• Clinical Pain
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• v.20 no.1
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• pp.49-52
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• 2021

Bertolotti's syndrome (BS) refers to chronic low back pain (LBP) associated with lumbosacral transitional vertebrae (LSTV). Many studies suggest that the anomalous articulation alters biomechanics, resulting in discomfort on the ipsilateral side. Herein, we present an unusual case of BS presenting pain on the non-articulated side. A 46-year-old man visited our clinic with history of chronic LBP, refractory to treatment of analgesics, modalities and manual therapies. Electrodiagnostic studies showed no evidence of lumbosacral radiculopathy. Radiographies noted unilateral pseudoarticulation of L5~S1 vertebrae, on the contralateral side of his pain. The pain improved dramatically after sacroiliac joint block and facet joint block with iliolumbar ligament infiltration on the non-articulated side. Clinicians should be cautious that the unaffected joint in BS may serve an important role in altered lumbopelvic biomechanism, since it might eventually lead to intractable chronic LBP when overlooked.

• Imaging Science in Dentistry
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• v.54 no.2
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• pp.201-206
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• 2024

This report showed a case of temporomandibular joint (TMJ) ankylosis suspected to be associated with ankylosing spondylitis based on the observation of bony ankylosis of the cervical spine on computed tomography (CT) images. A 53-year-old man presented with a chief complaint of difficulty in opening his mouth. His medical history indicated that in his 20 s, he became aware of the difficulty in moving his neck. CT revealed marked osteoarthritic changes in the right mandibular condyle, suggesting fibrotic TMJ ankylosis. In addition, bony ankylosis of the cervical vertebral body and facet joints from the axis (C2) to C5 in continuity was observed. CT of the entire spine also showed bony deformity of the sacroiliac joints and bony ankylosis. Based on these findings, ankylosing spondylitis was suspected. The possibility of an ankylosing spondylitis complication should be considered in cases of TMJ ankylosis if bony ankylosis of the cervical spine is observed.

• Journal of Korean Foot and Ankle Society
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• v.16 no.2
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• pp.116-122
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• 2012

Purpose: Subtalar arthrodesis has been the gold standard for the painful subtalar joint disorders. Successful subtalar arthrodesis requires fusion of the 3 facet joints. The purpose of the study is to compare the clinical outcome of the posterior fixation (P2) and anterior-posterior (A1P1) fixation technique for subtalar arthrodesis which enhance anterior and middle facet fixation. Materials and Methods: The study is based on the 20 feet (19 patients) of the subtalar arthrodesis utilizing cannulated screws from September 2006 to September 2009 with at least 1-year follow-up. Two fixation techniques were utilized for the subtalar arthrodesis: 1) posterior fixation only (P2, 7 feet, 35%) and 2) anterior-posterior (A1P1) fixation method (13 feet, 65%). Visual Analog Scale Pain (VAS) score, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score (maximum: 94 points), the time for returning to daily living and the patient satisfaction were also evaluated. Results: Average follow-up period were 13.2 months (12-3 mo). The AOFAS score improved from preoperative average 45 (0-68) to 81.6 (62-94), while VAS score was decreased from average 8.0 (3-10) to 1.8 (0-5) at final follow-up. Ninety-five percent of the patients were satisfied with surgery. All the patients returned to daily living at average 7.2 months (2-15 mo) post-surgery. Radiographically, 2 techniques both showed 100% fusion of the posterior compartment of the subtalar joint. Postoperative complications were 1 case of low grade infection and 1 case of sural nerve neuralgia. Conclusion: The subtalar arthrodesis using A1P1 fixation technique showed better fusion rate of the anterior compartment of the subtalar joint compared to P2 fixation technique although the 2 techniques both showed similar favorable clinical outcome. Therefore the A1P1 fixation technique is found to be a viable option to address chronic painful subtalar joint disorders to enhance the anterior compartment fixation.

• The Korean Journal of Pain
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• v.26 no.4
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• pp.368-373
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• 2013

Background: Bertolotti's syndrome (BS), a form of lumbago in lumbosacral transitional vertebrae, is an important cause of low back pain in young patients. The purpose of this study was to assess the etiology of low back pain and the efficacy of treatment offered to patients with BS. Methods: All patients of BS Castellvi type1a during a period of 6 months were enrolled in the study. The patients underwent interventional pain procedures for diagnosis and pain relief. Response to the therapy was assessed based on VAS and ODI scores. A 50% decrease in VAS score or a VAS score less than 3 would be considered adequate pain relief. Results: All 20 patients diagnosed with BS during the 6-month observation period had scoliosis. Common causes of back pain were the ipsilateral L5-S1 facet joint, neoarticulation, the SI joint, and disc degeneration. Responses to various interventions for pain relief were different and inconsistent from patient to patient. In particular, responses to interventions for neoarticular pain were generally poor. Conclusions: Pain in patients with BS does not usually respond to interventional pain treatment. A very dynamic treatment approach must be pursued while managing BS patients, and the treatment plan must be individualized at various stages in order to obtain satisfactory pain relief.

• Journal of Korean Neurosurgical Society
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• v.39 no.3
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• pp.204-209
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• 2006

Objective : The authors retrospectively evaluate the benefits of the various pain procedures for the treatment of low back pain unresponsive to conservative management. Methods : Over a period of 2 years from May 2002 and June 2004, the authors had performed various pain procedures on 106 patients with low back pain. Epidural block, facet joint block, sacroiliac joint block, and myofascial block were included among various pain procedures. The pain improvement, period of analgesic use, and degree of satisfaction were evaluated 1 day, 4 weeks, and 6 months after injections. The outcome of pain procedures was analyzed by using a modified Macnab criteria. Results : Sixty-four patients had a single procedure with no combination and 42 patients [39.6%] received the combination of the various pain procedure. Regardless of the single or combination cases of procedure, combination of appropriate spinal level on each procedure was conducted in 104 [98.1%]. Mean follow up period was 12.2 months. Eighty-two patients [77.4%] experienced significant pain relief and overall analgesic medication was reduced in 91 patients [85.8%] at 6 months after procedure. Unfavorable results were demonstrated in 10 patients. Permanent procedural complications did not occur. Conclusion : The various pain procedures are the possible therapeutic option for low back pain unresponsive to conservative management including medication or physical therapy.

• Transactions of the Korean Society of Automotive Engineers
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• v.15 no.2
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• pp.135-142
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• 2007

MADYMO human model with the detail neck was used to investigate the reaction force of neck and neck injury from rear impact directions. In the validation simulation, head acceleration, thorax acceleration and the global kinematics of the head and neck were correlated well with experimental data. Acceleration data from three 15 km/h low speed car rear impact pendulum tests(rear-end, offset, oblique) were used to simulate the model. In the simulation results, the reaction force on the facet joint and discs in the oblique rear impact were higher than rear-end, offset rear impacts. Further research is still needed in order to neck injury analysis about different crash parameters.

• Journal of Korean Neurosurgical Society
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• v.41 no.4
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• pp.264-266
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• 2007

Atlantoaxial facet joint osteoarthritis is rare, often undiagnosed because it may be misdiagnosed as occipital neuralgia, or degenerative cervical spondylosis. Unilateral occipitocervical pain aggravated by head rotation is a specific symptom. Conservative treatment is usually effective. But when the patient complains of intractable neck pain localized to occipitocervical junction and unresponsive to medical therapy, surgical treatment should be considered. Though a few reports of surgically treated atlantoaxial osteoarthritis has been published, surgical outcome is favorable. A case of a surgically treated atlantoaxial osteoarthritis is presented with a review of the literatures.

• Journal of Korean Foot and Ankle Society
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• v.10 no.2
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• pp.271-273
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• 2006

In closed calcaneus fractures, the occurrence of FHL interposition in subtalar joint is relatively rare and difficult to diagnosis preoperatively. But careful physical examination and significant radiologic findings could be useful tools to diagnosis preoperatively. This findings is shearing off a superior medial fragment made up of the sustentaculum talus connected to a significant portion of the medial wall and medial aticular surface of the posterior facet.

• Journal of the Korean Society of Physical Medicine
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• v.1 no.1
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• pp.125-137
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• 2006

Purpose : The purpose of the study was to examine lumbar pain through literature reviews about herniated intervertebral disc (HIVD). Methods : Diagnosis was made by patient's history, physical examination, simple radiography, myelography, spinal computerized tomography, electromyography, somatosensory evoked potential, etc. Results : There are two treatment modalities, one is conservative and the other is operative. About 90% of patients with HIVD have been recovered only by conservative treatment and therapeutic exercise was the most effective one among these conservative treatments. Conclusion : We consider HIVD can be treated with therapeutic exercise which can correct muscular imbalance and facet joint problems and make the degenerative process of intervertebral disc slower.

• The Korean Journal of Pain
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• v.7 no.1
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• pp.84-87
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• 1994

Retrospective analysis, of 1,734 patients treated for nerve block from October 1991 to March 1994. Largest percentage of patients were in the 50 year old range, with a distribution of 44.9% male and 55.1% female. Treatments were for ailments of: Low Back Pain 17.3%, Multiple Contusion 10.5%, and Cancer 10%. Most common nerve block was epidural block 38.6%, followed by stellate ganglion block 38.4%, intercostal block 5.4%, and suprascapular nerve block 5.2%. Nerve block under fluorscopic guide were as follows: facet joint block 34.1%, lumbar sympathetic ganglion block 13.6%, and celiac plexus block 12.9%.