• The Korean Journal of Pain
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• v.33 no.2
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• pp.183-191
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• 2020

Background: Opioids can present intolerable adverse side-effects to patients who use these analgesics to mitigate chronic pain. In this retrospective analysis, cooled radiofrequency (CRF) denervation was evaluated to provide pain and disability relief and reduce opioid use in patients with sacroiliac joint (SIJ) derived low back pain (LBP). Methods: Twenty-seven patients with pain from SIJ refractory to conservative treatments, and taking opioids chronically (> 3 mo), were included. Numeric rating scale (NRS) and Oswestry disability index (ODI) scores were collected at 1, 6, and 12 months post-procedure. Opioid use between baseline and each follow-up visit was compared for the entire group and for those who experienced successful (pain reduction ≥ 50% of baseline value) or unsuccessful CRF denervation. Results: Severe initial mean pain (NRS score: 7.7 ± 1.0) and disability (ODI score: 50.1 ± 9.0), and median opioid use (morphine equivalent daily dose: 40 ± 37 mg) were significantly reduced up to 12 months post-intervention. CRF denervation was successful in 44.4% of the patients at 12 months. Regardless of procedure success, patients demonstrated similar opioid reductions and changes in opioid use at 12 months. Two patients (7.4%) experienced neuritis following CRF denervation. Conclusions: CRF denervation of the SIJ can safely elicit pain and disability relief, and reduce opioid use, regardless of intervention success. Future studies may support CRF denervation as a dependable therapy to alleviate opioid use in patients with SIJ-derived LBP and show that opioid use measurements can be a surrogate indicator of pain.

• Journal of Acupuncture Research
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• v.23 no.5
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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.

• Journal of Korean Neurosurgical Society
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• v.60 no.1
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• pp.54-59
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• 2017

Objective : Postoperative pain is one of the major complaints of patients after lumbar fusion surgery. The authors evaluated the effects of intravenous patient controlled analgesia (IV-PCA) using fentanyl or sufentanil on postoperative pain management and pain-related complications. Methods : Forty-two patients that had undergone surgery with lumbar instrumentation and fusion at single or double levels constituted the study cohort. Patients were equally and randomly allocated to a sufentanil group (group S) or a fentanyl group (group F) for patient controlled analgesia (PCA). Group S received sufentanil at a dose of $4{\mu}g/kg$ IV-PCA and group F received fentanyl $24{\mu}g/kg$ IV-PCA. A numeric rating scale (NRS) of postoperative pain was applied before surgery, and immediately and at 1, 6, and 24 hours (hrs) after surgery. Oswestry disability index (ODI) scores were obtained before surgery and one month after surgery. Opioid-related side effects were also evaluated. Results : No significant intergroup difference was observed in NRS or ODI scores at any of the above-mentioned time points. Side effects were more frequent in group F. More specifically, nausea, vomiting rates were significantly higher (p=0.04), but pruritus, hypotension, and headache rates were non-significantly different in the two groups. Conclusion : Sufentanil displayed no analgesic advantage over fentanyl postoperatively. However, sufentanil should be considerable for patients at high risk of GI issues, because it had lower postoperative nausea and vomiting rates than fentanyl.

• Korean Journal of Acupuncture
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• v.38 no.3
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• pp.175-181
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• 2021

A 57-year-old female diagnosed with L5-S1 lumbar intervertebral disc herniation, suffering from severe pain despite taking tapentadol received combined Korean medicine treatment, including acupotomy, acupuncture, pharmacopuncture, and herbal therapies for 53 days. To assess pain, Numeric Rating Scale (NRS) and lumbar range of motion (ROM) were checked daily from the day of admission. Moreover, the Oswestry Disability Index (ODI) and European Quality of Life-5 Dimensions (EQ-5D) were used to evaluate function and quality of life. After combined Korean medicine treatment, reabsorptioin of intervertebral disc was confirmed by radiological examination; pain reduced from NRS 5~7 to NRS 1~2; lumbar ROM in extention increased from 20° to 30°; and function and quality of life improved. The results suggest the possibility that a combined Korean medical treatment, including acupotomy, can be used as an alternative to opioids for pain management of lumbar vertebral disc herniation.