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Comparative Analysis on Disc Resorption Rate of Lumbar Disc Herniation Patients after Korean Medicine Treatment and Predictive Factors Associated with Disc Resorption

요추 추간판 탈출증 환자의 한의치료 후 디스크 흡수율 비교 및 흡수에 영향을 주는 요인 분석 연구

  • Kim, Yong-Hyeon (Department of Rehabilitation Medicine of Korean Medicine, Haeundae Jaseng Hospital of Korean Medicine) ;
  • Lee, Ju-Young (Department of Rehabilitation Medicine of Korean Medicine, Haeundae Jaseng Hospital of Korean Medicine) ;
  • Kim, Kwang-Hwi (Department of Rehabilitation Medicine of Korean Medicine, Haeundae Jaseng Hospital of Korean Medicine) ;
  • Kim, Tae-Yeon (Department of Rehabilitation Medicine of Korean Medicine, Haeundae Jaseng Hospital of Korean Medicine) ;
  • Lee, Tae-Geol (Department of Rehabilitation Medicine of Korean Medicine, Haeundae Jaseng Hospital of Korean Medicine) ;
  • Lee, Sang-Woon (Department of Rehabilitation Medicine of Korean Medicine, Haeundae Jaseng Hospital of Korean Medicine) ;
  • Chu, Hui-Yeong (Department of Rehabilitation Medicine of Korean Medicine, Haeundae Jaseng Hospital of Korean Medicine) ;
  • Jeong, Hui-Gyeong (Department of Acupuncture and Moxibustion Medicine, Haeundae Jaseng Hospital of Korean Medicine)
  • 김용현 (해운대자생한방병원 한방재활의학과) ;
  • 이주영 (해운대자생한방병원 한방재활의학과) ;
  • 김광휘 (해운대자생한방병원 한방재활의학과) ;
  • 김태연 (해운대자생한방병원 한방재활의학과) ;
  • 이태걸 (해운대자생한방병원 한방재활의학과) ;
  • 이상운 (해운대자생한방병원 한방재활의학과) ;
  • 추희영 (해운대자생한방병원 한방재활의학과) ;
  • 정희경 (해운대자생한방병원 침구의학과)
  • Received : 2018.09.15
  • Accepted : 2018.10.03
  • Published : 2018.10.31

Abstract

Objectives The purpose of this study is to analyze the effects of Korean Medicine treatment on lumbar disc herniation (LDH) and predictive factors associated with disc resorption by magnetic resonance imaging (MRI). Methods A retrospective study was carried out in 79 lumbar disc herniation patients who had visited Haeundae Jaseng Hospital of Korean Medicine. Patients' diagnosis was based on MRI. MRI was performed on two or more occasions and patients were received Korean Medicine treatment within the period. The volume of each herniated disc was measured three-dimensionally and patient characteristics, interval between MRIs, herniated disc level, disc herniation type, disc migration, intactness of posterior longitudinal ligament (PLL), initial volume of herniated disc, modic change, disc resorption rate were statistically analyzed. Results The mean volumes of herniated discs before Korean Medicine treatment and after Korean Medicine treatment were $1,547.81{\pm}598.15mm^3$ and $947.06{\pm}335.28mm^3$, respectively. The mean resorption rate was $35.7{\pm}16.3%$. Disc extent, intactness of PLL and initial volume of herniated discs were significantly correlated with resorption rate (p=0.003, p=0.001 and p=0.024, respectively). Conclusions Korean Medicine treatment is an effective conservative treatment for lumbar disc herniation. Factors such as disc migration, intactness of PLL, initial volume of herniated disc have a significant association with disc resorption rate.

Keywords

References

  1. Sarwark JF. Essentials of Musculoskeletal Care. 4th ed. Seoul:Panmun Education. 2013:657.
  2. The Society of Korean Medicine Rehabilitation. Korean Rehabilitation Medicine. 4th ed. Paju:Koonja Publishing. 2015:65-6.
  3. Bozzao A, Gallucci M, Masciocchi C, Aprile I, Barile A, Passariello R. Lumbar disc herniation: MR imaging assessment of natural history in patients treated without surgery. Neuroradiology. 1992;185(1):135-41.
  4. Gugliotta M, da Costa BR, Dabis E, Theiler R, Juni P, Reichenbach S, Landolt H, Hasler P. Surgical versus conservative treatment for lumbar disc herniation: a prospective cohort study. BMJ Open. 2016;6(12):1-7.
  5. Cho HJ, Sul JU, Shin MS. Research trends on the treatment of lumbar herniated intervertebral disc in Korean Medicine. Korean Journal of Acupuncture. 2012;29(4):501-18.
  6. Kim SM, Lee SH, Shin YB, Choi JH, Koo JS, Yoo HJ, Lee DH. The effect of Korean Medical combination treatment on 72 cases of herniated intervertebral lumbar disc patients: an observational study. The Acupuncture. 2015;32(2):23-33.
  7. Kim HJ, Jeon JH, Kim YI. Clinical effect of acupotomy combined with Korean Medicine: a case series of a herniated intervertebral disc. Journal of Acupuncture and Meridian Studies. 2016;9(1):31-41. https://doi.org/10.1016/j.jams.2015.09.001
  8. Yang X, Zhang Q, Hao X, Guo X, Wang L. Spontaneous regression of herniated lumbar discs: report of one illustrative case and review of the literature. Clin Neurol Neurosurg. 2016;143:86-9. https://doi.org/10.1016/j.clineuro.2016.02.020
  9. Chiu CC, Chuang TY, Chang KH, Wu CH, Lin PW, Hsu WY. The probability of spontaneous regression of lumbar herniated disc: a systematic review. Clinical Rehabilitation. 2015;29(2):184-95. https://doi.org/10.1177/0269215514540919
  10. Zhong M, Liu JT, Jiang H, Mo W, Yu PF, Li XC, Xue RR. Incidence of spontaneous resorption of lumbar disc herniation: a meta-analysis. Pain Physician. 2017;20(1):E45-52.
  11. Seo JY, Roh YH, Kim YH, Ha KY. Three-dimensional analysis of volumetric changes in herniated discs of the lumbar spine: does spontaneous resorption of herniated discs always occur? Eur Spine J. 2016;25(5):1393-402. https://doi.org/10.1007/s00586-014-3587-1
  12. Komori H, Shinomiya K, Nakai O, Yamaura I, Takeda S, Furuya K. The natural history of herniated nucleus pulposus with radiculopathy. Spine (Phila Pa 1976). 1996;21(2):225-9. https://doi.org/10.1097/00007632-199601150-00013
  13. Modic MT, Steinberg PM, Ross JS, Masaryk TJ, Carter JR. Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging. Radiology. 1988;166(1):193-9. https://doi.org/10.1148/radiology.166.1.3336678
  14. de Roos A, Kressel H, Spritzer C, Dalinka M. MR imaging of marrow changes adjacent to end plates in degenerative lumbar disk disease. AJR. 1987;149(3):531-4. https://doi.org/10.2214/ajr.149.3.531
  15. Autio RA, Karppinen J, Niinimaki J, Ojala R, Kurunlahti M, Haapea M, Vanharanta H, Tervonen O. Determinants of spontaneous resorption of intervertebral disc herniation. Spine (Phila Pa 1976). 2006;31(11):1247-52. https://doi.org/10.1097/01.brs.0000217681.83524.4a
  16. Erly WK, Munoz D, Beaton R. Can MRI signal characteristics of lumbar disk herniations predict disk regression? J Comput Assist Tomogr. 2006;30(3):486-9. https://doi.org/10.1097/00004728-200605000-00022
  17. Ahn SH, Ahn MW, Byun WM. Effect of the transligamentous extension of lumbar disc herniations on their regression and the clinical outcome of sciatica. Spine (Phila Pa 1976). 2000;25(4):475-80. https://doi.org/10.1097/00007632-200002150-00014
  18. Rahme R, Moussa R. The modic vertebral endplate and marrow changes: pathologic significance and relation to low back pain and segmental instability of the lumbar spine. AJNR. 2008;29(5):838-42. https://doi.org/10.3174/ajnr.A0925
  19. Shan Z, Fan S, Xie Q, Suyou L, Liu J, Wang C, Zhao F. Spontaneous resorption of lumbar disc herniation is less likely when modic changes are present. Spine (Phila Pa 1976). 2014;39(9):736-44. https://doi.org/10.1097/BRS.0000000000000259
  20. Kawaguchi K, Harimaya K, Matsumoto Y, Hayashida M, Okada S, Iida K, Kato G, Tsuchiya K, Doi T, Oda Y, Iwamoto Y, Nakashima Y. Effect of cartilaginous endplates on extruded disc resorption in lumbar disc herniation. PLoS One. 2018;13(4):e0195946. https://doi.org/10.1371/journal.pone.0195946

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