**1. Introduction**

With the ageing of the intervertebral disc, the compression force increases, squeezing out the nucleus pulposus through the fissure and resulting in the mechanical pressure on the spinal nerve that causes low back pain (LBP) and radiating pain, known as lumbar intervertebral disc herniation (LHIVD) [1].

Lee, H.-J.; Kim, J.-S.; Nam, D.; Kang, J.W.; Kim, T.-H.; Park, Y.-C.; Baek, Y.-H.; et al. Korean Medicine Clinical Practice Guidelines for Lumbar Herniated Intervertebral Disc in Adults: Based on Grading of Recommendations Assessment, Development and Evaluation (GRADE). *Healthcare* **2022**, *10*, 246. https://doi.org/10.3390/ healthcare10020246

**Citation:** Goo, B.; Jo, M.-g.; Kim, E.-J.;

Academic Editors: Manoj Sharma and Kavita Batra

Received: 25 December 2021 Accepted: 24 January 2022 Published: 27 January 2022

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**Copyright:** © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).

In Korea, the overall annual incidence rate for spinal disease was a median of 16,387 per 100,000 individuals in 2016. The incidence rate and annual costs per patient increased by 7.6% and 14.7%, respectively, over the period from 2012 to 2016. The incidence and medical expenses of LHIVD were the highest in patients aged under 60 years [2].

Several clinical practice guidelines (CPGs) with a focus on Western medicine are available for LHIVD, such as CPGs for the diagnosis and treatment of LHIVD with radiculopathy (North American Spine Society, 2012) [3]. In Korea, several Korean medicine (KM) treatments are used to treat low back pain. As a result of a survey on low back pain patients conducted by the Ministry of Health and Welfare in 2017, 83.1% of outpatients and 90.3% of inpatients answered that they thought KM was effective, indicating a high level of trust in KM treatment [4].

In 2015, the Korea Institute of Oriental Medicine (KIOM) developed guidelines for LHIVD based on an acknowledgment of the need to amend the CPG evaluation instrument using the Appraisal of Guidelines for Research and Evaluation (AGREE) II [5]. We aimed to update the outdated 2015 KM CPGs for LHIVD and use Grading of Recommendations Assessment, Development and Evaluation (GRADE) to provide appropriate recommendations and address the key clinical questions about LHIVD in adults for KM doctors.
