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J Acupunct Res > Volume 32(2); 2015 > Article
Seo, Park, Kim, Kim, Seo, Lee, Kim, Hong, Kim, Kim, and Kim: Korean Medicinal Combination Treatments for Failed Back Surgery Syndrome: A Retrospective Case Series
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Abstract

Objectives:

This study is an evaluation of the effectiveness of treatments combined with Korean medical methods, such as relaxative Chuna and Gangchuk herbal medicines, for patients with failed back surgery syndrome.

Methods:

In this study, medical records of ten patients who experienced failed back surgery syndrome and participated in intensive Korean medical treatment were reviewed. All patients received relaxative Chuna and acupuncture along with Gangchuk herbal medicines during hospitalization. Numeric rating scale(NRS) in the degree of 0 to 10, pain-free walking distance(PFWD) and oswestry disability index(ODI) were measured before and after treatments.

Results:

The patients were hospitalized for an average of 22 days. The average NRS of lumbar pain in all patients decreased from 7.7±1.6 to 3.2±2.2 and the average NRS decline of leg pain was from 7.7±1.7 to 3.2±2.2, both of which indicate statistical significance(p < 0.05). PFWD in all patients increased from 113.3 m to 798.1 m on average. The average ODI in all patients significantly improved from 63.9±7.0 to 43.9±6.9(p < 0.05).

Conclusions:

The treatments combined with Korean medical methods for failed back surgery syndrome patients are clinically effective and viable.

Fig. 1.
L-spine MRI(2011. 5. 11)
a: L3~L4 stenosis. b: L4~L5 PLIF
acupunct-32-2-217f1.gif
Fig. 2.
L-spine MRI(2013. 2. 12)
a: L3~L4 stenosis. b: L4~L5~S1 PLIF.
acupunct-32-2-217f2.gif
Fig. 3.
L-spine MRI(2013. 1. 5)
a: L3~L4 stenosis. b: L4~L5 laminectomy.
acupunct-32-2-217f3.gif
Fig. 4.
L-spine MRI(2013. 3. 25)
a: L4~L5 right foraminal stenosis. b: L4~L5 laminectomy.
acupunct-32-2-217f4.gif
Fig 5.
L-spine MRI(2013. 4. 12)
a: L4~L5 stenosis & spondylolisthesis Gr 1.
b: L4-L5 laminectomy.
acupunct-32-2-217f5.gif
Fig. 6.
L-spine MRI(2013. 8. 26)
a: L4~L5 stenosis & spondylolisthesis Gr 1. b: L4~L5 laminectomy.
acupunct-32-2-217f6.gif
Fig. 7.
L-spine MRI(2013. 9. 27)
a: L3~L4 stenosis. b~L5~S1 laminectomy.
acupunct-32-2-217f7.gif
Fig. 8.
L-spine MRI(2013. 9. 30)
a: L3~L4 stenosis. b: L4~L5 partial laminectomy at left.
acupunct-32-2-217f8.gif
Fig. 9.
L-spine MRI(2011. 1. 17)
a: L4~L5 stenosis. b: L4~L5 PLIF.
acupunct-32-2-217f9.gif
Fig. 10.
L-spine MRI(2013. 6. 13)
a: L4-L5 stenosis. b: T10, L1, L4 osteoplasty.
acupunct-32-2-217f10.gif
Fig. 11.
Changes of NRS(lumber) score before and after treatments
acupunct-32-2-217f11.gif
Fig. 12.
Changes of NRS(leg) score before and after treatments
acupunct-32-2-217f12.gif
Fig. 13.
Changes of PFWD before and after treatments
acupunct-32-2-217f13.gif
Fig. 14.
Changes of ODI before and after treatments
acupunct-32-2-217f14.gif
Fig. 15.
Box plot showing the changes of NRS(lumbar) score between before and after treatment
There is significant improvement(p<0.001).
*: represent the average of NRS(lumbar) score.
acupunct-32-2-217f15.gif
Fig. 16.
Box plot showing the changes of NRS(leg) score between before and after treatment
There is significant improvement(p<0.001).
*: represent the average of NRS(Leg) score.
acupunct-32-2-217f16.gif
Fig. 17.
Box plot showing the changes of PFWD between before and after treatment.
There isn’t statistically significance(p>0.05).
* represent the average of PFWD.
acupunct-32-2-217f17.gif
Fig. 18.
Box plot showing the changes of ODI between before and after treatment
There is significant improvement(p<0.001).
*: represent the average of ODI.
acupunct-32-2-217f18.gif
Table 1.
Characteristics of Subjects
Age Sex HP Diagnosis before surgery Method of surgery Diagnosis Pain-free time(year) No. of surgery
Patient 1 78 M 13 L4/5 stenosis L4~L5 PLIF L3/4 stenosis 3 1
Patient 2 65 F 23 HIVD L4~L5~S1 PLIF L3~L4 stenosis 15 1
Patient 3 58 M 22 HIVD L4~L5 laminectomy L3~L4 stenosis 0.6 1
Patient 4 77 M 17 HIVD L4~L5 laminectomy L4~L5 right foraminal stenosis 0.6 1
Patient 5 81 F 28 Spondylolisthesis L4~L5 laminectomy L4~L5 stenosis & spondylolisthesis Gr 1 3 1
Patient 6 72 M 23 Spondylolisthesis L4~L5 Laminectomy L4~L5 stenosis & spondylolisthesis Gr 1 0.75 1
Patient 7 73 M 16 HIVD L5~S1 laminectomy L3~L4 stenosis 12 1
Patient 8 80 F 13 HIVD L4~L5 partial laminectomy at left L3~L4 stenosis 8 2
Patient 9 77 F 24 Stenosis L4~L5 PLIF L4~L5 stenosis 2 1
Patient 10 75 F 24 Compression fracture T10, L1, L4 osteoplasty L4~L5 stenosis 1 3

PLIF: posterior lumbar interbody fusion. HIVD: herniated inter vertebral disc. HP: hospitalization period

Table 2.
Changes of Clinical before and after Korean Medical Combination Treatments
NRS(lumbar) NRS(leg) PFWD(m) ODI
Before After Before After Before After Before After
Patient 1 5 1 5 1 20 72 55 38
Patient 2 10 7 10 7 500 3000 67 53
Patient 3 8 1 9 1 50 150 65 45
Patient 4 9 4 9 4 250 540 63 48
Patient 5 8 4 7 4 0 150 58 43
Patient 6 8 4 8 4 100 1071 72 54
Patient 7 5 1 5 1 100 2000 57 32
Patient 8 7 1 7 1 0 100 78 37
Patient 9 9 3 9 3 0 100 62 45
Patient 10 8 6 8 6 62 44
Mean 7.7±1.6 3.2±2.2 7.7±1.7 3.2±2.2 113.3 798.1 63.9±7.0 43.9±6.9
p-value* 5.83E−06 2.220E−05 0.0553 2.4676E−05

* p-value by paired t-test in before and after treatment. NRS: numerical rating scale.

PFWD: pain-free walking distance(neurogenic claudication distance). ODI: oswestry disability index.

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