• Journal of Acupuncture Research
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• v.15 no.2
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• pp.301-310
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• 1998

Infrared thermographic imaging visualizes noninvasively various abnormal condition by detecting the skin temperature. As the imaging represents the objective condition by the changes in blood flow under the control of autonomic nervous system, it is used to diagnosis and monitor the lumboscral radiculopathy. And asymmetry is important in the diagnosis of disc herniation. The most common type of disc herniation occurs psoterolaterally. This frequently causes nerve root compression leading to a radiculopathy in the distribution of the involved nerve root, most of which also provoke the asymmetric changes in thermography. Central disc herniation, which accounts for 5% to 35% of disc herniation, is typically associated with low back pain. But radiculopathy is usually abscent unless central disc heriniaton is large enough to cause compression of the cauda equina. To evalute the diagnostic value of the thermographic imaging in the diagnosis of central disc herniation, the imaging of 15 normal subjects and 48 patients with central disc herniation documented by CT scan were analyzed. The patients had either bilateral radiculophathy or no radiculopathy. The imaging of patient group with non rediculopathy did not show any significant thermal difference to control. While bilateral radiculopathy group reveled hypothermic pattern compared twith control. Thermal difference between left and right side did not present any significance in non radiculopathy group but hypothermia in bilateral radiculopathy group. Large herniation group demonstrated hyperthemic pattern while the others showed no significant change. Cranial caudal thermal difference did not show any difference between experiment groups. These results shows that infrared thermographic imaging can be used central disc herniation with bilateral radiculopathy, while it seems to little useful on the diagnosis of non radiculopathic disc herniation.

• Journal of Korean Medicine Rehabilitation
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• v.23 no.2
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• pp.129-138
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• 2013

Objectives : This study investigated the relationship between straight leg raising(SLR), valsalva test and size, position of lumbar disc herniation. Methods : We took SLR and valsalva test on 105 patients with lumbar disc herniation. According to the result of MRI findings, this study classified three groups of 105 patients with lumbar disc herniation, bulging, protrusion and extrusion. According to the position of lumbar disc herniation, 72 patients that were diagnosed protrusion and extrsuion were sorted 4 groups, lateral, lateral postero-lateral, central postero-lateral, central. The association size, position of lumbar disc herniation and SLR, valsalva test were analysed. Results : The bigger size of disc herniation, the more positive result of SLR and valsalva test, the lower angle of SLR test. There was not significant association between the position of lumbar disc herniation and the angle of SLR test. Conclusions : The SLR and valsalva test is an useful physical examination to speculate about the degree of lumbar disc herniation.

• Journal of Korean Neurosurgical Society
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• v.55 no.6
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• pp.383-386
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• 2014

Objective : Symptomatic thoracic disc herniation often requires prompt surgical treatment to prevent neurological deterioration and permanent deficits. Anterior approaches offer direct visualization and access to the herniated disc and anterior dura but require access surgeons and are often associated with considerable postoperative pain and pulmonary complications. A disadvantage with using posterior approaches in the setting of central calcified thoracic disc herniation however, has been the limited visualization of anterior dura and difficulty to accurately assess the extent of decompression. Methods : We report our experience with intraoperative ultrasound (US) guidance during a modified posterior transpedicular approach for removal of a central calcified thoracic disc herniation with a review of pertinent literature. Results : The herniated thoracic disc was successfully removed with posterior approach with the aid of intraoperative US. The patient had significant neurological improvement at three months follow-up. Conclusion : Intraoperative ultrasound is a simple yet valuable tool for real-time imaging during transpedicular thoracic discectomy. Visualization provided by intraoperative US increases the safety profile of posterior approaches and may make thoracotomy unnecessary in a selected group of patients, especially when a patient has existing pulmonary disease or is otherwise not medically fit for the transthoracic approach.

• 대한미세수술학회:학술대회논문집
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• 1997.10a
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• pp.127-127
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• 1997

• Journal of Korean Neurosurgical Society
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• v.42 no.6
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• pp.441-445
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• 2007

Objective : The purpose of this study was to investigate the surgical results and prognostic factors for patients with soft cervical disc herniation with myelopathy. Methods : During the last 7 years, 26 patients with cervical discogenic myelopathy were undertaken anterior discectomy and fusion. Clinical and radiographic features were reviewed to evaluate the surgical results and prognostic factors. The clinical outcome was judged using two grading systems (Herkowitz's scale and Nurick's grade). Results : Male were predominant (4:1), and C5-6 was the most frequently involved level. Gait disturbance, variable degree of spasticity, discomfort in chest and abdomen, hand numbness were the most obvious signs. Magnetic resonance(MR) images showed that central disc herniation was revealed in 16 cases, and accompanying cord signal changes in 4. Postoperatively, 23 patients showed favorable results (excellent, good and fair) according to Herkowitz's scale. Conclusion : Anterior cervical discectomy and fusion effectively reduced myelopathic symptoms due to soft cervical disc herniation. The authors assured that the shorter duration of clinical attention, the lesser the degree of myelopathy and better outcome in discogenic myelopathy.

• The Korean Journal of Pain
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• v.29 no.2
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• pp.119-122
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• 2016

Thalamic pain is a primary cause of central post-stroke pain (CPSP). Clinical symptoms vary depending on the location of the infarction and frequently accompany several pain symptoms. Therefore, correct diagnosis and proper examination are not easy. We report a case of CPSP due to a left acute thalamic infarction with central disc protrusion at C5-6. A 45-year-old-male patient experiencing a tingling sensation in his right arm was referred to our pain clinic under the diagnosis of cervical disc herniation. This patient also complained of right cramp-like abdominal pain. After further evaluations, he was diagnosed with an acute thalamic infarction. Therefore detailed history taking should be performed and examiners should always be aware of other symptoms that could suggest a more dangerous disease.

• Journal of Korean Neurosurgical Society
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• v.40 no.1
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• pp.58-62
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• 2006

Objective : Development of diagnostic tools has resulted in early detection of thoracic disc herniations[TDH] even when the herniated disc is soft in consistency. In some of the cases, it is considered better not to opt for surgical treatment due to the unduly high morbidity and potential complications associated with conventional approaches. The authors have applied percutaneous endoscopic thoracic discectomy[PETD] technique to soft TDHs in order to avoid the morbidity associated with conventional approaches. Methods : Eight consecutive patients [range, 31 to 75 years] with soft lateral or central TDH [from T2-3 to T11-12] underwent PETD between May 2001 and June 2004. The patient was positioned in a prone position with intravenous sedation and local anesthetic infiltration. The authors introduced a cannula into the thoracic intervertebral foramen using endoscopic foraminoplasty technique. Discectomy was performed with mechanical tools and a laser under continuous endoscopic visualization and flu oroscopic guidance. Functional status was assessed preoperatively and postoperatively using the Oswestry Disability Index[ODI]. Results : The mean ODI scores improved from 52.8 before the surgery to 25.8 at the final follow-up. In cases of myelopathy, long tract signs showed improvement. The mean operative time was 55 minutes, and no patient required conversion to open surgery. Conclusion : The technique allows a smaller incision and less morbidity. Soft TDH is amenable to this minimally invasive approach in selected patients with myeloradiculopathy.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.19 no.2
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• pp.19-22
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• 2013

Background: Excessive pronation of the feet can cause excessive inner rotation of the femur, followed by increased stress in the gluteus maximum, increased front slope of the pelvis, and lumbar lordosis, which leads to lumbar pain. The aim of the present study was to use the navicular drop test to examine foot pronation that can cause lumbar lordosis and to determine whether the navicular drop is lower in patients diagnosed with lumbar disc than in patients without this diagnosis. Methods: The Navicular Drop score was set by subtracting the navicular height at a standing position from the navicular height in a sitting position. The Navicular Drop measurements for college student with and without Lumbar Herniated Intervertebral Disc were compared using an independent t-test. Results: The control group were measured right $7.44{\pm}2.96$ and left $8.04{\pm}3.23$. The experimental group were measured right $2.12{\pm}1.33$ and left $2.80{\pm}1.29$. Therefore significant difference was found between the two groups (p<0.05). Conclusions: The navicular drop affected lumbar herniated intervertebral disc.

• Journal of Korean Neurosurgical Society
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• v.48 no.2
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• pp.119-124
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• 2010

Objective : Disc herniations at the L1-L2 and L2-L3 levels are different from those at lower levels of the lumbar spine with regard to clinical characteristics and surgical outcome. Spinal canals are narrower than those of lower levels, which may compromise multiple spinal nerve roots or conus medullaris. The aim of this study was to evaluate the clinical features and surgical outcomes of upper lumbar disc herniations. Methods : We retrospectively reviewed the clinical features of 41 patients who had undergone surgery for single disc herniations at the L1-L2 and L2-3 levels from 1998 to 2007. The affected levels were L1-L2 in 14 patients and L2-L3 in 27 patients. Presenting symptoms and signs, patient characteristics, radiologic findings, operative methods, and surgical outcomes were investigated. Results : The mean age of patients with upper lumbar disc was 55.5 years (ranged 31 to 78). The mean follow-up period was 16.6 months. Most patients complained of back and buttock pain (38 patients, 92%), and radiating pain in areas such as the anterior or anterolateral aspect of the thigh (32 patients, 78%). Weakness of lower extremities was observed in 16 patients (39%) and sensory disturbance was presented in 19 patients (46%). Only 6 patients (14%) had undergone previous lumbar disc surgery. Discectomy was performed using three methods : unilateral laminectomy in 27 cases, bilateral laminectomy in 3 cases, and the transdural approach in 11 cases, which were performed through total laminectomy in 10 cases and unilateral laminectomy in 1 case. With regard to surgical outcomes, preoperative symptoms improved significantly in 33 patients (80.5%), partially in 7 patients (17%), and were aggravated in 1 patient (2.5%). Conclusion : Clinical features of disc herniations at the L1-L2 and L2-L3 levels were variable, and localized sensory change or pain was rarely demonstrated. In most cases, the discectomy was performed successfully by conventional posterior laminectomy. On the other hand, in large central broad based disc herniation, when the neural elements are severely compromised, the posterior transdural approach could be an alternative.

• Journal of Acupuncture Research
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• v.21 no.5
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• pp.13-25
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• 2004

Objective : Herniation of Nucleus Pulpous(HNP) of Lumbar is the most important reason that causes low back pain. The aim of this study is to investigate the effectiveness of Bee-venom acua-acupuncture therapy for protrusion disc patients. Methods : To evaluate the effectiveness of Bee-Venom Acupuncture Therapy, 20 patients were treated by bee-venom acua-acupuncture therapy. To estimate the efficacy of treatment, we used Quardruple Visual Analog Scale(QVAS). Results : 1. As a objectivity treatment record, they test treatment record good 60%, fair 25%, excellent 15%. 2. After bee-venom therapy, pain rate changed from 8.25 to 2.15. 3. By the results which puts out the statistics in sex, a pain rate of male changed from 8.75 to 2.50, a pain rate of female 7.92 to 1.92. Intentional difference is none as a therapy. By the results which puts out the statistics in age, after forties changed from 7.78 to 2.22 and before forties changed from 7.90 to 1.92. By the results which puts out the statistics in disc herniation, pain rate of central type changed from 8.29 to 2.29, pain rate of left type changed from 8.20 to 1.40, pain rate of Right type changed from 8.00 to 4.00.