• 척추신경추나의학회지
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• 제5권1호
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• pp.67-80
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• 2010

Objectives : This study is to investigate the clinical application of conservative oriental medical treatment to a patient who were diagnosed as 'Sequestrated disc' on MRI. Methods: We evaluated 5 patients. who were diagnosed as 'Sequestrated disc' on MRI. after conservative oriental medical treatment by Numeric Rating Scale(NRS), Straight Leg Rasing Test(SLRT) and MRI follow-up. Result: 5 patients showed significant improvement in Numeric Rating Scale(NRS). Straight Leg Rasing Test(SLRT) after conservative oriental medical treatment. Also their sequestrated disc were significantly dissapeared or decreased in volume on MRI after the treatment. Conclusion: Conservative oriental medical treatment can be effective for improving pain and volume of herniated disc for patients with sequestrated disc.

• Journal of Acupuncture Research
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• 제19권6호
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• pp.256-263
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• 2002

Objective : This study is to report the radiological change after bee venom therapy about the patient of sequestrated disc. Methods : there was a report that the bee venom therapy was effective treatment on the patient of extruded or sequestrated disc. So we treated the patient who was diagnosed as sequestrated disc and hospitalized, and investigated the change of DITI, simple X-rays and MRI before and after treatment. Results : There was remarkable improvement in condition of the patient who had extruded or sequestrated disc after treated by bee venom therapy. It showed that the region of sequestrated L4-5 dise remarkably decreased in MRI, degree of scoliosis decreased from 17 degree to 15 degree in simple X-ray and the difference of right and left became equal in DITI through the follow-up survey. Conclusions : There was reports that bee venom therapy had antinflammatory and antalgic effect and was effective in treating patient of sequestrated disc and in curing pain, functional disorder, and clinical symptom of HIVD patients by means of grade index of lumbago. We think that the result of this study will be supporting data (that will be able to) proves more objectively the change following the improvement of condition with radiological check.

• Journal of Korean Neurosurgical Society
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• 제47권3호
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• pp.217-220
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• 2010

A 73-year-old male presented with a rare dorsally sequestrated lumbar disc herniation manifesting as severe radiating pain in both leg, progressively worsening weakness in both lower extremities, and urinary incontinence, suggesting cauda equina syndrome. Magnetic resonance imaging suggested the sequestrated disc fragment located in the extradural space at the L4-L5 level had surrounded and compressed the dural sac from the lateral to dorsal sides. A bilateral decompressive laminectomy was performed under an operating microscope. A large extruded disc was found to have migrated from the ventral aspect, around the thecal sac, and into the dorsal aspect, which compressed the sac to the right. After removal of the disc fragment, his sciatica was relieved and the patient felt strength of lower extremity improved.

• Journal of Acupuncture Research
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• 제18권6호
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• pp.84-92
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• 2001

Objectives : We defined that the ruptured disc is extruded trans ligamentous through the posterior longitudinal ligament or sequestrated. The authors have experienced 12 cases of ruptured disc that underwent the conservative treatment. We studied the effect and possibility of the conservative treatment for the ruptured disc. Methods : The patients with ruptured disc have underwent the conservative treatment. After the treatment, we compare pre-treatment with post treatment in the view of state of patients' ambulation and physical conditions. Results : In this study, 12 cases of ruptured disc have underwent the conservative oriental treatment. After the treatment, 75% of the cases were improved above good state Conclusion : The ruptured disc has been operated universally. Except the emergency state, the conservative treatment is helpful to improve the symptoms of the patients with ruptured disc.

• Journal of Korean Neurosurgical Society
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• 제52권2호
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• pp.156-158
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• 2012

Intervertebral intradural lumbar disc herniation (ILDH) is a quite rare pathology, and isolated intradural lumbar disc herniation is even more rare. Magnetic resonance imaging (MRI) may not be able to reveal ILDHs, especially if MRI findings show an intact lumbar disc annulus and posterior longitudinal ligament. Here, we present an exceedingly rare case of an isolated IDLH that we initially misidentified as a spinal intradural tumor, in a 54-year-old man hospitalized with a 2-month history of back pain and right sciatica. Neurologic examination revealed a positive straight leg raise test on the right side, but he presented no other sensory, motor, or sphincter disturbances. A gadolinium-enhanced MRI revealed what we believed to be an intradural extramedullary tumor compressing the cauda equina leftward in the thecal sac, at the L2 vertebral level. The patient underwent total L2 laminectomy, and we extirpated the intradural mass under microscopic guidance. Histologic examination of the mass revealed a degenerated nucleus pulposus.

• Journal of Korean Neurosurgical Society
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• 제46권6호
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• pp.515-521
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• 2009

Objective : The purpose of this study was to compare clinical and radiological outcomes of percutaneous endoscopic lumbar discectomy (PELD) and open lumbar microdiscectomy (OLM) for recurrent disc herniation. Methods : Fifty-four patients, who underwent surgery, either PELD (25 patients) or repeated OLM (29 patients), due to recurrent disc herniation at L4-5 level, were divided into two groups according to the surgical methods. Excluded were patients with sequestrated disc, calcified disc, severe neurological deficit, or instability. Clinical outcomes were assessed using Visual Analogue Scale (VAS) score and Oswestry Disability Index (ODI). Radiological variables were assessed using plain radiography and/or magnetic resonance imaging. Results : Mean operating time and hospital stay were significantly shorter in PELD group (45.8 minutes and 0.9 day, respectively) than OLM group (73.8 minutes and 3.8 days, respectively) (p < 0.001). Complications occurred in 4% in PELD group and 10.3% in OLM group in the perioperative period. At a mean follow-up duration of 34.2 months, the mean improvements of back pain, leg pain, and functional improvement were 4.0, 5.5, and 40.9% for PELD group and 2.3, 5.1, and 45.0% for OLM group, respectively. Second recurrence occurred in 4% after PELD and 10.3% after OLM. Disc height did not change after PELD, but significantly decreased after OLM (p = 0.0001). Neither sagittal rotation angle nor volume of multifidus muscle changed significantly in both groups. Conclusion : Both PELD and repeated OLM showed favorable outcomes for recurrent disc herniation, but PELD had advantages in terms of shorter operating time, hospital stay, and disc height preservation.