• Title/Summary/Keyword: Herniation of lumbar disc

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Changes on Magnetic resonance imaging in lumbar disc herniations treated with oriental medicine (한의학적 치료법으로 호전된 요추 추간판 탈출증 환자의 영상의학적 변화)

  • Kim, Wu-Young;Han, Sang-Yup;Kim, Ki-Yuk;Kong, Duck-Hyun;Lee, Hyun-Jong;Kim, Chang-Youn;Nam, Hang-Woo
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.4 no.1
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    • pp.31-41
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    • 2009
  • Objectives: The aim of this study was to evaluate the evolution of lumbar disc herniation in patients treated with oriental medicine. Methods: 14patients(15 cases) with lumbar disc herniation proved at MRI(Magnetic resonance imaging) underwent a follow-up MRI study. Follow-up MRI was performed $4{\sim}14$months(mean 7 months) after initial MRI. Results & Conclusions: 1. 13 cases(87%) had reduction of disc herniation. 1 showed no change in amount of disc herniation. 1 had an increase in disc herniation. 2. Comparison initial MRI with follow-up MRI showed that 2 of the herniations decreased between 0% and 25%, 3 decreased between 25% and 50%, 5 decreased between 50% and 75%, 3 decreased between 75% and 100%. The size of the herniation decreased on average by 49% in 14patients(15 cases). 3. On axial images, the proportion of the cross-sectional area of the spinal canal occupied by the herniated disc was 54.41% on the average on the initial scan, 29.65% on the follow-up scan.

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Surgery versus Nerve Blocks for Lumbar Disc Herniation : Quantitative Analysis of Radiological Factors as a Predictor for Successful Outcomes

  • Kim, Joohyun;Hur, Junseok W.;Lee, Jang-Bo;Park, Jung Yul
    • Journal of Korean Neurosurgical Society
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    • v.59 no.5
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    • pp.478-484
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    • 2016
  • Objective : To assess the clinical and radiological factors as predictors for successful outcomes in lumbar disc herniation (LDH) treatment. Methods : Two groups of patients with single level LDH (L4-5) requiring treatment were retrospectively studied. The surgery group (SG) included 34 patients, and 30 patients who initially refused the surgery were included in the nerve blocks group (NG). A visual analogue scale (VAS) for leg and back pain and motor deficit were initially evaluated before procedures, and repeated at 1, 6, and 12 months. Radiological factors including the disc herniation length, disc herniation area, canal length-occupying ratio, and canal area-occupying ratio were measured and compared. Predicting factors of successful outcomes were determined with multivariate logistic regression analysis after the optimal cut off values were established with a receiver operating characteristic curve. Results : There was no significant demographic difference between two groups. A multivariate logistic regression analysis with radiological and clinical (12 months follow-up) data revealed that the high disc herniation length with cutoff value 6.31 mm [odds ratio (OR) 2.35; confidence interval (CI) 1.21-3.98] was a predictor of successful outcomes of leg pain relief in the SG. The low disc herniation length with cutoff value 6.23 mm (OR 0.05; CI 0.003-0.89) and high baseline VAS leg (OR 12.63; CI 1.64-97.45) were identified as predictors of successful outcomes of leg pain relief in the NG. Conclusion : The patients with the disc herniation length larger than 6.31 mm showed successful outcomes with surgery whereas the patients with the disc herniation length less than 6.23 mm showed successful outcomes with nerve block. These results could be considered as a radiological criteria in choosing optimal treatment options for LDH.

The Clinical Analysis on 32 Cases of Herniated Lumbar Disc Patients according to Lumbar CT scan. (Lumbar Spine CT 촬영한 요각통 환자 32례의 치료경과 분석)

  • Kim, Jeong-Ho;Lee, Jeong-Hwan;Kim, Young-Il
    • Journal of Pharmacopuncture
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    • v.13 no.2
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    • pp.111-120
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    • 2010
  • Objective: This study is to evaluate the effectiveness of the oriental medicine treatment on lumbar disc herniation. Subjects and Methods : The clinical analysis was done on 32 cases of patients with lumbar disc herniation diagnosed by lumbar CT scan. Patients who admitted In Cheongju Oriental Medicine Hospital from April 2007 to April 2008 were analyzed according to the distribution of sex, age, the period of disease, condition on admission, the symptom on admission, Admission day, the treatment efficacy at discharge day. Results : 1. The forties was the most, the acutest phase the most, the day of 8-14 days the most. 2. Multiple bulging disc in 37.5% of CT scan was the most common, followed by a single HNP was 28.1%. 3. Almost 81 % patients showed effective efficacy under VAS 3 at discharge day. 4. Single bulging and herniated disc were more short admission days than multiple bulging and herniated disc.

Introducing a New Risk Factor for Lumbar Disc Herniation in Females : Vertical Angle of the Sacral Curvature

  • Kanat, Ayhan;Yazar, Ugur;Kazdal, Hizir;Sonmez, Osman Fikret
    • Journal of Korean Neurosurgical Society
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    • v.52 no.5
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    • pp.447-451
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    • 2012
  • Objective : To characterize the importance of the vertical angle of the sacral curvature (VASC) in lumbar disc herniations. Methods : Morphological data derived from lumbar sagittal MRI imaging. The statistical significance of the findings are discussed. The angles of 60 female patients with lumbar disc herniations (LDH) were compared with the 34 female patients without LDH. Results : 128 of the 185 patients met our inclusion criteria. The vertical angle of sacral curvature is statistically significantly bigger in females with lumbar disc herniations when compared to subjects in control group, 28.32 and 25.4, respectively. (p=0.034<0.05). Same difference was not seen in males. Conclusion : The vertical angle of sagittal sacral curvature may be another risk factor in females with lumbar disc herniations.

Clinical Study for Patients with Lumbar Disc Herniation on Change of Magnetic Resonance Imaging at One Year after Conservative Treatment (요추 추간판 탈출증 환자의 보존적 치료 후 변화된 자기공명영상에 따른 1년 후 임상변화 고찰)

  • Kwon, Hyeok-Joon;Park, Young-Hoi
    • Journal of Korean Medicine Rehabilitation
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    • v.21 no.2
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    • pp.253-263
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    • 2011
  • Objectives : To analyze the therapeutic outcomes of back pain modalities in patients with disc herniation according to the change of magnetic imaging(MRI) at one year after conservative treatment. Methods : Clinical outcomes of 35 patients diagnosed with lumbar disc herniation by MRI examination, treated conservatively, were analyzed according to MRI follow-up change; improved, unchanged, worsened. Patients underwent MRI examination at baseline and after 24 week of treatment. After 1 year, we followed up 30 patients. The patients' clinical outcomes were assessed at baseline, 24 week, 1 year by visual analogue scale(VAS), oswestry disability index (ODI), and analyzed by each of it's correlation. Results : 1. VAS of sciatica and ODI of disability of daily activities showed significant decrease in patients after 1 year follow up(p<0.05). 2. VAS(low back pain and sciatica) and ODI of disability of daily activities showed significant decrease in "improved" group and VAS(sciatica) and ODI showed significant decrease in "unchanged" group. "worsened" group showed no statistic significance(p<0.05). 3. The 1 year follow-up of VAS(low back pain and sciatica) and ODI change showed relationship with MRI follow-up change(p<0.05). Conclusions : This study suggests that "improved" groups compared to "unchanged" and "worsened" group on MRI follow-up in patients with lumbar disc herniation were more effective at 1 year after conservative treatment. MRI follow-up change affect clinical changes in patients with lumbar disc herniation after 1 year.

Correlation between Lumbar Malposition and Disc Herniation in Lumbar Disc Herniation Patients: Focused on L4-L5, L5-S1 (요추 추간판 탈출 환자에서 나타나는 요추부 변위와 추간판 탈출의 상관관계: L4-L5, L5-S1 요추 간 추간판 탈출을 중심으로)

  • Yeon-Hoo Yi;Da-woon Song;Jae-Min Jeong;Tae-ha Kwon;Sae-young Bong;Yoo-jin Lee;Jin-Bong Choi
    • 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.

Dorsal Extradural Lumbar Disc Herniation Causing Cauda Equina Syndrome : A Case Report and Review of Literature

  • Kim, Jin-Sung;Lee, Sang-Ho;Arbatti, Nikhil J.
    • Journal of Korean Neurosurgical Society
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    • v.47 no.3
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    • pp.217-220
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    • 2010
  • A 73-year-old male presented with a rare dorsally sequestrated lumbar disc herniation manifesting as severe radiating pain in both leg, progressively worsening weakness in both lower extremities, and urinary incontinence, suggesting cauda equina syndrome. Magnetic resonance imaging suggested the sequestrated disc fragment located in the extradural space at the L4-L5 level had surrounded and compressed the dural sac from the lateral to dorsal sides. A bilateral decompressive laminectomy was performed under an operating microscope. A large extruded disc was found to have migrated from the ventral aspect, around the thecal sac, and into the dorsal aspect, which compressed the sac to the right. After removal of the disc fragment, his sciatica was relieved and the patient felt strength of lower extremity improved.

The Effect of Shinbaro and Bee Venom Pharmacopuncture in Treating Lumbar Disc Herniations (요추간판 탈출증에 대한 신바로약침과 봉약침의 치료효과 비교 연구)

  • Park, Ok Ju;Kim, Sul Gi;Lee, Jeong Ju;Lee, Sang Mi;Kim, Seong Joung;Cho, Nam Geun
    • Journal of Acupuncture Research
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    • v.30 no.5
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    • pp.41-50
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    • 2013
  • Objectives : This study was performed to compare the effects of Shinbaro pharmacopuncture therapy and bee venom pharmacopuncture therapy in lumbar disc herniation Methods : We compared treatment efficacy of 12 patients with Shinbaro pharmacopuncture therapy and 10 patients with bee venom pharmacopuncture therapy, all of whom were diagnosed with lumbar disc herniation using computed tomography(CT) or magnetic resonance imaging(MRI). We performed a retrospective comparison and analysis during the course of 21 days since admission. To evaluate the treatment efficacy, we recorded the temperatures of the opposite back, hip, and legs with visual analog scale(VAS, back and legs), pain rating scale(PRS), Oswestry disability index(ODI) and digital infrared thermal imaging(DITI) based on patients' medical records. Results : Both treatments were effective in reducing pain and improving functions for lumbar disc herniation patients in terms of VAS, PRS, ODI, DITI. Shinbaro pharmacopuncture group showed slightly better results than the bee venom pharmacopuncture group, but the difference was not significant. Conclusions : For the treatment of lumbar disc herniation, it is suggested that Shinbaro pharmacopuncture therapy is thought to be as effective as bee venom pharmacopuncture therapy without side effects, although further study would be necessary.

Effects of Conservative Korean Traditional Medical Treatment on Lumbar Intervertebral Disc Herniation in 12 Adolescents : A Retrospective Study (청소년기 요추간판탈출증에 대한 한방 보존적 치료 12례의 후향적 분석)

  • Kim, Hae Sol;Bae, Young Hyun;Kim, Ho Sun;Suh, Chang Yong;Kim, No Hyeon;Lee, Gi Bum;Yang, Kyu Jin
    • Journal of Acupuncture Research
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    • v.33 no.1
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    • pp.103-116
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    • 2016
  • Objectives : This study was performed to assess the effectiveness of conservative Korean traditional medical treatment on lumbar intervertebral disc herniation in 12 adolescents. Methods : Data were collected from adolescent patients diagnosed with lumbar intervertebral herniation by MRI, hospitalized at Jaseng Korean Medicine Hospital from January 1, 2014 to December 31, 2015. A total of 12 patients were included in the study. Patients were treated by acupuncture, pharmacopuncture, electroacupuncture, herbal medicine, chuna manual therapy, physical therapy during hospitalization period. To measure treatment outcomes, a verbal numerical rating scale (VNRS), Oswestry disability index (ODI), range of motion (ROM), Straight leg raising test (SLR), and EQ-5D were used. Results : The average age of the participants was $16.05{\pm}1.62$. The average of duration of symptom was $19.25{\pm}26.83(weeks)$ and the average length of hospitalization was $23.8{\pm}16.4(days)$. 2 patients (17 %) suffered from only lumbar pain, while 10 patients (83 %) suffered from lumbar and leg pain. No participant suffered from only leg pain. 8 patients (67 %) were diagnosed with disc herniation in one segment, and 4 patients (33 %) were diagnosed with disc herniation in multiple segments. A total of 17 disc segments (28 %) were herniated. The most herniated lumbar level was L4-5. 3 segments were diagnosed with bulging (17 %), 6 with protrusion (35 %), and 8 with extrusion (47 %). Extrusion was the most frequent herniated type. After treatment, the average VNRS of lumbar pain significantly decreased from $5.58{\pm}1.62$ to $2.91{\pm}1.56$ (p<0.001) and the average VNRS of leg pain significantly decreased from $5.16{\pm}2.51$ to $3.08{\pm}1.8$ (p<0.001). ODI significantly decreased from $48.87{\pm}18.72$ to $28.57{\pm}15.05$ (p<0.05), and EQ-5D significantly increased $0.58{\pm}0.31$ to $0.80{\pm}0.12$ (p<0.05). Range of flexion significantly improved from $61.25{\pm}32.62$ to $68.33{\pm}26.22$ (p<0.05). Conclusion : Conservative Korean Traditional Medical Treatment may be effective in the treatment of lumbar intervertebral disc herniation in adolescence. However, more case reports and clinical research are needed.

A Case Report inculding Pharmacopuncture Therapy at Lumbar Facet joints for a Patient with Lumbar Disc Herniation with Lower Back Pain and Leg Radiating Pain that Worsen during Pregnancy (요추 후관절 약침 치료를 병행한 임신 중 요통 및 하지방사통이 악화된 요추 추간판 탈출증 환자 증례 보고)

  • Kim, Su-Jin;Kim, Sun-A;Kim, Min-Kyung;Lee, Si-Won;Kyung, Da-Hyun;Bae, Ji-Eun;Kwon, Yong-Su;Huh, Hyo-Seung
    • The Journal of Korean Obstetrics and Gynecology
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    • v.34 no.1
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    • pp.93-103
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    • 2021
  • Objectives: The purpose of this study was to report a case of a pregnant woman diagnosed with lumbar disc herniation that improved in lumbar pain and radiating leg pain through combined korean medical treatment including pharmacopuncture at lumbar facet joints in situations surgical and pharmacological treatment is limited due to pregnancy. Methods: A combination of treatment including pharmacopuncture at lumbar facet joints, acupuncture, cupping, and herbal medicine was provided for 1 month to a woman at 21 weeks pregnant who was diagnosed with lumbar disc herniation. Her progress was assessed with Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), EuroQol-5Dimension (EQ-5D) before and after treatment. Results: After the treatment, the pain decreased and the quality of life was enhanced. No adverse events were observed. Conclusions: The findings indicate that combined korean medical treatment including pharmacopuncture at lumbar facet joints can be safe and effective alternative to treat lumbar disc herniation during pregnancy.