• The Korean Journal of Pain
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• 제19권2호
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• pp.207-212
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• 2006

Background: The epidural injection technique is a commonly used intervention in the management of chronic spinal pain, which has the advantage of delivering various drugs, such as local anesthetics or steroids, in higher concentrations to the inflamed nerve root. A guidewire-reinforced epidural catheter was introduced through a Tuohy needle during the caudal epidural procedure, with a catheter threaded into the affected nerve roots and the spread-pattern of contrast agents observed under fluoroscopy. Methods: Sixty-seven patients with low back pain, who showed evidence of a herniated nucleus pulposus on magnetic resonance imaging, were included. All patients received fluoroscopically guided caudal epidural injections, with the guidewire-reinforced epidural catheter introduced through a Tuohy needle and threaded either to the right or left side toward the target nerve roots. After confirming the catheter tip position at the affected nerve root, 2 ml increments of contrast agents (up to 6 ml) were injected, and their corresponding AP fluoroscopic views were obtained. Three radiologists reviewed all the radiographic findings and measured the proportion of the area of contrast spread at the side of target nerve roots. Results: Greater proportion of the area of contrast spread was observed at the side of the target nerve roots (P < 0.0001). At each level of contrast injection (2-⁣, 4- ⁣ and 6 ml), more than 70% of the spread of contrast dye was observed at the side of the target nerve roots in 85%, 70%, and 55% of cases, respectively. Conclusions: The combination of a caudal epidural injection and use of a guidewire-reinforced epidural catheter significantly enhances the target specificity, as revealed by the selective spread of contrast dye at the side of target nerves.

• The Korean Journal of Pain
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• 제11권2호
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• pp.273-282
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• 1998

Background: Twelve years have passed since the Korean Pain Society was organized. Nowadays, there are so many problems to be solved in pain clinics including health insurance, pain education and public information etc. in Korea. The present study was designed to evaluate the current status of pain clinics in Korea. Methods: Eight hundred twenty regular members of Korean Pain Society were surveyed by questionnaire in October 1997. We compared the general characteristics, contents of diseases in pain clinic, treatment Methods, patients satisfaction, pain educations, problems in pain treatments, requests to Korean Pain Society among the 138 respondents. Results: Thirty seven percents of the respondents worked at university hospitals, 39% at non-university hospitals and 24% at private pain clinics. The most common diseases treated in pain clinics was low back pain(32% in university and non-university hospital and 28% in private pain clinic respectively). However, cancer pain was 10% in university and non-university hospital and 0.7% in private pain clinic. Epidural block was the most frequently used procedure in chronic pain treatments. And 74.6% of the respondents were studied and learned in Korea and Japan. And then, current problems in pain management and requests to Korean Pain Society were medical insurance problems, pain education and public information of pain clinics. Conclusions: These results suggest that the Korean Pain Society should make an effort to solve these current problems in order to activate pain medicine and increase the quality of life for those suffering from pain.

• 대한물리의학회지
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• 제8권4호
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• pp.479-487
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• 2013

PURPOSE: The purpose of this research was comparing and analyzing the exercise effect for the public who was not suffering back pain exercise in improving the waist flexibility, the waist muscular strength and the waist sense of equilibrium after grafted in William & McKenzie exercise with swiss ball. METHODS: 16 people who were not in progress of the chronic low-back pain were recruited. They were grouped into 8 for each experiment(GSBE=Group which play swiss ball exercise, GWME=Group which William & McKenzie exercise). RESULTS: The following result was obtained through measurement of three items in both pre and post examination. CONCLUSION: Comparing the average result of flexibility improvements of each group after 12-week exercise program, the result showed that GSBE was more effective than GWME with increase of muscular strength. Comparing the average result of muscular strength of each group after 12-week exercise program, the result showed that GSBE was more effective than GWME with increase of flexibility improvements. Comparing the average result of sense equilibrium of each group after 12-week exercise program, the result showed that GSBE was more effective than GWME with increase of sense equilibrium.

• Journal of Acupuncture Research
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• 제23권5호
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• pp.39-54
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• 2006

Objectives : Herniation of Nucleus Pulpous (HNP) of Lumbar is one of the most common causes of low back pain. The aim of this study is to investigate the effectiveness of acupuncture, bee venom acupuncture (BVA), and bee venom Pharmacopuncture (BVP) therapy for HNP. Methods : We separated 35 patients with HNP of L-spine into three groups; Acupuncture treated group, BVA treated group, and BVP treated group, and monitored for 30 days. 4 grades of recovery degree, score of Visual Analog Scale (VAS), and Oswestry Disability Index (ODI) were examined for comparison. Results : 1. Visual Analogue Scale of low back pain and radiating pain showed significant decrease in BVA and BVP groups compared to the Acupuncture group at VAS0_2, VAS0_3 evaluations. 2. ODI of disability of daily activities showed significant decrease in BVA and BVP groups compared to the Acupuncture group at VAS0_1, VAS0_2, and VAS0_3 evaluations. 3. Compared to the Acupuncture group, BVA and BVP groups were improved in S.L.R.T and R.O.M of L-spine as confirmed by the physical examination. 4. Treatment efficacy was more apparent in acute cases as ODI was significantly lower than chronic cases. Conclusion : BVA and BVP therapies can be used in addition to the acupuncture therapy for highly effective treatment of HNP. Further clinical studies are required to verify these findings.

• 대한물리의학회지
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• 제3권1호
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• pp.47-56
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• 2008

Purpose : This study observed the recovery of function and pain on the eletrostimulation therapy(transcutaneous electrical nerve stimulation(TENS) and micro current therapy(MT)). Methods : Subjects were assigned randomly either experimental group(n=17) who were taken TENS or the control group(n=20) who were taken MT. Also subjects were assessed for pain(Visual Analog Scale; VAS) and function(Oswestry LBP disability index). Results : The VAS has a statistically significant difference with each groups(p<.05), but there was no statistically significant difference with intergroup during treatment period(p>.05). The Oswestry LBP disability index has a statistically significant difference with each groups(p<.05), also there was a statistically significant difference with intergroup during treatment period(p<.05). Conclusion : The efficancy of microcurrent therapy used in this study should be futher investigated in a long period study and objective study outcomes.

• The Korean Journal of Pain
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• 제33권3호
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• pp.226-233
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• 2020

Background: We aimed to compare interlaminar epidural steroid injections (ILESI) and bilateral transforaminal epidural steroid injections (TFESI) on pain intensity, functional status, depression, walking distance, and the neuropathic component in patients with lumbar central spinal stenosis (LCSS). Methods: The patients were divided into either the ILESI or the bilateral TFESI groups. Prime outcome measures include the numerical rating scale (NRS), Oswestry disability index (ODI), Beck depression inventory (BDI), and pain-free walking distance. The douleur neuropathique en 4 questions score was used as a secondary outcome measure. Results: A total of 72 patients were finally included. NRS, ODI, and BDI scores showed a significant decline in both groups in all follow-ups. Third-month NRS scores were significantly lower in the ILESI group (P = 0.047). The percentages of decrease in the ODI and BDI scores between the baseline and the third week and third month were significantly higher in the ILESI group (P = 0.017, P = 0.001 and P = 0.048, P = 0.030, respectively). Pain-free walking distance percentages from the baseline to the third week and third month were significantly higher in the ILESI group (P = 0.036, P < 0.001). The proportion of patients with neuropathic pain in the bilateral TFESI group significantly decreased in the third week compared to the baseline (P = 0.020). Conclusions: Both ILESI and TFESI are reliable treatment options for LCSS. ILESI might be preferred because of easier application and more effectiveness. However, TFESI might be a better option in patients with more prominent neuropathic pain.

• The Korean Journal of Pain
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• 제19권1호
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• pp.22-32
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• 2006

Background: This study was conducted to investigate the roles of the spinal and peripheral ${\gamma}$-aminobutyric acid (GABA)- ergic systems for the mechanical hypersensitivity produced by chronic compression of the dorsal root ganglion (CCD). Methods: CCD was performed at the left 5th lumbar dorsal root ganglion. The paw withdrawal threshold (PWT) to von Frey stimuli was measured. The mechanical responsiveness of the lumbar dorsal horn neurons was examined. GABAergic drugs were delivered with intrathecal (i.t.) or intraplantar (i.pl.) injection or by topical application onto the spinal cord. Results: CCD produced mechanical hypersensitivity, which was evidenced by the decrease of the PWT, and it lasting for 10 weeks. For the rats showing mechanical hypersensitivity, the mechanical responsiveness of the lumbar dorsal horn neurons was enhanced. A similar increase was observed with the normal lumbar dorsal horn neurons when the GABA-A receptor antagonist bicuculline was topically applied. An i.t. injection of GABA-A or GABA-B receptor agonist, muscimol or baclofen, alleviated the CCD-induced hypersensitivity. Topical application of same drugs attenuated the CCD-induced enhanced mechanical responsiveness of the lumbar dorsal horn neurons. CCD-induced hypersensitivity was also improved by low-dose muscimol applied (i.pl.) into the affected hind paw, whereas no effects could be observed with high-dose muscimol or baclofen. Conclusions: The results suggest that the neuropathic pain associated with compression of the dorsal root ganglion is caused by hyperexcitability of the dorsal horn neurons due to a loss of spinal GABAergic inhibition. Peripheral application of low-dose GABA-A receptor agonist can be useful to treat this pain.

• The Korean Journal of Pain
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• 제11권1호
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• pp.165-168
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• 1998

Although the incidence of epidural abscess is low, patient requiring continuous epidural analgesia for control of acute and chronic pain is increasing rapidly. Therefore we anticipate more frequent encounters with epidural abscess patients in future. Once epidural abscess formation begins, early diagnosis and treatment is very important to prevent permanent neurologic damage. The authors encountered a case of epidural abscess after continuous epidural analgesia for control of perineal pain due to rectal cancer. Forty-eight hours after the block, patient began to suffer severe low back pain, local tenderness, and fever. So the catheter was removed and culture sensitivity test was done with blood and local drainage. The test results identified methicillin susceptible staphylococcus aureus. Antibiotics were administered. Ten days after the block, left ankle jerk disappeared, and force of dorsiflexion of great toe decreased, but numbness or anesthesia appeared at $L_5$ dermatome. Laminectomy was performed, and abscess and necrotic fat material was removed from left $L_5$ nerve root. The patient was discharged 12 days after operation without any neurologic sequalae.

• The Journal of Korean Physical Therapy
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• 제14권3호
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• pp.174-202
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• 2002

Twenty five patients, 14 males and 11 females with an average age of 75years with chronic Low Back Pain were tested before, during, and after 10minutes transcutaneous electrical nerve stimulation. It is important to consider the effect of TENS on the autonomic function because the pain pathway and the ANS pathway are somehow correlated to each other. There is still controversy among researchers who have reported the effect of TENS on autonomic function. So the purpose of this study is to measure the effect of TENS on the ANS and to see the relation of the pain control mechanism and the change in the ANS. The results were as follows : 1) Systolic blood pressure between before and during the experiment was apt to be a little increased, but statistically there was no significant change(P>.05). 2) Systolic blood pressure between during and after 10 minutes the experiment was apt to be a little decreased, but statistically there was no significant change(P>.05). 3) Systolic blood pressure between before and after 10 minutes experiment was apt to be a little decreased, but statistically there was no significant change(P>.05). 4) Diastolic blood pressure between before and during experiment was apt to be a little increased, but statistically there was no significant change(P>.05). 5) Diastolic blood pressure between during and after 10 minutes experiment was significantly decreased(P<.05). 6) Diastolic blood pressure between before and after 10 minutes the experiment was apt to be a little decreased, but statistically there was no significant change(P>.05). 7) Heart rate between before and during the experiment was apt to be a little decreased, but statistically there was no significant change(P>.05). 8) Heart rate between during and after 10 minutes the experiment was significantly decreased(P<.05). 9) Heart rate between before and after 10 minutes the experiment was significantly decreased(P<.05). 10) Skin temperature between before and during the experiment was significantly increased(P<.05). 11) Skin temperature between during and after 10 minutes the experiment was apt to be a little increased, but statistically there was no significant change(P>.05). 12) Skin temperature between before and after 10 minutes the experiment was significantly increased(P>.05). 13) Respiratory rate between before and during the experiment was apt to be a little increased, but statistically there was no significant change(Pgt;.05). 14) Respiratory rate between during and after 10 minutes the experiment was apt to be a little decreased, but statistically there was no significant change(Pgt;.05). 15) Respiratory rate between before and after 10 minutes the experiment was apt to be a little decreased, but statistically there was no significant change(P>.05).

• 한국엔터테인먼트산업학회논문지
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• 제13권8호
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• pp.583-593
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• 2019

본 연구는 만성허리통증자의 특징적과거력의 존재수와 주관적 불안정성 통증 양상 및 이학적 불안정성 검사 간의 상관성을 조사하였다. 40명의 만성허리통증자들에게 4가지 특징적과거력의 존재 유무를 조사 한 후, 존재 수에 따라 5개 그룹으로 분류 하였다[그룹 1 (0) : n = 8, 그룹 2 (1) : n = 8, 그룹 3 (2) : n = 8, 그룹 4 (3) : n = 8, 그룹 5 (4) : n = 8]. 불안정성과 관련한 주관적 통증 양상 16개 항목의 양성반응을 조사하고, 7개의 이학적 불안정성 검사를 수행하여 그 결과를 점수화 하였다. 특징적과거력의 존재 수에 따른 주관적 불안정성 통증 양상, 이학적 불안정성 검사 점수를 비교하고 상관 분석을 하였다. 그 결과, 그룹 간 비교에서 유의한 차이가 있었다(p<.05). 또한 특징적과거력의 존재 수와 주관적 불안정성 통증 양상(r = .819, p = .000), 이학적 불안정성 검사(r = .606, p = .000) 사이에는 높은 양의 상관성을 나타내었고, 주관적 불안정성 통증 양상과 이학적 불안정성 검사(r = .571, p = .000) 사이에도 양의 상관성을 나타냈다. 본 연구 결과에 따라 3개 이상의 특징적과거력의 존재는 만성허리통증자의 허리부위 불안정성 진단에 유용한 변수가 될 수 있다. 또한 특징적과거력 정보와 주관적 불안정성 통증 양상 및 이학적 불안정성 검사 결과의 조합은 불안정성 진단의 정확도를 높일 수 있다.