• Title/Summary/Keyword: lumbar diseases

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Trends in Incidence and Treatment of Herniated Lumbar Disc in Republic of Korea : A Nationwide Database Study

  • Jung, Jong-myung;Lee, Si Un;Hyun, Seung-Jae;Kim, Ki-Jeong;Jahng, Tae-Ahn;Oh, Chang Wan;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.63 no.1
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    • pp.108-118
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    • 2020
  • Objective : This study aimed to determine the incidence and analyze trends of the herniated lumbar disc (HLD) based on a national database in the Republic of Korea (ROK) from January 2008 to December 2016. Methods : This study was a retrospective analysis of data obtained from the national health-claim database provided by the National Health Insurance Service for 2008-2016 using the International Classification of Diseases. The crude incidence and age-standardized incidence of HLD were calculated, and additional analysis was conducted according to age and sex. Changes in trends in treatment methods and some treatments were analyzed using the Korean Classification of Diseases procedure codes. Results : The number of patients diagnosed with HLD was 472245 in 2008 and increased to 537577 in 2012; however, it decreased to 478697 in 2016. The pattern of crude incidence and the standardized incidence were also similar. Overall, the incidence of HLD increased annually for the 30s, 40s, 50s, and 70s until 2012 and then decreased. However, the incidence of HLD for the 80s continued to increase. The crude incidence of HLD in female patients exceeded that of male patients in their middle age (30s or 40s) and was 1.5-1.6 times higher than in male patients in their 60s. The total number of open discectomy (OD) increased from 71598 in 2008 to 93942 in 2012 and then decreased to 85846 in 2016. The rate of younger patients (the 20s, 30s, and 40s) who underwent OD was decreased, and the rate of younger patients who underwent percutaneous endoscopic lumbar discectomy was increased. However, the rate of older patients (the 70s and 80s) who underwent OD was continuously increased. Conclusion : This nationwide data on HLD from 2008 to 2016 in the ROK demonstrated that the crude incidence and the standardized incidence increased until 2012 and then decreased. The annual crude incidence was different according to age and sex. These findings may be considered when deciding future health policy, especially in countries with a similar national health insurance system (or with plans to adopt).

Image Analysis Using Digital Radiographic Lumbar Spine of Patients with Osteoporosis (골다공증 환자의 Digital 방사선 요추 Image를 이용한 영상분석)

  • Park, Hyong-Hu;Lee, Jin-Soo
    • The Journal of the Korea Contents Association
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    • v.14 no.11
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    • pp.362-369
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    • 2014
  • This study aimed to propose an accurate diagnostic method for osteoporosis by realizing a computer-aided diagnosis system with the application of the statistical analysis of texture features using digital images of lateral lumbar spine of patients with osteoporosis and providing reliable supplementary diagnostic information by model experimental research for early diagnosis of diseases. For these purposes, digital images of lateral lumbar spine of normal individuals and patients with osteoporosis were used in the experiments, and the values of statistical texture features on the set ROI were expressed in six parameters. Among the texture feature values of the six parameters of osteoporosis, the highest and lowest recognition rates of 95 and 80% were shown in average gray level and uniformity, respectively. Moreover, all the six parameters showed recognition rates of over 80% for osteoporosis: 82.5% in average contrast, 90% in smoothness, 87.5% in skewness, and 87.5% in entropy. Therefore, if a program developing into a computer-aided diagnosis system for medical images is coded based on the results of this study, it is considered possible to be applied to preliminary diagnostic data for automatic detection of lesions and disease diagnosis using medical images, to provide information for definite diagnosis of diseases, to diagnose by limited device, and to be used to shorten the time to analyze medical images.

The analysis on the use experience of other medical institution for the same symptoms and the frequent diseases of outpatients of Korean medical institution: Based on the 2017 Korean Medicine Utilization and Herbal Medicine Consumption Survey (한의 외래서비스 이용자의 동일 증상에 대한 타 의료기관 이용 경험과 다빈도 질환 분석: 2017년 한방의료이용 실태조사를 이용하여)

  • Cheon, Chunhoo;Kim, Jihyun;Cho, Yongkyu;Choi, Daepum;Yoon, Sanghoon;Cha, Jiewon;Jang, Bo-hyoung;Shin, Yong-Cheol;Ko, Seong-Gyu
    • Journal of Society of Preventive Korean Medicine
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    • v.23 no.3
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    • pp.13-20
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    • 2019
  • Objectives : The aim of this study is to investigate the use experience of other medical institution of outpatients of Korean medical institution. Methods : Cross-sectional study using the 2017 Korean Medicine Utilization and Herbal Medicine Consumption Survey was conducted. Demographic variables and frequent diseases were analyzed according to the experience of using other medical institutions. The proportions of experience of using other medical institutions of patients with frequent diseases of Korean medical outpatient were analyzed. Results : Fifty-three percent of outpatient had experiencing using other medical institutions for the same symptoms. The frequent diseases of the two groups were similar. The proportion of single use of Korean medicine for injury of lumbar and pelvic, rhinitis, and menstrual disorders were relatively high. Conclusions : There was no notable difference in the frequent diseases according to use experience of other medical institution. Further studies on this topic are needed.

Posterior Interspinous Fusion Device for One-Level Fusion in Degenerative Lumbar Spine Disease : Comparison with Pedicle Screw Fixation - Preliminary Report of at Least One Year Follow Up

  • Kim, Ho Jung;Bak, Koang Hum;Chun, Hyoung Joon;Oh, Suck Jun;Kang, Tae Hoon;Yang, Moon Sool
    • Journal of Korean Neurosurgical Society
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    • v.52 no.4
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    • pp.359-364
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    • 2012
  • Objective : Transpedicular screw fixation has some disadvantages such as postoperative back pain through wide muscle dissection, long operative time, and cephalad adjacent segmental degeneration (ASD). The purposes of this study are investigation and comparison of radiological and clinical results between interspinous fusion device (IFD) and pedicle screw. Methods : From Jan. 2008 to Aug. 2009, 40 patients underwent spinal fusion with IFD combined with posterior lumbar interbody fusion (PLIF). In same study period, 36 patients underwent spinal fusion with pedicle screw fixation as control group. Dynamic lateral radiographs, visual analogue scale (VAS), and Korean version of the Oswestry disability index (K-ODI) scores were evaluated in both groups. Results : The lumbar spine diseases in the IFD group were as followings; spinal stenosis in 26, degenerative spondylolisthesis in 12, and intervertebral disc herniation in 2. The mean follow up period was 14.24 months (range; 12 to 22 months) in the IFD group and 18.3 months (range; 12 to 28 months) in pedicle screw group. The mean VAS scores was preoperatively $7.16{\pm}2.1$ and $8.03{\pm}2.3$ in the IFD and pedicle screw groups, respectively, and improved postoperatively to $1.3{\pm}2.9$ and $1.2{\pm}3.2$ in 1-year follow ups (p<0.05). The K-ODI was decreased significantly in an equal amount in both groups one year postoperatively (p<0.05). The statistics revealed a higher incidence of ASD in pedicle screw group than the IFD group (p=0.029) Conclusion : Posterior IFD has several advantages over the pedicle screw fixation in terms of skin incision, muscle dissection and short operative time and less intraoperative estimated blood loss. The IFD with PLIF may be a favorable technique to replace the pedicle screw fixation in selective case.

Study on Dai Meridian(帶脈) and Meridian Points(經穴) of Joining with Circulation of Dai Meridian through Literatures of Every Generation (대맥(帶脈) 및 그 유주상(流注上) 회합(會合)하는 경혈(經穴)에 대한 문헌적(文獻的) 고찰(考察))

  • Yang Seung-Joung;Jin Cheon-Sik;Cho Myung-Rae
    • Korean Journal of Acupuncture
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    • v.18 no.1
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    • pp.105-116
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    • 2001
  • We examined and referred to some literatures on the meaning, Dai meridian and Meridian points of joining with circulation of Dai meridian through literatures of every generation. And then we came to get a few conclusions as follows. 1. Dai meridian starts below the hypochondriac region. Running obliquely downward, it runs transversely around the waist like a belt. Its function is to bind up all the meridians to circulate in a proper way. 2. The coalescent points of dai meridian are $D\grave{a}im\grave{a}i$(帶脈), $W\check{u}sh\bar{u}$(五樞) and $W\acute{e}id\grave{a}o$(維道). 3. Location of $D\grave{a}im\grave{a}i$(帶脈) is on the lateral side of the abdomen, 1.8 cun below $Zh\bar{a}ngm\grave{e}n$(章門), at the crossing point of vertical line through the free end of the 11th rib and a horizontal line through the umbilicus. Location of $W\check{u}sh\bar{u}$(五樞) is on the lateral side of the abdomen, anterior to the anterosuperior iliac spine, 3 cun below the level of the umbilicus. Location of $W\acute{e}id\grave{a}o$(維道) is on the lateral side of the abdomen, anterior and inferior to the anterosuperior iliac spine, 0.5 cun anterior and inferior to $W\check{u}sh\bar{u}$(五樞). 4. Indication of $D\grave{a}im\grave{a}i$(帶脈) is irregular menstruation, leukorrhea with reddish discharge, hernia, pain in the lumbar and hypochondriac region. Indication of $W\check{u}sh\bar{u}$(五樞) is prolapse of the uterus, leukorrhea with reddish discharge, irregular menstruation, hernia, pain in the lower abdomen, constipation and lumbosacral pain. Indication of $W\acute{e}id\grave{a}o$(維道) is edema, pain in the side of the lower abdomen, prolapse of the uterus, hernia and morbid leukorrhea. 5. The Dai meridian binds all meridians, produces pregnancy, grasps lumbar and abdomen region and controls leukorrhea. 6. Diseases of the Dai meridian manifested as distention and fullness in the lumbar region and abdomen, leukorrhea with reddish discharge, pain the navel, lumbar and spinal regions, flaccidity and hypoactivity of the lower limbs, etc.

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One Case of Video-Assisted Thoracoscopic Removal of Acupuncture Needle in Lung Parenchyma (폐실질 내 침술 침의 비디오 흉강경 제거 1예)

  • Jeong, Yeong-Gyu;Lee, Ho-Sung;Choi, Jae-Sung;Na, Joo-Ock;Seo, Ki-Hyun;Kim, Yong-Hoon;Lee, Seung-Jin
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.6
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    • pp.450-453
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    • 2011
  • We report the case of a 32-year-old woman presenting with intermittent chest pain resulted from a migratory acupuncture needle. The patient received acupuncture treatment approximately 3 years prior to this presentation, for the treatment of chronic left shoulder and lumbar pain after delivery. Chest radiography revealed a retained needle in the lingular segmental area. Video-assisted thoracoscopy was then used to remove the migratory acupuncture needle attached between the lingular segmental lobe and the pericardial fat. The patient recovered without complications and was discharged home.

Newly Developed Weakness of Lower Extremities Despite Improved Brain Metastasis of Lung Cancer after Radiotherapy

  • Yang, Jae Hyun;Jang, Young Joo;Ahn, Se Jin;Kim, Hye-Ryoun;Kim, Cheol Hyeon;Koh, Jae Soo;Choe, Du Hwan;Lee, Jae Cheol
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.6
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    • pp.574-576
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    • 2009
  • An intramedullary spinal cord metastasis (ISCM) rarely develops in systemic cancer but is indicative of a poor prognosis. A 56-year-old man was admitted due to weakness of the lower extremities. He had received radiotherapy 3 months prior for a brain metastasis that had developed 1 year after achieving a complete response from chemotherapy for extended stage small cell lung cancer. Although the brain lesion had improved partially, ISCM from the cervical to lumbar-sacral spinal cords, which was accompanied by a leptomeningeal dissemination, was diagnosed based on magnetic resonance imaging of the spine and cerebrospinal fluid cytology. Finally, he died of sudden cardiac arrest during treatment. This is the first case of ISCM involving the whole spinal segments. Physicians should be aware of the subsequent development of ISCM in lung cancer patients with a previously known brain metastasis who present with new neurological symptoms.

Skeletal Manifestations of Mucolipidosis II/III

  • Cho, Sung Yoon
    • Journal of mucopolysaccharidosis and rare diseases
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    • v.2 no.1
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    • pp.8-12
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    • 2016
  • Mucolipidosis (ML) is a kind of skeletal dysplasia. Characteristic X-ray findings of the bone may contribute to the early diagnosis and treatment of ML II/III. Skeletal radiographs show distinctive patterns at different ages: neonatal hyperparathyroidism, osteodystrophy (similar to chronic osteitis fibrosa cystica), and dysostosis multiplex. Patients with ML II/III show a mixture of osteodystrophic bone changes and atypical changes of dysostosis multiplex: proximal pointing of the metacarpals in the wrist, dysplastic changes in the lower third of the ilia, marked broadening of the ribs becoming oar-shaped, and beaking of the lower thoracic and lumbar vertebrae. In ML II, the osteodystrophy has clinical and radiographic features of neonatal hyperparathyroidism. In some neonatal subjects, chemical hyperparathyroidism is also demonstrated. After transient hyperparathyroidism in newborns, the progressive osteitis fibrosa cystica develops from 3-6 months of age. Patients with ML III show prominent skeletal involvement, particularly the destruction of vertebral bodies and the femoral heads. Intravenous pamidronate treatment is well tolerated, and it can produce clinical effects, with a reduction in bone pain and improvements in mobility in patients with ML III. In this review, the skeletal manifestations of ML II and III are investigated.

Early Diagnosis for Mucopolysaccharidosis I - A 6-month-old Female Infant Presenting with Gibbus, Hirsutism and Mongolian Spots in a Well Baby Clinic

  • Lin, Hsiang-Yu;Chuang, Chih-Kuang;Chang, Jui-Hsing;Lin, Shuan-Pei
    • Journal of mucopolysaccharidosis and rare diseases
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    • v.2 no.1
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    • pp.23-26
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    • 2016
  • Mucopolysaccharidosis (MPS) I is a rare, progressive and multisystemic disease with insidious initial signs and symptoms, and making an early diagnosis can be a challenge for the first-line general medical practitioner. We report a 6-month-old girl who was brought to our well baby clinic for regular immunization with the manifestations of lumbar gibbus, hirsutism, large Mongolian spots over back and buttock, and mild bilateral legs spasticity noticed by the general pediatrician, and then newly diagnosed with MPS I after referral to the geneticist in time. Her surgical history included inguinal hernia repair at 1 month old, $CO_2$ laser supraglottoplasty for laryngomalacia and tracheostomy due to chronic respiratory failure with ventilator dependence at 2 months old. Understanding and identification of the early signs and symptoms of this disease have the potential to early diagnosis and timely appropriate treatment, which could contribute to a better clinical outcome.

A Clinical Survey of Patients of Neuro-Pain Clinic 1 Year Period (신경통증클리닉 환자의 1년간 통계 고찰)

  • Yang, Seung-Kon;Lee, Seong-Yeon;Chae, Dong-Huhn;Chae, Hyun;Lee, Kyung-Jin;Kim, Chan
    • The Korean Journal of Pain
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    • v.8 no.2
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    • pp.304-307
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    • 1995
  • 1,666 patients treated by nerve block from September 1994 to August 1995 we statistically analyzed according to sex, age, diseases, and kinds of nerve blocks. Most patients were in the range from 30 to 60 year old, with a distribution of 43.9% male and 56.1% female. Diseases and ailments were as follows: low back pain 30.6%, frozen shoulder 14.0%, facial spasm 10.0%, cervical syndrome 9.7%, headache 7.3%, and hyperhidrosis 7.2%. Most common nerve blocks were stellate ganglion block 30.9%, epidural block 25.6%, trigger point injection 16.1%, and suprascapular nerve block 6.7%. Nerve blocks under fluoroscopic guide were as follows: facet joint block 28.6%, spinal root block 22.9%, thoracic sympathetic ganglion block 21.7%, and lumbar sympathetic ganglion block 15.4%.

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