• Title/Summary/Keyword: intervertebral disc disease

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A Case with Spondyloepiphyseal Dysplasia Tarda with TRAPPC2 Mutation

  • Kim, Hyun-Jin;Lee, Beom-Hee;Kim, Yoo-Mi;Kim, Gu-Hwan;Kim, Ok-Hwa;Yoo, Han-Wook
    • Journal of Genetic Medicine
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    • v.9 no.1
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    • pp.31-34
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    • 2012
  • Spondyloepiphyseal dysplasia tarda (SEDT) is an X-linked skeletal dysplasia. Patients show disproportionate short stature with short trunk and barrel-shaped chest, which usually become pronounced in late childhood. The radiologic findings are characterized by narrow intervertebral disc spaces and moderate epiphyseal dysplasia of long bones. Here we report a case of SEDT with a novel frameshift mutation in TRAPPC2, the disease-causing gene of SEDT. This is the first Korean report with SEDT confirmed by genetic testing.

An Analysis on Present Condition of the Cooperative Medical Care Using the Episode of Care : Claims Data of HEALTH INSURANCE REVIEW & ASSESSMENT SERVICE (진료 에피소드를 이용한 협진 의료이용 현황 분석 : 건강보험심사평가원 청구자료를 중심으로)

  • Uhm, TaeWoong;Kim, Nam-Kwen;Kim, Sina
    • Journal of Society of Preventive Korean Medicine
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    • v.19 no.2
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    • pp.51-56
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    • 2015
  • Objective : We analyzed present condition of cooperative medical care using claims data of HEALTH INSURANCE REVIEW & ASSESSMENT SERVICE form patients treated by Korean-Western cooperative medicine. The study aimed to offer guidelines in selecting disease-related research in developing Korean-Western convergence technology. Method : Based on the patients using Korean medical service, we analyzed claims data of patients using Korean medical service and western medical service from January 2012 to December 2013. We were assigned to the server remotely. With the concept of 'episode of care', we rebuilt claims data and analyzed present condition of cooperative medical usage. Results : We analyzed present condition of cooperative medical care per episode of care. Among outpatients, Low back pain, lumbar region(M5456) was the highest number. Among inpatients, Sciatica due to intervertebral disc disorder(M511) was the highest number. Conclusion : Based on the claims data provided by HEALTH INSURANCE REVIEW & ASSESSMENT SERVICE, we have derived a list of multy frequently disease frequently treated by cooperative medical care by analyzing present condition.

Case Report of spinal meningeal cyst patient treated with by bee venom therapy (봉약침요법으로 치료한 요추부 척수강내 낭종 1례에 대한 증례보고)

  • Hwang, Ook;Kim, Jung-sin;Jun, Hyung-joon;Nam, Sang-soo;Kim, Yong-suk
    • Journal of Acupuncture Research
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    • v.20 no.3
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    • pp.217-228
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    • 2003
  • Objective : Spinal meningeal cysts can be the cause of the low back pain and sciatica. We tried to manage the low back pain and sciatica caused by other disease besides intervertebral disc herniation. Methods : We treated the patient who diagnosed as spinal meningeal cyst and hospitalized. And we investigate the progress of physical condition, VAS, modified VAS, PRS by treatment and MRI before and after treatment. Results : There was remarkable improvement in condition of the patient who has spinal meningeal cyst after bee venom therapy. We found the size of cyst decreased in MRI and also progress in VAS modified VAS PRS physical view improved. Conclusions : We think that the result of this case can be a pilot study that proves the effect of bee venom therapy the low back pain and sciatica caused by variable disease.

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An Economic Evaluation of Thread Embedding Acupuncture for the Treatment of Lumbar Herniated Intervertebral Disc in a Randomized Controlled Clinical Trial

  • Kim, Ha-Na;Kim, Jun-Yeon;Park, Kyeong-Ju;Hwang, Ji-Min;Jang, Jun-Yeong;Jo, Min-Gi;Ko, Min-Jung;Chae, Sang-Yeup;Kim, Jung-Hyun;Goo, Bonhyuk;Park, Yeon-Cheol;Seo, Byung-Kwan;Baek, Yong-Hyeon;Nam, Sang-Soo
    • Journal of Acupuncture Research
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    • v.38 no.4
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    • pp.312-319
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    • 2021
  • Background: Lumbar herniated intervertebral disc (LHIVD) is a frequently presented condition/disease in Korean medical institutions. In this study, the economics of thread embedding acupuncture (TEA) was evaluated in a randomized controlled trial comparing TEA with sham TEA (STEA). Methods: This economic evaluation was analyzed from a limited social perspective, and the per-protocol set was from a basic analysis perspective. The cost-effectiveness analysis was based on the change in visual analog scale score, and the cost-utility analysis was based on the quality-adjusted life years. The final results were expressed as the average cost-effectiveness ratio and incremental cost-effectiveness ratio, and furthermore sensitivity analysis was performed to confirm the robustness of the results observed. Results: The cost-effectiveness analysis showed that TEA was 9,908 won lower than STEA, while the decrease in 100 mm visual analog scale score was 8.5 mm greater in the TEA group compared with the STEA group (p > 0.05). The cost-utility analysis showed that TEA was 9,908 won lower than STEA, while the quality-adjusted life years of TEA was 0.0026 years higher than STEA (p > 0.05). These results were robust in the sensitivity analysis, but were not statistically significant. Conclusion: In treating LHIVD, TEA appeared to have cost-effectiveness and cost-utility compared with STEA. However, there were no significant differences between the groups in terms of cost, effectiveness, and utility indicators. Therefore, results must be interpreted prudently; this study was the 1st to conduct an economic evaluation of TEA for LHIVD.

Clinical Outcomes of Percutaneous Lumbar Discectomy Using Dekompressor(R) (Dekompressor(R)를 이용한 요부의 경피적 추간판 감압술의 임상 결과)

  • Han, Sun Sook;Sim, Sung Eun;Kim, Yang Hyun;Lee, Eun Hyoung;Joh, Ju Yeon;Kim, Ji Young;Lee, Sang Chul
    • The Korean Journal of Pain
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    • v.18 no.2
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    • pp.187-191
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    • 2005
  • Background: Discogenic leg pain is a major cause of health problems, often due to herniation of the intervertebral disc, and has traditionally been treated conservatively or with an open surgical discectomy. Conventional open surgery has many complications, such as nerve root injury, discitis and a relatively high mortality rate; failure of conservative treatments is also common. Recently, the $Dekompressor^{(R)}$ Percutaneous Lumbar Discectomy probe was developed. Herein, we present the early results for a percutaneous lumbar discectomy in herniated lumbar disc disease. Methods: Eleven patients, including 8 men and 3 women, with ages ranging from 22 to 78 years, were enrolled in this study. Those patients with a previous history of back surgery were not excluded from the study. All patients were postoperatively evaluated for their clinical outcomes, such as visual analogue scale (VAS) for pain after 1 and 3 months, reduction in analgesics, functional improvement and overall satisfaction. Results: The percutaneous lumbar discectomy was completed in 11 patients (17 levels), with average reductions in pre-VAS of 61.3 and 60.2% at 1 and 3 months, respectively. Also, 72.7% of patients reported functional improvement, with 81.1% expressing overall satisfaction. There were no procedural related complications. Conclusions: We concluded that a percutaneous lumbar discectomy is a safe and effective treatment modality for a herniated lumbar disc.

Study on the Movement of New Qi-gong "WuQinXi" Exercise for Lumbar Spinal Disease : Based on 20 Mode, 30 Mode, 40 Mode (요추 질환에 대한 신기공 오금희의 동작연구 - 20식, 30식, 40식을 중심으로 -)

  • You, Kyung Gon;Kwon, Young Dal;Jeong, Hyun Woo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.28 no.2
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    • pp.129-136
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    • 2014
  • The "WuQinXi" exercise, one of the medical Qi-gongs, is an exercise maximizing human's self healing power and has been confirmed to be effective significantly at several modern researches. There are many exercise therapies in western medcine, such as Willams's flexion exercise, Mckenzie's extension exercise, vertebral stabilization exercise and so on. However, there isn't a special exercise therapy which can be applied for medical practice in oriental medicine. So we selected 24 motions which are related with lumbar movements from 3 type "WuQinXi" exercises ; 20 mode, 30 mode, and 40 mode. And then, we classified them according to lumbar movements as flexion, extention, lateral bending and rotation, and also functions as stabilization and rubbing. Next, with these classifications, we assorted them by kinds of lumbar spinal disease as HIVD(herniation of intervertebral disc), spinal stenosis, spondylolysis and spondylolisthesis, facet joint syndrome, compression fracture and spondylosis. We expect that "WuQinXi" exercise be a exercise therapy for lumbar spinal disease at an oriental medical clinic in this way. Oriental medical doctors will be able to teach easily patients "WuQinXi" exercise's motions at clinic, depending on kinds of lumbar spinal disease each patient suffers from. We plan to study the effect of "WuQinXi" exercise by comparing patients who do the "WuQinXi" exercise with the patients who do the western medical exercise therapy.

Risk Factors of Allogenous Bone Graft Collapse in Two-Level Anterior Cervical Discectomy and Fusion

  • Woo, Joon-Bum;Son, Dong-Wuk;Lee, Su-Hun;Lee, Jun-Seok;Lee, Sang Weon;Song, Geun Sung
    • Journal of Korean Neurosurgical Society
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    • v.62 no.4
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    • pp.450-457
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    • 2019
  • Objective : Anterior cervical discectomy and fusion (ACDF) is commonly used surgical procedure for cervical degenerative disease. Among the various intervertebral spacers, the use of allografts is increasing due to its advantages such as no harvest site complications and low rate of subsidence. Although subsidence is a rare complication, graft collapse is often observed in the follow-up period. Graft collapse is defined as a significant graft height loss without subsidence, which can lead to clinical deterioration due to foraminal re-stenosis or segmental kyphosis. However, studies about the collapse of allografts are very limited. In this study, we evaluated risk factors associated with graft collapse. Methods : We retrospectively reviewed 33 patients who underwent two level ACDF with anterior plating using allogenous bone graft from January 2013 to June 2017. Various factors related to cervical sagittal alignment were measured preoperatively (PRE), postoperatively (POST), and last follow-up. The collapse was defined as the ratio of decrement from POST disc height to follow-up disc height. We also defined significant collapses as disc heights that were decreased by 30% or more after surgery. The intraoperative distraction was defined as the ratio of increment from PRE disc height to POST disc height. Results : The subsidence rate was 4.5% and graft collapse rate was 28.8%. The pseudarthrosis rate was 16.7% and there was no association between pseudarthrosis and graft collapse. Among the collapse-related risk factors, pre-operative segmental angle (p=0.047) and intra-operative distraction (p=0.003) were significantly related to allograft collapse. The cut-off value of intraoperative distraction ${\geq}37.3%$ was significantly associated with collapse (p=0.009; odds ratio, 4.622; 95% confidence interval, 1.470-14.531). The average time of events were as follows: collapse, $5.8{\pm}5.7months$; subsidence, $0.99{\pm}0.50months$; and instrument failure, $9.13{\pm}0.50months$. Conclusion : We experienced a higher frequency rate of collapse than subsidence in ACDF using an allograft. Of the various preoperative factors, intra-operative distraction was the most predictable factor of the allograft collapse. This was especially true when the intraoperative distraction was more than 37%, in which case the occurrence of graft collapse increased 4.6 times. We also found that instrument failure occurs only after the allograft collapse.

Should We Start Treating Chronic Low Back Pain with Antibiotics Rather than with Pain Medications?

  • Birkenmaier, Christof
    • The Korean Journal of Pain
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    • v.26 no.4
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    • pp.327-335
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    • 2013
  • For those of us who have read the 2 recently published articles by a Danish - British research group, it might appear that we are observing an impending paradigm shift on the origins of chronic low back pain. The results of this research indicate, that chronic low back pain associated with bone marrow edema in vertebral endplates that are adjacent to herniated intervertebral discs may be caused by infections with anaerobic bacteria of low virulence. According to these articles, treatment with certain antibiotics is significantly more effective than placebo against this low back pain. If these findings are to hold true in repeat studies by other researchers, they stand to fundamentally change our concepts of low back pain, degenerative disc disease and in consequence the suitable therapies for these entities. It may in fact require pain specialists to become familiarized with the details of antibiotic treatments and their specific risks in order to be able to properly counsel their patients. While this seems hard to believe at first glance, bacteria have been implicated in the pathogenesis of other conditions that do not primarily impose as infectious diseases such as gastric ulcers. While the authors refer to a few previous studies pointing into the same direction, the relevant research is really only from one group of collaborating scientists. Therefore, before we start prescribing antibiotics for chronic low back pain, it is imperative that other researchers in different institutions confirm these results.

Zoster Paresis Misconceived as a Radiculopathy due to Herniated Intervertebral Disc (추간판 탈출증에 의한 신경근병증으로 오인된 대상포진성 부전마비)

  • Kim, Hyun Jee;Yeo, Jin Seok;Jeon, Young Hun;Choi, Jy Young;Ha, Mi Jin;Hong, Jung Gil
    • The Korean Journal of Pain
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    • v.22 no.2
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    • pp.181-185
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    • 2009
  • Herpes zoster is a viral disease of the posterior root ganglion and sensory nerve fiber, which presents clinically with vesicular eruption of the skin, radicular pain and sensory changes in the distribution of the affected ganglion. However, involvement of the motor neurons can be seen as well. If classic cutaneous lesions are present, herpes zoster-related motor paresis is easily diagnosed. Otherwise, the diagnosis may be more difficult and suspicious, especially if weakness occurs as a symptom before cutaneous lesions appear, or abnormal findings on the MRI are consistent with the signs. There have been few reports of sciatica with motor loss preceding skin lesions. Here, we report a patient with herpes zoster-related motor paresis preceding skin lesions. In the preliminary diagnosis, the herpes zoster-related motor paresis was confused for some structural disorder.

Anterior Cervical Interbody Fusion with the Carbon Composite Osta-Pek Frame Cage in Degenerative Cervical Diseases

  • Han, Kwang-Wook;Kim, Joon-Soo;Kim, Kyu-Hong;Cho, Yong-Woon;Lee, In-Chang;Bae, Sang-Do
    • Journal of Korean Neurosurgical Society
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    • v.37 no.6
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    • pp.422-426
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    • 2005
  • Objective: Different types of interbody fusion cages are available for use in the surgical treatment of degenerative cervical diseases. The purpose of this study is to assess the technical feasibility, clinical efficacy and radiological results of intervertebral fusion with a carbon composite Osta-Pek frame cage (Co-Ligne AG, Switzerland) following anterior cervical discectomy. Methods: 41 patients (25males and 16females) with minimum 6months follow-up were included in the study. Disc height, cervical lordotic angle, segmental angle, and fusion rate were assessed by lateral radiographs. In this retrospective analysis, clinical outcome was assessed as evaluated according to Odom's criteria. Results: Fifty-four cages were implanted in 30 single-level, 9 two-level, and 2 three-level procedures. The mean disc height, cervical lordosis angle, segmental angle were $4.2{\pm}1.8mm,\;23.5{\pm}7.2^{\circ},\;2.3{\pm}3.3^{\circ}$ pre-operatively and $5.3{\pm}2.1mm,\;24.2{\pm}8.3^{\circ},\;3.8{\pm}3.5^{\circ}$ at 6months after the surgery. Six months after surgery, there was radiographic evidence of fusion in 92.7% (38/41) of the patients. According to Odom's criteria, 37 of 41 (90.2%) patients experienced good to excellent functional recovery. Conclusion: These clinical and radiological results suggest that the carbon composite Osta-Pek frame cages are safe and effective alternative to autologous bone graft after anterior cervical discectomy for treatment of degenerative cervical disease.