• The Journal of Korean Orthopaedic Ultrasound Society
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• v.3 no.2
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• pp.54-58
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• 2010

Purpose: In patients with chronic cervical pain, the facet joint is the source of the majority. Due to the difficulty of identifying the exact location of the joint that causes these symptoms, the possibility of complications and the placebo effect brings clinical application into question. In this study, we assessed the prevalence of patients with chronic cervical pain and report the diagnostic and therapeutic usefulness of ultrasonography - guided facet joint block therapy. Materials and Methods: Patients with nonspecific chronic cervical pain for more than 6 months were selected. Patients with disc herniation, sciatica-related pain were excluded from the study and 160 patients who failed in conservative treatment (physical therapy, chiropractic therapy, medication) were included in the study. Diagnostic Ultrasonography-guided facet joint block was performed with 1% lidocaine, and after two weeks, Bupivacaine 0.25% was used in patients who tested positive for lidocaine. Patients with more than 75% pain reduction during movement after facet joint block were considered positive. Results: Among the 160 patients with chronic cervical pain, 96 patients(60%) had a positive reaction after facet block using lidocaine. Among the 64 patients with a negative reaction to lidocaine, 48 patients(75%) had a positive reaction to bupivacaine. There were 48 false positive patients(50%) who showed a positive reaction to lidocaine but a negative reaction to bupivacaine. The mean VAS of the total 160 patients before blocks was 8.5, after 2 weeks follow up it decreased to 2.7 (p = 0.001) and after 4weeks 3.6 (p = 0.001). The 8 patients as an initial improvement of symptoms are not satisfied with the procedure and the 3 patients had been worsened during observation, were showed pain relief after additional ultrasonography-guided facet joint block at 4th week. Conclusion: A single ultrasonography-guided block to chronic cervical pain patients has relatively low diagnostic value since high false positive rate. The twice facet joint blocks is thought to be a useful method for interventional pain management of patients with chronic cervical pain.

• Journal of the Korean Society for Precision Engineering
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• v.23 no.3 s.180
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• pp.187-194
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• 2006

Unexpected postoperative changes, such as growth in rib hump and shoulder unbalance, have been occasionally reported after corrective surgery for scoliosis. However there has been neither experimental data fer explanation of these changes, nor the suggestion of optimal correction method. Therefore, the numerical study was designed to investigate the post-operative changes of vertebral rotation and rib cage deformation after the corrective surgery of scoliosis. A mathematical finite element model of normal spine including rib cage, sternum, both clavicles, and pelvis was developed with anatomical details. In this study, we also developed a special program which could convert a normal spine model to a desired scoliotic spine model automatically. A personalized skeletal deformity of scoliosis model was reconstructed with X-ray images of a scoliosis patient from the normal spine structures and rib cage model. The geometric mapping was performed by translating and rotating the spinal column with an amount analyzed from the digitized 12 built-in coordinate axes in each vertebral image. By utilizing this program, problems generated in mapping procedure such as facet joint overlapping, vertebral body deformity could be automatically resolved.