• Title/Summary/Keyword: 척추관협착증

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Preservation of the Posterior Ligaments for Preventing Postoperative Spinal Instability in Posterior Decompression of Lumbar Spinal Stenosis: Comparative Study between Port-Hole Decompression and Subtotal Laminectomy (요추부 척추관 협착증의 후방 감압술에서 후방 인대의 보존 여부와 술 후 척추 불안정성과의 연관성: 포트홀(Port-Hole) 감압술과 후궁 아전절제술 간 비교 연구)

  • Jung, Yu-Hun;Na, Hwa-Yeop;Choe, Saehun;Kim, Jin;Lee, Joon-Ha
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.71-77
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    • 2020
  • Purpose: To determine if sparing the interspinous and supraspinous ligaments during posterior decompression for lumbar spinal stenosis is significant in preventing postoperative spinal instability. Materials and Methods: A total of 83 patients who underwent posterior decompression for lumbar spinal stenosis between March 2014 and March 2017 with a minimum one-year follow-up period, were studied retrospectively. The subjects were divided into two groups according to the type of surgery. Fifty-six patients who underwent posterior decompression by the port-hole technique were grouped as A, while 27 patients who underwent posterior decompression by a subtotal laminectomy grouped as B. To evaluate the clinical results, the Oswestry disability index (ODI), visual analogue scale (VAS) for both back pain (VAS-B) and radiating pain (VAS-R), and the walking distance of neurogenic intermittent claudication (NIC) were checked pre- and postoperatively, while simple radiographs of the lateral and flexion-extension view in the standing position were taken preoperatively and then every six months after to measure anteroposterior slippage (slip percentage), the difference in anteroposterior slippage between flexion and extension (dynamic slip percentage), angular displacement, and the difference in angular displacement between flexion and extension (dynamic angular displacement) to evaluate the radiological results. Results: The ODI (from 28.1 to 12.8 in group A, from 27.3 to 12.3 in group B), VAS-B (from 7.0 to 2.6 in group A, from 7.7 to 3.2 in group B), VAS-R (from 8.5 to 2.8 in group A, from 8.7 to 2.9 in group B), and walking distance of NIC (from 118.4 m to 1,496.2 m in group A, from 127.6 m to 1,481.6 m in group B) were improved in both groups. On the other hand, while the other radiologic results showed no differences, the dynamic angular displacement between both groups showed a significant difference postoperatively (group A from 6.2° to 6.7°, group B from 6.5° to 8.4°, p-value=0.019). Conclusion: Removal of the posterior ligaments, including the interspinous and supraspinous ligaments, during posterior decompression of lumbar spinal stenosis can cause a postoperative increase in dynamic angular displacement, which can be prevented by the port-hole technique, which spares these posterior ligaments.

Design of the Interspinous Process Fixator Using Biomechanical Analysis for the Treament of Degenerative Lumbar Spinal Stenosis (퇴행성 요추부 척추관 협착증 치료를 위한 극돌기간 고정기구의 설계 및 생체역학적 분석)

  • Heo S.;Son K.;Lee S.J.;Moon B.Y.
    • 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.

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Lumbar Spinal Stenosis Cases Managed by Yinyang Balance Appliance of FCST, a TMJ Therapy for the Balance of Meridian and Neurological System (FCST의 음양균형장치를 활용한 요추 척추관 협착증의 증례보고)

  • Lee, Sang Bae;Park, Sang Gil;O, Se Chang;Lee, Young Jun;Yin, Chang Shik
    • Journal of TMJ Balancing Medicine
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    • v.5 no.sup
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    • pp.25-30
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    • 2015
  • Therapeutic effect of Yinyang Balancing Appliance of functional cerebrospinal therapy (FCST) for meridian and neurologic yinyang balance was observed in a lumbar spinal stenosis case. One lumbar spinal stenosis case was managed with the Yinyang Balancing Appliance on temporomandibular joint (TMJ), combined with acupuncture. Clinical outcome measurement was based on subjective measures and clinical observations. The patient showed positive changes even after the initial treatment and this effect maintained over the follow-up period. further clinical and biological research on FCST is expected.

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A Study on Assessment of Patient with Lumbar Spinal Stenosis (요추 척추관 협착증의 평가척도에 대한 고찰)

  • Park, Kyoung-Su;Chung, Seok-Hee
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.2 no.1
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    • pp.23-38
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    • 2007
  • Objectives : The aim of this study was to understand scale of lumbar spinal stenosis. Methods : Papers including questionnaires for assessment disability, fuction, activity limitation, or prticipation restriction in adult patients with low back pain or spinal stenosis were searched in the MEDLINE. Results and Conclusions : 1. VAS, VRS, NRS were recommended to the pain scale. 2.ODI and RMDQ were recommended to the function scale. 3. ODI, RMDQ, QBPDS, LBOS, MVAS, WDI commonly used to the fuction scale.

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Effect of Bergamot Essential Oil-Inhalation on Chronic Pain after Surgery for Lumbar Spinal Stenosis (버가못 에센셜 오일 향흡입이 요추관협착증 환자의 수술 후 만성통증에 미치는 효과)

  • Seol, Geun-Hee;Jung, Myung-Hee
    • 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.

The Biomechancial Effects of an Interspinous Spacer Implant on 3-D Motions for the Treatment of Lumbar Spinal Stenosis (요추부 척추관 협착증 치료를 위한 극돌기간 삽입술의 3차원 분석을 통한 생체역학적 효과 분석)

  • 이희성;신규철;문수정;정태곤;이권용;이성재
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2004.10a
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    • pp.1207-1210
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    • 2004
  • As many humans age, degenerative lumbar spinal stenosis (DLSS) becomes a major cause of lower limb discomfort and disability. By surgical treatment method of DLSS, the existing surgical treatment methods using internal fixation have showed degeneration changes of an adjacent vertebrae and loss of lumbar spine lordosis-kyphosis due to eliminating a motion. For solving the problems of internal fixation, a novel interspinous spacer has been developed to treat DLSS by surgical treatment method. In this study, we evaluated the biomechanical effects of the interspinous spacer on the kinematics of the porcine lumbar spine before and after insertion of the implant. For this purpose, a device that is capable of measuring 3-D motions were built based on direct linear transformation (DLT) algorithm written with MATLAB program. Results showed that in extension, a change of the mean angle between the intact and the implanted specimens at L4-L5 was 1.87 degree difference and the implant reduced the extension range of motion of the L4-L5 (p<0.05). But the range of motion in flexion, axial rotation and lateral bending at the adjacent segments was not statistically affected by the implant. In conclusion, we thought that interspinous spacer may have remedical value for DLSS by flexing human lumbar spine.

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The Case Report of Lumbar Spinal Stenosis Treated with Bee Venom Acupuncture Therapy (봉약침 요법을 이용한 요추관 협착증 치험 1례)

  • 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.1
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    • pp.49-57
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    • 2007
  • Objectives : This study was performed to evaluate the effect of Bee Venom Acupuncture Therapy on Lumbar Spinal Stenosis. Methods : The patient was diagnosed as Lumbar Spinal Stenosis through Lumbar spine MRI and treated with Bee Venom Acupuncture Therapy and so on and measured of VAS and ODI score to evaluate treatment effects. Results and Conclusions : ROM of Lumbar, Milgram test and sensory test has improved. VAS and ODI score were also decreased.

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The Case Report of Conservative Treatment on Failed Back Surgery Syndrome (요추관 협착증 수술 실패 증후군 환자에 대한 보존적 치료 치험 1례)

  • Lee, Gil-Jae;Lee, Byeong-Yee;Song, Yun-Kyung;Lim, Hyung-Ho
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.3 no.1
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    • pp.9-18
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    • 2008
  • Objective : The purpose of this study is to evaluate the conservative treatment for FBSS patient. Methods : We used Herbal medication, Acupuncture, burning Acupuncture, Physical Therapy for this patient. And we measured of VAS and ODI score to evaluate treatment effects. Results : Patient's sciatica and sensory test has improved. VAS and ODI score were also decreased.

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Chuna Manual Therapy for Lumbar Spinal stenosis : A Systematic Review (요추 척추관협착증에 대한 추나요법의 효과 : 체계적 문헌 고찰)

  • Lim, Kyeong-Tae;Shin, Byung-Cheul;Heo, In;Hwang, Man-Suk
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.13 no.2
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    • pp.1-10
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    • 2018
  • Objectives : To evaluate the evidence supporting the effectiveness and safety of Chuna manual therapy(CMT) for lumbar spinal stenosis Methods : We searched 10 electronic databases(Pubmed, EMBASE, Cochrane Library, CAJ, RISS, KISS, KISTI, KMBASE, DBpia, NDSL) and related 2 journals up to October 2018. We included randomized controlled trials(RCTs) of testing CMT for lumbar spinal stenosis patients. The methodological quality of RCTs related assessed by the Cochrane risk of bias tool 1.0. Results : Three RCTs were eligible in our inclusion criteria. The meta-analysis of 3 studies showed positive results for the using CMT for lumbar spinal stenosis. Conclusions : The review found favorable evidence of CMT for treating lumbar spinal stenosis with meta-analysis. However, our systematic review has limited evidence to support CMT for lumbar spinal stenosis because of low quality of original articles and further well-designed RCTs should be encouraged.

The Relationship between Neural Foraminal Stenosis and Imaging Features of Lumbar Spine MRI in Patients Older Than 60 Years with Lumbar Radiculopathy (요추신경근병증이 있는 60세 이상의 환자에서 신경공 협착과 자기공명영상 평가를 통한 인자와의 상관관계)

  • Kyeyoung Lee;Hee Seok Jeong;Chankue Park;Maeran Kim;Hwaseong Ryu;Jieun Roh;Jeong A Yeom;Jin Hyeok Kim;Tae Un Kim;Chang Ho Jeon
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.862-875
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    • 2021
  • Purpose To investigate the MRI features associated with neural foraminal stenosis (NFS) in patients older than 60 years with lumbar (L) radiculopathy. Materials and Methods This study included 133 retrospectively selected patients older than 60 years with lumbar radiculopathy who had undergone a lumbar spine MRI (from January 2018 to April 2018). For L4/L5 and L5/sacral (S)1 levels, NFS was reviewed blindly by two radiologists. Spondylolisthesis, retrolisthesis, disc height loss, disc bulging/herniation/central canal stenosis, ligamentum flavum thickening, and facet hypertrophy were evaluated separately for the NFS and non-NFS groups, and they were compared using univariate and multivariate analyses. Results The univariate analysis revealed that disc height loss (p = 0.006) was associated with NFS for L4/L5. For L5/S1, both spondylolisthesis (p = 0.005) and facet hypertrophy (p = 0.006) were associated with NFS. The multivariate logistic analysis revealed that disc height loss was associated with NFS for L4/L5 [odds ratio (OR) = 4.272; 95% confidence interval (CI) 1.736-10.514]. For L5/S1, spondylolisthesis (OR = 3.696; 95% CI 1.297-10.530) and facet hypertrophy (OR = 6.468; 95% CI 1.283-32.617) were associated with NFS. Conclusion Disc height loss was associated with NFS for L4/L5 and spondylolisthesis and facet hypertrophy were associated with NFS for L5/S1.