• Title, Summary, Keyword: 추간판 탈출지수

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The effects of Cox distraction manipulation on functional assessment measures and disc herniation index in patients with L4-5 herniated disc (칵스 신연교정이 L4-5 추간판 탈출증 환자의 기능적 평가측정과 추간판탈출지수에 미치는 효과)

  • Kwon, Won-An;Ryu, Young-Sang;Ma, Sang-Yeol
    • Journal of the Korean Data and Information Science Society
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    • v.23 no.4
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    • pp.727-738
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    • 2012
  • The purpose of the present study was to determine the effect of a 4 week course of Cox distraction manipulation (CDM) combined with therapeutic modalities on the treatment of patients with L4-5 herniated nucleus pulposus (HNP). A total of 15 patients with L4-5 HNP (mean age, 37.76 years; age range 20-50years) participated in the study. A 4 week course of CDM combined with therapeutic modalities was delivered to the patients for 6 days per week for the first two weeks, and three times per week for two additional weeks. The entire treatment consisted of 18 visits over 4 week period. Comparisons of changes in the muscle strengthening (MS), straight leg raise (SLR), and oswestry disability index (ODI) at pre-intervention, after two weeks treatment sessions, and at discharge (after 18 treatment sessions) were analyzed. Comparisons of changes in the disc herniation index (DHI) at pre-intervention and at discharge were analyzed using the paired t-test. There were significant improvements in the outcome measures of MS Ibs, SLR test, and ODI score after 2 weeks and 4 weeks sessions of CDM combined with therapeutic modalities as compared with the pre-intervention. However, no significant different pre-test and post-test DHI. CDM combined with therapeutic modalities appears to be a safe and efficacious, noninvasive treatment modality for patients with L4-5 HNP.

The Effects of Spinal Decompression Combined with Therapeutic Modalities for Patients with Lumbar Radiculopathy (치료적 모달리티를 병용한 척추 감압치료가 요추 신경뿌리병증 환자에게 미치는 효과)

  • Ma, Sang-Yeol;Kwon, Won-An;Lee, Jae-Hong;Min, Dong-Gi
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.1
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    • pp.336-343
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    • 2013
  • The purpose of the present study was to determine the effect of 4 weeks course of motorized spinal decompression delivered via SpineMT(mobilization & traction) combined with therapeutic modalities on the treatment of patients with lumbar radiculopathy(LRP). A total of 15 patients with LRP (mean age, 36.63 years; age range 20-50years) participated in this study. 4 weeks course of spinal decompression delivered via SpineMT combined with therapeutic modalities was delivered to the patients for 6 days per week for the first two weeks, and four times per week for two additional weeks. The entire treatment consisted of 20 visits over 4 week period. Comparisons of changes in the muscle strengthening (MS), straight leg raise (SLR), and Oswestry disability index (ODI) at pre-intervention, after 10 treatment sessions, and at discharge (after 20 treatment sessions) were analyzed. There were significant improvements in the outcome measures of MS test, SLR test, and ODI score after 10 and 20 sessions of spinal decompression treatment combined with therapeutic modalities as compared with the pre-intervention(p<0.05). Spinal decompression treatment combined with therapeutic modalities appears to be a safe and efficacious, noninvasive treatment modality for patients with LRP.

The Effect of Lumbar Stabilization Exercises with Neurodynamic Techniques on Lumbar Muscular Strength and Oswestry Disability Index in Lumbar Disc Herniation Patient's (요추 안정화 운동과 결합된 신경역동학기법이 요추 추간판 탈출증 환자의 요부근력과 오스웨스트리 장애지수에 미치는 영향)

  • Mo, Min-sang;Park, Hyun-sik
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.22 no.1
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    • pp.1-7
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    • 2016
  • Background: The purpose of this study was to investigate the effects of lumbar stabilization exercise with neurodynamic techniques on lumbar muscular strength and Oswestry index in lumbar disc herniation patient. Method: The Lumbar stabilization exercise with neurodynamic techniques was performed by 30 pt's in G hospital. The subjects were randomly organized into a study group 15 and control group 15. The exercises and neurodynamic technique were conducted for 40 minutes and, 3 times a week (total 24 times for 8 weeks). General characteristics of the Lumbar muscular strength and Oswestry disability index (ODI) were measured before the training and at 4 weeks and 8 weeks after the intervention. Comparison of the time dependent variable for each group was Calculated by a one way repeated analysis of variance (ANOVA). Comparison between the two groups was Calculated by an analysis of covariance (ANCOVA). Result: There was a significant difference in the Lumbar muscular strength and ODI (p<.05). Similarly in the inter-group analysis, significant differences (p<.05) occurred. Conclusion: In this study, we demonstrated that lumbar stabilization exercises with neurodynamic techniques are an effective therapy for Lumbar muscular strength and ODI in lumbar disc herniation patient's.

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The Study of Fat Infiltration Ratio in Lumbar Paraspinal Muscle of Patient with Herniated Intervertebral Lumbar Disc (요추간판 수핵 탈출증 환자의 요부 척추 주위근 내 지방침윤 비율에 관한 연구)

  • Kong, Bong-Jun;Lee, Jung-Ho;Yong, Min-Sik;Kim, Jin-Sang
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.11
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    • pp.5254-5260
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    • 2012
  • The purpose of this study is to find the relationship between lumber Herniated Nuclesus Pulposus of specific part and fat infiltration in paraspinal muscle. Also we intended to find the relationship between Body Mass Index(BMI) and fat infiltration ratio in the lumber paraspinal muscle based on the sexes of patients. We conducted this study of patients who visited our hospital from May, 2010 to May, 2012. The subjects are composed of 40 patients(20 females and 20 males), who are 30 to 50 years old suffering from severe lumber herniated nuclesus pulposus, who had or were going to have operation treatment. BMI is measured through anthropometry of each patient and fat infiltration inside the muscle is estimated by measuring the cross section area of lumbar paraspinal muscle from mid-cross section of disc(L2-S1) and fat infiltration ratio. The data of this study are analyzed by independent t-test to figure out the difference of fat infiltration between male and female, and by paired sample T-test after getting mean and standard deviation to find the changes of fat infiltration of lumbar on each level. Also correlation analysis is done by setting age as a control variable to find the correlation between BMI and fat infiltration of the whole lumbar. As a result, we could get only the meaningful difference between the sexes on upper lumber part(L2-L3) while we couldn't find any significant difference in the rest of lumbar(L3-S1). Besides, the changes of fat infiltration ratio on each lumbar level increased rapidly from lumbar 3,4 to lumbar 4,5. We also found that there is no correlation between fat infiltration ratio of lumbar paraspinal muscle(L2-S1) and BMI.

Brown-Sequard Syndrome Produced by Cervical Disc Herniation : Manual and Exercise Therapy after Operation-Case Studies (경추 추간판탈출증에 의한 브라운-시쿼드 증후군 : 수술 후 도수치료와 운동치료 효과-사례연구)

  • Kim, Myung-Joon
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.15 no.1
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    • pp.79-85
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    • 2009
  • 목적 : 브라운시쿼드는 대부분 척추손상과 수질외 척추 종양에서 주로 나타난다. 드물게 경추 디스크가 브라운시쿼드의 원인이 된다. 경추디스크에 의한 브라운시쿼드 증세의 수술후 물리치료 및 도수치료 결과를 보고하기 위함이다. 방법 : 50세 남자로써 브라운시쿼드 증세로 진단을 받고 수술후 좌측 팔과 다리에 운동신경에 의한 마비증세가 있었으며(팔>다리), 우측으로 감각과 온도감각이 저하된 경우이다(팔>다리). 측정방법은 통증지수(VAS), 근력(Distal PowerTracII$^{TM}$ test), 지구력(Ergometer) 측정과 심리상태(설문)를 치료전과 후를 비교하였다. 물리치료에서는 기능적 전기자극 치료와 도수치료 및 운동치료 방법을 실시하였다. 도수치료는 통증완화와 근력강화를 위한 MET, MFR, Mobilization 등을 실시하였으며, 운동은 슬링시스템 등을 이용한 운동과 견관절의 불안정을 위해 안정화운동을 실시하였다. 결과 : 이 케이스는 수술후 이상 징후가 척수압박으로 인하여 보다 넓게 통증이 나타났으며, 운동 및 감각신경이 둔해지고 온도에 대한 감각이 반대편 결손으로 나타났으며, 좌측 어깨, 팔 견갑부의 근육 마비와 우측의 감각이 떨어진 현상이 나타났다. 물리치료 후 단기목표와 장기목표에 있어서 통증과 운동 및 감각 기능이 회복되어 각각 팔 통증에서는 VAS 8 ${\rightarrow}$ 1, 상지 하지의 운동기능은 Trace ${\rightarrow}$ Good 로 평가 회복되었으며, 근력측정에서 모두 유의한 차이를 보였다. 모든 치료과정 결과에서 심리적 상태의 설문에서도 높은 점수를 얻어 긍정적 신뢰가 높아 진 것으로 나타났다. 검사결과 다리의 근력이 증가는 걷기 운동 및 에르고메터의 지구력 및 균형이 레벨1의 10분 수행능력이 레벨 20에서 30분 수행능력으로 향상되어 일상적인 활동이 가능해졌다. 결론 : 예상하지 못했던 수술 후유증(side effects)에 대한 치료과정이 환자의 심리에 심각한 부정적인 생각이 신체의 기능과 감정의 손상에 영향을 미치기 때문에 체계적이고 장기적인 치료 과정에서 기능적 향상과 더불어 정신적인 심리의 정서 안정이 매우 필요하다고 사료된다.

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Effects of Integrative Korean Medical Treatment for a Failed Epidural Steroid Injections to L-spine Disk Herniation: A Retrospective Case Series (경막외 스테로이드 주사치료에 실패 후 한방복합치료에 의해 호전된 요추 추간판 탈출증 환자 10례 : 후향적 증례 연구)

  • Kim, Ji Su;Kim, Yoo Jong;Hong, Je Rak;Kim, Min Chul;Park, Han Sol;Kim, Seh Young;Seo, Young Woo;Lee, Sang Min;Seo, Young Hoon;Kim, Ki Ok;Kim, Tae Hun
    • Journal of Acupuncture Research
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    • v.32 no.4
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    • pp.203-211
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    • 2015
  • Objectives : The purpose of this study was to assess the effectiveness of integrative Korean Medical treatments for patients with L-spine disk herniation that showed no response to Epidural Steroid Injections (ESI). Methods : In this study, we reviewed the medical records of ten patients who showed no improvement or relapsed after ESI. The patients each received more than three weeks of integrative treatments at Mokhuri Neck&Back Hospital. The Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) was measured before and after treatment. A statistical analysis to compare before and after treatments was assessed using paired t-test the SPSS 12.0 Windows program. Results : After three weeks of treatment, patients showed a significant decrease in VAS and ODI scores compared to before receiving treatment. VAS scores decreased from $5.3{\pm}1.25$ to $1.9{\pm}0.99$ (p<0.001), and ODI scores decreased from $59.8{\pm}22.2$ to $32.7{\pm}14.11$ (p<0.001). Conclusions : Complex Korean Medical treatment showed effectiveness in the treatment of L-spine HIVD patients that showed no response to ESI, and more objective research is needed.

Cardiovascular Effects of Free Movement of Abdominal Muscle in Prone Positioning during General Anesthesia (전신마취동안에 복와위시 자유로운 복근 움직임이 심혈관계에 미치는 영향)

  • Kim, Ji-Yoon;Lee, Dong-Won;Seo, Il-Sook;Kim, Sae-Yeon
    • Yeungnam University Journal of Medicine
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    • v.24 no.2
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    • pp.206-215
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    • 2007
  • Background : The prone position is often used for operations involving the spine and provides excellent surgical access. The complications associated with the prone position include ocular and auricular injuries, and musculoskeletal injuries. In particular, the prone position during general anesthesia causes hemodynamic changes. To evaluate the cardiovascular effects of the prone position in surgical patients during general anesthesia, we investigated the effects on hemodynamic change of the prone position with the Jackson spinal surgery table. Materials and Methods : Thirty patients undergoing spine surgery in the prone position were randomly selected. After induction of general anesthesia, intra-arterial and central venous pressures (CVP) were monitored and cardiac output was measured by $NICO^{(R)}$. We measured stroke volume, cardiac index, cardiac output, mean arterial pressure, heart rate, CVP and systemic vascular resistance (SVR) before changing the position. The same measurements were performed after changing to the prone position with the patient on the Jackson spinal surgery table. Results : In the prone position, there was a significant reduction in stroke volume, cardiac index and cardiac output. The heart rate, mean arterial pressure and CVP were also decreased in the prone position but not significantly. However, the SVR was increased significantly. Conclusion : The degree of a reduced cardiac index was less on the Jackson spinal surgery table than other conditions of the prone position. The reduced epidural pressure caused by free abdominal movement may decrease intraoperative blood loss. Therefore, the Jackson spinal surgery table provides a convenient and stable method for maintaining patients in the prone position during spinal surgery.

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Paradoxical Upper Airway Obstruction and Central Sleep Apnea Developed After Anterior Cervical Spine Fusion (전방경추융합술 후 발생한 역설상기도폐쇄 및 중추성 수면 무호흡)

  • Lee, Sang Haak;Choi, Young Mee;Park, Ye Ree;Kang, Ji Ho;Kim, Young Kyoon;Kim, Kwan Hyoung;Song, Jeong Sup;Park, Sung Hak;Moon, Hwa Sik
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.3
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    • pp.295-298
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    • 2005
  • We report a case of a 48-year-old man with a paradoxic upper airway obstruction and central sleep apnea that developed after an anterior cervical spinal fusion. Nine months before being admitted to this hospital, he was diagnosed with a herniated intervertebral disc between the 5th and 6th cervical spine, and the first operation was carried out. Two months later, a pseudoarthrosis has developed and a second operation, an anterior interbody fusion of the C5 and C6 using autogenous strut bone graft, was performed. After the second operation, he began to complain of snoring, excessive daytime sleepiness, insomnia, and a bizarre sound heard near the upper airway during breathing. Nasopharyngoscope and magnetic resonance imaging disclosed a paradoxical narrowing of the nasopharynx during expiration. On the overnight polysomnography, the apnea index was 8.7/h (central apnea, 7.0/h; obstructive apnea, 1.7/h). Nasal continuous positive airway pressure was applied, but he complained of pressure-intolerance, and laser-assisted uvulopalatoplasty was then performed. Two months after surgery, clinical symptoms as well as the apneas had improved markedly. We suggest that this paradoxic upper airway obstruction might be associated with the anterior cervical spinal surgery even though the mechanism is unclear. This case also emphasizes that an upper airway obstruction can contribute to the development of central sleep apnea.