• Physical Therapy Korea
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• v.26 no.4
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• pp.10-19
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• 2019

Background: In patients with lumbar spinal stenosis (LSS), lumbar flexion exercise (LFE) is considered a standard therapeutic exercise that widens the space between the spinal canal and intervertebral foramen. However, some researchers have reported that lumbar extension exercise (LEE) may improve lumbar pain and functional ability in patients with LSS. Although exercise intervention methods for patients with LSS have been widely applied in clinical settings, few studies have conducted comparative analysis of these exercise methods. Objects: This study aimed to compare the effects of LFE, LEE, and lumbar flexion combined with lumbar flexion-extension exercise (LFEE) on pain, range of motion (ROM), pelvic tilt angle, and functional gait ability in patients with LSS. Methods: A total of 30 patients with LSS, LFE (n1=10), LEE (n2=10), and LFEE (n3=10) were assigned to each of the three exercise groups. The numerical pain rating scale (NPRS), modified-modified schober test (MMST)-flexion, MMST-extension, pelvic tilt inclinometer, and 6-minute walking test (6MWT) were measured. Results: After the intervention, statistically significant differences were observed in the NPRS (p=.043), MMST-flexion (p<.001), MMST-extension (p<.001), and 6MWT (p=.005) between groups. According to the post hoc test, the NPRS was statistically significant difference between the LFEE and LEE groups (p=.034). The MMST-flexion was statistically significantly different between the LFE and LEE (p=.000), LFE and LFEE (p=.001), and LEE and LFEE (p=.001) groups. The MMST-extension was statistically significantly different between the LFE and LEE (p<.001), LFE and LFEE (p=.002), and LEE and LFEE (p=.008) groups. The 6MWT was statistically significantly different between the LFE and LFEE (p=.042) and the LEE and LFEE (p=.004) groups. Conclusion: This study suggested that LFEE was the most effective exercise for pain and functional gait ability in patients with LSS, LFE was the most effective exercise for lumbar flexion ROM, and LEE was the most effective exercise for lumbar extension ROM.

• Journal of Korean Neurosurgical Society
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• v.49 no.4
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• pp.234-236
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• 2011

Lumbar spinal stenosis (LSS) is a common spinal disease in the elderly. The cardinal symptom of LSS is neurogenic claudication, but not all patients present with such typical symptom. The clinical symptoms are often confused with symptoms of peripheral neuropathy, musculo-skeletal disease and other medical conditions in elderly patients. In particular, LSS presenting with rapid progression of leg weakness must be distinguished from other combined diseases. We report a case of rapid progressive leg weakness in a patient with LSS and iatrogenic adrenal insufficiency that was induced by obscure health supplement.

• Journal of Acupuncture Research
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• v.34 no.4
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• pp.172-179
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• 2017

Background: This study was designed to evaluate the clinical effectiveness of traditional Korean medicine treatment for lumbar spinal stenosis as assessed by radiological criteria. Methods: This was an observational study of 122 patients who were diagnosed with lumbar spinal stenosis and admitted to Jaseng Hospital between January 2016 and June 2017. They were analyzed according to sex, age, cause of disease, disease stage, length of admission, type of stenosis, morphological grade, and dural sac cross-sectional area. All patients were treated with traditional Korean medicine. Patients were assessed with the Numeric Rating Scale (NRS), Oswestry Disability Index (ODI) and EQ-5D before and after treatment. Results: Regarding the distribution of the factors analyzed, these were of note: more females than males (1:3.52); and highest proportions were age more than 70 years (37.70%), cause of lumbar spinal stenosis unknown (67.21%), and subacute stage (42.62%). Comparing before and after treatment, the NRS score for low back and pelvic pain decreased from $6.14{\pm}1.71$ to $4.28{\pm}1.91$ (p < 0.001), and the NRS score for radiating pain and numbness decreased from $6.27{\pm}1.61$ to $2.02{\pm}1.54$ (p < 0.001). ODI decreased from $46.86{\pm}19.40$ to $33.63{\pm}18.66$ (p < 0.001), and gait-related ODI decreased from $3.34{\pm}1.23$ to $2.80{\pm}1.11$ (p < 0.001). There were no statistically significant differences in improvement of the NRS, ODI, gait-related ODI, and EQ-5D for morphological grade and dural sac cross-sectional area. Conclusion: Traditional Korean medicine is effective treatment for patients with lumbar spinal stenosis. Even in patients with severe radiological findings, it is possible to reduce pain and improve quality of life.

• Journal of Acupuncture Research
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• v.28 no.3
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• pp.21-31
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• 2011

Objectives : The purpose of this study was to evaluate the effect of bee venom pharmacopuncture therapy in patients with lumbar spinal stenosis. Methods : This clinical study was carried out on 119 patients with lumbar spinal stenosis, who had been admitted from May, 2009 to March, 2011. Patients were sorted into two groups ; One group(bee venom pharmacopuncture group) was treated with bee venom pharmacopuncture and acupuncture therapy, the other(non-bee venom pharmacopuncture group) with acupuncture therapy only. Verbal numerical rating scale(VNRS) and Oswestry disability index(ODI) were used to evaluate the effectiveness of the treatment in both groups. VNRS and ODI scores of the two groups were statistically compared. Results : The bee venom pharmacopuncture group demonstrated a more significant improvement than non-bee venom pharmacopuncture group when evaluated with VNRS and ODI. Conclusions : In the case of the patients with spinal stenosis, it was found that treatment with combination of bee venom pharmacopuncture and acupuncture was more effective in improving the conditions of the patients (subsidence of the symptoms) than the acupuncture treatment only.

• Journal of Korean Neurosurgical Society
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• v.38 no.2
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• pp.107-110
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• 2005

Objective : Lumbar spinal stenosis is increasingly recognized as a common cause of low back pain in elderly patients. Conservative treatment has been initially applied to elderly patients, however, surgical treatment is sometimes indispensable to relieve severe pain. We retrospectively examine the age-related effects on the surgical risk, and results following general anesthesia and operative procedure in geriatric patients for two different age groups of at least 65years old. Methods : Consecutive 51 patients [${\ge}$ 65years], who underwent open surgical procedure for degenerative lumbar spinal stenosis, were selected in the study. Patients were divided into two groups. Group A included all patients who were between 65 and 69years of age at the time of surgery. Group B included all patients who were at least 70years of age at the time of surgery. We reviewed medical history including preoperative American Society of Anesthesiologists[ASA] classification of physical status, anesthetic risk factor, operative time, estimated blood loss, transfusion requirements, hospital stay, operated level, and clinical outcome to look for comparisons between two age groups [$65{\sim}69$ and over 70years]. Results : In preoperative evaluation, mean anesthetic risk factor of patients was numerically similar between the groups. The American Society of Anesthesiologists classification of physical status was similar between two groups. There was no difference in operated level, operative time, estimated blood loss, hospital stay, and anesthetic risk factor between the two groups. The clinical successful outcome showed 82.7% for Group A and 81.8% for group B. The overall postoperative complication rates were similar for both group A and B. Conclusion : We conclude that advanced age per se, did not increase the associated morbidity and mortality in surgical decompression for spinal stenosis.

• Journal of Korean Neurosurgical Society
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• v.42 no.1
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• pp.11-15
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• 2007

Objective : Lumbar foraminal stenosis is an important etiology of lumbar radicular symptomatology and frequent causes of remained symptoms after decompressive surgery. This study was conducted to determine the precise clinical and radiologic diagnosis of lumbar foraminal stenosis, and to demonstrate thorough treatment by decompressive surgery using a minimally invasive technique. Methods : Seven patients with established unilateral lumbar foraminal stenosis according to clinical and radiologic diagnosis were retrospectively studied. All patients underwent combined interlaminar and paraisthmic procedure with partial facetectomy. The outcome of surgery was evaluated and classified into excellent, good, fair and poor. Results : The results were excellent in four patients, good in two, and fair in one during the follow-up. There were no surgery-related complications. Conclusion : Minimally invasive combined interlaminar and paraisthmic approach provides good outcome in carefully selected patients with symptomatic lumbar foraminal stenosis.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2005.06a
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• pp.1963-1966
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• 2005

Degenerative lumbar spinal stenosis(DLSS) is a disease inducing low back pain, leg pain, convulsion, numbness, and neurogenic claudication from compression of nerve root. Intervertebra fixation was reported to increase the degenerative of neighbor region after treatment. Recently, a new surgical technique of inserting a fixator between interspinous processes has been introduced. The purpose of this study is to design of the interspinous process fixator with flexibility to complement the trouble of using fixator in DLSS. This study evaluated the existing fixator through the mechanical test and modified fixators using the finite element analysis(FEA). Displacement, stiffness and Von-Mises stress were found to have similar values to those obtained from the mechanical test and the FEA in the biomechanical loading condition. Effects of variation in length and thickness were investigated to design an optimal fixator.

• Journal of Korean Biological Nursing Science
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• v.13 no.2
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• pp.156-163
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• 2011

Purpose: The purpose of this study was to examine the effects of a bergamot essential oil-inhalation on chronic pain after surgery for lumbar spinal stenosis. Methods: Fifty-two subjects were randomly assigned to the experimental (bergamot essential oil-inhalation) and control (almond oil-inhalation) group. All patients understood the purpose of this study and a written informed consent for the study was obtained. Results: Bergamot essential oil-inhalation was conducted during twenty minutes. Visual analog scale, blood pressure, heart rate, and respiratory rate were measured before and after treatment in the two groups. The visual analog scale score, heart rate, and respiratory rate in bergamot essential oil-inhalation group were significantly lower than those in almond oil-inhalation group. However, there was no significant difference in systolic and diastolic blood pressure between the two groups. Conclusion: Therefore, bergamot essential oil-inhalation is effective in alleviating pain, heart rate, and respiratory rate. These results suggest that bergamot essential oil-inhalation can be a useful method for the relief of chronic pain during the treatment after spinal surgery.

• Journal of the Korean Orthopaedic Association
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• v.54 no.3
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• pp.219-226
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• 2019

Lumbar decompressive surgery is a standard surgery for lumbar spinal stenosis. Many surgical techniques have been introduced, ranging from open surgery to percutaneous procedures. Minimally invasive techniques are preferred because of the less postoperative pain and shorter hospital stay. Uniportal percutaneous endoscopic decompression has technical difficulties due to the narrow field. Biportal percutaneous endoscopic decompression is a satisfactory technique that can compensate for the shortcomings and provide sufficient decompression.

• The Journal of the Korean bone and joint tumor society
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• v.17 no.2
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• pp.106-110
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• 2011

In the patient who has intradural mass associated with spinal stenosis, if the operation for spinal stenosis is performed alone, the symptom may remain. We report with literature review that we achieved the successful outcome after simultaneous decompression of spinal stenosis and space occupying mass removal in the case of intradural and extradural compression. A 71-year-old female patient suffering from low back pain and radiating pain of both lower extremities admitted. In magnetic resonance imaging, spinal stenosis on L4-5 and spondylolisthesis on L5-S1 compressed dural sac and intradural space occupying mass on L4 level compressed. By posterior approach, decompression and interbody fusion were carried out. Then mass was removed with median durotomy. Pathologic diagnosis was schwannoma and the symptom was improved remarkably.