• Title/Summary/Keyword: Spine pain

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Continuous wound infiltration of ropivacaine for reducing of postoperative pain after anterior lumbar fusion surgery: a clinical retrospective comparative study

  • Lee, Sang-Min;Yun, Dong-Ju;Lee, Sang-Ho;Lee, Hyung-Chang;Joeng, Kyung Ho
    • The Korean Journal of Pain
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    • v.34 no.2
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    • pp.193-200
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    • 2021
  • Background: Local anesthetic infiltration at the site of a surgical wound is commonly used to control postoperative pain. In this study, we examined the effectiveness of continuous local infiltration at an abdominal surgical site in patients undergoing anterior lumbar interbody fusion (ALIF) surgery. Methods: Sixty-one patients who underwent ALIF surgery were enrolled. For thirtyone of them, a continuous local anesthetics infiltration system was used at the abdominal site. We collected data regarding the patients' sleep quality; satisfaction with pain control after surgery; abilities to perform physical tasks and the additional application of opioids in the postoperative 48 hours. Results: The On-Q system group showed reduced visual analogue scale scores for pain at the surgical site during rest and movement at 0, 12, 24, and 48 hours; and more was satisfied with pain control management at the first postoperative day (7.0 ± 1.2 vs. 6.0 ± 1.4; P = 0.003) and week (8.1 ± 1.6 vs. 7.0 ± 1.8; P = 0.010) than the control group. The number of additional patient-controlled analgesia (PCA) bolus and pethidine injections was lower in the On-Q group (PCA: 3.67 ± 1.35 vs. 4.60 ± 1.88; P = 0.049 and pethidine: 2.09 ± 1.07 vs. 2.73 ± 1.38; P = 0.032). Patients who used the On-Q system performed more diverse activity and achieved earlier ambulation than those in the control group. Conclusions: Continuous wound infiltration with ropivacaine using an On-Q system may be effective for controlling postoperative pain after ALIF surgery.

Gas-Filled Intradural Cyst within the Cauda Equine

  • Cho, Hyung-Lea;Lee, Sang-Ho;Kim, Jin-Sung
    • Journal of Korean Neurosurgical Society
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    • v.49 no.3
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    • pp.182-185
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    • 2011
  • A case of radicular pain that resulted from a gas-filled intradural cyst in an 80-year-old male is described. Temporary improvement of radicular pain was observed after CT-guided aspiration. However, recurrent radicular pain led to surgical treatment. In this report, the authors document the radiologic and intraoperative features of a gas-filled intradural cyst that migrated into the nerve root, and propose an optimal treatment plan based on a review of the literature.

Treatment with Epidural Blood Patch for Iatrogenic Intracranial Hypotension after Spine Surgery

  • Kim, Jaekook;Lee, Sunyeul;Ko, Youngkwon;Lee, Wonhyung
    • Journal of Korean Neurosurgical Society
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    • v.52 no.3
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    • pp.254-256
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    • 2012
  • Intracranial hypotension syndrome typically occurs spontaneously or iatrogenically. It can be associated with headache, drowsy mentality and intracranial heamorrhage, Iatrogenic intracranial hypotension can occur due to dural pucture, trauma and spine surgery. Treatment may include conservative therapy and operation. We report a case of a 54-year-old man who was successfully treated with epidural blood patches for intracranial hypotension due to cerebrospinal fluid (CSF) leakage into the lumbosacral area after spine surgery.

Discogenic Abdominal Pain

  • Choi, Seok-Min;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • v.38 no.5
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    • pp.384-386
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    • 2005
  • There have been several reports about abdominal pain due to discitis in children or thoracic disc herniation. However, none of them could verify causal relationship between disc disease and abdominal pain clearly. The authors report a patient with discogenic abdominal pain who had disc degeneration at lower lumbar level without definite protrusion or any evidence of inflammation. We could reproduce the abdominal pain by using discography. The patient was treated by percutaneous disc decompression successfully.

A Clinical Study on Effect of Chuna Treatment for Neck Pain Patients Caused by Traffic Accident (자동차사고로 발생한 경항통 환자의 추나요법의 효과에 대한 임상적 연구)

  • Heo, Su-Young;Jee, Jae-Dong;Sung, Ik-Jae;Kim, Gyu-Sub;Lee, Seung-Woo;Kim, Hyun-Seok;Kim, Jae-Young;Kwon, Oh-Gon
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.8 no.1
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    • pp.87-96
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    • 2013
  • Objectives : The purpose of this study is to investigate the effect of Chuna treatment for neck pain patients caused by traffic accident. Methods : 64 patients were divided into two groups, experimental group and control group, of 32 patients each. Control group was treated with general korean medical treatment three times per week for 2 weeks. Experimental group was treated with Chuna treatment and general korean medical treatment three times per week for 2 weeks. We evaluated the treatment effect of each group with the visual analog scale(VAS) and neck disability index(NDI). Results : 1. In both two groups, VAS were decreased significantly in statistics after treatment. 2. In both two groups, NDI were decreased significantly in statistics after treatment. 3. There were significant reduction of the VAS in experimental group than control group, but, there were not significant reduction of the NDI in experimental group than control group. Conclusions : We suggest that Chuna treatment could be recommended as a useful therapy to neck pain patients caused by traffic accident.

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Effect of Deep Neck Flexor Performance on the Stability of the Cervical Spine in Subject With and Without Neck Pain

  • Kwon, Oh-Yun;Lee, Won-Hwee;Jung, Sung-Dae;Kim, Si-Hyun;Jung, Do-Heon
    • Physical Therapy Korea
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    • v.18 no.4
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    • pp.1-10
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    • 2011
  • This study compared the stability of the cervical spine according to the presence of neck pain and deep neck flexor performance. Thirty subjects with neck pain, and thirty subjects without neck pain were recruited for this study. The Cranio-cervical flexion (CCF) test was applied using a pressure biofeedback unit to classify the subjects into four subgroups; no cervical pain and good deep neck flexor performance (NG group), no cervical pain and poor deep neck flexor performance (NP group), cervical pain and good deep neck flexor performance (PG group), and cervical pain and poor deep neck flexor performance (PP group). The head sway angle was measured using a three-dimensional motion analysis system. A 3-kg weight was used for external perturbation with the subject sitting in a chair in the resting and erect head positions with voluntary contraction of the deep neck flexors. A one-way analysis of variance (ANOVA) was performed with a Bonferroni post hoc test. The deep neck flexor performance differed significantly among the four groups (p<.05). The NG group had significantly greater deep neck flexor performance than NP and PP groups. The stability of the cervical spine also differed significantly among the four groups in the resting head position (p<.05). The head sway angle was significantly smaller in NG group as compared with the other groups. The PP group had the greatest head sway angle in the resting head position. However, there was no significant difference in the stability of the cervical spine among the groups in the erect head position with voluntary contraction of deep neck flexors (p=.57). The results of this study suggest that the deep neck flexor performance is important for maintaining the stability of cervical spine from external perturbation.

Cryo-Compression Therapy After Elective Spinal Surgery for Pain Management: A Cross-Sectional Study With Historical Control

  • Nabiyev, Vugar Nabi;Ayhan, Selim;Adhikari, Prashant;Cetin, Engin;Palaoglu, Selcuk;Acaroglu, R. Emre
    • Neurospine
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    • v.15 no.4
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    • pp.348-352
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    • 2018
  • Objective: Postoperative dynamic cryo-compression (DC) therapy has been proposed as a method of reducing pain and the inflammatory response in the early postoperative period after orthopedic joint reconstruction surgery. Our aim was to analyze the analgesic efficacy of DC therapy after adult lumbar spinal surgery. Methods: DC was applied for 30 minutes every 6 hours after surgery. Pain was measured by a visual analogue scale (VAS) in the preoperative period, immediately after surgery, and every 6 hours postoperatively for the first 72 hours of the hospital stay. Patients' pain medication requirements were monitored using the patient-controlled analgesia system and patient charts. Twenty patients who received DC therapy were compared to 20 historical controls who were matched for demographic and surgical variables. Results: In the postanesthesia care unit, the mean VAS back pain score was $5.87{\pm}0.9$ in the DC group and $6.95{\pm}1.0$ (p=0.001) in the control group. The corresponding mean VAS scores for the DC vs. control groups were $3.8{\pm}1.1$ vs. $5.4{\pm}0.7$ (p < 0.001) at 6 hours postoperatively, and $2.7{\pm}0.7$ vs. $6.25{\pm}0.9$ (p<0.001) at discharge, respectively. The cumulative mean analgesic consumption of paracetamol, tenoxicam, and tramadol in the DC group vs. control group was $3,733.3{\pm}562.7mg$ vs. $4,633.3{\pm}693.5mg$ (p<0.005), $53.3{\pm}19.5mg$ vs. $85.3{\pm}33.4mg$ (p<0.005), and $63.3{\pm}83.4mg$ vs. $393.3{\pm}79.9mg$ (p<0.0001), respectively. Conclusion: The results of this study demonstrated a positive association between the use of DC therapy and accelerated improvement in patients during early rehabilitation after adult spine surgery compared to patients who were treated with painkillers only.

Analysis of Women with Low Back Pain and Bone mineral density (일부 여성의 요통과 골밀도에 관한 분석)

  • Kang, Jeom-Deok
    • Journal of Korean Physical Therapy Science
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    • v.8 no.2
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    • pp.1015-1021
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    • 2001
  • Objectives: The objective of this study was to investigate analysis of women with low back pain and osteoporosis were measured for 40 normal in the women from July 20, 2000 to October 20, 2000. Methods: Bone mineral density(BMD) of lumbar spine was measured using energy absorptiometry and were correlated with age, calcium. alkaline phosphatase. bone mineral density standard T scores(p<0.05). Results: The bone mineral density of the lumbar spine decreased with aging, The bone mineral density of the lumbar spine decreased with the serum calcium and phosphate increased. The mean bone mineral density of the lumbar spine of healthy women in age($50\sim59$) was $0.83g/cm^2$, the lumbar spine of women low back pain in age($50\sim59$) was 0.75 glad. Conclusion: In the multiple regression of risk factors to bone mineral density(BMD) of lumbar spine were correlated with age, of abortion, calcium, bone mineral density standard T scores(p<0,05). In the prevention and early diagnosis and treatment of osteoporosis, the physician should consider the risk factors.

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Microdecompression for Extraforaminal L5-S1 Disc Herniation; The Significance of Concomitant Foraminal Disc Herniation for Postoperative Leg Pain

  • Lee, Dong-Yeob;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • v.44 no.1
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    • pp.19-25
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    • 2008
  • Objective : To analyze the relationship of concomitant foraminallumbar disc herniation (FLDH) with postoperative leg pain after microdecompression for extraforaminallumbar disc herniation (EFLDH) at the L5-S1 level. Methods : Sixty-five patients who underwent microdecompression for symptomatic EFLDH at the L5-S1 level were enrolled, According to the severity of accompanying FLDH, EFLDH was classified into four categories (Class I : no FLDH; Class II : mild to moderate FLDH confined within a lateral foraminal zone; Class III : severe FLDH extending to a medial foraminal zone; Class IV : Class III with intracanalicular disc herniation). The incidence of postoperative leg pain, dysesthesia, analgesic medication, epidural block, and requirement for revision surgery due to leg pain were evaluated and compared at three months after initial surgery. Results : The incidences of postoperative leg pain and dysesthesia were 36.9% and 26.1%, respectively. Pain medication and epidural block was performed on 40% and 41.5%, respectively, Revision surgery was recommended in six patients (9.2%) due to persistent leg pain, The incidences of leg pain, dysesthesia, and requirement for epidural block were higher in Class III/IV, compared with Class I/II. The incidence of requirement for analgesic medication was significantly higher in Class III/IV, compared with Class I/II (p=0,02, odds ratio=9,82). All patients who required revision surgery due to persistent leg pain were included in Class III/IV. Conclusion : Concomitant FLDH seems related to postoperative residual leg pain after microdecompression for EFLDH at the L5-S1 level.

Effect of Cervical Corrective Exercises on Pain, Neck Posture, and Intersegmental Motion of Cervical Spine in a Patient With Cervical Radiculopathy: A Case Report

  • Yun, Sung-joon;Kim, Moon-hwan;Weon, Jong-hyuck;Kwon, Oh-yun
    • Physical Therapy Korea
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    • v.22 no.4
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    • pp.1-7
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    • 2015
  • This case report describes the effectiveness of cervical corrective exercises in a patient with cervical radiculopathy (CR) who experienced radicular pain, upper limb paresis, and limited functional activity. A 39-year-old male with cervical radiculopathy performed the cervical corrective exercises for reducing pain. Pain intensity, cervical posture, and active range of motion of cervical intersegmental spine motion were measured baseline, after 4 weeks, and after 8 weeks with self-reported questionnaire and radiographs. After 8 weeks of intervention, the patient demonstrated alleviated radicular symptoms, improved neck posture and active range of flexion and extension of the cervical intersegmental spine. Especially in the angle between the cervical vertebra 6 and 7, the angle was changed from $-4.69^{\circ}$ to $3.30^{\circ}$ during resting position after intervention. The present case indicates that the cervical corrective exercises might be a possible treatment to effectively reduce radicular symptoms, improve neck posture, and active cervical intersegmental motion for patient with CR.