• Title/Summary/Keyword: spinal decompression

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Effect of whole body cryotherapy with spinal decompression on lumbar disc herniation by functional assessment measures (기능적 평가 측정을 통하여 전신냉기치료와 척추 감압기 적용이 요추 추간판 탈출증 환자에게 미치는 효과)

  • Ma, Sang-Yeol
    • Journal of the Korean Data and Information Science Society
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    • v.21 no.6
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    • pp.1101-1108
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    • 2010
  • This study was conducted to investigate whether whole body cryotherapy and spinal decompression have effectiveness on the pain, lumbar flexion range of motion, and global perceived effect scale in patients with lumbar disc herniation. Thirty subjects were participated in this study. And they were all randomly divided into whole body cryotherapy and spinal decompression group. To evaluate the effects of whole body cryotherapy and spinal decompression, subjects were evaluated by using visual analogue scale, lumbar flexion range of motion, and global perceived effect scale. The assessment parameters were evaluated before, after 2 weeks treatments. And we received a consent form whole body cryotherapy subjects. The results of paired t-test, independent t-test, and ANCOVA analysis of variance showed that pain, lumbar flexion range of motion, global perceived effect scale were significantly improved after than before therapy in whole body cryotherapy group. So we conclude that whole body cryotherapy has effectiveness on the pain, lumbar flexion range of motion, and global perceived effect scale in patients with lumbar disc herniation.

Acute Spinal Epidural Hematoma Following Unilateral Laminectomy for Bilateral Decompression

  • Lee, Dong-Yeob;Lee, Sang-Ho;Jang, Jee-Soo
    • Journal of Korean Neurosurgical Society
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    • v.40 no.1
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    • pp.35-37
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    • 2006
  • We present a case of acute spinal epidural hematoma[EDH] following unilateral laminectomy for bilateral decompression[ULBD]. A 45-year-old male presented with severe multi-level spinal stenosis underwent ULBD on the left side at the L2-3 and L3-4 level. Five hours after operation, paraparesis developed along with severe bilateral buttock pain. The CT scan showed an acute spinal EDH at the L2-3 level. The acute spinal EDH was successfully decompressed after emergency decompressive surgery with performing an additional laminectomy on the contralateral side at the L2-3 level. Although ULBD is an effective minimally invasive surgical technique for treating spinal stenosis, the possibility of acute spinal EDH should be kept in mind, as happened in our case.

The Clinical Studies for Non Surgical Spinal Decompression Treatment on Cervical Disc Herniation (경추추간판 탈출증환자의 감압치료 병행효과에 대한 임상적 연구)

  • Seo, Sang-Kyoung;Kim, Byoung-Jung;Park, Kuk-Ji;Kang, Jun-Hyuk;Kim, Seong-Ki;Seo, Deok-Won
    • Journal of Korean Medicine Rehabilitation
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    • v.21 no.4
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    • pp.131-143
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    • 2011
  • Objectives: The purpose of this study is to make a survey of the effectiveness of the non surgical spinal decompression treatment in patients with cervical disc herniation documented on magnetic resonance imaging(MRI). Methods: We studied about 27 cases of cervical disc herniation which were treated with non surgical spinal decompression and other medical treatment (acupuncture, interferential current therapy and ice poultice). Each patient has been treated with spine decompression and other medical treatment. And degree of improvement has been evaluated by short form-McGill pain questionnaire(SF-MPQ), visual analogue scale(VAS) and neck disability index(NDI) before treatment and 5th, 10th times after treatments. Results: 1. The VAS SF-MPQ and NDI scores showed statistically significant improvement after 5th and 10th treatment. 2. The VAS, SF-MPQ and NDI scores after 5th treatment showed better improvement than those of after 10th treatment. 3. The VAS, SF-MPQ and NDI scores in Subacute stage showed more statistically significant improvement among the other stages. Conclusions: As a result, non surgical spinal decompression treatment has clinical effects of pain reduction on patient with cervical disc herniation.

Change of the Intervertebral Foraminal Pressure after Removal of the Disc Material (디스크 제거 후 추간공내 압력의 변화)

  • Hong, Chang Kie;Park, Chong Oon;Hyun, Dong Keun;Ha, Young Soo
    • Journal of Korean Neurosurgical Society
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    • v.30 no.2
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    • pp.144-149
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    • 2001
  • Objective : Spinal nerve root compression occurs commonly in conditions, such as herniated nucleus pulposus, spinal stenosis, intervertebral foraminal stenosis, and trauma. However, the pathophysiolosy of the symptoms and signs related to spinal nerve root compression is poorly understood. The purpose of the present study was to assess and compare the changes of various pressures of intervertebral foraminal pressure before and after decompression. Method : After laminetomy without foraminotomy was performed, pressure sensor tip of Camino parenchymal type was located at the middle-central portion of the intervertebral foramen and anterior portion of nerve root for the foraminal pressure before decompression of the intervertebral foramen. After laminectomy with foraminotomy, the same method was used for the foraminal pressure after decompression. The authors studied 40 consecutive patients (57 disc spaces) with severe constant root pain to the lower leg, pain unrelived by bed rest, and minimal tension signs, diagnosed by MRI. Results : In patients with intervertebral foraminal stenosis, the intraforaminal pressure was decreased from $86{\pm}2.23mmHg$ to $17.1{\pm}1.51mmHg$ and in patients without stenosis, from $55.9{\pm}1.08mmHg$ to $11.9{\pm}1.25mmHg$. All patients below 20mmHg after decompression showed good outcome, but 4 cases who showed poor outcome had foraminal stenosis, posterolateral type of the herniated disc, and above 30mmHg of foraminal pressure after decompression. Conclusion : These findings suggest that if the foraminal pressure falls below 20mmHg after decompression, good outcome can be anticipated. Central type of the herniated disc shows better outcome compared to the posterolateral type.

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Lateral Laminectomy in Thoracolumbar Disc Herniated Dogs (흉요추 추간원반탈출증 권에서의 편측 추궁절제술)

  • 엄기동;윤정회
    • Journal of Veterinary Clinics
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    • v.15 no.2
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    • pp.255-262
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    • 1998
  • Lateral laminectomy was performed far spinal decompression in 7 thoracolumbar disc herniated dogs. These dogs showed upper motor neurologic signs including kyphosisi urinary dysfunction, and paraplegia or paralysis in hindlimbs. The lesions were evaluated with myelographic findings and predominated in $T_{12}-T_{13}, T_{13}-L_{1} and L_{1}-L_{2}$ discs. Five dogs which were operated within 48 hours after the onset of paraplegia were recovered from kyphosis and sustained the normal gait and walkings furthermore normal urination and defecation were presented within 3 days of postoperation. One dog was expired with steroid induced intestinal bleeding. The other dog operated on 96 hours after the onset of paraplegia was not recovered from neurologic deficits. Spinal decompression technique was considered to be useful method fur improving neurological problems resulted firom thoracolumbar disc herniation, if dogs are operated on early stage of the onset of paraplegia.

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Efficacy of Unilateral Laminectomy for Bilateral Decompression in Elderly Lumbar Spinal Stenosis

  • Ji, Yong-Cheol;Kim, Young-Baeg;Hwang, Sung-Nam;Park, Seung-Won;Kwon, Jeong-Taik;Min, Byung-Kook
    • Journal of Korean Neurosurgical Society
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    • v.37 no.6
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    • pp.410-415
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    • 2005
  • Objective: The aim of our study is to evaluate the effectiveness of unilateral hemilaminectomy for bilateral decompression in elderly patients with degenerative spinal stenosis. For this purpose, we studied the co-morbid condition and clinical outcome of patients who underwent decompressive surgery using the unilateral approach technique. Methods: Thirty-four patients over 65years of age who underwent unilateral partial laminectomy for bilateral decompression from January 2000 to October 2003 were analyzed. These patients were studied for preoperative co-morbid condition and physical status according to the American Society of Anesthesiologists(ASA) classification, postoperative morphometrical change, and clinical outcomes, including visual analogue scale(VAS) score. The mean follow-up was 23months (range 6 - 48months). Results: A patient's physical status was recorded as class I, II, or III by ASA classification, which correlated to 41.2%, 44.1%, and 14.7% of patients, respectively. The cross-sectional area of the pre- and postoperative dural sac at the level of the stenosis was $52.5{\pm}19.9mm^2$ and $110.6{\pm}18.2mm^2$, respectively. The outcome was excellent in 8.8%, good in 58.8%, fair in 23.6%, and poor in 8.8% of the patients. The VAS was changed postoperatively to $3.1{\pm}1.2$. There was no operation-related transfusion yet there was no evidence of postoperative instability at the follow-up examination. Conclusion: Unilateral laminectomy for bilateral decompression, in spite of the limited exposure, can result in satisfactory decompression of the lumbar spinal stenosis and tolerable clinical outcome. This approach is thought to be appropriate for elderly patients who have a greater surgical burden.

Usefulness of Intraoperative Monitoring during Microsurgical Decompression of Cervicomedullary Compression Caused by an Anomalous Vertebral Artery

  • Kim, Sung Tae;Paeng, Sung Hwa;Jeong, Dong Mun;Lee, Kun Soo
    • Journal of Korean Neurosurgical Society
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    • v.56 no.6
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    • pp.513-516
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    • 2014
  • We report a case of cervicomedullary compression by an anomalous vertebral artery treated using microsurgical decompression with intraoperative monitoring. A 68-year-old woman presented with posterior neck pain and gait disturbance. MRI revealed multiple abnormalities, including an anomalous vertebral artery that compressed the spinal cord at the cervicomedullary junction. Suboccipital craniectomy with C1 laminectomy was performed. The spinal cord was found to be compressed by the vertebral arteries, which were retracted dorsolaterally. At that time, the somatosensory evoked potential (SSEP) changed. After release of the vertebral artery, the SSEP signal normalized instantly. The vertebral artery was then lifted gently and anchored to the dura. There was no other procedural complication. The patient's symptoms improved. This case demonstrates that intraoperative monitoring may be useful for preventing procedural complications during spinal cord microsurgical decompression.

Unilateral Biportal Endoscopic Spinal Surgery Using a 30° Arthroscope for L5-S1 Foraminal Decompression

  • Kim, Ju-Eun;Choi, Dae-Jung
    • Clinics in Orthopedic Surgery
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    • v.10 no.4
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    • pp.508-512
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    • 2018
  • Foraminal decompression using a minimally invasive technique to preserve facet joint stability and function without fusion reportedly improves the radicular symptoms in approximately 80% of patients and is considered one of the good surgical treatment choices for lumbar foraminal or extraforaminal stenosis. However, proper decompression was not possible because of the inability to access the foramen at the L5-S1 level due to prominence of the iliac crest. To overcome this challenge, endoscopy-based minimally invasive spine surgery has recently gained attention. Here, we report the technical skills required in unilateral extraforaminal biportal endoscopic spinal surgery using a $30^{\circ}$ arthroscope to enable foraminal decompression at the L5-S1 level. Two 0.8-cm portals were created 2 cm lateral from the lateral border of the pedicles at the L5-S1 level. After sufficient working space was made, half of the superior articular process (SAP) in the hypertrophied facet joint was removed using a high-speed burr and a 5-mm wide osteotome, whereas the remaining inside part of the SAP was removed using a Kerrison punch and pituitary punch. The foraminal ligamentum flavum should be removed to inspect the conditions of the L5 exiting root and disc. Removing of the extruded disc could decompress the L5 root. The extraforaminal approach using a $30^{\circ}$ arthroscope is considered a minimally invasive alternative technique for decompressing foraminal stenosis at the L5-S1 level that preserves facet stability and provides symptomatic relief.

Effect of Cervical Spinal Decompression on the Cervical Muscle Tone and Disc Height in Patients with Cervical Intervertebral Disc Herniation

  • Kang, Jeong il;Jeong, Dae Keun;Choi, Hyun
    • Journal of International Academy of Physical Therapy Research
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    • v.9 no.1
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    • pp.1420-1425
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    • 2018
  • The purpose of this study was to investigate the effect of traction and decompression therapies on the cervical muscle tone and disc height. The decompression group (n=16) received decompression therapy and Mckenzie exercises once a day and four times a week respectively, for three weeks. The traction group (n=15) also received traction therapy and Mckenzie exercises for the same period. Muscle tone was measured with a myotonometer, and the disk height was measured using magnetic resonance imaging (MRI), before the interventions. Three weeks later, we investigated the therapeutic effect by repeating these measurements. The difference in disk height between the two groups was not significant. There was a significant difference in the disk herniation index (p<.05). A significant difference was found only in the upper trapezius muscle after comparison of muscle tone and stiffness between the groups (p<.05). Findings from this study suggest that the decompression therapy is a more effective intervention for patients with cervical intervertebral disc herniation.