• Title/Summary/Keyword: Radiculopathy

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A Study of the Clinical Application of Thermography in Musculoskeletal Disease (근골격계(筋骨格系) 영역(領域)에서 Thermography의 임상적(臨床的) 활용(活用)에 대(對)한 고찰(考察))

  • Shin, Hyun-Taeg;Chung, Seok-Hee;Lee, Jong-Soo;Kim, Sung-Soo;Shin, Hyun-Dae
    • The Journal of Dong Guk Oriental Medicine
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    • v.8 no.2
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    • pp.47-67
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    • 2000
  • The purpose of this study is to assess the usefulness of thermography in patients with musculoskeletal disease. Thermography is noninvasive, easy to reading, objective and physiologic instrument by measuring and imaging infrared energy emitted from skin surface. Thermography can show the skin temperature changes in various conditions of the body with musculoskeletal disease. This literature review was done for the usefulness of thermography in diagnosing musculoskeletal disease. In conclusion, thermography was adapted in radiculopathy, MPS, peripheral neuropathy, RSD, Raynaud's phenomen, TMJ dysfunction, etc. It was useful as a secondary diagnostic method in those diseases, also possible as a primary diagnostic method in RSD, Raynaud's phenomen. And, it might be reliable tool for estimating disease procedure and consequence after treatment. But, the objectivity of the reading and the development of the operating method are required for further adaptation in musculoskeletal disease.

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An Electrophysiologic Study on the Median Motor Nerve and Ulnar Motor Nerve (정중운동신경과 척골운동신경의 전기생리학적 연구)

  • Kim, Jong-Soon;Lee, Hyun-Ok;Ahn, So-Youn;Koo, Bong-Oh;Nam, Kun-Woo;Kim, Young-Jick;Kim, Ho-Bong;Ryu, Jae-Kwan;Ryu, Jae-Moon
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.11 no.2
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    • pp.62-70
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    • 2005
  • The determination of peripheral nerve conduction velocity is an important part to electrodiagnosis. Its value as neurophysiologic investigative procedure has been known for many years but normal value of median and ulnar motor nerve was poorly reported in Korea. To evaluate of median and ulnar motor nerve terminal latency, amplitude of CMAP(compound muscle action potential), conduction velocity and F-wave latency for obtain clinically useful reference value. 71 normal volunteers(age, 19-65 years; 142 hands) examined who has no history of peripheral neuropathy, diabetic mellitus, chronic renal failure, endocrine disorders, anti-cancer medicine, anti-tubercle medicine, alcoholism, trauma, radiculopathy. Nicolet Viking II was use for detected terminal latency, amplitude of CMAP, conduction velocity and F-wave latency of median and ulnar motor nerve. Data analysis was performed using SPSS. Descriptive analysis was used for obtain mean and standard deviation, independent t-test was used to compare between Rt and Lt side also compare between different in genders. The results are summarized as follows: 1. Median motor nerve terminal latency was right 3.00ms, left 2.99ms and there was no significantly differences between right and left side and genders. 2. Median motor nerve amplitude of CMAP was right 17.26mV, left 1750mV and there was no significantly differences between right and left side and genders. 3. Median motor nerve conduction velocity was right 57.89m/sec, left 58.03m/sec and there was no significantly differences between right and left side and genders. 4. Median motor nerve F-wave latency was right 25.74ms, left 25.59ms and there was significantly differences between genders. 5. Ulnar motor nerve terminal latency was right 2.38ms, left 2.45ms and there was significantly differences between right and left side. 6. Ulnar motor nerve amplitude of CMAP was right 15.99mV, left 16.02mV and there was no significantly differences between right and left side and genders. 7. Ulnar motor nerve conduction velocity was right 60.35m/sec, left 59.73m/sec and there was no significantly differences between right and left side and genders. 8. Ulnar motor nerve F-wave latency was right 25.53ms, left 25.57ms and there was significantly differences between genders.

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An Electrophysiologic Study on the Ulnar Digital Nerves (척골 지단 신경의 전기생리학적 연구)

  • Kim, Jong-Soon;Lee, Hyun-Ok;Ahn, So-Youn;Koo, Bong-Oh;Nam, Kun-Woo;Kim, Ho-Bong;Ryu, Jae-Kwan;Ryu, Jae-Moon
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.11 no.2
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    • pp.13-18
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    • 2005
  • The ulnar nerve extends down the arm, across the elbow, and into the hand. It provides sensation to the little and ring fingers and activates many of the small muscles in the hand. The determination of peripheral nerve conduction velocity is an important part of ulnar nerve evaluation. The electrodiagnostic value as neurophysiologic investigative procedure has been known for many years but normal value of digital nerve was not reported in Korea. The purpose of this investigation was to measure the digital nerve conduction velocity of ulnar nerve for obtain clinically useful reference value and compare difference in each fingers and then compare with the other countries. 71 normal Korean volunteers (age, 19-65 years; 142 hands) examined who has no history of peripheral neuropathy, diabetic mellitus, chronic renal failure, endocrine disorders, anti-cancer medicine, anti-tubercle medicine, alcoholism, trauma, radiculopathy. Nicolet Viking II (EMG machine) was use for detected conduction velocity and amplitude of digital nerves in ulnar nerve. Data analysis was performed using SPSS. Descriptive analysis was used for obtain mean and standard deviation and independent t-test was used to compare with ring and little finger. Conduction velocity of the right ring finger was 57.44m/sec and little finger was 55.32msec. The left ring finger was 55.55msec and little finger was 54.11msec. Amplitude of the right ring finger was $30.28{\mu}V$ and little finger was $48.36{\mu}V$. The left ring finger was $30.67{\mu}V$ and little finger was $52.76{\mu}V$. There were significantly difference between ring and little in amplitude (p<.05) but there were no statistically difference between conduction velocity of ring and little finger (p>.05). The amplitude of little finger are greater than ring finger. The present results revealed that electodiagnosis can easily perform in little finger for digital nerve of ulnar nerve study.

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The Descriptive Analysis on the General Characteristics of the Inpatients with Occupational Injuries in an Oriental Medicine Hospital (한방병원에 입원한 산업재해 환자의 일반적 특성에 대한 기술적 분석)

  • Park, Tae-Yong;Lee, Jung-Han;Moon, Soo-Jeong;Ko, Ha-Neul;Ko, Yeon-Suk;Song, Young-Sun;Kwon, Kang-Beom
    • Journal of Society of Preventive Korean Medicine
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    • v.14 no.3
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    • pp.117-127
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    • 2010
  • Objectives : The purpose of this study was to find out the characteristics of patients who admitted due to industrial accident and to promote the superiority of oriental medical treatment on the sequelae of industrial accident. Methods : We analyzed the medical charts of 51 inpatients in a local oriental medicine hospital. The patients had been hospitalized from May 1, 2003 to October 31, 2010. Results : 1. By gender, males accounted for 78.4%, while females 21.6%. By age, most incidences occurred in the forties(29.4%), fifties(23.5%) and thirties(19.6%) in order. 2. Most causes of accident was carelessness(27.5%) and fall down(21.6%) was the next. 3. With regard to the interval from occurrence of accidents to hospitalization, 20 cases(39.2%) were found to be hospitalized 31~90 days after the accidents, followed by 11 cases(21.6%) in 91~180 days and 7 cases(13.7%) in 181~360 days. 4. Most cases turned out to be injuries with 40 patients from Sequelae of intracerebral hemorrhage (23.5%) and Lumbar and other intervertebral disc disorders with radiculopathy(13.7%). The mean duration of hospitalization was $209.03{\pm}346.04$ days. Inpatients of Organic brain syndrome NOS numbered the longest stay($676{\pm}86.26$days), Sequelae of intracerebral hemorrhage recorded $541.91{\pm}541.83$ days hospitalized. 5. Most of inpatients were treated with acupuncture(100%), herbal medication(98.0%), oriental physiological therapy(82.3%), and moxibustion(76.4%). Conclusions : This article will help the researchers related to Oriental medicine establish basic source of Oriental medicine approach for inpatients due to industrial accident.

"Post-Decompressive Neuropathy": New-Onset Post-Laminectomy Lower Extremity Neuropathic Pain Different from the Preoperative Complaint

  • Boakye, Lorraine A.T.;Fourman, Mitchell S.;Spina, Nicholas T.;Laudermilch, Dann;Lee, Joon Y.
    • Asian Spine Journal
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    • v.12 no.6
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    • pp.1043-1052
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    • 2018
  • Study Design: Level III retrospective cross-sectional study. Purpose: To define and characterize the presentation, symptom duration, and patient/surgical risk factors associated with 'post-decompressive neuropathy (PDN).' Overview of Literature: PDN is characterized by lower extremity radicular pain that is 'different' from pre-surgical radiculopathy or claudication pain. Although it is a common constellation of postoperative symptoms, PDN is incompletely characterized and poorly understood. We hypothesize that PDN is caused by an intraoperative neuropraxic event and may develop early (within 30 days following the procedure) or late (after 30 days following the procedure) within the postoperative period. Methods: Patients who consented to undergo lumbar laminectomy with or without an instrumented fusion for degenerative lumbar spine disease were followed up prospectively from July 2013 to December 2014. Relevant data were extracted from the charts of the eligible patients. Patient demographics and surgical factors were identified. Patients completed postoperative questionnaires 3 weeks, 3 months, 6 months, and 1 year postoperatively. Questions were designed to characterize the postoperative pain that differed from preoperative pain. A diagnosis of PDN was established if the patient exhibited the following characteristics: pain different from preoperative pain, leg pain worse than back pain, a non-dermatomal pain pattern, and nocturnal pain that often disrupted sleep. A Visual Analog Scale was used to monitor the pain, and patients documented the effectiveness of the prescribed pain management modalities. Patients for whom more than one follow-up survey was missed were excluded from analysis. Results: Of the 164 eligible patients, 118 (72.0%) completed at least one follow-up survey at each time interval. Of these eligible patients, 91 (77.1%) described symptoms consistent with PDN. Additionally, 75 patients (82.4%) described early-onset symptoms, whereas 16 reported symptoms consistent with late-onset PDN. Significantly more female patients reported PDN symptoms (87% vs. 69%, p=0.03). Patients with both early and late development of PDN described their leg pain as an intermittent, constant, burning, sharp/stabbing, or dull ache. Early PDN was categorized more commonly as a dull ache than late-onset PDN (60% vs. 31%, p=0.052); however, the difference did not reach statistical significance. Opioids were significantly more effective for patients with early-onset PDN than for those with late-onset PDN (85% vs. 44%, p=0.001). Gabapentin was most commonly prescribed to patients who cited no resolution of symptoms (70% vs. 31%, p=0.003). Time to symptom resolution ranged from within 1 month to 1 year. Patients' symptoms were considered unresolved if symptoms persisted for more than 1 year postoperatively. In total, 81% of the patients with early-onset PDN reported complete symptom resolution 1 year postoperatively compared with 63% of patients with late-onset PDN (p=0.11). Conclusions: PDN is a discrete postoperative pain phenomenon that occurred in 77% of the patients who underwent lumbar laminectomy with or without instrumented fusion. Attention must be paid to the constellation and natural history of symptoms unique to PDN to effectively manage a self-limiting postoperative issue.

Effects of Korean Medicine Treatment for a Patient with Lumbar Radiculopathy Diagnosed with Bertolotti's Syndrome: A Case Report (베르톨로티 증후군으로 확인된 요추 신경병증 환자에 대한 한의학적 치료 효과: 증례보고)

  • Han, Jeonghun;Park, Byunghak;Son, Jaemin;Lee, Namwoo;Kang, Dohyeon;Min, Taewoon;Ahn, Jaeseo;Lee, Hansol;Lee, Hyunjun;Ji, Hyungwook;Cho, Sohyun;Lee, Seongmin;Kim, Hankyul
    • Journal of Korean Medicine Rehabilitation
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    • v.31 no.4
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    • pp.203-210
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    • 2021
  • Bertolotti's syndrome is a rare spinal disease and it is known to cause low back pain due to a lumbosacral transitional vertebra. There has been rare study of Bertolotti's syndrome. This study reports the effects of Korean medicine treatment on the patient who was diagnosed on Bertolotti's syndrome. The patient was treated with Korean medicine treatment including acupuncture, pharmacopuncture, herbal medicine, and Chuna manual therapy during 40 days. Numerical rating scale (NRS), Euroqol five dimension (EQ-5D) index, Oswestry disability index (ODI), lumbar range of motion were used for assessment. After treatment, low back pain NRS decreased from 3 to 2, and low limb pain NRS decreased from 5 to 2. EQ-5D index, ODI and lumbar range of motion also were improved. This study shows Korean medicine treatment can be an effective care for Bertolotti's syndrome.

A Comparative Study of a Deeply-inserted Acupotomy Applied to Hyeopcheok Points and Usual Korean Medicine Treatments for Lumbosacral Radiculopathy: Safety, Effectiveness, Cost-effectiveness: A Study Protocol (요천추신경병증에 대한 심부협척 도침술과 한의통상치료의 효과 비교: 안전성, 유효성, 경제성평가: 연구 프로토콜)

  • Heo, In;Lee, Jin-Hyun;Ko, Youn-Suk;Jo, Dong Chan;Kim, Young Il;Lee, Sang-Hyun;Hwang, Eui-Hyoung;Park, Tae-Yong;Hwang, Man-Suk
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.16 no.2
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    • pp.69-77
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    • 2021
  • 연구 배경 최근 한국 및 중국에서 근골격계 질환에 대한 도침술의 활용이 늘고 있다. 하지만 현재까지의 임상연구는 대부분 증례보고 형태에 그치거나, 충분한 근거가 확보되지는 않은 실정이다. 우리는 요천추신경병증환자의 치료에 있어 도침치료와 통상한의치료와의 비교를 통해 도침치료의 유효성, 안전성, 경제성 평가를 시행하기 위해 본 연구를 기획하게 되었다. 연구 방법 본 연구는 예비임상 연구로, 다기관에서 진행되며, 무작위대조군, 활성 대조군을 통한 2개군 병행집단 연구로 평가자 맹검을 시행하게 된다. 이 연구에서는 총 50명의 요천추신경병증 환자를 대상으로 2개군으로 균등하게 분배하여 도침술 또는 통상한의치료를 시행하게 된다(각군당 25명). 도침술 그룹의 경우 협척혈에 도침치료를 시행 받게 되며, 통상 한의치료군은 연구자 판단하에 도침술을 제외한 적절한 한의치료를 시행 받게 된다. 두 개의 그룹은 주당 2회씩 총 3주간 치료를 받게 된다. 일차 유효성 평가는 요통으로 인한 기능장애를 평가하기 위한 Oswestry disability index를 통해 시행한다. 이차 유효성 평가지표로는 numeric rating scale, European Quality of Life 5-Dimension 5-Level, short-form McGill Pain Questionnaire, Roland-Morris Disability Questionnaire scores를 시행하게 된다. 고찰 본 예비임상연구의 결과는 추후 있을 요천추신경병증에 대한 도침치료 및 한의통상치료 비교효과 연구의 유효성, 경제성평가 본 임상연구를 위한 기초 정보 및 가능성을 확인하고 적절한 대상자수 산정에 도움이 될 것이다.

Efficacy of Fluoroscopy-Guided Lumbar Facet Joint Synovial Cyst Rupture with Intra-Articular Steroid Injection after Laminectomy (척추 후궁절제술 이후 발생한 요추 후관절 활액낭에서 투시유도 하 낭종파열술 및 관절 내 스테로이드 주입술의 임상적 경험)

  • Hyo Jin Kim;Eugene Lee;Joon Woo Lee;Yusuhn Kang;Joong Mo Ahn
    • Journal of the Korean Society of Radiology
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    • v.82 no.1
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    • pp.162-172
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    • 2021
  • Purpose We retrospectively evaluated the technical success rate and long-term efficacy of fluoroscopy-guided synovial cyst rupture followed by an intra-articular steroid injection at the post-laminectomy lumbar facet. Materials and Methods We selected subjects who had undergone a fluoroscopy-guided synovial cyst rupture with simultaneous intra-articular steroid injection within 6 months of MRI and demonstrated a symptomatic facet joint synovial cyst at the level of a previous lumbar laminectomy. Fourteen patients were enrolled, and we determined whether cyst rupture and symptom improvement were achieved after each procedure. The degrees of symptom improvement were categorized into 4: 1) symptoms improved (30% or more reduction, based on pre-procedural and post-procedural Numerical Pain Rating Scale scores), 2) symptoms not improved, 3) patient underwent surgery after injection, and 4) loss of follow-up. Results The success rate of percutaneous synovial cyst rupture decreased with repeated procedures (62.5% for the first procedure and 0% to 33.3% for additional procedures). However, 80% of the patients had symptom improvement with the procedures, overall. The surgery rate was 14.3% in 14 patients. Conclusion For patients with post-laminectomy symptomatic lumbar facet joint synovial cysts, fluoroscopy-guided synovial cyst rupture with intra-articular steroid injection may be an effective and less invasive treatment before considering a surgical approach.

A Descriptive Statistical Analysis of the Hospitalized Patients with Low Back Pain in Departments of Korean Rehabilitation Medicine of Korean Medicine Hospitals (한국의 5개 한의과대학 부속한방병원 재활의학과의 요통 입원 환자에 대한 후향적 기술통계분석 - 입원 기간, 상병명, 치료 방법을 중심으로 -)

  • Maeng, Tae-Ho;Kim, Jongyeon;Yi, Woon-Sup;Chung, Won-Seok;Ko, Youn-Seok;Lee, Jung-Han;Shin, Byung-Cheul;Cha, Yun-Yeop;Go, Ho-Yeon;Sun, Seong-Ho;Jeon, Chan-Yong;Jang, Bo-Hyoung;Song, Yun-Kyung;Ko, Seong-Gyu
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.4
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    • pp.213-223
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    • 2013
  • Objectives Low back pain (LBP) is one of the most common reason for people in Korea to visit Korean medical institutions. To assess actual amounts of use in the treatment of LBP in Korean medicine and to provide objective base line data for policy decision making, research regarding the current state of LBP patients' treatment in Korean medical institutions are in need. Methods The current study was designed as a retrospective chart review to investigate descriptive characteristics of LBP patients. The clinical records of 304 patients who were hospitalized for the treatment of LBP in Korean rehabilitation medicine inpatient clinics of five different Korean medicine hospitals were analyzed. The percentage of patient characteristics such as sex, age, average duration of admission, insurance type, diagnosed LBP related disease code, and rates of interventions applied were assessed. Results 1. The female sex was significantly predominant among patients with LBP : 105 patients (34.5%) were male and 199 patients (65.5%) were female. Percentage of the patients' age appeared as followed : 76 people (25.0%) were in their 50s, 64 people (21.1%) were in their 40s, 51 people (16.8%) were in their 30s, 37 people (12.2%) were in their 60s, and 33 people (10.9%) were in their 70s. Approximately half of the total LBP patients investigated were older than 50. 2. The average duration of admission was 16.2 days. Approximately one third (30.3%) of the patients were hospitalized for 8 to 14 days. 3. Female patients tended to stay admitted in hospitals slightly longer than male patients. Elderly (age 60~79) patients stayed in hospitals longer (17.8 days) compared to younger (age 20~39) patients (13.5 days). 4. More than half of the patients (171 cases, 56.3%) had their hospital bills covered with automobile insurance. 40.1% (122 cases) of the patients had medical insurance to cover their hospital bills. The average duration of admission of patients who had automobile insurance was 14.2 days, while that of the patients who had medical insurance was 18.4 days. 5. "Sprain and strain of the lumbar spine and pelvis" was the most commonly used (195 cases, 64.1%) disease code in patients with LBP. Patients diagnosed as "lumbar and other intervertebral disc disorders with radiculopathy" required the longest admission duration (22.1 days). 6. Herbal medication was applied to all of the patients during admission. Acupuncture was applied to all of the patients except one case diagnosed as spinal stenosis. Physical therapy, cupping therapy, moxibustion therapy, chuna therapy, and pharmacopuncture therapy were applied to 94.7, 92.8, 85.2, 83.9, and 49.7% of the patients, respectively. 7. There were certain differences among Korean medicine hospitals in terms of the LBP patients' duration of admission, type of insurance, frequency of the disease code use, type of intervention applied. Conclusions It is thought that the current study can be used as reference data in assessing the current state of LBP treatment in Korean rehabilitation medicine and a basis for future research. Provided improvements of certain limitations of the current study in future researches, such data would act as better base line data in policy decision making.

Comparison of the Clinical Outcomes of an Ultrasound-Guided and C-Arm Guided Cervical Nerve Root Block (초음파와 방사선 투시장치를 이용한 경추 신경근 차단술의 임상결과 비교)

  • Ha, Dae Ho;Shim, Dae Moo;Kim, Tae Kyun;Oh, Sung Kyun;Lee, Hyun Jun
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.78-84
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    • 2020
  • Purpose: This paper compares the clinical outcomes of patients who were treated with a cervical nerve block by ultrasound and C-arm and reports the complication. Materials and Methods: A total of 97 patients were treated with an ultrasound-guided nerve root block from May 1, 2015 to February 8, 2018. On the other hand, 94 patients were treated with a C-arm guided nerve root block. The consequences of the cervical pain and the radiating pain before and after the procedures were reviewed using the verbal numeric rating scale (VNRS). In addition, the complications related to the procedures from the daily notes from the chart were inspected. Results: Sixty-six cases out of 97 cases of ultrasound-guided nerve root block were enrolled in the study. The average age of the patients was 57 years, including 41 males and 25 females. Seventy seven out of 94 cases by a C-arm guided root block were included in the study. The average age of the patients was 55 years, including 40 males and 37 females. Before the nerve root block, the mean numeric rating pain scale (NRS) of the cervical pain in ultrasound-guided block decreased from 5.4 points to 2.7 points at three weeks and 1.4 points at six weeks (p=0.0023, p<0.001), and 3.1 points in the C-arm (p<0.001, p<0.001) at three weeks and 1.5 points at six weeks (p<0.001, p<0.001). In the case of radiating pain, the mean NRS in the ultrasound-guided nerve root block group improved from 6.3 points after the procedure to 2.8 points at three weeks and 1.5 points at six weeks (p<0.001, p<0.001). In the C-arm guided nerve root block group, the NRS improved from 7.4 points after the procedure to 3.3 points at three weeks and 1.9 points at six weeks. In the case of complications, Horner's syndrome and propriospinal myoclonus were observed in one case of C-arm guided block group. Conclusion: The clinical results of the patients who underwent ultrasound-guided cervical nerve root block were not significantly different from those who underwent a C-arm guided cervical nerve root block.