A Case Report of Oriental Medical Treatment for the Left Lower Limb Monoplegia after Herniated Intervertebral Disc Operation at L-spine

요추 추간판 탈출증 수술 후 발생한 좌하지 단마비의 한의학적인 치료 증례보고

  • You, Kyung-Gon (Dept. of Oriental Rehabiliation Medicine, College of Oriental Medicine, Won-Kwang University) ;
  • Park, Min-Jung (Dept. of Oriental Rehabiliation Medicine, College of Oriental Medicine, Won-Kwang University) ;
  • Jung, Il-Min (Dept. of Oriental Rehabiliation Medicine, College of Oriental Medicine, Won-Kwang University) ;
  • Yeom, Seung-Ryong (Dept. of Oriental Rehabiliation Medicine, College of Oriental Medicine, Won-Kwang University) ;
  • Kwon, Young-Dal (Dept. of Oriental Rehabiliation Medicine, College of Oriental Medicine, Won-Kwang University)
  • 유경곤 (원광대학교 한의과대학 한방재활의학과교실) ;
  • 박민정 (원광대학교 한의과대학 한방재활의학과교실) ;
  • 정일민 (원광대학교 한의과대학 한방재활의학과교실) ;
  • 염승룡 (원광대학교 한의과대학 한방재활의학과교실) ;
  • 권영달 (원광대학교 한의과대학 한방재활의학과교실)
  • Received : 2011.07.09
  • Accepted : 2011.10.14
  • Published : 2011.10.30

Abstract

Objectives: This study was performed to report the case of oriental medical treatment for the left lower limb monoplegia after herniated intervertebral disc(HIVD) operation at lumbar(L)-spine. Methods: A 38-year-old man who underwent lumbar HIVD operation at a hospital admitted with motor weakness of left lower limb, a little decreased left leg radiation pain and low back pain. We treated him by acupuncture, herbal medicine, bee venom injection moxibustion, cupping treatment physical therapy and measured with visual analogue scale(VAS), Oswestry disability index(ODI), Roland-Morris disability questionnaire(RMDO) and manual muscle test(MMT) from 8th February to 4th May 2011. Results: After treatment most symptoms decreased, VAS score changed from 10 to 3, ODI changed 71% to 37% RMDQ changed 13 to 8 and MMT changed from 3 to 5. Conclusions: Our study suggested that oriental medical treatments are significantly applicable to the monoplegia and pain after lumbar HIVD operation. And further studies ire required to identify underlying mechanism of the treatment.

References

  1. 신병준, 김경제, 장인관, 서유성, 김연일. 요추부 추간판 절제술 후의 초기 문제점. 대한척추외과학회지. 1999;96(1):104-9.
  2. 신병준, 김준범, 조영훈, 권희, 서유성, 김연일, 나수균, 최창욱. 요추 추간판 탈출증 수술 후 임상 증상의 회복. 대한척추외과학회지. 1997;4(2):337-43.
  3. 한방재활의학과학회. 한방재활의학. 제2판. 서울:군자출판사. 2007:82-5, 135-7, 169.
  4. Shin BJ. Percutaneous Endoscopic discectomy. The 49th Spring Congress of the Korea Orthop. Assoc. 2004:266-71.
  5. 신병준, 이재철, 남준서, 엄제필, 조영일, 김연일. 제 5요추-제1 천추간 내시경적 추간판 절제술 후 발생한 마미 증후군-1례 보고-. 대한척추외과학회지. 2005;12:365-8.
  6. Hudgins, RW. The role of microdiscectomy. Orthop. Clin. North. Am. 1983;14:589-603.
  7. 하인혁, 박원상, 우인, 김하늘, 고동현, 윤유석. 요각통 환자의 통증 평가에 있어서 수직, 수평선 visual analogue scale과 numerical rating scale의 상관관계. 한방재활의학과학회지. 2006;16(4);125-33.
  8. 조규정, 문경호, 김명구, 최동훈, 이상형, 박승림, 이동주. Change of clinical outcomes after decompression and fusion for spinal stenosis during 2-year follow-up periods. 대한척수외과학회지. 2003;10(2):113-8.
  9. Roland M, Fairbank J. The Roland Morris disability questionnaire and the Oswestry disability questionnaire. Spine. 2000:15;25(24):3115-24. https://doi.org/10.1097/00007632-200012150-00006
  10. 양승훈. 요부 안정화 운동이 요통 환자의 요추부 기능개선에 미치는 영향. 용인대학교 재활보건과학대학원 물리치료학과 물리치료전공. 2004.
  11. 고도일. 질환별 키네시오 테이핑요법. 서울:푸른솔. 2002:12-6.
  12. Mixster WJ, Barr JS. Rupture of the intervertebral disc with involvement of the spinal canal. N Eng J. 1934;211:210-5. https://doi.org/10.1056/NEJM193408022110506
  13. Crock HV. Observation on the management of failed spinal operation. J Bone Joint Surg. 1975;58(B):193-9.
  14. Weber H. Lumbar disc herniation. A prospective study of prognostic factors including a controlled trial. J Osle City Hosp. 1978;28:33-7.
  15. Pappas CTE, Harrinton T, Sonntag VKH. Outcome analysis in 654 surgically treated lumbar disc herniation. Neurosurgery. 1992;30(6):862-6. https://doi.org/10.1227/00006123-199206000-00007
  16. Neil K, Kathleen V, John ML. Limited surgical discectomy and microdiscectomy : a clinical comparison. Spine. 1914;1:79-81.
  17. McCulloch JA, Young PH. Microsurgery of the lumbar spine, a 10-year experience, complications(adverse effects) in lunbar microsurgery. Essentials of Spinal Microsurgery. Philadelphia:Lippincott-Raven. 1998:493-529.
  18. Kambin P, Sampson S. Posterolateral percutaneous suction excision of herniated lumbar intervertebral discs: report of interim results. Clin Orthop. 1986;207:37-43.
  19. Casey KF, Chang MK, O'Brein ED, Yuan HA, McCullen GM, Schaffer J, Kambin P. Arthroscopic microdiscectomy: comparison of preoperative and postoperative imaging studies. Arthroscopy. 1997;13:438-45. https://doi.org/10.1016/S0749-8063(97)90121-3
  20. 정영기, 유정한, 정국진, 왕진식. 요추 추간판 탈출증에서 내시경을 이용한 경피적 추간판 재거술의 임상적 결과. 대한척추외과학회지. 2005;12:224-8.
  21. Hoppenfeld S. Percutaneous removal of herniated lumbar discs. 50 cases with ten-year follow-up periods. Clin Orthop. 1989;238:92-7.
  22. 박기현. 요통과 요각통에 대한 임상적 고찰. 동서의학. 1995;21(1):30-8.
  23. 이홍석, 이재동, 고형균. 최근 10년간 국내의 봉독관련 연구에 대한 고찰. 대한침구학회지. 2003;20(3):154-65.
  24. 이건목, 이길숭, 염승철, 장재호, 윤주영, 황병천, 국우석, 장지연, 최정선, 김양중, 박종운. 봉약침을 위주로 한 요추 추간판 탈출증의 돌출형 환자에 대한 임상적 고찰. 대한 침구학회지. 2004;21(5):13-25.