• 제목/요약/키워드: intervertebral disc disease

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요추 추간판 탈출증환자에서 동반된 장요근 화농근육염 -증례보고- (Iliopsoas Pyomyositis Overlaping the Herniated Intervertebral Lumbar Disc Symptom -A case report-)

  • 이은경;손윤숙;조현숙;강준구;김대영;이상묵
    • The Korean Journal of Pain
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    • 제19권2호
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    • pp.278-281
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    • 2006
  • The diagnosis of pyomyositis in the pelvic region is difficult, as its incidence is relatively, with symptoms that mimic those of discogenic pain. Sciatica is a common presentation of a prolapsed lumbar disc. Less common causes, such as spinal stenosis, pelvic tumors or even primary nerve tumors can also cause these symptoms. Magnetic resonance imaging (MRI) is a useful diagnostic tool. Herein, the case of a patient with an acute pyogenic infection in the iliopsoas muscle, presenting with sciatica, is reported. This is a rare infective disease, which if promptly treated with intravenous antibiotics, can be completely resolved; otherwise, it can result in deep abscess formation, sepsis and death.

신경통증클리닉 환자의 1년간 통계고찰 (A Clinical Survey of the Patients in Neuro-Pain Clinic at Ajou University)

  • 박은정;한경림;김도완;김찬
    • The Korean Journal of Pain
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    • 제20권2호
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    • pp.181-185
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    • 2007
  • Background: The first pain clinic opened in korea in 1973 at Yonsei University Hospital, however, since then the number of pain clinics has gradually increased, as has the number of patients visiting them. This increase in patient has caused concerns about the way in which pain is managed, therefore, we conducted a retrospective review of data according to the sex, age and disease in an attept to aid us in planning for the future of our pain clinic. Methods: We analyzed 1,282 new patients who had visited our pain clinic and 828 inpatients who were admitted to our pain clinic between March 2006 and February 2007. Results: The most frequent age group was in the sixties in outpatient and in the seventies in inpatient. In addition, the incidence of disease in new patients and inpatients was as follows: in new patients, lumbar herniated intervertebral disc 16.5%, hyperhidrosis 12.3%, cervical disc disorder 10.5%, acute herpes zoster 8.2%, postherpetic neuralgia 7.9%, and trigeminal neuralgia 7.0%; in admitted patients, acute herpes zoster 17.6%, trigeminal neuralgia 15.6%, lumbar herniated intervertebral disc 13.0%, postherpetic neuralgia 11.2%, hyperhidrosis 9.8%, and complex regional pain syndrome 7.0%. Conclusions: The patients visiting our pain clinic have presented with a wide variety of diseases. This improved care reflects an effort to expand our fields not only to the management of outpatients but also inpatients, as well as to the treatment of new fields of disease. In the future, We need to manage various pain patients not only in outpatients but also in inpatients to expand our field even through pain clinic is rapidly growing in Korea.

추간판 장애 환자의 의료이용 현황 및 특성 -경추질환을 중심으로- (Status and Characteristics of Applying Medical Use Analysis of intervertebral Disc Disorder Patients - Focusing on cervical spinal disease)

  • 서영우;박초열
    • 보건의료생명과학 논문지
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    • 제9권1호
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    • pp.103-115
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    • 2021
  • 본 연구는 건강보험심사평가원 2010~2018년까지 표본자료 DB에서 설정한 의료서비스를 이용대상자 중 경추간판장애를 주상병으로 1회 이상 요양급여를 받은 환자를 대상으로 하였다. 경추간판장애 환자는 9개년 모두 성별로는 여성이, 연령별로는 50~59세에서 가장 많았다. 의료기관 종별 이용행태는 남성과 여성 모두, 모든 연령대에서 의원 이용자가 가장 많았다. 질환별 입원일수는 M50.0(척수병증을 동반한 경추간판장애)은 종합병원과 병원, 의원에서 가장 길었으며, M50.1(신경뿌리병증을 동반한 경추간판장애)은 상급종합병원과 한방의료기관에서 가장 길었다. 외래 진료일수는 M50.0(척수병증을 동반한 경추간판장애)은 상급종합병원과 종합병원, 병원, 의원에서 가장 길었으며, M50.8(기타 경추간판장애)은 보건기관과 한방의료기관에서 가장 길었다. 경추간판장애 환자의 수술은 남성이 많았으며, 40~49세, 50~59세에서 높았다. 2010년 대비 2018년의 수술 추이는 남성, 여성, 전체 환자 모두 감소 추세를 보였다.

추간판 탈출증이 발생한 개에서 동종의 지방유래 줄기세포의 임상적 적용 (Clinical Application of Mesenchymal Stem Cells in a Dog with Intervertebral Disc Disease)

  • 김영기;이승용;박세진;이스캇;김진현;이희천;장홍희;이효종;연성찬
    • 한국임상수의학회지
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    • 제28권1호
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    • pp.122-127
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    • 2011
  • 후지마비와 심부통각의 소실을 보이는 5 년령의 수컷 Cocker Spaniel이 내원하였다. 신체검사, 신경검사, 방사선검사와 컴퓨터 단층촬영결과 심부통각의 소실을 동반한 요추 2번과 3번 사이의 디스크 탈출증으로 진단하였다. 편측 추궁 절제술을 시행하여 감압술과 탈출된 디스크 물질을 제거하였으며 $1{\times}10^6$ 개의 동종 지방유래 줄기세포를 $50{\mu}l$ 생리식염수에 희석하여 손상된 척수에 직접 주입하였다. 수술 10주 후, 양쪽 후지 모두에서 심부통각과 운동기능이 완전히 회복되었으며 세포이식과 관련된 부작용은 현재까지 발견되지 않았다. 본 증례를 통해 심각한 정도의 디스크질환을 가진 환축에서 감압술과 병행된 줄기세포의 이식방법은 좀더 나은 예후를 기대하기 위한 치료방법들 중 하나로 고려해볼 수 있을 것으로 생각된다.

신경파괴적 요부교감신경절 차단의 적정 부위 (Appropriate Block Level in Neurolytic Lumbar Sympathetic Ganglion Block)

  • 김희정;이철오;신양식;이윤우
    • The Korean Journal of Pain
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    • 제14권2호
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    • pp.199-206
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    • 2001
  • Background: The lumbar sympathetic ganglia are variable in both position and numbers. The aim of this study was to detect the appropriate lumbar vertebral level where the lumbar sympathetic ganglia primarily aggregate. Methods: Forty patients comprising of hyperhidrosis (26 cases), complex regional pain syndrome (10 cases), peripheral artery occlusion disease (3 cases) and postherpetic neuralgia (1 case) underwent lumbar sympathetic block. We randomly selected one of two (L2 or L3) levels and the L4 level. The position of the needle tip and distribution of dye was verified by injection of a mixture of radio-opaque dye (1.5 ml) and 4% lidocaine (1.5 ml) and subsequently confirmed by L-spine anteroposterior and a lateral view X-ray. We considered the response positive when the skin temperature increased more than $1^{\circ}C$ in 5 min. Results: In general, the positive response ratio was greater when the needle tip located at the L2 or L4 level vice L3 and when the drug was distributed on the lower half of the L4 body and in the L4/5 intervertebral disc space. In a right side block, the positive response ratio was greater when the drug was distributed on the lower half of the L4 body and in the L4/5 intervertebral disc space, although in a left side block there was no significant difference seen between the levels. The complications of the neurolytic block were alcohol neuritis (7.5%) and hypoesthesia (5%) on the L1 or L2 dermatome. Conclusions: The best effect with least chance of complication may be induced by spreading the drug on the lower half of the L4 body and/or into the L4/5 intervertebral disc space by placing the needle tip on the L4 body.

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요추 추간판탈출증 입원환자 72례에 대한 한의학적 복합치료 효과의 관찰 연구 (The Effect of Korean Medical Combination Treatment on 72 Cases of Herniated Intervertebral Lumbar Disc Patients: An Observational Study)

  • 김상민;이순호;신유빈;최지훈;구자성;유형진;이동현
    • Journal of Acupuncture Research
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    • 제32권2호
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    • pp.23-33
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    • 2015
  • Objectives : This study was designed to assess the general distribution and clinical effectiveness of Korean medical treatment on lumbar disc herniation. Methods : This is an observational study. 72 patients admitted to Daejeon Jaseng Hospital of Korean Medicine with a diagnosis of herniated intervertebral disc(HIVD) by lumbar-CT of lumbar-MRI were observed from July, 2014 to April, 2015. They were analyzed according to sex, age, the period of disease, causal factors, symptoms on admission, admission day, disc herniation type and treatment efficacy. All patients received a combination of treatments during hospitalization, including acupuncture, Chuna, herbal medicines and physical therapy. A zero to ten numerating rating scale(NRS) assessing pain, Oswestry disability index(ODI) and EuroQol-5 dimension(EQ-5D) was used before and after treatments. Results : Average admission duration was $28.00{\pm}12.85$ days in lumbar disc patients. For lumbar patients, lower back pain NRS decreased from $5.89{\pm}2.00$ to $3.42{\pm}1.87$(p<0.001) and radiating pain from $5.96{\pm}2.12$ to $3.38{\pm}1.83$(p<0.001). ODI decreased from $46.69{\pm}19.25$ to $35.69{\pm}16.67$(p<0.001), and EQ-5D index increased from $0.63{\pm}0.26$ to $0.71{\pm}0.20$(p<0.05) after treatment in lumbar disc patients. Conclusions : Korean medical combination treatment might be effective in reducing pain and improving quality of life for patients with lumbar disc herniation. This study further confirmed the efficacy of Korean medical treatment on HIVD.

A Minimally Invasive Rabbit Model of Progressive and Reproducible Disc Degeneration Confirmed by Radiology, Gene Expression, and Histology

  • Kwon, Young-Joon
    • Journal of Korean Neurosurgical Society
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    • 제53권6호
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    • pp.323-330
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    • 2013
  • Objective : To develop a simple, reproducible model of disc degeneration in rabbits through percutaneous annular puncture and to confirm the degree of degeneration over time. Methods : Fifteen New Zealand white rabbits (4 to 5 months old and weighing approximately 3 to 3.5 kg each) underwent annular puncture of the L2-L3, L3-L4, and L4-L5 discs. Rabbits were sacrificed at 4, 8, or 20 weeks after puncture. For a longitudinal study to assess changes in disc height over time, serial X-rays were performed at 0, 2, 4, 8, and 20 weeks for rabbits in the 20-week group. Upon sacrifice, the whole spinal column and discs were extracted and analyzed with magnetic resonance imaging (MRI), real time reverse transcriptase-polymerase chain reaction, and histological staining. Results : The X-rays showed a slow, progressive decrease in disc height over time. Significant disc space narrowing compared to preoperative disc height was observed during the time period (p<0.001). The MRI grade, aggrecan, and matrix metalloprotease-13 mRNA expression and hematoxylin and eosin/safranin O/anti-collagen II staining were consistently indicative of degeneration, supporting the results of the X-ray data. Conclusion : Percutaneous annular puncture resulted in slow, reproducible disc degeneration that was confirmed by radiology, biochemistry, and histology. This in vivo model can be used to study and evaluate the safety and efficacy of biologic treatments for degenerative disc disease.

요추 추간판 탈출증에 대한 경피적 내시경 레이저 수핵 제거술 후 임상 결과 (Clinical Outcomes of Percutaneous Endoscopic Laser Lumbar Discectomy)

  • 장원석;이상호
    • The Korean Journal of Pain
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    • 제18권1호
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    • pp.34-38
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    • 2005
  • Background: Over the years, disc surgery has progressively evolved in the direction of decreasing trauma and its invasiveness. Conventional open surgery has many complications, such as scarring, instability, bleeding and a relative high mortality rate. Minimally invasive spinal surgery is now an alternative to a traditional discectomy. Herein, we present an operative technique, and the early results, for a percutaneous endoscopic lumbar discectomy in herniated lumbar disc disease. Methods: 43 patients, including 27 men and 16 women, with ages ranging from 18 to 66 years, were enrolled in this study. All the patients showed a protruded or extruded soft disc herniation at the lumbar level on magnetic resonance imaging and computed tomography. A percutaneous endoscopic lumbar discectomy was applied to the patients, and clinical responses evaluated using MacNab's criteria. Results: 40 patients were regarded as showing successful responses (93.1%), and there were no severe complications, such as a hematoma, nerve injury, postoperative dysesthesia or death. One patient underwent fusion surgery for remnant back pain six month later. Conclusions: We conclude that, in properly selected patients, a percutaneous endoscopic lumbar discectomy is a safe, noninvasive and effective treatment modality for herniated lumbar intervertebral disc disease.

허리디스크 환자를 위한 허리보호용 이너웨어 개발 연구(제2보) -여성 이너웨어 개발과 착의평가- (A Study on the Development of Protective Inner Wear for Lumbar Disc Disease Patients (Part II) -Development of Female Inner Wear and Wearing Test-)

  • 강혜진;정명숙
    • 한국의류학회지
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    • 제41권1호
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    • pp.141-152
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    • 2017
  • The lumbar disc is one of the first parts of the human body to age. Female discs start to age at twenty and completely age between fifty and sixty. The number of lumbar herniated intervertebral disc patients is increasing rapidly; however, studies on protective inner wear are insufficient. This study develops protective inner wear equipment for bodies. The following were the study methods and procedures. First, the protective design, pattern and making of the inner wear were based on the analysis of collected data. Second, one subject was selected, then human body parts were measured to create the inner protective pattern. The inner pattern was made by the basic size of the subject. The inner protective equipment was made for lumbar disc disease patients after a wearing test and after correcting the pattern. Third, inner protective equipment was thoroughly tested to verify the compatibility of lumbar pads. The following were the study results and observations. First, lumbar pads who had inner protection were easily worn and the design was very ladyish in contrast to other lumbar pads on the market. Second, the pattern was completed by referring to, Lee Hyoung Sook's, torso and her lumbar pad shape. The fabric was mesh (for good ventilation) and poly spandex (for elasticity). Third, lumbar inner protective equipment was verified through a subject assessment and a major assessment. This study showed high scores on appearance and functional satisfaction versus existing disc lumbar pads in the market. This study predicts that new waist protective inner wear can help the female patient's health and social life because it has great functionality and can maintain outer line patterns.