• 제목/요약/키워드: 척추 협착증

검색결과 65건 처리시간 0.027초

척추관협착증에 있어서 침과 뜸 자극에 의한 체열 변화의 정량적 해석에 관한 연구 (A Study on the Quantity Analysis to the Heat Variation for the Stenosis of the Lumber by the Acupuncture-Moxa Cautery Stimulations)

  • 조봉관
    • 대한한의진단학회지
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    • 제17권3호
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    • pp.253-262
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    • 2013
  • Objectives This study is on the quantifying method for the acupuncture-moxa cautery heat response index, which are based on the some definitions. Methods The magnitude of the acupuncture-moxa cautery is defined by the pain-feeling of the acupuncture-moxa cautery stimulation: the stimulation magnitude of the acupuncture is 1, that of the direct moxa-cautery is 2, and that of the indirect moxa-cautery is 0.5. The heat variation of the acupuncture-moxa cautery stimulation is defined by the heat variations of the characteristic points pre/post-stimulations in the stenosis of the lumber. The acupuncture-moxa cautery heat response index is defined by the ratio of between the magnitude of the heat variation and the natural logarithmic magnitude of the stimulation. Results With the respect of the acupuncture-moxa cautery heat response index, I experimented and estimated 4 types of stimulations in the stenosis of the lumber: the single acupuncture stimulation with 40%, the single direct moxa-cautery stimulation with 52%, the combinational acupuncture-moxa cautery stimulations with 27%, and the combinational acupuncture-indirect electronic moxa-cautery stimulations with 53%. Conclusions According to the acupuncture-moxa cautery heat response index. the combinational acupuncture-moxa cautery stimulations especially need to be changed to the combinational acupuncture-indirect electronic moxa-cautery stimulations.

전신마취동안에 복와위시 자유로운 복근 움직임이 심혈관계에 미치는 영향 (Cardiovascular Effects of Free Movement of Abdominal Muscle in Prone Positioning during General Anesthesia)

  • 김지윤;이동원;서일숙;김세연
    • Journal of Yeungnam Medical Science
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    • 제24권2호
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    • pp.206-215
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    • 2007
  • 복와위는 신체 후부 노출이 필요한 척추 수술을 위해 주로 사용되고 있으며 수술부위로의 접근이 용이하고 수술 도중에 척추를 안정적으로 유지해주는 장점이 있다. 하지만 전신마취하에 있는 환자를 앙와위에서 복와위로의 전환은 여러 가지 부작용을 동반하며 특히 순환기계의 변화를 초래할 수 있다. 이를 줄이기 위해 다양한 복와위 전용 수술대들이 연구 개발되어 임상에 사용되고 있다. 이에 저자들은 앙와위에서 복와위로의 체위 변환 시에 Jackson spinal surgery table의 이용이 체위에 의한 압박 때문에 생기는 환자의 순환기계 변화를 얼마나 효과적으로 줄여줄 수 있는지 알아보고자 하였다. 본 연구는 추간판탈출증, 퇴행성척추전방전위증, 척추협착증의 진단 하에 본원 정형외과와 신경외과에서 수술을 받기로 예정된 환자 중 미국 마취과학회 신체등급 분류 1급 또는 2급에 해당하는 성인 환자 30명을 대상으로 하였다. 연구 대상 환자의 성별은 남자가 15명, 여자가 15명이었고, 심혈관계나 호흡기계 질환이 있는 환자는 연구 대상에서 제외하였다. 모든 환자는 마취전투약으로 수술 시작 1시간 전에 glycopyrrolate 0.2 mg, fentanyl $1{\mu}g/kg$을 근주하였으며 수술실에 도착한 후 비침습적 자동 혈압 측정기, 심전도 및 맥박산소 계측기를 거치하였다. Thiopental sodium과 vecuronium으로 마취를 유도하였으며 환자의 의식소실과 충분한 근이완을 확인한 후 기관내 삽관을 시행하였다. Enflurane 1.5-2.0 vol%와 $O_2$, $N_2O$ 각각 2 L/min을 사용하여 마취유지를 하였으며 급격한 활력 징후의 변동으로 마취유지가 용의치 않은 경우는 연구 대상에서 제외시켰다. 환자의 활력 징후 안정 후 요골 동맥에 카테터를 거치하여 지속적으로 동맥압을 측정하였고, 우측 쇄골하 정맥에 중심정맥 카테터를 거치하여 중심정맥압을 측정하였다. 부분재호흡 심박출량 감시기 ($NICO^{(R)}$, Novametrix Medical Systems INC., USA)를 통해 비침습적으로 환자의 심박출량을 측정하였다. 앙와위에서 복와위로 체위변경 직전에 심박출 계수, 심박출량, 평균동맥압, 심박수, 중심정맥압을 측정하여 앙와위의 값으로 삼았으며, 척추 수술 전용 수술대인 Jackson spinal surgery table을 사용하여 복와위를 취하였다. 복와위로 체위 변경 뒤 심박출 계수, 심박출량, 평균동맥압, 심박수, 중심정맥압을 측정하여 복와위의 값으로 기록하였다. 본 연구 결과 앙와위와 복와위의 혈역학적 지수의 비교시 심박수와 평균동맥압은 별다른 차이가 없었다. 중심정맥압은 유의한 정도는 아니지만 감소 소견을 보여 수술시 출혈의 위험성을 감소시킬 것으로 생각된다. 심박출량과 심박출 계수도 유의한 감소 소견을 보였으나 convex saddle table을 이용한 경우와 kneechest position을 취한 경우보다 적은 변화를 보여 Jackson spinal surgery table의 사용은 유용할 것으로 사료된다. 그러나 Jackson spinal surgery table을 사용하여 복부와 흉부에 과도한 압력이 가해지지 않더라도 유의한 심박출량 감소가 있을 수 있음을 유념해야 할 것이다. 특히 심폐여력이 부족한 환자들에 있어서는 심박출량의 감소는 위험한 결과를 초래할 수 있으므로 복와위에 의한 생리적 변화에 관한 충분한 이해와 함께 마취 시 보다 적극적인 감시와 관리가 요구된다고 여겨진다.

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한방병원에 입원한 역류성 식도염을 동반한 척추관협착증 환자에 대한 한방 치료 1례 (A Case Report on Reflux Esophagitis Treated with Korean Medicine in a Patient with Spinal Stenosis)

  • 김소원;공건식;송진영;박진훈;왕연민;김상윤;이형철;엄국현;강만호;박성환
    • 대한한방내과학회지
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    • 제42권5호
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    • pp.800-807
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    • 2021
  • Objectives: This study investigated the efficacy of Korean medical treatment for reflux esophagitis. Methods: We used Korean medical treatment (herbal medicines, acupuncture, herbal acupuncture, and therapy) to treat a hospitalized patient with reflux esophagitis. To evaluate the treatment, we measured the symptoms using the Reflux Symptom Index (RSI) and the Visual Analogue Scale (VAS) for heartburn, acid reflux, chest pain, foreign body sensations in the throat, chronic cough, hoarseness, and bronchial asthma. The generic health status was evaluated using the European Quality of Life Five-Dimension (EQ-5d) Scale. Results: The RSI and EQ-5d scores improved following treatment, but the VAS scores showed that only heartburn, acid reflux, and chest pain symptoms were relieved. Conclusions: This study suggests that Korean medicine may be effective for treating reflux esophagitis.

요추 추간판 탈출증 및 척추관 협착으로 인한 하지 근력 저하 및 보행 장애 환자에 대한 추나요법을 포함한 한방복합치료 치험 1예 (A Case of Korean Medicine Treatments Including Chuna Therapy in Lower Extremity Weakness and Gait Disturbance Due to Lumbar Disk Herniation and Spinal Stenosis)

  • 정수은;박송미;조성우
    • 한방재활의학과학회지
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    • 제31권2호
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    • pp.99-108
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    • 2021
  • The study reports the clinical case of a patient with lower extremity weakness and gait disturbance treated with Korean medicine treatments including Chuna therapy. The patient suffered lower extremity weakness and gait disturbance with diagnosis of lumbar disk herniation and spinal stenosis. As a treatment, the doctor applied Chuna therapy, herbal medicine, acupuncture, pharmacopuncture, cupping and moxa. The effect of treatment was evaluated by numeral rating scale (NRS), self-walkable distance, functional independence measure (FIM), Oswestry disability index (ODI) and manual muscle test (MMT). NRS decreased from 6 to 4 at the leg. Self-walkable distance increased from 0 m to 10 m, FIM increased 85 to 96 points while ODI decreased 64% to 54%. MMT of hip flex and knee extension improved from grade 3+, grade 3 to grade 4, respectively. Korean medicine treatment can be effective for patients who suffer lower extremity weakness and gait disturbance due to lumbar disk herniation and spinal stenosis. Further clinical studies are required to verify these findings.

한방병원에 입원한 요추관협착증을 동반한 만성 위염 환자에 대한 한방 치료 1례 (A Case Report of Chronic Gastritis in a Patient with Spinal Stenosis Hospitalized at a Korean Medicine Hospital and Treated with Korean Medicine)

  • 김소원;박진훈;왕연민;김상윤;백길근;윤상훈;이형철;강만호;박성환;이지영
    • 대한한방내과학회지
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    • 제43권5호
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    • pp.854-863
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    • 2022
  • Objectives: The purpose of this study is to report the efficacy of applying Korean medical treatment to chronic gastritis. Methods: We treated a chronic gastritis patient with Korean medical treatments (herbal medicines, acupuncture, and herbal acupuncture therapy). To evaluate the results of this treatment, we took measurements using the Gastrointestinal Symptom Rating Scale and Visual Analogue Scale for abdominal pain, heartburn, nausea, and abdominal distension. The patient's generic health status was evaluated using the European Quality of Life 5 Dimensions Scale. Results: Improvements in gastrointestinal symptom ratings and the European Quality of Life 5 Dimensions Scale were observed after the treatments. Relief of symptoms was observed in abdominal pain, heartburn, nausea, vomiting, and abdominal distension using the Visual Analogue Scale. Conclusions: This study suggests that Korean medicine may be effective in the treatment of chronic gastritis.

한방병원에 입원한 요추관협착증을 동반한 말초성 안면신경마비 환자에 대한 한방 치료 1례 (A Case Report of Peripheral Facial Nerve Palsy in a Patient with Spinal Stenosis Hospitalized at a Korean Medicine Hospital and Treated with Korean Medicine)

  • 왕연민;박진훈;김소원;김상윤;백길근;윤상훈;강만호;박성환;이형철;이지영
    • 대한한방내과학회지
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    • 제43권5호
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    • pp.827-837
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    • 2022
  • Objectives: The purpose of this study is to investigate the effectiveness of using Korean medical treatment for peripheral facial nerve palsy. Methods: We primarily treated the patient's peripheral facial nerve palsy during hospitalization (06/28/21~07/13/21) without any other steroids or antiviral drug treatments and additionally treated their spinal stenosis, using Korean medical treatments in both cases (herbal medicine, acupuncture, and herbal acupuncture therapy). The House-Brackmann grading system and Yanagihara's unweighted grading system were used to assess facial symptom changes, and the Numerical Rating Scale was used to evaluate the back pain caused by the spinal stenosis. Results: Following treatment, the patient's House-Brackmann and Numerical Rating Scale scores decreased, while their Yanagihara unweighted score improved. Conclusions: This study suggests that Korean medicine may be effective in the treatment of facial nerve palsy.

요추 전만 각도 및 요추 추간판 각도와 요추 척추관 협착증의 상관관계에 관한 연구 (A Study for Clinical and Radiological Correlation between Lumbar Lordotic Angle, Lumbar Intervertebral Disc Angle and Lumbar Spinal Stenosis)

  • 김종수;손슬기;김세준;김신웅;정승현;김태호;정연재;김효섭
    • 한방재활의학과학회지
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    • 제24권4호
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    • pp.129-136
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    • 2014
  • Objectives The purpose of this study is to find out clinical and radiological correlation between lumbar lordotic angle, lumbar intervertebral disc angle and lumbar spinal stenosis. Methods Total 250 patients' who had visited Bu-Chun Jaseng Hospital of Korean Medicine lumbar lordotic angle, intervertebral disc angle of L4/5 and dural sac dimension of L4/5 were measured by X-ray and MRI films. We analysed correlation between lumbar lordotic angle, intervertebral disc angle of L4/5 and lumbar spinal stenosis in terms of clinical and radiological aspect. Results 1. The mean intervertebral disc angle of L4/5 were $10.72{\pm}3.98^{\circ}$, the mean lumbar lordotic angle were $41.97{\pm}11.73^{\circ}$ and the mean dural sac dimension of L4/5 were $133.18{\pm}45.46mm^2$. 2. This study shows that dural sac dimension of L4/5 was inversely reated to intervertebral disc angle of L4/5 by statistically (p<0.05). 3. There was visible difference regarding intervertebral disc angle of L4/5 between patients who had been diagnosed with lumbar spinal stenosis by clinically and patients who had not been diagnosed with lumbar spinal stenosis by clinically; The former's angle was relatively higher than the latter's (p<0.05). Conclusions There was a statistical significance between intervertebral disc angle of L4/5 and lumbar spinal stenosis in single-segment.

관절경적 전방 견봉 성형술을 이용한 만성 견관절 충돌 증후군의 치료 (Arthroscopic Anterior Acromioplasty for the Treatment of Chronic Impingement Syndrome of the Shoulder)

  • 박태수;김재영
    • 대한관절경학회지
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    • 제4권1호
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    • pp.49-53
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    • 2000
  • 목적 :. 만성 견관절 충돌증후군에 대한 수술적 치료로서 사용한 관절경적 전방 견봉 성형술의 치료 결과를 분석하고 임상적 효용성을 평가하고자 하였다. 대상 및 방법 : 1995년 7월부터 1997년 12월까지 만성 견관절 충돌증후군 환자 중 6개월 이상 보존적 치료에도 불구하고 증상이 호전되지 않아 관절경을 이용하여 전방 견봉 성형술을 시행한 26명의 환자, 27례의 견관절들을 대상으로 하였다. 심한 퇴행성 관절염 회전근 개 전층 파열 및 견관절 비출구 충돌증후군 (nonoutlet impingement) 등은 모두 연구 대상에서 제외하였다. 평균 추시 기간은 2년 3개월(범위, 1년 7개월-3년 11개월)이었다. 임상적인 결과 판정은 UCLA 견관절 평가지수를 이용하였다. 결과 : 27례 중 23례$(85.2\%)$에서 매우 우수 또는 우수한 결과를 보였으며, 4례$(14.8\%)$에서 양호의 결과를 나타내었다. 환자의 만족도는 27례 중 26례$(96.3\%)$에서 주관적인 만족을 나타내었고, 1례 $(3.7\%)$에서 불만족을 나타내었으며 이 경우 Parkinson 증후군과 경추 후종인대 골화증 및 제 5-6번 경추의 척추 협착증이 동반된 환자였다. 결론 : 관절경적 전방 견봉 성형술은 특히 술전 동통의 정도가 술후 현저히 개선되는 등 증상 완화에 우수한 결과를 예상할 수 있는 만성 견관절 충돌증후군의 효율적 치료법이지만, 견관절 및 그 주위의 병변이나 전신 질환 등이 동반될 경우 치료 결과에 영향을 미칠 수 있다.

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비구이형성증에 의한 고관절염과 요추 척추관 협착증 환자의 턱관절자세 음양교정술을 이용한 치험 1례 (A Case Report on a Patient with Osteoarthritis of the Hip Caused by Hip Dysplasia and Lumbar Spinal Stenosis, Treated by Postural Yinyang Correction of Temporomandibular Joint)

  • 임재은;김경민;장선희;박은진;이영준;홍누리;장영숙;양수현;최윤영;오다윤;이수진;김철홍
    • 턱관절균형의학회지
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    • 제9권1호
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    • pp.12-17
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    • 2019
  • Objectives: The purpose of this study is to report the effect of Postural Yinyang Correction of Temporomandibular Joint (Functional Cerebrospinal Therapy, FCST) on a patient with Osteoarthritis of the hip caused by Hip dysplasia and Lumbar spinal stenosis. Methods: A patient with Osteoarthritis of the hip caused by Hip dysplasia and Lumbar spinal stenosis was treated at Dept. of Acupuncture & Moxibustion, ○○ University Korean Medicine Hospital from Nov 8th, 2019 to Dec 6th, 2019 and received a Korean-Western medical treatment mainly managed with FCST. This study was measured with VAS (Visual Analogue Scale), ODI (Oswestry Disability Index) and questionnaire. Results: After treatment, the patient's pain was controlled and gait ability was improved, also VAS, ODI and questionnaire score were improved. Conclusions: Korean-Western Medical Treatment mainly managed with FCST may be helpful in controling pain with Osteoarthritis of the hip caused by Hip dysplasia and Lumbar spinal stenosis, but the further researches are needed.

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경막외신경차단술로 치료 중인 척추관 협착증 환자에서 거창만령단과 침의 효능 및 안전성 연구(예비임상연구) (Efficacy and Safety of Geochangmanryeung-dan and Acupuncture on Patient with Spinal Stenosis Treated by Epidural Steroid Injection: a Study Protocol for a Randomized Controlled Pilot Trial)

  • 이현종;이초인;이사람;곽민아;곽상규;노운석;정진용
    • Korean Journal of Acupuncture
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    • 제32권3호
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    • pp.99-107
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    • 2015
  • Objectives : This study was designed to obtain basic data for a further large-scale trial as evaluating the efficacy and safety of Geochangmanryeung-dan(GMD) and acupuncture on patient with spinal stenosis treated by epidural steroid injection. Methods: The study is a randomized controlled pilot clinical trial, conducted over 8 weeks. Twenty participants will be recruited and randomly allocated to 2 groups: an experimental(GMD and acupuncture with epidural steroid injection) group and a control(only epidural steroid injection) group. The epidural steroid injection will be administered once per 2 weeks for 6 weeks(3 times in total). GMD will be administered as a dose of 5 pills, 3 times per day, for 6 weeks. Acupuncture will be performed 2 times per week for 6 weeks(12 times in total). The primary outcome will be measured by visual analogue scale and self-rated walking distance. The secondary outcome will be measured by PainVision, short-form McGill Pain Questionnaire, and Oswestry Disability Index. Both primary and secondary outcomes will be measured at baseline, 2, 4, 6, and 8 weeks. The last assessment(at 8 weeks) will be performed 2 weeks after treatment cessation. Conclusions : This clinical trial, as the pilot study for a future large-scale trial, will provide clinical information for evaluating the efficacy and safety of GMD and acupuncture treatment in combination with epidural steroid injection for the treatment of spinal stenosis.