• 제목/요약/키워드: Intervertebral disc herniation

검색결과 113건 처리시간 0.027초

Microdecompression for Extraforaminal L5-S1 Disc Herniation; The Significance of Concomitant Foraminal Disc Herniation for Postoperative Leg Pain

  • Lee, Dong-Yeob;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • 제44권1호
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    • pp.19-25
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    • 2008
  • Objective : To analyze the relationship of concomitant foraminallumbar disc herniation (FLDH) with postoperative leg pain after microdecompression for extraforaminallumbar disc herniation (EFLDH) at the L5-S1 level. Methods : Sixty-five patients who underwent microdecompression for symptomatic EFLDH at the L5-S1 level were enrolled, According to the severity of accompanying FLDH, EFLDH was classified into four categories (Class I : no FLDH; Class II : mild to moderate FLDH confined within a lateral foraminal zone; Class III : severe FLDH extending to a medial foraminal zone; Class IV : Class III with intracanalicular disc herniation). The incidence of postoperative leg pain, dysesthesia, analgesic medication, epidural block, and requirement for revision surgery due to leg pain were evaluated and compared at three months after initial surgery. Results : The incidences of postoperative leg pain and dysesthesia were 36.9% and 26.1%, respectively. Pain medication and epidural block was performed on 40% and 41.5%, respectively, Revision surgery was recommended in six patients (9.2%) due to persistent leg pain, The incidences of leg pain, dysesthesia, and requirement for epidural block were higher in Class III/IV, compared with Class I/II. The incidence of requirement for analgesic medication was significantly higher in Class III/IV, compared with Class I/II (p=0,02, odds ratio=9,82). All patients who required revision surgery due to persistent leg pain were included in Class III/IV. Conclusion : Concomitant FLDH seems related to postoperative residual leg pain after microdecompression for EFLDH at the L5-S1 level.

MRI로 관찰한 요추 추간판탈출증 환자의 호전례 보고 (The Changes on MRI of the HIVD Patients after Oriental Medicine Treatment)

  • 임명장;송주현;문자영;강인;이효은;조재희;왕오호;장형석
    • 척추신경추나의학회지
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    • 제2권2호
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    • pp.89-104
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    • 2007
  • Objectives : The purpose of this study is to report the image changes of four cases of Lumbar intervertebral disc Herniation after Oriental medicine Treatment Methods : We examined 4 patients with Lumbar intervertebral disc Herniation (HIVD of L-spine) who showed changes on MRI images before/after the treatment among HIVD of L-spine patients who visited Jaseng Hospital of Oriental Medicine from Jan. 2006 to Apr. 2007. Results & Conclusions : In this study, the first MRI examination of HIVD of L-spine patients was performed at the first visit and re-examination of MRI was done after the treatment. We assessed clinical symptoms by using Numerical rating scales(NRS). In each case, the size of the disc herniation was considerably reduced in MRI image. NRS was also reduced significantly.

한의학적 치료로 호전된 경추추간판탈출증 환자의 영상의학적 변화 5례 (Magnetic Resonance Imaging Follow-up Study on Five Cases of HIVD-Cervical Spine Patients Treated with Oriental Medical Treatment)

  • 문자영;송주현;임명장;강인;이효은;조재희;김학재;장형석
    • Journal of Acupuncture Research
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    • 제24권5호
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    • pp.229-240
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    • 2007
  • Objectives : The purpose of this study is to report the image changes of five cases of Cervical intervertebral disc Herniation after Oriental medicine Treatment. Patient & Methods : We examined 5 patients with Cervical intervertebral disc Herniation (HIVD of C-spine) who showed changes on MRI images before/after the treatment among HIVD of C-spine patients who visited Cervical Spine center, Jaseng Hospital of Oriental Medicine from March, 2006 to May, 2007. Results & Conclusions : In this study, the first MRI examination of HIVD of C-spine patients was performed at the first visit and re-examination of MRI was done after the treatment. We assessed clinical symptoms by using Numerical rating scales(NRS). In each case, the size of the disc herniation was considerably reduced in MRI image. NRS was also reduced significantly.

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요추간판탈출증으로 보존적 치료후 호전되지 않는 환자 6 례 보고 (Case Report of 6 Patients Not Improved after Conservative Treatment of Herniated Lumbar Intervertebral Disc)

  • 이삼로;김현중;변재영;안수기;이종덕
    • Journal of Acupuncture Research
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    • 제17권3호
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    • pp.265-276
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    • 2000
  • 1997년 11월 1일부터 2000년 6월30일까지 원광대 부속 광주 한방병원 침구과에 요추 추간판 탈출증으로 진단받고 다른 합병증이 발견되지 않은 311례의 입원치료한 환자를 대상으로 보존적 치료를 하였으나, 전혀 호전되지 않았거나 통증만 약간 감소하였던 환자 6례를 분석 검토한 결과, 다음과 같은 결론을 얻었다. 1. 4례에서 large herination이고 2례에서 medium herniation으로 대부분 탈출량이 많았다. 2. 6례 모두에서 하지직거상검사의 각도가 낮았으며 퇴원시까지 호전되지 않았다. 3. X-ray상, 6례 모두에서 straightening되어 있었고, 6례중 3례에서 disc space가 좁아져 있었다. 4. 통증이 심한 4례중 3례에서 측만증이 동반되었다. 발병일이 최소 30일부터 최고 7년까지로 오래되었다. 6. 환자들은 10대에서 30대까지로 연령층이 젊은 편이었다. 7. 입원기간이 최소 32일부터 최대 105일까지로 긴 편이었다. 총괄하면, 상기 6례는 디스크 탈출량이 많았고, 하지직거상검사상 각도가 낮았으며, 연령층이 젊었고, x-ray상 straightening되어 있었다.

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로지스틱 회귀 분석을 이용한 고관절 내회전 각도와 단분절 요추 추간판 탈출증 발생 부위의 상관성 분석 (Analysis of the Relationship between Hip Internal Rotation Angle and the Site of Herniation of Single Level Lumbar Intervertebral Disc Using Logistic Regression)

  • 김신웅;남항우;김세준;손슬기;김종수;정재현;윤영웅;최영준;문병헌;유수빈;임한빛;김동환
    • 한방재활의학과학회지
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    • 제24권4호
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    • pp.117-127
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    • 2014
  • Objectives The purpose of this study is to find out the relationship between the hip internal rotation angle and the site of herniation of single level lumbar intervertebral disc. Methods This study was carried out to 418 patients with lumbar disc herniation diagnosed by M.R.I, who visited Bu-Chun Jaseng Hospital of Korean Medicine with low back pain. Researchers measured their hip internal rotation angle and analyzed the relationship between the hip internal rotation angle and the site of herniation of single level lumbar intervertebral disc. Results 1. Excessive right internal rotation of hip joint increases risk of L5/S1 HIVD. 2. Limited left internal rotation of hip joint decreases risk of L4/L5 HIVD. 3. In cases of L4/L5 HIVD level, there was evidence that the prevalence of HNP in men was 1.85 times as higher than that in women. 4. In cases of L5/S1 HIVD level, there was the evidence that the prevalence of HNP in men was 0.64 times as lower than that in women. Conclusions In single-segment lumbar HIVD patients, limited left internal rotation of hip joint decreases risk of HIVD of L4/5 and excessive right internal rotation of hip joint mainly leads to L5/S1 HIVD.

요추부 한 분절 유합술 이후 발생한 추간판 탈출증환자에 대한 보존적 치료 치험 1례 (The Case Report of Conservative Treatment on the Herniation of Intervertebral Disc Patient After the Fusion Surgery of a Lumbar Segment)

  • 강명진;공덕현;김우영;조태영;남항우
    • 척추신경추나의학회지
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    • 제5권2호
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    • pp.127-134
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    • 2010
  • 요추부 한 분절 유합술 이후 발생한 추간판 탈출증으로 내원한 외래 환자 1례에 한방치료를 적용하여 요통 및 하지방사통 통증 감소와 요추부 관절가동범위(ROM) 증가에 유의한 효과를 보였기에 보고하는 바이다.

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경추 전만 정도 및 연령에 따른 경추 추간판 탈출 양상 분석 연구 (An Analysis of the State of Cervical Disc Herniation According to Cervical Lordosis and Age)

  • 임지석;윤강현;이승민;조예은;박지민;이상훈;김용석
    • Journal of Acupuncture Research
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    • 제32권3호
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    • pp.107-115
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    • 2015
  • Objectives : The aim of this study is to investigate the state of cervical disc herniation according to the degree of cervical lordosis and age. Methods : 67 records of inpatients who were diagnosed with herniated intervertebral disc(HIVD) of the cervical spine were analyzed. Cobb's method, Jochumsen method and the Ishihara index were used to measure the degree of cervical lordosis. The state of the cervical disc was identified using magnetic resonance imaging(MRI) of the cervical spine. Then correlations among cervical lordosis, age and cervical disc herniation were analyzed. Results : Disc bulging was associated with hypolordosis and disc protrusion was associated with hyperlordosis and age. Disc extrusion was not associated with either cervical lordosis or age. The number of disc herniations in the cervical spine was correlated with age significantly, but not with cervical lordosis. Conclusions : Cervical disc herniation had a tendency to correlate with age and cervical lordosis, although this is not definite. Future studies that analyze more radiographic images of patients with HIVD of the cervical spine might be necessary to identify the influence of cervical lordosis on cervical disc herniation.

신추보건탕 및 한방공통치료가 요추추간판탈출증 환자의 증상 호전에 미치는 영향 (Effects of Shinchubogun-tang and Common Korean Medicine Treatment on Symptom Reduction in Patients with Intervertebral Lumbar Disc Herniation)

  • 이은정;최정준;장은수;박양춘;정인철
    • 동의생리병리학회지
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    • 제30권1호
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    • pp.66-72
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    • 2016
  • This retrospective observational study was aimed to assess that Shinchubogun-tang (Shenzhuibujian-tang ; SBT) improves the symptoms related to lumbar disc herniation. We analyzed the medical records of 36 patients, who were satisfied with inclusion and exclusion criteria. The patients were diagnosed with lumbar disc herniation and prescribed with SBT in addition to Korean medical common treatments at Dunsan Korean Medicine Hospital of Daejeon University from January 1st, 2013 to November 30th, 2015. The effects of SBT was evaluated by comparing before and after taking SBT through 0-10 visual analogue scale(VAS) of the symptoms including lower back pain, radiating pain, and lower extremity numbness. The average period of common Korean medicine treatment before SBT prescription was 9.78 days and then the patients received SBT along with common Korean medicine treatment for 13.17 days on average. SBT plus common korean medicine treatment group significantly decreased VAS score of lower back pain from 5.40±1.62 to 3.28±1.70 (p<0.01), radiating pain from 5.60±1.42 to 2.35±1.79 (p<0.01), lower extremity numbness from 5.77±1.52 to 2.55±1.85(p<0.01). These results demonstrated that SBT might have a potential on improvement of lumbar disc herniation by reducing the symptoms of lower back pain, radiating pain, and lower extremity numbness.

한방 복합치료를 병행한 도인운동요법이 요추추간판탈출증을 진단받은 요통 환자의 통증 및 기능 개선에 미치는 영향 : 후향적 관찰연구 (Effects of Daoyin Exercise Therapy Combined with Korean Medicine Treatment on the Pain and Function Improvement of Low Back Pain Patients Diagnosed with Lumbar Disc Herniation : A Retrospective Observational Study)

  • 김연희;이정민;이은정;오민석
    • 동의생리병리학회지
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    • 제31권4호
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    • pp.238-245
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    • 2017
  • This retrospective observational study was aimed to evaluate that Daoyin Exercise therapy improves the symptoms related to lumbar disc herniation. We analyzed the medical records of 7 patients, who satisfied with inclusion and exclusion criteria. The subjects of the study were the patients who were prescribed Daoyin Exercise Therapy and Korean medical treatments for lumbar intervertebral disc herniation at Dunsan Korean Medicine Hospital of Daejeon University from July 25th, 2016 to March 31th, 2017. The effects of Daoyin Exercise Therapy was evaluated by comparing before and after taking Daoyin Exercise Therapy through 0-10 Numeric Rating Scale(NRS), Roland & Morris Disability Questionnaire(RMDQ), Trunk Extension Flexion(TEF) Program, EuroQol five Demension Questionnaire(EQ-5D, EQVAS) of the symptoms including lower back pain. The Daoyin Exercise Therapy combined with Korean medicine treatment reduced NRS($3.357{\pm}3.038$) and RMDQ($9.50{\pm}6.364$), and improved Muscle endurance($44.429{\pm}45.136$), EQ-5D($0.09{\pm}0.12$) and EQVAS($6.571{\pm}19.260$) of the 7 patients without side effects. These results implied that Daoyin Exercise Therapy might helps to improve symptoms of patients with lumbar disc herniation by reducing the symptoms of lower back pain and improving muscle endurance, quality of life, strength enhancement and core muscles.

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

  • 이연후;송다운;정재민;권태하;봉세영;이유진;최진봉
    • 한방재활의학과학회지
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    • 제33권4호
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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.