• Title/Summary/Keyword: Herniated Nucleus Pulposus

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Expression of TRPV1 and iNOS in the Dorsal Root Ganglion Exposed by Autologous Nucleus Pulposus in the Rat

  • Kim, Su-Jeong;Seo, Jeong-Min;Cho, Yun-Woo;Park, Hea-Woon;Lee, Joon-Ha;Hwang, Se-Jin;Ahn, Sang-Ho
    • The Journal of Korean Physical Therapy
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    • v.22 no.3
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    • pp.71-77
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    • 2010
  • Purpose: To determine whether upregulation of inducible nitric oxide synthase (iNOS) transcription and translation is related to radicular pain in a model of lumbar disc herniation. Also, to investigate the temporal changes of mRNA expression of iNOS and the identity of iNOS and transient receptor potential vanilloid (TRPV) 1 channel expression cells in dorsal root ganglion (DRG) of a model of lumbar disc herniation. Methods: A lumbar disc herniated rat model was developed by implantation of the autologous nucleus pulposus, harvested from the coccygeal vertebra of each tail, on the left L5 nerve root just proximal to the DRG. Rats were tested for mechanical allodynia of the plantar surface of both hind paws 2 days before surgery and 1, 5, 10, 20 and 30 days postoperatively. Reverse transcription polymerase chain reaction (RT-PCR) was used to follow iNOS mRNA expression. To stain iNOS and TRPV1 in DRG, an immunohistochemical study was done 10 days after surgery. Results: A significant drop in mechanical withdrawal threshold on the ipsilateral and contralateral hind paws was observed 1 day after surgery and was prolonged to 30 days in rats with lumbar disc herniation. The expression of mRNA for iNOS peaked at postoperative day 10 on both sides of the DRG. iNOS-positive sensory neurons in the DRG varied in size from large to small diameter cells. A majority of small and intermediate sensory neurons were TRPV1-positive cells. Double immunofluorescence staining for TRPV1 and iNOS revealed that most intermediate TRPV1-positive sensory neurons co-localized with iNOS-positive neurons. Conclusion: Nucleus pulposus-induced mechanical allodynia can be generated without mechanical compression. This pain is related to temporal changes in expression of iNOS mRNA in the DRG. Co-localization of TRPV1 and iNOS in intermediate neurons of the DRG is correlated with pain modality and intensity.

요통환자의 물리치료에 관한 임상적 연구

  • Lee, Jae-Hak;Jang, Su-Gyeong;Han, Dong-Jik
    • Journal of the Korean Physical Therapy Association
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    • s.3
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    • pp.11-18
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    • 1981
  • A Clinical Study of physical Therapy on the Low Back Conditions J. B. Rhee, S. K. fang, D. J, Han Low back pain usually is due primarily to a faulty mechanics, ,dis'c disease and other contributing factors .Conservative treatment of low back pain is considered to be useful with applicationes physical therapeutic measures including elimination of gravity, but surgical treatment is alternative to conservative .This study 1s conducted to analyse and evaluate efficiency of physical therapy on the low back pain on 452 cases who were treated at the Korea University Hospital, from January 1, 1978 to December 31. 1978.The results obtained in this study are summarized as follows :1. Sex distribution of total rationㄷs surveyed showed that 5l.3% in male and 487% in female.2 . In the age distrbution. the mest Liedominant age group was 25-54 years with7O.8 % .3 . The most proportion of the cases by occupation was housewife 27.7%, clerical and office workers 2l.7% , students 12.8% and labours 12.2 % respectively .4 . The most common causes of low back conditions classified, the Strain or Trau-rla revealed the highest frequency with 58.4% and thc Herniated Nucleus Pulpe-sus with 29.2 % of the total.5 . The modalities of physical therapy suitable to each cases were applied : 94.0%of all cases were treated with deep thermotherapy, 91.4 % hydrocollator steampack, 86.7% strengthening exercise of the weak muscles, pelvic traction 34.1%.6 . In regard to the duration required for the physical therapy. Herniated Nucleus Pulposus were approximately 4 weeks and strain or trauma were 2 weeks.7 . The improvement by physical therapy on lcw back conditions was classified in-to 41grades and showed following reaulits , excellent 42.5%, good 37.8%, fair 13.7% and poor 6.0% respectively.

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Change of the Intervertebral Foraminal Pressure after Removal of the Disc Material (디스크 제거 후 추간공내 압력의 변화)

  • Hong, Chang Kie;Park, Chong Oon;Hyun, Dong Keun;Ha, Young Soo
    • Journal of Korean Neurosurgical Society
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    • v.30 no.2
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    • pp.144-149
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    • 2001
  • Objective : Spinal nerve root compression occurs commonly in conditions, such as herniated nucleus pulposus, spinal stenosis, intervertebral foraminal stenosis, and trauma. However, the pathophysiolosy of the symptoms and signs related to spinal nerve root compression is poorly understood. The purpose of the present study was to assess and compare the changes of various pressures of intervertebral foraminal pressure before and after decompression. Method : After laminetomy without foraminotomy was performed, pressure sensor tip of Camino parenchymal type was located at the middle-central portion of the intervertebral foramen and anterior portion of nerve root for the foraminal pressure before decompression of the intervertebral foramen. After laminectomy with foraminotomy, the same method was used for the foraminal pressure after decompression. The authors studied 40 consecutive patients (57 disc spaces) with severe constant root pain to the lower leg, pain unrelived by bed rest, and minimal tension signs, diagnosed by MRI. Results : In patients with intervertebral foraminal stenosis, the intraforaminal pressure was decreased from $86{\pm}2.23mmHg$ to $17.1{\pm}1.51mmHg$ and in patients without stenosis, from $55.9{\pm}1.08mmHg$ to $11.9{\pm}1.25mmHg$. All patients below 20mmHg after decompression showed good outcome, but 4 cases who showed poor outcome had foraminal stenosis, posterolateral type of the herniated disc, and above 30mmHg of foraminal pressure after decompression. Conclusion : These findings suggest that if the foraminal pressure falls below 20mmHg after decompression, good outcome can be anticipated. Central type of the herniated disc shows better outcome compared to the posterolateral type.

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A Study on Incidence of Spinal Disease by Occupational Type (직업 유형에 따른 척추질환 유병률 조사)

  • Jeong, Beoul;Shin, Dong-Jae
    • Journal of Korean Medicine Rehabilitation
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    • v.20 no.4
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    • pp.131-138
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    • 2010
  • Objectives : Recently work-related musculoskeletal disorders have increased in various workplaces and many reports have been confirming this, but a comparative study on incidence of spinal disease by occupation has not been established yet. So this study was designed to clarify the distinction on incidence of spinal disease between white and blue collar workers. Methods : The subjects who visited with spinal disease to Ja-Seng oriental hospital from January to April in 2020 were selected and divided into white collar workers(n=844) and blue collar workers(n=333). We counted the number of patients with each spinal disease in both groups and carried out comparative analysis in five items(herniated nucleus pulposus(HNP), stenosis, spondylosis, sprain, etc). All data were analyzed by chi-square test. Results and Conclusions : Whit collar workers had higher incidence in HNP(p=0.030), sprain(p=0.016),etc(p=0.035) than blue collar workers, while blue collar workers had higher incidence in stenosis(p=0.002). But we think that the confidence is low in stenosis because the number of cases are very small. There were no significance between two groups with spondylosis.

A Study on Effect by Lumbar Extension Exercise (요부신전운동에 의한 효과에 관한 연구)

  • Lee, Suk-Min;Lee, Myeong-Hee
    • Journal of Korean Physical Therapy Science
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    • v.9 no.2
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    • pp.37-48
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    • 2002
  • The purpose of this study is to improve the effect of Lumbar extensor exercise program and develop the Lumbar extensor exercise program which will be suitable to the patients characteristics. In this study the experimental group was made up of 38 subjects. They are the patients with low back pain using the Lumbar extension exercise program in C hospital. The lumbar extension exercise program was given two times a week for 8 weeks. The results were estimated by Lumbar extensor strength by diagnosis agent. The results were measured three times, one time pre-treatment and two times post-treatment at 4weeks and 8weeks by lumbar extensor curve angle(0, 12, 24, 36, 48, 60, 72). The results were compared at pre-test 4weeks and 8weeks. The muscle strength measured at both 4weeks and 8weeks with the greater strength was shown at 4weeks. The muscle strength of patients with M.strain, Laminectomy and HNP was increased at all angles except for patients with stenosis. The results of this study indicated that diagnosis influenced the muscle strength in Lumbar extensor exercise program.

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The Effect of Lumbar Stabilization Exercises with Neurodynamic Techniques on Lumbar Muscular Strength and Oswestry Disability Index in Lumbar Disc Herniation Patient's (요추 안정화 운동과 결합된 신경역동학기법이 요추 추간판 탈출증 환자의 요부근력과 오스웨스트리 장애지수에 미치는 영향)

  • Mo, Min-sang;Park, Hyun-sik
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.22 no.1
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    • pp.1-7
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    • 2016
  • Background: The purpose of this study was to investigate the effects of lumbar stabilization exercise with neurodynamic techniques on lumbar muscular strength and Oswestry index in lumbar disc herniation patient. Method: The Lumbar stabilization exercise with neurodynamic techniques was performed by 30 pt's in G hospital. The subjects were randomly organized into a study group 15 and control group 15. The exercises and neurodynamic technique were conducted for 40 minutes and, 3 times a week (total 24 times for 8 weeks). General characteristics of the Lumbar muscular strength and Oswestry disability index (ODI) were measured before the training and at 4 weeks and 8 weeks after the intervention. Comparison of the time dependent variable for each group was Calculated by a one way repeated analysis of variance (ANOVA). Comparison between the two groups was Calculated by an analysis of covariance (ANCOVA). Result: There was a significant difference in the Lumbar muscular strength and ODI (p<.05). Similarly in the inter-group analysis, significant differences (p<.05) occurred. Conclusion: In this study, we demonstrated that lumbar stabilization exercises with neurodynamic techniques are an effective therapy for Lumbar muscular strength and ODI in lumbar disc herniation patient's.

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Investigation on the correlation Improvement Rate of Symptoms with Moire Topography Analytic Improvement Rate (추나요법을 시행한 요통환자의 호전도와 Moire 영상 개선도와의 상관관계)

  • Heo, Su-Young;Kim, Ki-Ho
    • The Journal of Korea CHUNA Manual Medicine
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    • v.1 no.1
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    • pp.55-65
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    • 2000
  • The present study retrospectively investigated clinical outcome at patients with low back pain or sciatica during Chuna treatment (flexion-distraction technique). The study population consisted of 29 patients. Discogenic group consisted of 21 patients who were already diagnosed as HNP of lumbar spine with serial MRIs(magnetic resonance imaging) or CTs(computerized tomography). Simple LBP group consisted of 8 patients with low back pain & sciatica who were non-specific disorder on radiologic examination. All patients were treated with flexion-distraction technique, one of Chuna technique, under analysis of Moire Topography. And the evaluation of clinical outcome was done twice during this study by Moire Topography Analytic Point and Low Back Pain Assesment, Visual Analogue Scale. The results were summarized as follows; Total improvement rate of Moire Topography was $25.8{\pm}17.8%$, and the rate of Low Back Pain Assesment was $56.5{\pm}23.0%$, Visual Analogue Scale of post-treatment was $32.6{\pm}22.5$ Between Improvement rate of Moire Topography and improvement rate of Low Back Pain Assesment, significant correlation was proved(Person's coefficient was 0.381, p<0.05). After all, it is certain improvement of Moire Topography represents symptom's improvement.

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Quadriplegia due to Epidural Abscess following Continuous Cervical Epidural Block -A case report- (지속적 경부 경막외 차단 중 발생한 경막외 농양에 의한 사지마비 -증례 보고-)

  • Lee, Hyo-Keun;Yang, Seung-Kon;Kim, Ji-Young;Chae, Hwa-Ju;Kim, Ki-Yeob;Kim, Chan
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.279-282
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    • 1996
  • A 45-year-old male received cervical continuous epidural block for posterior neck pain radiating to right upper extremity secondary to cervical herniated nucleus pulposus. Three days after epidural catheterization, fever, radicular pain and weakness of both upper extremities were developed. On admission, his temperature was $38.3^{\circ}C$ and showed progressive weakness and numbness in both upper and lower extremities. Cervical epidural abscess was suspected; MRI showed an epidural abscess from C4 to C7 level. Within 24 hours of admission, surgical decompression and drainage was effected. Culture of pus obtained at the lesion yielded Staphylococcus aureus. He was treated with intravenous antibiotics for 7 weeks resulting marked improvement of neurologic signs and symptoms.

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Health Status and Musculoskeletal Workload of Red Pepper Farmers (노지고추 농업인의 건강실태와 근골격계 작업부담)

  • Kim, Kyung-Ran;Lee, Kyung-Suk;Kim, Hyo-Cher;Song, Eun-Young
    • Journal of the Ergonomics Society of Korea
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    • v.28 no.3
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    • pp.7-15
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    • 2009
  • The objective of this study is to survey the working environmental conditions and musculoskeletal workload(DMQ) in red pepper farmers. 155 full-time farmers(males=91, females=64) lived in Chungnam and Jeonbuk participated in the study. To offer the fundamental data for agricultural improvement of red pepper farms, information about working farm conditions, health condition, musculoskeletal disorders(MSDs), labor intensity and musculoskeletal workload was obtained by questionnaire and interviews. The results are as follows: 1. The farmers reported sunlights, high temperature and cold/ draught as uncomfortable work environment. 2. Physical and mental fatigue in females is higher than that of males. 3. The prevalence rates of medical diagnosed diseases are higher in order of osteoarthritis, herniated nucleus pulposus(HNP), and chronic gastritis/gastric ulcer. 4. Prevalence rates of musculoskeletal symptoms more than standard 1 among the various pain areas are higher in order of low back, shoulders and knees. These results can be used practically for agricultural improvement of red pepper farms to prevent MSDs.

Trend of Pharmacopuncture Therapy for Treating Cervical Disease in Korea

  • Kim, Seok-Hee;Jung, Da-Jung;Choi, Yoo-Min;Kim, Jong-Uk;Yook, Tae-Han
    • Journal of Pharmacopuncture
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    • v.17 no.4
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    • pp.7-14
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    • 2014
  • Objectives: The purpose of this study is to analyze trends in domestic studies on pharmacopuncture therapy for treating cervical disease. Methods: This study was carried out on original copies and abstracts of theses listed in databases or published until July 2014. The search was made on the Oriental medicine Advanced Searching Integrated System (OASIS) the National Digital Science Library (NDSL), and the Korean traditional knowledge portal. Search words were 'pain on cervical spine', 'cervical pain', 'ruptured cervical disk', 'cervical disc disorder', 'stiffness of the neck', 'cervical disk', 'whiplash injury', 'cervicalgia', 'posterior cervical pain', 'neck disability', 'Herniated Nucleus Pulposus (HNP)', and 'Herniated Intervertebral Disc (HIVD)'. Results: Twenty-five clinical theses related to pharmacopuncture were selected and were analyzed by year according to the type of pharmacopuncture used, the academic journal in which the publication appeared, and the effect of pharmacopuncture therapy. Conclusion: The significant conclusions are as follows: (1) Pharmacopunctures used for cervical pain were Bee venom pharmacopuncture, Carthami-flos pharmacopuncture, Scolopendra pharmacopuncture, Ouhyul pharmacopuncturen, Hwangryun pharmacopuncture, Corpus pharmacopuncture, Soyeom pharmacopuncture, Hwangryunhaedoktang pharmacopuncture, Shinbaro phamacopuncture. (2) Randomized controlled trials showed that pharmacopuncture therapy combined with other methods was more effective. (3) In the past, studies oriented toward Bee venom pharmacopuncture were actively pursued, but the number of studies on various other types of pharmacopuncture gradually began to increase. (4) For treating a patient with cervical pain, the type of pharmacopuncture to be used should be selected based on the cause of the disease and the patient's condition.