• Title/Summary/Keyword: Low-back pain

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A Clinical Observation on the Case of Cauda Equina Syndrome Using Scolopendrid Pharmacopuncture (오공약침(蜈蚣藥鍼)을 시술한 마미증후군(馬尾症候群) 환자(患者)에 대한 증례(證例) 보고(報告))

  • Lee, Hwi-Yong;Cho, Yi-Hyun;You, Jeong-Seok;Yook, Tae-Han;Hong, Kwon-Eui
    • Journal of Pharmacopuncture
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    • v.11 no.2
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    • pp.117-124
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    • 2008
  • Objective This study was investigated on the Scolopendrid Pharmacopuncture of Caude equina syndrome which has been described as a complex of low back pain, bilateral sciatica, saddle anesthesia and motor weakness in the lower extremity that progress to paraplegia with baldder and bowel incontinence. Methods & Results Clinical observation was done on Cauda equina syndrome in the Department of Acupuncture & Moxibustion, Woosuk jeonju Oriental Medical Hospital frome May 30 to July 13. The patient was treated with Scolopendrid Pharmacopuncture at Shinsu(B23), Gihaesu(B24), Taejangsu(B25), Gwanweonsu(b26), Dangryo(b31), Charyo(b32), Jang-gang(gv1) and Hoe-eum(cv1) with Oriental Medicine treatment. We evaluated SF-36, the bladder incontinence, bowel incontinence, sensibility by sting skin, before and after treatmeat. Conclusion 1. At the early time, gait disturbance was treated well, but discomfort of bladder incontinence, bilateral sciatica, saddle anesthesia and motor weakness was remained. 2. The symptoms of Cauada equina syndrome, especially bladder incontinence and bilateral sciatica, was recurred in short duration by scolopendrid Pharmacopuncture and oriental medicine treatment.

Biomechanical Effects of Posterior Dynamic Stabilization System on Lumbar Kinematics: A Finite Element Analysis (Posterior Dynamic Stabilization System의 요추거동에 대한 생체역학적 분석)

  • Ahn, Y.H.;Chen, Wen-Ming;Jung, D.Y.;Park, K.W.;Lee, S.J.
    • Journal of Biomedical Engineering Research
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    • v.29 no.2
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    • pp.139-145
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    • 2008
  • Many recent studies suggest that the posterior dynamic stabilization(PDS) can be a more physiologically-relevant alternative to the rigid fixation for the patients suffering from low back pain. However, its biomechanical effects or clinically proven efficacies still remain unknown. In this study, we evaluated kinematic behaviors of the lower lumbar spine with the PDS system and then compared to those of the rigid fixation system using finite element (FE) analysis. A validated FE model of intact lumbar spine(L2-L5) was developed. The implanted model was then constructed after modification from the intact to simulate two kinds of pedicle screw systems (PDS and the rigid fixation). Hybrid protocol was used to flex, extend, laterally bend and axially rotate the FE model. Results showed that the PDS systems are more flexible than rigid fixation systems, yet not flexible enough to preserve motion. PDS system allowed $16.2{\sim}42.2%$ more intersegmental rotation than the rigid fixation at the implanted level. One the other hand, at the adjacent level it allowed more range of motion ($2.0%{\sim}8.3%$) than the rigid fixation. The center of rotation of the PDS model remained closer to that of the intact spine. These results suggest that the PDS system could be able to prevent excessive motion at the adjacent levels and restore the spinal kinematics.

The Effects of Lumbar Repositioning Sense and Muscle Fatigue after Stabilization Exercise Program in Disc Disease Patients (허리 디스크탈출증 환자의 재위치 감각과 근 피로도에 미치는 안정화운동 프로그램의 영향)

  • Kim, Myung-Joon
    • Journal of Korean Physical Therapy Science
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    • v.16 no.3
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    • pp.11-17
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    • 2009
  • Background: The purpose of this study was designed to find out the effectiveness of reposition sense, muscle fatigue response on lumbar spine after apply lumbosacral stabilization exercise program to 4 patients with chronic low back pain and for 12 weeks. Method: In this study the reposition sense was measured in 3 angle(60, 30, 12) of the lumbar spine motion with blind by MedX test machine and the difference of instability to lumbar vertebra segments in flexion, extension test of standing position and spinal load test Mattress Test by Spinal Mouse. The stabilization exercise program was applied 2 times a week for 12 weeks in hospital and 2 times a day for 20 minutes at home. Result: The results of the present study were that the repositioning sense was appeared the most error in 12 angles of lumbar flexion and Men was appeared to decrease an error more than female in average value of 4 angles after 12 weeks. And average error of male was decrease more than female. Thus the effects of lumbosacral stabilization exercise was improved repositioning sense of prorioceptor. Fatigue response test(FRT) results, in male, was raised muscle fatigue rate during increase weight, on the other hand female appeared lower than male. Conclusion: As a results, lumbosacral stabilization exercise was aided to improvement of lumbar spine repositioning sense and vertebra segments stabilization. It was showed the rate of decrease in typically 12 degree angle point of each 3 angle(60, 36, 12). Especially, that spine instability patients will have a risk when in lifting a load or working with slight flexion posture around 12 degree during the daily of living life and it is probably to increase recurrence rate. Thus, not only lumbar extension muscle strength but also stability of vertebra segments in lumbar spine may be very important.

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The Effects of Ramp Gradients and Pushing-Pulling Techniques on Lumbar Spinal Load in Healthy Workers

  • Pinupong, Chalearmpong;Jalayondeja, Wattana;Mekhora, Keerin;Bhuanantanondh, Petcharatana;Jalayondeja, Chutima
    • Safety and Health at Work
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    • v.11 no.3
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    • pp.307-313
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    • 2020
  • Background: Many tasks in industrial and health care setting are involved with pushing and pulling tasks up or down on a ramp. An efficient method of moving cart which reduces the risk of low back pain should be concerned. This study aimed to investigate the effects of handling types (HTs) and slope on lumbar spinal load during moving a cart on a ramp. We conducted a 2 × 2 × 4 factorial design with three main factors: 2 HTs, 2 handling directions of moving a cart and 4 degrees of ramp slope. Methods: Thirty healthy male workers performed 14 tasks consist of moving a cart up and down on the ramp of 0°, 10°, 15°, and 20° degrees with pushing and pulling methods. Joint angles from a 3D motion capture system combined with subject height, body weight, and hand forces were used to calculate the spinal load by the 3DSSPP program. Results: Our results showed significant effect of HT, handling directions and slope on compression and shear force of the lumbar spine (p < 0.001). When the ramp gradient increased, the L4/5 compression forces increased in both pushing and pulling (p < 0.001) Shear forces increased in pulling and decreased in pushing in all tasks. At high slopes, pulling generated more compression and shear forces than that of pushing (p < 0.01). Conclusion: Using the appropriate technique of moving a cart on the ramp can reduce the risk of high spinal load, and the pushing is therefore recommended for moving a cart up/down on ramp gradients.

Idiopathic Hypertrophic Spinal Pachymeningitis : Report of Two Cases and Review of the Literature

  • Kim, Jee-Hee;Park, Young-Mok;Chin, Dong-Kyu
    • Journal of Korean Neurosurgical Society
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    • v.50 no.4
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    • pp.392-395
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    • 2011
  • Idiopathic hypertrophic spinal pachymeningitis (IHSP) is a rare inflammatory disease characterized by hypertrophic inflammation of the dura mater and various clinical courses that are from myelopathy. Although many associated diseases have been suggested, the etiology of IHSP is not well understood. The ideal treatment is controversial. In the first case, a 55-year-old woman presented back pain, progressive paraparesis, both leg numbness, and voiding difficulty. Initial magnetic resonance imaging (MRI) demonstrated an anterior epidural mass lesion involving from C6 to mid-thoracic spine area with low signal intensity on T1 and T2 weighted images. We performed decompressive laminectomy and lesional biopsy. After operation, she was subsequently treated with steroid and could walk unaided. In the second case, a 45-year-old woman presented with fever and quadriplegia after a spine fusion operation due to lumbar spinal stenosis and degenerative herniated lumbar disc. Initial MRI showed anterior and posterior epidural mass lesion from foramen magnum to C4 level. She underwent decompressive laminectomy and durotomy followed by steroid therapy. However, her conditions deteriorated gradually and medical complications occurred. In our cases, etiology was not found despite through investigations. Initial MRI showed dural thickening with mixed signal intensity on T1- and T2-weighted images. Pathologic examination revealed chronic nonspecific inflammation in both patients. Although one patient developed several complications, the other showed slow improvement of neurological symptoms with decompressive surgery and steroid therapy. In case of chronic compressive myelopathy due to the dural hypertrophic change, decompressive surgery such as laminectomy or laminoplasty may be helpful as well as postoperative steroid therapy.

A Study on the Infrared Thermographic Imaging in Diagnosis of the Central Type of Herniated Disc (중앙형 추간판탈출증의 진단에서 체열촬영의 의의)

  • Song Bong-Keun;Lee Jong-Duk;Pak Yong-Hyun;Song Un-Yong;Kim Jung-Gyl
    • Journal of Acupuncture Research
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    • v.15 no.2
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    • pp.301-310
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    • 1998
  • Infrared thermographic imaging visualizes noninvasively various abnormal condition by detecting the skin temperature. As the imaging represents the objective condition by the changes in blood flow under the control of autonomic nervous system, it is used to diagnosis and monitor the lumboscral radiculopathy. And asymmetry is important in the diagnosis of disc herniation. The most common type of disc herniation occurs psoterolaterally. This frequently causes nerve root compression leading to a radiculopathy in the distribution of the involved nerve root, most of which also provoke the asymmetric changes in thermography. Central disc herniation, which accounts for 5% to 35% of disc herniation, is typically associated with low back pain. But radiculopathy is usually abscent unless central disc heriniaton is large enough to cause compression of the cauda equina. To evalute the diagnostic value of the thermographic imaging in the diagnosis of central disc herniation, the imaging of 15 normal subjects and 48 patients with central disc herniation documented by CT scan were analyzed. The patients had either bilateral radiculophathy or no radiculopathy. The imaging of patient group with non rediculopathy did not show any significant thermal difference to control. While bilateral radiculopathy group reveled hypothermic pattern compared twith control. Thermal difference between left and right side did not present any significance in non radiculopathy group but hypothermia in bilateral radiculopathy group. Large herniation group demonstrated hyperthemic pattern while the others showed no significant change. Cranial caudal thermal difference did not show any difference between experiment groups. These results shows that infrared thermographic imaging can be used central disc herniation with bilateral radiculopathy, while it seems to little useful on the diagnosis of non radiculopathic disc herniation.

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The Study on Relation of Low back pain and Obesity (요통과 비만과의 상관성에 관한 연구)

  • Park, Sang-dong;Lee, A-ram;Hwang, Jong-soon;Son, Seong-cheol;Song, In-kwang;Kim, Kyung-ho
    • Journal of Acupuncture Research
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    • v.20 no.4
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    • pp.102-113
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    • 2003
  • Objective: The purpose of this study is to examine the relation between the Obesity and the prevalence of LBP. Methods: From February 2001 to April 2001 we studied body composition, Body Mass Index, Basal Metabolic Rate, Obesity Degree, Waist Hip Ratio, percent body fat and muscular form of 40 patients with LBP and 40 patients with Internal disease, who visited Dong-Guk University Bundang Hospital by using Inbody 3.0. Results: 1. Sexual ratio in this study is 1:4(male:female). 2. Fluid, protein, mineral mass and BMR in patients with LBP are lower than those in patients with Internal disease, but percent body, WHR and obesity degree with LBP are higher than those in patients with Internal disease. 3. LBP prevalence is shown to rise with increasing WHR. 4. LBP prevalence is shown to rise with decreasing BMR. Conclusions: Patients with LBP are obeser than patients with Internal disease. LBP prevalence is shown to rise with increasing WHR in statistics. But LBP prevalence is shown to rise with decreasing BMR in statistics.

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The Comparison of Effectiveness between Acupuncture and Its Cotreatment with Bee Venom Acua-Acupuncture Therapy on the Treatment of Herniation of Nucleus Pulpous (요추간판탈출증에 기인한 요통환자의 침치료와 봉독약침 병행치료에 대한 비교 연구)

  • Cha, Jae-deog;Jung, Sung-min;Kim, Kyung-ok;Kim, Kyung-sok;Kim, Nam-ok
    • Journal of Acupuncture Research
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    • v.21 no.1
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    • pp.149-158
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    • 2004
  • Objective: Herniation of Nucleus Pulpous(HNP) of L-spine is the most important reason that causes low back pain. The aim of this study is to investigate the effectiveness of Bee venom acua-acupuncture therapy for HNP. Methods: We divided HNP patient into 2 groups: Control group with acupuncture therapy only, and Experimental group with both acupuncture and bee venom acua-acupuncture therapy. To estimate the efficacy of treatment that applied for two groups, we used visual analog scale(VAS) and Oswestry disability index(ODI). We compared the VAS and ODI score of two groups statistically. Results & Conclusions: 1. In VAS, experimental group shows statitically significant improvement rate, but control group does not show statistical significance. 2. In ODI, both the experimental and control group shows statistically significant improvement. 3. By comparing the experimental and control group, there was more significant improvement in experimental group than control group of VAS and ODI. As a result, bee venom acua-acupuncture therapy can be used with acupuncture therapy for highly effective treatment for HNP.

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Comparison of Modified-Modified Schober Test with Range of Motion in Evaluating Visual Analog Scale of Patients with Low Back Pain (요통 환자의 시각 통증 등급 평가에 있어서 Modified-Modified Schober Test와 관절 운동 범위의 비교)

  • Park, In-Shik;Byun, Hyuk;Jung, Chan-Young;Lee, Seung-Deok;Kim, Eun-Jung;Kim, Kap-Sung
    • Journal of Acupuncture Research
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    • v.24 no.5
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    • pp.97-104
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    • 2007
  • 목적 : 요통 환자에서 Modified-Modified Schober Test (MMST)와 관절 운동 범위를 비교하여 시각 통증 등급 평가에 있어서 타당도의 우위를 추정하여 보고자 하였다. 방법 : 요통으로 입원한 31명의 환자들을 대상으로 MMST, 관절 운동 범위 및 시각 통증 등급을 주 3회씩 입원 기간 동안 측정하였다. 각 측정 방법의 시행 순서는 무작위로 선택되었으며, 환자들은 맨발로 환자복을 입은 채 측정하였다. 결과 : 각 자료의 상관성을 분석하기 위하여 피어슨 상관계수가 사용되었다. 요추의 MMST 측정값(r=-0.61 ; 99%CI)이 요추의 신전 및 굴곡의 관절 운동 범위 측정값보다 시각 통증 등급에 통계적으로 의미 있게 나타났다. 또한 요추의 MMST 측정값(r= -0.77 ; 99%CI)은 요추의 신전 관절 운동 범위 측정값보다 요추의 굴곡 관절 운동 범위 측정값과 통계적으로 의미 있게 나타났다. 결론 : 이상의 결과를 통하여 요통 환자의 평가에 있어서 MMST가 관절 운동 범위보다 높은 타당도를 가지는 것으로 추정된다.

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Prediction of the Spinal Load during Static Loading Conditions using EMG model and Three Optimization models (정적 부하 작업에서 EMG 모델과 세가지 최적화 모델을 이용한 척추 부하 평가)

  • Song, Young Woong;Chung, Min Keun
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.15 no.1
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    • pp.61-70
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    • 2005
  • This study investigated the spinal loads(L5/S1 disc compression and shear forces) predicted from four biomechanical models: one EMG model and three optimization models. Three objective functions used in the optimization models were to miminize 1) the cubed muscle forces : MF3, 2) the cubed muscle stress : MS3, 3) maximum muscle intensity : MI. Twelve healthy male subjects participated in the isometric voluntary exertion tests to six directions : flexion/extension, left/right lateral bending, clockwise/ counterclockwise twist. EMG signals were measured from ten trunk muscles and spinal loads were assessed at 10, 20, 30, 40, 50, 60, 70, 80, 90%MVE(maximum voluntary exertion) in each direction. Three optimization models predicted lower L5/S1 disc compression forces than the EMG model, on average, by 31%(MF3), 27%(MS3), 8%(MI). Especially, in twist and extension, the differences were relatively large. Anterior-posterior shear forces predicted from optimization models were lower, on average, by 27%(MF3), 21%(MS3), 9%(MI) than by the EMG model, especially in flexion(MF3 : 45%, MS3 : 40%, MI : 35%). Lateral shear forces were predicted far less than anterior-posterior shear forces(total average = 124 N), and the optimization models predicted larger values than the EMG model on average. These results indicated that the optimization models could underestimate compression forces during twisting and extension, and anterior-posterior shear forces during flexion. Thus, future research should address the antagonistic coactivation, one major reason of the difference between optimization models and the EMG model, in the optimization models.