• Title/Summary/Keyword: herniated lumbar disc

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Two Cases of Patients Visiting with Herniated Intervertebral Disc of Lumbar Spine Showing Symptoms Opposed to Radiological Findings (영상 의학적 소견과 상반된 증상으로 내원한 요추 추간판탈출증 환자 2례)

  • Kim, Eun-Seok;Han, Kyung-Wan;Lee, Han;Jung, Ho-Suk;Lee, Hyo-Eun;Cho, Jae-Hee;Kim, Chang-Youn
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.4 no.2
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    • pp.185-196
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    • 2009
  • Objective: The purpose of this study is to investigate the effects of oriental medicine conservative treatment on patients who show symptoms at the legion opposed to that shown in Magnetic Resonance Image(MRI) findings. Subject & Method: Oriental medicine treatment such as acupuncture and herbs was applied to two patients who were diagnosed as lateral herniated intervertebral disc of lumbar spine via MRI but whose pain and muscular force attenuation were shown at the opposed lower limb, for measuring its effects. Results: As for the two cases, the patients were favored in the Visual Analog Score (VAS) and the Straight leg Raising(SLR) test after the oriental medicine conservative treatment. In one case, the muscular force in the lower limb was favored. Conclusion: Based on the results in this study, oriental medicine conservative treatment might be effective on patients who show symptoms at the legion opposed to that shown in MRI findings.

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Herniated Lumbar Disc Combined with Spinal Intradural Extramedullary Cysticercosis

  • Choi, Kyeong-Bo;Hwang, Byeong-Wook;Choi, Won-Gyu;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • v.48 no.6
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    • pp.547-550
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    • 2010
  • Spinal cysticercosis is a very uncommon manifestation of neurocysticercosis which is caused by the larvae of Taenia solium. However, it can develop as a primary infection through blood stream or direct larval migration. It can result in high recurrence and severe neurologic morbidity if not treated appropriately. We report the case of a 43-year-old woman who presented with severe lower back pain and left leg radiating pain in recent 2 weeks. Magnetic resonance image (MRI) of lumbar spine demonstrated extruded disc at the L5-S1 level combined with intradural extramedullary cystic lesion. We performed the open lumbar microdiscectomy (OLM) at L5-S1 on the left with total excision of cystic mass. After surgery, the patient showed an improvement of previous symptoms. Diagnosis was confirmed by histopathological examination as intradural extramedullary cysticercosis. We discuss clinical features, diagnostic screening, and treatment options of spinal cysticercosis.

The Clinical Study on 137 Cases of Herniated Lumbar Disc Patients (요추 추간판 탈출증 환자 137례에 대한 한의학적 임상고찰)

  • Lee, Eun-Kyoung;Choi, Eun-Hee;Lee, Ji-Eun;Jeon, Ju-Hyun;Lee, Sung-Hwan;Lee, Jae-Min;Kim, Yeon-Mi;Kwak, Byung-Min;Yang, Gi-Young;Kim, Young-Il
    • Journal of Acupuncture Research
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    • v.25 no.3
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    • pp.127-138
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    • 2008
  • Objectives : This study was designed to evaluate the general distribution and the efficacy of oriental medical treatment for Lumbar Disc Herniation. Subjects and Methods : The 137 patients who had a diagnosis of HIVD by Lumbar-CT of Lumbar-MRI and admitted to Dunsan oriental medical hospital in Daejon university from January 2005 to December 2007 were observed. They were analyzed according to the distribution of sex, age, the period of disease, causing factor, The patient-condition on admission, the symptom on admission, Admission day, Herniation type of the disc and the treatment efficacy was evaluated respectively. Results : 1. Male was more than female in the ratio of 1 : 1.174, and forties 28% the most, the acutest phase 48% the most, reason unknown 30% the most, Grade III 42% the most, Back and Leg radiate pain 65% the most, the day of 6-10 29% the most, protruded disc type 48% the most. 2. In the total treatment result, the good was 48%, the excellent 28%, the fair 15%, the poor 9% in order. 3. the "effective rate"(the percentage of positive effective treatment case) of each distribution, the thirties and fifties 100% the most, subacute phase 100% the most, exercise, traffic accident 100% the most respectively, Grade III 93% the most, only low back pain 97% the most, the day of 16-20 100% the most, Extruded disc 100% the most. Conclusions : Total effective rate was 91%. We have Known the efficacy of oriental medical treatment for HIVD, was good and early treatment was better than late treatment.

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Transdural Nerve Rootlet Entrapment in the Intervertebral Disc Space through Minimal Dural Tear : Report of 4 Cases

  • Choi, Jeong Hoon;Kim, Jin-Sung;Jang, Jee-Soo;Lee, Dong Yeob
    • Journal of Korean Neurosurgical Society
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    • v.53 no.1
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    • pp.52-56
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    • 2013
  • Four patients underwent lumbar surgery. In all four patients, the dura was minimally torn during the operation. However, none exhibited signs of postoperative cerebrospinal fluid leakage. In each case, a few days after the operation, the patient suddenly experienced severe recurring pain in the leg. Repeat magnetic resonance imaging showed transdural nerve rootlets entrapped in the intervertebral disc space. On exploration, ventral dural tears and transdural nerve rootlet entrapment were confirmed. Midline durotomy, herniated rootlet repositioning, and ventral dural tear repair were performed, and patients' symptoms improved after rootlet repositioning. Even with minimal dural tearing, nerve rootlets may become entrapped, resulting in severe recurring symptoms. Therefore, the dural tear must be identified and repaired during the first operation.

The Case Report of Conservative Treatment on the Herniation of Intervertebral Disc Patient After the Fusion Surgery of a Lumbar Segment (요추부 한 분절 유합술 이후 발생한 추간판 탈출증환자에 대한 보존적 치료 치험 1례)

  • Kang, Myung-Jin;Kong, Duck-Hyun;Kim, Wu-Young;Cho, Tae-Young;Nam, Hang-Woo
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.5 no.2
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    • pp.127-134
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    • 2010
  • Objectives: The purpose of this study is the evaluation of conservative medical treatment on the herniation of intervertebral disc(HIVD) patient after the fusion surgery of a lumbar segment. Methods: We used acupuncture, herbal medication, and manipulation for this patient. And we measured of VNRS score and SLR test result to evaluate effect of conservative medical treatment. Results & Conclusions: Patient's low back and left leg pain VNRS is decreased, and the SLR test result is improved.

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Changes on Magnetic resonance imaging in lumbar disc herniations treated with oriental medicine (한의학적 치료법으로 호전된 요추 추간판 탈출증 환자의 영상의학적 변화)

  • Kim, Wu-Young;Han, Sang-Yup;Kim, Ki-Yuk;Kong, Duck-Hyun;Lee, Hyun-Jong;Kim, Chang-Youn;Nam, Hang-Woo
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.4 no.1
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    • pp.31-41
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    • 2009
  • Objectives: The aim of this study was to evaluate the evolution of lumbar disc herniation in patients treated with oriental medicine. Methods: 14patients(15 cases) with lumbar disc herniation proved at MRI(Magnetic resonance imaging) underwent a follow-up MRI study. Follow-up MRI was performed $4{\sim}14$months(mean 7 months) after initial MRI. Results & Conclusions: 1. 13 cases(87%) had reduction of disc herniation. 1 showed no change in amount of disc herniation. 1 had an increase in disc herniation. 2. Comparison initial MRI with follow-up MRI showed that 2 of the herniations decreased between 0% and 25%, 3 decreased between 25% and 50%, 5 decreased between 50% and 75%, 3 decreased between 75% and 100%. The size of the herniation decreased on average by 49% in 14patients(15 cases). 3. On axial images, the proportion of the cross-sectional area of the spinal canal occupied by the herniated disc was 54.41% on the average on the initial scan, 29.65% on the follow-up scan.

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A Case Report of a Sporadic Spinocerebellar Ataxia Patient with Herniated Intervertebral Lumbar Discs Treated with Traditional Korean Medicine (요추 추간판 탈출증을 동반한 산발성 소뇌 운동실조 환자에 대한 한방치험 증례보고 1례)

  • Seo, Hye-jin;Kang, Ah-hyun;Han, Dong-geun;Sung, Jae-yeon;Oh, Ju-hyun;Lee, Yu-ra;Kang, Man-ho;Lee, Hyung-chul;Eom, Guk-hyeon;Song, Woo-sub
    • The Journal of Internal Korean Medicine
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    • v.39 no.5
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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.

Minimally Invasive Muscle Sparing Transmuscular Microdiscectomy : Technique and Comparison with Conventional Subperiosteal Microdiscectomy during the Early Postoperative Period

  • Park, Beom-Seok;Kwon, Young-Joon;Won, Yu-Sam;Shin, Hyun-Chul
    • Journal of Korean Neurosurgical Society
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    • v.48 no.3
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    • pp.225-229
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    • 2010
  • Objective : The authors introduce a minimally invasive muscle sparing transmuscular microdiscectomy (MSTM) to treat herniated lumbar disc disease. Its results are compared with conventional subperiosteal microdiscectomy (CSM) to validate the effectiveness. Methods : Muscle sparing transmuscular microdiscectomy, which involves muscle dissection approach using the natural fat cleavage plane between the multifidus to expose the interlaminar space, was performed in 23 patients to treat a single level unilateral lumbar radiculopathy. The creatine phosphokinase (CPK)-MM serum levels were measured on admission and at 1, 3, and 5 days postoperatively. Postoperative pain was evaluated using a 10-point visual analogue scale (VAS) and recorded on admission and at 1, 3, and 5 days postoperatively. The results were compared to those from the conventional subperiosteal microdiscectomy (43 patients). Results : The CPK-MM levels were significantly lower in the serum of the MSTM group compared to the CSM group on postoperative days three and five (p = 0.03 and p = 0.02, respectively). The clinical scales for back pain using VAS were significantly lower in the MSTM group than in the CSM group on postoperative days three (p = 0.04). The mean VAS scores for leg pain in both groups showed no significant differences during the early postoperative period. Conclusion : Muscle sparing transmuscular microdiscectomy is a minimally invasive surgical option to treat lumbar radiculopathy due to herniated disc. The approach affected minimal injury to posterior lumbar supporting structures with alleviated postoperative back pain.

The Effect of Transforaminal Epidural Block with Hyaluronidase and Triamcinolone (Hyaluronidase를 사용한 경추간공 경막외 차단의 효과)

  • Jo, Dae Hyun;Hong, Ji Hee;Kim, Myoung Hee
    • The Korean Journal of Pain
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    • v.18 no.2
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    • pp.176-180
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    • 2005
  • Background: Epidural steroid injections benefit certain patients with radicular pain, and often have only a limited duration. We compared the efficacy of hyaluronidase and triamcinolone and triamcinolone alone in patients with lumbar herniated disc disease treated with transforaminal epidural block. Methods: Forty patients who had undergone a transforaminal epidural injection were retrospectively reviewed. The T group received triamcinolone and local anesthetics; whereas, the HT group received hyaluronidase, triamcinolone and local anesthetics. We evaluated the improvement as being good, moderate, mild or no improvement, and in those where the improvement was good or moderate, also evaluated the duration of pain relief. Data were collected from the medical records of patients or via phone calls, which were analyzed using Student t- and chi-squared tests. A value of P < 0.05 was considered significant. Results: There were no significant differences in the degree of pain improvement or duration of pain relief between the two groups. Conclusions: A hyaluronidase and triamcinolone injection during transforaminal epidural block has on benefit with respect to the degree of pain improvement or its duration compared to a triamcinolone only injection.

Historical Changes of Extruded Lumbar Intervertebral Disc -A case report- (유출된 요추부 추간판의 시간에 따른 변화 -증례보고-)

  • Park, Jeong Goo;Kwon, Won An
    • The Korean Journal of Pain
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    • v.22 no.1
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    • pp.99-103
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    • 2009
  • We studied the historical changes of intervertebral disc displacement using magnetic resonance imaging. The phenomenon of the spontaneous regression of herniated discs is well known. The case of a 40-years-old male presenting with a large disc herniation at L5-S1, experiencing severe sciatic pain, and having the straight leg raising test positive at 25 degrees is presented. The extruded disc was documented by clinical examination. He was treated conservatively with epidural steroid injection (ESI), medication, physical therapy and self-exercise and reevaluated in 10 weeks later, 30 and 1 year. Large extruded disc can be treated successfully by physical therapy with ESI. However, the degeneration and the dehydration of disc result in decrease of disc height. Consequently, the regression of extruded disc might have been due to the resorption and the dehydration.