• 제목/요약/키워드: Herniation of lumbar disc

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Effectiveness of ShinBaro Pharmacopuncture on Lumbar Spinal Herniated Intervertebral Disc : A Randomized Controlled Trial (요추추간판탈출증에 대한 신바로약침의 효과 : 무작위 대조군 시험)

  • Jun, Byung-Chul;Kim, Eun-Soo;Kim, Dong-Sub;Kim, Tae-Hun;Kim, Jee-Yong
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.6 no.2
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    • pp.109-119
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    • 2011
  • Objective : The aim of this study is to investigate the effectiveness of ShinBaro Pharmacopuncture in the treatment of patients with Lumbar spine Herniated Nucleus Pulposus. Methods : We investigated 20 cases of patients with lumbar disc herniation and devided into two groups. Experimental group were treated with ShinBaro Pharmacopuncture with integrated package treatment and control group were treated the same therapies without ShinBaro Pharmacopuncture. To evaluate the treatment effects of two groups, we used numeric rating scale(NRS), oswestry disability index(ODI). Results : In NRS of lumbar and sciatica pain and ODI, that of experimental group was much more improved than control group, and decrement of NRS of lumbar pain showed statistical significance along with the duration of treatment. Conclusions : ShinBaro Pharmacopuncture was thought to be effective for relieving symptoms of lumbar spine herniated nucleus pulposus, although further study is needed.

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Suggestion of Sacral Lumbar joint distraction technic with prone position in Chuna Manual Therapy (추나요법에서 복와위 요천관절 신연기법에 대한 제언)

  • Cha, Yun-Yeop
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.15 no.1
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    • pp.115-119
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    • 2020
  • Objectives : This study aimed to introduce a new sacral lumbar joint distraction technique in the prone position in Chuna manual therapy for effective lumbar distraction. Methods : The patient was placed in the prone position. Next, clinicians contacted the sacrum and L1, L2, L3, L4 and L5 spinal processes. Then they were pulled in the direction of the head and leg respectively while pressing down with 30% force to maintain the lumbar lordosis. This is a more effective and safer lumbar distraction technique according to the latest knowledge. Conclusions : This technique can be used for lumbar disc herniation in addition to relaxing the existing lumbar muscles, and is suggested to be used as a safe and effective Chuna manual therapy.

The Clinical Study on 137 Cases of Herniated Lumbar Disc Patients (요추 추간판 탈출증 환자 137례에 대한 한의학적 임상고찰)

  • Lee, Eun-Kyoung;Choi, Eun-Hee;Lee, Ji-Eun;Jeon, Ju-Hyun;Lee, Sung-Hwan;Lee, Jae-Min;Kim, Yeon-Mi;Kwak, Byung-Min;Yang, Gi-Young;Kim, Young-Il
    • Journal of Acupuncture Research
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    • v.25 no.3
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    • pp.127-138
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    • 2008
  • Objectives : This study was designed to evaluate the general distribution and the efficacy of oriental medical treatment for Lumbar Disc Herniation. Subjects and Methods : The 137 patients who had a diagnosis of HIVD by Lumbar-CT of Lumbar-MRI and admitted to Dunsan oriental medical hospital in Daejon university from January 2005 to December 2007 were observed. They were analyzed according to the distribution of sex, age, the period of disease, causing factor, The patient-condition on admission, the symptom on admission, Admission day, Herniation type of the disc and the treatment efficacy was evaluated respectively. Results : 1. Male was more than female in the ratio of 1 : 1.174, and forties 28% the most, the acutest phase 48% the most, reason unknown 30% the most, Grade III 42% the most, Back and Leg radiate pain 65% the most, the day of 6-10 29% the most, protruded disc type 48% the most. 2. In the total treatment result, the good was 48%, the excellent 28%, the fair 15%, the poor 9% in order. 3. the "effective rate"(the percentage of positive effective treatment case) of each distribution, the thirties and fifties 100% the most, subacute phase 100% the most, exercise, traffic accident 100% the most respectively, Grade III 93% the most, only low back pain 97% the most, the day of 16-20 100% the most, Extruded disc 100% the most. Conclusions : Total effective rate was 91%. We have Known the efficacy of oriental medical treatment for HIVD, was good and early treatment was better than late treatment.

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Transdural Nerve Rootlet Entrapment in the Intervertebral Disc Space through Minimal Dural Tear : Report of 4 Cases

  • Choi, Jeong Hoon;Kim, Jin-Sung;Jang, Jee-Soo;Lee, Dong Yeob
    • Journal of Korean Neurosurgical Society
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    • v.53 no.1
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    • pp.52-56
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    • 2013
  • Four patients underwent lumbar surgery. In all four patients, the dura was minimally torn during the operation. However, none exhibited signs of postoperative cerebrospinal fluid leakage. In each case, a few days after the operation, the patient suddenly experienced severe recurring pain in the leg. Repeat magnetic resonance imaging showed transdural nerve rootlets entrapped in the intervertebral disc space. On exploration, ventral dural tears and transdural nerve rootlet entrapment were confirmed. Midline durotomy, herniated rootlet repositioning, and ventral dural tear repair were performed, and patients' symptoms improved after rootlet repositioning. Even with minimal dural tearing, nerve rootlets may become entrapped, resulting in severe recurring symptoms. Therefore, the dural tear must be identified and repaired during the first operation.

Intensive Korean Medicine Treatments for Low Back Pain and Decreased Living Function due to Herniation Intervertebral Discs in the Lumbar Spine: A Case Study (요추 추간판 탈출증으로 인한 요통 및 생활기능저하에 대한 한방 집중치료 치험 1례)

  • Choi, Ki-won;Kim, Tae-ju;Park, Han-bin;Yoo, Dong-hui;Kim, Ho;Lee, Sang-gun;Jo, Hyun-woo;Choi, Jae-yong
    • 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.

Historical Changes of Extruded Lumbar Intervertebral Disc -A case report- (유출된 요추부 추간판의 시간에 따른 변화 -증례보고-)

  • Park, Jeong Goo;Kwon, Won An
    • The Korean Journal of Pain
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    • v.22 no.1
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    • pp.99-103
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    • 2009
  • We studied the historical changes of intervertebral disc displacement using magnetic resonance imaging. The phenomenon of the spontaneous regression of herniated discs is well known. The case of a 40-years-old male presenting with a large disc herniation at L5-S1, experiencing severe sciatic pain, and having the straight leg raising test positive at 25 degrees is presented. The extruded disc was documented by clinical examination. He was treated conservatively with epidural steroid injection (ESI), medication, physical therapy and self-exercise and reevaluated in 10 weeks later, 30 and 1 year. Large extruded disc can be treated successfully by physical therapy with ESI. However, the degeneration and the dehydration of disc result in decrease of disc height. Consequently, the regression of extruded disc might have been due to the resorption and the dehydration.

Toll-like receptor 4/nuclear factor-kappa B pathway is involved in radicular pain by encouraging spinal microglia activation and inflammatory response in a rat model of lumbar disc herniation

  • Zhu, Lirong;Huang, Yangliang;Hu, Yuming;Tang, Qian;Zhong, Yi
    • The Korean Journal of Pain
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    • v.34 no.1
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    • pp.47-57
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    • 2021
  • Background: Lumbar disc herniation (LDH) is a common cause of radicular pain, but the mechanism is not clear. In this study, we investigated the engagement of toll-like receptor 4 (TLR4) and the nuclear factor-kappa B (NF-κB) in radicular pain and its possible mechanisms. Methods: An LDH model was induced by autologous nucleus pulposus (NP) implantation, which was obtained from coccygeal vertebra, then relocated in the lumbar 4/5 spinal nerve roots of rats. Mechanical and thermal pain behaviors were assessed by using von Frey filaments and hotplate test respectively. The protein level of TLR4 and phosphorylated-p65 (p-p65) was evaluated by western blotting analysis and immunofluorescence staining. Spinal microglia activation was evaluated by immunofluorescence staining of specific relevant markers. The expression of proand anti-inflammatory cytokines in the spinal dorsal horn was measured by enzyme linked immunosorbent assay. Results: Spinal expression of TLR4 and p-NF-κB (p-p65) was significantly increased after NP implantation, lasting up to 14 days. TLR4 was mainly expressed in spinal microglia, but not astrocytes or neurons. TLR4 antagonist TAK242 decreased spinal expression of p-p65. TAK242 or NF-κB inhibitor pyrrolidinedithiocarbamic acid alleviated mechanical and thermal pain behaviors, inhibited spinal microglia activation, moderated spinal inflammatory response manifested by decreasing interleukin (IL)-1β, IL-6, tumor necrosis factor-α expression and increasing IL-10 expression in the spinal dorsal horn. Conclusions: The study revealed that TLR4/NF-κB pathway participated in radicular pain by encouraging spinal microglia activation and inflammatory response.

A Clinical Study for Patients with Lumbar Disc Herniation: Association Between Clinical Outcomes of Conservative Treatment and Cigarette Smoking (요추 추간판 탈출증 환자의 보존적 치료결과와 흡연의 상관성에 대한 임상적 고찰)

  • Bahn, Hyo-Jung;Kim, Seok;Yoon, Hyun-Seok;Kim, Han-Kyum;Kim, Sun-Min;Kim, Jee-Yang;Kim, Tae-Hun;Park, Byoung-Yoon
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.5 no.2
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    • pp.17-32
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    • 2010
  • Objectives : To investigate the association between cigarette smoking and clinical outcomes of conservative treatment for lumbar herniated disc. Methods : We reviewed 74 male patients with lumbar herniated disc who were hospitalized at the Jaseng Oriental Medicine Hospital. 74 patients were divided into 2 groups(smokers, non-smokers) and we measured age, ODI score, SF-36 score, VAS. Results : Between smokers and non-smokers, statically significant differences were found in clinical symptoms on the time of 6 months later, effective scores of treatments, value of ODI and value of VAS on the time of 6 months later. And in these values of measurements, non-smokers were higher than those of smokers. Conclusion : These results suggest that possibility of the association between cigarette smoking and clinical outcomes of conservative treatment for lumbar herniated disc.

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Clinical Outcomes of Percutaneous Lumbar Discectomy Using Dekompressor(R) (Dekompressor(R)를 이용한 요부의 경피적 추간판 감압술의 임상 결과)

  • Han, Sun Sook;Sim, Sung Eun;Kim, Yang Hyun;Lee, Eun Hyoung;Joh, Ju Yeon;Kim, Ji Young;Lee, Sang Chul
    • The Korean Journal of Pain
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    • v.18 no.2
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    • pp.187-191
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    • 2005
  • Background: Discogenic leg pain is a major cause of health problems, often due to herniation of the intervertebral disc, and has traditionally been treated conservatively or with an open surgical discectomy. Conventional open surgery has many complications, such as nerve root injury, discitis and a relatively high mortality rate; failure of conservative treatments is also common. Recently, the $Dekompressor^{(R)}$ Percutaneous Lumbar Discectomy probe was developed. Herein, we present the early results for a percutaneous lumbar discectomy in herniated lumbar disc disease. Methods: Eleven patients, including 8 men and 3 women, with ages ranging from 22 to 78 years, were enrolled in this study. Those patients with a previous history of back surgery were not excluded from the study. All patients were postoperatively evaluated for their clinical outcomes, such as visual analogue scale (VAS) for pain after 1 and 3 months, reduction in analgesics, functional improvement and overall satisfaction. Results: The percutaneous lumbar discectomy was completed in 11 patients (17 levels), with average reductions in pre-VAS of 61.3 and 60.2% at 1 and 3 months, respectively. Also, 72.7% of patients reported functional improvement, with 81.1% expressing overall satisfaction. There were no procedural related complications. Conclusions: We concluded that a percutaneous lumbar discectomy is a safe and effective treatment modality for a herniated lumbar disc.