• Title/Summary/Keyword: intervertebral disc disease

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Systematic Review of High Frequency of Acupuncture Point and Self Exercise Therapy for Lower Back Pain (요통 치료의 빈용 경혈과 자가 운동 요법에 대한 체계적 문헌 고찰)

  • Nam, Dae-Jin;Huh, Gun;Lee, Hyung-Eun;Choi, Bo-Mi;Lee, Jung-Min;Lee, Eun-Jung;Oh, Min-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.4
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    • pp.59-71
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    • 2013
  • Objectives The aim of this review is to figure out which acupoints are frequently used to treat low back pain and which exercises are effective to low back pain. Methods We searched the three electronic database (RISS, KISS, KTKP) and manually checked related Korean journals and reference lists up to June 2013. We investigated the frequency of acupoints for using treatment of low back pain. We Introduce exercise therapies we can do easily at home without professional skills for treatment low back pain. Results We included 72 articles in this study. The most frequently adopted acupoints were BL25, BL23, BL24, GB30, BL40, BL26, BL60, GB34, BL52, BL57, GB39. The most frequently adopted meridian pathways were BL, GB, GV, ST. The most frequently adopted disease causing low back pain were HIVD (Herniated intervertebral disc), Lumbar sprain, Spinal stenosis, Compression fracture, Cauda equina syndrome, Spondylolisthesis, Ankylosing spondylitis. There are many exercise therapies (Lumbar stabilizing exercise, Resistance exercise, Bareunmom physical exercise, Mckenzie exercise, Williams exercise, Emblass exercise, Swiss ball exercise, Thera band exercise, Yoga) for treatment low back pain. Conclusions These results suggest that most frequently adopted acupoints were foot taeyang urinary bladder channel acupoints. Beacuse foot taeyang urinary bladder channel is passes through the waist, it will be effective for treatment of low back pain. Also exercise therapy is effective for enhance Muscular strength. In order to treatment of low back pain, Acupuncture treatment is also important, as well as exercise therapy.

Full-Endoscopic versus Minimally Invasive Lumbar Interbody Fusion for Lumbar Degenerative Diseases : A Systematic Review and Meta-Analysis

  • Son, Seong;Yoo, Byung Rhae;Lee, Sang Gu;Kim, Woo Kyung;Jung, Jong Myung
    • Journal of Korean Neurosurgical Society
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    • v.65 no.4
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    • pp.539-548
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    • 2022
  • Objective : Although full-endoscopic lumbar interbody fusion (Endo-LIF) has been tried as the latest alternative technique to minimally invasive transforaminal lumbar interobody fusion (MIS-TLIF) since mid-2010, the evidence is still lacking. We compared the clinical outcome and safety of Endo-LIF to MIS-TLIF for lumbar degenerative disease. Methods : We systematically searched electronic databases, including PubMed, EMBASE, and Cochrane Library to find literature comparing Endo-LIF to MIS-TLIF. The results retrieved were last updated on December 11, 2020. The perioperative outcome included the operation time, blood loss, complication, and hospital stay. The clinical outcomes included Visual analog scale (VAS) of low back pain and leg pain and Oswestry disability index (ODI), and the radiological outcome included pseudoarthosis rate with 12-month minimum follow-up. Results : Four retrospective observational studies and one prospective observational study comprising 423 patients (183 Endo-LIF and 241 MIS-TLIF) were included, and the pooled data analysis revealed low heterogeneity between studies in our review. Baseline characteristics including age and sex were not different between the two groups. Operation time was significantly longer in Endo-LIF (mean difference [MD], 23.220 minutes; 95% confidence interval [CI], 10.669-35.771; p=0.001). However, Endo-LIF resulted in less perioperative blood loss (MD, -144.710 mL; 95% CI, 247.941-41.478; p=0.023). Although VAS back pain at final (MD, -0.120; p=0.586), leg pain within 2 weeks (MD, 0.005; p=0.293), VAS leg pain at final (MD, 0.099; p=0.099), ODI at final (MD, 0.141; p=0.093) were not different, VAS back pain within 2 weeks was more favorable in the Endo-LIF (MD, -1.538; 95% CI, -2.044 to -1.032; p<0.001). On the other hand, no statistically significant group difference in complication rate (relative risk [RR], 0.709; p=0.774), hospital stay (MD, -2.399; p=0.151), and pseudoarthrosis rate (RR, 1.284; p=0.736) were found. Conclusion : Relative to MIS-TLIF, immediate outcomes were favorable in Endo-LIF in terms of blood loss and immediate VAS back pain, although complication rate, mid-term clinical outcomes, and fusion rate were not different. However, the challenges for Endo-LIF include longer operation time which means a difficult learning curve and limited surgical indication which means patient selection bias. Larger-scale, well-designed study with long-term follow-up and randomized controlled trials are needed to confirm and update the results of this systematic review.

Recent Interventional Procedures for Spinal Discogenic Pain for Life Care : Technical and Ethical Issues (라이프케어를 위한 추간판성 통증 치료의 최신중재기법 기술적 윤리적 문제들에 관하여)

  • Hong, Young-Ki
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.4
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    • pp.311-320
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    • 2019
  • Discogenic pain which develops during the degenerative process of intervertebral disc is an intractable disease of musculoskeletal system. Unlike other diseases in modern medical science, it is not clinically confirmed through objective imaging and clinicopathologic index. Moreover, current technology has been facing difficulties finding fundamental treatment. This study examined through reviewing literature whether the therapeutic rationales of interventional procedures for the discogenic pain, such as nerve block, intradiscal electrothermal therapy and nucleoplasty, are valid and whether safety reviews such as preclinical tests are carried out faithfully during the technology development process. As a result, it is presumed that there is not yet an interventional treatment for discogenic pain, whose therapeutic rationale has been objectively verified. And there are some cases of interventional treatment that have not been adequately equipped with the preclinical test steps necessary to review the safety of the procedure during the technology development process. In conclusion, since there is still no interventional treatment for discogenic pain which has clear therapeutic rationale, it is necessary to recognize that a more careful approach is needed to judge whether the procedure is performed in clinical settings. And medical ethical issues may arise for some interventional treatment that are deemed to have been carried out without a thorough review of safety.

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.

Treatment by Injection-Acupuncture with Apitoxin and Apitoxin Combined by Chinese Herbal Medicine in Patients with Canine Bind Limb Paralysis : Case Report (후지마비견(後肢痲痺犬)에 대한 봉독(蜂毒) 약침(藥鍼) 및 봉독(蜂毒) 약침(藥鍼)과 한약제(漢藥劑)의 병용치료(倂用治療) : 증례보고(症例報告))

  • Jun, Hyung-Kyou;Park, Se-Kun;Kim, Duck-Hwan;Kim, Mun-Ho;Hsu, Chin-Yuan;Hsu, Chin-Ling;Liao, Jim-Cai;Chueh, Hao-Jen;Cheng, Han-Wen
    • Journal of Veterinary Clinics
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    • v.24 no.2
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    • pp.225-228
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    • 2007
  • The therapy by injection-acupuncture (AP) with bee-venom (apitoxin) and injection-AP with apitoxin combined by administration of Chinese herbal medicine was applied in 2 cases with canine intervertebral disc disease (IVDD). Case 1 was diagnosed as thoraco-lumbar IVDD (T11-T12, T12-T13, L3-L4 and L4-L5) and case 2 was diagnosed as IVDD at T10-T11 and T12-T13, respectively Injection-AP with apitoxin($Apitoxinc{(R)}$, total $200{\mu}g$ of apitoxin, 0.1 ml/acupoint) plus physical exercise (walking with gocart, TID/day) and aquatherapy (swimming treatment, BID/week) were given to each patient. The used acupoints were GV20 (Bai Hui), GB30 (Huan Tiao), ST36 (Zu San Li), GB34 (Yang Ling Quan), ST40 (Feng Long), ST41 (Jie Xi) and BL40 (Wei Zhong), the lesions, and trigger points. In addition, Chinese herbal medicine (Koda Pharmaceutical Co., Taiwan) including Zheng Gu Zi Jin Dan (正骨紫金丹 : 1 g), Shiuh Duann(續斷 : 0.2 g), Du Zhong(杜仲 : 0.2 g), Mo Yao(沒藥 : 0.2 g), Ru Xian(乳香 : 0.2 g) and Pyrite(自然銅 : 0.2 g) were orallly mdeicated BID for 0\9days in case 2. Walking was possible after session 11 for 4 weeks in case 1 and after session 6 for 2 weeks in case 2, respectively.

The Effect of the Simple Fogarty Thromboembolectomy (단순 Fogarty 혈전색전 제거술의 효과)

  • Oh, Joong-Hwan;Park, Il-Hwan;Lee, Chong-Kookk
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.480-486
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    • 2009
  • Background: The Fogarty thromboembolectomy catheter technique was devised to extract distal arterial emboli and it represents a milestone for the treatment of patients with acute arterial occlusion since the 1960s. The major causes of arterial occlusion have changed from emboli of a heart origin to atherosclerosis over the past 30 years. Accordingly, questions have been raised about the effectiveness of simple Fogarty thromboembolectomy. Material and Method: During the period from March 1990 through August 2008, 156 patients who requiring Fogarty thromboembolectomy were analyzed. The patients were divided into two groups: those with simple Fogarty thromboembolectomy (Group 1, 79 patients) and those with additional vascular bypass graft surgery (Group 2, 77 patients). The duration of symptoms, the cause of thrombi, admission via the emergency room, a history of acupuncture or misdiagnosis, combined diseases, the anatomic occlusion site and the cause of death were analyzed using T-tests, cross tab tests, Chi square tests and Kaplan-Meier tests, respectively. Result: The mean age was 64$\pm$10 years in the 2 groups. The duration of symptoms (pain) in Group 1 vs Group 2 was 12$\pm$4 days vs 71$\pm$14 days (p=0.001). 50 (63%) patients in Group 1 were admitted via the emergency room vs 18 (23%) patients in Group 2 (p=0.005). Misdiagnosis and the treatment for herniated intervertebral disc or acupuncture were given to, 20 (25%) patients in Group 1 vs 30 (39%) patients in Group 2. Anticoagulation treatment before admission was performed in 22 (28%) patients in Group 1 vs 11 (14%) patients in Group 2. The causes of thrombi were heart disease in, 24 (30%) patients in Group 1 vs 6 (8%) patients in Group 2 (p=0.001), atherosclerosis in 46 (58%) patients in Group 1 vs 67 (87%) patients in Group 2 (p=0.001) and trauma in 9 (11%) patients in Group 1 vs 6 (8%) patients in Group 2. The combined diseases were cerebrovascular accident, hypertension and diabetes mellitus in 22 $\sim$ 37% of the total patients. The occlusion sites were mainly in the iliac and femoral arteries. Endarterectomy was performed in 7 (9%) patients in Group 1 vs 18 (23%) patients in Group 2 (p=0.012). Treatment was successful in 27 (34%) patients in Group 1 and in 40 (52%) patients in Group 2 (p=0.019). Reocclusion occurred in 37(47%) patients in Group 1 vs 20 (26%) patients in Group 2 (p=0.000), Amputation was done in 4 (5%) patients in Group 1 vs 12 (16%) patients in Group 2 (p=0.012) and death occurred in 10 (13%) patients (Group 1) vs 3(4%) patients (Group 2) (p=0.044). Conclusion: The recent past has shown a decline in the effectiveness of simple Fogarty thromboembolectomy with a changing pattern of acute arterial occlusion from a rheumatic heart origin to atherosclerosis. Additional bypass procedures play a role for the treatment of arterial occlusion instead of always performing simple Fogarty thromboembolectomy.