• 제목/요약/키워드: Cervical herniated intervertebral disc

검색결과 30건 처리시간 0.024초

한방병원에 입원한 경추 추간판 탈출증 환자의 치료 및 경제성 평가 연구 (An Analysis of Treatment and Economic Evaluation on the Part of Cervical HIVD Inpatients at Korean Medicine Hospital)

  • 이현재;장선정;허동석
    • 한방재활의학과학회지
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    • 제23권3호
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    • pp.159-175
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    • 2013
  • Objectives Herniated Intervertebral Disc of C-spine is one of the most common diseases that causes posterior neck pain. This study was designed to analyze the general distribution and hospital cost by day and case of Korean medical treatment for Cervical Herniated Intervertebral Disc (HIVD). Methods The 132 impatients for treatment of HIVD were analyzed according to the distribution of sex, age, the duration of HIVD, the contributory factors, the Clinical grade at admission, the clinical findings at admission, the duration of hospitalization, the clinical grade at admission and the hospital cost per day and case. Results 1) The total hospital cost per case averaged 1,985,600 Won, which was consisted of room charge 584,044 Won (29.41%), performance fee 511,463 Won (25.76%), herbal medication 381,517 Won (19.21%), Korean medical physiotherapy 296,310 Won (14.92%), food expenses 199,997 Won (10.07%) in order. 2) The total hospital cost per day averaged 137,285 Won, which was consisted of room charge 39,036 Won (28.43%), performance fee 33,594 Won (24.47%), herbal medication 30,642 Won (22.32%), food expenses 12,870 Won (9.37%), and the average duration of hospitalization was 15.1 days. 3) There was statistically significant difference in the consultation fee, room charge, and herbal medication on the part of sex. 4) There was statistically significant difference not only in the performance and consultation on the part of duration of hospitalization but also the in the duration of average duration of hospitalization. 5) There was statistically significant difference in the Korean medical physiotherapy and herbal medication on the part of clinical findings. 6) There was statistically significant difference in the Korean medical physiotherapy and herbal medication on the part of duration of HIVD. 7) There was statistically significant difference in the Korean medical physiotherapy and herbal medication on the part of clinical outcome. 8) There was not only statistically significant difference in the performance, but also in the herbal medication on the part of clinical grade at admission. Conclusions This study provides plenty of information to design out the specific terms of Korean medical expenses of Cervical HIVD inpatients hospitalized at Korean medicine hospital.

경항통 환자에 있어서 방사통과 영상의학검사 소견상의 연관성 분석 (Correlation Analysis between Radiological Result and Radiating Pain in Neck Pain)

  • 한경완;김은석;우재혁;김호준;이명종
    • 한방재활의학과학회지
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    • 제20권4호
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    • pp.139-146
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    • 2010
  • Objectives : To compare the differences between the symptoms and the findings of MRI(magnetic resonance imaging) and x-ray, we studied the patients with neck pain or radiating pain, which has been diagnosed as cervical herniated disc recently. Methods : We randomly selected among the 143 patients with x-ray and cervical spine(C-spine) MRI films who have visited Ja-seng hospital with neck pain and neck and radiating pain from April 1 of 2010 to May 1. We used SPSS 13.0 for windows in analyzing statistical data of study results and the level of significance was below 0.05. Results : 1. There were no significant differences between the presence of radiating pain and the amount of cervical herniation(p>0.05). 2. If the finding of a x-ray showed narrowing, based on MRI findings, the amount of herniation was more severe(p>0.05). 3. There were no significant differences between the presence of radiating pain and the findings of x-ray(p>0.05). 4. Among the 143 cases, which showed findings beside HIVD(herniation of intervertebral disc) were 13 cases. 88 cases of straightening(61.5%). 78 cases of uncovertebral joint arthrosis(54.5%). 25 cases of stenosis(17.5%), 13 cases of retrolisthesis(9.1%), 8 cases of osteophyte(6.6%), 4 cases of spondylolisthesis(2.8%), 2 cases of hemangioma(1.4%), 3 cases of OPLL(ossification of posterior longitudinal ligament)(2.1%), 2 cases of block vertebrae(1.4%), 2 cases of spondylitis(1.4%), 1 case of kyphosis(0.1) and 1 case of ligamentum flavum hypertrophy(0.1%). Conclusions : The findings from this study suggest that there was no relation between radiating pain and radiological result. On the other hand, diagnosis of x-ray and MRI showed significant relevance. The narrower disc space there were, the severer the state of herniation there existed.

Effect of Cervical Interlaminar Epidural Steroid Injection: Analysis According to the Neck Pain Patterns and MRI Findings

  • Choi, Ji Won;Lim, Hyung Woo;Lee, Jin Young;Lee, Won Il;Lee, Eun Kyung;Chang, Choo Hoon;Yang, Jae Young;Sim, Woo Seog
    • The Korean Journal of Pain
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    • 제29권2호
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    • pp.96-102
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    • 2016
  • Background: It is widely accepted that cervical interlaminar steroid injection (CIESI) is more effective in treating radicular pain than axial neck pain, but without direct comparison. And the differences of effect after CIESI according to MRI findings are inconsistent. In this retrospective study, we evaluated the therapeutic response of CIESI according to pain sites, durations, MRI findings, and other predictive factors altogether, unlike previous studies, which evaluated them separately. Methods: The medical records of 128 patients who received fluoroscopy guided CIESI were analyzed. We evaluated the therapeutic response (more than a 50% reduction on the visual analog scale [VAS] by their second visit) after CIESI by (1) pain site; neck pain without radicular pain/radicular pain with or without neck pain, (2) pain duration; acute/chronic (more than 6 month), and (3) findings of MRI; herniated intervertebral disc (HIVD)/spinal stenosis, respectively and altogether. Results: Eighty-eight patients (68%) responded to CIESI, and there were no significant differences in demographic data, initial VAS score, or laboratory findings. And there were no significant differences in the response rate relating to pain site, pain duration, or MRI findings, respectively. In additional analysis, acute radicular pain with HIVD patients showed significantly better response than chronic neck pain with spinal stenosis (P = 0.04). Conclusions: We cannot find any sole predictive factor of therapeutic response to the CIESI. But the patients having acute radicular pain with HIVD showed the best response, and those having other chronic neck pain showed the worst response to CIESI.

Analysis on the Acupuncture Contents of the Domestic Neck Pain and HIVD-Cervical Spine Clinical Studies : a literature review

  • Mo, Min Ju;Hwang, Doo Ree;Lee, Ju Hyeon;Kim, Dong Hoo;Hwang, Seon Hye;Sohn, Soo Ah;Hwang, Ji Hoo
    • Journal of Acupuncture Research
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    • 제34권2호
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    • pp.113-125
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    • 2017
  • Objectives : Cervical herniated intervertebral disc (HIVD) are common diseases. They can be managed with acupuncture, but the evidence for effectiveness is uncertain. This review analyzed the acupuncture studies of domestic neck pain and cervical HIVD; the purpose of this study was to provide basic data useful for future research. Methods : We investigated acupuncture treatments for neck pain and cervical HIVD by searching 5 Korean Internet databases. The keywords used were "neck pain", "HIVD-cervical spine", and "nuchal pain". A total of 53 research papers (17 case reports, 16 clinical data analyses, 11 randomized controlled trials, and 9 non-randomized controlled trials) were found and analyzed according to the publication year, type of study, treatment, use of filiform needles, and type of pharmacopuncture used acupoint. The effectiveness of acupuncture treatment was determined. Results : 1. Filiform needles have been primarily used in domestic research and were used in at least half of published pharmacopuncture studies. 2. In 51 papers using filiform needles, many studies used only local acupoints; few studies used only distant acupoints. 3. All studies using pharmacopuncture were performed using local acupoints. In particular, the studies based on A-shi point, trigger point, and radiologic lesion sites were useful for multiple purposes. Conclusion : In this study, we analyzed the acupuncture contents of the domestic neck pain and HIVD-cervical spine clinical studies. This study considers the assessment of the quality and efficacy of each study, which is likely to require research that reflects the future.

경근요법(經筋療法)을 통한 근원성 신경 포착 증후군의 치료 (Investigation on the Meridian-Muscle Therapy for Myogenic Nerve Entrapment Syndrome)

  • 허수영;최진만;서해경
    • 대한추나의학회지
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    • 제2권1호
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    • pp.43-50
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    • 2001
  • Objectives : Scalenus anticus syndrome and Piriformis syndrome is representative of myogenic Nerve entrapment syndrome, and their clinical symptoms are similar to HIVD(herniated Intervertebral disc) of cervical or lumbar spine. But, distinguished by muscle test, these syndrome apply to Meridian-muscle therapy. Methods : Meridian-muscle therapy consists of Ashi(阿是)-point therapy, taping therapy, myofascial release technique, manipulation, their based on the traditional meridian-muscle theory. This theory is similar to myofascial pain syndrome in western medicine. The study population consisted of 9 patients who were already diagnosed as Nerve entrapment syndrome with radiological examination & physical examination and muscle test. The evaluation of clinical outcome was done by Visual Analogue Scale (VAS) and Pain Assesment Questionnaire(PAQ). Results and Conclusions : After treatment, All patient's VAS is decreased as $2.11{\pm}1.59$ and the evaluation of clinical effect was excellent(6 cases) or good(3 cases) according to PAQ. Conclusively, Meridian muscle therapy is efficacious against Nerve entrapment syndrome.

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Comparative Study of Clinical and Radiological Outcomes of a Zero-Profile Device Concerning Reduced Postoperative Dysphagia after Single Level Anterior Cervical Discectomy and Fusion

  • Son, Doo Kyung;Son, Dong Wuk;Kim, Ho Sang;Sung, Soon Ki;Lee, Sang Weon;Song, Geun Sung
    • Journal of Korean Neurosurgical Society
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    • 제56권2호
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    • pp.103-107
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    • 2014
  • Objective : This study analyzed clinical and radiological outcomes of a zero-profile anchored spacer (Zero-P) and conventional cage-plate (CCP) for single level anterior cervical discectomy and fusion (ACDF) to compare the incidence and difference of postoperative dysphagia with both devices. Methods : We retrospectively reviewed our experiences of single level ACDF with the CCP and Zero-P. From January 2011 to December 2013, 48 patients who had single level herniated intervertebral disc were operated on using ACDF, with CCP in 27 patients and Zero-P in 21 patients. Patients who received more than double-level ACDF or combined circumferential fusion were excluded. Age, operation time, estimated blood loss (EBL), pre-operative modified Japanese Orthopaedic Association (mJOA) scores, post-operative mJOA scores, achieved mJOA scores and recovery rate of mJOA scores were assessed. Prevertebral soft tissue thickness and postoperative dysphagia were analyzed on the day of surgery, and 2 weeks and 6 months postoperatively. Results : The Zero-P group showed same or favorable clinical and radiological outcomes compared with the CCP group. Postoperative dysphagia was significantly low in the Zero-P group. Conclusions : Application of Zero-P may achieve favorable outcomes and reduce postoperative dysphagia in single level ACDF.

The Effects of Miniscalpel Acupuncture on Cervicogenic Headache: A report of three cases

  • Jun, Seungah;Lee, Jung Hee;Gong, Han Mi;Chung, Yeon Joong;Kim, Ju Ran;Park, Chung A;Choi, Seong Hun;Lee, Geon Mok;Lee, Hyun Jong;Kim, Jae Soo
    • Journal of Acupuncture Research
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    • 제34권3호
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    • pp.131-138
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    • 2017
  • Objectives : This study examined the effects of miniscalpel acupuncture (MA) in three patients with cervicogenic headache. Methods : Patients were treated with MA, which was performed once per week for three weeks. A headache score, visual analogue scale (VAS), and neck disability index (NDI) were used for the evaluation of treatment effects. Results : In cases 1, 2, and 3, the headache score decreased from 4 to 1, 3 to 0, and 3 to 1, respectively. The VAS score decreased from 8.5 to 1.9, 5 to 0.4, and 5.3 to 2 in cases 1, 2, and 3, respectively. The NDI score decreased from 28 to 4, 50 to 4, and 38 to 16 in cases 1, 2, and 3, respectively. Conclusion : MA appears to be effective for the treatment of cervicogenic headache. Further data should be collected and a comparative study using other treatment methods should be performed.

후종인대 골화증 3례에 대한 임상적 고찰 (Clinical studies on Ossification of posterior longitudinal ligament(OPLL))

  • 김숙경;서원희;최성권;문익렬;박종태
    • Journal of Acupuncture Research
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    • 제19권6호
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    • pp.264-279
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    • 2002
  • Objective : Ossification of the posterior longitudinal ligament(OPLL) is considered kind of degenerative disease usually found in the cervical vertebrae. Most of cases of OPLL have radiculopathy, myelopathy or both of them such as neck pain, numbness, myatonia. These symptoms seems to be similar with those of HIVD(Herniated intervertebral disc), sprain, spondylosis of C-spine. Lost of patients who have those symptoms are visiting oriental medicine hospital, clinic so we thought that making differential diagnosis, treating and prognosing might be needed with acupuncture, Herb medication. Methods : We examined the 3 patients of OPLL who visited Dong-in-dang Oriental Medicine Hospital from 1st November 1999 to 1st February 2002. We treated patients of OPLL with Oriental Medicine care (Acupuncture, Herb medication, Negative treatment) based on oriental diagnosis of neck pain(項强痛), numbness(痺證), myatonia. Results : clinical grade of 3 cases was all Gr III. After treated with oriental medical care, 2 cases were evaluated poor, I cases were evaluated fair and resulted in Clinical grade II. Conclusions : Treating OPLL with oriental medical carte was very difficult to palliate symptoms, to stop progress of OPLL. We might need to reconsider oriental medical care as conservative treatment for OPLL.

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전방경추융합술 후 발생한 역설상기도폐쇄 및 중추성 수면 무호흡 (Paradoxical Upper Airway Obstruction and Central Sleep Apnea Developed After Anterior Cervical Spine Fusion)

  • 이상학;최영미;박예리;강지호;김영균;김관형;송정섭;박성학;문화식
    • Tuberculosis and Respiratory Diseases
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    • 제58권3호
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    • pp.295-298
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    • 2005
  • 전방경추융합술을 시행한 후 역설상기도폐쇄와 중추성 무호흡이 발생하였던 증례를 경험하여 이를 보고하고자 한다. 환자는 48세 남자로 본원으로 전원되기 9개월 전에 5번과 6번 경추사이의 추간판탈출증으로 수술을 시행받았으며, 내원 2개월 전에는 가성관절증이 발생하여 자가골이식과 함께 전방접근법으로 5번과 6번 경추의 경추융합술을 시행받았다. 이 수술을 시행 후 환자는 코골이와 과도한 주간 졸음증, 불면증 등의 증세가 생겼으며 호흡시에 상기도부위에서 이상한 소리가 발생하였다. 코인두경 및 자기공명영상으로 호기시 코인두부위의 역설적 협착소견을 관찰할 수 있었고, 철야 수면다원검사에서 무호흡지수는 8.7/시간 (중추성 무호흡, 7.0/시간; 폐쇄성 무호흡, 1.7/시간)이었다. 경비적 지속성 기도양압치료를 시작하였으나 환자가 압력을 못견뎌하여 레이저목젖입천장성형술을 시행하였다. 수술 2개월 경과 후 무호흡과 더불어 임상증세는 현격히 호전되었다. 저자들은 이러한 역설상기도폐쇄가 비록 그 기전이 명확하지는 않지만 전방경추융합술과 관련되어 있다고 추정한다. 또한 이러한 상기도 폐쇄가 중추성 수면 무호흡을 유발할 수 있다는 것을 보여주는 증례라고 생각한다.

국내 데이터 베이스 검색을 통한 오공 약침 시술에 대한 임상 논문고찰 (Narrative Review of Clinical Trial on Scolopendrid Pharmacopuncture in Korean Literature)

  • 조동찬;이진현;김창곤;정우석;문수정;박태용;이정한
    • 한방재활의학과학회지
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    • 제23권4호
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    • pp.73-82
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    • 2013
  • Objectives The purpose of this review is to investigate studies of Scolopendrid pharmacopuncture and the evidence of it's effects in order to suggest a better research method in the future. Methods We retrieved numbers of clinical studies about Scolopendrid pharmacopuncture from 7 Korean web databases, using key words such as 'Scolopendrid', 'Scolopendrid AND Pharmacopuncture'. This study had been conducted from 1st May 2013 to 31th July 2013. Controlled studies and case studies were only used for this study. Clinical studies that we picked from the databases were classified according to the diseases that those studies are about, and from these clinical studies, we are to research what has to be improved generally in clinical researches. Results 18 case studies, 4 controlled studies had been under research. Scolopendrid pharmacopuncture has a therapeutic effect mainly in musculoskeletal and neurological diseases such as herniated intervertebral disc, carpal tunnel syndrome, swollen leg, feeling of cold on legs, wrist ganglion, lateral epicondylitis, radial nerve palsy, cervical myelopathy, cauda equina syndrome, postauricular pain; as an early symptom of Bell's palsy, pain of popliteal part, gout, plantar fasciitis, cellulitis, frozen shoulder, pain of hip adductors. However objectivity and reliability of the Scolopendrid pharmacopuncture studies still remains controversial. Conclusions It has been suggested that there are positive effects of Scolopendrid pharmacopuncture therapy in treating specific diseases (especially neuromusculoskeletal diseases). However, this narrative review can't conclude and prove that the Scolopendrid pharmacopuncture has positive effectiveness on these diseases unlike systematic review. So, in order to put Scolopendrid pharmacopuncture therapy to use for many kinds of diseases in more reasonable ways, it is essential to build well-designed clinical research tools. In the future, abundant case studies, more follow-up trials and randomized controlled trials based on the korean medicine should be done to use Scolopendrid pharmacopuncture for a clinical purpose.