• Title, Summary, Keyword: Herniation of lumbar disk

Search Result 9, Processing Time 0.044 seconds

Prolonged Physiotherapy versus Early Surgical Intervention in Patients with Lumbar Disk Herniation: Short-term Outcomes of Clinical Randomized Trial

  • Abou-Elroos, Doaa Abdelmohsen;El-Toukhy, Mirvat Abd El-Hameed;Nageeb, Ghada Sanad;Dawood, Essam Abdelhameed;Abouhashem, Safwat
    • Asian Spine Journal
    • /
    • v.11 no.4
    • /
    • pp.531-537
    • /
    • 2017
  • Study Design: Randomized controlled trial. Purpose: We compared the disability and functional outcome after conservative treatment with prolonged physiotherapy versus early surgical intervention in patients with lumbar disk herniation. Overview of Literature: Lumbar disk herniation is one of the most common causes of job-related disability in individuals less than 45 years old. Conservative treatment is the initial pathway for the majority of patients but the duration of conservative treatment remains debatable and the adverse effects of prolonged conservative treatment are still unclear. Prolonged duration of symptoms before surgical intervention is associated with worse outcomes than a short period of symptoms. Methods: From June 2011 to July 2013, 60 patients with lumbar disk herniation at our institute were randomized into two groups. Group I was treated with prolonged physiotherapy and rehabilitation for 6 months, while group II was treated with early surgical discectomy. Oswestry disability index was used to assess disability, while the Prolo economic outcome rating scale was used to assess the work status. Results: Most patients were males between 21 and 45 years old (mean age, $35.88{\pm}7.15$). There was significant improvement in the disability and work status in both groups without statistically significant differences in the disability score at the second or third assessment. However, the Prolo scale became significantly better in group I than in group II patients during the second and third assessments. Conclusions: A prolonged physiotherapy and rehabilitation program is a beneficial and successful treatment in patients with recently diagnosed lumbar disk herniation.

Misunderstanding of Foot Drop in a Patient with Charcot-Marie-Tooth Disease and Lumbar Disk Herniation

  • Han, Youngmin;Kim, Kyoung-Tae;Cho, Dae-Chul;Sung, Joo-Kyung
    • Journal of Korean Neurosurgical Society
    • /
    • v.57 no.4
    • /
    • pp.295-297
    • /
    • 2015
  • We report the case of 57-year-old woman diagnosed with Charcot-Marie-Tooth (CMT) disease and lumbar disk herniation (LDH). She had left leg weakness and foot numbness, foot deformity (muscle atrophy, high arch, and clawed toes). The lumbar spine MRI showed LDH at L4-5. Additionally, electrophysiology results were consistent with chronic peripheral motor-sensory polyneuropathy (axonopathy). In genetic testing, 17p11.2-p12 duplication/deletions characteristic of CMT disease were observed. We confirmed the patient's diagnosis as CMT disease and used conservative treatment.

Lumbar Disc Herniation Presented with Contralateral Symptoms

  • Kim, Pius;Ju, Chang Il;Kim, Hyeun Sung;Kim, Seok Won
    • Journal of Korean Neurosurgical Society
    • /
    • v.60 no.2
    • /
    • pp.220-224
    • /
    • 2017
  • Objective : This study aimed to unravel the putative mechanism underlying the neurologic deficits contralateral to the side with lumbar disc herniation (LDH) and to elucidate the treatment for this condition. Methods : From January 2009 to June 2015, 8 patients with LDH with predominantly contralateral neurologic deficits underwent surgical treatment on the side with LDH with or without decompressing the symptomatic side. A retrospective review of charts and radiological records of these 8 patients was performed. The putative mechanisms underlying the associated contralateral neurological deficits, magnetic resonance imaging (MRI), electromyography (EMG), and the adequate surgical approach are discussed here. Results : MRI revealed a similar laterally skewed paramedian disc herniation, with the apex deviated from the symptomatic side rather than directly compressing the nerve root; this condition may generate a contralateral traction force. EMG revealed radiculopathies in both sides of 6 patients and in the herniated side of 2 patients. Based on EMG findings and the existence of suspicious lateral recess stenosis of the symptomatic side, 6 patients underwent bilateral decompression of nerve roots and 2 were subjected to a microscopic discectomy to treat the asymptomatic disc herniation. No specific conditions such as venous congestion, nerve root anomaly or epidural lipomatosis were observed, which may be considered the putative pathomechanism causing the contralateral neurological deficits. The symptoms resolved significantly after surgery. Conclusion : The traction force generated on the contralateral side and lateral recess stenosis, rather than direct compression, may cause the contralateral neurologic deficits observed in LDH.

The State of Clinical Trials on Acupotomy for Lumbar Disc Herniation in China (요추 추간판 탈출증에 대한 중국 내 도침 임상 연구의 현황 분석)

  • Jun, Purumea;Liu, Yan;Park, Ji-Eun;Jung, So-Young;Han, Chang-Hyun
    • Journal of Korean Medicine Rehabilitation
    • /
    • v.27 no.2
    • /
    • pp.39-54
    • /
    • 2017
  • Objectives This study aimed to search the Chinese literature on acupotomy for lumbar disc herniation and to analyze their methodologies. Methods Using 4 Chinese databases (CBM [www.sinomed.ac.cn], CNKI [www.cnki.net], WANFANG [www.wanfangdata.com], and WEIPU [www.cqvip.com]), we searched for clinical trials conducted in China over the past 10 years on acupotomy for lumbar disc herniation. The search terms used were "(腰椎椎間板脫出症 or 椎間板脫出症 or 椎間板脫出) and (针刀or 针刀松解术)" and we selected only meta-analyses that were published before December 2016. From among these meta-analyses, we excluded duplicates and selected the remaining 36 randomized controlled trials (RCTs) for our final analysis. Results The largest numbers of acupotomy papers were published in 2008 and 2013 (8 papers each). The average number of subjects was 120; the most common treatment method used for the control group was standard acupuncture (in 11 papers), and the most common concurrent treatment in the treatment group was massage (in 10 papers). The most common site of needle insertion was between the spinous processes, or at less than 0.5 cm on either side of the spinous processes (in 24 papers). The most common site of adhesion lysis was at the transverse process (in 24 papers). Two studies were blinded, and the mean Jadad score was 1.17. Conclusions A large number of RCTs on the use of acupotomy for lumbar disc herniation are conducted every year in China, and the procedure has been shown to be very effective, with few adverse effects. However, the average quality of the studies was not very high. Based on our study, we expect several high-quality clinical trials on acupotomy to be conducted in Korea in the future.

Literature Review of Catgut-embedding Therapy for Lumbar Disk Herniation (요추 추간판 탈출증의 매선치료에 대한 문헌적 고찰)

  • Park, Sang-Hun;Jeon, Yong-Tae;Han, Kuk-In;Kim, Min-Ji;Lee, Ha-Il;Lee, Jung-Han;Ko, Youn-Seok
    • Journal of Korean Medicine Rehabilitation
    • /
    • v.25 no.4
    • /
    • pp.29-40
    • /
    • 2015
  • Objectives We have attempted to provide the basis of treatment effects by considering foreign & domestic randomized controlled trials (RCTs), being implemented with catgut-embedding therapy for lumbar disc herniation. Methods We found the literatures prepared in Korean, English, and Chinese by December 2014 in electronic databases (Pubmed, Science Direct, Proquest, OASIS, KMbase, NDSL, RISS, National Assembly Library). We choosed RCTs by selection criteria through abstracts & articles, extracted and analyzed data. Cochrane's Risk of Bias Tool was used & implemented for the risk of bias. Results The total of 17 studies were included in the review. 88.2% of studies were accomplished within the last decade. The experimental group has shown more significant effects in 70.6% of studies, and the long-term & partial significant results were obtained in 29.4% of studies. Affected lumbar area and pelvic limb area with radiating pain were mostly selected for acupoint. Conclusions Overall and partial significant results were obtained from 17 foreign & domestic comparative RCTs which substantiates the treatment effects of catgut-embedding therapy for lumbar disc herniation. Since all studies, however, were exposed to the risk of bias, so future research of higher quality shall be necessary.

A Case of Neurogenic Bladder Patient with Lumbar Disc Herniation (요추간판탈출증(腰椎間板脫出症)과 동반한 신경인성(神經因性) 방광(膀胱) 치험(治驗) 1례(例))

  • Kim, Sung-Nam;Lim, Jeong-A;Lee, Sung-Yong;Yun, Jong-Min;Choi, Sung-Yong;Kim, Hong-Hoon;Moon, Hyung-Cheol;Kim, Sung-Chul
    • Journal of Acupuncture Research
    • /
    • v.22 no.4
    • /
    • pp.155-163
    • /
    • 2005
  • Objectives : This is a clinical report about neurogenic bladder patient with lumbar disc hernication. Neurogenic bladder is a dysfunction that results from interference with the normal nerve pathways associated with urination. Hypotonic (flaccid) neurogenic bladder can be caused by ruptured or herniated intervertebral disk. Methods : The patient was treated by Oriental medicine treatment with needle acupuncture, electropuncture, bee venom acua-acupuncture and Daeboonchungeum-gami etc. Voided volume and frequency, visual analogue scale and physical examination was used to estimate the efficacy of these treatment. Results : STZ As using these treatments, voided volume and frequency returns normal condition. Visual analogue scale dips as low as 2. Physical examination showed improvement as compared with the fist visit. And further, these treatment may influence on the recovery of neurogenic bladder patient with lumbar disc herniation. Conclusion : The results suggest that Oriental medicine treatment have an useful effect on neurogenic bladder patient's treatment and recovery.

  • PDF

Effect of Combined Traditional Acupuncture, Pharmacopuncture and Applied Kinesiology on Lumbar Diseases of Resident Patients

  • Lee, Sang-Ju;Ahn, Chang Beohm
    • Journal of Pharmacopuncture
    • /
    • v.22 no.3
    • /
    • pp.184-191
    • /
    • 2019
  • Objectives: Recently several Korean medical doctors have begun practicing applied kinesiology (AK). Although the efficacy of combining traditional acupuncture (TA) and pharmacopuncture (PP) on lumbar diseases such as lumbar spinal stenosis (LSS) and lumbar herniation of intervertebral disk (LHID) has been examined, the possible benefits of combining TA, PP and AK approaches have not been examined. Therefore the aim of this study was to develop effective treatment for lumbar disorders by combining TA, PP, and AK treatments. Methods: Twenty-four patients hospitalized at Samse Korean Traditional Medicine Hospital between March and September 2018 with L5 or S1 root radiculopathy associated with LSS and LHID were included in this study. They were treated for 10 days with TA, PP and AK approaches that included category block, manipulation and strain/counterstrain treatments. The primary outcomes were mainly assessed using Japanese Orthopedic Association lumbar scores (JOALS). JOALS were determined before the start of treatment as well as five and 10 days after treatment started. Results: The treatments improved the lumbar condition of the patients based on JOA pain score. Conclusion: The combined TA, PP and AK treatments were effective in treating spinal diseases of resident patients. Prospective, controlled, and relevant protocols using multimodal strategies to define the role of TA, PP and AK are needed.

Effect of Combined Traditional Acupuncture and Applied Kinesiology on Lumbar Diseases

  • Ahn, Chang Beohm;Lee, Sang-Ju;Park, Yeo Bin;Park, Yun Leong
    • Journal of Acupuncture Research
    • /
    • v.37 no.2
    • /
    • pp.94-101
    • /
    • 2020
  • Background: Several Korean medical doctors have been practicing applied kinesiology (AK), invented in 1964 by Dr. George J Goodheart, USA. Although the efficacy of traditional acupuncture (TA) and pharmacopucture treatment for lumbar conditions/diseases has been examined, the possible benefits of combining TA and AK have not been reported. Therefore, the aim of this study was to report the effects of combining TA and AK treatment for lumbar disorders using the Japanese Orthopedic Association lumbar score (JOALS) assessment. Methods: There were 21 outpatients treated at Samse Korean Traditional Hospital between March 2018 and September 2018, who presented with L4/L5 or L5/S1 root radiculopathy associated with lumbar spinal stenosis (LSS) and lumbar herniation of intervertebral disk (LHID). They were treated 10×(2 sessions per week, for 5 weeks) with TA and AK approaches that included a category block, manipulation or strain/counterstrain treatments. The primary outcome was mainly assessed using the JOALS score which was used before (0 ×), during (5 ×), and after treatment (10 ×). Results: There were 19 patients diagnosed with LSS and 2 were diagnosed with LHID. Using the JOALS assessment, TA and AK combined approaches improved the lumbar conditions of all 21 patients after 5 × treatmentsand continued to improve after 10 × treatments (p < 0.001). Conclusion: Combined TA and AK treatment was effective in treating spinal conditions/diseases. Prospective, relevant, well-controlled protocols for TA and AK therapies for various conditions are needed.

Occurrence of Trochlear Nerve Palsy after Epiduroscopic Laser Discectomy and Neural Decompression

  • Yoon, Keon Jung;Lee, Eun Ha;Kim, Su Hwa;Noh, Mi Sun
    • The Korean Journal of Pain
    • /
    • v.26 no.2
    • /
    • pp.199-202
    • /
    • 2013
  • Epiduroscopic laser discectomy and neural decompression (ELND) is known as an effective treatment for intractable lumbar pain and radiating pain which develop after lumbar surgery, as well as for herniation of the intervertebral disk and spinal stenosis. However, various complications occur due to the invasiveness of this procedure and epidural adhesion, and rarely, cranial nerve damage can occur due to increased intracranial pressure. Here, the authors report case in which double vision occurred after epiduroscopic laser discectomy and neural decompression in a patient with failed back surgery syndrome (FBSS).