• Journal of the Korean Society of Physical Medicine
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• v.2 no.1
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• pp.93-99
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• 2007

Purpose : The aim of this study is to consider degenerative spine disease theoretically and compare plain radiography which is a basic study for low back pain with MRI in cases of degenerative lumbar spine disease to find out whether the abnormalities agree with each other. Methods : In 4 cases of lumbar degenerative disease, we studied the relation of the abnormalities such as disc space narrowing, spinal space narrowing, loss of lordosis and osteophytes on plain radiography with those on MRI of HIVD, spinal stenosis and spondylolisthesis. Results : Many abnormalities such as disc space narrowing, spinal space narrowing, loss of lordosis, osteophytes and change of cortex & bone marrow on plain radiography suggest HIVD, spinal stenosis, spondylolysis or spondylolisthesis on MRI. Conclusion : For low back pain patients, plain radiography is a basic study in diagnosis of HIVD, spinal stenosis, spondylolysis or spondylolisthesis but MRI or CT scan is necessary to develop(build) a treatment plan like an operation.

• Journal of Korean Neurosurgical Society
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• v.55 no.6
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• pp.331-336
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• 2014

Objective : The purpose of this study was to evaluate the differences in sagittal spinopelvic alignment between lumbar degenerative spondylolisthesis (DSPL) and degenerative spinal stenosis (DSS). Methods : Seventy patients with DSPL and 72 patients with DSS who were treated with lumbar interbody fusion surgery were included in this study. The following spinopelvic parameters were measured on whole spine lateral radiographs in a standing position : pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis angle (LL), L4-S1 segmental lumbar angle (SLL), thoracic kyphosis (TK), and sagittal vertical axis from the C7 plumb line (SVA). Two groups were subdivided by SVA value, respectively. Normal SVA subgroup and positive SVA subgroup were divided as SVA value (<50 mm and ${\geq}50mm$). Spinopelvic parameters/PI ratios were assessed and compared between the groups. Results : The PI of DSPL was significantly greater than that of DSS (p=0.000). The SVA of DSPL was significantly greater than that of DSS (p=0.001). In sub-group analysis between the positive (34.3%) and normal SVA (65.7%), there were significant differences in LL/PI and SLL/PI (p<0.05) in the DSPL group. In sub-group analysis between the positive (12.5%) and normal SVA (87.5%), there were significant differences in PT/PI, SS/PI, LL/PI and SLL/PI ratios (p<0.05) in the DSS group. Conclusion : Patients with lumbar degenerative spondylolisthesis have the propensity for sagittal imbalance and higher pelvic incidence compared with those with degenerative spinal stenosis. Sagittal imbalance in patients with DSPL is significantly correlated with the loss of lumbar lordosis, especially loss of segmental lumbar lordosis.

• Journal of Acupuncture Research
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• v.38 no.4
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• pp.320-324
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• 2021

Lumbar spinal stenosis (LSS) is a common degenerative spinal condition that can have unpredictable improvement and worsening of symptoms which include low back pain, radiating pain, claudication, and degenerative lumbar scoliosis affecting quality of life. In this study, thread embedding acupuncture (TEA) was used as a conservative treatment for LSS in combination with complex Korean medicine treatments (acupuncture, herbal medicines, and physical therapy). The treatment was evaluated using the numerical rating scale, walking distance and duration, and inclination of radiological lumbar scoliosis according to antalgic posture. TEA was performed 27 times between June 8, 2020, and March 16, 2021. The patient showed improvement in numerical rating scale score from 7 to 2, pain-free walking distance from 10 m to 900 m, and scoliosis inclination following treatment. The findings of this study suggest that TEA may be helpful in the treatment of LSS.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2005.06a
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• pp.1963-1966
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• 2005

Degenerative lumbar spinal stenosis(DLSS) is a disease inducing low back pain, leg pain, convulsion, numbness, and neurogenic claudication from compression of nerve root. Intervertebra fixation was reported to increase the degenerative of neighbor region after treatment. Recently, a new surgical technique of inserting a fixator between interspinous processes has been introduced. The purpose of this study is to design of the interspinous process fixator with flexibility to complement the trouble of using fixator in DLSS. This study evaluated the existing fixator through the mechanical test and modified fixators using the finite element analysis(FEA). Displacement, stiffness and Von-Mises stress were found to have similar values to those obtained from the mechanical test and the FEA in the biomechanical loading condition. Effects of variation in length and thickness were investigated to design an optimal fixator.

• Journal of Korean Neurosurgical Society
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• v.56 no.3
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• pp.206-210
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• 2014

Objective : Lumbar spinal stenosis is a common degenerative spine disease that requires surgical intervention. Currently, there is interest in minimally invasive surgery and various technical modifications of decompressive lumbar laminectomy without fusion. The purpose of this study was to present the author's surgical technique and results for decompression of spinal stenosis. Methods : The author performed surgery in 57 patients with lumbar spinal stenosis between 2006 and 2010. Data were gathered retrospectively via outpatient interviews and telephone questionnaires. The operation used in this study was named central decompressive laminoplasty (CDL), which allows thorough decompression of the lumbar spinal canal and proximal two foraminal nerve roots by undercutting the lamina and facet joint. Kyphotic prone positioning on elevated curvature of the frame or occasional use of an interlaminar spreader enables sufficient interlaminar working space. Pain was measured with a visual analogue scale (VAS). Surgical outcome was analyzed with the Oswestry Disability Index (ODI). Data were analyzed preoperatively and six months postoperatively. Results : The interlaminar window provided by this technique allowed for unhindered access to the central canal, lateral recess, and upper/lower foraminal zone, with near-total sparing of the facet joint. The VAS scores and ODI were significantly improved at six-month follow-up compared to preoperative levels (p<0.001, respectively). Excellent pain relief (>75% of initial VAS score) of back/buttock and leg was observed in 75.0% and 76.2% of patients, respectively. Conclusion : CDL is easily applied, allows good field visualization and decompression, maintains stability by sparing ligament and bony structures, and shows excellent early surgical results.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.1 no.1
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• pp.105-111
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• 2006

Objective : The aim of this study was to evaluate association between lumbar spinal stenosis, one of degenerative diseases, and bone mineral density. Methods : We monitored 9 lumbar spinal stenosis patients in women above 50 years, visiting outpatient clinic of the Jaseng Oriental Medicine Hospital between January 5 2006 and March 31, 2006. They were diagnosed by radiologist ist after taking Magnetic Resonance Imaging(MRI). The cases were Investigated the bone mineral density using Dual Energy X-ray Absorptiomerty(DEXA). and then Picture Archiving Communication System(PACS) were used to assess correlation between lumbar spinal stenosis and bone mineral density. Results : 1. In comparison of the spinal canal area and lumbar spine 2 level bone mineral density, the data showed a significant result 2. The data, between spinal canal area and lumbar spine 1-2 level bone mineral density, indicated a significant result. 3. Also, the result of comparison between spinal canal area and the lowest value of bone mineral density showed significance. Conclusions : It showed that there is a statistically significant correlation between lumbar spinal stenosis and bone mineral density.

• Journal of Korean Neurosurgical Society
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• v.29 no.5
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• pp.599-603
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• 2000

Objectives : In lumbar spine surgery it is observed that the ligamentum flavum(LF) is bilayered, and the inner layers can be left in situ to prevent peridural adhesion in open lumbar disc surgeries. The purposes of this study are to investigate ultrastructural differences between the inner and outer layer of lumbar LF by electron microscopic examination, and to see whether these differences are, if present, more prominent in chronic degenerative lumbar spinal disorders as compared with acute lumbar disc diseases. Methods : Biopsy specimens of LF were obtained from nine patients undergoing lumbar spine surgery, five of them for degenerative spinal stenosis and four for acute disc herniation. During the surgery the outer layers of LF were carefully dissected from the inner layer, and four pieces($1{\times}1{\times}1-mm$) of biopsy samples were made from each layer. These were examined with electron microscope for the morphologies and the contents of the elastic and the collagen fibers. Results : The outer layer of LF showed elastic fiber degeneration as evidenced and decreased fiber content, while the inner layer was relatively preserved in both cases of degenerative spinal stenosis and acute disc herniation. The ultrastructural changes of the layers were more evident in the outer layer. Conclusion : With these observations the authors believe that the LF degeneration may occur mainly in the outer layer, and that this fact may aid in making the rationale for using the inner layer as physiologic barrier to prevent peridural adhesion in open lumbar disc surgeries.

• Journal of Korean Neurosurgical Society
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• v.37 no.4
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• pp.313-315
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• 2005

A 66 year-old woman was admitted to our hospital for progressive weakness of both lower extremities since a month ago. Imaging study, based on plain X-ray, computed tomography and magnetic resonance image revealed spinal stenosis owing to anterior slipping of T10/11 segment. Degenerative spondylolisthesis is common in the lumbar spine and rarely occurs in the cervical spine. But there was no report of degenerative spondylolisthesis in thoracic spine. The authors experienced a case of degenerative spondylolisthesis in the thoracic spine. And we achieved a satisfactory result with posterior decompressive laminectomy alone.

• Journal of Korean Neurosurgical Society
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• v.43 no.5
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• pp.221-226
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• 2008

Objective : The aim of the present study was to assess the safety and efficacy of the dynamic stabilization system in the treatment of degenerative spinal diseases. Methods : The study population included 20 consecutive patients (13 females, 7 males) with a mean age of $61{\pm}6.98$ years (range 46-70) who underwent decompression and dynamic stabilization with the Dynesys system between January 2005 and August 2006. The diagnoses included spinal stenosis with degenerative spondylolisthesis (9/20, 45%), degenerative spinal stenosis (5/20, 25%), adjacent segmental disease after fusion (3/20, 15%), spinal stenosis with degenerative scoliosis (2/20, 10%) and recurrent intervertebral lumbar disc herniation (1/20, 5%). All of the patients completed the visual analogue scale (VAS) and the Korean version of the Oswestry Disability Index (ODI). The following radiologic parameters were measured in all patients : global lordotic angles and segmental lordotic angles (stabilized segments, above and below adjacent segments). The range of motion (ROM) was then calculated. Results : The mean follow-up period was $27.25{\pm}5.16$ months (range 16-35 months), and 19 patients (95%) were available for follow-up. One patient had to have the implant removed. There were 30 stabilized segments in 19 patients. Monosegmental stabilization was performed in 9 patients (47.3%), 9 patients (47.3%) underwent two segmental stabilizations and one patient (5.3%) underwent three segmental stabilizations. The most frequently treated segment was L4-5 (15/30, 50%), followed by L3-4 (12/30, 40%) and L5-S1 (3/30, 10%). The VAS decreased from $8.55{\pm}1.21$ to $2.20{\pm}1.70$ (p<0.001), and the patients' mean score on the Korean version of the ODI improved from $79.58%{\pm}15.93%$ to $22.17%{\pm}17.24%$ (p<0.001). No statistically significant changes were seen on the ROM at the stabilized segments (p=0.502) and adjacent segments (above segments, p=0.453, below segments, p=0.062). There were no patients with implant failure. Conclusion : The results of this study show that the Dynesys system could preserve the motion of stabilized segments and provide clinical improvement in patients with degenerative spinal stenosis with instability. Thus, dynamic stabilization systems with adequate decompression may be an alternative surgical option to conventional fusion in selected patients.

• Journal of the Korean Society for Precision Engineering
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• v.23 no.3 s.180
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• pp.195-202
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• 2006

The degenerative lumbar spinal stenosis (DLSS) is a disease inducing low back pain, leg pain, convulsion. numbness, and neurogenic claudication from compression of nerve root. Intervertebra fixation was reported to increase the degeneration of neighbor lesion after treatment. Recently, a new surgical technique of inserting a fixator between interspinous processes has been introduced. The purpose of this study is to design the interspinous process fixator with flexibility to complement the trouble of using fixator in DLSS. This study evaluated the existing fixator through the mechanical test and modified it using the finite element analysis (FEA). The evaluation was based on the displacement, stiffness and von-Mises stress obtained from the mechanical test and calculated from the FEA in the biomechanical loading condition. Effects of variation in length and thickness were investigated to design an optimal fixator. Three prototypes were manufactured using FEA results. Mechanical tests under the biomechanical loading condition were performed to select the best one from these three. The selected fixator increased flexiblity by 32.9%.