• Korean Journal of Applied Biomechanics
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• v.15 no.2
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• pp.147-153
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• 2005

The purpose of this study were to compare the differences of isometric lumber extension strength and subjective pain degrees between obesity patients group and normal body fat group in disc surgical operated patients. The research purposed to indicate how isometric lumbar extension exercise for 12 weeks affected to lumbar strength and visual analogue scale of patients suffered by chronic back pain. The subjects were 65 low back pain patients(male 30, female 35)who had disease on lumbar in W hospital. The lumbar extension strength was measured at seven degrees of angles, which were $0^{\circ}$ $12^{\circ}$ $24^{\circ}$ $36^{\circ}$ $48^{\circ}$ $60^{\circ}$ and $72^{\circ}$ before and after the exercise program. We got the results of subjective pain degree using the modified visual analogue scale(VAS) of Lawlis et al(1989) and measured the maximal isometric lumbar strength of all subjects using MedX lumbar extension machine. Results were as follows; After the exercise, the lumbar extension strength of normal body fat patients groups included males and female were greater than that of the obesity patients groups in all angles(p<.05). The visual analogue scale of chronic back pain patients was decreased significantly after the exercise(p<.05). The results showed the significance between the lumbar extension strength and the visual analogue scale of chronic back pain patients and showed that the isometric lumbar extension exercise decreased the subjective pain degrees of visual analogue scale with and increased lumbar extension strength. The correlation between the visual analogue scale and the %body fat of chronic back pain patients was no significant after exercise. Therefore, the lumbar extension strength exercise is needed for improvement of back strength, decrease of %body fat.

• Korean Journal of Applied Biomechanics
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• v.22 no.3
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• pp.349-356
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• 2012

This study aimed to assess the effects of progressive lumbar stability exercises and lumbar stability exercises on changes in the transversus abdominis muscle thickness and lower extremity muscle fatigue index in soccer players. Ten subjects were assigned to undergo training in each of the 2 groups, namely, the progressive lumbar stability exercise group and lumbar stability exercise group. Each intervention session lasted for 30 min, and 4 sessions were conducted in a week for 6 weeks for soccer players of S. University in Jeonnam, Korea. Changes in the transversus abdominis muscle thickness and lower extremity muscle fatigue index were measured using ultrasound and surface electromyogram. The results of the ultrasound measurement for the transversus abdominis muscle thickness indicated that progressive lumbar stability exercises were more effective than lumbar stability exercises. The results of the lower extremity muscle fatigue index measurements using surface electromyogram indicated that the fatigue index decreased in the progressive lumbar stability exercise group. Progressive lumbar stability exercise is believed to have put more workload during the shaking of the limbs, leading to increased stability and increased efficiency of the lower extremity muscle, thereby decreasing the fatigue index. Therefore, progressive lumbar stability exercises can be an effective measure for preventing injuries and improving the game performance of sports players by increasing the transversus abdominis muscle thickness and decreasing the lower extremity muscle fatigue index.

• The Korean Journal of Pain
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• v.9 no.2
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• pp.407-411
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• 1996

Stereotactic radiofrequency dorsal root ganglionotomy can be very useful procedures for the treatment of pain emanating from the lumbar segmental nerves. This procedure is reserved for patients who have failed conservative interventional treatments and in whom open surgical intervention is not an option. The advantages of the radiofrequency lesion method are presented, excellent control of the lesion process using temperature monitoring to quantify the lesion size, prevent boiling, and to produce differential destruction of neural tissue. The afferent fibers in the ventral root which are spared by dorsal rhizotomy but nerve fibers with their cells in the ganglion from either dorsal or ventral root can be destructed with stereotactic radiofrequency ganglionotomy. This technique is performed using a 100 mm cannula with a 5 mm active tip. Repeated lateral fluoroscopic view should be taken to make sure that cannlua still resides within the superior, dorsal quadrant or the foramen. With the cannula in this position, electrostimulation is performed and good paresthesia on the leg should be noted with 0.3 and 0.5 volt at 50 Hz stimulation. At 2Hz stimulation distinct dissociation between motor and sensory should be shown. Percutaneous lumbar ganglionotomy have carried out under local anesthesia on inpatient basis in 6 patients. A series of 5 patients with metastatic cancer pain and a patient with compression fracture have been relieved of pain without serious complications.

• The Korean Journal of Pain
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• v.13 no.2
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• pp.196-201
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• 2000

Background: Currently, minimally invasive operations are preferred to open surgery whenever possible. Lumbar sympathectomy using RF (radiofrequency) thermocoagulation is both safe and minimally invasive. The problem with the technique is that it cannot be performed successfully in a significant number of cases. If the temperature change in the sole is monitored immediately after the procedure then it can be determined if the procedure needs to be repeated. Methods: A curved tip cannula, 150 mm long with a 10 mm active tip, was used for RF lumbar sympathectomy. The temperature of the soles of both the foot on the affected side and the foot on the control side was monitored immediately before the procedure, immediately after making the L2 lesion, immediately after making the L3 lesion and at 5, 10, and 15 minutes after the procedure. Results: No statistically significant difference was observed in the temperature of the two soles before making the lesions. In the 24 of the 27 patients, there were prominent differences in temperature between the two soles at 10 minutes after the procedures. 11 of the 24 patients showed a significant temperature change after the first trial. But the remaining 13 required a second lesion on L2 and L3. Conclusions: We judged the success of the operation in the operating room by monitoring the temperature difference in the soles of the feet. When no increase in the temperature difference is observed, we can move the electrode and make another lesion. With this procedure, we can drastically increase the success rate of the procedure.

• The Journal of Korean Physical Therapy
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• v.15 no.3
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• pp.346-360
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• 2003

The purpose of this study was to evaluate effects of education and stabilization exercise of lumbar neutral zone is range of motion and pain of lumbar spine on the with non-specific low back pain. And the randomly selected each twenty patients out of the forty non-specific low back pain patients were classified as an stabilization exercise group and the other the patients were in a control group. stabilization exercise group in non-specific low back pain patients participated in exercise program of Richardson & Jull (1995) four week from October 1st, 2002 to February 28st, 2003 in Daegu 00 hospital. The conclusion were as follows: 1. After 4 weeks of therapy, Visual analogue scale in stabilization exercise group and control group with non-specific low back pain patients were not significantly decreased(p>.05). 2. Remodified Schober test in range of motion lumbar spine of stabilization exercise group and control group with non-specific low back pain patients were significantly increased(p<.05). 3. Finger-to-Floor test in range of motion whole spine of stabilization exercise group and control group with non-specific low back pain patients were not significantly increased(p>.05). 4. Visual analogue scale, Remodified Schober test and Finger-to-Floor test in pre and post treatment of stabilization exercise group and control group with non-specific low back pain patients were significant different(p<.05). 5. Visual analogue scale, Remodified Schober test and Finger-to-Floor test in stabilization exercise group and control group with non-specific low back pain patients were not significant different(p>.05).

• The Korean Journal of Pain
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• v.18 no.2
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• pp.187-191
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• 2005

Background: Discogenic leg pain is a major cause of health problems, often due to herniation of the intervertebral disc, and has traditionally been treated conservatively or with an open surgical discectomy. Conventional open surgery has many complications, such as nerve root injury, discitis and a relatively high mortality rate; failure of conservative treatments is also common. Recently, the $Dekompressor^{(R)}$ Percutaneous Lumbar Discectomy probe was developed. Herein, we present the early results for a percutaneous lumbar discectomy in herniated lumbar disc disease. Methods: Eleven patients, including 8 men and 3 women, with ages ranging from 22 to 78 years, were enrolled in this study. Those patients with a previous history of back surgery were not excluded from the study. All patients were postoperatively evaluated for their clinical outcomes, such as visual analogue scale (VAS) for pain after 1 and 3 months, reduction in analgesics, functional improvement and overall satisfaction. Results: The percutaneous lumbar discectomy was completed in 11 patients (17 levels), with average reductions in pre-VAS of 61.3 and 60.2% at 1 and 3 months, respectively. Also, 72.7% of patients reported functional improvement, with 81.1% expressing overall satisfaction. There were no procedural related complications. Conclusions: We concluded that a percutaneous lumbar discectomy is a safe and effective treatment modality for a herniated lumbar disc.

• The Korean Journal of Pain
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• v.11 no.2
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• pp.307-310
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• 1998

Selective lumbosacral radiculography and nerve root block techniques are very useful in determining the nerve root involved. We have done the lumbar root block to 61-year-old female who had suffered from low back pain radiating to right lower leg which was not relieved by epidural steroid injection two times. $L_5$ root block was performed under the fluoroscopic C-arm guide. When the needle was in correct position, we injected contrast medium (Isovist$^{(R)}$ - 300, Schering, Germany). After we injected 1.5 cc isovist, the S1 root was figured but L5 root was not figured. When we reinjected 1.5 cc isovist, $S_1$ root was enhanced and $L_5$ root was slightly visible due to severe disc bulging and lateral spinal stenosis.

• The Korean Journal of Pain
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• v.14 no.2
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• pp.199-206
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• 2001

Background: The lumbar sympathetic ganglia are variable in both position and numbers. The aim of this study was to detect the appropriate lumbar vertebral level where the lumbar sympathetic ganglia primarily aggregate. Methods: Forty patients comprising of hyperhidrosis (26 cases), complex regional pain syndrome (10 cases), peripheral artery occlusion disease (3 cases) and postherpetic neuralgia (1 case) underwent lumbar sympathetic block. We randomly selected one of two (L2 or L3) levels and the L4 level. The position of the needle tip and distribution of dye was verified by injection of a mixture of radio-opaque dye (1.5 ml) and 4% lidocaine (1.5 ml) and subsequently confirmed by L-spine anteroposterior and a lateral view X-ray. We considered the response positive when the skin temperature increased more than $1^{\circ}C$ in 5 min. Results: In general, the positive response ratio was greater when the needle tip located at the L2 or L4 level vice L3 and when the drug was distributed on the lower half of the L4 body and in the L4/5 intervertebral disc space. In a right side block, the positive response ratio was greater when the drug was distributed on the lower half of the L4 body and in the L4/5 intervertebral disc space, although in a left side block there was no significant difference seen between the levels. The complications of the neurolytic block were alcohol neuritis (7.5%) and hypoesthesia (5%) on the L1 or L2 dermatome. Conclusions: The best effect with least chance of complication may be induced by spreading the drug on the lower half of the L4 body and/or into the L4/5 intervertebral disc space by placing the needle tip on the L4 body.

• The Korean Journal of Pain
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• v.14 no.2
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• pp.218-224
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• 2001

Background: Response to diagnostic blocks does not consistently predict the outcome of interventional facet denervation. We investigated the relationship between pain relief by the percutaneous radiofrequency denervation of the lumbar zygapophysial joints with the result of facet joint diagnostic local anesthetic injection in patients with back pain originating from the lumbar zygapophysial joint. Methods: There were 35 patients enrolled, with ranging in age from 25 to 76 years ($52.6{\pm}12.7$ years, mean ${\pm}$ SD). We studied 7 men (20%) and 28 women (80%). All patients underwent double diagnostic block of $L_{3/4}$, $L_{4/5}$ and $L_5-S_1$ facet joint with 0.5% bupivacaine. The 35 patients fell into the following group. (1) Group A (n = 16): those who felt clear relief (pain free with Likert scale) from the double diagnostic block (2) Group B (n = 19): 11 patients who were always equivocal in their response to the double diagnostic block and 8 patients who were either pain free or equivocal in their response to the double diagnostic block. All 11 patients were done the facet joint denervation. The effect on the pain was evaluated with 4 point Likert scale 1, 6 and 12 weeks after the procedure. We evaluated the relationship between the pain response to diagnostic block and the pain relief with facet joint denervation. Results: Significant correlation was observed between the response to diagnostic block and pain relief with facet denervation (P < 0.05). We found no correlation between the categories of spinal operation and pain response to facet denervation (P value > 0.05). Conclusions: A satisfactory result of lumbar facet joint denervation can be obtained in many patients, especillay in patients whose pain were relieved by the diagnostic double facet joint block. It may be said that facet joint denervation for mechanical low back pain using radiofrequency thermocoagulation is a safe, easy, and repeatable technique.

• Journal of Korean Physical Therapy Science
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• v.7 no.1
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• pp.353-365
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• 2000

The purpose of this study were to compare the lumbar extensor strength between pre op patients group and after 6 weeks post op patients group. To evaluate lumbar extensor strength of total 273 patients with HIVD. Lumbar extensor strength was measured in 151 male patients and 122 female patients(Lumbar extensor strength was measured in 91 PELD patients group and 182 OLM group patients) by Medx lumbar extension machine. Maximum voluntary lumbar extension strength was appear $149.36{\pm}61.92ft$-lbs in pre op of PELD group, $158.47{\pm}54.67ft$-lbs in post op of PELD group and $135.54{\pm}54.24ft$-lbs in pre op of OLM group. $147.19{\pm}52.42ft$-lbs in post op of OLM group in male. Maximum voluntary lumbar extension strength was appear $83.85{\pm}30.22ft$-lbs in pre op of PELD group. $92.99{\pm}28.66ft$-lbs in post op of PELD group and $75.16{\pm}24.98ft$-lbs in pre op of OLM group, $79.88{\pm}25.25ft$-lbs in post op of OLM group in female. Male and female lumbar extension strength was statistically significant difference(P<.05). Lumbar flexion/extension ratio of the two group was 2.14:1 pre op and 2.05:1 post op in lumbar flexion 72 and 0 degree. The ratio of post op group was lesser than pre op group.