• 한방재활의학과학회지
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• 제24권4호
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• pp.49-60
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• 2014

Objectives The purpose of this study is to research current trends of acupuncture treatment of lumbar herniated intervertebral disc using the PubMed database. Methods We set up the search strategy and investigated clinical trials on acupuncture treatment of lumbar herniated intervertebral disc through PubMed search. This study analyzed previous researched papers published from January 1st, 2000 to April 30th, 2014, and classified them by publication year, journal names, types of literature, treatment methods and evaluation scales. To assess the quality of the reviewed literature, randomized controlled trial (RCT) studies were assessed by Cochrane's risk of bias (ROB) tool and non-RCT studies were assessed by risk of bias for non-randomized studies (RoBANS). Results We found 35 studies on the acupuncture treatment of lumbar herniated intervertebral disc. Papers on this topic have been published, on average, three to four times annually in 9 journals since the mid-2000's. The journal with the largest number of publications was Chinese Acupuncture & Moxibustion, and most of articles were classified as RCT. Acupuncture treatment was performed individually or together with other treatments. The most frequently used pain evaluation index was visual analogue scale (VAS). The index of effective rate was used frequently but there was a lack of objectivity. In regards to the quality of the studies, outcome assessment in RCT showed that random sequence generation, allocation concealment, and the blinding of participants and personnel increase potential of risk of bias. For non-RCT assessment, outcome showed that confounding variable, measurement of intervention were at high risk of bias. Conclusions In order to obtain objective clinical evidence of acupuncture treatment of lumbar herniated intervertebral disc, further clinical studies should be designed to minimize the risk of bias, using STRICTA with larger sample sizes.

• The Korean Journal of Pain
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• 제23권1호
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• pp.51-54
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• 2010

A herniated intervertebral disc is the most common type of soft tissue mass lesion within the lumbar spinal canal. Magnetic resonance imaging (MRI) is a useful tool for the assessment of patients with lower back pain and radiating pain, especially intervertebral disc herniation. MRI findings of intervertebral disc herniation are typical. However, from time to time, despite an apparently classic history and typical MRI findings suggestive of disc herniation, surgical exploration fails to reveal any lesion of an intervertebral disc. Our patient underwent lumbar disc surgery with the preoperative diagnosis of lumbar disc herniation; however, nothing could be found during the surgical procedure, except a swollen nerve root.

• The Korean Journal of Pain
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• 제18권2호
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• pp.192-197
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• 2005

Background: Radicular pain, associated with herniated intervertebral disc, has been treated with either conservative treatments or a traditional surgical discectomy. Several modalities for minimally invasive percutaneous procedures have been developed as alternatives to a surgical discectomy. Percutaneous decompression using a $Dekompressor^{(R)}$ probe has been recently introduced. Herein, we report the outcome of percutaneous decompression with a $Dekompressor^{(R)}$ for the treatment of a herniated intervertebral disc. Methods: Between August 2004 and April 2005, percutaneous decompression was performed using a $Dekompressor^{(R)}$, 1.5-mm percutaneous lumbar discectomy probe in 17 patients with a herniated lumbar intervertebral disc resistant to conservative treatments, with the results reviewed retrospectively. The procedure was performed under fluoroscopic guidance after local anesthesia. Disc access was gained with a posterolateral approach on the symptomatic side and intradiscal placement of the discectomy probe in the herniated disc confirmed from the anteroposterior and lateral views on the fluoroscopy. Results: We obtained satisfactory clinical results in 14 patients with a decrease in the initial Visual analogue scale (VAS) of more than 55% and the elimination or reduction of analgesic medication, with a follow-up of 3 to 11 months. Conclusion: We concluded that a percutaneous discectomy with a $Dekompressor^{(R)}$ probe might be an effective alternative for the treatments of painful disc herniations resistant to conservative managements when performed under proper selection criteria.

• Korean Journal of Acupuncture
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• 제29권4호
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• pp.501-518
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• 2012

Objectives : To research trends of studies on treatments of lumbar herniated intervertebral disc in Korean medicine. Methods : We searched papers using Korean Traditional Knowledge Portal, OASIS, KISS. We used "low back pain", "radiculopathy", "lumbar herniated intervertebral disc" as keyword. Limitations were as follows; Domestic studies, published from 2000 to 2011, mentioning the treatments of lumbar herniated intervertebral disc in Korean medicine. This study researched and classified the papers according to the fields of the treatment and methods of study. Results : The results were obtained as below ; 1. The number of papers published in 2000 was only three, but steadily increased to 15 in 2010 and the total number of papers was 93. 2. When categorized according to the fields of treatment, 93 researches are classified as acupuncture, moxibustion, Chuna therapy, drug, various physical therapies and collaborative Oriental-Western medicine therapy. 3. When categorized according to the methods of study, 70 researches were the simple case report and non-RCT(non-randomized controlled trial) were 11 and RCT(randomized controlled trials) has been reported in 11 researches. 4. General assessment tools were VAS, ODI before, however these days, Physical examination(ROM, SLRT, etc.), Radiologic tests(MRI, X-ray), DITI etc. are used more in order to evaluate objective therapeutic effects. Conclusions : These results indicate that researches on lumbar herniated intervertebral disc in Korean medicine have been investigated by various method and steadily increasing.

• 대한물리치료과학회지
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• 제25권3호
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• pp.9-16
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• 2018

Background: In order to find out the effect of therapy methods through Flexion-distraction technique and drop technique on pain, sacral angle of patients with lumbar herniated intervertebral disc targeting patients with lumbar herniated intervertebral disc due to L5-S1. Method: This study was to present the directivity of the therapy method for lumbar herniated intervertebral disc by comparing and analyzing the spinal decompression therapy and provide an effective treatment method to patients with lumbar herniated intervertebral disc by identifying the therapeutic effect of Flexion-distraction technique and drop technique. The research period is March 1, 2018 to June 30, 2018 and subjects are the patients diagnosed as lumbar herniated intervertebral disc due to L5-S1 by their doctor through clinical findings and medical equipment such as X-ray, CT, MRI etc. Among patients who visited and hospitalized in S Orthopaedics located in Daegu and 30 female patients with sacral angle of more than $30^{\circ}$ were randomly classified into 15 people and we carried out treatment three times a week for 8 weeks for 15 people in the experimental group applying Flexion-distraction technique and drop technique and 15 people in the control group applying spinal decompression therapy to compare and analyze the changes in pain, sacral angle of patients with lumbar herniated intervertebral disc. Result: According to the results of this study, changes in the Visual Analogue Scale showed statistically significant differences in both the experimental group and control group(p<.05), while there was statistically significant difference in the comparison between groups before and after measurement of experimental group (p<.05). In the comparison within two groups of sacral angle, both groups showed statistically significant difference(p<.05) but there was no statistically significant difference in the comparison of scores between groups before and after measurement of each group(p>.05). Discussion: All those results the above proved that we need to confirm various benefits of the therapy with the flexion-distraction technique and drop technique, and the findings of the concerned study will possibly become useful information when doctors actually work on a therapy to treat patients with the lumbar herniated intervertebral disc.

• 한국임상수의학회지
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• 제20권4호
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• pp.519-522
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• 2003

An appearance of herniated intervertebral disc into thoracolumbar vertebral canal was evaluated in two patients using computed tomography (CT). Before CT scanning, plain radiography and myelography were performed in both cases. CT images were compared to those of myelography. Dogs were positioned in sternal recumbency under inhalation anesthesia and transverse slices with 2 mm thickness were obtained around thoracolumbar region. The transverse CT images were examined using both vertebral and spiral window mode. The most common findings on CT images were loss of vertebral canal epidural fat, bulging of vertebral canal disc margins, displacement of spinal cord and flatted vertebral canal. Whereas, narrowed intervertebral disc space and simple extradural pattern were the main findings on plain and contrast radiographs. CT imges showed the extent of the herniated disc lesion, type II intervertebral disc hernation, and the displacement of spinal cord in detail in both occations. It is considered that degree and precise localization of the intervertebral disc herniation and subtle lesion of spinal cord could be identified accurately using computed tomography.

• The Journal of Korean Physical Therapy
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• 제19권3호
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• pp.31-39
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• 2007

Purpose: This study was conducted to investigate the effect of distraction manipulation on the pain and. intervertebral disc angle in patients with herniated intervertebral lumbar discs. Methods: 30 patients who visited to receive the treatments of the physical therapy in W pain clinic in Daejeon. All subjects had been treated with flexion-distraction manipulation for 30 minutes per day and three times a week during 12 weeks period from June 10 to 19 August 2006. They were randomly divided into two groups: lumbar 4 and lumbar 5 group. Results: Pain of L4 and L5 group was significantly reduced after than before treatment(p<0.05). The intervertebral lumbar disc angle was significantly improved after than before treatment(p<0.05). Conclusion: These results indicated that distraction manipulation has a effectiveness in patients with herniated lumbar disc.

• 한방재활의학과학회지
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• 제15권2호
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• pp.67-75
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• 2005

Objectives : Straight leg raising test(SLR) is useful clinical test to diagnose herniated lumbar intervertebral disc. The purpose of this study is to analyse diagnostic value of straight leg raising test between traffic accident patients group and non-traffic accident patients group. Methods : The study involved 26 traffic accident patients group and 45 non-traffic accident patients group with low back pain or radiating pain into the leg. All had a result of straight leg raising test and lumbar computed tomography(CT) or magnetic resonance imaging(MRI). The associations between straight leg raising test and herniated lumbar intervertebral disc were analysed. Results and Conclusions : 1. There is not significant associations between straight leg raising test and herniated lumbar intervertebral disc in traffic accident patients group. 2. There is significant associations between straight leg raising test and herniated lumbar intervertebral disc in non-traffic accident patients group. 3. In traffic accident patients group, and negative predictive value are higher than non-traffic accident patients group. 4. In non-traffic accident patients group, sensitivity, positive predictive value and odds ratios are higher than traffic accident patients-group.

• 대한물리의학회지
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• 제1권1호
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• pp.125-137
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• 2006

Purpose : The purpose of the study was to examine lumbar pain through literature reviews about herniated intervertebral disc (HIVD). Methods : Diagnosis was made by patient's history, physical examination, simple radiography, myelography, spinal computerized tomography, electromyography, somatosensory evoked potential, etc. Results : There are two treatment modalities, one is conservative and the other is operative. About 90% of patients with HIVD have been recovered only by conservative treatment and therapeutic exercise was the most effective one among these conservative treatments. Conclusion : We consider HIVD can be treated with therapeutic exercise which can correct muscular imbalance and facet joint problems and make the degenerative process of intervertebral disc slower.

• 척추신경추나의학회지
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• 제10권2호
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• pp.87-95
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• 2015

Objectives : The purpose of this study was to evaluate the effects of spinal cord stimulation acupuncture therapy for lower limb numbness resulting from lumbar herniated intervertebral disc(HlVD). Methods : From 8th August, 2015 to 30th October, 2015, 1 male patient diagnosed as herniated intervertebral disc at L5/S1(Diffuse bulging disc with smooth ventral thecal sac indentation at L5-S1) was treated with spinal cord stimulation acupuncture and general Korean medicine therapy(acupuncture, herbal injection). Numerical Rating Scale(NRS) and Oswestry Disability Index(ODI) were recorded during the treatment. Results : 1. The patient's chief complaints were remarkably improved - Rt. lower limb numbness remained 15% compared before treatment, Rt. lower limb paresthesia and gait disturbance almost disappeared after 25 times of treatment during 3 months. 2. NRS score decreased from 7 to 3, ODI decreased from 16 to 7. Conclusions : This study demonstrates that spinal cord stimulation acupuncture therapy with Korean medicine treatment has notable effect in improving lower limb numbness induced by lumbar HlVD.