• Journal of Korean Neurosurgical Society
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• v.51 no.4
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• pp.208-214
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• 2012

Objective : Discal cyst is rare and causes indistinguishable symptoms from lumbar disc herniation. The clinical manifestations and pathological features of discal cyst have not yet been completely known. Discal cyst has been treated with surgery or with direct intervention such as computed tomography (CT) guided aspiration and steroid injection. The purpose of this study is to evaluate the safety and efficacy of the percutaneous endoscopic surgery for lumbar discal cyst over at least 6 months follow-up. Methods: All 8 cases of discal cyst with radiculopathy were treated by percutaneous endoscopic surgery by transforaminal approach. The involved levels include L5-S1 in 1 patient, L3-4 in 2, and L4-5 in 5. The preoperative magnetic resonance imaging and 3-dimensional CT with discogram images in all cases showed a connection between the cyst and the involved intervertebral disc. Over a 6-months period, self-reported measures were assessed using an outcome questionaire that incorporated total back-related medical resource utilization and improvement of leg pain [visual analogue scale (VAS) and Macnab's criteria]. Results : All 8 patients underwent endoscopic excision of the cyst with additional partial discectomy. Seven patients obtained immediate relief of symptoms after removal of the cyst by endoscopic approach. There were no recurrent lesions during follow-up period. The mean preoperative VAS for leg pain was $8.25{\pm}0.5$. At the last examination followed longer than 6 month, the mean VAS for leg pain was $2.25{\pm}2.21$. According to MacNab' criteria, 4 patients (50%) had excellent results, 3 patients (37.5%) had good results; thus, satisfactory results were achieved in 7 patients (87.5%). However, one case had unsatisfactory result with persistent leg pain and another paresthesia. Conclusion : The radicular symptoms were remarkably improved in most patients immediately after percutaneous endoscopic cystectomy by transforaminal approach.

• The Journal of Internal Korean Medicine
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• v.40 no.1
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• pp.126-135
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• 2019

Background: Because of fear of reoperation and low efficiency, some patients with failed back surgery syndrome (FBSS) opt for Korean medicine treatment. Gold standard treatment is not present for FBSS, therefore both surgical and non-surgical treatment are possible. Studies of Korean conservative medicine for FBSS had a short duration of treatment and mainly pre- and post-treatment comparisons. And case of female patients who have worsened after childbirth is rare. The purpose of this study was to report long-term follow-up and rare cases of FBSS. Case summary: A 33-year-old female patient diagnosed with lumbar disc herniation complained with low back pain and radicular pain in the left leg after surgery in 2011. Acupuncture and decoction (Cheongpa-jeon, GCSB-5) were administered to her twice a day for about 6 years and 6 months. The patient's complaints improved with each hospitalization, and Magnetic Resonance Imaging (MRI) showed a slight decrease in the size of the recurrent disc (L4/5) and a newly developed disc (L5/S1) that had deteriorated after delivery. Conclusion: Korean medicine could be used to manage the pain of lumbar spine FBSS patients for 6-7 years and to alleviate lumbago after delivery.

• Journal of Korean Physical Therapy Science
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• v.28 no.3
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• pp.42-52
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• 2021

Background: The purpose of this study was to investigate the effects of the severity and direction of lumbar disc herniation (LDH) on the facet joints and paraspinal muscles. Design: Cross-sectional design. Methods: The subjects were divided according to the diagnosis for severity of unilateral herniation of L4-L5 disc. The groups consisted of disc protrusion group (n=15), disc extrusion group (n=15), and no disc herniation group (n=15). The asymmetry and angle of facet joints and the cross-sectional area of paraspinal muscles were analyzed and compared using magnetic resonance imaging (MRI). Results: The results showed that the angle of facet tropism was larger in disc extrusion group than the disc protrusion group and the difference was found to be significant difference (p<0.01). In addition, when both left and right angles of patients with unilateral disc herniation were measured, the results showed larger facet joint angle in the herniated area of the disc extrusion group than in the disc protrusion group. When paraspinal muscles were measured according to the severity of disc herniation and the degree of facet joint asymmetry, there was no difference in paraspinal muscles between the disc protrusion and disc extrusion groups. Meanwhile, the multifidus muscle was smaller in the group with facet tropism than the group without facet tropism (p<0.03), while there were no significant differences in the erector spinae and psoas muscles. Conclusion: Progression of disc herniation resulted in increased facet joint tropism, increased angle of the facet joints in the direction of disc herniation, and decreased size of the multifidus muscle.

• Journal of Veterinary Clinics
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• v.26 no.5
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• pp.495-498
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• 2009

A female, nine-month-old Rottweiler was presented with bilateral hind limbs lameness. Physical examination, survey radiography, computed tomography (CT) and magnetic resonance imaging (MRI) were performed. Oblique fracture of L6 vertebral body and abnormal alignment was observed in survey radiographs, CT, and MRI. No significant lesion was found in the intervertebral disc adjacent to fracture site. The patient was applied by bandage and medical management including corticosteroid administration was performed. The patient was able to walk after 4 weeks and prognosis was good.

• Journal of Physiology & Pathology in Korean Medicine
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• v.30 no.5
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• pp.360-365
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• 2016

The purpose of this study is to suggest a possibility of the Korean medical treatment in patient with peroneal nerve palsy, and to suggest importance of differential diagnosis of foot drop. Peroneal nerve pasly was diagnosed by lumbar spine magnetic resonance imaging(MRI) and electromyogram(EMG). The patient was treated with acupuncture, herbal medicine, bee-venom acupuncture and moxibustion from March 7th to May 2nd. We measured Numerical Rating Scale(NRS), Range of Motion(ROM) of the ankle, and observed the change in body temperature using Digital Infrared Thermal Imaging(DITI). After received Korean medical treatment, the patient showed improvement in all the scales mentioned above. The result showed that Korean medical treatment is effective in peroneal nerve palsy before operation.

• Journal of Korean Neurosurgical Society
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• v.62 no.4
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• pp.414-421
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• 2019

Objective : To evaluate 3-dimensional magnetic resonance imaging (MRI) of Kambin's safe zone to calculate maximum cannula diameter permissible for safe percutaneous endoscopic lumbar discectomy. Methods : Fifty 3D MRIs of 19 males and 31 females (mean, 47 years) were analysed. Oblique, axial and sagittal views were used for image analysis. Three authors calculated the inscribed circle (cannula diameter) individually, within the neural (original) and bony Kambin's triangle in oblique views, disc heights on sagittal views and root to facet distances at upper and lower end plate levels on axial views and their averages were taken. Results : The mean root to facet distances at upper end plate level measured on axial sections increased from $3.42{\pm}3.01mm$ at L12 level to $4.57{\pm}2.49mm$ at L5S1 level. The mean root to facet distances at lower end plate level measured on axial sections also increased from $6.07{\pm}1.13mm$ at L12 level to $12.9{\pm}2.83mm$ at L5S1 level. Mean maximum cannula diameter permissible through the neural Kambin's triangle increased from $5.67{\pm}1.38mm$ at L12 level to $9.7{\pm}3.82mm$ at L5S1 level. The mean maximum cannula diameter permissible through the bony Kambin's triangle also increased from $4.03{\pm}1.08mm$ at L12 level to $6.11{\pm}1mm$ at L5S1 level. Only 2% of the 427 bony Kambin's triangles could accommodate a cannula diameter of 8mm. The base of the bony Kambin's triangle taken in oblique view (3D MRI) was significantly higher than the root to facet distance at lower end plate level taken in axial view. Conclusion : The largest mean diameter of endoscopic cannula passable through "bony" Kambin's triangle was distinctively smaller than the largest mean diameter of endoscopic cannula passable through "neural" Kambin's triangle at all levels. Although proximity of exiting root to the facet joint is always taken into consideration before PELD procedure, our 3D MRI based anatomical study is the first to provide actual maximum cannula dimensions permissible in this region.

• The Korean Journal of Pain
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• v.34 no.4
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• pp.471-478
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• 2021

Background: The effect of lumbar spinal stenosis (LSS) and peripheral vascular disease (PVD), which occurs with similar degenerative conditions, when seen together, has not been studied. The aim of this study is to examine and compare the relationship between pain, balance, disability, fear of falling, and kinesiophobia in LSS patients with intermittent vascular claudication (IVC). Methods: Seventy-two patients diagnosed with LSS using magnetic resonance imaging participated in this study. Thirty-five patients with IVC symptoms and showing vascular lesions by lower extremity venous and arterial Doppler ultrasonography imaging were included in the IVC-LSS group. The pain, static balance, dynamic balance, disability, fear of falling, and kinesiophobia were evaluated using the numeric rating scale, single leg stance test, Time Up and Go (TUG), the Oswestry Disability Index (ODI), Fall Efficacy Scale-International (FES-I), and Tampa Scale for Kinesiophobia (TSK), respectively. Results: Age and female sex were found to be higher in the IVC-LSS group (P = 0.024; P = 0.012). The IVC-LSS group had a shorter single leg stance time and TUG test duration, pain intensity, ODI, FES-I, and TSK scores were higher than patients with LSS (P = 0.001). Pain, fear of falling, and kinesiophobia were moderately correlated with disability in the IVC-LSS group. No relationship was found between pain and dynamic balance. Also, the pain was not related to kinesiophobia. Conclusions: The findings indicated that IVC causes loss of balance and an increase in pain, disability, fear of falling, and kinesophobia in patients with LSS.

• Journal of the Korean Society of Radiology
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• v.14 no.5
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• pp.715-723
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• 2020

Cross-talk artifacts occur in two adjacent groups of axial imaging of lesions lumbar 4-5 and sacrum 1 in lumbar spine MRI. This causes problems in reading lesions in areas corresponding to the posterior vertebra. In this study, we are going to completely remove the cross-talk artifacts through optimal concatenation TR. The region of interested were measured by averaging them into fat (ROI1), erector spinal muscle(lateral tract: iliocostalis lumborum muscle) (ROI2), erector spinal muscle(lateral tract: longissimus muscle) (ROI3), and spinous process (ROI4). The mean signal intensity (SI) was 163.43 ± 25.08 at C4 for ROI1, ROI 2 and ROI 3 at C6, 67.89 ± 11.75 and 69.99 ± 10.91 and ROI4 at C5, respectively (p<0.000). The mean signal to noise ratio (SNR) was 135.45 ± 35.90, 56.92 ± 15.90, 58.77 ± 15.59, and 54.91 ± 118.95 for SNR 1, 2, 3 and 4 (p<0.000). The contrast-to-noise ratio (CNR) was CNR1 78.52 ± 24.11, CNR2 was 76.67 ± 24.38 and CNR3 was 80.54 ± 26.33 in concatenation 6, respectively (p<0.000). The SNR, CNR, and the most efficient concatenation TR value over time are 6, and it is considered to help reduce cross-talk artifact if this is applied to T1 axial images.

• Journal of Korean Medicine Rehabilitation
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• v.33 no.4
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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.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.2 no.2
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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.