• Title/Summary/Keyword: 척추 협착증

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Patient's Perception for Developing Research Questions of a Clinical Practice Guideline of Korean Medicine for Degenerative Lumbar Spinal Stenosis: A Descriptive Cross-Sectional Survey (퇴행성 요추 척추관 협착증의 한의표준임상진료지침 핵심질문 설정에 대한 환자 인식 설문 조사: 단면 설문 연구)

  • Choi, Seo Young;Bae, Ji Min;Choi, Ji Won;Yang, Gi Young;Lee, Byung Ryul;Kim, Kun Hyung
    • Korean Journal of Acupuncture
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    • v.35 no.3
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    • pp.130-138
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    • 2018
  • Objectives : The purpose of this study is to explore patients' perceptions that deserve attention when designing core questions for a clinical practice guideline of Korean medicine(KM) for degenerative lumbar spinal stenosis (LSS). Methods : Patients who had been admitted to Pusan National Korean Medicine Hospital from November 1, 2015 to October 31, 2016 were invited to the survey. Patients were eligible if they were both clinically and radiologically confirmed as degenerative LSS. The structured questionnaire was distributed by mail and outpatient visits. Questions included types of experienced Korean/Western medical interventions for LSS, their perceived effectiveness on symptoms, the necessity for studies of KM for degenerative LSS, the types of KM interventions to be investigated and the types of outcome measures after treatments. Data were descriptively analysed. Results : Twenty of thirty-one invited participants responded to the questionnaire. Acupuncture and herbal medicine were the most frequently used KM interventions. Eighteen respondents reported that KM treatments were helpful for their improvement. Sixteen patients who mentioned that research on KM is needed chose acupuncture as the top priority(88%) among KM interventions. The most important outcomes in the view of nineteen respondents included functional recovery (68%) and pain relief (53%). Thirteen respondents (65%) replied that both short-term and long-term outcome were important for them. Conclusions : Our findings may have limited validity due to the small number of respondents and the potential selection and information bias. Further qualitative studies and large-scale surveys to comprehensively identify patients' views are warranted.

Effect of the Radius of Curvature on the Contact Pressure Applied to the Endplate of the Sliding Core in an Artificial Intervertebral Disc (인공추간판 슬라이딩 코어의 곡률반경 변화가 종판의 접촉압력에 미치는 영향)

  • Kim, Cheol-Woong
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.36 no.1
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    • pp.29-35
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    • 2012
  • The treatments for spinal canal stenosis are radicular cyst removal, spine fusion, and implantation of an artificial intervertebral disc. Artificial intervertebral discs have been most widely used since the mid-2000s. The study of artificial intervertebral discs has been focused on the analysis of the axial rotation, lateral bending, the degrees of freedom of the disc, and flexion-extension of the vertebral body. The issue of fatigue failure years after the surgery has arisen as a new problem. Hence, study of artificial intervertebral discs must be focused on the fatigue failure properties and increased durability of the sliding core. A finite element model based on an in the artificial intervertebral disc (SB Charit$\acute{e}$ III) was produced, and the influence of the radius of curvature and the change in the coefficient of friction of the sliding core on the von-Mises stress and contact pressure was evaluated. Based on the results, new artificial intervertebral disc models (Models-I, -II, and -III) were proposed, and the fatigue failure behavior of the sliding core after a certain period of time was compared with the results for SB Charit$\acute{e}$ III.

The Effect of Intravenous Lipo-Prostaglandin E1 Injectioin in a Rat Foraminal Stenosis Model (백서의 척추간 신경공 협착증 모델에서 Lipo-Prostaglandin E1의 정주효과)

  • Yoon, Hye Kyoung;Lee, Pyung Bok;Han, Jin Soo;Park, Sang Hyun;Lee, Seung Yoon;Lee, Yang Hyun;Kim, Yong Chul;Lee, Sang Chul
    • The Korean Journal of Pain
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    • v.20 no.1
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    • pp.15-20
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    • 2007
  • Background: Lipo-prostaglandin E1 (Lipo-$PGE_1$) has vasodilating and platelet aggregation inhibitory characteristics and it has been used as a treatment for patients with blood flow dysfunction disease. Based on the mechanisms of lumbar spinal stenosis, including veno congestion, neuro-ischemia and mechanical compression, we aimed to study whether intravenous Lipo-$PGE_1$ injection has any therapeutic effect on hyperalgesia in a rat foraminal stenosis model. Methods: In this study, twenty male Sprague-Dawley rats were divided into the control (n = 10) and Lipo-$PGE_1$ (n = 10) groups. A small stainless steel rod was inserted into the L5-6 intervertebral foramen to induce intervertebral foramen stenosis and chronic DRG compression. In the Lipo-$PGE_1$ group, $0.15{\mu}g/kg$ of Lipo-$PGE_1$ were injected intravenously via a tail vein for 10 days starting from the $3^{rd}$ day after operation. Behavioral testing for mechanical and thermal hyperalgesia was performed for 3 weeks after the injections. Results: From the $10^{th}$ day after Lipo-$PGE_1$ injection, the rats in the experimental group showed significant recovery of their mechanical threshold, and this effect was maintained for 3 weeks. No significant differences of the thermal hyperalgesia were observed between the two groups. Conclusions: These findings suggest that intravenously injected Lipo-$PGE_1$ may be effective for alleviating neuropathic pain, which isthe main symptom of spinal stenosis, by improving the blood flow dysfunction.

The Value of Additional Cervicothoracic Spine Sagittal T2-weighted Images Included in Routine Lumbar Spine MR Imaging (요추 MR영상에 포함된 경흉추 시상T2강조영상의 효용성 평가)

  • Seo, Jiwoon;Park, So Young;Lee, Joon Woo;Lee, Guen Young;Kang, Heung Sik
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.2
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    • pp.91-100
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    • 2013
  • Purpose : To evaluate the usefulness of cervicothoracic spine sagittal T2-weighted images (CT SAG T2WIs) included in routine lumbar spine MRI. Materials and Methods: Institutional review board approval was obtained and informed consents were waived for this retrospective study. The study group comprised 2,113 patients who underwent lumbar spine MRI from January 2005 to December 2005. CT SAG T2WIs were added in the routine lumbar spine MRIs. Radiologic reports were reviewed retrospectively for pathologic lesions on CT SAG T2WIs by one radiologist. Information of additional cervical or thoracic spine MRI and/or CT for further evaluation of positive findings on CT SAG T2WIs and their treatment were collected by retrospectively reviewing medical records. Results: The CT SAG T2WIs revealed 142 pathologic lesions in 139 (6.58%) of the 2,113 patients. They were easily obtained without positional change in a scan time of less than 2 minutes. Additional cervical or thoracic spine MRI and/or CT for positive findings on CT SAG T2WIs were performed in 13 patients. Seven patients underwent surgical treatment. Conclusion: CT SAG T2WIs included in routine lumbar spine MRI were useful in finding the pathologic lesions in cervicothoracic spine for the patients who assumed to have lesions in lumbar spine.

A Case Report of Combined Korean Medicine Treatment of Spinal Stenosis with Lipomatosis (지방종을 동반한 척추관협착증 환자의 복합한방치료 치험 1예)

  • Kim, Mihye;Han, Su-Bin;Park, Byunghak;Son, Jaemin;Lee, Nam-Woo;Han, Jeong-Hun;Kang, Do-Hyeon;Min, Tae-Woon;Ahn, Jae-Seo;Lee, Hansol;Lee, Hyun-Jun
    • Journal of Korean Medicine Rehabilitation
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    • v.30 no.4
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    • pp.195-201
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    • 2020
  • Spinal epidural lipomatosis is a rare disorder characterized by overgrowth of fat in the extradural space, causing spinal stenosis with compression of the neural elements. This study reports on the effectiveness of Korean medicine treatment on a patient who was diagnosed on lumbar stenosis with lipomatosis. The patient was treated with Korean traditional medicine including pharmacopucture, acupuncture, Chuna manual treatment, and Korean herbal medicine, cupping. Numerical rating scale (NRS), Oswestry disability index (ODI), Euroqol five dimension (EQ-5D) index, lumbar range of motion were used as objective tools for evaluating the patient's progress. Back NRS decreased from 6 to 3. In the case of lower limbl radiation NRS, 5 was reduced to 3 upon discharge. EQ-5D index also increased from 0.751 to 0.766. For ODI, the score dropped from 26.67 to 24.44 on hospitalization. As a result, clinical improvements were found in a patient. In conclusion, this study shows that Korean medicine treatment can be considered as effective conservative care for spinal stenosis with lipomatosis.