• Title/Summary/Keyword: Herniation of lumbar disc

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Case Report: Changes in Magnetic Resonance Imaging in Lumbar Disc Herniation Treated with Korean Medicine (한의원에서 도침치료로 영상의학적 소견을 호전시킨 요추 추간판 탈출증 증례 1례)

  • Park, Sang-kyu;Kim, Yoon-sik;Jo, Hyun-kyung;Yoo, Ho-ryong;Seol, In-chan
    • The Journal of Internal Korean Medicine
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    • v.39 no.5
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    • pp.863-869
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    • 2018
  • Objectives: The purpose of this case study was to report the effectiveness of Korean medicine treatment on severe lumbar disc herniation patient diagnosed by magnetic resonance imaging (MRI). Methods: The patient was treated with complex Korean medicine treatment, including acupuncture, pharmacopuncture, acupotomy, and Chu-na treatment. The treatment effect was evaluated by a Numerical Rating Scale (NRS), and MRI. Results: After the treatment, the NRS score of pain intensity was reduced from severe to mild degree. The volume of extruded disc in MRI images was clearly reduced. Conclusion: Korean medicine treatment might be effective in patients with lumbar disc herniation.

The Clinical Comparison between Open Surgery and Percutaneous Endoscopic Lumbar Discectomy in Extraforaminal Lumbar Disc Herniation

  • Jeong, Jin-Seok;Lee, Sang-Ho;Lee, Sang-Jin;Hwang, Byeong-Wook
    • Journal of Korean Neurosurgical Society
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    • v.39 no.6
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    • pp.413-418
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    • 2006
  • Objective : The objective of this study is to evaluate and compare the clinical results between classical open surgery and percutaneous endoscopic lumbar discectomy[PELD] in cases of extraforaminal lumbar disc herniation. Methods : We obtained the clinical data from 47 patients with extraforaminal lumbar disc herniations who underwent the open paramedian muscle-splitting approach or percutaneous endoscopic lumbar discectomy[PELD] between January 2001 and February 2004. This study consisted of patients with soft disc extraforaminal herniations. The patients were assessed with the visual analogue scale[VAS] and MacNab's criteria before surgery, just before discharge, and postoperative 1 year. Results : There were 25 cases in the open surgery group and 22 cases in the PELD group. The average operating time was $78{\pm}36.71\;min$ in the PELD group and $110{\pm}29.68\;min$ in the open surgery group. The mean hospital stay was $2.73{\pm}2.62$ days in the PELD group and $7.68{\pm}2.59$ days in the open surgery group. VAS decreased from $8.34{\pm}0.66$ to $1.29{\pm}2.27$ in the PELD group and from $8.40{\pm}1.40$ to $1.70{\pm}1.72$ in the open surgery group at the one-year follow-up. The success rate of PELD was 86.4%, compared with 80.0% for open surgery. However, there were no statistically significant difference between two groups for success rate and VAS. Conclusion : Although the success rates were similar in both groups, PELD is less invasive, faster, and safe procedure than open surgery for extraforaminal disc herniation in selected patients.

The Effect of Lumbar Stabilization Exercises with Neurodynamic Techniques on Lumbar Muscular Strength and Oswestry Disability Index in Lumbar Disc Herniation Patient's (요추 안정화 운동과 결합된 신경역동학기법이 요추 추간판 탈출증 환자의 요부근력과 오스웨스트리 장애지수에 미치는 영향)

  • Mo, Min-sang;Park, Hyun-sik
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.22 no.1
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    • pp.1-7
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    • 2016
  • Background: The purpose of this study was to investigate the effects of lumbar stabilization exercise with neurodynamic techniques on lumbar muscular strength and Oswestry index in lumbar disc herniation patient. Method: The Lumbar stabilization exercise with neurodynamic techniques was performed by 30 pt's in G hospital. The subjects were randomly organized into a study group 15 and control group 15. The exercises and neurodynamic technique were conducted for 40 minutes and, 3 times a week (total 24 times for 8 weeks). General characteristics of the Lumbar muscular strength and Oswestry disability index (ODI) were measured before the training and at 4 weeks and 8 weeks after the intervention. Comparison of the time dependent variable for each group was Calculated by a one way repeated analysis of variance (ANOVA). Comparison between the two groups was Calculated by an analysis of covariance (ANCOVA). Result: There was a significant difference in the Lumbar muscular strength and ODI (p<.05). Similarly in the inter-group analysis, significant differences (p<.05) occurred. Conclusion: In this study, we demonstrated that lumbar stabilization exercises with neurodynamic techniques are an effective therapy for Lumbar muscular strength and ODI in lumbar disc herniation patient's.

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Effects of Decompression Therapy for the Treatment of a Herniated Lumbar Disc (요부 디스크 탈출의 감압치료 효과)

  • Park, Jeong Goo;Kim, Dong Geun
    • The Korean Journal of Pain
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    • v.21 no.2
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    • pp.143-149
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    • 2008
  • Background: Traction has often been utilized to treat patients with a herniated lumbar disc. Currently, the most advanced type of traction therapy is non-surgical spinal decompression. Therefore, this study was conducted to evaluate the effectiveness of decompression therapy in patients with a herniated lumbar disc based on clinical findings and symptoms. Methods: Sixty patients with herniated lumbar discs were included in this study. The patients were randomly divided into two groups, a decompression group (n = 30) and a traction group (n = 30). To evaluate the impact of decompression and traction therapy on the herniated disc, the clinical symptoms for each group were evaluated prior to and after treatment using the visual analogue scale (VAS), straight leg raising (SLR), the herniation index, and the disc height. Results: The VAS score was significantly lower in the decompression group ($2.0{\pm}0.2$) than the traction group ($3.9{\pm}0.2$) following treatment. In addition, the SLR angle was significantly higher in the decompression group ($79{\pm}1.5$) than the traction group ($63.3{\pm}1.9$). The herniation index was significantly lower in the decompression group ($217.6{\pm}19.1$) than the traction group ($259.5{\pm}16.4$). Finally, the disc height was not significant differences between pre-treatment and follow-up in two groups. Conclusions: The results of this study suggest that decompression therapy for the treatment of patients suffering from a herniated lumbar disc has an effect on the pain, SLR, and herniation indices, not disc heights.

Comparative Analysis on Disc Resorption Rate of Lumbar Disc Herniation Patients after Korean Medicine Treatment and Predictive Factors Associated with Disc Resorption (요추 추간판 탈출증 환자의 한의치료 후 디스크 흡수율 비교 및 흡수에 영향을 주는 요인 분석 연구)

  • Kim, Yong-Hyeon;Lee, Ju-Young;Kim, Kwang-Hwi;Kim, Tae-Yeon;Lee, Tae-Geol;Lee, Sang-Woon;Chu, Hui-Yeong;Jeong, Hui-Gyeong
    • Journal of Korean Medicine Rehabilitation
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    • v.28 no.4
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    • pp.33-41
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    • 2018
  • Objectives The purpose of this study is to analyze the effects of Korean Medicine treatment on lumbar disc herniation (LDH) and predictive factors associated with disc resorption by magnetic resonance imaging (MRI). Methods A retrospective study was carried out in 79 lumbar disc herniation patients who had visited Haeundae Jaseng Hospital of Korean Medicine. Patients' diagnosis was based on MRI. MRI was performed on two or more occasions and patients were received Korean Medicine treatment within the period. The volume of each herniated disc was measured three-dimensionally and patient characteristics, interval between MRIs, herniated disc level, disc herniation type, disc migration, intactness of posterior longitudinal ligament (PLL), initial volume of herniated disc, modic change, disc resorption rate were statistically analyzed. Results The mean volumes of herniated discs before Korean Medicine treatment and after Korean Medicine treatment were $1,547.81{\pm}598.15mm^3$ and $947.06{\pm}335.28mm^3$, respectively. The mean resorption rate was $35.7{\pm}16.3%$. Disc extent, intactness of PLL and initial volume of herniated discs were significantly correlated with resorption rate (p=0.003, p=0.001 and p=0.024, respectively). Conclusions Korean Medicine treatment is an effective conservative treatment for lumbar disc herniation. Factors such as disc migration, intactness of PLL, initial volume of herniated disc have a significant association with disc resorption rate.

Intradural Lumbar Disc Rupture - Case Report - (경막내 요추 추간반 탈출증 - 증례보고 -)

  • Jeong, Ju-Ho;Lee, Sang-Gu;Yoo, Chan-Jong;Han, Ki-Soo;Kim, Woo-Kyung;Kim, Young-Bo;Park, Cheol-Wan;Lee, Uhn
    • Journal of Korean Neurosurgical Society
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    • v.30 no.10
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    • pp.1233-1236
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    • 2001
  • The intradural lumbar disc herniation which was first described by Dandy in 1942 is unusual. The pathogenesis is obscure and preoperative diagnosis is not easy. The patient usually have more severe neurologic deficits than those found in the much more common extradural disc herniations. We experienced two cases of the intradural lumbar disc herniation who had previous disc operations and the symptoms and neurologic signs were improved after removal of the intradural sequestration of disc fragments.

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Analysis of relationship between hip internal rotation angle and the level of herniation of lumbar intervertebral disc(HIVD) in single-segment (고관절 내회전 각도와 단분절 요추 추간판 탈출증 발생 부위의 상관성 분석)

  • Kim, Jin-Soo;Choi, Hee-Seung;Jung, Yoon-Gyoo;Choo, Won-Jung;Nam, Hang-Woo
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.8 no.1
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    • pp.39-47
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    • 2013
  • Objectives : The purpose of this study is to find out the relationship between hip internal rotation angle and the level of herniation of lumbar intervertebral disc(HIVD) in single-segment. Methods : We investigated 314 patients (158 male, 156 female) who were diagnosed as herniation of lumbar intervertebral disc(HIVD) in single-segment. We measured 314 patients' hip internal rotation angle and analysed the relationship between the hip internal rotation angle and the level of herniation of lumbar intervertebral disc(HIVD). Results : 1. Among 314 cases, the hip internal rotation angle was different between male and female. Hip internal rotation angle of male was mainly limited and that of female was mainly excessive. 2. Among 314 cases, the normal group, defined as patients who have specific range of hip internal rotation angle(male : $35^{\circ}{\pm}10^{\circ}$, female : $45^{\circ}{\pm}10^{\circ}$), tends to be occurred HIVD at L4/5 level. The limited group, defined as patients who have less angle than normal group, the excessive group, defined as patients who have more angle than normal group, and the complex group, defined as patients who have more angle of one leg and less angle of the other leg than normal group, tend to be occurred HIVD at L5/S1 level(p<0.05). Conclusions : In single-segment lumbar HIVD patients, The normal hip internal rotation angle mainly leads to L4/5 HIVD, while the limited and excessive hip internal rotation angle mainly lead to L5/S1 HIVD.

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Effects of Treatment of Oriental Medicine and Sling Exercise Therapy on Herniated Lumbar Intervertebral Disc (요추 추간판 탈출증의 한의학적 치료와 슬링운동 병행 치료 효과)

  • Yang, Mi-Sung;Kang, Dae-Hee;Ki, Young-Bum;Park, Su-Gon;Cho, Hee-Geun;Choi, Jin-Bong;Sul, Jae-Uk;Kim, Sun-Jong
    • Korean Journal of Acupuncture
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    • v.27 no.4
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    • pp.5-13
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    • 2010
  • Objectives : Herniated lumbar intervertebral disc is common reason causing back pain. Lumbar stabilization exercise prevent back pain recurrence by strengthening lumbar muscles. Sling Exercise Therapy(SET) is a system for spinal muscle stabilization and strengthening using fixed string and mobile band. The purpose of this study is to investigate and measure the effectiveness of SET and oriental medicine for Herniated lumbar intervertebral disc. Methods : The subjects for this study are 40 patients suffering from Herniated lumbar intervertebral disc in our clinic. They were measured and compared by Visual Analogue Scale(VAS), 4 grades of recovery degree and sex, age, period of disease, disc herniation type, times of exercise. Results : In the above index, the score(VAS, 4 grades of recovery degree) improved after treatments. But they make no difference between sex, age, period of disease, disc herniation type and times of exercise. Conclusions : These results suggest that SET may be used for Herniated lumbar intervertebral disc for pain management and muscle strengthening as an essential treatment regardless of sex, age, period of disease and disc herniation type.

A Comparative Study with Lumbar Disc Herniation under Conservative Treatment according to the Duration (요추 추간판탈출증 환자의 발병시기에 따른 보존적 치료 결과 비교 연구)

  • Youn, You-Suk;Lee, Jong-Soo;Ha, In-Hyuk;Kim, Joo-Won;Kwon, Hyeok-Joon
    • Journal of Korean Medicine Rehabilitation
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    • v.18 no.4
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    • pp.135-145
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    • 2008
  • Objectives : To investigate therapeutic outcomes of back pain modalities in patients with disc herniation according to the duration by treated with herbal medicine, chuna, acupuncture, bee-venom acupuncture. Methods : We separated 36 patients with disc herniation into three group according to duration; acute patients within 4 week, subacute patients within 5-12 week, and chronic group within 13-24 week. 36 patients with lumbar disc herniation were treated with chuna therapy, acupuncture, bee-venom acupuncture one times a week and took herbal medicine after a meal two times daily. The patients' symptoms were assessed 1 week, 2 week, 4 week, 8 week by Visual analogue scale(VAS), Oswestry disability index(ODI), 36-Item short-form health survey(SF-36). Results : 1. ODI of disability of daily activities showed significantly decreased in acute stage group compared to subacute and chronic stage groups(P<0.05). 2. Physical functioning(PF), bodily pain(BP), social functioning(SF) score of SF-36 showed significantly increased in acute stage group compared to subacute and chronic stage groups(P<0.05). Conclusions : This study suggests that acute stage group compared to subacute and chronic stage groups in patients with lumbar disc herniation is the more effective to improve symptoms treated with herbal medicine, chuna therapy, acupuncture, bee-venom acupuncture.

An Unappreciated Correlation : Surgical Treatment of Lumbosacral Disc Disease and Erectile Dysfunction

  • Kulaksizoglu, Haluk;Kaptan, Hulagu
    • Journal of Korean Neurosurgical Society
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    • v.47 no.4
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    • pp.282-286
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    • 2010
  • Objective : The aim of the present study was to assess the effect of lumbar disc herniation surgery for low back pain on the erectile functioning. Methods : Thirty-eight patients, with age ranging from 22 to 56 years, who had presented with pain due to herniated lumbar discs were included in the study. International Index of Erectile Function (IIEF) Short Form questionnaire was used to evaluate the erectile functioning. Patient visits on the 1st week,1st month and 3rd month postoperatively were analyzed. Pain scores were also noted together with side effects and the complications of the surgery. Results : Of the 38 patients, 18 patients had reported erectile dysfunction; 10 patients mild and 8 patients moderate erectile dysfunction. Twenty patients did not report erectile problems. The herniation levels mostly were L5-S1 in 12 (31.6%). Overall, erectile dysfunction rates have improved in 31.7% of those previously with erectile dysfunction in a 3 month period after the surgery. Best results were obtained in those patients with mild erectile dysfunction preoperatively. Conclusion : Mild erectile dysfunction together with radiculopathy tends to improve after lumbosacral disc surgery. Moderate and severe erectile dysfunction may be related to a more severe nerve injury or to vascular and/or psychiatric factors. An evaluation of erectile functioning should routinely be performed in patients with lumbosacral disc disease both for data accumulation and for medico legal causes since the documentation of the correlation between erectile dysfunction and lumbosacral disc disease is still lacking.