• 대한방사선기술학회지:방사선기술과학
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• 제23권2호
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• pp.21-26
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• 2000

The classification of herniated intervertebral cervical disc types are clinically important, as treatment methods would be slightly different according to the specific type of the herniated disc. 423 patients who suffered from herniated intervertebral cervical discs were tested with Magnetic Resonance Imaging (MRI), to distinguish the type of the herniated discs. The followings are the results ; 1) The age of the patients tested ranged from 16 to 75 years old and the mean age of the patients was 41.4 years of age. 2) There were twice as many male patients, with a ratio of 288 : 135 men to women. 3) 101 patients suffered from single herniated discs, while 322 patients suffered from multi-herniated discs. 4) Of single herniated disc injuries, 52 patients had protruded discs (52%), while 25 patients had extruded discs (25%). 21 Patients (21%) had herniated intervertebral discs between $C_4{\sim}C_5$, and 51 patients (50%), and had the same injury between $C_5$ and $C_6$. 5) Of multi-herniated disc injuries, 140 patients had protruded discs(44%). while 45 patients had extruded discs (14%). 54 patients had both protruded and extruded discs(17%). 36 patients(11%), herniated discs $C_3{\sim}C_6$ ; 69 patients (21%), herniated discs $C_3{\sim}C_7$ ; 47 patients(15%) herniated discs $C_4{\sim}C_6$ and 67 patients(20%) herniated discs $C_5{\sim}C_7$.

• Journal of Korean Neurosurgical Society
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• 제47권1호
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• pp.26-29
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• 2010

Objective: Recurrent lumbar disc herniation has been reported to occur in 5% to 15% of surgically treated primary lumbar disc herniation cases. We investigated the molecular biologic characteristics of primary herniated discs and recurrent discs to see whether the recurrent discs has the similar biological features with primary herniated discs. Methods: Primary hemiated disc and recurrent disc cells were obtained by discectomy of lumbar disc patients and cells were isolated and then taken through monolayer cultures. We compared chondrogenic and osteogenic mRNA gene expression, and western blot between the two groups. Results: The mRNA gene expression of recurrent disc cells were increased 1.47* times for aggrecan, 1.38 times for type I collagen, 2.04 times for type II collagen, 1.22 times for both Sox-9 and osteocalcin, and 1.31 times for alkaline phosphatase, respectively, compared with the primary herniated lumbar disc cells (*indicates p < 0.05). Westem blot results for each aggrecan, type I collagen, type II collagen, Sox-9, osteocalcin, and alkaline phosphatase were similar between the primary herniated disc cells and recurrent disc cells. Conclusion: These results indicate that the recurrent disc cells have similar chondrogenic and osteogenic gene expression compared to primary herniated disc cells. Therefore, we assumed that the regeneration of remaining discs could fill the previous discectomy space and also it could be one of the factors for disc recurrence especially in the molecular biologic field.

• The Korean Journal of Pain
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• 제21권1호
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• pp.84-88
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• 2008

The spontaneous regression of herniated cervical discs is not a well established phenomenon. However, we encountered the 3 cases of spontaneous regression of severe radiculopathic herniated cervical discs that were treated using a non-surgical method. Each of the patients were treated with a combination of manipulation, dry needling and analgesics. In each case, the symptoms improved within 12 months of treatment and magnetic resonance imaging (MRI) conducted at that time revealed marked regression of the herniated disc in all cases. These cases provide additional examples of spontaneous regression of herniated cervical discs documented by MRI following non-surgical treatment.

• Journal of Korean Neurosurgical Society
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• 제29권12호
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• pp.1577-1583
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• 2000

Objectives : Among the various types of minimally invasive spine surgeries, thoracoscopic surgery is becoming more widely accepted and increasingly utilized. This report delineates our clinical experience using thoracoscopy to resect herniated thoracic discs in 16 patients who suffered from myelopathy or intolerable radiculopathy. Patients and Methods : Between Mar. 1997 and Sep. 1999, 16 consecutive patients underwent thoracoscopic discectomy for treatment of herniated thoracic discs. There were 12 men and 4 women(mean age 43.5 years ; range 18-61 years). Eleven patients presented with myelopathic signs and symptoms from spinal cord compression and 5 patients had incapacitating thoracic radicular pain without myelopathy. The surgical level was varied between T3 and T12. The pathology of specimen were 11 hard discs and 5 soft discs herniations. Thoracoscopic techniques were performed with long narrow spine instruments and high speed drill through 3 or 4 ports under one lung ventilated general anesthesia. During the operation three patients were converted to open thoracotomy due to intolerable one lung ventilation, excessive bleeding and inadequate operation field. The mean operation time was 264min.(range : 100-420min.), and postoperative mean admission period was 11 days. Results : Clinical and neurological outcomes were good in all patients(mean follow-up period 20 months). Among the eleven myelopathic patients, 8 improved neurologically, and 3 stabilized. Among the five radiculopathic patients, 4 recovered completely and no patient had worsened. Postoperative complications were pleural effusion in one case, intercostal neuralgia in one, delayed hemopneumothorax in one, prolonged air leakage in one and pneumonia in one case. Conclusions : Thoracoscopic discectomy needs a steep learning curve to be familiar to anatomical space and handling of endoscopic instruments. However, it is technically feasible and can be effectively performed with acceptable results.

• The Korean Journal of Pain
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• 제21권1호
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• pp.38-43
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• 2008

Background: Spinal stenosis and herniated intervertebral discs are the principal causes of lumbosacral radiculopathy. This study was conducted to compare the therapeutic value and duration of pain relief of fluoroscopic guided transforaminal epidural steroid injections (TFESIs) in patients with refractory radicular leg pain. Methods: Between August 2006 and March 2007, 87 patients (H group: patients with herniated intervertebral disc, S group: patients with spinal stenosis) who met the inclusion criteria were treated with fluoroscopic guided TFESIs. Prior to treatment, the VAS and ODI scores were determine to evaluate the degree of pain and level of disability. The degree of pain relief was then assessed 1 month after treatment with the TFESIs and graded as excellent (no residual pain), good (improvement of pain symptoms by more than 50%), fair (improvement of pain symptoms by less than 50%) and Poor (no improvement of pain). In addition, the duration of pain relief was evaluated by regular outpatient visits for 6 months, and by telephone interviews after 6 months. Results: The H and S group both had excellet results at 1 month after treatment with TFESIs showing improvements of 44.1% and 20.8% respectively. However this difference was not significant between groups. In addition, a duration of pain relief greater than 6 months was achieved in 32.4% of the patients in the H group and 37.7% of those in the S group. Conclusions: TFESIs had a similar degree of therapeutic effectiveness and duration of pain relief in patients with spinal stenosis and herniated intervertebral discs.

• 대한한방내과학회지
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• 제39권5호
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• pp.994-1003
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• 2018

Objective: The aim of this study was to report a clinical case suggesting the potential effects of traditional Korean medicine for the treatment of sporadic spinocerebellar ataxia in a patient with herniated intervertebral lumbar discs. Methods: The patient was treated with a series of Korean medicine treatments including the herbal medicine Zhenganxifeng-tang-gagam, acupuncture, pharmacoacupuncture, and electroacupuncture along with herniated intervertebral lumbar disc treatments. Results: Improvements of Numeric rating scale (NRS) and European Quality of Life-5 Dimensions (EQ-5D) score were observed after the treatment. Conclusion: Traditional Korean medicine has potential benefits for sporadic spinocerebellar ataxia patients with herniated intervertebral lumbar discs.

• Journal of Acupuncture Research
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• 제38권3호
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• pp.227-232
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• 2021

Background: The purpose of this study was to statistically analyze the treatment effect and patient satisfaction of traditional Korean medicine, including acupotomy treatment of cervical herniated intervertebral disc. Methods: This was a retrospective study of 22 patients who received traditional Korean medicine including acupotomy treatment amongst all patients diagnosed with cervical herniated intervertebral discs at the Korean Medicine hospital in Daejeon, Korean, from January 01, 2020 to April 30, 2021. The clinical data from patient medical records were statistically analyzed. Results: The Numeric Rating Scale, the European Quality of Life 5 Dimensions, and the European Quality of Life Visual Analogue Scale questionnaire scores were each compared before and after traditional Korean medicine treatment, including acupotomy, showed significantly improved scores after treatment (p < 0.001). Out of a total of 22 patients, 11 rated the treatment "very satisfactory" (50%), 5 "satisfactory" (22.7%), 5 "indifferent" (22.7%), 1 "unsatisfactory" (4.5%), and 0 "very unsatisfactory" (0%). Of the total 22 patients, 17 patients (77.3%) were willing to have further treatment, and 5 patients (22.7%) were not willing. Conclusion: Traditional Korean medicine treatment including acupotomy was an effective treatment for cervical herniated intervertebral discs. To determine the effect of an individual application (e.g., acupotomy) of traditional Korean medicine treatment for cervical herniated intervertebral disc, a prospective, controlled study is needed.

• Anatomy and Cell Biology
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• 제56권3호
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• pp.382-393
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• 2023

Cell clusters are a histological hallmark feature of intervertebral disc degeneration. Clusters arise from cell proliferation, are associated with replicative senescence, and remain metabolically, but their precise role in various stages of disc degeneration remain obscure. The aim of this study was therefore to investigate small, medium, and large size cell-clusters. For this purpose, human disc samples were collected from 55 subjects, aged 37-72 years, 21 patients had disc herniation, 10 had degenerated non-herniated discs, and 9 had degenerative scoliosis with spinal curvature <45°. 15 non-degenerated control discs were from cadavers. Clusters and matrix changes were investigated with histology, immunohistochemistry, and Sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE). Data obtained were analyzed with spearman rank correlation and ANOVA. Results revealed, small and medium-sized clusters were positive for cell proliferation markers Ki-67 and proliferating cell nuclear antigen (PCNA) in control and slightly degenerated human discs, while large cell clusters were typically more abundant in severely degenerated and herniated discs. Large clusters associated with matrix fissures, proteoglycan loss, matrix metalloproteinase-1 (MMP-1), and Caspase-3. Spatial association findings were reconfirmed with SDS-PAGE that showed presence to these target markers based on its molecular weight. Controls, slightly degenerated discs showed smaller clusters, less proteoglycan loss, MMP-1, and Caspase-3. In conclusion, cell clusters in the early stages of degeneration could be indicative of repair, however sustained loading increases large cell clusters especially around microscopic fissures that accelerates inflammatory catabolism and alters cellular metabolism, thus attempted repair process initiated by cell clusters fails and is aborted at least in part via apoptosis.

• 대한한방내과학회지
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• 제38권5호
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• pp.828-833
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• 2017

Objective: The aim of this study was to evaluate the effects of traditional Korean medicine as a treatment for diabetes mellitus with herniated intervertebral lumbar discs. Method: The patients were treated with the herbal medicine Jungso-tang to reduce serum glucose (FBS/PP2hrs) and HbA1c to improve diabetes mellitus in parallel with lumbar herniated intervertebral disc treatment. Results: The treatment with Jungso-tang decreased the serum glucose (FBS/PP2hrs) and HbA1c levels. Conclusion: Korean medicine may be an effective treatment for diabetes mellitus with lumbar herniated intervertebral disc.

• 대한약침학회지
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• 제15권2호
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• pp.36-39
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• 2012

The spontaneous regression of herniated cervical discs is not a well-established phenomenon. However, we encountered a case of a spontaneous regression of a severe radiculopathic herniated cervical disc that was treated with acupuncture, pharmacopuncture, and herb medicine. The symptoms were improved within 12 months of treatment. Magnetic resonance imaging (MRI) conducted at that time revealed marked regression of the herniated disc. This case provides an additional example of spontaneous regression of a herniated cervical disc documented by MRI following non-surgical treatment.