• Title, Summary, Keyword: Chronic low back pain

Search Result 360, Processing Time 0.041 seconds

Idiopathic Hypertrophic Spinal Pachymeningitis : Report of Two Cases and Review of the Literature

  • Kim, Jee-Hee;Park, Young-Mok;Chin, Dong-Kyu
    • Journal of Korean Neurosurgical Society
    • /
    • v.50 no.4
    • /
    • pp.392-395
    • /
    • 2011
  • Idiopathic hypertrophic spinal pachymeningitis (IHSP) is a rare inflammatory disease characterized by hypertrophic inflammation of the dura mater and various clinical courses that are from myelopathy. Although many associated diseases have been suggested, the etiology of IHSP is not well understood. The ideal treatment is controversial. In the first case, a 55-year-old woman presented back pain, progressive paraparesis, both leg numbness, and voiding difficulty. Initial magnetic resonance imaging (MRI) demonstrated an anterior epidural mass lesion involving from C6 to mid-thoracic spine area with low signal intensity on T1 and T2 weighted images. We performed decompressive laminectomy and lesional biopsy. After operation, she was subsequently treated with steroid and could walk unaided. In the second case, a 45-year-old woman presented with fever and quadriplegia after a spine fusion operation due to lumbar spinal stenosis and degenerative herniated lumbar disc. Initial MRI showed anterior and posterior epidural mass lesion from foramen magnum to C4 level. She underwent decompressive laminectomy and durotomy followed by steroid therapy. However, her conditions deteriorated gradually and medical complications occurred. In our cases, etiology was not found despite through investigations. Initial MRI showed dural thickening with mixed signal intensity on T1- and T2-weighted images. Pathologic examination revealed chronic nonspecific inflammation in both patients. Although one patient developed several complications, the other showed slow improvement of neurological symptoms with decompressive surgery and steroid therapy. In case of chronic compressive myelopathy due to the dural hypertrophic change, decompressive surgery such as laminectomy or laminoplasty may be helpful as well as postoperative steroid therapy.

A Comparative Review on Carthmi-Flos Pharmacopuncture Treatment - Focused on Clinical Study (홍화약침 시술에 관한 임상논문 비교연구)

  • Lee, Soo-Hwan;Yoon, Jeong-Won;Kim, Soon-Joong
    • Journal of Korean Medicine Rehabilitation
    • /
    • v.27 no.4
    • /
    • pp.55-65
    • /
    • 2017
  • Objectives The purpose of this review is to analyze results of case studies and controlled studies about Carthmi-Flos pharmacopuncture. Based on the review, authors desire to suggest the study model including precise information and evident the effect of Carthmi-Flos pharmacopuncture objectively in treating clinical disorders. Methods We search 44 studies about Carthmi-Flos pharmacopuncture from 6 Korean web databases, using words 'Carthmi-Flos pharmacopuncture' in Korean alphabet. This study had been conducted throughout 1 month (July, 2017). We selected case studies and controlled trials in investigated 44 thesis, excluding experimental research and thesis not using the Carthmi-Flos pharmacopuncture for major treatment. Results We analyze 13 case reports and 7 controlled trials. As a result, Carthmi-Flos Pharmacopuncture was used mostly in musculoskeletal, neurological diseases. But this can be applied to internal diseases. Disorders reported effectively were carpal tunnel syndrome, degenerative knee joint arthritis, posterior neck pain, low back pain, radial nerve palsy, shoulder pain, lumbar compression fracture, alopecia areata, chronic daily headache, duverney fracture, oligomenorrhea, cervical disc herniation, rheumatoid arthritis and cervical headache. Conclusions As we analyzed, Carthmi-Flos pharmacopuncture is specifically effective in musculoskeletal and neurologic diseases. But there are various problems in study design. To design accurately, the study design should include much more specific information. And the result can be more precise by excluding other methods.

Minimally-Invasive versus Conventional Repair of Spondylolysis in Athletes: A Review of Outcomes and Return to Play

  • Kolcun, John Paul G.;Chieng, Lee Onn;Madhavan, Karthik;Wang, Michael Y.
    • Asian Spine Journal
    • /
    • v.11 no.5
    • /
    • pp.832-842
    • /
    • 2017
  • Spondylolysis from pars fracture is a common injury among young athletes, which can limit activity and cause chronic back pain. While current literature has examined the relative benefits of surgical and conservative management of these injuries, no study has yet compared outcomes between conventional direct repair of pars defects and modern minimally invasive procedures. The goals of surgery are pain resolution, return to play at previous levels of activity, and a shorter course of recovery. In this review, the authors have attempted to quantify any differences in outcome between patients treated with conventional or minimally invasive techniques. A literature search was performed of the PubMed database for relevant articles, excluding articles describing conservative management, traumatic injury, or high-grade spondylolisthesis. Articles included for review involved young athletes treated for symptomatic spondylolysis with either conventional or minimally invasive surgery. Two independent reviewers conducted the literature search and judged articles for inclusion. All studies were classified according to the North American Spine Society standards. Of the 116 results of our initial search, 16 articles were included with a total of 150 patients. Due to a paucity of operative details in older studies and inconsistencies in both clinical methods and reporting among most articles, little quantitative analysis was possible. However, patients in the minimally invasive group did have significantly higher rates of pain resolution (p<0.001). Short recovery times were also noted in this group. Both groups experienced low complication rates, and the majority of patients returned to previous levels of activity. Surgical repair of spondylolysis in young athletes is a safe and practical therapy. Current literature suggests that while conventional repair remains effective, minimally invasive procedures better clinical outcomes. We await further data to conduct a more thorough quantitative analysis of these techniques.

Korean Medicinal In-patient Treatments for Chronic Renal Disease : 2 cases report (만성신질환 환자의 한의 입원치료 치험 2례)

  • Oh, Jeong Min;Jung, Eun Sun;Choi, Koh Eun;Heo, Jong Won;Kim, Hyun Tae;Ryu, Ju Young;Lee, Kang Wook;Cha, Ji Yun;Seol, In Chan;Cho, Hyun Kyoung;Yoo, Ho Ryong;Cho, Min Kyoung;Kim, Yoon Sik
    • Journal of Physiology & Pathology in Korean Medicine
    • /
    • v.30 no.4
    • /
    • pp.289-299
    • /
    • 2016
  • This study is aimed to report two cases of chronic kidney disease treated with Korean traditional medicine. We treated the patients with traditional herbal medicine and other treatments including acupuncture. We measured serum creatinine, estimated glomerular filtration rate(eGFR), blood urea nitrogen(BUN), albumin, red blood cell count(RBC), hemoglobin for several times during admission. Case 1 patient was diagnosed with right medulla infarction, bladder stone, chronic kidney disease. The symptoms were quadriplegia, right side dysesthesia, drowsiness and edema. Case 2 patient was diagnosed with acute cerebral infarction, hypertension, chronic kidney disease. The symptoms were right side weakness, delusion, anorexia, low back pain. Case 1 patient was hospitalized for 80 days, and case 2 patient was for 31 days. Korean traditional medicine decreased serum creatinine and BUN level, improved eGFR, increased RBC and hemoglobin. The symptoms of chronic kidney disease such as edema, general body weakness and anorexia were also improved. These cases suggest that Korean traditional medicine can be effective and safe for patients with chronic kidney disease.

Development of a Discogenic Pain Animal Model: Preliminary Study (추간판성통증 동물모델의 개발: 초기 연구)

  • Kim, Byung-Jo;Lee, Min;Lim, Eun-Jeong;Yu, Sung-Wook;Hong, Sung-Ha;Hong, Seok-Joo;Na, Heung-Sik
    • Annals of Clinical Neurophysiology
    • /
    • v.11 no.2
    • /
    • pp.41-47
    • /
    • 2009
  • Background: Discogenic pain can develop into chronic low back pain that is very difficult to treat effectively, because the pathogenesis of the disease still remains controversial. To clarify the pathogenesis, numerous animal models of intervertebral disc degeneration have been proposed in the literature, each with attendant advantages and disadvantages. The aim of this study was to determine the most efficacious method and dose of complete Freund's adjuvant (CFA) injection into intervertebral disc to develop a discogenic pain in a rat. Methods: CFA was injected into the L5-L6 or L4-L5 disc of male Sprague-Dawley rats in various conditions including a dose of CFA (10, 20, or 50 uL), drilling, injection site sealing using cyanoacrylate, and injection velocity. Sham animals were subjected to the same procedure, except for the CFA injection. Mechanical and heat allodynia were serially measured at both hindpaws until 8 weeks post-operatively. Serial MRI analyses were performed to observe degenerative changes of the discs. In addition, CGRP & Substance P-immunoreactivities (ir) in the superficial dorsal horn were evaluated at 4 weeks using immunohistochemistry. Results: Each condition provoked various problems such as development of hindpaw paralysis, CFA leakage, and no pain development. Mid-sagittal T2 MRI revealed no significant degenerative changes in the CFA injected disc. The CGRP-ir of the bilateral superficial dorsal horns at the level of L5-L6 was significantly increased in the CFA group. Conclusions: A total of 10 uL CFA injection into L5-L6 disc for a period of 10 minutes using a 26-gauge needle without drilling was the most efficacious way to develop discogenic pain animal model.

  • PDF

Postural Aberrations in Female Patients With Chronic Low Back Pain (만성요통 여성 환자들에서 발생되는 자세의 변화)

  • Oh, Duck-Won
    • Physical Therapy Korea
    • /
    • v.7 no.4
    • /
    • pp.1-7
    • /
    • 2000
  • 이 연구의 목적은 만성요통 여성 환자들에서 나타나는 자세 이상을 평가하고 방사선적 변수들과 임상적인 변수들과의 상관성을 알아보는 것이다. 이 연구의 대상자는 만성요통 여성 환자 38명과 대조군 32명이었다. 변수의 측정은 모든 대상자들이 이완된 자세로 기립한 상태에서 방사선 검사를 실시한 후 경추전만각, 흉추후만각, 요추전만각, 그리고 요추경사각을 측정하였다. 대상자들의 연령과 통증기간은 의무기록지를 참고하였다. 자료분석은 요통군과 대조군의 방사선적 변수들 간의 유의한 차이가 있는지를 알아보기 위해 독립된 t-검정을 시행하였고, 방사선적 변수들과 임상적 변수들과의 상관성을 알아보기 위해 피어슨 상관분석을 시행하였다. 연구결과 만성요통 환자군과 대조군사이의 경추전만각(p<.05), 요추전만각(p<.001), 그리고 천추경사각(p<.01)에서 통계학적으로 유의한 차이가 보였다. 통증기간은 요추전만각과 통계적학으로 유의한 상관관계가 있었으며(p<.05), 경추전만각은 흉추후만각과 통계학적으로 유의한 상관관계가 있었다(p<.05). 또한 흉추후만각, 요추전만각, 그리고 천추경사각은 각각 상호간에 상관관계가 있었다(p<.05). 만성요통은 요추만곡의 변화를 초래하여 흉추부 및 경추부의 자세이상을 유발할 수 있다. 그러므로 요통으로 인하여 올 수 있는 신체 전반적인 자세이상을 미리 예측하고 이를 교정하여야만 장기적으로 올 수 있는 합병증들을 예방할 수 있을 것이다.

  • PDF

Health Status and Musculoskeletal Workload of Red Pepper Farmers (노지고추 농업인의 건강실태와 근골격계 작업부담)

  • Kim, Kyung-Ran;Lee, Kyung-Suk;Kim, Hyo-Cher;Song, Eun-Young
    • Journal of the Ergonomics Society of Korea
    • /
    • v.28 no.3
    • /
    • pp.7-15
    • /
    • 2009
  • The objective of this study is to survey the working environmental conditions and musculoskeletal workload(DMQ) in red pepper farmers. 155 full-time farmers(males=91, females=64) lived in Chungnam and Jeonbuk participated in the study. To offer the fundamental data for agricultural improvement of red pepper farms, information about working farm conditions, health condition, musculoskeletal disorders(MSDs), labor intensity and musculoskeletal workload was obtained by questionnaire and interviews. The results are as follows: 1. The farmers reported sunlights, high temperature and cold/ draught as uncomfortable work environment. 2. Physical and mental fatigue in females is higher than that of males. 3. The prevalence rates of medical diagnosed diseases are higher in order of osteoarthritis, herniated nucleus pulposus(HNP), and chronic gastritis/gastric ulcer. 4. Prevalence rates of musculoskeletal symptoms more than standard 1 among the various pain areas are higher in order of low back, shoulders and knees. These results can be used practically for agricultural improvement of red pepper farms to prevent MSDs.

Collaborative Study of Oriental-Western Medicine on HIVD (요추추간판탈출증의 동·서의학적 협진연구)

  • Lee, geon-mok;Lee, kang-chang;Hwang, yoo-jin
    • Journal of Acupuncture Research
    • /
    • v.17 no.2
    • /
    • pp.1-10
    • /
    • 2000
  • Herniated lumbar intervertebral disc(HIVD) is the most common reason causing low back pain and leg radiating pain. The purpose of this study is to see the good of Oriental-Western medicine on HIVD. In order to this syudy, HIVD patients divided into two groups: Group with Oriental medicine(GOM) and Group with Oriental-Westem medicine(GOWM). The results of treatments were summarized as follows. 1. If We investigate a state of patients, GrIII type is 17 cases in GOM and is 16 cases in GOWM. In the GOM, Gr II shows better than the others and in the GOWM, GrI, III shows better than the others. 2. The results of treatments in GOM and GOWM is the good in a general way. It shows excellent type at 10 cases in the GOM, and shows excellent type at 14 cases in GOWM. 3. In Acute stage(in one month), subacute stage(one month~six months) and chronic stage(over six months), the therapic point of GOM and GOWM is 2.9~3.5 on the average. 4. If we notice the effect point of HIVD, in GOM, the point of bulging type is 3, protruded type is 3.5 extruded type is 3. But in GOWM, the point of bulging type is 3.7, protruded type is 3.5 extruded type is 2.7.

  • PDF

Study on Characteristics of 7-Zone-Diagnostic System before and after Treatment in the Traffic Accident Patients and Patients with Low Back Pain or Nuchal Pain (경항부.요부 통증환자와 교통사고환자의 치료 전.후에 따른 7구역진단기의 특성연구)

  • Kim, Eu-Gene;Cha, Yun-Yeop
    • Journal of Physiology & Pathology in Korean Medicine
    • /
    • v.23 no.1
    • /
    • pp.225-231
    • /
    • 2009
  • The purpose of this study was to compare the effectiveness of Dangkisoo-san(Dangguixu-san) and Gamihwalhyul-tang(Jiaweihuoxie-tang) herb-medication for the Traffic accident patient group with the effectiveness of common herb-medication for the general patient group by using 7-Zone-Diagnostic System. Two groups were selected from those who took the CP-6000A test in College of Oriental Medical Hospital of Sangji University from March 2007 to January 2008. Mean values of Factor AA on Skin Resistance Variability(SRV) of two groups were compared. The mean values of the deviation between measurement and 50 in pre-examination was higher than those of post-examination. Especially, there were remarkable difference between the mean values of the deviation between measurement and 50 in pre-examination and those of post-examination within the general patient group. When we compare pre-examination with post-examination in each area, 2 areas have remarkable difference within the general patient group. The mean values of positive deviation in pre-examination was higher than those of post-examination within both group. Especially, the TA patient group was remarkable. The other side the mean values of negative deviation in pre-xamination was remarkably higher than those of post-examination within the general patient group. By contraries the mean values of negative deviation in pre-examination was lower than those of post-examination within the TA patient group. These results suggest that Dangkisoo-san(Dangguixu-san) and Gamihwalhyul-tang(Jiaweihuoxie-tang) herb-medication will be less effective for chronic and weak traffic accident patients.

Prevalence Rate of Low_Back Pain and Its Related Factors in Physical Therapists (물리치료사의 요통 유병률과 관련요인)

  • Jung Soo-yeoun;Shin Hyung-soo;Park Jae-yong
    • The Journal of Korean Physical Therapy
    • /
    • v.17 no.2
    • /
    • pp.22-37
    • /
    • 2005
  • This study was performed to investigate LBP(low-back pain) prevalence rate and its related factors inphysical therapists. A self-administered questionnaire survey was conducted to 522 physical therapists in Daegu and Gyeongsangbuk. The LBP prevalence rate for recent 6 months was $61.7\%$. According to age, the prevalence rate was highest in the group aged 24 or less for both male and female physical therapistis. For male physical therapists , it was higher in smokers and drivers, but for female ones, it was not in a significant relationship with smoking and driving. According to work experience, the prevalence rates of those who had been working for less than one year were the highest, and those who had been working at hospitals and clinics were $69.1\%$, significantly high. According to therapy techinque, the prevalence rate related ti PNF was $71.6\%$, the highest and to occupational therapy was $34.3\%$, the lowest. According to working environment for six months, in both male and female physical therapists. LBP prevalence rate was in a statistically significant relationship with work hours during the day, night and weekend duties, repetitive works, motions that bend or twist the waist, the number of patients per day, the number of time to help patients per day, the number of time to carry medical equipment per day and the length of time to work standing. The rate was also higher when physical therapists fekt nire stress from their work. According to the result of multiple logistic regression analysis, male was in a significant relationship with work experience and motions that bend or twist the waist and female was in a significant relationship with work hours during the night and weekend duties, the number of time to help patients per day, motions that bena or twist the waist, actions taken to protect the waist. As for the developmental pattem of LBP in the group of physical therapists with LBP for six moths, $15.7\%$ of them had LBP for first time, $42.3\%$ had recurred LBP, and $42.0\%$ had chronic LBP. As for the causes of LBP, $51.7\%$ said that it was because they worked in the same posture for a long time, and as for how to treat LBP, 48.8% said that they treated themselvs or got help from their co-wokers. The results presented above suggest that physical therapists are exposed to high risk of LBP caused form occupational activities. Therefire, it is necessary to improve working environment to reduce the occurrence of LBP and to develop education programs for preventing the occurrence and recurrence of LBP.

  • PDF