• 국제물리치료학회지
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• 제2권2호
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• pp.318-323
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• 2011

The purpose of this study identify that spinal decompression therapy effect on and pain, length Of leg distance(LLD), and muscle power and flexibility in patient with low back pain. The participants is 20 female and male with low back pain, and participant assign to decompression therapy group and control group at random. The decompression therapy apply to 20 minute 3 time for a week during 4 weeks. The Measurement items is pain, LLD, and muscle power, flexibility. The comparison between the before and after was Wilcoxon's U test, and 2 group after spinal decompression therapy application compared Mann-Whithney U test. Spinal decompression therapy reduced statistically significance the pain, LLD, and increased statistically significance the muscle power and flexibility increased the muscle power(p<.05). This study showed that spinal decompression therapy does affect pain, LLD, and muscle power and flexibility in patient with low back pain.

• The Journal of Korean Physical Therapy
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• 제29권6호
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• pp.299-302
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• 2017

Purpose: The purpose of this study was to examine the effects of spinal decompression therapy on pain and disability in patients with chronic low back pain. Methods: Twenty patients with chronic low back pain were divided into an experimental group (spinal decompression therapy, n=10) and a control group (conservative physical therapy, n=10). Both groups were treated three times a week over a four-week period. Results: The comparison of between-group changes post-treatment revealed statistically significant lower levels of pain and disability in the experimental group than the control group. The comparison of within each group changes before and after the treatment showed statistically significant declines in pain and disability indexes of both groups. Conclusion: Spinal decompression therapy may be an effective intervention for improving pain and disability in patients with chronic low back pain.

• Journal of Korean Neurosurgical Society
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• 제58권1호
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• pp.65-71
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• 2015

Objective : Lumbar spinal stenosis is conventionally treated with surgical decompression. However, bilateral decompression and laminectomy is more invasive and may not be necessary for lumbar stenosis patients with unilateral radiculopathy. We aimed to report the outcomes of unilateral laminectomy and bilateral pedicle screw fixation with fusion for patients with lumbar spinal stenosis and unilateral radiculopathy. Methods : Patients with lumbar spinal stenosis with unilateral lower extremity radiculopathy who received limited unilateral decompression and bilateral pedicle screw fixation were included and evaluated using visual analog scale (VAS) pain and the Oswestry Disability Index (ODI) scores preoperatively and at follow-up visits. Ligamentum flavum thickness of the involved segments was measured on axial magnetic resonance images. Results : Twenty-five patients were included. The mean preoperative VAS score was $6.6{\pm}1.6$ and $4.6{\pm}3.1$ for leg and back pain, respectively. Ligamentum flavum thickness was comparable between the symptomatic and asymptomatic side (p=0.554). The mean follow-up duration was 29.2 months. The pain in the symptomatic side lower extremity (VAS score, $1.32{\pm}1.2$) and the back (VAS score, $1.75{\pm}1.73$) significantly improved (p=0.000 vs. baseline for both). The ODI improved significantly postoperatively ($6.60{\pm}6.5$; p=0.000 vs. baseline). Significant improvement in VAS pain and ODI scores were observed in patients receiving single or multi-segment decompression fusion with fixation (p<0.01). Conclusion : Limited laminectomy and unilateral spinal decompression followed by bilateral pedicle screw fixation with fusion achieves satisfactory outcomes in patients with spinal stenosis and unilateral radiculopathy. This procedure is less damaging to structures that are important for maintaining posterior stability of the spine.

• Journal of Korean Neurosurgical Society
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• 제66권1호
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• pp.6-11
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• 2023

Spinal cord injury (SCI) has a significant negative effect on the quality of life due to permanent neurologic damage and economic burden by continuous treatment and rehabilitation. However, determining the correct approach to ensure optimal clinical outcomes can be challenging and remains highly controversial. In particular, with the introduction of the concept of early decompression in brain pathology, the discussion of the timing of decompression in SCI has emerged. In addition to that, the concept of "time is spine" has been added recently, and the mortality and complications caused by SCI have been reduced by providing timely and professional treatment to patients. However, there are many difficulties in establishing international clinical guidelines for the timing of early decompression in SCI because policies for each country and medical institution differ according to the circumstances of medical infrastructure and economic conditions in the surgical treatment of SCI. Therefore, we aim to provide a current review of timing of early decompression in patient with SCI.

• Journal of Korean Neurosurgical Society
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• 제56권3호
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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.

• Journal of Korean Neurosurgical Society
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• 제62권4호
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• pp.467-475
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• 2019

Objective : There is a lack of knowledge regarding whether decompression is necessary in treating patients with epidural spinal cord compression (ESCC) grade 2. The purpose of this study was to compare the outcomes of minimally invasive surgery (MIS) without decompression and conventional open surgery (palliative laminectomy) for patients with hepatocellular carcinoma (HCC) spinal metastasis of ESCC grade 2. Methods : Patients with HCC spinal metastasis requiring surgery were retrospectively reviewed. Patients with ESCC grade 2, medically intractable mechanical back pain, a Nurick grade better than 3, 3-6 months of life expectancy, Tomita score ${\geq}5$, and Spinal Instability Neoplastic Score ${\geq}7$ were included. Patients with neurological deficits, other systemic illnesses and less than 1 month of life expectancy were excluded. Thirty patients were included in the study, including 17 in the open surgery group (until 2008) and 13 in the MIS group (since 2009). Results : The MIS group had a significantly shorter operative time ($94.2{\pm}48.2minutes$ vs. $162.9{\pm}52.3minutes$, p=0.001), less blood loss ($140.0{\pm}182.9mL$ vs. $1534.4{\pm}1484.2mL$, p=0.002), and less post-operative intensive care unit transfer (one patient vs. eight patients, p=0.042) than the open surgery group. The visual analogue scale for back pain at 3 months post-operation was significantly improved in the MIS group than in the open surgery group ($3.0{\pm}1.2$ vs. $4.3{\pm}1.2$, p=0.042). The MIS group had longer ambulation time ($183{\pm}33days$ vs. $166{\pm}36days$) and survival time ($216{\pm}38days$ vs. $204{\pm}43days$) than the open surgery group without significant difference (p=0.814 and 0.959, respectively). Conclusion : MIS without decompression would be a good choice for patients with HCC spinal metastasis of ESCC grade 2, especially those with limited prognosis, mechanical instability and no neurologic deficit.

• Journal of Korean Neurosurgical Society
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• 제42권3호
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• pp.195-199
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• 2007

Objective : Bilateral laminotomy and unilateral laminotomy for bilateral decompression are becoming the minimally invasive procedures for lumbar spinal stenosis (LSS). With the aim of less invasiveness and better preservation of spinal stability. these techniques have been developed. But there are no large randomized studies to show the surgical results between these two techniques. The objective of this study was to examine the safety and efficacy of these two minimally invasive techniques. Methods : A total of 80 patients were included in this study (Group I : bilateral laminotomy, Group II : Unilateral laminotomy for bilateral decompression). Perioperative parameters and complications were analyzed. Symptoms and scores such as visual analog scale (VAS) scores, Oswestry Disability Index (ODI) scores, and SF-36 scores of prospectively accrued patients were assessed preoperatively and at 1 month and 12 months after surgery. Paired-t test, two-sample student-t tests, and non parametric tests were used to determine cross-sectional differences between two groups. Results : No major complications such as spinal instability or deaths occurred during follow-up periods. VAS, ODI scores and SF-36 body pain and physical function scores showed statistically significant improvements in both groups (p<0.001). The significant widening of the spinal canal diameter was also noted in both groups. But, in Group II. there were minor postoperative complications such as dural tear (2 cases 5.0%), fracture of ipsilateral inferior facet (1 case 2.5%), and 5 cases of transient leg symptoms of contralateral side. Conclusion : Both bilateral laminotomy and unilateral laminotomy for bilateral decompression allow achievement of adequate and long-lasting operative results in patients with LSS. But postoperative complications are more frequent in Group II (unilateral laminotomy and bilateral decompression). These results indicate that bilateral laminotomy is the preferred minimally invasive technique to treat symptomatic LSS.

• Journal of Korean Neurosurgical Society
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• 제53권1호
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• pp.19-25
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• 2013

Objective : We compared the results of two surgical techniques by retrospective study of 60 elderly patients (65 years or older) who underwent either decompression alone or fusion for the treatment of two-level or more lumbar spinal stenosis. Methods : During the period of 2003 and 2008, two-level or more decompression alone or fusion was performed for lumbar spinal stenosis by three surgeons at our institution. Patients were allocated to two groups by surgical modality, namely, to a decompression group (31 patients) or a fusion group (29 patients). Overall mean age was 71.1 years (range, 65-84) and mean follow-up was 5.5 years (range, 3-9). A retrospective review of clinical, radiological, and surgical data was conducted. Results : No significant difference between the two groups was found with respect to age, follow-up period, surgical levels, or preoperative condition. At the last follow-up, correction of lumbar lordotic angle (determined radiologically) was better in the fusion group. However, clinical outcomes including visual analogue scale, Oswestry Disability Index, and the Odom's criteria were not significantly different in the two groups. On the other hand, surgical outcomes, such as, operation time, estimated blood loss, and surgical complications were significantly better in the decompression alone group. Conclusion : Our findings suggest that decompressive laminectomy alone achieves good outcomes in patients with two-level or more lumbar spinal stenosis, associated with an advanced age, poor general condition, or osteoporosis.

• Journal of Korean Neurosurgical Society
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• 제37권4호
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• pp.258-262
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• 2005

Objective: The 5th lumbar spinal nerve can be entrapped in the intraspinal zone, foraminal zone, and the extraforaminal zone simultaneously. The failure to recognize that the nerve root can be compressed in such manners may be the reason of a number of failures of surgical decompression. Here we describe a microsurgical method for the decompression of the triple entrapment of the L5 spinal nerve in 21 patients. Methods: Clinical manifestations and surgical results of twenty-one patients treated surgically under the diagnosis of the triple entrapment of the L5 spinal nerve were reviewed retrospectively. All patients were treated by the posterior midline approach for the intraspinal entrapment and by the paraspinal approach for the foraminal and the extraforaminal entrapment. Results: Pain relief was obtained in all patients immediately after surgery. The mean follow-up period after the surgery was 13 months, ranged from 6 to 24 months. The mean Numeric Rating Scale (pain score) improved from 8.9 before the surgery to 1.4 (P<0.0001). The mean ODI scores improved from 76.2 before the surgery to 13.1 (P<0.0001). Nineteen patients were satisfied with their result at the last follow-up examination. Neither complications related to the surgery, nor the spinal instability was detected. Conclusion: The triple entrapment of the 5th lumbar spinal nerve is an important pathologic entity to identify for the treatment of L5 radiculopathy. Combined medial and lateral approaches are safe, minimally invasive and it provide the complete decompression of triple entrapment of the L5 spinal nerve without causing secondary instability like after complete facetectomy.

• 한국임상수의학회지
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• 제22권4호
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• pp.297-301
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• 2005

개에 실험적으로 후구마비를 유발한 후 감압술과 전침술을 병행 처치하였을 때 그 임상적 효과를 알아보고자 본 실험을 실시하였다. 3.15.0kg, 12년령의 신경계 질환이 없는 임상적으로 건강한 10두의 수캐를 각 5두씩 감압술 및 전침술 병용군 (A군)과 감압술 단독군 (B군)으로 편성하여 각 군의 실험견에 약 $40\%$의 척수압박을 하여 심부통각 지각이 있는 후구마비를 유발하였다. 후구마비 유발 48시간 후, 두 군 모두에 편측추궁절제술을 실시하고 압박물을 제거하였고, 감압술 및 전침술 병용군은 감압 이틀 후부터 회복시점까지 2일에 1회씩 전침 치료를 하였다. 실험기간 중, 매일 Talrov's grading system 변법을 사용하여 임상적 평가를 하였다. 실험전과 치료종료 시점의 체성감각유발전위(SEPs)를 측정하여 측정된 유발전위를 신경전도 속도로 환산하여 신경기능을 확인하였다. 감압술 및 전침술 병용군에서는 술후 보행능력 회복까지 $10.0\pm2.7$일이 걸렸으며, 완전회복까지는 $17.2\pm3.9$일이 소요되어 보행능력 회복에서 완전회복까지 $7.2\pm1.8$일의 재활기간이 필요하다. 한편 감압술 단독 적용군은 술 후 보행능력 회복까지 $13.4\pm3.7$일이 걸렸으며, 완전회복까지는 $34.2\pm14.5$일이 소요되어 보행능력 회복에서 완전회복까지 $20.8\pm11.8$일의 재활기간이 필요했다. 완전회복 후의 SEPs의 전도속도는 실험전의 정상범위로 회복된 양상을 보였다. 감압술 적용 후, 보행능력 획득까지의 기간은 두 군간에 유의적인 차가 없었으나, 완전회복 및 재활기간에 있어서는 감앗술과 전침 병용군이 더 짧은 치료기간을 보였다. 이상의 결과로 보아 개에서 추간판 탈출증에 의한 후구마비가 있는 경우, 감압술과 전침 치료를 병행하면 기능회복 기간을 단축시킬 수 있을 건으로 판단된다.