scholarly journals Thread Embedding Acupuncture and Complex Korean Medicine Treatment for Lumbar Spinal Stenosis with Degenerative Scoliosis: A Clinical Case Report

2021 ◽  
Vol 38 (4) ◽  
pp. 320-324
Author(s):  
Yu-Kyeong Park ◽  
Jung Hee Lee ◽  
Jae Soo Kim ◽  
Yun Kyu Lee ◽  
Hyun-Jong Lee
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Walking Distance ◽  
Degenerative Lumbar Scoliosis ◽  
Korean Medicine ◽  
Lumbar Scoliosis ◽  
Numerical Rating ◽  
Lumbar Spinal

Lumbar spinal stenosis (LSS) is a common degenerative spinal condition that can have unpredictable improvement and worsening of symptoms which include low back pain, radiating pain, claudication, and degenerative lumbar scoliosis affecting quality of life. In this study, thread embedding acupuncture (TEA) was used as a conservative treatment for LSS in combination with complex Korean medicine treatments (acupuncture, herbal medicines, and physical therapy). The treatment was evaluated using the numerical rating scale, walking distance and duration, and inclination of radiological lumbar scoliosis according to antalgic posture. TEA was performed 27 times between June 8, 2020, and March 16, 2021. The patient showed improvement in numerical rating scale score from 7 to 2, pain-free walking distance from 10 m to 900 m, and scoliosis inclination following treatment. The findings of this study suggest that TEA may be helpful in the treatment of LSS.

scholarly journals Can decompression surgery relieve low back pain in patients with lumbar spinal stenosis combined with degenerative lumbar scoliosis?

2013 ◽  
Vol 22 (9) ◽  
pp. 2010-2014 ◽  
Author(s):  
Shunji Tsutsui ◽  
Ryohei Kagotani ◽  
Hiroshi Yamada ◽  
Hiroshi Hashizume ◽  
Akihito Minamide ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Decompression Surgery ◽  
Degenerative Lumbar Scoliosis ◽  
Low Back ◽  
Lumbar Scoliosis ◽  
Lumbar Spinal

scholarly journals Prediction of walking ability following posterior decompression for lumbar spinal stenosis

2021 ◽  
Author(s):  
Suzanne McIlroy ◽  
Feroz Jadhakhan ◽  
David Bell ◽  
Alison Rushton
Keyword(s):  
Quality Of Life ◽  
Higher Education ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Walking Distance ◽  
Walking Ability ◽  
Poor Outcome ◽  
Lumbar Spinal ◽  
Reduced Risk

Abstract Purpose Following surgery for lumbar spinal stenosis (LSS) up to 40% of people report persistent walking disability. This study aimed to identify pre-operative factors that are predictive of walking ability post-surgery for LSS. Methods An observational cohort study was conducted using data from the British Spine Registry (2017–2018) of adults (≥ 50 years) with LSS, who underwent ≤ 2 level posterior lumbar decompression. Patients receiving fixation or who had previous lumbar surgery were excluded. Walking ability was assessed by a single item on the Oswestry Disability Index and dichotomised into poor/good outcome. Multivariable regression models were performed. Results 14,485 patients were identified. Pre-operatively 30% patients reported poor walking ability, this decreased to 8% at 12 months follow-up. Predictors associated with poor walking ability at 12 months were: increasing age (≥ 75 years OR 1.54, 95% CI 1.07, 2.18), BMI ≥ 35 kg/m2 (OR 1.52, 95% CI 1.00, 2.30), severity of leg pain (OR 1.10, CI 95% 1.01, 1.21), disability (OR 1.01, 95% CI 1.01, 1.02) and quality of life (OR 0.72, 95% CI 0.56, 0.89). Pre-operative maximum walking distance (OR 1.10, 95% CI 1.05, 1.25) and higher education (OR 0.90, 95% CI 0.80, 0.96) were associated with reduced risk of poor walking ability at 12 months; p < 0.05. Depression, fear of movement and symptom duration were not associated with risk of poor outcome. Conclusion Older age, obesity, greater pre-operative pain and disability and lower quality of life are associated with risk of poor walking ability post-operatively. Greater pre-operative walking and higher education are associated with reduced risk of poor walking ability post-operatively. Patients should be counselled on their risk of poor outcome and considered for rehabilitation so that walking and surgical outcomes may be optimised.

scholarly journals Outcome of Surgical Treatment of Degenerative Lumbar Spinal Stenosis.

2016 ◽  
Vol 14 (1) ◽  
pp. 25-28
Author(s):  
Bishnu Babu Thapa ◽  
Sushil Rana Magar ◽  
Pankaj Chand ◽  
Bachhu Ram KC
Keyword(s):  
Conservative Treatment ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Leg Pain ◽  
Walking Distance ◽  
Neurogenic Claudication ◽  
Long Term Outcome ◽  
Degenerative Lumbar Spinal Stenosis ◽  
Vas Score ◽  
Lumbar Spinal

Introduction: Spinal stenosis mostly occur in lumbar spine and causes back pain, leg pain & neurogenic claudication. Although conservative treatment is mainstay, decompression with or without fusion (with or without instrumentation) can be considered in non-responsive cases. However, long term outcome of the surgery is controversial. The aim of our study was to analyze the outcome of surgery in lumbar spinal stenosis in terms of post-operative pain and claudication distance.Methods: A prospective analysis of patients who underwent decompression or decompression with fusion (with or without instrumentation), after failure of 3-6 months conservative treatment, for lumbar spinal stenosis were conducted. Only those who were operated and followed up for at least two years were included.Their preop and postop VAS score and walking distance compared.Results: Of 22 cases enrolled in this study, VAS score was improved in 21 patients and walking distance increased. Only one patient complained of increase in pain score at 24 months.Conclusion: Operative management is a good option for selected patients, 21 out of 22 have improved VAS and claudication distance in our study

Facet-Sparing Decompression of Lumbar Spinal Stenosis: The Minimally Invasive Bilateral Crossover Approach

2021 ◽  
Author(s):  
Jan Helge Klingler ◽  
Ulrich Hubbe ◽  
Christoph Scholz ◽  
Marie T. Krüger
Keyword(s):  
Minimally Invasive ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Case Series ◽  
Surgical Decompression ◽  
Walking Distance ◽  
Adjacent Segment ◽  
Facet Joints ◽  
Study Objective ◽  
Lumbar Spinal

Abstract Background and Study Objective One risk of established decompression techniques for lumbar spinal stenosis is the resection of facet joints, especially if they are steeply configured, promoting destabilization. Minimally invasive bilateral crossover decompression aims to preserve the facet joints and thus stability of the spine. The purpose of this study is to demonstrate the feasibility and early results of this technique. Methods This retrospective case series includes 10 consecutive patients with lumbar stenosis and steep-angle (<35 degrees) facet joints who were treated with minimally invasive bilateral crossover decompression. Eleven segments were decompressed, most commonly L3/L4 (63.6%), followed by L1/L2 and L2/L3 (18.2% each). The effectiveness of surgical decompression was assessed by self-reporting questionnaires. Results After a follow-up of 10.5 months, the Symptom Severity Scale and Physical Function Scale of the Swiss Spinal Stenosis Questionnaire improved by 0.9 (p < 0.05) and 0.7 points, respectively. The mean Oswestry Disability Index improved from 53.9 to 34.6 (p < 0.05). Local and radiating pain under strain showed statistically significant improvement on the Visual Analog Scale (8.9 vs. 5.0 and 8.4 vs. 4.6, respectively). Maximum walking distance increased from 190 to 1,029 m. Apart from one patient requiring surgical decompression of an adjacent segment, there were no reoperations, neurological deteriorations, or other complications. Conclusion The results of this study indicate that minimally invasive bilateral crossover decompression is a promising technique for the treatment of spinal canal stenosis. With its design to spare facet joints, it can potentially reduce the risk of spinal instability, especially in patients with steep facet joints.

scholarly journals Physical Therapy Interventions for Degenerative Lumbar Spinal Stenosis: A Systematic Review

2013 ◽  
Vol 93 (12) ◽  
pp. 1646-1660 ◽  
Author(s):  
Luciana Gazzi Macedo ◽  
Abraham Hum ◽  
Laura Kuleba ◽  
Joey Mo ◽  
Linda Truong ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Walking Distance ◽  
Controlled Trials ◽  
Physical Therapy Treatment ◽  
Lumbar Spinal ◽  
Therapy Treatment ◽  
Better Than

Background Physical therapy is commonly prescribed for patients with lumbar spinal stenosis (LSS); however, little is known about its effectiveness. Purpose The purpose of this study was to systematically review randomized controlled trials (RCTs), controlled trials, and cohort studies evaluating the effectiveness of physical therapy for LSS. Data Sources Studies were searched on electronic databases to January 2012. Study Selection Inclusion criteria were: clinical diagnosis of LSS with confirmatory imaging, evaluation of physical therapy treatment, presence of a comparison group, and outcomes of pain, disability, function, or quality of life. Data Extraction Outcomes were extracted and, when possible, pooled using RevMan 5, a freely available review program from the Cochrane Library. Data Synthesis Ten studies were included: 5 RCTs, 2 controlled trials, 2 mixed-design studies, and 1 longitudinal cohort study. Pooled effects of 2 studies revealed that the addition of a physical therapy modality to exercise had no statistically significant effect on outcome. Pooled effects results of RCTs evaluating surgery versus physical therapy demonstrated that surgery was better than physical therapy for pain and disability at long term (2 years) only. Other results suggested that exercise is significantly better than no exercise, that cycling and body-weight–supported treadmill walking have similar effects, and that corsets are better than no corsets. Limitations The limitations of this review include the low quality and small number of studies, as well as the heterogeneity in outcomes and treatments. Conclusions No conclusions could be drawn from the review regarding which physical therapy treatment is superior for LSS. There was low-quality evidence suggesting that modalities have no additional effect to exercise and that surgery leads to better long-term (2 years) outcomes for pain and disability, but not walking distance, than physical therapy in patients with LSS.

Lumbar Spinal Stenosis: Prognostic Factors for Bilateral Microsurgical Decompression Using a Unilateral Approach

2009 ◽  
Vol 65 (suppl_6) ◽  
pp. ons182-ons187 ◽  
Author(s):  
Luca Papavero ◽  
Marco Thiel ◽  
Erik Fritzsche ◽  
Christina Kunze ◽  
Manfred Westphal ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Walking Distance ◽  
Functional Improvement ◽  
Neurogenic Claudication ◽  
Opioid Use ◽  
Independent Observer ◽  
Outcome Score ◽  
Walking Performance ◽  
Lumbar Spinal

Abstract Objective: We describe a prospective cohort study that investigated the effectiveness of microsurgical bilateral decompression using unilateral laminotomy for lumbar spinal stenosis and assessed the factors influencing the outcome. Methods: A total of 165 consecutive patients underwent decompression for lumbar spinal stenosis. They were divided into 3 age groups: A (&lt;65 years), B (65–75 years), and C (&lt;75 years). Further classification was perforemed according to body mass index (BMI): BMI 1 (&lt;26), BMI 2 (26–30), and BMI 3 (&lt;30), anesthesiological risk factors (American Society of Anesthesiologists), and the number of levels decompressed. The outcome was monitored by an independent observer at 1 week, 3 months, and 1 year after surgery. The following parameters were evaluated: pain (visual analog scale and analgesic consumption), functional improvement (Neurogenic Claudication Outcome Score), and walking performance, defined as walking distance × speed (treadmill). Results: One week after surgery, pain decreased in 85.9% of patients, and a comparison of the pre-and postoperative use of analgesics showed that 38% of nonopioid use and 74% of opioid use were discontinued, whereas nonsteroidal anti-inflammatory drug consumption increased 13%. One year after surgery, pain remained decreased in 83.9% of patients, Neurogenic Claudication Outcome Score increased in 90.3% of patients, and walking performance improved in 92.2% of patients. BMI greater than 30 was the only negative prognostic factor for pain reduction (P = 0.012) and Neurogenic Claudication Outcome Score improvement (P = 0.019). Surprisingly, patients who underwent multilevel decompression benefitted more from surgery than those who underwent single-level decompression. Conclusion: Microsurgical bilateral decompression using unilateral laminotomy is an effective surgical option for lumbar spinal stenosis, even in high-risk patients with multilevel stenosis.

scholarly journals Effect of Complex Korean Medicine Treatment on Sacral Insufficiency Fracture: A Case Report

2020 ◽  
Vol 37 (3) ◽  
pp. 187-192
Author(s):  
Ga Hyeon Jung ◽  
Hyun Lee ◽  
Hwa Yeon Ryu ◽  
Jae Hui Kang
Keyword(s):  
Rating Scale ◽  
Numerical Rating Scale ◽  
Insufficiency Fracture ◽  
Sacral Insufficiency Fracture ◽  
Korean Medicine ◽  
Numerical Rating ◽  
Numerical Rating Scale Score ◽  
History Of ◽  
Sacral Insufficiency Fractures

Sacral insufficiency fractures (SIF) are a common, but often underdiagnosed source of lower back pain without apparent trauma. This report presents the clinical outcome of a 75-year-old female with SIF, and an underlying medical history of osteoporosis and rheumatoid arthritis. She was treated non-operatively, in-hospital, with Korean medicine. Patient progress was assessed using the numerical rating scale and selfreported symptoms. Post-treatment, the numerical rating scale score for pain in her hip decreased from 7 to 2. At admission, the patient was unable to sit, and could only walk 3 m with assistance. At discharge, she could sit for longer than 1 hour and walk further than 200 m unassisted. On the follow-up visit, the patient was asymptomatic, and x-ray scans showed ossification of the sacral and pubic fractures. These results suggest that, Korean medicine can effectively reduce pain and aid rehabilitation in patients with SIF, without the need for surgery.

scholarly journals A Case Report of Korean Medicine Treatment of Lateral Medullary Infarction with Central Dizziness and Hypoesthesia

2021 ◽  
Vol 42 (5) ◽  
pp. 982-990
Author(s):  
Ji-hae Yang ◽  
Jie-yoon Kang ◽  
In-cheol Chae ◽  
In-woo Choi ◽  
Ju-young Ryu ◽  
...  
Keyword(s):  
Case Report ◽  
Herbal Medicine ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Lateral Medullary Infarction ◽  
Korean Medicine ◽  
Numerical Rating ◽  
Medullary Infarction

Objectives: The aim of this study was to report the effectiveness of Korean medicine treatment for a patient with lateral medullary infarction who presented with central dizziness and hypoesthesia.Methods: The patient was treated with Korean medicine treatment, including acupuncture, moxibustion, and herbal medicine. We measured the progress of the case using the Numerical Rating Scale (NRS).Results: After the treatment, the NRS scores for dizziness and hypoesthesia decreased.Conclusions: This study suggests that Korean medicine treatment might be effective for lateral medullary infarction in patients who present with central dizziness and hypoesthesia.

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