Annals of Rehabilitation Medicine

Korean Academy of Rehabilitation Medicine (대한재활의학회)
권호 표지

Comparison between the Effect of Transforaminal Steroid Injection and Transforaminal Steroid Injection Combined with Spinal Decompressor on Lumbar Disc Herniation

요추 추간판 탈출증 치료 시 경막외 주사와 척추감압기 병용 시의 효과 비교

Lee, Jeoung-Eun;Lee, Ho-Jun;Hong, Young-Ki;Kang, Seouk;Yoon, Bum-Chul;Lee, Sang-Heon
이정은;이호준;홍영기;강석;윤범철;이상헌

  • Published : 2007.10.30
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Abstract

Objective: To assess the short-term clinical effect of a new spinal decompression device (DRX-3000) combined with transforaminal steroid injection (TFI) in comparison with TFI only in patients with lumbar herniated intervertebral disc (HIVD) Method: Fourty-one patients diagnosed as lumbar intervertebral disc herniation were recruited and divided into two therapeutic groups. Eighteen patients were treated with DRX-3000 combined with TFI. Twenty-three patients were treated with only TFI. The visual analogue scale (VAS), straight leg rasing test (SLR), radiating pain, Oswestry Disability Index (ODI), sitting tolerance, standing tolerance and sleeping tolerance were measured before treatment and 4 weeks after treatment. Results: VAS, radiating pain, sitting tolerance and ODI were significantly improved after treatment in all patients (p＜0.05). SLR and sleeping tolerance were significantly improved in combined treatment group and standing tolerance were significantly improved in TFI group after treatment (p＜0.05). After treatment, degree of VAS decrease was larger in combined treatment group than TFI group(p＜0.05). Conclusion: Spinal decompression with TFI was more effective than only TFI in patients with lumbar HIVD in a short period. (J Korean Acad Rehab Med 2007; 31: 590-595)

Keywords

References

  1. Weinstein JN, Lurie JD, Tosteson TD, Skinner JS, Hanscom B, Tosteson AN, Herkowitz H, Fischgrund J, Cammisa FP, Albert T, et al. Surgical vs nonoperative treatment for lumbar disk herniation: the Spine Patient Outcomes Research Trial (SPORT) observational cohort. JAMA 2006; 296: 2451-2459 https://doi.org/10.1001/jama.296.20.2451
  2. Weinstein JN, Tosteson TD, Lurie JD, Tosteson AN, Hanscom B, Skinner JS, Abdu WA, Hilibrand AS, Boden SD, Deyo RA. Surgical vs nonoperative treatment for lumbar disk herniation: the Spine Patient Outcomes Research Trial (SPORT): a randomized trial. JAMA 2006; 296: 2441-2450 https://doi.org/10.1001/jama.296.20.2441
  3. Carragee EJ, Han MY, Suen PW, Kim D. Clinical outcomes after lumbar discectomy for sciatica: the effects of fragment type and anular competence. J Bone Joint Surg Am 2003 Jan; 85: 102-108 https://doi.org/10.2106/00004623-200301000-00016
  4. Carragee EJ, Spinnickie AO, Alamin TF, Paragioudakis S. A prospective controlled study of limited versus subtotal posterior discectomy: short-term outcomes in patients with herniated lumbar intervertebral discs and large posterior anular defect. spine 2006; 31: 653-657 https://doi.org/10.1097/01.brs.0000203714.76250.68
  5. Barr KP, Harrast MA. Low back pain. In: Braddom RL, editor. Physical medicine and rehabilitation, 3rd ed, Philadelphia: Saunders, 2007, pp883-927
  6. Lee GW. Low back pain and cervical pain. In: Kim JH, Han TR, editors. Rehabilitation medicine, 2nd ed, Seoul: Kunja, 2001
  7. Abdi S, Datta S, Trescot AM, Schultz DM, Adlaka R, Atluri SL, Smith HS, Manchikanti L. Epidural Steroids in the Management of Chronic Spinal Pain: a Systematic Review. Pain Phys 2007; 10: 185-212
  8. Buttermann GR. Treatment of lumbar disc herniation: epidural steroid injection compared with discectomy. J Bone Joint Surg Am 2004: 86; 670-679 https://doi.org/10.2106/00004623-200404000-00002
  9. Brault JS, Kappler RE, Grogg BE. Manupulation, traction and massage. In: Braddom RL, editor. Physical medicine and rehabilitation, 3rd ed, Philadelphia: Saunders, 2007, pp447-449
  10. Karuse M, Refshauge KM, Dessen M, Boland R. Lumbar spine traction: evaluation of effects and recommended application for treatment. Man Ther 2000; 5: 72-81 https://doi.org/10.1054/math.2000.0235
  11. Macario A, Pergolizzi JV. Systematic literature review of spinal decompression via motorized traction for chronic discogenic low back pain. Pain Practice 2006; 6: 171-178 https://doi.org/10.1111/j.1533-2500.2006.00082.x
  12. Clarke J, van Tulder M, Blomberg S, de Vet H, der Heijden G, Bronfort G. Traction for low back pain with or without sciatica: an updated systematic review within the framework of the Cochrane collaboration. spine 2006; 31: 1591-1599 https://doi.org/10.1097/01.brs.0000222043.09835.72
  13. O'Hara K. Clinical care update. Decompression: a treatment for back pain. Occupational Medicine 2004; 11: 1-2
  14. Gionis TA, Groteke E. Spinal decompression. Orthopedic Technol Rev 2003; 5: 36-39
  15. Weinstein JN, Tosteson TD, Lurie JD, Tosteson AN, Hanscom B, Skinner JS, Abdu WA, Hilibrand AS, Boden SD, Deyo RA. Surgical vs nonoperative treatment for lumbar disk herniation: the Spine Patient Outcomes Research Trial (SPORT): a randomized trial. JAMA 2006; 296: 2441-2450 https://doi.org/10.1001/jama.296.20.2441
  16. LeBlanc AD, Evans HJ, Schneider VS, Wendt RE III, Hedrick TD. Changes in intervertebral disc crosssectional area with bed rest and space flight. Spine 1994; 19: 812-817 https://doi.org/10.1097/00007632-199404000-00015
  17. Guehring T, Omlor GW, Lorenz H, Engelleiter K, Richter W, Carstens C, Kroeber M. Disc distraction shows evidence of regenerative potential in degenerated intervertebral discs as evaluated by protein expression, magnetic resonance imaging, and messenger ribonucleic acid expression analysis. Spine 2006; 31: 1658-1665 https://doi.org/10.1097/01.brs.0000224558.81765.56
  18. Guiot BH, Fessler RG. Molecular biology of degenerative disc disease. Neurosurgery 2000; 47: 1034-1040 https://doi.org/10.1097/00006123-200011000-00003
  19. Schnake KJ, Putzier M, Haas NP, Kandziora F. Mechanical concepts for disc regeneration. Eur Spine J 2006; 15: S354-S360 https://doi.org/10.1007/s00586-006-0176-y