• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제33권4호
• /
• pp.323-330
• /
• 2011

Purpose: The present study examined the reproducibility of an operation plan by comparing the jaw position of STO with the postoperative mandibular set back measurement in sagittal split ramus osteotomy. Methods: Thirty patients with class III dental and skeletal malocclusion and who were treated with BSSRO were reviewed. Three plain radiographs such as the panoramic view, the lateral cephalogram and the submentovertex view were taken before and after operation. Also, paper surgery for STO and model surgery were used to evaluate the amount of mandibular set back. Results: On the panoramic view, the amount of mandibular set back in STO was similar to the postoperative results of model surgery, but the amount of mandibular set back on the lateral cephalogram was smaller than the postoperative result of model surgery and then the amount of set back on submentovertex view was similar to the postoperative result of model surgery. Conclusion: Precise tracing and paper surgery should be performed for a combined expected STO in order to predict the exact amount of preoperative mandibular set back.

• The Korean Journal of Pain
• /
• 제18권2호
• /
• pp.151-155
• /
• 2005

Background: A significant number of patients complain of persistent pain or neurologic symptoms after lower back surgery. It is reported that facet joint pain plays a role in failed back surgery syndrome. To the best of our knowledge, there are few studies that have investigated the outcome of radiofrequency neurotomy in the patients with failed back surgery syndrome. Methods: The study group was composed of thirteen patients who were operated on due to their low back pain, and they displayed no postoperative improvement. All the patients underwent double diagnostic block of the lumbar medial branch of the dorsal rami with using 0.5% bupivacaine. The patients who revealed a positive response to the double diagnostic block were then treated with percutaneous radiofrequency neurotomy. The effect on their pain was evaluated with using a 4 point Likert scale. Results: Eleven patients revealed a positive response to the double diagnostic block. Ten patients were given percutaneous radiofrequency neurotomy. Nine patients showed sustained pain relief for 3 months after the percutaneous radiofrequency neurotomy. Conclusions: We found lumbar facet joint syndrome in the patients with failed back surgery syndrome by performing double diagnostic block and achieving pain relief during the short term follow-up after percutaneous radiofrequency neurotomy of the lumbar zygapophysial joints. This suggested that facet joint pain should be included in failed back surgery syndrome.

• 대한한의학회지
• /
• 제37권2호
• /
• pp.93-103
• /
• 2016

Objectives: The purpose of this study was to report Four cases of Failed Back Surgery Syndrome (FBSS) patients after spinal fusion surgery who showed significant improvement in pain and function with Complex Korean medical treatment. Methods: This study was a retrospective observational study. We reviewed medical records of Four patients with lumbar pain or radiating leg pain, who have received spinal fusion surgery in the past. All Four patients took complex treatments of Mokhuri Neck and Back hospital which involes Acupuncture, Pharmaco-acupuncture, Gangchuk herbal medicine, Chuna and Physical therapy during about four-week of admission treatment. Visual Analogue Scale (VAS), Oswestry disability index (ODI), Pain Free Walking Distance (PFWD) scores were assessed before and after treatments. Results: The average of hospitalization period was 28.5 days. Mean VAS scores decreased from 6.5 to 2.3, Oswestry Disability Index (ODI) scores decreased from 56.25 to 38.25 and Pain Free Walking Distance (PFWD) also improved from 10m to 166.6m. Conclusion: This study implies that a combination of Korean medical treatments might be effective in relieving pain, and improving the functional status of FBSS patients. Further studies are needed to fully understand the mechanisms underlying the effects.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제23권1호
• /
• pp.95-102
• /
• 2001

Temporomandibular ankylosis is defined as a situation in which the condyle is fused to the fossa by bone or fibrous tissue. Conditons such as trauma, infection, or systemic disease may predispose to various types of ankylosis, bringing about different levels of limitation in mandibular movement. Most patients with temporomandibular ankylosis are associated with limitation of maximal mouth opening, deviation of the chin toward the affected side, impaired occlusion, chronic pain, compromised oral hygiene, severe facial asymmetry & impeded mandibular molar eruption occurring in childhood. Several techniques to release ankylosis have been described in the literature, showing variable and often unsatisfactory results. The most frequently used operations are gap arthroplasty, interpositional arthroplasty, and exicision and joint reconstruction with autogenous or alloplastic materials. We have managed the two patients of TMJ ankylosis. They had previously TMJ surgery and we treated with gap arthroplasty & active physial therapy. We have obtained favorable results and report these cases with literatures review.

• Journal of Korean Neurosurgical Society
• /
• 제66권4호
• /
• pp.344-355
• /
• 2023

Chronic lower back pain is a leading cause of disability in musculoskeletal system. Degenerative disc disease is one of the main contributing factor of chronic back pain in the aging population in the world. It is postulated that sinuvertebral nerve and basivertebral nerve main mediator of the nociceptive response in degenerative disc disease as a result of neurotization of sinuvertebral and basivertebral nerve. A review in literature is done on the pathoanatomy, pathophysiology and pain generation pathway in degenerative disc disease and chronic back pain and management strategy is discussed in this review to aid understanding of sinuvertebral and basivertebral neuropathy treatment strategies.

• The Korean Journal of Pain
• /
• 제27권1호
• /
• pp.63-67
• /
• 2014

Background: Epiduroscopic laser neural decompression (ELND) has been performed as a treatment tool for chronic refractory low back pain and/or radicular pain. There are some studies about the usefulness of epiduroscopy for post lumbar surgery syndrome, however, few studies about the effectiveness of epiduroscopy for patients without back surgery. We compared the satisfaction of patients who underwent ELND for chronic low back pain and/or radicular pain after back surgery and for the same symptoms without surgery. Methods: We compared the degree of satisfaction of patients after ELND between who had underwent the lumbar spine surgery and who had not retrospectively by chart reviewing. We divided 39 patients who had received ELND into two groups, one is the group of patients who got the lumbar surgery (group 1), and the other is the group of patients who did not (group 2). Their medical records including age, sex, previous treatment, duration of illness, degree of symptom relief were investigated. We compared each items between two groups. Results: The number of patients in group 1 was 17, and group 2 was 22. In group 1, 16 patients (94.1%) showed more than 'Acceptable', and 19 patients (86.4%) showed more than 'Acceptable' in group 2. There is no significant differences statistically in percentage of patients who showed more than 'Acceptable' in the satisfaction after ELND between two groups. Conclusions: ELND provided satisfaction (more than 85%) for patients with chronic low back pain and/or leg pain regardless of previous back surgery history.

• Journal of Acupuncture Research
• /
• 제32권2호
• /
• pp.217-227
• /
• 2015

Objectives : This study is an evaluation of the effectiveness of treatments combined with Korean medical methods, such as relaxative Chuna and Gangchuk herbal medicines, for patients with failed back surgery syndrome. Methods : In this study, medical records of ten patients who experienced failed back surgery syndrome and participated in intensive Korean medical treatment were reviewed. All patients received relaxative Chuna and acupuncture along with Gangchuk herbal medicines during hospitalization. Numeric rating scale(NRS) in the degree of 0 to 10, pain-free walking distance(PFWD) and oswestry disability index(ODI) were measured before and after treatments. Results : The patients were hospitalized for an average of 22 days. The average NRS of lumbar pain in all patients decreased from $7.7{\pm}1.6$ to $3.2{\pm}2.2$ and the average NRS decline of leg pain was from $7.7{\pm}1.7$ to $3.2{\pm}2.2$, both of which indicate statistical significance(p < 0.05). PFWD in all patients increased from 113.3 m to 798.1 m on average. The average ODI in all patients significantly improved from $63.9{\pm}7.0$ to $43.9{\pm}6.9$(p < 0.05). Conclusions : The treatments combined with Korean medical methods for failed back surgery syndrome patients are clinically effective and viable.

• Journal of Korean Neurosurgical Society
• /
• 제29권2호
• /
• pp.203-209
• /
• 2000

Objective : The authors retrospectively analysed the factors affecting the favorable outcomes in the treatment of the Failed Back Surgery Syndrome(FBSS) or six years. Method : From March 1991 to December 1996, seventy-five patients were diagnosed as FBSS and its incidence was 3.4% of admitted patients with back pain in our department. We analysed the demographic data, etiologies, clinical menifestations, outcomes according to methods of operation, numbers of previous surgery, and time intervals between initial operation and final operation. Result : The most common etiology and previous surgical method of FBSS were insufficient surgery(54.7%) and partial laminectomy(53.3%). Patients were managed as followings ; Total laminectomy and spinal fusion with instrument in 41 cases(54.7%), total laminectomy without fusion in 23 cases(30.7%), and only partial laminectomy in 11 cases(14.7%). The overall treatment outcome was satisfactory in 48 cases(64%). Satisfactory results were observed in those patients who were treated by spinal fusion after complete laminectomy(34 cases), who had underwent only one operation previously(45 cases), and when the time interval between the initial operation and reoperation is shorter than 12 months(43 cases). Conclusion : The treatment outcome in FBSS was favorable in cases of the complete total laminectomy and spinal fusion with instrument, only one previous back surgery, and short time interval between initial and final operations.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제33권4호
• /
• pp.319-322
• /
• 2011

Purpose: The purpose of this study was to examine the appropriate degree of set-back of the mandible by evaluating the rate of relapse after surgery. Methods: Among the patients who visited our hospital from January 2002 to January 2007 and who underwent orthognathic surgery, of the patients available for follow-up observation, the rate of relapse after surgery was investigated according to the set-back degree. The patients were divided into groups by the degree of set-back, and relapse was evaluated by the radiographs performed the day after surgery, 6 months after surgery, 1 year after surgery, 2 years after surgery and 3 years after surgery. Results: In cases that exceeded the limit of posterior movement of the mandible (13 mm) or that had the wrong position of the condyle, a greater tendency toward relapse was shown. Conclusion: Based on the results of this study, among the cases that required a large amount of posterior movement of the mandible, two jaw surgeries accompanied by bilateral sagittal split ramus osteotomy (BSSRO) and LeFort I osteotomy are recommended.

• 척추신경추나의학회지
• /
• 제17권2호
• /
• pp.131-139
• /
• 2022

Objectives This study aimed to analyze the medical utilization of low back pain (LBP) patients after back surgery and estimate the medical costs of Korean and Western medicine collaborative treatment, odds ratio, and hazard ratio between the two groups using the 2019 Health Insurance Review and Assessment Service-National Patient Sample (HIRA-NPS-2019). Methods Data management and descriptive analysis, logistic regression, and survival analysis were conducted for defining and estimating the LBP patients after back surgery in the NPS 2019 dataset. Results A total of 216,424 patients out of 991,189 were identified as having LBP. Among the patients with LBP, 1,734 were treated with surgery while 214,690 were not. Among those who had surgery, 937 were treated with conventional treatments only and 797 underwent Korean medicine treatments. The odds ratio of the logistic regression analysis was 0.7129, suggesting that Korean medical treatment experience group had a 28.7% lower risk of reoperation than the Western medical treatments only group. The hazard ratio of the survival analysis was 0.9145; thus, the risk probability of reoperation was estimated to be approximately 8.55% lower. The 50% risk of reoperation was 69 days (0.5044) for the conventional group, and 97 days (0.5008) for the Korean medical group in the survival analysis using the Kaplan-Meier graph. Conclusions These results could be utilized in future studies in conducting economic evaluation for estimating cost-effectiveness of Western medicine and Korean medicine treatment compared to Western medicine alone in LBP patients after back surgery in a South Korean perspective. mended and should be applied while taking the necessary precautions.