• Journal of Korean Neurosurgical Society
• /
• v.30 no.2
• /
• pp.150-155
• /
• 2001

Between January 1995 and May 1998, 177 patients with proven lumbar disc herniation were treated by microdiscectomy or by percutaneous endoscopic discectomy(PED). Among them, 43(24.2%) patients underwent PED and were followed for long term outcome. We included only those patients who were followed up more than 13 months. Three patients who did not improved immediately after PED and underwent microdiscectomy were excluded for this study. Of remaining 40 patients, there were 22 men and 18 women who ranged in age from 23 to 68 years (mean 38.1 years). The disc herniations were located at L1-2(1), L2-3(1), L3-4(1), L4-5(26) and L5-S1(11). Three patients were treated by biportal approach. The mean follow up period was 34.7 months(range 13-47 months). Overall, excellent and good results were achieved in 12(30%) and 19(47.5%) patients, and fair and poor results in 7(17.5%) and 2(5%) patients, respectively. Thirty-eight(95%) patients returned to their previous works and the mean duration was 5.7 months. Thirty-three(82.5%) patients answered that they would recommend this procedure to others. There was no complication except for one patient who suffered from discitis. The indication of PED is restricted to contained or small subligamentous lumbar disc herniation without stenosis, spondylolisthesis and sequestration. PED can be performed under local anesthesia and tissue trauma, risk of epidural scarring, hospitalization time and postoperative morbidity are minimal. The result of the present study justify the assumption that PED can be a surgical alternative for patients suitable for its indications.

• The Journal of Korean Medicine
• /
• v.42 no.3
• /
• pp.1-8
• /
• 2021

Objectives: A critical pathway defines the optimal care process, sequencing and timing of intervention by multi-disciplinary health care teams for a particular diagnosis and procedure. It plays an important role as a cost-effective health care delivery system and a tool for quality control of medical and dental services by means of standardizing medical practices. The aim of this study is to investigate the satisfaction of patients and medical staff after implementation of a critical pathway for Korean medical treatment of lumbar disc herniation in integrative medical. Methods and Results: The pre-critical pathway group included 3 patients who underwent the implementation procedure from October 2020. All three patients have successfully been applied critical pathways during inpatient and outpatient treatment. Additionally, medical staff members were satisfied with the usefulness of the critical pathway. Conclusions: The implementation of critical pathway for the Korean medical treatment with lumbar disc herniation in integrative medical hospital can appraise possible applicability in actual clinical field.

• Journal of Korean Medicine Rehabilitation
• /
• v.28 no.4
• /
• pp.43-50
• /
• 2018

Objectives Upper lumbar disc herniation (LDH) (L1/2, L2/3) has specific anatomical characteristics and different outcome after conventional treatment compared to lower LDH (L3/4, L4/5, L5/S1). The purpose of this study was to compare the clinical features and effects of korean medical treatment of upper LDH between lower LDH. Methods We retrospectively reviewed the clinical data collected from 121 patients who was had admitted at the Haeundae Jaseng Hospital of Korean Medicine from June 1st, 2014 to August 31th, 2018. The patients who had treated at L1/2, L2/3 level LDH were grouped and compared with those treated at the L3/4, L4/5, L5/S1 level. We reviewed the patient characteristics such as age, the positive rate of Straight Leg Raise Test (SLR test), the presence or absence of previous lumbar surgery. Numeric Rating Scale (NRS) and Oswestry Disability Index (ODI) were evaluated at adimission and discharge. Results Mean age was significantly higher at upper LDH group and positive rate of SLR test was higher at lower LDH group. There was no significant difference of gender and previous lumbar surgery between two groups. Each group had a significant improvement of NRS, ODI scores. But between two groups, there was no significant difference of NRS, ODI scores. Conclusions Upper LDH group was older than lower LDH group. SLR test was useful tool to exclude upper LDH. Korean medical treatment was significantly effective to both upper and lower LDH groups. Further well designed prospective comparative studies are needed.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.24 no.6
• /
• pp.1087-1093
• /
• 2010

The purpose of this study is to survey the effectiveness of oriental medicine treatment on lumbar herniated intervertebral disc and spondylolisthesis. The clinical study was performed on 32 cases of patients with lumbar herniated intervertebral disc and spondylolisthesis as diagnosed by X-ray, Magnetic resonance imaging(MRI) exams amongst the patients who were admitted to Jaseng Hospital of Oriental Medicine from January 2010 to June 2010. 32 cases of patients were analyzed according to the distribution of sex, age, duration of disease, contributory factor, symptoms, admission period, disc herniation type and level of spondylolisthesis. The efficacy of treatment was evaluated respectively. The number of the female patients were larger than that of male with the ratio of 1:0.6. Most of the patients were in their fifties(43.8%), choronic phase(46.9%), those patients suffered from lower back pain and leg pain radiation(90.6%), reasons unknown(56.3%). Most of them also had mixed disc(37.5%), bulging disc(37.5%) and spondylolisthesis of LS on L5(50.0%). Most of them stayed in the hospital for 21-25days. After treatment, the percentage with good improvement was 62.5%, fair 18.8%, poor 12.5%, and excellent 6.3%, respectively. Oriental medicine treatment has on useful effect on the recovery of lumbar herniated intervertebral disc with spondylolisthesis.

• Journal of Korean Neurosurgical Society
• /
• v.47 no.3
• /
• pp.224-227
• /
• 2010

Small bowel injury resulting from unforeseen penetration of the anterior annulus fibrosus and longitudinal ligament is a rare complication of lumbar microdiscectomy. The patient complained of abdominal tenderness and distention immediately after microdiscectomy for L4-5 and L5-S1 disc herniation. Using abdominal computed tomography, we found several foci of air overlying the anterior aspect of the vertebral body at the L5-S1 level. Segmental resection of the small bowel including small tears and primary anastomosis of the jejunum were performed. Here, we present a case of intestinal perforation after lumbar microdiscectomy and discuss technical methods to prevent this complication with a review of literature.

• Journal of Acupuncture Research
• /
• v.25 no.4
• /
• pp.149-156
• /
• 2008

Objectives : The purpose of this study is to report the effect of acupotomy for patients with Lumbar intervertebral disc Herniation. Methods : We treated Four patients who have HIVD of L-spine with acupotomy. Visual analog scores(VAS) and Oswestry Low-back pain Disabiliby Index(ODI) were compared before-treatment with after-tretment. When the patients is discharged, the satisfaction of acupotomy were graded by Five-point Likert scale. Results : VAS and ODI were decreased at all case. Likert scale point were cheked as grade 4 at all case. Conclusions : This study shows acupotomy has useful effect on HIVD of L-spine.

• Journal of the Korean Society of Radiology
• /
• v.85 no.1
• /
• pp.3-23
• /
• 2024

Intervertebral disc herniation is frequently encountered in radiological practice. Sequestered disc herniation occurs when the disc material undergoes degeneration and completely loses continuity with the parent nucleus pulposus. Sequestered discs can reside within and outside the spinal canal, exerting a mass effect on adjacent structures, compressing nerve pathways, and eliciting a range of clinical symptoms. In particular, sequestered discs within the dura cannot be identified without durotomy. Therefore, precise preoperative localization is crucial for surgical planning. On MRI, the signal intensity of the sequestered disc may vary due to independent degeneration processes. Additionally, most sequestered disc fragments show varying degrees of peripheral enhancement depending on the degree of angiogenesis and granulation around the isolated tissue. In this article, we review various imaging findings and the location of the sequestered disc to provide patients with an accurate diagnosis and appropriate treatment direction.

• Journal of the Korean Society of Radiology
• /
• v.10 no.5
• /
• pp.359-365
• /
• 2016

Fluoroscopy is performed when tissue or organ in the human body is examined, and it is used for diagnosis and procedure in back ailments. With regard to fluoroscopy equipment, distortion occurs on the peripheral part of fluoroscopic image rather than on its central part. This study measured distortion factors of vertical spacing ratio and distortion factor of diagonal spacing ratio before and after correction by applying a correction algorithm. According to measuring the vertical spacing ratio, post-correction standard deviation decreased by 0.04 in comparison with pre-correction one. Also measuring the diagonal spacing ratio, post-correction standard deviation decreased by 0.06 in comparison with pre-correction one. Consequently, the distortion of fluoroscopic image decreased after correction. A decrease in the distortion of image through the application of correction algorithm and the improvement of performance will be helpful in finding a correct position of lumbar puncture in nucleoplasty to treat lumbar disc herniation in the future.

• Journal of Acupuncture Research
• /
• v.37 no.3
• /
• pp.177-180
• /
• 2020

Background: The aim of this study was to examine whether the effects of acupotomy therapy were beneficial for the treatment of protrusion of lumbar intervertebral disc. Methods: The number of patients (n = 80) were equally assigned into treatment group and control group. Treatment group was given acupotomy therapy twice a week, and control group was given acupuncture 3 times a week, for 4 weeks. The beneficial effect and changes in score of the Japan Orthopedic Association (JOA) for low back pain were observed. Results: Among 40 cases in the treatment group, there were 25 (62.5%) with an excellent effect, 13 (32.5%) with good effect, 1 (2.5%) with a medium effect and 1 (2.5%) with poor effect, with the total experiencing an excellent/good effect of 95.0%. Among 40 cases in the control group, there were 11 (27.5%) with an excellent effect, 17 (42.5%) with good effect, 10 (25.0%) with a medium effect, and 2 (5.0%) with poor effect, with an excellent/good rate of 70.0%. The result of the rank sum test showed Z = -4.923, p < 0.05 in the comparison, indicating a significantly better outcome following acupotomy compared with acupuncture. JOA scores increased in both groups after treatment (p < 0.05), which was more significant in the acupotomy treatment group (p < 0.05). Conclusion: Acupotomy therapy has a beneficial effect on protrusion of lumbar intervertebral disc.

• The Journal of Korea CHUNA Manual Medicine
• /
• v.3 no.1
• /
• pp.43-53
• /
• 2002

Objectives : The object is to study a clinical effect regarding the conservative treatment of the patient who was diagnosed as the herniated Intervertebral lumbar disc(HIVD) and hospitalized in the oriental medical hospital and clinical study about the type of the HIVD. Methods. The clinical studies were done on 65 cases (hospitalized in Dept. of Oriental Rehabilitation Medicine, jaseng on oriental medical hospital from June 2001 to May 2002) who complained of low back pain or sciatica and diagnosed as HIVD on CT(computerized tomography) or MRI(magnetic resonance imaging). They were given both oriental conservative treatment and exercise during the hospitalization period. We investigated and observed 20 items about sex, age, weight, height, occupation, smoking. obesity, duration of disease, clinical symptom and treatment duration in basis of medical recording which was drawn up at patient hospitalization. We classified HIVD with 4 types(Bulging. Protruded. Extruded, Sequestered) and decided the case which simultaneously had 2 overs with Mixed type. The treatment evaluation standard was classified with 4 branches; Excellent. Good, Fair and Poor. Results & Conclusions : The treatment result of over 'fair' is bulging type 85%, protruded type 92.7%, extruded type 100% and the mixed type was 85.1 %. The effect was good in order of bulging, mixed, protruded and extruded type. It appeared most plentifully with 30 people in L4-5 and L5-S 1 disc herniation type.