results, the diagnosis was neurogenic muscle hypertrophy. Neurogenic muscle hypertrophy is very rare, but we recommend that clinicians consider this problem when a patient complains of lower limb hypertrophy and pain.

Sacral Insufficiency Fracture, Usually Overlooked Cause of Lumbosacral Pain

  • Lee, Yong-Jeon;Bong, Ho-Jin;Kim, Jong-Tae;Chung, Dong-Sup
    • Journal of Korean Neurosurgical Society
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    • v.44 no.3
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    • pp.166-169
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    • 2008
  • Sacral insufficiency fractures are usually known to develop in elderly patients with osteoporosis without definite trauma history. It is difficult to diagnose the sacral insufficiency fracture at an early stage because lower lumbar diseases. concurrently or not, may also be presented with similar symptoms and signs. We report a rare case of sacral insufficiency fracture who was not diagnosed initially but, instead, showed progressively worsening of clinical symptoms and radiological findings after decompression surgery for upper level lumbar stenosis.

Concurrent Degenerative Cervical and Lumbar Spondylolisthesis (경추 및 요추 퇴행성 척추전위증의 병발성 유병률)

  • Park, Moon Soo;Hwang, Ji-Hyo;Kim, Tae-Hwan;Oh, Jae Keun;Chang, Ho Guen;Kim, Hyung Joon;Park, Kun-Tae;Lim, Jin Kyu;Riew, K. Daniel
    • Journal of Korean Society of Spine Surgery
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    • v.25 no.4
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    • pp.154-159
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    • 2018
  • Study Design: Retrospective radiographic study. Objective: To evaluate the characteristics of concurrent degenerative cervical and lumbar spondylolisthesis. Summary of Literature Review: Concurrent degenerative cervical and lumbar spondylotic diseases have been reported. Given that severe spondylosis can result in spondylolisthesis, one might expect that concurrent spondylolisthesis of the cervical and lumbar spines might also be prevalent. However, the incidence of spondylolistheses in the lumbar and cervical spines might differ due to anatomical differences between the 2 areas. Nonetheless, there is minimal information in the literature concerning the incidence of concurrent cervical and lumbar spondylolisthesis. Material and Methods: We evaluated standing cervical and lumbar lateral radiographs of 2510 patients with spondylosis. Concurrence, age group, gender, and direction of spondylolisthesis were evaluated. Lumbar spondylolisthesis was defined as at least Meyerding grade I and degenerative cervical spondylolisthesis was defined as over 2 mm of displacement on standing lateral radiographs. Results: Lumbar spondylolisthesis was found in 125 patients (5.0%) and cervical spondylolisthesis was found in 193 patients (7.7%). Seventeen patients had both degenerative cervical and lumbar spondylolistheses (0.7%). Lumbar spondylolisthesis is a risk factor for coexisting cervical spondylolisthesis. Lumbar spondylolisthesis was more common in females than males, independent of advancing age. In contrast, degenerative cervical spondylolisthesis was more common in older patients, independent of gender. Anterolisthesis was more common in the lumbar spine. Retrolisthesis was more common in the cervical spine. Conclusions: There was a higher prevalence of degenerative cervical spondylolisthesis in patients with degenerative lumbar spondylolisthesis.

Musculoskeletal diseases of heavy industrial workers

  • Baek, Hyunjin;Song, Sunhae;Lee, Donggeon;Pyo, Seunghyeon;Shin, Doochul;Lee, Gyuchang
    • Physical Therapy Rehabilitation Science
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    • v.6 no.2
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    • pp.71-76
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    • 2017
  • Objective: The purpose of this study was to investigate the musculoskeletal diseases (MSDs) that occur in heavy industrial workers according to the occupational category, prevalence, environment, and number of physical therapy visits. Design: Retrospective cohort study. Methods: For this study, data was collected of workers who were engaged in heavy industry in Korea and who visited the company physicians and received physical therapy in 2016. Data was collected from 855 subjects and was analyzed. With the data collected, analysis of the type and prevalence of MSDs and the number of physical therapy visits that have occurred according to the occupational category and environment was performed. Results: The most common MSDs were lumbar sprains and spasms (31.1%), and shoulder sprain and spasm (19.4%). In addition, the most common type of MSDs according to the occupational category and environment (occupational type) were lumbar sprain and spasms in 11 occupations, including white collar workers, and in milling, inspection, crane operation, and finishing jobs, shoulder muscle sprain and strain were the most common disorders. Also, the prevalence of MSDs according to occupational category and environment (occupational type) was the highest in workers involved with welding, which was 29.7%. Conclusions: Through this study, the type and prevalence of MSDs according to the occupational category and environment of heavy industrial workers have been confirmed. Further studies are necessary to study the future types of the work patterns of industrial workers and to develop a system for preventing and managing MSDs that may occur.

GS-KG9 ameliorates diabetic neuropathic pain induced by streptozotocin in rats

  • Lee, Jee Youn;Choi, Hae Young;Park, Chan Sol;Pyo, Mi Kyung;Yune, Tae Young;Kim, Go Woon;Chung, Sung Hyun
    • Journal of Ginseng Research
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    • v.43 no.1
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    • pp.58-67
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    • 2019
  • Background: Diabetic neuropathy is one of the most devastating ailments of the peripheral nervous system. Neuropathic pain develops in ~30% of diabetics. Here, we examined the suppressive effect of GS-KG9 on neuropathic pain induced by streptozotocin (STZ). Methods: Hyperglycemia was induced by intraperitoneal injection of STZ. Rats showing blood glucose level > 250 mg/dL were divided into five groups, and treatment groups received oral saline containing GS-KG9 (50 mg/kg, 150 mg/kg, or 300 mg/kg) twice daily for 4 wk. The effects of GS-KG9 on pain behavior, microglia activation in the lumbar spinal cord and ventral posterolateral (VPL) nucleus of the thalamus, and c-Fos expression in the dorsal horn of the lumbar spinal cord were examined. Results: The development of neuropathic pain began at Day 5 and peaked at Week 4 after STZ injection. Mechanical and thermal pains were both significantly attenuated in GS-KG9-treated groups from 10 d after STZ injection as compared to those in the STZ control. GS-KG9 also repressed microglia activation in L4 dorsal horn and VPL region of the thalamus. In addition, increase in c-Fos-positive cells within L4 dorsal horn lamina I and II of the STZ control group was markedly alleviated by GS-KG9. Conclusion: These results suggest that GS-KG9 effectively relieves STZ-induced neuropathic pain by inhibiting microglial activation in the spinal cord dorsal horn and VPL region of the thalamus.