• Title/Summary/Keyword: Herniation of lumbar disc

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Recalcitrant Low Back Pain Diagnosed as Hypophosphatemic Osteomalacia Induced by Antiviral Medication (항바이러스제에 의한 저인산성 골연화증으로 진단된 난치성 요통)

  • Chae, Hyun Jun;Won, Jun Hee;Lee, Won Kyung;Kim, Keewon
    • Clinical Pain
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    • v.20 no.2
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    • pp.131-134
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    • 2021
  • We report a rare case of anti-viral agent induced hypophosphatemic osteomalacia presented with localized and radicular pain. A 51-year-old man, who had been taking adefovir for chronic hepatitis, had experienced low back pain radiating to his right thigh for 2 years. With impression of lumbar disc herniation, he underwent magnetic resonance imaging and found multi-level disc herniation with facet joint synovial cysts. He received transforaminal epidural steroid injections, however, symptoms did not improve. To find other possible causes, additional tests were performed. Blood tests revealed hypophosphatemia and increased serum alkaline phosphatase, and osteoporosis was noted in dual-energy X-ray absorptiometry with multiple hot uptakes in bone scan. After replacement of adefovir to entecavir and supplement of phosphate and vitamin D, phosphate level and the clinical symptoms were improved. This is the first to report the presentation of osteomalacia due to anti-viral agent as radicular low back pain with facet synovial cysts.

Fourty One Cases on MRI (Magnetic Resonance Imaging) Change of Hivd of L-Spine Patient Who Have Been Improvement on Megadose Pharmacoacupuncture and Korean Medical Treatments (대용량 약침 및 한방치료로 호전된 요추 추간판탈출증 환자의 영상의학적 변화 41사례 보고)

  • Yoo, Su-bin;Kim, Moon-hwui;Moon, Byung-heon;Yoon, Tae-kyung;Ju, Yeong-guk;Kwon, Ok-jun;Choo, Won-jung;Kim, Joo-won
    • Journal of Korean Medicine Rehabilitation
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    • v.26 no.4
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    • pp.117-126
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    • 2016
  • Objectives The purpose of this study is to report the effect of Megadose Pharmacoacupuncture combined with conservative Korean medicine treatment on Herniated InterVertebral Disc (HIVD) of lumbar spine patient diagnosed by Magnetic Resonance Imaging (MRI). Methods This study includes 41 patients whose Lumbar Disc Herniations were by MRIbetween 1st Aprill 2011 and 31th March 2016. All of the patients were treated with Megadose Pharmacoacupuncture combined with Korean medicine treatment. The MRI examination was performed on two or more occasions (minimally, pre-treatment and post-treatment). The volume of each herniated disc was measured. For each patient, age, sex, disc migration, morphology, initial LDH size, herniated disc resorption rate were analysed. Results The mean volumes of herniated discs at pre-treatment and post-treatment were $1321.62{\pm}467.53mm^3$ and $648.72{\pm}313.38mm^3$. The volumes of all patients were decreased. The resorption means of each class of the extent of LDH were significantly different (p=0.041). On the other hand, no difference was found in sex, age, level, herniated disc grade. Conclusions The MRI results suggest that Megadose Pharmacoacupuncture combined with Korean medicine treatment can help treat lumbar herniated disc.

Case Report of a Lumbar Disc Herniation (LDH) Patient with Chronic Active Hepatitis B (만성 활동성 B형 간염 질환 환자의 요추간판 탈출증 치험례)

  • Jung, You-jin;Kang, Kyung-rae;Lee, Min-su;Choi, A-ryun;Kang, A-hyun;Han, Dong-kun;Song, Woo-sub;Lee, Hyung-chung
    • The Journal of Internal Korean Medicine
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    • v.37 no.2
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    • pp.374-380
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    • 2016
  • Objective: Although the incidence of chronic hepatitis B has decreased around the world due to widespread national preventative control measures, mortality from the same condition can increase if the condition leads to liver cancer or liver cirrhosis. In most cases, herbal medicine does not show any statistically significant effects related to liver damage, but preconceptions do exist that herbal medicine can be toxic and cause such liver damage. To investigate this situation, this study therefore investigated a patient with hepatitis B who had combined traditional Korean medicine therapy and the use of analgesic drugs during a hospitalization period.Method: A patient with hepatitis B was given combined traditional Korean medicine therapy and the use of analgesic drugs during a hospitalization period.Results: Within 26 days, the patient was free from liver damage during the hospitalization period. She was followed up with a liver function test and was discharged after her condition improved; she also reported decreased back pain.

Oriental Medical Treatment of Lumbar Spinal Stenosis (요추관협착증(腰椎管狹窄症)(Lumbar Spinal Stenosis) 환자 치험례)

  • Lee, Hae-Yeon;Lee, Tae-Hun;Park, Jung-Han;Cho, Hyun-Seok;Lee, Jae-Jun;Bae, Dong-Joo;Kong, Kyung-Hwan;Baik, Tae-Hyun
    • Journal of Pharmacopuncture
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    • v.6 no.3
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    • pp.75-80
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    • 2003
  • Lumbar spinal stenosis results from the progressive combined narrowing of the central spinal canal, the neurorecesses, and the neuroforaminal canals. In the absence of prior surgery, tumor, or infection, the spinal canal may become narrowed by bulging or protrusion of the intervertebral disc annulus, herniation of the nucleus pulposis posteriorly, thickening of the posterior longitudinal ligament, hypertrophy of the ligamentum flavum, epidural fat deposition, spondylosis of the intervertebral disc margins, or a combination of two or more of the above factors. Patients with spinal stenosis become symptomatic when pain, motor weakness, paresthesia, or other neurologic compromise causes distress. In one case, we administrated oriental medical treatment with acupuncture treatment and herb-medicine. Oriental medical treatment showed desirable effect on lumbar spinal stenosis.

Investigation of Beck's Depression Inventory Score of Patients with Cervical and Lumbar Herniation of Intervertebral Disc (만성 경추, 요추 추간판 탈출증 질환군의 우울 척도(BDI) 비교 연구)

  • Kwon, Seung-Ro;Kim, Gwang-Ho;Kim, Gyu-Tae;An, Keon-Sang;You, Hye-Kyung;Kang, Man-Ho;Lee, Jin-Kyu;Lee, Je-Kyun
    • Journal of Oriental Neuropsychiatry
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    • v.17 no.2
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    • pp.159-165
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    • 2006
  • Objective : It Is known that depression disorder has been related to chronic pains such as HIVD and physical harm. We propose that chronic cervical and lumbar herniations of intervertebral disc patients have emotional and psychiatric problems, therefore we compared it to Beck's Depression Inventory scores. Method : We divided them into two groups: The groups consisted of cervical and lumbar HIVD patients. We then requested them to fill out BDI research questionnaires, and evaluated patients according to the information and results. Result : The Beck's Depression Inventory mean score for the cervical - lumbar HIVD group was $14.00{\pm}5.80$, $10.83{\pm}$5.64 each. Higher Scores were recorded for cervical HIVD group than the lumbar HIVD group. Conclusion : There is statistical significance among two groups.(p<.05) however, the two groups' BDI score were lower than the defined boundary line of Depression disorder(16 points).

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Analysis of Inadvertent Intradiscal Injections during Lumbar Transforaminal Epidural Injection

  • Hong, Ji Hee;Lee, Sung Mun;Bae, Jin Hong
    • The Korean Journal of Pain
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    • v.27 no.2
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    • pp.168-173
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    • 2014
  • Background: Recently, there have been several case reports and retrospective studies about the incidence of intradiscal (ID) injection during transforaminal epidural steroid injection (TFESI). Inadvertent ID injection is not a rare complication, and it carries the risk of developing diskitis, although there has been no report of diskitis after TFESI. We prospectively evaluated the incidence of inadvertent ID injection during lumbar TFESI and analyzed the contributing factors. Methods: Ten patients received 2-level TFESI, and the remaining 229 patients received 1-level TFESI. When successful TFESI was performed, 2 ml of contrast dye was injected under real-time fluoroscopy to check for any inadvertent ID spread. A musculoskeletal radiologist analyzed all magnetic resonance images (MRIs) of patients who demonstrated inadvertent ID injection. When reviewing MRIs, the intervertebral foramen level where ID injection occurred was carefully examined, and any anatomical structure which narrowing the foramen was identified. Results: Among the 249 TFESI, we identified 6 ID injections; thus, there was an incidence of 2.4%. Four patients had isthmic spondylolisthesis, and the level of spondylolisthesis coincided with the level of ID injection. We further examined the right or left foramen of the spondylolisthesis level and identified the upward migrated disc material that was narrowing the foramen. Conclusions: Inadvertent ID injection during TFESI is not infrequent, and pain physicians must pay close attention to the type and location of disc herniation.

The Comparative Study of Improvement of Patients Who Were Diagnosed with HIVD of L-Spine with Iliopsoas Muscles Tenderness by MST(Motion Style Treatment) on Iliopsoas Muscles: A Randomized, Controlled, Trial (장요근 압통을 동반한 요추 추간판 탈출증 환자에 대한 장요근 MST 호전도 비교 연구: 무작위 대조 연구)

  • Lee, Sun Ho
    • Korean Journal of Acupuncture
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    • v.31 no.2
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    • pp.79-89
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    • 2014
  • Objectives : This research was to evaluate the MST effectiveness on iliopsoas muscle of herniated inter-vertebral disc in lumbar spine. Methods : This research was carried out with the 58 inpatients who received treatment for their HIVD in lumbar spine from January 1 to April 12, 2014 in Daejeon Jaseng hospital of oriental medicine. We randomly divided into two groups: Group A=common treatment on HIVD of L-spine without MST(acupuncture, pharmacopuncture, herb medication, chuna treating and physiotherapy) and Group B=common treatment on HIVD of L-spine with MST. To verify the MST effect, tenderness(checked by algometer pressure), NRS(numeric rating scale), and ODI(Oswestry disability index) were measured before and after treatment. The statistically significance was evaluated by SPSS 18.0 for Windows. Results : In the Group B, the tenderness was significantly decreased compared with Group A. However, on the NRS and ODI, it did not produce the meaningful results as these two values decreased in all groups. Conclusions : From this research, when patients who were diagnosed HIVD of L-spine with iliopsoas muscles tenderness receive MST additionally, the satisfaction of patients as well as physician confidence will increase.

The Complications of the Graf Stabilization for Lumbar Disc Herniation with Posterior Instability (후방불안정성을 동반한 요추 추간판 탈출증에서 Graf 고정술후 발생한 합병증 분석)

  • Park, Joo-Tae;Shin, Young-Shik;Yang, Jeong-Ho;Min, Kang-Woo
    • Journal of Yeungnam Medical Science
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    • v.15 no.1
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    • pp.164-172
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    • 1998
  • The Graf stabilization has been introduced in treating lumbar spinal disorder associated with posterior instability. This study reviewed some problems of the Graf instrumentation as a soft stabilizer. The purpose of this study is to analyse the problems of the soft stabilization in spinal instability. We reviewed 145 cases which were operative treatment using the Graf instrument for lumbar spinal disorder associated with posterior instability at our department from May, 1991 to Dec, 1995. The mean follow up periods was 29 months ranging from 24 months to 6 years 8 months. Of the 145 cases, 22 cases were showed the problem. The diagnostic method were simple x-ray, flexion-extension lateral stress view and CT scan. Results were as follows: Adjacent segmental instability was 10 cases(6.9%), disc space narrowing was 8 cases(5.5%), screw loosening was 3 cases(2.1%) and breakage of the Graf band was 1 case(0.6%). The problems of the soft stabilization were adjacent segmental instability, disc space narrowing, screw loosening, and breakage of the Graf band. But the rate of adjacent segmental instability and disc space narrowing was lower than other lumbar spinal instrumentation.

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Lumbar Intraspinal Extradural Ganglion Cysts

  • Cho, Sung-Min;Rhee, Woo-Tack;Choi, Soo-Jung;Eom, Dae-Woon
    • Journal of Korean Neurosurgical Society
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    • v.46 no.1
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    • pp.56-59
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    • 2009
  • The lumbar intraspinal epidural ganglion cyst has been a rare cause of the low back pain or leg pain. Ganglion cysts and synovial cysts compose the juxtafacet cysts. Extensive studies have been performed about the synovial cysts, however, very little has been known about the ganglion cyst. Current report is about two ganglion cysts associated with implicative findings in young male patients. We discuss about the underlying pathology of the ganglion cyst based on intraoperative evidences, associated disc herniation at the same location or severe degeneration of the ligament flavum that the cyst originated from in young patients.

Brown-Sequard Syndrome Caused by a Cervical Synovial Cyst

  • Kim, Seok Won;Ju, Chang Il;Kim, Hyeun Sung;Kim, Yun Sung
    • Journal of Korean Neurosurgical Society
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    • v.55 no.4
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    • pp.215-217
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    • 2014
  • Synovial cysts are recognized as an uncommon cause of radicular and myelopathic symptoms. They are most frequently found in the lumbar region. The cervical spine or cervicothoracic junction is a rare location for a degenerative intraspinal synovial cyst as compared with the lumbar spine. At given cervical spinal levels, synovial cysts probably share clinical features with disc herniation and stenosis. However, the pathogenesis of synovial cysts remains still controversial. Here, we report a rare case of a synovial cyst in the lower cervical spine presented as Brown-Sequard syndrome and include a brief review of the literature. To the best of our knowledge, no previous report has been issued in the English literature on a synovial cyst presenting with Brown-Sequard syndrome. Neurologic function recovered completely after complete removal of the cyst and expansive laminoplasty.