• Journal of Pharmacopuncture
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• v.18 no.1
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• pp.79-85
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• 2015

Objectives: A vertebral compression fracture (VCF) is characterized by back pain and fracture of a vertebral body on spinal radiography. VCFs of the thoraco lumbar spine are common in the elderly. In general, appropriate analgesics should be prescribed to reduce pain and, thus, promote early mobilization. The ideal treatment approach for VCFs has not been determined. In Korea, acupuncture and herbal medication have been used to treat VCFs for many years. There is empirical evidence that acupuncture might benefit patients with a VCF. However, no randomized, controlled, clinical trials evaluating the efficacy and the safety of acupuncture for treating a VCF have been published. Therefore, we designed a randomized, controlled, pilot, clinical trial to obtain information for the design of a further full scale trial. Methods: A five week protocol for a randomized, controlled, pilot, clinical trial is presented. Fourteen patients will be recruited and randomly allocated to two groups: a control group receiving interlaminar epidural steroid injections once a week for three weeks, and an experimental group receiving interlaminar epidural steroid injections plus acupuncture treatment (three acupuncture sessions per week for three weeks, nine sessions in total). The primary outcomes will be the pain intensity (visual analogue scale and PainVision$^{TM}$ system). The secondary outcome measurements will be the answers on the short form McGill pain questionnaire and the oswestry disability index. Assessments will be made at baseline and at one, three, and five weeks. The last assessment (week five) will take place two weeks after treatment cessation. This study will provide both an indication of feasibility and a clinical foundation for a future large scale trial. The outcomes will provide additional resources for incorporating acupuncture into existing treatments, such as nonsteroidal anti-inflammatory medications, narcotics and vertebral augmentation. This article describes the protocol.

• Journal of Korean Neurosurgical Society
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• v.60 no.2
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• pp.225-231
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• 2017

Objective : Solid bone fusion is an essential process in spinal stabilization surgery. Recently, as several minimally invasive spinal surgeries have developed, a need of artificial bone substitutes such as demineralized bone matrix (DBM), has arisen. We investigated the in vivo bone growth rate of DBM as a bone void filler compared to a local autologous bone grafts. Methods : From April 2014 to August 2015, 20 patients with a one or two-level spinal stenosis were included. A posterior lumbar interbody fusion using two cages and pedicle screw fixation was performed for every patient, and each cage was packed with autologous local bone and DBM. Clinical outcomes were assessed using the Numeric Rating Scale (NRS) of leg pain and back pain and the Korean Oswestry Disability Index (K-ODI). Clinical outcome parameters and range of motion (ROM) of the operated level were collected preoperatively and at 3 months, 6 months, and 1 year postoperatively. Computed tomography was performed 1 year after fusion surgery and bone growth of the autologous bone grafts and DBM were analyzed by ImageJ software. Results : Eighteen patients completed 1 year of follow-up, including 10 men and 8 women, and the mean age was 56.4 (32-71). The operated level ranged from L3/4 to L5/S1. Eleven patients had single level and 7 patients had two-level repairs. The mean back pain NRS improved from 4.61 to 2.78 (p=0.003) and the leg pain NRS improved from 6.89 to 2.39 (p<0.001). The mean K-ODI score also improved from 27.33 to 13.83 (p<0.001). The ROM decreased below 2.0 degrees at the 3-month assessment, and remained less than 2 degrees through the 1 year postoperative assessment. Every local autologous bone graft and DBM packed cage showed bone bridge formation. On the quantitative analysis of bone growth, the autologous bone grafts showed significantly higher bone growth compared to DBM on both coronal and sagittal images (p<0.001 and p=0.028, respectively). Osteoporotic patients showed less bone growth on sagittal images. Conclusion : Though DBM alone can induce favorable bone bridging in lumbar interbody fusion, it is still inferior to autologous bone grafts. Therefore, DBM is recommended as a bone graft extender rather than bone void filler, particularly in patients with osteoporosis.

• Journal of Acupuncture Research
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• v.33 no.4
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• pp.149-163
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• 2016

Objectives : The purpose of this study is to determine the effect of Functional Cerebrospinal Therapy(FCST) on patients from traffic accidents with Temporomandibular Joint Disorder. Methods : We reviewed the medical records of 33 patients who were treated for injuries stemming from traffic accidents at the Dong-Eui University Korean Medicine Hospital from December 29th, 2015 to August 29th, 2016. The patients were divided into 2 groups: Group A(n = 15) and Group B(n = 18). In Group A, patients received Korean medical treatments with FCST using an Accurate Balancing Appliance(ABA) - a standard intra-oral appliance. In Group B, patients received Korean medical treatments without FCST. To estimate the efficacy of the treatments in decreasing pain, we analyzed the Visual Analogue Scale(VAS), Neck Disability Index(NDI) and Oswestry Disability Index(ODI). Results : In Group A, VAS of headache(VAS H), VAS of neck & nuchal pain(VAS N), VAS of shoulder pain(VAS S), and VAS of low back pain(VAS L) were significantly improved during each period. In Group B, VAS H was significantly improved during each period, except the period from the first visit to two weeks later. VAS N, S, L were significantly improved during each period, except the period from the first visit to one week later. The total VAS improvement during each period in Group A was significantly higher than Group B. In both groups, NDI and ODI were improved significantly during each period. The improvement of NDI and ODI during each period in Group A was significantly higher than Group B. Conclusion : According to the results, FCST using ABA may be an effective treatment for patients from traffic accidents.

• Journal of Korean Neurosurgical Society
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• v.51 no.6
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• pp.343-349
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• 2012

Objective : Pedicle-based dynamic stabilization systems, in which semi-rigid rods or cords are used to restrict or control spinal segmental motion, aim to reduce or eliminate the drawbacks associated with rigid fusion. In this study, we analyzed the two-year clinical outcomes of patients treated with the NFlex (Synthes Spine, Inc.), a pedicle-based dynamic stabilization system. Methods : Five sites participated in a retrospective study of 72 consecutive patients who underwent NFlex stabilization. Of these 72 patients, 65 were available for 2-year follow-up. Patients were included based on the presence of degenerative disc disease (29 patients), degenerative spondylolisthesis (16 patients), lumbar stenosis (9 patients), adjacent segment degeneration (6 patients), and degenerative lumbar scoliosis (5 patients). The clinical outcome measures at each assessment were Visual Analogue Scale (VAS) to measure back pain, and Oswestry Disability Index (ODI) to measure functional status. Radiographic assessments included evidence of instrumentation failure or screw loosening. Results : Sixty-five patients (26 men and 39 women) with a mean age of 54.5 years were included. Mean follow-up was 25.6 months. The mean VAS score improved from 8.1 preoperatively to 3.8 postoperatively, representing a 53% improvement, and the ODI score from 44.5 to 21.8, representing a 51% improvement. Improvements in pain and disability scores were statistically significant. Three implant-related complications were observed. Conclusion : Posterior pedicle-based dynamic stabilization using the NFlex system seems effective in improving pain and functional scores, with sustained clinical improvement after two years. With appropriate patient selection, it may be considered an effective alternative to rigid fusion.

• Journal of Pharmacopuncture
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• v.15 no.3
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• pp.39-44
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• 2012

Objective: The purpose of this study is to report the effects of Chukyu (spine-healing) pharmacopuncture treatment in patients with lumbago and skelalgia. Methods: This clinical study included 45 patients who were treated for lumbago and skelalgia at the Department of Acupuncture and Moxibustion, Dong-Eui University College of Oriental Medicine, from July 5, 2011, to January 31, 2012. Subjects were randomly divided into two groups: Chukyu (spine-healing)-pharmacopuncture-treated group (experimental group, n = 23) and normal saline-pharmacopuncture-treated group (control group, n = 22). Patients in the experimental group were treated with acupuncture and Chukyu (spine-healing) pharmacopuncture while those in the control group were treated with acupuncture and normal saline pharmacopuncture. To estimate the efficacy of controlling pain, we checked the visual analog scale [VAS], and to estimate the improvement of the symptoms, we evaluated by pain rating scale [PRS] and the Oswestry low-back pain disability index [ODI]. Results: A comparison of the experimental and the control groups showed more significant improvements in the VAS, PRS, and ODI for the experimental group than for the control group. Conclusions: Chukyu (spine-healing) pharmacopuncture can be used for effective treatment in patients with lumbago and skelalgia.

• Journal of Korean Neurosurgical Society
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• v.48 no.4
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• pp.347-353
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• 2010

Objective : Iliac screw fixation has been used to prevent premature loosening of sacral fixation and to provide more rigid fixation of the sacropelvic unit. We describe our technique for iliac screw placement and review our experience with this technique. Methods : Thirteen consecutive patients who underwent spinopelvic fixation using iliac screws were enrolled. The indications for spinopelvic fixation included long segment fusions for spinal deformity and post-operative flat-back syndrome, symptomatic pseudoarthrosis of previous lumbosacral fusions, high-grade lumbosacral spondylolisthesis, lumbosacral tumors, and sacral fractures. Radiographic outcomes were assessed using plain radiographs, and computed tomographic scans. Clinical outcomes were assessed using the Oswestry Disability Index (ODI) and questionnaire about buttock pain. Results : The median follow-up period was 33 months (range, 13-54 months). Radiographic fusion across the lumbosacral junction was obtained in all 13 patients. The average pre- and post-operative ODI scores were 40.0 and 17.5, respectively. The questionnaire for buttock pain revealed the following : 9 patients (69%) perceived improvement; 3 patients (23%) reported no change; and 1 patient (7.6%) had aggravation of pain. Two patients complained of prominence of the iliac hardware. The complications included one violation of the greater sciatic notch and one deep wound infection. Conclusion : Iliac screw fixation is a safe and valuable technique that provides added structural support to S1 screws in long-segment spinal fusions. Iliac screw fixation is an extensive surgical procedure with potential complications, but high success rates can be achieved when it is performed systematically and in appropriately selected patients.

• Journal of Acupuncture Research
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• v.37 no.4
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• pp.281-284
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• 2020

Filum terminale lipoma is an inherited lumbosacral abnormality that can cause tethered cord syndrome. This report describes an unusual case of lumbago and sciatica, pain suspected to be caused by a filum terminale lipoma where a herniated intervertebral disc had occurred. The patient was hospitalized for 43 days and received integrative Korean medicine treatment, including acupuncture, pharmacopuncture, Chuna therapy, cupping therapy, physiotherapy and herbal medicine. Treatment effectiveness was assessed using the numerical rating scale, Oswestry Disability Index, European Quality of Life 5-Dimensions, and patient symptoms. After inpatient treatment, the pain the patient suffered was significantly reduced, and the evaluation indices scores reflected this. Integrative Korean remedies may be an effective option for lower back pain and lower extremity symptoms which are caused by filum terminale lipoma where a herniated intervertebral disc has occurred. Additional clinical research is required to support this observation.

• The Journal of Internal Korean Medicine
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• v.39 no.2
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• pp.107-115
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• 2018

Objectives: In the case of a diabetic patient diagnosed with lumbar burst fracture, we aim to present effective results in terms of pain management and blood glucose level stabilization. Methods: A patient was given combined traditional Korean medicine therapy, such as herbal medicine, acupuncture, and antidiabetic medications, during a hospitalization period. We measured the state and progress of this case with the NRS (Numeric Rating Scale) and ODI/NDI (Oswestry/Neck Disability Index). We also checked blood glucose levels regularly. Results: After treatment, the patient's pain was controlled, and the NRS score was decreased. Not only were the overall symptoms of the patient improved positively but the ODI/NDI scores were also improved. Blood glucose level was stabilized. Conclusions: One case of a diabetic patient diagnosed with lumbar burst fracture showed improvement of ODI, NDI, and NRS scores for back and neck pain. Further, the blood glucose level was stabilized.

• Journal of Korean Medicine Rehabilitation
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• v.21 no.4
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• pp.227-239
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• 2011

Objectives: This study was performed to report the case of oriental medical treatment for the left lower limb monoplegia after herniated intervertebral disc(HIVD) operation at lumbar(L)-spine. Methods: A 38-year-old man who underwent lumbar HIVD operation at a hospital admitted with motor weakness of left lower limb, a little decreased left leg radiation pain and low back pain. We treated him by acupuncture, herbal medicine, bee venom injection moxibustion, cupping treatment physical therapy and measured with visual analogue scale(VAS), Oswestry disability index(ODI), Roland-Morris disability questionnaire(RMDO) and manual muscle test(MMT) from 8th February to 4th May 2011. Results: After treatment most symptoms decreased, VAS score changed from 10 to 3, ODI changed 71% to 37% RMDQ changed 13 to 8 and MMT changed from 3 to 5. Conclusions: Our study suggested that oriental medical treatments are significantly applicable to the monoplegia and pain after lumbar HIVD operation. And further studies ire required to identify underlying mechanism of the treatment.

• The Journal of the Society of Korean Medicine Diagnostics
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• v.17 no.3
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• pp.179-188
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• 2013

Objectives This study was designed to development the diagnosis indicators for the fatigue group without disease using analysis of questionnaire data. Methods The subjects were divided into three groups, the fatigue group with disease, the fatigue group without disease, non-fatigue group without disease. Thirteen kinds of questionnaire (Fatigue visual analogue scale, Fatigue severity scale, Pain visual analogue scale, Short-form McGill pain questionnaire score, Headache impact Test-6, Neck disability index, Oswestry low back pain disability questionnaire score, Blood stasis assessment scale, Physical activities questionnaire score, Beck depression inventory, Anger expression inventory score, Mood disability scale, Job stress scale) were carried out for the subjects. Results The results of this study are ; 1) The weight, the systolic and diastolic blood pressure were different among three groups. 2) Among nine questionnaires related to the physical or life conditions, the averages of eight questionnaires were not same one another. 3) Among four questionnaires related to the mental condition or autonomic nervous system, the averages of Beck depression inventory were not same one another. Conclusion The fatigue group without disease can be diagnosed through using the both the questionnaires related to the physical or life condition and the those related to the mental condition or autonomic nervous system.