• Journal of Korean Medicine Rehabilitation
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• v.33 no.4
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• pp.185-193
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• 2023

Objectives This study was conducted to find out the correlation between lumbar malposition and lumbar disc herniation. Methods Among the patients who visited Gwangju Jaseng Hospital of Korean Medicine from January 2019 to January 2021, taking 92 patients under age 60 who had the records of X-rays and magnetic resonance imaging (MRI) images as the research subjects, Cobb's angle was measured in anterior-posterior (AP) view and lateral (LAT) view, the number of displacements was scored by listing categories defined by The Korean Society of Chuna Manual Medicine for Spine and Nerves. The degree of lumbar intervertebral disc herniation was expressed as a percentage according to the method of Kato, etc., and the correlation between each factor was analyzed. Results AP curvature and MRI herniation index showed significant positive correlation in L4-L5 level but there was no significant difference in L5-S1 level. LAT curvature and MRI herniation index had no correlation in L4-L5 level, but there was a significant negative correlation in L5-S1 level. Malposition score and MRI herniation index had a significant positive correlation in L5-S1 level, whereas there was no correlation in L4-L5. Conclusions As a result of the study, AP curvature and MRI herniation index showed a significant positive tendency in L4-L5 lumbar spine, and LAT curvature and MRI herniation index showed a significant negative tendency in L5-S1 lumbar spine. Malposition score and MRI herniation index were found to have a significant positive tendency in L5-S1 lumbar spine.

• Journal of Korean Neurosurgical Society
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• v.42 no.6
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• pp.441-445
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• 2007

Objective : The purpose of this study was to investigate the surgical results and prognostic factors for patients with soft cervical disc herniation with myelopathy. Methods : During the last 7 years, 26 patients with cervical discogenic myelopathy were undertaken anterior discectomy and fusion. Clinical and radiographic features were reviewed to evaluate the surgical results and prognostic factors. The clinical outcome was judged using two grading systems (Herkowitz's scale and Nurick's grade). Results : Male were predominant (4:1), and C5-6 was the most frequently involved level. Gait disturbance, variable degree of spasticity, discomfort in chest and abdomen, hand numbness were the most obvious signs. Magnetic resonance(MR) images showed that central disc herniation was revealed in 16 cases, and accompanying cord signal changes in 4. Postoperatively, 23 patients showed favorable results (excellent, good and fair) according to Herkowitz's scale. Conclusion : Anterior cervical discectomy and fusion effectively reduced myelopathic symptoms due to soft cervical disc herniation. The authors assured that the shorter duration of clinical attention, the lesser the degree of myelopathy and better outcome in discogenic myelopathy.

• The Korean Journal of Pain
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• v.34 no.3
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• pp.346-368
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• 2021

Background: Recalcitrant disc herniation may result in chronic lumbar radiculopathy or sciatica. Fluoroscopically directed epidural injections and other conservative modalities may provide inadequate improvement in some patients. In these cases, percutaneous neurolysis with targeted delivery of medications is often the next step in pain management. Methods: An evidence-based system of methodologic assessment, namely, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used. Multiple databases were searched from 1966 to January 2021. Principles of the best evidence synthesis were incorporated into qualitative evidence synthesis. The primary outcome measure was the proportion of patients with significant pain relief and functional improvement (≥ 50%). Duration of relief was categorized as short-term (< 6 months) and long-term (≥ 6 months). Results: This assessment identified one high-quality randomized controlled trial (RCT) and 5 moderate-quality non-randomized studies with an application of percutaneous neurolysis in disc herniation. Overall, the results were positive, with level II evidence. Conclusions: Based on the present systematic review, with one RCT and 5 non-randomized studies, the evidence level is II for percutaneous neurolysis in managing lumbar disc herniation.

• Journal of Korean Neurosurgical Society
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• v.62 no.6
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• pp.691-699
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• 2019

Objective : Lumbar discectomy is an effective treatment for lumbar disc herniation (LDH); however, up to 2-18% of patients with LDH have experienced recurrent disc herniation. The purpose of this study was to evaluate the efficacy of a novel annular closure device (ACD) for preventing LDH recurrence and re-operation compared with that of conventional lumbar discectomy (CLD). Methods : In this prospective randomized controlled trial, we compared CLD with discectomy utilizing the $Barricaid^{(R)}$ (Intrinsic Therapeutics, Inc., Woburn, MA, USA) ACD. Primary radiologic outcomes included disc height, percentage of preoperative disc height maintained, and re-herniation rates. Additional clinical outcomes included visual analog scale (VAS) scores for back and leg pain, Oswestry Disability Index (ODI) scores, and 12-item short-form health survey (SF-12) quality of life scores. Outcomes were measured at preoperation and at 1 week, 1, 3, 6, 12, and 24 months postoperation. Results : Sixty patients (30 CLD, 30 ACD) were enrolled in this study. At 24-month follow-up, the disc height in the ACD group was significantly greater than that in the CLD group ($11.4{\pm}1.5$ vs. $10.2{\pm}1.2mm$, p=0.006). Re-herniation occurred in one patient in the ACD group versus six patients in the CLD group (${\chi}^2=4.04$, p=0.044). Back and leg VAS scores, ODI scores, and SF-12 scores improved significantly in both groups compared with preoperative scores in the first 7 days following surgery and remained at significantly improved levels at a 24-month follow-up. However, no statistical difference was found between the two groups. Conclusion : Lumbar discectomy with the $Barricaid^{(R)}$ (Intrinsic Therapeutics, Inc.) ACD is more effective at maintaining disc height and preventing re-herniation compared with conventional discectomy. Our results suggest that adoption of ACD in lumbar discectomy can help improve the treatment outcome.

• The Journal of Internal Korean Medicine
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• v.39 no.5
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• pp.879-885
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• 2018

Background: A herniated intervertebral disc (HIVD) triggers low back pain (LBP). Korean conservative treatment can decrease the herniated disc size without traditional surgery, but detailed prognosis is unclear. Case summary: One patient presented with LBP and bilateral sciatica. She was diagnosed with lumbar HIVD by magnetic resonance imaging (MRI) and treated by Korean medicine (acupuncture, decoction, and physical therapy). For 6 months, MRI follow-up exams showed the aggravation and migration of L5-S1 followed by distinct improvement of the same lumbar vertebra. Conclusion: The disc size in a patient with lumbar HIVD was reduced by Korean conservative treatment, and periodic radiologic examination showed the previously unrecognized process of absorbing the disc.

• The Journal of Internal Korean Medicine
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• v.41 no.2
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• pp.283-292
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• 2020

Background: This case study suggests the potential use of Korean medicine treatments as a conservative management for low back pain and decreased living function due to herniation of intervertebral discs in the lumbar spine. Case Summary: The patient suffered low back pain and decreased living function due to herniation of intervertebral discs of the lumbar spine. Korean medicine treatments, including herbal medicine, acupuncture performed on BL23, BL40, SP6, and GB39, and pharmacupuncture containing Sinbaro, were applied for eight days. The numeric rating scale (NRS) results for low back pain decreased from 6 to 2 and the Oswestry Disability Index (ODI) low back pain scores decreased from 75.56 to 31.11. Walking time also increased from less than one minute to 20 minutes, with an increase in range of motion (ROM) from "Uncheckable" to about normal motion range. Conclusion: Korean medicine treatment can be considered to be an effective conservative management option for pain and decreased living function in patients with herniation of intervertebral discs in the lumbar spine.

• Journal of Veterinary Clinics
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• v.36 no.3
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• pp.139-144
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• 2019

Intervertebral disk disease is a common neurological disease in dogs. In veterinary neurology clinics, the incidence of intervertebral disk disease and the spinal cord compression rate of the disk are well documented. However, the direction of herniation of the intervertebral disk is relatively less known on Magnetic resonance imaging (MRI). Therefore, this study systematically investigated and analyzed the intervertebral disk disease in dogs. Especially, classification according to the direction of herniation of the disk, the degree of pre - treatment neurological manifestation, and the compression rate was investigated. In addition, the treatment methods of patients who received treatment after visiting the Chonbuk animal medical center (CAMC) were divided into pharmacological treatment and surgical treatment. The location of intervertebral disc in spinal canal was mainly ventral (69.9%), and when the prognosis was evaluated according to the compression rate of the spinal cord, the prognosis of the surgical treatment (72.7%) was more effective than the non - surgical medication (40.6%). Surgical treatment (83.3%) was more successful than nonsurgical medication (60%), especially in cases of severe spinal cord compression (> 50%). In this study, surgical treatment was more effective when the neurological symptoms were severe or the spinal cord compression rate was high.

• Journal of Korean Neurosurgical Society
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• v.52 no.2
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• pp.156-158
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• 2012

Intervertebral intradural lumbar disc herniation (ILDH) is a quite rare pathology, and isolated intradural lumbar disc herniation is even more rare. Magnetic resonance imaging (MRI) may not be able to reveal ILDHs, especially if MRI findings show an intact lumbar disc annulus and posterior longitudinal ligament. Here, we present an exceedingly rare case of an isolated IDLH that we initially misidentified as a spinal intradural tumor, in a 54-year-old man hospitalized with a 2-month history of back pain and right sciatica. Neurologic examination revealed a positive straight leg raise test on the right side, but he presented no other sensory, motor, or sphincter disturbances. A gadolinium-enhanced MRI revealed what we believed to be an intradural extramedullary tumor compressing the cauda equina leftward in the thecal sac, at the L2 vertebral level. The patient underwent total L2 laminectomy, and we extirpated the intradural mass under microscopic guidance. Histologic examination of the mass revealed a degenerated nucleus pulposus.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.19 no.2
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• pp.19-22
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• 2013

Background: Excessive pronation of the feet can cause excessive inner rotation of the femur, followed by increased stress in the gluteus maximum, increased front slope of the pelvis, and lumbar lordosis, which leads to lumbar pain. The aim of the present study was to use the navicular drop test to examine foot pronation that can cause lumbar lordosis and to determine whether the navicular drop is lower in patients diagnosed with lumbar disc than in patients without this diagnosis. Methods: The Navicular Drop score was set by subtracting the navicular height at a standing position from the navicular height in a sitting position. The Navicular Drop measurements for college student with and without Lumbar Herniated Intervertebral Disc were compared using an independent t-test. Results: The control group were measured right $7.44{\pm}2.96$ and left $8.04{\pm}3.23$. The experimental group were measured right $2.12{\pm}1.33$ and left $2.80{\pm}1.29$. Therefore significant difference was found between the two groups (p<0.05). Conclusions: The navicular drop affected lumbar herniated intervertebral disc.

• Journal of the Korean Society of Radiology
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• v.11 no.4
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• pp.273-278
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• 2017

Among 45 patients of herniation of intervertebral disc with $L_4$ to $L_5$ herniation, who underwent infrared thermography, the number of female was larger than male and the age of 50s was highest. From the results measured from the distribution table, we have confirmed that there was no significant difference depending on sex and age (p> 0.05). The region of the highest ROI temperature for patients with $L_4-L_5$ intervertebral disc prolapse was the back of the posterior right tibia, and followed by the back of the left shin bone-below the front right knee-below the front left knee. There was a significant difference depending on the measured site. The average ROI temperature for patients was $30.30{\pm}0.50$ whereas that for normal persons was $31.20{\pm}0.58$, yielding the temperature difference of $0.66{\pm}0.59$ between the two groups. The ROI of patients was lower than $31.20{\pm}0.58$ (p <0.05) because the significance of the sample, which has been obtained from the results of a sample t-test, was less than 0.05 (p <0.05). From further researches, it may necessary to develope the methodology for correcting data regarding thermal environment and, in addition, to develope a new thermal index based on it. Therefore, we can confirm that pre-treatment for infrared thermography is very important in order to minimize the procedure for correcting data. It is required that radiologists who inspect disc herniations should carefully observe and consider the patients during their measurements.