Journal of Korean Medicine Rehabilitation (한방재활의학과학회지)

The society of Korean Medicine Rehabilitation (한방재활의학과학회)
권호 표지

Clinical Study for Patients with Lumbar Disc Herniation on Change of Magnetic Resonance Imaging at One Year after Conservative Treatment

요추 추간판 탈출증 환자의 보존적 치료 후 변화된 자기공명영상에 따른 1년 후 임상변화 고찰

  • Kwon, Hyeok-Joon (Dept. of Oriental Rehabilitation Medicine, Ja-Seng Oriental Medicine Hospital) ;
  • Park, Young-Hoi (Dept. of Oriental Rehabilitation Medicine, College of Oriental Medicine, Dong-Guk University)
  • 권혁준 (자생한방병원 한방재활의학과) ;
  • 박영회 (동국대학교 한의과대학 한방재활의학과교실)
  • Received : 2011.03.08
  • Accepted : 2011.04.13
  • Published : 2011.04.30
⟨ Previous Next ⟩

Abstract

Objectives : To analyze the therapeutic outcomes of back pain modalities in patients with disc herniation according to the change of magnetic imaging(MRI) at one year after conservative treatment. Methods : Clinical outcomes of 35 patients diagnosed with lumbar disc herniation by MRI examination, treated conservatively, were analyzed according to MRI follow-up change; improved, unchanged, worsened. Patients underwent MRI examination at baseline and after 24 week of treatment. After 1 year, we followed up 30 patients. The patients' clinical outcomes were assessed at baseline, 24 week, 1 year by visual analogue scale(VAS), oswestry disability index (ODI), and analyzed by each of it's correlation. Results : 1. VAS of sciatica and ODI of disability of daily activities showed significant decrease in patients after 1 year follow up(p<0.05). 2. VAS(low back pain and sciatica) and ODI of disability of daily activities showed significant decrease in "improved" group and VAS(sciatica) and ODI showed significant decrease in "unchanged" group. "worsened" group showed no statistic significance(p<0.05). 3. The 1 year follow-up of VAS(low back pain and sciatica) and ODI change showed relationship with MRI follow-up change(p<0.05). Conclusions : This study suggests that "improved" groups compared to "unchanged" and "worsened" group on MRI follow-up in patients with lumbar disc herniation were more effective at 1 year after conservative treatment. MRI follow-up change affect clinical changes in patients with lumbar disc herniation after 1 year.

Keywords

References

  1. 한방재활의학과학회. 한방재활의학. 서울:군자출판사. 2005:60-1.
  2. Hurme M, Alaranta H. Factors predicting the results of surgery for lumbar intervertebral disc herniation. Spine. 1987;12(9):933-8. https://doi.org/10.1097/00007632-198711000-00016
  3. 이은경, 최은희, 이지은, 전주현, 이성환, 이재민, 김연미, 곽병민, 양기영, 김영일. 요추 추간판 탈출증 환자 137례에 대한 한의학적 임상고찰. 대한침구학회지. 2008;25(3):127-38.
  4. 박원상, 하인혁, 권혁준, 우인, 윤유석, 송주현. 보존적 치료를 통해 호전된 요추 추간판 탈출증 환자의 자기공명영상으로 추적 관찰한 증례 4례 보고. 한방재활의학과학회지. 2007;17(4):269-80.
  5. 정벌, 정석희, 이종수. 추나치료를 병행한 돌출형 요추추간판탈출증 환자의 영상의학적 변화 1례. 한방재활의학과학회지. 2006;16(3):149-57.
  6. Ahn SH, Park HW, Byum WM, Ahn MW, Jang SH, Bae JH. Comparison of clinical outcomes and natural morpologic changes between sequestered and large central extruded disc herniations. Yonsei Med J. 2002;43:283-90. https://doi.org/10.3349/ymj.2002.43.3.283
  7. 권혁준, 정해찬, 김호준, 박영회, 금동호, 이명종. 요추 추간판 탈출증 환자의 보존적 치료 후 변화된 자기공명영상에 따른 임상적 고찰. 한방재활의학과학회지. 2009;19(3):1-10.
  8. 장호근, 이영건. 요추 추간판 탈출증의 자연경과와 임상 소견. 대한척추외과학회지. 2001;8(3):305-13.
  9. Tue S, Hanne B, Joan S. Natural course of disc morphology in patients with sciatica. Spine. 2006;31:1605-12. https://doi.org/10.1097/01.brs.0000221992.77779.37
  10. 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.
  11. 이현종, 남상수, 이윤호. 요통의 통증과 기능장애 평가에 대한 고찰. 대한침구학회지. 2002;19(2):137-48.
  12. Weber H. Lumbar disc herniation: a controlled prospective study with ten years of observation. Spine. 1983;8:131-40. https://doi.org/10.1097/00007632-198303000-00003
  13. Saal JA et al. The natural history of lumbar intervertebral disc herniations treated nonoperatively. Spine. 1989;15:683-6.
  14. 신민섭, 노정도, 최석우. 파열형 요추 추간판 탈출증에 대한 임상적 연구. 대한침구학회지. 2001;18(6):84-92.
  15. Bozzao A, Galluci M, Maxciocchi C. Lumbar disc herniation: MR imaging assessment of natural history in patients treated without surgery. Radiology. 1992;185:135-41. https://doi.org/10.1148/radiology.185.1.1523297
  16. Komori H, Shinomiya K, Nakai O. The natural history of herniated nucleus pulposus with radiculopathy. Spine. 1996;21:225-9. https://doi.org/10.1097/00007632-199601150-00013