• The Korean Journal of Pain
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• v.18 no.1
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• pp.69-73
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• 2005

This report describes a case of spinal nerve root compression due to an acute inflammatory granuloma after lumbar surgery. A 39 year-old man with a history of increasing back pain with a 3-week duration was diagnosed with a herniated intervertebral disc (HIVD). The diagnosis of a HIVD was confirmed by magnetic resonance imaging (MRI) with indications for surgery. A discectomy and a partial laminectomy was performed and the symptoms were alleviated immediately after surgery for a five-day period. However, a slowly progressing pain was subsequently noted along a different dermatome. There was no pain relief despite the patient being given pharmacological treatments, combined with an epidural steroid injection. The follow up MRI images showed severe compression of the nerve roots by a epidural lesion. Another procedure was performed 17 days after the initial operation. The lesion responsible for the compression of the nerve roots was found to be an acute inflammatory granuloma. The pain was relieved after the second procedure and there were no other symptoms or neurological problems. This case is remarkable in that a granuloma formed relatively quickly and grew to such a size that it was able to severely compress the surrounding nerve roots.

• Korean Journal of Acupuncture
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• v.18 no.1
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• pp.105-116
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• 2001

We examined and referred to some literatures on the meaning, Dai meridian and Meridian points of joining with circulation of Dai meridian through literatures of every generation. And then we came to get a few conclusions as follows. 1. Dai meridian starts below the hypochondriac region. Running obliquely downward, it runs transversely around the waist like a belt. Its function is to bind up all the meridians to circulate in a proper way. 2. The coalescent points of dai meridian are $D\grave{a}im\grave{a}i$(帶脈), $W\check{u}sh\bar{u}$(五樞) and $W\acute{e}id\grave{a}o$(維道). 3. Location of $D\grave{a}im\grave{a}i$(帶脈) is on the lateral side of the abdomen, 1.8 cun below $Zh\bar{a}ngm\grave{e}n$(章門), at the crossing point of vertical line through the free end of the 11th rib and a horizontal line through the umbilicus. Location of $W\check{u}sh\bar{u}$(五樞) is on the lateral side of the abdomen, anterior to the anterosuperior iliac spine, 3 cun below the level of the umbilicus. Location of $W\acute{e}id\grave{a}o$(維道) is on the lateral side of the abdomen, anterior and inferior to the anterosuperior iliac spine, 0.5 cun anterior and inferior to $W\check{u}sh\bar{u}$(五樞). 4. Indication of $D\grave{a}im\grave{a}i$(帶脈) is irregular menstruation, leukorrhea with reddish discharge, hernia, pain in the lumbar and hypochondriac region. Indication of $W\check{u}sh\bar{u}$(五樞) is prolapse of the uterus, leukorrhea with reddish discharge, irregular menstruation, hernia, pain in the lower abdomen, constipation and lumbosacral pain. Indication of $W\acute{e}id\grave{a}o$(維道) is edema, pain in the side of the lower abdomen, prolapse of the uterus, hernia and morbid leukorrhea. 5. The Dai meridian binds all meridians, produces pregnancy, grasps lumbar and abdomen region and controls leukorrhea. 6. Diseases of the Dai meridian manifested as distention and fullness in the lumbar region and abdomen, leukorrhea with reddish discharge, pain the navel, lumbar and spinal regions, flaccidity and hypoactivity of the lower limbs, etc.

• Journal of Haehwa Medicine
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• v.14 no.2
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• pp.177-187
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• 2005

Objective : This study is designed in order to evaluate the therapeutic effect of Scalp Acupuncture and Do-ma Acupuncture related with Governer Vessel(Dok) and Bladder Meridian(Chok-taeyang) on acute low back pain Methods : We investigated 10 patients suffering from acute low back pain were treated from Mach. 1st 2005 to Jun. 30th 2005. 10 patients, were diagnosed only straightened curvature on lateral view of lumbar spine X-ray and get Scalp acupunture related with Governer Vessel(Dok) and Bladder Meridian(Chok-taeyang) and Do-ma acupuncture. Pain rating score(PRS) was used to assess the pain for its intensity, frequency, duration, and aggravating factors. And visual analog scale(VAS) was used, too. Results : Both Scalp acupunture related with Governer Vessel(Dok) and Bladder Meridian(Chok-taeyang) and Do-ma acupuncture therapy showed good effect on acute low back pain. It was proved by the difference between PRS and VAS checked before treatment and what checked after treatment. In the evaluation of treatment effect, Exellent was 2(20%), Good was 5(50%), Moderate was 3(30%), Poor was 0(0%). Conclusion : The therapeutic effect of Scalp Acupuncture and Do-ma Acupuncture on acute low back pain can be recommended as a useful therapy to treat acute low back pain.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.2 no.2
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• pp.171-179
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• 2007

Objectives : To investigate the relationship in acute lateral tortipelvis and breaks in low back pain patients with acute lateral tortipelvis were discussed. Methods : The subject of this study consisted of 43 patients who were diagnosed as acute lateral tortipelvis by X-ray and 23 patients who were diagnosed as none tortipelvis by X-ray. We investigated acute lateral tortipelvis and breaks on X-ray film. Results and Conclusions : In the distribution of acute lateral tortipelvis, L4 was 17 cases(39.5%), L3 was 14 cases(32.6%), L2 was 9 cases(18.6%), L1 was 4 cases(9.3%) in the sequence. In acute lateral tortipelvis group, the number of breaks was more than none tortipelvis group(p>0.05). The most common parity of breaks was L4-5 in low back pain patient. Between distribution of lumbar level of acute lateral tortipelvis and breaks, there was no significant relationship.

• Journal of Korean Neurosurgical Society
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• v.57 no.1
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• pp.32-35
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• 2015

Objective : The purpose of this study was to analyze the relationship between fracture pattern and the development of acute radiculopathy after osteoporotic lumbar compression fracture. Methods : This study included 59 patients who underwent bone cement augmentation for osteoporotic compression fracture below the L2 level, which can lead to radiculopathic radiating pain. The patients were divided into two groups according to the presence of radiculopathy (group A : back pain only; group B : back pain with newly developed radiating pain). We categorized compression fractures into three types by the position of the fracture line. The incidence of newly developed radiculopathy was examined retrospectively for each compression fracture type. Results : The overall incidence of newly developed leg pain (group B) was 25%, and the frequency increased with descending spinal levels (L2 : 0%, L3 : 22%, L4 : 43%, and L5 : 63%). The back pain-only group (group A) had mostly superior-type fractures. On the other hand, the back pain with radiculopathy group (group B) had mostly inferior-type fractures. Most patients in group B showed significant relief of leg pain as well as back pain after bone cement augmentation. Conclusion : The incidence of a newly developed, radiating pain after osteoporotic compression fractures increased gradually from the L3 to L5 levels. Most of these fractures were of the inferior type, and the bone cement augmentation procedures seemed to be sufficient for relief of both back and radiating pain.

• The Korean Journal of Pain
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• v.19 no.2
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• pp.278-281
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• 2006

The diagnosis of pyomyositis in the pelvic region is difficult, as its incidence is relatively, with symptoms that mimic those of discogenic pain. Sciatica is a common presentation of a prolapsed lumbar disc. Less common causes, such as spinal stenosis, pelvic tumors or even primary nerve tumors can also cause these symptoms. Magnetic resonance imaging (MRI) is a useful diagnostic tool. Herein, the case of a patient with an acute pyogenic infection in the iliopsoas muscle, presenting with sciatica, is reported. This is a rare infective disease, which if promptly treated with intravenous antibiotics, can be completely resolved; otherwise, it can result in deep abscess formation, sepsis and death.

• The Korean Journal of Pain
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• v.28 no.1
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• pp.52-56
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• 2015

Painful periarticular calcification most commonly occurs within the rotator cuff of the shoulder and rarely around the elbow, hip, foot, and neck. As acute inflammatory reaction develops, severe pain, exquisite tenderness, local swelling, and limitation of motion with pain occur. In case of calcific tendinitis of the shoulder, it can be easily diagnosed according to the symptoms and with x-ray. However, in lesions of the hip, as it is a rare location and usually involves pain in the posterolateral aspect of the thigh, which can simulate radicular pain from a lumbar intervertebral disc, it could be difficult to diagnose. Hence, physicians usually focus on lumbar lesions; therefore, misdiagnosis is common and leads to a delayed management. Here, we report the case of a 30-year-old female patient with calcific tendinitis of the rectus femoris that was successfully managed with ultrasound-guided steroid injection. This study offers knowledge about the rectus femoris calcification.

• Journal of the Korean Society of Radiology
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• v.8 no.5
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• pp.255-260
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• 2014

The acute lumbar pain patients who were unavoidable to take MRI examination were made to take altered lateral recumbent position. they were also not able to control their painfulness and to be in supine position. In this study, it is supposed to increase success rate of the MRI examination through taking the altered lateral recumbent position in using spine and body matrix coil. This altered position made relaxing lumber pain and fatigue for the patients who suffered from sever lumber pain. In these reasons, it decreases the motion artifacts through correcting uncomfortable posture. As a result, qualitative analysis for the image quality was estimated to have average points of supine position A group(lateral recumbent position) of normal candidates and B group(lateral recumbent position) of the abnormal candidates who have sever pain at 4.64, 3.44, and 3.40, respectively. In conclusion, while qualitative analysis in the examination with supine position of the normal patients had significantly high points, the qualitative analysis in the examination with lateral recumbent position of the normal patients and abnormal patients who had sever lumbar pain was almost same. In addition, it was judged that radiologists' imagery interpretation had no other problems in the image evaluation of B group who had acute lumbar pain of abnormal patients. Hereupon, if this technique becomes generalized for the patients who suffer from supine position in the examination, it is supposed to be useful in medical field.

• The Korean Journal of Pain
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• v.24 no.2
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• pp.74-80
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• 2011

Background: Lidocaine patch (L5P) has demonstrated short-term efficacy in treating both acute surgical pain and chronic neuropathic pain with tolerable side effects. Percutaneous endoscopic lumbar discectomy (PELD) is the mainstay of minimally invasive spine surgery (MISS). Sufficient analgesia during PELD surgery makes the patient consider it real MISS. This study was performed to evaluate the efficacy and adverse effects of lidocaine patch in patients who underwent PELD under local anesthesia. Methods: L5P (L group) or placebo (P group) was randomly applied on the skin of the back covering the anticipated path of the working channel before 1 hour of surgery in 100 patients who underwent a single level PELD at L4-L5. Efficacy of the lidocaine patch was assessed by patient's numeric rating scale (NRS) of pain at each stage during the surgery and by a 5-scale grading of the satisfaction with the anesthesia of the operator and patients after surgery. Results: Mean NRS scores at the stages of needle insertion, skin incision, serial dilation and insertion of working channel, and subcutaneous suture were significantly lower in the L group than the P group. Postoperative operator's and patients' satisfaction scores were also significantly higher in L group than in the P group. There were subtle adverse effects in both groups. Conclusions: L5P provided better pain relief during PELD, especially at the stage of needle insertion, skin incision, serial dilation and insertion of working channel, and subcutaneous suture. It also provided higher patient and operator postoperative satisfaction, with only subtle adverse effects.

• The Korean Journal of Pain
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• v.11 no.1
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• pp.150-154
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• 1998

Epidural steroid injection have become one of the most frequently applied conservative option for the management of acute and chronic back pain. As the indications for epidural steroid injections increase so do the adverse responses associated with this procedure. This study reports the succession of 3 patients who developed galactorrhea and hyperprolactinemia after recieving an epidural steroid injection for lumbar radiculopathy and low back pain. Serum prolactin level was elevated in accordance with epidural injection of corticosteroid. We measured the serum prolactin level by immunoradiometric assay method and peak serum prolactin level at above 500, 144.2, 150.3 ng/ml respectively. Also we found the serum prolactin level decreased to normal values 3 wks after corticosteroid injection. Galactorrhra ceased in advance of decrease of serum prolactin level. That "Hyperprolactinemia and galactorrhea can occur following epidural steroid injection", requires a much larger prospective investigation.