• 제목/요약/키워드: Lumbar disc

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하지 근력 저하를 동반한 만성기 요추 추간판 탈출증 환자 치험 1례 (A Case Report of Patient with Muscles Weakness Caused by Chronic Lumbar Disc Herniation)

  • 김지용;김선민;김태헌;박병윤;전병철;최우성
    • 척추신경추나의학회지
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    • 제5권2호
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    • pp.159-168
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    • 2010
  • Objectives : The object of this study is to report a clinical effect of oriental medical treatments lot chronic muscle weakness caused by herniated intervertbral lumbar disc. Methods : The patient was diagnosed as lumbar disc herniation, and was treated by conservative treatments including acupunture, herbal mixture, pharmacopuncture. And we measured Visual Analog Score(VAS), Walking time and Manual Muscle testing(MMT). Results : After treatments, Visual Analog Score, Walking time and Manual Muscle testing(MMT) were improved in case. Conclusions : Chronic Muscle weakness caused by lumbar disc herniation can be improved by conservative maneuver as to oriental medical method.

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요추 추간판 탈출증 환자의 단기 입원에 대한 임상적 분석 (The Clinical Analysis of Short Hospitalization for Patients with Lumbar Disc Herniation)

  • 임병철;송준혁;박향권;신규만;박동빈;김성학
    • Journal of Korean Neurosurgical Society
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    • 제30권sup2호
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    • pp.242-246
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    • 2001
  • Objective : The short hospitalization or outpatient care for patients undergoing laminectomy is not popular practice in Korea. We evaluated the clinical and economical significance of short hospitalization for patients undergoing microdiscectomy for their lumbar disc herniation. Material and Methods : From March 1999 to December 2000, patients were hospitalized for intended short period hospitalization for lumbar disc surgery. Their radiological and clinical data were analyzed for their clinical and economical results. We compared these data with 20 patients who hospitalized conventionally. Results : Total of 64 patients were evaluated. Three were lost to follow-up. Mean postoperative hospitalization period is 2.0 days(excluding one patient). Excellent to good outcome was achieved in 90.6 % of the patients. They payed about half expenses for hospitalization compared with conventional group. Their mean number of outpatient visit was 3.0. Conclusion : Short hospitalization for lumbar disc surgery is an acceptable option in Korea. It is also economically beneficial while achieving acceptable clinical results.

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Risk Factors of Secondary Lumbar Discectomy of a Herniated Lumbar Disc after Lumbar Discectomy

  • Beack, Joo Yul;Chun, Hyoung Joon;Bak, Koang Hum;Choi, Kyu-Sun;Bae, In-Suk;Kim, Kee D.
    • Journal of Korean Neurosurgical Society
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    • 제62권5호
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    • pp.586-593
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    • 2019
  • Objective : To study risk factors of secondary lumbar discectomy (LD) for recurrent herniated lumbar disc (HLD) and identify methods to lower the rate of recurrence. Methods : Data from 160 patients who underwent primary LD were collected retrospectively. Demographic features, radiologic findings including Pfirrmann disc degeneration, and surgical information were analyzed to compare risks between revision and non-revision patients. Results : The revision rate was 15% (24 patients), and the mean follow-up was 28.3 months. HLD recurrence was not related to any demographic characteristics. Primary and secondary LD were most common at the L4-5 level, but the level of operation was not significantly associated with revision. Primary LD most commonly had a Pfirrmann disc degeneration grade of 3, followed by 4. For recurrent HLD, Pfirrmann grade 4 was most common and was statistically significant (p<0.05). A body mass index (BMI) over 30 was considered obese and was significantly related with HLD revision (p<0.05). Conclusion : Patients with high BMI or severe disc degeneration should be informed of HLD revision.

Immediate Effects of Side Lying Manual Lumbar Traction in Patients with Painful Active Lumbar Motion

  • Creighton, Doug;Schweiger, Alexa;Cubr, Sarah
    • 국제물리치료학회지
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    • 제8권1호
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    • pp.1071-1076
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    • 2017
  • The purpose of this study was to determine if a gentle form of manual lumbar traction could reduce painful lumbar motions associated with lumbar disc degeneration (LDD). This clinical trial incorporated 134 participants with painful active lumbar motion. Participants were randomly assigned to an experimental treatment or sham group. 67 participants received sidelying manual lumbar traction while the other 67 participants received a sham treatment. Pre and post treatment NPRS values for the painful active lumbar motion were recorded for each group. There was a statistically significant improvement (P=0.00) for decreased pain intensity during active lumbar motion in the experimental group as compared to the sham treatment group. The average percent decrease in numeric pain rating scale (NPRS) values was 52.1% for the experimental treatment group and 8.1% for the sham group. The results of the study suggest that side-lying manual lumbar traction can improve painful lumbar motion in patients with LDD.

Isthmic Spondylolisthesis Associated with Foraminal Disc Herniation Treated by Anterior Lumbar Interbody Fusion

  • Lee, Dong-Yeob;Lee, Sang-Ho;Maeng, Dae-Hyeon;Jang, Jee-Soo
    • Journal of Korean Neurosurgical Society
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    • 제38권4호
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    • pp.320-322
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    • 2005
  • A 45-year-old man presented with lower back pain and pain in the right leg of 3years duration. A plain radiographic examination revealed grade I isthmic spondylolisthesis, with instability at L4-5. Computed tomography and magnetic resonance imaging demonstrated bilateral foraminal stenosis, with soft foraminal disc herniation on the right side at the L4-5 level. He underwent anterior lumbar interbody fusion[ALIF] with percutaneous posterior fixation[PF] at the L4-5 level. Without removing the posterior bony structures, removal of foraminal disc herniation and reduction of spondylolisthesis were successfully performed using ALIF with percutaneous PF. When there is no hard disc herniation or lateral recess stenosis, ALIF with percutaneous PF can be one of the treatment options for isthmic spondylolisthesis, even in the presence of foraminal disc herniation, as in our case.

Dorsal Extradural Lumbar Disc Herniation Causing Cauda Equina Syndrome : A Case Report and Review of Literature

  • Kim, Jin-Sung;Lee, Sang-Ho;Arbatti, Nikhil J.
    • Journal of Korean Neurosurgical Society
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    • 제47권3호
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    • pp.217-220
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    • 2010
  • A 73-year-old male presented with a rare dorsally sequestrated lumbar disc herniation manifesting as severe radiating pain in both leg, progressively worsening weakness in both lower extremities, and urinary incontinence, suggesting cauda equina syndrome. Magnetic resonance imaging suggested the sequestrated disc fragment located in the extradural space at the L4-L5 level had surrounded and compressed the dural sac from the lateral to dorsal sides. A bilateral decompressive laminectomy was performed under an operating microscope. A large extruded disc was found to have migrated from the ventral aspect, around the thecal sac, and into the dorsal aspect, which compressed the sac to the right. After removal of the disc fragment, his sciatica was relieved and the patient felt strength of lower extremity improved.

누운 자세에서 호흡에 따른 요추분절의 운동학적 분석 (Kinematics Analysis of Lumbar Spine during Breathing in Lying Position)

  • 육군창;박소현;김중선
    • The Journal of Korean Physical Therapy
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    • 제23권5호
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    • pp.15-21
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    • 2011
  • Purpose: The purpose of this study was to describe the influence of respiration on the segmental motion of the lumbar spine in the lying position. Methods: Twelve healthy females without a history of low back pain participated. Lumbosacral lordosis, intervertebral body angles, intervertebral body displacements, and anterior heights of the intervertebral disc of the lumbar spine were measured at inspiration, expiration and forced expiration in the supine and prone positions via fluoroscopy. Results: The results of lumbar kinematic analysis in the supine position according to respiration pattern were as follows. The L4/5 intervertebral body angle was significantly higher at forced expiration than at expiration (p<0.05). The L3/4 anterior height of the intervertebral disc was significantly higher at expiration than at forced inspiration and the L5/S1 anterior height of the intervertebral disc was significantly higher at inspiration than at forced expiration (p<0.05). There were no significant differences in the intervertebral body displacements and lumbosacral lordosis in the supine position (p>0.05). The results of lumbar kinematic analysis in the prone position according to respiration pattern were as follows. The L5/S1 anterior height of the intervertebral disc was significantly higher at inspiration than at forced expiration (p<0.05). However, there was no significant difference in the intervertebral body angle, the intervertebral body displacements, and the lumbosacral lordosis (p>0.05). Conclusion: These findings suggested that respiration can affect the intervertebral body angle and anterior height of the intervertebral disc in some segments. The results from this study serve as a step in the development of guidelines for lumbar kinematic analysis for lumbar breathing training.

The Ligamentotactic Effect on a Herniated Disc at the Level Adjacent to the Anterior Lumbar Interbody Fusion : Report of Two Cases

  • Min, Jun-Hong;Jang, Jee-Soo;Kim, Seok-Kang;Maeng, Dae-Hyeon;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • 제46권1호
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    • pp.65-67
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    • 2009
  • The authors report two cases of spontaneous regression of disc herniation at the level adjacent to the anterior lumbar interbody fusion (ALIF) level. This phenomenon may be due to the increased tension on the posterior longitudinal ligament (PLL) by appropriate restoration of the disc height and lumbar lordosis, which is a mechanism similar to ligamentotaxis applied to the thoracolumbar burst fracture.

상위 요추간판 탈출증에 대한 후측방 접근술 - 증 례 보 고 - (High Lumbar Disc Herniation Treated with A Modified Posterolateral Approach - Case Report -)

  • 황형식
    • Journal of Korean Neurosurgical Society
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    • 제30권1호
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    • pp.114-117
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    • 2001
  • Generally, the posterolateral approach had been recommended in case of extraforaminal disc herniation or lateral stenosis but it has been speculated that this procedure may be feasible to posterolateral disc herniation at the high lumbar levels of the L1-L2 interspace. Topographically, a posterolateral approach should be able to access anteromedial side of the spinal canal without the risk of the bony instability and damage to the neural structures. During the past one year period, three patients with high lumbar discs at the L1-L2 level were treated by the modified posterolateral approach. This article describeds the details of this approach with pertinent literature review.

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Endovascular Treatment for Common Iliac Artery Injury Complicating Lumbar Disc Surgery : Limited Usefulness of Temporary Balloon Occlusion

  • Nam, Taek-Kyun;Park, Seung-Won;Shim, Hyung-Jin;Hwang, Sung-Nam
    • Journal of Korean Neurosurgical Society
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    • 제46권3호
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    • pp.261-264
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    • 2009
  • Vascular injury during lumbar disc surgery is a rare but potentially life-threatening complication. It has been managed by open vascular surgical repair. With recent technologic advance, endovascular treatment became one of effective treatment modalities. We present a case of a 32-year-old woman who suffered with common iliac artery injury during lumbar disc surgery that was treated successfully by endovascular repair with temporary balloon occlusion and subsequent insertion of a covered stent. Temporary balloon occlusion for 1.5 hours could stop bleeding, but growing pseudoaneurysm was identified at the injury site during the following 13 days. It seems that the temporary balloon occlusion can stall bleeding from arterial injury for considerable time duration, but cannot be a single treatment modality and requires subsequent insertion of a covered stent.