• Title/Summary/Keyword: Lumbar disc

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A Case Study of Spinal Cord Stimulation Acupuncture for Lower Limb Numbness Induced by Lumbar Herniated Intervertebral Disc (하지 비증을 주소증으로 한 요추 추간판 탈출증 환자에 대한 척수 자극 침술의 임상 증례 보고)

  • Seo, Ha-Ra;Park, Jung-Oh;Lee, Han-Gil
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.10 no.2
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    • pp.87-95
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    • 2015
  • Objectives : The purpose of this study was to evaluate the effects of spinal cord stimulation acupuncture therapy for lower limb numbness resulting from lumbar herniated intervertebral disc(HlVD). Methods : From 8th August, 2015 to 30th October, 2015, 1 male patient diagnosed as herniated intervertebral disc at L5/S1(Diffuse bulging disc with smooth ventral thecal sac indentation at L5-S1) was treated with spinal cord stimulation acupuncture and general Korean medicine therapy(acupuncture, herbal injection). Numerical Rating Scale(NRS) and Oswestry Disability Index(ODI) were recorded during the treatment. Results : 1. The patient's chief complaints were remarkably improved - Rt. lower limb numbness remained 15% compared before treatment, Rt. lower limb paresthesia and gait disturbance almost disappeared after 25 times of treatment during 3 months. 2. NRS score decreased from 7 to 3, ODI decreased from 16 to 7. Conclusions : This study demonstrates that spinal cord stimulation acupuncture therapy with Korean medicine treatment has notable effect in improving lower limb numbness induced by lumbar HlVD.

A Modified Approach of Percutaneous Endoscopic Lumbar Discectomy (PELD) for Far Lateral Disc Herniation at L5-S1 with Foot Drop

  • Chun, Eun Hee;Park, Hahck Soo
    • The Korean Journal of Pain
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    • v.29 no.1
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    • pp.57-61
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    • 2016
  • Foraminal or extraforaminal Far Lateral Disc Herniations (FLDH) extending into or beyond the foraminal zone have been recognized as between 7-12% of all lumbosacral disc herniations. Conventional posterior laminectomy may not provide good access to a herniation that lies far lateral to the lateral margin of the pedicle. Use of the endoscopic technique through a percutaneous approach to treat such FLDH patients can decrease the surgical morbidity while achieving better outcomes. We made an effort to utilize the advantages of percutaneous endoscopic lumbar discectomy (PELD) and to determine the appropriate approach for FLDH at the level between the 5th Lumbar and first Sacral vertebrae(L5-S1). The authors present a case of an endoscopically resected lumbar extruded disc of the left extraforaminal zone with superior foraminal migration at the level of L5-S1, which had led to foot drop, while placing the endoscope in the anterior epidural space without facetectomy.

Intradural Migration of a Sequestrated Lumbar Disc Fragment Masquerading as a Spinal Intradural Tumor

  • Kim, Hyeong-Suk;Eun, Jong-Pil;Park, Jung-Soo
    • Journal of Korean Neurosurgical Society
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    • v.52 no.2
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    • pp.156-158
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    • 2012
  • Intervertebral intradural lumbar disc herniation (ILDH) is a quite rare pathology, and isolated intradural lumbar disc herniation is even more rare. Magnetic resonance imaging (MRI) may not be able to reveal ILDHs, especially if MRI findings show an intact lumbar disc annulus and posterior longitudinal ligament. Here, we present an exceedingly rare case of an isolated IDLH that we initially misidentified as a spinal intradural tumor, in a 54-year-old man hospitalized with a 2-month history of back pain and right sciatica. Neurologic examination revealed a positive straight leg raise test on the right side, but he presented no other sensory, motor, or sphincter disturbances. A gadolinium-enhanced MRI revealed what we believed to be an intradural extramedullary tumor compressing the cauda equina leftward in the thecal sac, at the L2 vertebral level. The patient underwent total L2 laminectomy, and we extirpated the intradural mass under microscopic guidance. Histologic examination of the mass revealed a degenerated nucleus pulposus.

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.

L1-2 Disc Herniations : Clinical Characteristics and Surgical Results

  • Lee, Sang-Ho;Choi, Seok-Min
    • Journal of Korean Neurosurgical Society
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    • v.38 no.3
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    • pp.196-201
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    • 2005
  • Objective : Among upper lumbar disc herniations, L1-2 disc herniations are especially rare. We present the specific clinical features of L1-2 disc herniation and compared results of different surgical options. Methods : The authors undertook a retrospective single institution review of the patients who underwent surgery for L1-2 disc herniation. Thirty patients who underwent surgery for isolated L1-2 disc herniations were included. Results : Buttock pain was more frequent than anterior or anterolateral thigh pain. Standing and/or walking intolerance was more common than sitting intolerance. The straight leg raising test was positive only in 15 patients [50%]. Iliopsoas weakness was more frequent than quadriceps weakness. Percutaneous discectomy group demonstrated worse outcome than laminectomy group or lateral retroperitoneal approach group. Conclusion : Standing and/or walking intolerance, positive femoral nerve stretch test, and iliopsoas weakness can be useful clues to the diagnosis of L1-2 disc herniation. Posterior approach using partial laminectomy and medial facetectomy or minimally invasive lateral retroperitoneal approach seems like a better surgical option for L1-2 disc herniation than percutaneous endoscopic discectomy.

Prevalence of Disc Degeneration in Asymptomatic Korean Subjects. Part 3 : Cervical and Lumbar Relationship

  • Kim, Sang Jin;Lee, Tae Hoon;Yi, Seong
    • Journal of Korean Neurosurgical Society
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    • v.53 no.3
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    • pp.167-173
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    • 2013
  • Objective : There are many cases in which degenerative changes are prevalent in both the cervical and lumbar spine, and the relation between both spinal degenerative findings of MRI is controversial. The authors analyzed the prevalence of abnormal findings on MRI, and suggested a model to explain the relationship between cervical and lumbar disc in asymptomatic Korean subjects. Methods : We performed 3 T MRI sagittal scans on 102 asymptomatic subjects (50 men and 52 women) who visited our hospital between the ages of 14 and 82 years (mean age 46.3 years). Scores pertaining to herniation (HN), annular fissure (AF), and nucleus degeneration (ND) were analyzed. The total scores for the cervical and lumbar spine were analyzed using correlation coefficients and multiple linear regression with various predictive parameters, including weight, height, sex, age, smoking, occupation, and sedentary fashion. Results : The correlation coefficients of HN, AF, and ND were 0.44, 0.50, and 0.59, respectively. We made the best model for relationship by using multiple linear regression. Conclusion : The results of the current study showed that there was a close relationship between the cervical score (CS) and lumbar score (LS). In addition, the correlation between CS and LS, as well as the LS value itself, can be altered by other explanatory variables. Although not absolute, there was also a linear relationship between degenerative changes of the cervical and lumbar spine. Based on these results, it can be inferred that degenerative changes of the lumbar spine will be useful in predicting the degree of cervical spine degeneration in an actual clinical setting.

Effect of whole body cryotherapy with spinal decompression on lumbar disc herniation by functional assessment measures (기능적 평가 측정을 통하여 전신냉기치료와 척추 감압기 적용이 요추 추간판 탈출증 환자에게 미치는 효과)

  • Ma, Sang-Yeol
    • Journal of the Korean Data and Information Science Society
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    • v.21 no.6
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    • pp.1101-1108
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    • 2010
  • This study was conducted to investigate whether whole body cryotherapy and spinal decompression have effectiveness on the pain, lumbar flexion range of motion, and global perceived effect scale in patients with lumbar disc herniation. Thirty subjects were participated in this study. And they were all randomly divided into whole body cryotherapy and spinal decompression group. To evaluate the effects of whole body cryotherapy and spinal decompression, subjects were evaluated by using visual analogue scale, lumbar flexion range of motion, and global perceived effect scale. The assessment parameters were evaluated before, after 2 weeks treatments. And we received a consent form whole body cryotherapy subjects. The results of paired t-test, independent t-test, and ANCOVA analysis of variance showed that pain, lumbar flexion range of motion, global perceived effect scale were significantly improved after than before therapy in whole body cryotherapy group. So we conclude that whole body cryotherapy has effectiveness on the pain, lumbar flexion range of motion, and global perceived effect scale in patients with lumbar disc herniation.

The Retrospective Study on the Correlation between the Multifidus Muscle Atrophy on Low Back Pain Patients and the Magnetic Resonance Images (자기공명영상 (Magnetic Resonance Image)을 통한 요통 환자의 다열근 위축에 대한 후향적 연구)

  • Lee, Kil-Joon;Park, Young-Hoi;Keum, Dong-Ho
    • Journal of Korean Medicine Rehabilitation
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    • v.19 no.4
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    • pp.151-163
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    • 2009
  • Objectives : In the assessment of the lumbar spine by magnetic resonance imaging (hereinafter, "MRI"), changes in the paraspinal muscles are overlooked. The purpose of our study is to examine the correlation between the multifidus muscle atrophy on MRI findings and the clinical findings in low back pain (hereinafter, "LBP") patients. Methods : The retrospective study on 38 LBP patients, presenting either with or without associated leg pains, was undertaken. The MRI findings on the patients were visually analysed to find out a lumbar multifidus muscle atrophy, disc herniation, disc degeneration, spinal stenosis and nerve root compressions. The clinical history in each case was obtained from their case notes and pain drawing charts. Results : The lumbar multifidus muscle atrophy has occurred from more than 80% of the patients with LBP. Most of lumbar multifidus muscle atrophies have increased from lower level of lumbar spine. It was bilateral in the majority of the cases. In addition, multifidus muscle atrophy was correlated to the patient's age, disc degenerations and spinal stenosis. On the contrary, gender, the duration of LBP, referred leg pain, disc herniation and nerve root compressions had no relevance to multifidus muscle atrophies. Therefore, when assessing the MRIs of the lumbar spine, we should have more attetion on multifidus muscle, because it has lot's of information about spinal neuropathy problems. Conclusions : Therefore, the examination of multifidus muscle atrophies should be considered when assessing the MRIs of the lumbar spine. In addition, it helps to evaluate and plan the treatment modalities of LBP. Moreover, it prevents from LBP by discovering the importance between the multifidus muscle and the spine stabilization exercise.

Follow-Up MR Imaging Assessment of Natural History of Lumbar Disc Herniation in Patients with Recurred Low Back Pain (재발성 요통을 호소하는 환자들의 추적 요추부 자기공명영상에서 보이는 요추간판 병변의 변화)

  • Lee, Kyung-Mi;Park, Ji-Seon;Ryu, Kyung-Nam;Park, So-Young;Jin, Wook
    • Investigative Magnetic Resonance Imaging
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    • v.15 no.2
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    • pp.123-129
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    • 2011
  • Purpose : To compare lumbar disc changes between initial lumbar spine (L-spine) MRI and follow-up (f/u) MRI that were performed due to recurred backaches. Materials and Methods : A total 50 patients who had undergone f/u L-spine MRI were retrospectively reviewed. Five discs (L1-S1) were surveyed in each f/u MRI. Lumbar disc changes were defined as no change, aggravations, or improvements compared to initial disc states. These states were defined on the basis of morphologic status and disc levels. Results : In a total of 250 discs in 50 patients, 31 discs (12.4%) showed morphologic changes of disc lesions, whereas 219 discs (87.6 %) showed no changes. Among the 31 disc lesions, 24 were aggravated and 7 were partially improved. And on the basis of disc status, initially abnormal discs revealed any morphologic changes of the degree of disc herniation. A total of 33.3% of the morphologic changes are noted in initially extruded discs. Fifteen morphologic changes of disc lesions were located at the L4-5 level. Conclusion : Our results suggest that correlations between lumbar disc herniations and back pain symptoms are limited, and that evaluations of extra disc lesions are required.

Correlation Analysis Between Narrowing Disc Space of Lumbar X-ray and HIVD of L-spine CT in Lumbosacral Strain Patients (좌섬요통환자에서 X-ray상 narrowing과 CT상 HIVD와의 연관성 분석)

  • Kim, Eun-young;Kim, Young-wook;Lee, Kyung-min;Kim, Ju-youn;Kim, Hyo-eun;Kang, Young-hwa;Seo, Jung-chul;Lim, Sung-chul;Han, Sang-won
    • Journal of Acupuncture Research
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    • v.19 no.6
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    • pp.125-133
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    • 2002
  • Objective : This study was designed to analyze the of correlation between narrowing disc space of lumbar X-ray and HIVD of L-spine CT in lumbosacral strain patients. Methods : 63 cases of lumbosacral strain patients who visited Bul-kyooh Oriental Hospital from June 13, 2000 to August 9, 2001 were selected. We performed the radiography by lumbar X-ray and L-spine CT for all cases. Results : 28 of 63 cases revealed narrowing disc space in Lumbar X-ray and these 28 cases were diagnosed as HIVD in L-spine CT at all. 35 of 63 cases revealed normal in Lumbar X-ray and 13 of these 35 cases were diagnosed as HIVD in L-spine CT. Conclusions : We found that narrowing disc space in lumbar X-ray has significant relevance to HIVD in L-spine CT(P-value = 0.001). For accurate diagnosis and treatment of lumbosacral strain patients. combination of clinical symptoms, physical examination and radiography of X-ray and HIVD is needed.

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