• Title/Summary/Keyword: Lumbar disc herniation

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Two Cases on Tortipelvis caused by Lumbar Disc Herniation - Using Mckenzie Method Treatment (요추 추간판 탈출증에 의한 골반경사 치험 2례 - Mckenzie 수기요법을 이용)

  • Hwang, Hyung-Joo;Heo, Kwang-Ho;Keum, Dong-Ho
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.2 no.1
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    • pp.85-97
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    • 2007
  • Objectives : We evaluated the effect of Mckenzie method treatment by participating two patients suffering from Tortipelvis by lumbar disc herniation. Methods : Two patients were diagnosed as Tortipelvis by lumbar disc herniation through CT scan and X-ray examination. We used Mckenzie method and measured VAS(Visual analogue scale). Results and Conclusions : After using Mckenzie method treatment, We found out a recovery from both patients suffering from Tortipelvis by lumbar disc herniation. The result, through our study, suggests that Mckenzie method treatment was effective to cure the Tortipelvis by lumbar disc herniation. It also was effective to reduce the low back pain and to stabilize the lumbar disc herniation.

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A Study of the Relationship between Straight Leg Raising, Valsalva Test and Size, Position of Lumbar Disc Herniation (요추부 추간판 탈출 정도와 SLR, valsalva test의 관계)

  • Eom, Tae-Woong;Choo, Won-Jung;Lee, Cha-Ro;Kim, Ho-Jun;Lee, Myeong-Jong
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.2
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    • pp.129-138
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    • 2013
  • Objectives : This study investigated the relationship between straight leg raising(SLR), valsalva test and size, position of lumbar disc herniation. Methods : We took SLR and valsalva test on 105 patients with lumbar disc herniation. According to the result of MRI findings, this study classified three groups of 105 patients with lumbar disc herniation, bulging, protrusion and extrusion. According to the position of lumbar disc herniation, 72 patients that were diagnosed protrusion and extrsuion were sorted 4 groups, lateral, lateral postero-lateral, central postero-lateral, central. The association size, position of lumbar disc herniation and SLR, valsalva test were analysed. Results : The bigger size of disc herniation, the more positive result of SLR and valsalva test, the lower angle of SLR test. There was not significant association between the position of lumbar disc herniation and the angle of SLR test. Conclusions : The SLR and valsalva test is an useful physical examination to speculate about the degree of lumbar disc herniation.

Diagnostic Significance of Discography on Multiple Lumbar Disc Herniation (다발성 요추간반 탈출증에서 추간반조영술의 진단적 의의)

  • Lee, Sang-Won;Kim, Keung-Nyun;Chin, Dong-Kyu;Kim, Young-Soo;Cho, Yong-Eun;Jin, Byung Ho
    • Journal of Korean Neurosurgical Society
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    • v.29 no.5
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    • pp.628-634
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    • 2000
  • Objective : The introduction of MRI makes it easy to detect multiple lumbar disc herniation. However, MRI is not a physiologic test for detecting the symptomatic level. For the surgical plan, it is very important to determine the symtomatic level among the multiple lumbar disc herniation. In this regard, we studied diagnostic significance of discography on multiple lumbar disc herniation in determining the symptomatic level. Method and Material : We retrospectvely analyzed the discographic and clinical findings of 121 patients with multiple lumbar disc herniation for investigating the diagnostic availability of discography. All were surgically treated from January 1995 through May 1998. Result : Discography provocated the same pain as usual symptom in 99 out of 121 patients(81.8%). Compared with surgical findings, the diagnostic accuracy of the discography in multiple lumbar disc herniation was 75.6%, sensitivity was 64.6%, and specificity 87.2%. There was no correlation between the pain provocation of discography and the extent of annular degeneration on CT/discogram. The pain provocation showed good correlation with the extent of annular disruption on CT/discogram. The rate of same result(correlation rate) between the discography and D.I.T.I was 81.4% in multiple lumbar disc herniation patients with unilateral leg pain. Conclusion : These results indicate that in multiple lumbar disc herniation, the discography is considered useful diagnostic tool to determine the symptomatic level and to decide the surgical plan.

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Multi-access for the Diagnosis of Missed Upper Lumbar Disc Herniation

  • Lee, Dong-Yeob;Kim, Hyung-Seok;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • v.38 no.2
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    • pp.144-146
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    • 2005
  • Herein, a case of missed upper lumbar disc herniation, diagnosed by thorough neurological examination, digital infrared thermographic imaging[DITI], and repeated magnetic resonance[MR] image study, is reported. A 36-year-old female presented with intractable leg pain on left anterior thigh. Although she underwent lumbar MR image at other hospital, she was misdiagnosed as acute sprain. Neurological examination suggested the possibility of upper lumbar disc herniation, which was confirmed by DITI, MRI, and selective root block. After operation, her leg pain was significantly improved. It should be considered that upper lumbar disc herniation might be misdiagnosed as an acute sprain, as in our case. A high index of suspicion based on thorough neurological examination is most important in such cases. Then, multi-access such as DITI, MR image, and selective block, base on thorough neurological examination, are warranted.

Lumbar Epidural Varix Mimicking Disc Herniation

  • Bursali, Adem;Akyoldas, Goktug;Guvenal, Ahmet Burak;Yaman, Onur
    • Journal of Korean Neurosurgical Society
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    • v.59 no.4
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    • pp.410-413
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    • 2016
  • Lumbar radiculopathy is generally caused by such well-recognized entity as lumbar disc herniation in neurosurgical practice; however rare pathologies such as thrombosed epidural varix may mimic them by causing radicular symptoms. In this case report, we present a 26-year-old man with the complaint of back and right leg pain who was operated for right L4-5 disc herniation. The lesion interpreted as an extruded disc herniation preoperatively was found to be a thrombosed epidural varix compressing the nerve root preoperatively. The nerve root was decompressed by shrinking the lesion with bipolar thermocoagulation and excision. The patient's complaints disappeared in the postoperative period. Thrombosed lumbar epidural varices may mimic lumbar disc herniations both radiologically and clinically. Therefore, must be kept in mind in the differential diagnosis of lumbar disc herniations. Microsurgical techniques are mandatory for the treatment of these pathologies and decompression with thermocoagulation and excision is an efficient method.

Effect of Neurodynamics on Pain and Paresthesia in Post-operated Patients with Lumbar Disc Herniation

  • Jang, Ki-ryong;Park, Ji-Won;Nam, Kiseok
    • The Journal of Korean Physical Therapy
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    • v.32 no.2
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    • pp.80-87
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    • 2020
  • Purpose: Some patients who have undergone surgery due to lumbar disc herniation still complain of leg pain and other abnormal sensations. Therefore, the study examined the effects of the neurodynamics on pain and other abnormal nerve sensations in post-operated patients with lumbar disc herniation. Methods: The participants of this study comprised 20 adults (10 males and 10 females) who were diagnosed with lumbar disc herniation. The subjects were classified into two groups of 10 patients each in the lower extremity neurodynamics (LEN) and lumbar stabilization exercise (LSE) groups. Each intervention was applied twice a day for one week and was composed of two different exercise patterns; one was applied by a therapist, and the other was performed by the patients themselves. The data were analyzed using assessment methods of Digital Infrared Thermal Imaging (DITI), Toronto clinical neuropathy scoring system (TCNSS), Sympathetic Skin Response (SSR) test, and Oswestry Disability Index (ODI) scale. Results: Significant differences in TCNSS, DITI, ODI scale were observed between the LEN and LSE group (p<0.01). On the other hand, there was no significant difference in the SSR test between pre and post-treatment (p>0.05). Conclusion: The results indicated that neurodynamics treatment is effective in pain reduction and abnormal sensations, such as leg muscle cramps, in post-operated patients with lumbar disc herniation.

Clinical and Radiological Findings of Nerve Root Herniation after Discectomy of Lumbar Disc Herniation

  • Bae, Jun-Seok;Pee, Yong-Hun;Jang, Jee-Soo;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • v.52 no.1
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    • pp.62-66
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    • 2012
  • The authors report 2 cases of nerve root herniation after discectomy of a large lumbar disc herniation caused by an unrecognized dural tear. Patients complained of the abrupt onset of radiating pain after lumbar discectomy. Magnetic resonance imaging showed cerebrospinal fluid signal in the disc space and nerve root displacement into the disc space. Symptoms improved after the herniated nerve root was repositioned. Clinical symptoms and suggestive radiologic image findings are important for early diagnosis and treatment.

10 Cases of Patients with Lumbar Disc Herniation Improved after Oriental Intensive Therapy (한방 집중 치료 후 호전된 요추 추간판 탈출증 환자 10례)

  • Lee, Sang-Young;Cheong, Pil-Sun;Han, Se-Hyuk;Hwang, Choon-Ho;Yoon, Young-Jeoi;Kim, Hyung-Seok;Kim, Hyung-Woo;Jeong, Hyun-Woo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.25 no.4
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    • pp.702-707
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    • 2011
  • Patients with lumbar disc herniation are faced with lowered quality of life. For this reason, we investigated the effects of Oriental Intensive Therapy (OIT) including acupuncture, pharmacopuncture, manual therapy and herbal medicine on patients with lumbar disc herniation. Ten patients, diagnosed with lumbar disc herniation by MRI in hospital, were treated with OIT for 12 weeks. Symptoms of the patients were assessed using Verbal Numerical Rating Scale (VNRS) and Oswestry Disability Index (ODI). All patients were investigated every a week. In our results, intensity of pain was reduced after 4 weeks treatment significantly by VNRS, Quality of life has also improved after 4 weeks treatment by ODI. In conclusion, this study suggests that OIT may be effective to treat patients with lumbar disc herniation.

Effect on the facet joint tropism and lumbar paraspinal muscles according to the type of lumbar disc herniation (허리 척추사이원반 탈출 정도가 척추 후관절의 비대칭과 허리 주변근육에 미치는 영향)

  • Baek, Min-Joo;Lee, Yang-Jin;Kim, Seong-Yoel
    • Journal of Korean Physical Therapy Science
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    • v.28 no.3
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    • pp.42-52
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    • 2021
  • Background: The purpose of this study was to investigate the effects of the severity and direction of lumbar disc herniation (LDH) on the facet joints and paraspinal muscles. Design: Cross-sectional design. Methods: The subjects were divided according to the diagnosis for severity of unilateral herniation of L4-L5 disc. The groups consisted of disc protrusion group (n=15), disc extrusion group (n=15), and no disc herniation group (n=15). The asymmetry and angle of facet joints and the cross-sectional area of paraspinal muscles were analyzed and compared using magnetic resonance imaging (MRI). Results: The results showed that the angle of facet tropism was larger in disc extrusion group than the disc protrusion group and the difference was found to be significant difference (p<0.01). In addition, when both left and right angles of patients with unilateral disc herniation were measured, the results showed larger facet joint angle in the herniated area of the disc extrusion group than in the disc protrusion group. When paraspinal muscles were measured according to the severity of disc herniation and the degree of facet joint asymmetry, there was no difference in paraspinal muscles between the disc protrusion and disc extrusion groups. Meanwhile, the multifidus muscle was smaller in the group with facet tropism than the group without facet tropism (p<0.03), while there were no significant differences in the erector spinae and psoas muscles. Conclusion: Progression of disc herniation resulted in increased facet joint tropism, increased angle of the facet joints in the direction of disc herniation, and decreased size of the multifidus muscle.

Effectiveness of Korean Medicine Treatment on Lumbar Intervertebral Disc Herniation Patients' Fear-Avoidance Belief (요추 추간판 탈출증 환자에 적용된 한의학적 치료가 공포-회피 반응에 미치는 효과)

  • Choi, Young-Jun;Moon, Byung-Heon;Ju, Yeung-Guk;Kim, Kil-Hwan;Song, Seong-Bae;Shin, Dong-Jae;Chung, Jai-Hyeon;Lee, Chi-Ho
    • Journal of Korean Medicine Rehabilitation
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    • v.26 no.3
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    • pp.97-108
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    • 2016
  • Objectives This study is planned to classify effectiveness of Korean medicine treatment on lumbar intervertebral Disc herniation patients' fear-avoidance belief. Methods We measured 84 patients with lumbar intervertebral disc herniation in Jaseng Korean Medicine Hospital. We used numeric rating scale, oswestry disability index, fear-avoidance belief questionaire for evaluating effectiveness of oriental medicine treatment on lumbar intervertebral disc herniation. And We used Magentic Resonance Imaging(MRI) for classifying the patient who has lumbar intervertebral disc or not. Results 1. There was statistical effectiveness of korean medicine treatment on lumbar intervertebral disc herniation patients' fear-avoidance belief (p<0.01). ${\Delta}NRS$ and ${\Delta}ODI$ (r=0.587) was Most statistically correlative. ${\Delta}ODI$ and ${\Delta}FABQ$ had a little of statistically correlation (r=0.313). ${\Delta}NRS$ and ${\Delta}FABQ$ has no statistically correlation (r=0.145). Conclusions This study suggests that screening for the korean medicine treatment reduces fears and negative belief of patients with the lumbar disc herniation and prevents chronic physical symptoms that come from them so that it can be a great help to controlling patients' pain clinically.