This study was performed to compare the TMJ sounds by means of vibration-related items by Sonopak such as integral, high integral, above 300/(0-300) ratio, peak amplitude, peak frequency and median frequency before and after occlusa1 splint therapy as well as counselling, physical modalities. For this study 22 patients with craniomandibular disorders (CMDs) were selected and examined by routine diagnostic procedure for CMDs including Transcranial and Panoramic radiographs and were classified into 3 CMDs subgroups : disc displacement with reduction, disc displacement without reduction, and degenerative joint disease. Visual analogue scale (VAS) about joint sound was recorded during treatment period and VAS treatment index (VAS Ti) was calculated from the VAS data and treatment duration. The author evaluated and compared treatment results by several parmeters such as symptom duration, timing of joint sound, parafunctional habits, trauma, and diagnostic classification. The obtained results were as follows : 1. Before the treatment, the highest value of peak amplitude was observed in disc displacement with reduction group and value of median frequency was highest in degenerative joint disease group. In addition the highest values of peak frequency and ratio ware observed in degenerative joint disease group, though they were not significant. Furthermore the lowest value of high integral was observed in disc displacement without reduction group and though it was not significant, value of integral was lowest in that group. 2. Among 3CMDs subgroups disc displacement with reduction group showed the significantly decreased value of high integral and degenerative joint disease group had the significantly decreased value of integral after conservative treatment including occlusal splint therapy. Conclusively conservative treatment including occlusal splint therapy vay be effective in the treatment of CMDs including TMJ sound. 3. Fair prognosis for conservative treatment was observed in acute group under 6 months than chronic group, 6 months over in symptom duration but there was no statistical difference. The result for conservative treatment was observed slightly poor in subjects with bruxism, clenching, unilateral chewing habit and trauma history but there were no statistical differences.
Degenerative disc disease has traditionally been thought of as low back pain caused by changes in the nucleus pulposus and annulus fibrous, in recent studies, however, changes in the upper and lower endplates cause degeneration of the disc, resulting in mechanical pressure, inflammatory reactions and low back pain. Recently, the bone marrow of the vertebral body-endplate-nucleus pulposus and annulus fibrous were considered as a single unit, and the relationship was explained. Once the endplate is damaged, it eventually aggravates the degeneration of the bone marrow, nucleus pulposus, and annulus fibrosus. In this process, the compression force of the annulus fibrosus increases, and an inflammatory reaction occurs due to inflammatory mediators. Hence, the sinuvertebral nerves and the basivertebral nerves are stimulated to cause back pain. If these changes become chronic, degenerative changes such as Modic changes occur in the bone marrow in the vertebrae. Finally, in the case of degenerative intervertebral disc disease, the bone marrow of the vertebral body-endplate-nucleus pulposus and annulus fibrous need to be considered as a single unit. Therefore, when treating patients with chronic low back pain, it is necessary to consider the changes in the nucleus pulposus and annulus fibrosus and a lesion of the endplate.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.46
no.3
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pp.174-182
/
2020
Objectives: Joint injuries frequently lead to progressive joint degeneration that causes articular disc derangement, joint inflammation, and osteoarthritis. Such arthropathies that arise after trauma are defined as post-traumatic arthritis (PTA). Although PTA is well recognized in knee and elbow joints, PTA in the temporomandibular joint (TMJ) has not been clearly defined. Interestingly, patients experiencing head and neck trauma without direct jaw fracture have displayed TMJ disease symptoms; however, definitive diagnosis and treatment options are not available. This study will analyze clinical aspects of PTA in TMJ and their treatment outcomes after joint arthrocentesis and lavage. Materials and Methods: Twenty patients with history of trauma to the head and neck especially without jaw fracture were retrospectively studied. Those patients developed TMJ disease symptoms and were diagnosed by computed tomography or magnetic resonance imaging. To decrease TMJ discomfort, arthrocentesis and lavage with or without conservative therapy were applied, and efficacy was evaluated by amount of mouth opening and pain scale. Statistical differences between pre- and post-treatment values were evaluated by Wilcoxon signed-rank test. Results: Patient age varied widely between 20 and 80 years, and causes of trauma were diverse. Duration of disease onset was measured as 508 post-trauma days, and 85% of the patients sought clinic visit within 2 years after trauma. In addition, 85% of the patients showed TMJ disc derangement without reduction, and osteoarthritis was accompanied at the traumatized side or at both sides in 40% of the patients. After arthrocentesis or lavage, maximal mouth opening was significantly increased (28-44 mm on average, P<0.001) and pain scale was dramatically decreased (7.8-3.5 of 10, P<0.001); however, concomitant conservative therapy showed no difference in treatment outcome. Conclusion: The results of this study clarify the disease identity of PTA in TMJ and suggest early diagnosis and treatment options to manage PTA in TMJ.
Yun, Wang Hyeon;Park, Jinyoung;Kim, Doyoung;Park, Jung Hyun
Clinical Pain
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v.18
no.2
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pp.65-69
/
2019
Objective: This study aims to evaluate the efficacy of high-voltage microcurrent therapy in patients with herniated lumbar disc (HLD) presenting radicular or back pain. Method: This is a retrospective study with 33 patients who are complaining pain with HLD findings on magnetic resonance image. Microcurrent therapy was applied to leg or paralumbar area. Treatment was conducted for seven minutes with 250~1000 uA intensity as high as the patients could tolerate via stimulating probe with roller type and the frequency was 60 Hz with a sine wave pulse. The visual analogue scale (VAS) was measured just before and after the treatment. Results: The degree of pain reduction (△VAS) was 1.6 points after treatment on average. The △VAS according to the diagnosis, stenosis, dermatome area, medication, pain site and caudal epidural block was not statistically significant. However, the △VAS according to the number of treatments (< 3, ≥ 3 times) showed a statistically significant difference (p=0.04). Conclusion: High-voltage microcurrent therapy may help reduce lumbar or lumbosacral radiating pain after the procedure. The effect was better when microcurrent was applied three times or more. This result suggests that the microcurrent would have cumulative effect on reducing radicular or back pain in patients with HLD.
Park, Young-Eun;Kim, Chul-Soo;Kim, Kyu-Tae;Lee, Je-Kyun;Ahn, Gun-Sang;You, Hye-Kyung
The Journal of Korean Obstetrics and Gynecology
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v.19
no.3
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pp.203-213
/
2006
Purpose : This study was carried out to evaluate correlation between Bone Mineral Density(BMD) and degenerative lumbar disease in postmenopausal low back pain patients. Methods : 69 postmenopausal patients with low back pain were examined. Magnetic resonance imaging was performed to evaluate degenerative lumbar disease and bone mineral density of lumbar spine was measured by Dual energy X-ray absorptiometry. Data were analyzed by Pearson's Linear Correlation Coefficient. Results : In postmenopausal patients with low back pain, BMD(T-score, Z-score) had negative correlation with the grade of intervertebral disc herniation and positive correlation with weight. Other lumbar diseases including Spinal stenosis, Spondylolisthesis and Facet joint arthrosis didn't have significant correlation with BMD. Conclusion : In postmenopausal patients with low back pain, BMD(T-score, Z-score) had inverse relationship with the grade of intervertebral disc herniation.
In this study, epidemiological cut-off values were estimated for 44 Photobacterium damselae isolates, since clinical breakpoints have not been established for this pathogenic bacterium. The susceptibility of the isolates to 10 antibiotics was evaluated using internationally standardized disc diffusion protocols. Normalized resistance interpretation was used to generate statistically valid epidemiological cut-off values for the susceptibility data. There were not enough strains exhibiting full sensitivity to ampicillin and amoxicillin to allow analysis of these antibiotics. Because there were only a marginally sufficient number of strains exhibiting full sensitivity to oxytetracycline, the cut-off value generated provided only a provisional estimate. The valid wild-type cut-off values were <13, 13, 9, 22, 25, 27, and 28 mm for gentamicin, cephalexin, erythromycin, oxolinic acid, flumequine, florfenicol, and sulfamethoxazole/trimethoprim, respectively. The application of these cut-off values should greatly facilitate the rational selection of antibiotics for use in commercial fish farms.
The Purpose of this study was to compare the lumbar strength and lumbar flexor/extensor ratio between spondylolisthesis and herniated disc patients. The patients who had a subacute low back pain have been proved to each disease through MRI and we measured the maximal isometric strength of all patients(28) through MedX lumbar extension machine(Ocala, FL). In all patients, males had higher lumbar extensor strength than that of females. Especially, the spondylolisthesis patients had lower lumbar extensor strength than that of herniated disc patients. The statistical significant(p<.05, p<.01) differences were manifested in $48^{\circ},\;60^{\circ}\;and\;72^{\circ}$ between male groups. Also the statistical significant (p<.05) differences were manifested in $60^{\circ}\;and\;72^{\circ}$between female groups. In the lumbar flexor/ extensor ratio, the males of spondylolisthesis groups represented the functional weakness in the flexed portion of the range of motion, and the females of spondylolisthesis and the all patients of herniated disc represented the functional weakness in the extended portion of the range of motion. In conclusion, we may propose the program such that the spondylolisthesis males must increase the ratio of extended portion exercise, and the spondylolisthesis females and herniated disc patients must increase the ratio of flexed portion exercise.
Lee, Hyung Ggeol;Im, Jeong Gyun;Jung, Da Jung;Yook, Tae Han;Kim, Jong Uk
Journal of Physiology & Pathology in Korean Medicine
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v.27
no.1
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pp.124-129
/
2013
Embedding Therapy keep the stimulation to acupoint. Recently, Embedding Therapy is used for various disease and also studied in many different fields especially in China. In Korea, Embedding Therapy is studied and used for dermatology, face-lift, obesity, facial palsy most frequently. Chinese studies shows us Embedding Therapy could help musculoskeletal system disorder, lumbar herniated intervertebral disc, sprain, spinal canal stenosis. In Korea study concerning lumbar herniated intervertebral disc treatment used Embedding Therapy is few. This study's purpose is to ensure effect of Embedding Therapy at lumbar herniated intervertebral disc treatment. Four lumbar disc herniation patients had been treated with Embedding Therapy were described in this article. The patients(n=4) had been suffering from chronic lower back and leg pain that continued for more than 6 months. All patients had been diagnosed as lumbar disc herniation by MRI or CT, and treated with Embedding Therapy at least 2 times(7 days interval). 2 patients had been treated with concurrent treatment of acupuncture therapy, and the other 2 patients with concurrent treatment of acupuncture and herbal therapy. We observed 4 patients for more than 2 weeks, and their symptoms and quality of daily life had been improved. This suggests that lumbar disc herniation can be successfully recovered with Concurrent Embedding Therapy under conventional Korean Medical Treatment without side effects.
Herniation of intervertevral disc(HIVD) is the most common disease causing low back pain. Acupuncture, electroacupuncture and moxibustion has been used for treatment of HIVD. Bee venom (BV) also has been traditionally applied to relieve pain. Recently, it has been reported that BV is effective in treating HIVD. But more objective methods were required to assess the efficacy of BV on HlVD. So we assessed of BV-acupuncture effect on herniated disc patients by use of rating scale for low back pain. We researched 22 patients who were treated at Department of Acupuncture & Moxibustion, Kyung Hee Medical Center from January 1999 to June 1999. The patients were diagnosed by MRI as having a herniated disc. The results of treatment using rating scale for low back pain in HIVD showed that $43.77{\pm}14.39$ point of pre-treatment score and $84.5{\pm}3.97$ point post-treatment score. The improvement index showed $0.43{\pm}0.15$. Especially, clinical score of neurologic deficits showed most highest improvement index of $0.7{\pm}0.45$. Assessment of BV-acupuncture Effect by MRI finding were showed that protruded disc and extruded disc got more higher improvement index than bulging disc. Among 22 patients, satisfactory assessment of BV-acupuncture effect showed that 15(68.2%) were excellent, and 7(31.8%) were good. The result suggest that BV-acupuncture is good method for treatment of HIVD.
Objective : This is prospective study of clinical outcomes of percutaneous plasma disc coagulation Therapy (PDCT) in patients with herniated lumbar disc disease (HLD) to evaluate the safety and efficacy in its clinical application and usefulness as a reliable alternative to microscopic discectomy. Methods : Forty-six patients were enrolled in this study from April 2006 to June 2010. All patients had one-level HLD. Disc degeneration was graded on routine T2-weighted magnetic resonance Image (MRI) using the Pfirrmann's grading system and all index levels were grade 3 and grade 4. Indications for surgery were radiculopathy caused by disc protrusion with soft consistency. MRI was done at one month after the procedure in all patients to check post-PDCT change. The clinical outcomes were evaluated using Visual Analog Scales (VAS) score and MacNab's criteria. Results : This study was approved by the Institutional Review Board of our institution. The age of the study population ranged from 16 to 59 years with a mean age of 37.2 years. There were 29 males and 17 females in this study. The mean period of clinical follow-up was 21 months. The average preoperative VAS score for radiculopathy was $7.4{\pm}1.4$, while the final follow-up VAS score was $1.4{\pm}0.7$ (p<0.001). In MacNab's criteria, 41 patients (89.1%) had achieved favorable improvement (excellent and good) until later follow-up. There were one patient from infection and two patients who needed to convert to open discectomy. Conclusion : PDCT is a safe and efficient treatment modality in a selective patient with HLD.
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