Lumbar spine

Lumbar spine CT 32 111 DOI : 10.3831/KPI.2010.13.2.111 Lumbar Spine CT 32 Received : 10. 05. 23 Revised : 10. 06. 04 Accepted : 10. 06. 11 Key Words: Disc herniation, CT scan, Clinical analysis The Clinical Analysis on 32 Cases of Herniated Lumbar Disc Patients according to Lumbar CT scan. Jeong-ho Kim, Jeong-hwan Lee, Young-il Kim Dept. of Acupuncture & Moxibustion College of Oriental Medicine, Daejeon University. ABSTRACT Objective : This study is to evaluate the effectiveness of the oriental medicine treatment on lumbar disc herniation. Subjects and Methods : The clinical analysis was done on 32 cases of patients with lumbar disc herniation diagnosed by lumbar CT scan. Patients who admitted in Cheongju Oriental Medicine Hospital from April 2007 to April 2008 were analyzed according to the distribution of sex, age, the period of disease, condition on admission, the symptom on admission, Admission day, the treatment efficacy at discharge day. Results : 1. The forties was the most, the acutest phase the most, the day of 8-14 days the most. 2. Multiple bulging disc in 37.5% of CT scan was the most common, followed by a single HNP was 28.1%. 3. Almost 81% patients showed effective efficacy under VAS 3 at discharge day. 4. Single bulging and herniated disc were more short admission days than multiple bulging and herniated disc. I 12 2 4 Correspondence to : Jeong-ho Kim, Cheongju Oriental Hospital of Daejeon University, 173-9 Yongdam-dong, Sangdang-gu, Cheongju, Chungcheongbuk-Do, Rep. of Korea. Tel:82-43-229-3700, Fax:82-43-253-8757, E-mail: omdkjh@dju.ac.kr This research was supported by Daejeon University in 2008

112 Journal of Pharmacopuncture 13 2 2010 06 10 80~90% X CT MRI 2007 4 2008 4 32 CT II 1 2007 4 1 2008 4 30 L-Spine CT 4 32 2 BL23 BL24 BL25 BL26 GB30 BL40 BL57 BL60 BL36 BL37 BL56 GB31 GB34 GB39 BL36 BL37 GB31 GB34 BL36 BL56 GB31 GB34 GB39 0.25 30 2 25 SONOTRON PGN-300N, Neomyth Co., Korea 15-30-60 Hz 5 1 cycle 1 15 2 L-Spine CT 32 CT CT VAS CT 3 3 1 1 T.E.N.S 4 SKIN KOREA, Model KES-650 2 g 15 1 1 1 4

Lumbar spine CT 32 113 1 1 1 1 6 6 2 5 Grade 0 Grade Grade Grade Grade Grade 17 53.1% Grade 9 28.1% Grade 6 19% Table 3 4. 2 6.3% 18 56.3% 9 28.1% 3 9.4% Table 4 5. 8~14 12 37.5% 1~7 7 21.9% 15~21 5 15.6% 22~28 36 3 9.4% 29~35 2 6.3% 16 Table 5 III 6. 1. 19 59.4% 13 40.6% 1.46 : 1 40 13 40.6% 30 11 34.4% 60 4 12.5% 20 2 6.3% 50 70 1 3.1% Table 1 CT Multiple Bulging Disc 12 37.5% H.N.P 9 28.1% Bulging Disc 5 15.6% Bulging Disc & H.N.P 4 12.5% Multiple H.N.P 2 6.3% Table 6 Fig.1 7. CT 2. 17 53.1% 8 25% 7 21.9% Table 2 3. CT Multiple Bulging Disc 8~14 6 36 2 1~7 15~21 22~28 20~35 1 H.N.P 8~14 4 1~7 2 15~21 22~28 29~35 1 Bulging Disc 1~7 2 8~14 15~21 22~28 1 Bulging Disc & H.N.P 15~21 2 1~7 36 1 Multiple H.N.P 1~7 8~14 1 Table 7

114 Journal of Pharmacopuncture 13 2 2010 06 8. CT CT VAS Multiple Bulging Disc VAS 2, 3 4 VAS 1 2 VAS 6, 7 1 Bulging Disc VAS 2 3 VAS 3, 5 1 H.N.P VAS 2 4 VAS 3 3 VAS 1, 5 1 Multiple H.N.P VAS 5, 7 1 Bulging Disc & H.N.P VAS 2, 3 2 Table 8 IV 50~80% 40% protrusion 6~12 80% 19 59.4% 13 40.6% 1.46 : 1 40 13 40.6% 30 11 34.4% 60 4 12.5% 20 2 6.3% 50 70 1 3.1% Table 1 17 53.1% 8 25% 7 21.9% 50% 1 Table 2 Grade 17 53.1% Grade 9 28.1% Grade 6 `19% Grade, Table 3 18 56.3% 9 28.1% 3 9.4% 2 6.3% Table 4 8~14 12 37.5% 1~7 7 21.9% 15~21 5 15.6% 22~28 36 3 9.4% 29~35 2 6.3% 16 1~14

Lumbar spine CT 32 115 Table 5 Multiple Bulging Disc 12 37.5% H.N.P 9 28.1% Bulging Disc 5 15.6% Bulging Disc & H.N.P 4 12.5% Multiple H.N.P 2 6.3% Table 6 CT Multiple Bulging Disc 8~14 6 36 2 1~7 15~21 22~28 20~35 1 H.N.P 8~14 4 1~7 2 15~21 22~28 29~35 1 Bulging Disc 1~7 2 8~14 15~21 22~28 1 Bulging Disc & H.N.P 15~21 2 1~7 36 Multiple H.N.P 1~7 8~14 1 8~14 Bulging Disc H.N.P Bulging Disc H.N.P Table 7 CT VAS Multiple Bulging Disc VAS 2, 3 4 VAS 1 2 VAS 6, 7 1 Bulging Disc VAS 2 3 VAS 3, 5 1 H.N.P VAS 2 4 VAS 3 3 VAS 1, 5 1 Multiple H.N.P VAS 5, 7 1 Bulging Disc & H.N.P VAS 2, 3 2 81% VAS 3 VAS 5 Table 8 V 2007 4 2008 4 32 L- spine CT 1 40 1 2 1~14 2. CT scan Multiple bulging disc 37.5% 3 CT 81% VAS3 4. CT VI 1. Kim KY, Park BM. Causes and Management of Low Back Pain. J Korean Orthop Assoc. 1977;12(1):1-8. 2. 3. Korean Orthopaedic Association. Orthopedics. Seoul:. 1993:375-80. 4. 1986:31. 5. 1994:397-582. 6. 1992:45-6. 7 1993:309 8 1966:278-81. 9. Korean Neurosurgical Society. Neurosurgery. 2nd rev. Seoul 2001:457-68. 10. 1988;4(4):425-31. 11. 1978;1:159-87.

116 Journal of Pharmacopuncture 13 2 2010 06 12. 1977;2:22-4. 13. 1989;6(1):113-28. 14. Kim JK, Song BK, Jung IS. Efficency of Simultaneous Administration of Herb Medicine and NSAIDs in Herniated Lumbar Intervertebral Disc. J Korean Oriental Internal Medicine. 2000;21(1):1-6. 15. 1995:323-407. 16. Choi JR. Back Pain of Muscular Origin. J Korean Pain Society. 1993;6(1):83-95. 17. Korean Neurosurgical Society. Neurosurgery. 1st ed. Seoul: 1998:398-403. 18. Chae SJ, Kim NO, Park YC, Son SS. Comparison of the Improvement of Subjective Symptoms between Body Acupuncture Group 48 Constitution Acupuncture Group. J Korean Acupuncture & Moxibustion Society. 2001;18(3):48-55. 19. Shvartsman L, Weingarten E, Sherry H, Levin C, Persaud A. Cost-effectness analysis of extended conservative theraphy versus surgival intervention in management of H.I.V.D. spine. 1992;17(2):176-82. 20. 1995;12(1):364-79. 21. 1996;13(1):181-90. 22. Park KW, Lee H, Lee BR. The Clinical Study on the Stability of the Lumbosacral angle of the Patient suffering from Low back pain. J Korean Acupuncture & Moxibustion Society. 1999;16(1):41-55. 23. Lee EK, Choi EH, Lee JE, Jeon JH, Lee SH, Lee JM, Kim YM, Kwak BM, Yang GY, Kim YI. The Clinical Study on 137 Cases of Herniated Lumbar Disc Patients. J Korean Acupuncture & Moxibustion Society. 2008;25(3):127-38.

Lumbar spine CT 32 117 Table 1. Distribution of Sex and Age Age Sex Male Female Total(%) 20-29 1 1 2(6.3%) 30-39 10 1 11(34.4%) 40-49 6 7 13(40.6%) 50-59 1 0 1(3.1%) 60-69 0 4 4(12.5%) 70-79 1 0 1(3.1%) Total(%) 19(59.4%) 13(40.6%) 32(100%) Table 2. Distribution of the Period of onset Total(%) Under 1week 17(53.1%) Acute stage 7(21.9%) Subacute stage 8(25%) Total(%) 32(100%) Table 3. Distribution of Patient condition on Admission Male Female Total(%) Grade 0 0 0(0%) Grade 3 3 6(19%) Grade 9 8 17(53.1%) Grade 7 2 9(28.1%) Total(%) 19(59.4%) 13(40.6%) 32(100%)

118 Journal of Pharmacopuncture 13 2 2010 06 Table 4. Distribution of Symptoms Symptoms Sex Male Female Total(%) Only Back pain 1 1 2(6.3%)) Lt. Leg radiate pain 6 3 9(28.1%) Rt. Leg radiate pain 9 9 18(56.3%) Both. Leg radiate pain 3 0 3(9.4%) Total(%) 19(59.4%) 13(40.6%) 32(100%) Table 5. Distribution of Admission Days Days Sex Male Female Total(%) 1-7 3 4 7(21.9%) 8-14 9 3 12(37.5%) 15-21 2 3 5(15.6%) 22-28 1 2 3(9.4%) 29-35 1 1 2(6.3%) 36-3 0 3(9.4%) Total(%) 19(59.4%) 13(40.6%) 32(100%) Table 6. Distribution of Disc type on L-spine CT Disc type Sex Male Female Total(%) Bulging D. 1 4 5(15.6%) Multiple Bulging D. 6 6 12(37.5%) H.N.P. 7 2 9(28.1%) Multiple H.N.P. 2 0 2(6.3%) Bulging & H.N.P. 3 1 4(12.5%) Total(%) 19(59.4%) 13(40.6%) 32(100%)

Lumbar spine CT 32 119 1) Bulging Disc 2) H.N.P 3) H.N.P 4) H.N.P Fig. 1. Lumbar CT scan

120 Journal of Pharmacopuncture 13 2 2010 06 Table 7. Distribution of Admission Days on Disc type Type Days Bulging D. Multiple Bulging D. H.N.P. Multiple H.N.P. Bulging & H.N.P. Total(%) 1-7 2 1 2 1 1 7(32.9%) 8-14 1 6 4 1 12(37.5%) 15-21 1 1 1 2 5(15.6%) 22-28 1 1 1 3(9.4%) 29-35 1 1 2(6.3%) 36-2 1 3(9.4%) Total(%) 5(15.6%) 12(37.5%) 9(28.1%) 2(6.3%) 4(12.5%) 32(100%) Table 8. Result of Treatment According to Disc type Type VAS VAS 1 VAS 2 VAS 3 VAS 4 VAS 5 VAS 6 VAS 7 Total(%) Bulging D. 3 1 1 5(15.6%) Multiple Bulging D. 2 4 4 1 1 12(37.5%) H.N.P. 1 4 3 1 9(28.1%) Multiple H.N.P. Bulging & H.N.P. 1 1 2(6.3%) 2 2 4(12.5%) Total(%) 3(9.4%) 13(40.6%) 10(31.3%) 0(0%) 3(9.4%) 1(3.1%) 2(6.3%) 32(100%)