• Title/Summary/Keyword: Minimally invasive therapy

Search Result 64, Processing Time 0.022 seconds

Epiduroscopic Removal of a Lumbar Facet Joint Cyst

  • Jin, Hyun Seung;Bae, Jun Yeol;In, Chi Bum;Choi, Eun Joo;Lee, Pyung Bok;Nahm, Francis Sahngun
    • The Korean Journal of Pain
    • /
    • v.28 no.4
    • /
    • pp.275-279
    • /
    • 2015
  • Facet joint synovial cysts are usually associated with osteoarthritis of the adjacent facet joint and/or spondylolisthesis. In between the conservative and operative ends of the treatment spectrum lie minimally invasive techniques such as cyst rupture using epiduroscopy. In this report, we describe an 82-year-old male patient presenting with low back pain radiating to his lower left extremity and associated paresthesia. Magnetic resonance imaging of the lumbar spine revealed a synovial cyst at left L4/5 facet joint. Using epiduroscopy, the cyst was mechanically ruptured by popping it with the tip of the scope. The patient remained symptom-free at his successive visits until 12 months after the procedure, and was opened for desired follow up.

Complication of epiduroscopy: a brief review and case report

  • Marchesini, Maurizio;Flaviano, Edoardo;Bellini, Valentina;Baciarello, Marco;Bignami, Elena Giovanna
    • The Korean Journal of Pain
    • /
    • v.31 no.4
    • /
    • pp.296-304
    • /
    • 2018
  • Epiduroscopy is defined as a percutaneous, minimally invasive endoscopic investigation of the epidural space. Periduroscopy is currently used mainly as a diagnostic tool to directly visualize epidural adhesions in patients with failed back surgery syndrome (FBSS), and as a therapeutic action in patients with low back pain by accurately administering drugs, releasing inflammation, washing the epidural space, and mechanically releasing the scars displayed. Considering epiduroscopy a minimally invasive technique should not lead to underestimating its potential complications. The purpose of this review is to summarize and explain the mechanisms of the side effects strictly related to the technique itself, leaving aside complications considered typical for any kind of extradural procedure (e.g. adverse reactions due to the administration of drugs or bleeding) and not fitting the usual concept of epiduroscopy for which the data on its real usefulness are still lacking. The most frequent complications and side effects of epiduroscopy can be summarized as non-persistent post-procedural low back and/or leg discomfort/pain, transient neurological symptoms (headache, hearing impairment, paresthesia), dural puncture with or without post dural puncture headache (PDPH), post-procedural visual impairment with retinal hemorrhage, encephalopathy resulting in rhabdomyolysis due to a dural tear, intradural cyst, as well as neurogenic bladder and seizures. We also report for first time, to our knowledge, a case of symptomatic pneumocephalus after epiduroscopy, and try to explain the reason for this event and the precautions to avoid this complication.

Results of Intradiscal Pulsed Radiofrequency for Lumbar Discogenic Pain: Comparison with Intradiscal Electrothermal Therapy

  • Fukui, Sei;Nitta, Kazuhito;Iwashita, Narihito;Tomie, Hisashi;Nosaka, Shuichi;Rohof, Olav
    • The Korean Journal of Pain
    • /
    • v.25 no.3
    • /
    • pp.155-160
    • /
    • 2012
  • Background: We have developed an intradiscal pulsed radiofrequency (Disc PRF) technique, using Diskit $II^{(R)}$ needles (NeuroTherm, Wilmington, MA, USA), as a minimally invasive treatment option for chronic discogenic low back pain (LBP). The purpose of this study was to compare the representative outcomes of Disc PRF and Intradiscal Electrothermal Therapy (IDET) in terms of pain relief and reduction of disability. Methods: Thirty-one patients with chronic discogenic LBP who underwent either Disc PRF (n = 15) or IDET (n = 16) were enrolled in the study. A Diskit $II^{(R)}$ needle (15-cm length, 20-gauge needle with a 20-mm active tip) was placed centrally in the disc. PRF was applied for 15 min at a setting of $5{\times}50$ ms/s and 60 V. The pain intensity score on a 0-10 numeric rating scale (NRS) and the Roland-Morris Disability Questionnaire (RMDQ) were assessed pretreatment and at 1, 3, and 6 months post-treatment. Results: The mean NRS was significantly improved from $7.2{\pm}0.6$ pretreatment to$2.5{\pm}0.9$ in the Disc PRF group, and from $7.5{\pm}1.0$ to $1.7{\pm}1.5$ in the IDET group, at the 6-month follow-up. The mean RMDQ also showed significant improvement in both the Disc PRF group and the IDET group at the 6-month follow-up. There were no significant differences in the pretreatment NRS and RMDQ scores between the groups. Conclusions: Disc PRF appears to be an alternative to IDET as a safe, minimally invasive treatment option for patients with chronic discogenic LBP.

Right anterior mini-thoracotomy aortic valve replacement versus transcatheter aortic valve implantation in octogenarians: a single-center retrospective study

  • Ji Eun Im;Eun Yeung Jung;Seok Soo Lee;Ho-Ki Min
    • Journal of Yeungnam Medical Science
    • /
    • v.41 no.2
    • /
    • pp.96-102
    • /
    • 2024
  • Background: The aim of this study was to compare the early outcomes of octogenarians undergoing minimally invasive right anterior mini-thoracotomy aortic valve replacement (RAT-AVR) with those undergoing transcatheter aortic valve implantation (TAVI) for aortic valve disease. Methods: In this single-center retrospective study, data were collected from octogenarians before and after RAT-AVR and TAVI between January 2021 and July 2022. Short-term outcomes, including the length of hospital stay, in-hospital mortality, all-cause mortality, and other major postoperative complications, were compared and analyzed. Results: There were no significant differences in in-hospital mortality, stroke, acute kidney dysfunction requiring renal replacement therapy, length of intensive care unit stay, or length of hospital stay. However, the TAVI group had a higher incidence of permanent pacemaker insertion (10% vs. 0%, p=0.54) and paravalvular leaks (75% vs. 0%, p<0.001). Conclusion: In the present study on octogenarians, both TAVI and RAT-AVR showed comparable short-term results. Although both procedures were considered safe and effective in the selected group, RAT-AVR had a lower incidence of complete atrioventricular block and paravalvular regurgitation.

Antireflux Surgery (위식도역류질환의 수술)

  • Na, Kook-Joo
    • Korean Journal of Bronchoesophagology
    • /
    • v.16 no.2
    • /
    • pp.105-108
    • /
    • 2010
  • The prevalence of gastroesophageal reflux disease(GERD) has been increased recently in Korea. Most patients who have GERD are well treated by medication. But patients who have suboptimal disease control under medical therapy are needed further treatment. Nowadays minimally invasive surgery using laparoscopy and thoracoscopy has become popular in the operation of GERD although antireflux surgery is vary. Antireflux surgery is a well-documented, effective therapeutic alternative to control GERD.

  • PDF

Radiofrequency Thermal Ablation of Hepatocellular Carcinomas

  • Hyo Keun Lim
    • Korean Journal of Radiology
    • /
    • v.1 no.4
    • /
    • pp.175-184
    • /
    • 2000
  • Although surgical resection remains the best option as potentially curative therapy for hepatocellular carcinoma, radiofrequency thermal ablation has begun to receive much attention as an effective minimally invasive technique for the local control of unresectable malignant hepatic tumors. Most recent radiofrequency devices equipped with a powerful generator and larger needle electrode permit larger thermal lesions, up to 5 cm in diameter, with a single ablation. In this article, the author reviews the technical developments and early clinical results obtained with radiofrequency ablation techniques.

  • PDF

A Microstructural Analysis for Preventive Treatments of Vertebral Fracture (척추 골절의 예방적 치료법에 관한 미세 구조해석)

  • 김형도;탁계래;김한성;이성재
    • Proceedings of the Korean Society of Precision Engineering Conference
    • /
    • 2002.05a
    • /
    • pp.146-149
    • /
    • 2002
  • It is reported that the mechanical properties of vertebral trabecular bone depend on the density and the mass of bones. Osteoporosis is a systemic skeletal disease caused by low bone mass and microstructure deterioration of trabecular bone. Silva and Gibson (1997) studied the treatment of age-related bone loss using drug therapy. Vertebroplasty is a minimally invasive surgery for the treatment of osteoporosis vertebrae. This procedure includes puncturing vertebrae and filling with Polymethylmethacrylate (PMMA). However, the relative effect of drug therapy and bone cement for osteoporosis treatment is not reported yet. In this study, several 2D models of human vertebral trabecular bone are analyzed by finite element method. The mechanical behaviors of the vertebral trabecular bone treated by the drug therapy and the bone cement are compared. This study shows that bone cement treatment is more effective strategy than drug therapy to prevent the degradation of bone strength.

  • PDF

Modern acupuncture-like stimulation methods: a literature review

  • Jun, Min-Ho;Kim, Young-Min;Kim, Jaeuk U.
    • Integrative Medicine Research
    • /
    • v.4 no.4
    • /
    • pp.195-219
    • /
    • 2015
  • Acupuncture therapy has been proved to be effective for diverse diseases, symptoms, and conditions in numerous clinical trials. The growing popularity of acupuncture therapy has triggered the development of modern acupuncture-like stimulation devices (ASDs), which are equivalent or superior to manual acupuncture with respect to safety, decreased risk of infection, and facilitation of clinical trials. Here, we aim to summarize the research on modern ASDs, with a focus on featured devices undergoing active research and their effectiveness and target symptoms, along with annual publication rates. We searched the popular electronic databases Medline, PubMed, the Cochrane Library, and Web of Science, and analyzed English-language studies on humans. Thereby, a total of 728 studies were identified, of which 195 studies met our inclusion criteria. Electrical stimulators were found to be the earliest and most widely studied devices (133 articles), followed by laser (44 articles), magnetic (16 articles), and ultrasound (2 articles) stimulators. A total of 114 studies used randomized controlled trials, and 109 studies reported therapeutic benefits. The majority of the studies (32%) focused on analgesia and pain-relief effects, followed by effects on brain activity (16%). All types of the reviewed ASDs were associated with increasing annual publication trends; specifically, the annual growth in publications regarding noninvasive stimulation methods was more rapid than that regarding invasive methods. Based on this observation, we anticipate that the noninvasive or minimally invasive ASDs will become more popular in acupuncture therapy.

Current Research Status of Irreversible Electroporation for Hollow Viscus Organ of Gastrointestinal Tract (위장관 비가역적 전기천공법의 연구 현황)

  • Keum, Bora;Choi, Hyuk Soon;Jeon, Han Jo
    • Journal of Digestive Cancer Reports
    • /
    • v.8 no.1
    • /
    • pp.61-64
    • /
    • 2020
  • Ablative therapy has drawn attention for cancer treatment as minimally invasive therapy. Recently, irreversible electroporation which has a different concept from the existing ablation method has emerged. Although gastrointestinal tract cancer is commonly managed by ablation such as liver, pancreas cancer, hollow viscus cancer is extremely challenging for applying ablative therapy because of its high perforation risk. Therefore, several studies about hollow viscus irreversible electroporation will be introduced in this review regarding its pre-clinical relevance.

Methods of Evaluating Efficacy of Hair Growth Following Treatment for Alopecia in Oriental Medicine (한의학적 탈모 치료효과의 객관적 평가 방법)

  • Moon Jung-Bae;Kim Young-Jin;Yi Tae-Hoo
    • The Journal of Korean Medicine
    • /
    • v.27 no.2 s.66
    • /
    • pp.57-69
    • /
    • 2006
  • For decades, scientists and clinicians have examined methods of measuring scalp hair growth. There has been a greater need for reliable, economical and minimally invasive means of measuring hair growth and, specifically, response to Oriental medicine therapy. We review the various methods of measurement described to date, their limitations and value to the clinician. In our opinion, the potential of computer-assisted technology in this field is yet to be maximized and the currently available tools are less than ideal. The most valuable means of measurement at the present time are global photography and phototrichogram-based techniques (with digital image analysis). Subjective scoring systems are also of value in the overall assessment of response to therapy and these are under-utilized and merit further refinement.

  • PDF