• Journal of Korean Medicine Rehabilitation
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• v.24 no.4
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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.

• Journal of Korean Medicine Rehabilitation
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• v.26 no.4
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• pp.117-126
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• 2016

Objectives The purpose of this study is to report the effect of Megadose Pharmacoacupuncture combined with conservative Korean medicine treatment on Herniated InterVertebral Disc (HIVD) of lumbar spine patient diagnosed by Magnetic Resonance Imaging (MRI). Methods This study includes 41 patients whose Lumbar Disc Herniations were by MRIbetween 1st Aprill 2011 and 31th March 2016. All of the patients were treated with Megadose Pharmacoacupuncture combined with Korean medicine treatment. The MRI examination was performed on two or more occasions (minimally, pre-treatment and post-treatment). The volume of each herniated disc was measured. For each patient, age, sex, disc migration, morphology, initial LDH size, herniated disc resorption rate were analysed. Results The mean volumes of herniated discs at pre-treatment and post-treatment were $1321.62{\pm}467.53mm^3$ and $648.72{\pm}313.38mm^3$. The volumes of all patients were decreased. The resorption means of each class of the extent of LDH were significantly different (p=0.041). On the other hand, no difference was found in sex, age, level, herniated disc grade. Conclusions The MRI results suggest that Megadose Pharmacoacupuncture combined with Korean medicine treatment can help treat lumbar herniated disc.

• Journal of Acupuncture Research
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• v.25 no.3
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• pp.127-138
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• 2008

Objectives : This study was designed to evaluate the general distribution and the efficacy of oriental medical treatment for Lumbar Disc Herniation. Subjects and Methods : The 137 patients who had a diagnosis of HIVD by Lumbar-CT of Lumbar-MRI and admitted to Dunsan oriental medical hospital in Daejon university from January 2005 to December 2007 were observed. They were analyzed according to the distribution of sex, age, the period of disease, causing factor, The patient-condition on admission, the symptom on admission, Admission day, Herniation type of the disc and the treatment efficacy was evaluated respectively. Results : 1. Male was more than female in the ratio of 1 : 1.174, and forties 28% the most, the acutest phase 48% the most, reason unknown 30% the most, Grade III 42% the most, Back and Leg radiate pain 65% the most, the day of 6-10 29% the most, protruded disc type 48% the most. 2. In the total treatment result, the good was 48%, the excellent 28%, the fair 15%, the poor 9% in order. 3. the "effective rate"(the percentage of positive effective treatment case) of each distribution, the thirties and fifties 100% the most, subacute phase 100% the most, exercise, traffic accident 100% the most respectively, Grade III 93% the most, only low back pain 97% the most, the day of 16-20 100% the most, Extruded disc 100% the most. Conclusions : Total effective rate was 91%. We have Known the efficacy of oriental medical treatment for HIVD, was good and early treatment was better than late treatment.

• Journal of Korean Neurosurgical Society
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• v.41 no.4
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• pp.241-245
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• 2007

Objective : So called "minimally invasive procedures" have evolved from chemonucleolysis, automated percutaneous discectomy, arthroscopic microdiscectomy that are mainly working within the confines of intradiscal space to transforaminal endoscopic technique to remove herniated epidural disc materials directly. The purpose of this study is to assess the result of endoscopic spinal surgery and favorable indication in the thoracolumbar spine. Methods : The records of 71 patients, 73 endoscopic procedures, were retrospectively analysed. Yeung Endoscopic Spine Surgery system with 7 mm working sleeve and $25^{\circ}$ viewing angle was used. The mean follow up period was 6 months [range, 3-9]. Results : Operated levels were from T12-L1 disc down to L5-L6 of S1 disc. Of 71 cases, 2 patients underwent transforaminal endoscopic surgery twice due to recurrence after initial operation. MacNab's criteria was used to assess the outcome. Favorable outcome, excellent of good, was seen in 78% [57 procedures] of the patients. Among 11 fair outcomes, only 1 procedure was followed by secondary open procedure, laminectomy with discectomy. Two of 5 poor outcomes were operated again by same procedure which resulted in fair outcomes. One patient with aggravated cauda equina syndrome remained poor and a lumbar fusion procedure was performed in other patient with poor outcome. There were 2 postoperative discitis that were treated with conservative care in one and anterior lumbar interbody fusion in the other. Conclusion : Evolving technology of mechanical, visual instrument enables minimal invasive procedure possible and effective. The transforaminal endoscopic spinal surgery can reach as high as T12-L1 disc level. The rate of favorable outcome is mid-range among reported endoscopic lumbar surgery series. Authors believe that the outcome will be better as cases accumulate and will be able to reach the fate of standard open microsurgery.

• The Korean Journal of Pain
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• v.30 no.1
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• pp.44-50
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• 2017

Background: Low back pain is a frequent condition that results in substantial disability and causes admission of patients to neurosurgery clinics. To evaluate and present the therapeutic outcomes in lumbar disc hernia (LDH) patients treated by means of a conservative approach, consisting of bed rest and medical therapy. Methods: This retrospective cohort was carried out in the neurosurgery departments of hospitals in KahramanmaraŞ city and 23 patients diagnosed with LDH at the levels of L3-L4, L4-L5 or L5-S1 were enrolled. Results: The average age was $38.4{\pm}8.0$ and the chief complaint was low back pain and sciatica radiating to one or both lower extremities. Conservative treatment was administered. Neurological examination findings, durations of treatment and intervals until symptomatic recovery were recorded. $Las{\grave{e}}gue$ tests and neurosensory examination revealed that mild neurological deficits existed in 16 of our patients. Previously, 5 patients had received physiotherapy and 7 patients had been on medical treatment. The number of patients with LDH at the level of L3-L4, L4-L5, and L5-S1 were 1, 13, and 9, respectively. All patients reported that they had benefit from medical treatment and bed rest, and radiologic improvement was observed simultaneously on MRI scans. The average duration until symptomatic recovery and/or regression of LDH symptoms was $13.6{\pm}5.4$ months (range: 5-22). Conclusions: It should be kept in mind that lumbar disc hernias could regress with medical treatment and rest without surgery, and there should be an awareness that these patients could recover radiologically. This condition must be taken into account during decision making for surgical intervention in LDH patients devoid of indications for emergent surgery.

• Journal of Acupuncture Research
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• v.32 no.4
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• pp.29-36
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• 2015

Objectives : The purpose of this study is to compare the efficacy of fire needling therapy and general acupuncture for the patient with lumbar herniated intervertebral disc. Methods : We observed 20 lumbar herniated intervertebral disc patients from March, 2014 to October, 2015. This study was randomized and assessor blinded. The patients were divided into two groups: one group(group A) was treated by general acupuncture only, and the other group(group B) was treated by fire needling therapy and general acupuncture. We evaluated the treatment effect experienced by each group using the visual analogue scale(VAS) and Oswestry disability index(ODI). Results : 1. In group A, VAS and ODI from before treatment to treatment 4, 8, 12, 16 were significantly improved in statistics. 2. In group B, VAS from before treatment to treatment 4, 8, 12, 16 was significantly improved, but ODI was significantly improved in statistics only from before treatment to treatment 12, not in treatment 4, 8, 16. 3. As a result of comparisons between group A and B, there were no statistical significance in VAS and ODI. Conclusions : This study was not able to determine statistical significance between the group treated by general acupuncture only and the group treated by fire needling therapy and general acupuncture, so further studies are required in the future.

• Journal of Korean Neurosurgical Society
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• v.47 no.6
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• pp.446-453
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• 2010

Objective : The purpose of this study was to analyze the biomechanical effects of three different constrained types of an artificial disc on the implanted and adjacent segments in the lumbar spine using a finite element model (FEM). Methods : The created intact model was validated by comparing the flexion-extension response without pre-load with the corresponding results obtained from the published experimental studies. The validated intact lumbar model was tested after implantation of three artificial discs at L4-5. Each implanted model was subjected to a combination of 400 N follower load and 5 Nm of flexion/extension moments. ABAQUS$^{TM}$ version 6.5 (ABAQUS Inc., Providence, RI, USA) and FEMAP version 8.20 (Electronic Data Systems Corp., Plano, TX, USA) were used for meshing and analysis of geometry of the intact and implanted models. Results : Under the flexion load, the intersegmental rotation angles of all the implanted models were similar to that of the intact model, but under the extension load, the values were greater than that of the intact model. The facet contact loads of three implanted models were greater than the loads observed with the intact model. Conclusion : Under the flexion load, three types of the implanted model at the L4-5 level showed the intersegmental rotation angle similar to the one measured with the intact model. Under the extension load, all of the artificial disc implanted models demonstrated an increased extension rotational angle at the operated level (L4-5), resulting in an increase under the facet contact load when compared with the adjacent segments. The increased facet load may lead to facet degeneration.

• Journal of Korean Physical Therapy Science
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• v.12 no.3
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• pp.13-26
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• 2005

Low back pain is one of the most frequent problems treated in clinical feild. Eight out of ten people will experience significant low back pain sometime during their life. Most cases low back pain are not serious and respond to conservative treatment. It's pain is severe and not responding to conservative treatment or if it has significant leg pain. In these cases are may recommend surgery. The purpose of this study is to analyze the effective duration of treatment and degree of variable pain approached conservative treatment. The persons who diagnosed to herniated intervertebral lumbar disc were attended in this study. number of cases were 60cases. We evaluated their chart, X-ray and MRI. The result of the study were as follows; 1. The patients who treated for 33days were improved 100%, which was 3cases(5%). 2. The patients who treated for 45days were improved 90%, which was 13cases(22%). 3. The patients who treated for 43days were improved 80%, which was 28cases(47%). 4. The patients who treated for 39days were improved 70%, which was 6cases(10%). 5. The patients who treated for 28days were improved 60%, which was 5cases(28%). 6. The patients who treated for 22days were improved 50%, which was 4cases(7%). Conclusion ; In herniated intervertebral lumbar disc patients who had conservative treatment. The highest improve patients were 28 cases(47%), who treated for 43 days. The lowest improve patient was 1case(2%), who treated for 28 day. The Effective duration of conservative treatment was more than 43days. If they wants to be improving their symptoms, they should be treat for more than 43days.

• Journal of Acupuncture Research
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• v.22 no.4
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• pp.155-163
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• 2005

Objectives : This is a clinical report about neurogenic bladder patient with lumbar disc hernication. Neurogenic bladder is a dysfunction that results from interference with the normal nerve pathways associated with urination. Hypotonic (flaccid) neurogenic bladder can be caused by ruptured or herniated intervertebral disk. Methods : The patient was treated by Oriental medicine treatment with needle acupuncture, electropuncture, bee venom acua-acupuncture and Daeboonchungeum-gami etc. Voided volume and frequency, visual analogue scale and physical examination was used to estimate the efficacy of these treatment. Results : STZ As using these treatments, voided volume and frequency returns normal condition. Visual analogue scale dips as low as 2. Physical examination showed improvement as compared with the fist visit. And further, these treatment may influence on the recovery of neurogenic bladder patient with lumbar disc herniation. Conclusion : The results suggest that Oriental medicine treatment have an useful effect on neurogenic bladder patient's treatment and recovery.

• Journal of Acupuncture Research
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• v.30 no.4
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• pp.169-173
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• 2013

Objectives : The purpose of this study is to report the effect of Dochim & Gwanchim therapy combined with Korean medicine treatment in patients of herniated lumbar disc. Methods : Clinical study was conducted to 103 patients who were treated in Department of Acupuncture and Moxibustion Medicine, Korean Medicine Hospital, Daejeon University from 1st september, 2011 th 31th July, 2013. We divided into two groups. The group A(n=80) was treated with Gwanchim therapy combined with Korean medicine treatment, and the group B(n=23) was treated only Korean medicine treatment. We evaluated the treatment effect with the verbal numerical rating scale(VNRS), and compared admission day and one day after admission. Results : 1. In both two groups VNRS was decreased and this therapy is safety. 2. In group A, VNRS was decreased 10 to 5.68 and in group B, VNRS was decreased 10 to 8.7 Conclusion : This study demonstrates that Gwan acupuncture therapy has significant effect reducing pain for HIVD(herniated lumbar intervertebral disc) patients.