• The Korean Journal of Pain
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• 제29권2호
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• pp.129-135
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• 2016

Although discal cysts are a rare cause of low back pain and radiculopathy. Currently, surgical excision is usually the first-line treatment for discal cysts. However, alternative treatment methods have been suggested, as in some cases symptoms have improved with interventional therapies. A 27-year-old man presented with an acute onset of severe pain, and was found to have a discal cyst after an open discectomy. The patient underwent cyst aspiration and steroid injection through the facet joint under C-arm guidance. After the procedure, the patient's pain improved to NRS 0-1. On outpatient physical examination 1 week, and 1 and 3 months later, no abnormal neurological symptoms were present, and pain did not persist; thus, follow-up observation was terminated. When a discal cyst is diagnosed, it is more appropriate to consider interventional management instead of surgery as a first-line treatment, while planning for surgical resection if the symptoms do not improve or accompanying neurologic deficits progress.

• 대한물리의학회지
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• 제16권3호
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• pp.15-20
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• 2021

PURPOSE: This study examined the influence of treadmill exercise with initial pain control using transcutaneous electrical nerve stimulation (TENS) on induced pain of knee osteoarthritis in rats. METHODS: Thirty adult male Sprague - Dawley rats were divided randomly into the TENS Group (TG, n = 10), Treadmill Exercise Group (TEG, n = 10), and Treadmill with TENS Group (TTG, n = 10). In the TG, TENS was performed for 20 min per day for two weeks with a TENS program at the knee joint. The TEG performed treadmill exercise 15 m/min for 20 min per day for two weeks. The TTG performed initial pain control by TENS program during the 1st ~ 3rd days, and treadmill exercise was performed using the TEG methods from the 4th day. The lumbar spine was extracted and processed using western blot analysis to evaluate pain (c-fos expression). RESULTS: The results showed that c-fos expression was decreased significantly in all groups after each intervention (p < .05). In particular, TTG produced the most significant decrease compared to the other groups. CONCLUSION: These results suggest that treadmill exercise with initial pain control using TENS is a suitable method for relieving pain in knee osteoarthritis.

• The Korean Journal of Pain
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• 제22권3호
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• pp.199-205
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• 2009

Background: A major ingredient of green tea is epigallocatechin-3-gallate (EGCG), and this is known to have many beneficial effects for cancer prevention and also on the cardiovascular system and neurodegenerative diseases through its anti-oxidant, anti-angiogenic, anti-inflammatory, lipid-lowering and neuroprotective properties. Its actions on nociception and the spinal nervous system have been examined in only a few studies, and in these studies EGCG showed an antinociceptive effect on inflammatory and neuropathic pain, and a neuroprotective effect in motor neuron disease. This study was performed to investigate the effect of EGCG on acute thermal pain and the development of morphine tolerance at the spinal level. Methods: The experimental subjects were male Sprague-Dawley rats and the Hot-Box test was employed. A single or double-lumen intrathecal catheter was implanted at the lumbar enlargement for drug administration. An osmotic pump was used to infuse morphine for 7 days for induction of morphine tolerance. EGCG was injected repeatedly for 7 days at twice a day through the intrathecal catheter. Results: Intrathecal EGCG increased the paw withdrawal latency (PWL) after repeated administration for 7 days at twice a day, but this did not happen with administering on single bolus injection of EGCG. In addition, the antinociceptive effect of intrathecal morphine was not affected by co-administration with EGCG. A continuous 7-day infusion of morphine caused a significant decrease of the PWL in the control group (M + S, morphine plus saline). In contrast, intrathecal EGCG injection over 7 days blocked the decrease of the PWL in the experiment group (M + E, morphine plus EGCG). Conclusions: Intrathecal ECGC produced a weak antinociceptive effect for acute thermal pain, but it did not change the morphine's analgesic effect. However, the development of antinociceptive tolerance to morphine was attenuated by administering intrathecal EGCG.

• The Korean Journal of Pain
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• 제10권2호
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• pp.296-300
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• 1997

Continuous epidural analgesia has been used widely for treatment of acute abdominal postoperative pain. Neurologic complications related to epidural analgesia occur infrequently but may be caused by various chemical, mechanical, ischemic or idiopathic factors. We report a case of abdominal hysterectomy in which unilateral lower extremity paralysis occurred after continuous epidural analgesia.

• Journal of Acupuncture Research
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• 제30권4호
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• pp.139-149
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• 2013

Objectives : The aim of this study was to observe the effect of balanced acupuncture on herniated intervertebral disc of lumbar spine patients. Methods : We investigated 23 cases of in-patients with acute & subacute herniated intervertebral disc of lumbar spine in oriental hospital, and divided patients into two groups. We treated one group(12 people) by complex oriental medical treatment with Balanced acupuncture, and the other group(11 people) by complex oriental medical treatment without Balanced acupuncture. To evaluate the effectiveness of treatment applied for two groups, we used visual analog scale(VAS) and rating scale for low back pain at admission and discharge. Results : 1. In balanced acupuncture group and control group, compared with baseline and final. VAS was significantly improved. 2. In Balanced acupuncture group and control group, compared with baseline and final. Rating scale for low back pain was significantly improved. 3. VAS and rating scale for low back pain improvement rate in balanced acupuncture group were no statistical significance compared with control group. Conclusions : Balanced acupuncture might be used for relieving symptoms related with herniated intervertebral disc of lumbar spine, but it's no statistical significance.

• The Korean Journal of Pain
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• 제9권1호
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• pp.98-101
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• 1996

Background: Lumbar epidural steroid injection for relief of low back pain and sciatica has become a popular procedure. further, cervical epidural steroid injection with nerve block (CESNB) is known to be effective for the management of acute and chronic pain of neck, shoulder and arm. However, many anesthesiologists are not familiar with CESNB. Methods: Charts of 34 patients who had undergone 60 cervical epidural steroid injections over a three year period, 1993 to 1995, were reviewed. We studied the followings: initial visit and department, injected interspaces, personal characteristics, indications for injection and complications. Results: Patients' first visits were mainly to orthopaedics (11 patients) and neurosurgery (10 patients). Epidural injection sites were: C7-T1 interspace (29 patients) and C6-C7 interspace (6 patients). Mean age of patients were 50.1 years. range 21~73 years. There were twenty male and fourteen female patients. Complications varied from dizziness after CESNB (1 patient). loss of consciousness with transient apnea (2 patients), and local infection with suspicious meningitis (1 patient). Conclusion: We conclude from the above data that CESNB is a good, safe and conservative form of therapeutic procedure in the management of patients suffering from cervical radiculopathy, and neck and shoulder pain.

• The Korean Journal of Pain
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• 제14권2호
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• pp.234-238
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• 2001

Percutaneous laser discectomy has potential advantages over conservative therapy and classical open surgery as a minimally invasive procedure, although clinical experiences are limited. We experienced a patient treated with herniated lumbar discs using Nd：YAG laser. A 55-year-old woman complained of severe back pain with sciatica on L4/5 and L5/S1 dermatome for several months. The MRI finding showed bulging discs at L4/5 and L5/S1. Epidural, transsacral and root block treatments were attempted without effect. Under fluoroscopic guidance, a 14 G biopsy needle was inserted into the L4/5 and L5/S1 disc spaces to the margin of the nucleus pulposus. Laser irradiation for vaporization of tissue was performed at 20 W/second to 1200 J. A laser fiber ($600{\mu}m$) was advanced 1 cm from the tip of the needle. At the end of the procedure, the patient began to feel relief of pain (VAS changed from 9 to 4) and was discharged the same day after staying 2 hours in the recovery room. Antibiotics were administered for prevention of discitis. She had no complaints of pain until the 1-month follow up visit. Percutaneous laser discetomy technique has the disadvantages of expensive equipment, high temperature and amount of vaporing disc tissue is empirical. However, this technique, as one of the therapeutic modalities for disc herniation, provides faster relief from acute attack than conservative management techniques in carefully selected patients with sciatica due to disc prolapse.

• Journal of Acupuncture Research
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• 제18권4호
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• pp.1-12
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• 2001

Study design : A retrospective study of lumbar disc herniations using results of follow-up computed tomographic scan examinations. Objective : Lumbar disc herniations is one of the cause low back pain and lower extremity pain. To clarify the lumbar disc herniations morphological changes over time(mean 5.3 years) in order to establish a strategy for treatment. Methods : Sixteen patients with lumbar disc herniations who underwent follow-up computed tomographic scan examinations were studied. The changes over time in herniated disc size(herniation ratio) were evaluated using this scan technique. The initial computed tomographic scan allowed classification of the herniations according to herniation ratio: small, medium and large. Results : Comparison with follow-up computed tomographic scans showed that of the 16 patients, in 14 patients(88%), the herniation ratio(HR) was decreased and among them, 8 patients had complet resolution of herniated disc. In 2 patients with small herniations, the HR of one case was increased, the other was decreased. In 8 patients with medium herniations, the HR of one case had no change, the others was decreased. In 6 patients with large herniation, the HR of all patients was decreased. Interestingly, 4 of the 16 patients showed calcification change of herniated disc. Conclusion : There is no doubt that herniated disc size is decreased over time. The largest herniations were those which had the greatest tendency to decrease in size. But in some cases, the HR was increased, or calcification change was showed.

• The Korean Journal of Pain
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• 제9권1호
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• pp.140-144
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• 1996

Electrical stimulation is a common method for successful pain management for both acute and a some cases of chronic pain. The incidence of cervical sprain is very high with automobile accidents. Treatment of cervical sprain is consists of analgesic drugs and physical therapy. Lower back pain is a common problem in pain clinics. back pain management are complex, so we have difficulty to choose best treatment modality. The prevalence of herniated lumbar disc(HLD) is 1~3% of lower back pain. The cases of laminectomy varies between 10~20% and postoperative pain is prolonged for several day. We applied Acupuncture like TENS (ALTENS) on the digit for cervical sprain patients and post laminectomy pain patient for three days. The result was very satisfactory. And we found that total hospital days in ALTEND groups are shorter than control group in both disease entities. In conclusion, acupuncture like TENS on finger control gate is an effective method of the pain management.

• Journal of Korean Neurosurgical Society
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• 제30권2호
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• pp.163-167
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• 2001

Objective : Percutaneous vertebroplasty has recently been introduced as an interesting therapeutic alternative for the treatment of thoracolumbar vertebral body fractures in elderly persons with osteoporosis. The authors present the early results of this method. Method and Material : From July 1999 to April 2000, percutaneous transpedicular technique was used in 20 patients (2 men and 18 women) whose mean age was 67.5 years old(range 59-79) with painful vertebral compression(22) and burst(2) fractures. The interval between fracture and vertebroplasty ranged 1 day to 4 months. The procedure involved percutaneous puncture of the injured vertebra via transpedicular approach under fluoroscopic guidance, followed by injection of polymethylmetacrylate(PMMA) into the vertebral body through a disposable 11-guage Jamshidi needle. Result : The most common cause of fracture was slip down and the most frequent injured level was the twelfth thoracic spine. The procedure was technically successful bilaterally in 18 patients(9 thoracic and 15 lumbar spines) with an average injection amount of 7.7ml PMMA in each level. Seventeen(94.4%) patients reported significant pain relief immediately after treatment. Two leaks of PMMA were detected with postoperative CT in spinal epidural space and extravertebral soft tissue without clinical symptoms. Conclusion : Although this study represents the early results, percutaneous vertebroplasty seems to be valuable tool in the treatment of painful osteoporotic vertebral body fractures in elderly, providing acute pain relief and early mobilization.