유출된 요추부 추간판의 시간에 따른 변화 −증례보고−
Historical Changes of Extruded Lumbar Intervertebral Disc −A case report−
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
We studied the historical changes of intervertebral disc displacement using magnetic resonance imaging. The phenomenon of the spontaneous regression of herniated discs is well known. The case of a 40-years-old male presenting with a large disc herniation at L5-S1, experiencing severe sciatic pain, and having the straight leg raising test positive at 25 degrees is presented. The extruded disc was documented by clinical examination. He was treated conservatively with epidural steroid injection (ESI), medication, physical therapy and self-exercise and reevaluated in 10 weeks later, 30 and 1 year. Large extruded disc can be treated successfully by physical therapy with ESI. However, the degeneration and the dehydration of disc result in decrease of disc height. Consequently, the regression of extruded disc might have been due to the resorption and the dehydration.
Abstract
We studied the historical changes of intervertebral disc displacement using magnetic resonance imaging. The phenomenon of the spontaneous regression of herniated discs is well known. The case of a 40-years-old male presenting with a large disc herniation at L5-S1, experiencing severe sciatic pain, and having the straight leg raising test positive at 25 degrees is presented. The extruded disc was documented by clinical examination. He was treated conservatively with epidural steroid injection (ESI), medication, physical therapy and self-exercise and reevaluated in 10 weeks later, 30 and 1 year. Large extruded disc can be treated successfully by physical therapy with ESI. However, the degeneration and the dehydration of disc result in decrease of disc height. Consequently, the regression of extruded disc might have been due to the resorption and the dehydration.
참고문헌 (20)
- Wheeler AH, "Chronic lumbar spine and radicular pain: pathophysiology and treatment", Curr Pain Headache Rep, 6, pp.97~105 (2002)
- Nakagawa H, "Optimal duration of conservative treatment for lumbar disc herniation depending on the type of herniation", J Clin Neurosci, 14, pp.104~109 (2007)
- Benoist M, "The natural history of lumbar disc herniation and radiculopathy", Joint Bone Spine, 69, pp.155~160 (2002)
- Birbilis TA, "Spontaneous regression of a lumbar disc herniation: case report", Med Sci Monit, 13, pp.121~123 (2007)
- 김영훈, "요추 추간판탈출증의 자연적 흡수 증례 보고", The Korean Journal of Pain, 18(1), pp.56~59 (2005), 대한통증학회
- 안상호, "Comparison of Clinical Outcomes and Natural Morphologic Changes between Sequestered and Large Central Extruded Disc Herniations", Yonsei Medical Journal, 43(3), pp.283~290 (2002), 연세대학교의과대학
- Hogrel JY, "Development of a French isometric strength normative database for adults using quantitative muscle testing", Arch Phys Med Rehabil, 88, pp.1289~1297 (2007)
- Kim DY, "Validation of the Korean version of the oswestry disability index", Spine, 30, pp.123~127 (2005)
- Griffith JF, "Modified Pfirrmann grading system for lumbar intervertebral disc degeneration", Spine, 32, pp.708~712 (2007)
- Fagerlund MK, "Size of lumbar disc hernias measured using computed tomography and related to sciatic symptoms", Acta Radiol, 31, pp.555~558 (1990)
- Inoue H, "Radiographic evaluation of the lumbosacral disc height", Skeletal Radiol, 28, pp.638~643 (1999)
- Yu CY, "Geometric and morphological changes of the intervertebral disc under fatigue testing", Clin Biomech, 18, pp.3~9 (2003)
- Iatridis JC, "Mechanisms for mechanical damage in the intervertebral disc annulus fibrosus", J Biomech, 37, pp.1165~1175 (2004)
- Takahashi H, "A mechanism for sciatic pain caused by lumbar disc herniation-involvement of inflammatory cytokines with sciatic pain", Nippon Seikeigeka Gakkai Zasshi, 69, pp.17~29 (1995)
- Balagué F, "Recovery of impaired muscle function in severe sciatica", Eur Spine J, 10, pp.242~249 (2001)
- Henmi T, "Natural history of extruded lumbar intervertebral disc herniation", J Med Invest, 49, pp.40~43 (2002)
- Tertti M, "Disc degeneration in magnetic resonance imaging. A comparative biochemical, histologic, and radiologic study in cadaver spines", Spine, 16, pp.629~634 (1991)
- Splendiani A, , Neuroradiology, 46, pp.916~922 (2004)
- Gelabert-González M, "Spontaneous resolution of a lumbar disc herniation", Neurocirugia, 18, pp.138~140 (2007)
- Roberts S, "Biochemical and structural properties of the cartilage end-plate and its relation to the intervertebral disc", Spine, 14, pp.166~174 (1989)