요추 추간판 탈출증에서의 자기공명영상소견과 수술소견과의 비교

장진,임오경,하태호,최무림 大韓再活醫學會 1998 Annals of Rehabilitation Medicine Vol.22 No.1

한방병원에 요통으로 내원한 환자에서 X-ray상 요추측만과 MRI상 HIVD와의 연관성 분석

김길환,최영준,권옥준,주영국,송승배,송광찬,서지연,추원정,Kim, Kil-Hwan,Choi, Young-Jun,Kwon, Ok-Jun,Joo, Young-Kuk,Song, Seung-Bae,Song, Gwang-Chan,Seo, Ji-Yeon,Choo, Won-Jung 척추신경추나의학회 2016 척추신경추나의학회지 Vol.11 No.1

Objectives : This study is planned to classify Correlation between Cobbs Angle of Lumbar scoliosis and prevalence of Lumbar Intervertebral Disc. Methods : We Measured the lumbar scoliosis angle of the 114men and 91 women patients with lumbar pain in Bucheon Jaseng Korean Medicine Hospital. We use Cobb's angle method for measuring the lumbar scoliosis. And We use Magentic Resonance Imaging(MRI) for classifying the patient who has lumbar intervertebral disc or not. Results : 1.There was no statistical relation between the Cobbs angle and gender(P>0.05) 2.There was no statistical relation between the Cobbs angle and age(P>0.05) 3.There was significant relation between the direction of lumbar scoliosis and the direction of disc herniation(P<0.05) 4.There was no statistical relation between on the Cobbs angle and disc herniation. The more severe of lumbar scoliosis has not tendency of disc herniation. 5.There was no statistical relation between lumbar scoliosis Cobbs Angle on HIVD of L-spine patient and direction of disc herniation on horizontal plane. Conclusions : The direction of disc herniation has tendency of the opposite direction of lumbar scoliosis. When disc herniation, opposite side bending broad intervertebral foramen and reduce pressure.

요추 추간판 탈출증의 한의학적 치료와 슬링운동 병행 치료 효과

양미성 ( Mi Sung Yang ),강대희 ( Dae Hee Kang ),기영범 ( Young Bum Ki ),박수곤 ( Su Gon Park ),조희근 ( Hee Geun Cho ),최진봉 ( Jin Bong Choi ),설재욱 ( Jae Uk Sul ),김선종 ( Sun Jong Kim ) 경락경혈학회 2010 Korean Journal of Acupuncture Vol.27 No.4

Objectives: Herniated lumbar intervertebral disc is common reason causing back pain. Lumbar stabilization exercise prevent back pain recurrence by strengthening lumbar muscles. Sling Exercise Therapy(SET) is a system for spinal muscle stabilization and strengthening using fixed string and mobile band. The purpose of this study is to investigate and measure the effectiveness of SET and oriental medicine for Herniated lumbar intervertebral disc. Methods: The subjects for this study are 40 patients suffering from Herniated lumbar intervertebral disc in our clinic. They were measured and compared by Visual Analogue Scale(VAS), 4 grades of recovery degree and sex, age, period of disease, disc herniation type, times of exercise. Results: In the above index, the score(VAS, 4 grades of recovery degree) improved after treatments. But they make no difference between sex, age, period of disease, disc herniation type and times of exercise. Conclusions: These results suggest that SET may be used for Herniated lumbar intervertebral disc for pain management and muscle strengthening as an essential treatment regardless of sex, age, period of disease and disc herniation type.

요추간판 탈출증의 보존적인 치료에서 적외선 체열촬영의 의의

박승원,송봉근,정인석,김중길,송운용 대한한방성인병학회 2000 韓方成人病學會誌 Vol.6 No.1

Objectives ; Lumbar disc disease is a common cause of chronic or recurrent low back pain and leg pain. This disease is most likely to occur at the L4-L5 and L5-S1 levels, but upper lumbar levels are involved occasionally. Degeneration of the nucleus pulposus and the annulus fibrosus, which increases with age, may have been asymptomatic or painful. A sneeze, cough, or trivial movement may cause the nucleus pulposus to prolapse, pushing the frayed and weakened annulus posteriorly. This degenerated changes of disc leads to low back pain and radiculopathy. Lumbar radiculopathy due to disc herniation makes difference in the temperature of lower extremities caused by the changes in general function and autonomic functions of the nerve root. Digital infrared thermographic imaging(DITI) shows noninvasively various abnormal condition by detecting the skin temperature. And asymmetry is imfortant in the diagnosis of disc herniation. The study is carried out to investigate the thermal difference of DITI so as to evaluate the conservative therapy of herniated lumbar intervertebral disc's patients Methods ; To evaluate the conservative therapy of the thermographic imaging, the imaging of 47 patients with herniated lumbar intervertebral disc documented by CT scan were analyzed. All the patients had unilateral radiculopathy. Results ; The thermographic imaging of the 47 patients with unilateral radiculopathy showed that the thermal difference of DITI affects conservative therapy. The more the thermal difference of DITI increased, the more the effect of conservative therapy decreased. Conclusion ; The thermal difference of DITI can be useful for the conservative therapy and prognosis of lumbar disc disease patients.

청소년기 요추간판탈출증에 대한 한방 보존적 치료 12례의후향적 분석

김해솔,배영현,김호선,서창용,김노현,이기범,양규진 대한침구의학회 2016 대한침구의학회지 Vol.33 No.1

Objectives : This study was performed to assess the effectiveness of conservative Korean traditional medical treatment on lumbar intervertebral disc herniation in 12 adolescents. Methods : Data were collected from adolescent patients diagnosed with lumbar intervertebral herniation by MRI, hospitalized at Jaseng Korean Medicine Hospital from January 1, 2014 to December 31, 2015. A total of 12 patients were included in the study. Patients were treated by acupuncture, pharmacopuncture, electroacupuncture, herbal medicine, chuna manual therapy, physical therapy during hospitalization period. To measure treatment outcomes, a verbal numerical rating scale (VNRS), Oswestry disability index (ODI), range of motion (ROM), Straight leg raising test (SLR), and EQ-5D were used. Results : The average age of the participants was 16.05±1.62. The average of duration of symptom was 19.25±26.83 (weeks) and the average length of hospitalization was 23.8±16.4 (days). 2 patients (17 %) suffered from only lumbar pain, while 10 patients (83 %) suffered from lumbar and leg pain. No participant suffered from only leg pain. 8 patients (67 %) were diagnosed with disc herniation in one segment, and 4 patients (33 %) were diagnosed with disc herniation in multiple segments. A total of 17 disc segments (28 %) were herniated. The most herniated lumbar level was L4-5. 3 segments were diagnosed with bulging (17 %), 6 with protrusion (35 %), and 8 with extrusion (47 %). Extrusion was the most frequent herniated type. After treatment, the average VNRS of lumbar pain significantly decreased from 5.58±1.62 to 2.91±1.56 (p<0.001) and the average VNRS of leg pain significantly decreased from 5.16±2.51 to 3.08±1.8 (p<0.001). ODI significantly decreased from 48.87±18.72 to 28.57±15.05 (p<0.05), and EQ-5D significantly increased 0.58±0.31 to 0.80±0.12 (p<0.05). Range of flexion significantly improved from 61.25±32.62 to 68.33±26.22 (p<0.05). Conclusion : Conservative Korean Traditional Medical Treatment may be effective in the treatment of lumbar intervertebral disc herniation in adolescence. However, more case reports and clinical research are needed.

재활 필라테스 운동이 허리원반 탈출증 여성 환자의 ODI, 허리뼈 앞굽음각 및 근 횡단면적에 미치는 영향

김원문(Kim, Wonl-Moon) 한국웰니스학회 2021 한국웰니스학회지 Vol.16 No.2

본 연구는 12주간의 재활 필라테스 운동프로그램이 허리원반 탈출증이 있는 여성 환자의 허리뼈 앞굽음각, 허리통증장애지수, 그리고 허리 근 횡단면적 변화에 어떠한 영향을 미치는지를 알아보는 것이다. 본 운동 프로그램은 연구대상자들에게 주 3회, 1회에 70분, 총 12주간 수행하도록 하였다. 본 연구대상자들은 30-40대 허리원반 탈출증 환자 20명을 재활 필라테스 운동집단(EG, n=10), 물리치료집단(CG, n=10)으로 무선 배정하였으며, 본 연구대상자를 대상으로 실험 전, 실험 12주 후 결과를 관찰하여 다음과 같은 결과를 도출하였다. 자료 처리는 이원변량반복분석, 대응표본 t-검증, 독립표본 t-검증을 실시하였다. 모든 통계학적 유의수준은 P<.05로 설정하였다. 허리통증장애지수는 운동 집단에서 시기와 상호작용(P<.001), 집단(P<.05)에서 유의차가 나타냈고, 허리뼈 앞굽음각은 재활 필라테스 운동 집단에서 시기, 집단, 상호작용에서 모두 유의한 차이를 나타났다(P<.001). 그리고 허리 근 횡단면적은 시기(P<.05), 상호작용(P<.001)에서 유의차가 나타났으며, 사후분석 결과 운동집단에서(P<.001) 유의한 차이를 나타내어 각각 요소에서 12주 후 긍정적인 양상을 볼 수 있었다. 결론적으로 이 연구를 통하여 30-40대 허리원반 탈출증 중년 여성 환자의 경우 재활 필라테스 운동을 통하여 허리 원반 탈출증 질환 정도를 개선시킬 수 있다는 가능성을 제시하고 있다. 향후의 연구에서는 50-60대 이상의 연령대 환자를 대상으로 진행되는 비교 연구들이 진행될 필요성을 가지고 있다. The purpose of this study is to investigate how the 12-week rehabilitation Pilates exercise program affects the oswestry disability index, lumbar lordosis angle, and lumbar muscle cross-sectional area in female patients with lumbar herniated intervertebral disc. The exercise program was conducted by subjects 3 times a week, 70 minutes at a time, for a total of 12 weeks. The study subjects were assigned 20 patients with lumbar herniated intervertebral disc in their 30s and 40s wirelessly to the rehabilitation Pilates exercise group (EG, n=10) and the general physical therapy group (CG, n=10), and the results were observed 12 weeks after the experiment. Data processing is two-way repeated ANOVA, paired t-test and independent t-test. The significant level of hypothesis verification is set-up (p<.05). The following results were derived. oswestry disability index in the period and interaction (P<.001), and in the group (P<.05). Lumbar lordosis angle showed significant differences in period, group, and interaction in the rehabilitation Pilates exercise group (P<.001). Lumbar cross-sectional area is used by a significant difference in period (P<.05), interaction (P<.001), As a result of the paired t test, there was a significant difference (P<.001) in the exercise group, and each element showed a positive pattern after 12 weeks. In conclusion, this study suggests the possibility that middle-aged female patients with lumbar disc herniation in their 30s and 40s can improve the degree of lumbar disc disease through rehabilitation pilates exercise. In conclusion, this study suggests the possibility of improving lumbar disc disease through rehabilitation Pilates exercise in middle-aged female patients with lumbar herniated intervertebral disc in their 30s and 40s. In future studies, there is a need for comparative studies conducted on patients in their 50s and 60s or older.

PubMed 검색을 통한 요추 추간판 탈출증의 침치료 연구 동향

신우석 ( Woo Suk Shin ),박원형 ( Won Hyung Park ),차윤엽 ( Yun Yeop Cha ) 한방재활의학과학회 2014 한방재활의학과학회지 Vol.24 No.4

ObjectivesThe purpose of this study is to research current trends of acupuncture treat-ment of lumbar herniated intervertebral disc using the PubMed database.MethodsWe set up the search strategy and investigated clinical trials on acupuncture treatment of lumbar herniated intervertebral disc through PubMed search. This study ana-lyzed previous researched papers published from January 1st, 2000 to April 30th, 2014, and classified them by publication year, journal names, types of literature, treatment meth-ods and evaluation scales. To assess the quality of the reviewed literature, randomized controlled trial (RCT) studies were assessed by Cochrane`s risk of bias (ROB) tool and non-RCT studies were assessed by risk of bias for non-randomized studies (RoBANS).ResultsWe found 35 studies on the acupuncture treatment of lumbar herniated inter-vertebral disc. Papers on this topic have been published, on average, three to four times annually in 9 journals since the mid-2000`s. The journal with the largest number of pub-lications was Chinese Acupuncture & Moxibustion, and most of articles were classified as RCT. Acupuncture treatment was performed individually or together with other treatments. The most frequently used pain evaluation index was visual analogue scale (VAS). The index of effective rate was used frequently but there was a lack of objectivity. In regards to the quality of the studies, outcome assessment in RCT showed that random sequence gen-eration, allocation concealment, and the blinding of participants and personnel increase po-tential of risk of bias. For non-RCT assessment, outcome showed that confounding varia-ble, measurement of intervention were at high risk of bias.ConclusionsIn order to obtain objective clinical evidence of acupuncture treatment of lumbar herniated intervertebral disc, further clinical studies should be designed to minimize the risk of bias, using STRICTA with larger sample sizes. (J Korean Med Rehab 2014;24(4):49-60)

요추 추간판 탈출증 환자에 대한 한의학적 복합치료 효과의 관찰 연구

김세영,박한솔,김민철,서영우,서영훈,이상민,김기옥,김태훈 대한침구의학회 2014 대한침구의학회지 Vol.31 No.4

Objectives : Lumbar disc herniations are common conditions which induce severe pain and disability. We assessed the clinical effectiveness of Korean medical combination treatment. Methods : This is an observational study. We reviewed the medical records of 46 patients with lumbar disc herniations, who attended intensive Korean medical combination treatments at Mokhuri Neck and Back Hospital, Korea during March, 2012 to October, 2012. All the patients took combination treatments of acupuncture, Chuna and herbal medicines during the hospitalization treatments. Zero to ten pain numerating rating scale(NRS) of pain and SF-36 were assessed before and after treatments. Results : During the period, 46 patients with lumbar disc herniation participated in the treatments, respectively. Average admission duration were 20.32 days(SD 9.67) in lumbar disc patients. For lumbar patients, low back pain NRS decreased from 5.84 ± 2.58 to 2.12 ± 1.74(p<0.001) and radiating pain from 6.25 ± 2.30 to 2.59 ± 1.97(p<0.001). Total SF-36 score increased significantly after treatment in lumbar disc patients(p<0.001). Conclusions : Korean medical combination treatment might be effective in reducing pain and improving life quality of patients with lumbar disc herniation.

요추부 추간판 탈출 환자들에서 저산소 유도 인자-1а와 세포사멸

한창환 ( Chang Whan Han ),권순용 ( Soon Yong Kwon ),조윤경 ( Yun Kyoung Cho ),지보근 ( Bo Keun Jee ),김영율 ( Young Yul Kim ),김순희 ( Soon Hee Kim ),강길선 ( Gil Son Khang ) 한국조직공학과 재생의학회 2004 조직공학과 재생의학 Vol.1 No.2

To analyze the expression of a hypoxia inducible factor (HIF)-1а and apoptosis in herniated lumbar discs. 12 human intervertebral discs (IVD) from surgery for lumber disc herniation (LDH) were stained for HIF-1а immunohistochemically and apoptosis through TUNEL method. The patients were on average 35.9 years old. The cases were divided into non-contained (NC: 6 cases) and contained (C: 6 cases) groups. For the control group, IVD from 2 cases of adolescent idiopathic scoliosis (AIS) and 2 of bursting fracture were used. Expression of HIF-1а was visualized in every case, with an average of 65.2±9.5% of the disc cells in the NC group, 33.5±3.6% in the C group, and 13.4±9.7% in the control. Apoptosis occurred in 77.3±7.3% of the cells in the NC group, 45.8±5.5% of C group, and 26.8±8.4% of the control. HIF-1а and apoptosis expressions were both observed more frequently in the LDH groups, and the NC group showed greater expression.(P<0.001) In correlation analysis, the relationship between the degree of HIF-1а expression and apoptosis showed statistically significant correlation. HIF-1а and apoptosis occur physiologically in human IVD. Their expression was the greatest among the NC group.

요추 추간판 탈출증 환자에 대하여 기타 한방치료를 병행한 가열식 화침과 일반침의 효능 비교 연구: 무작위배정, 평가자 맹검, 평행군 설계

정세호,성희진,임수지,이은용,이참결,Jung, Se Ho,Sung, Hee Jin,Lim, Su Ji,Lee, Eun Yong,Lee, Cham Kyul 대한침구의학회 2015 대한침구의학회지 Vol.32 No.4

Objectives : The purpose of this study is to compare the efficacy of fire needling therapy and general acupuncture for the patient with lumbar herniated intervertebral disc. Methods : We observed 20 lumbar herniated intervertebral disc patients from March, 2014 to October, 2015. This study was randomized and assessor blinded. The patients were divided into two groups: one group(group A) was treated by general acupuncture only, and the other group(group B) was treated by fire needling therapy and general acupuncture. We evaluated the treatment effect experienced by each group using the visual analogue scale(VAS) and Oswestry disability index(ODI). Results : 1. In group A, VAS and ODI from before treatment to treatment 4, 8, 12, 16 were significantly improved in statistics. 2. In group B, VAS from before treatment to treatment 4, 8, 12, 16 was significantly improved, but ODI was significantly improved in statistics only from before treatment to treatment 12, not in treatment 4, 8, 16. 3. As a result of comparisons between group A and B, there were no statistical significance in VAS and ODI. Conclusions : This study was not able to determine statistical significance between the group treated by general acupuncture only and the group treated by fire needling therapy and general acupuncture, so further studies are required in the future.