• Title/Summary/Keyword: Spine pain

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Case Report of Sacrum Malposition Analysed by Relative Research of Test (검사법의 비교연구로 살펴본 천골변위 증례보고)

  • Kim, Gyu-Sub;Kang, Woo-Jin;Moon, Ik-Ryoul;Park, Jae-Sung;Jeon, Jun-Hyeon;Jeong, Won-Choon;Heo, Su-Young
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.10 no.1
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    • pp.129-137
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    • 2015
  • Objectives : The purpose of this study is to find out the relation between Orthopedic Test of sacroiliac joint and two Sacrum Malposition Tests. Methods : We investigated 56 cases of patients who complained of unilateral sacroiliac joint pain and were diagnosed as sacrum malposition. We used Gaenslen's Test, Sacroiliac Resisted Abduction Test and Patric's Test as Orthopedic Test for pain area, while used Thompson's Sacrum Test and Greenman's 4 Point Test for diagnosis of sacrum malposition. Results : P-value was 0.511 between Thompson's Sacrum Test and Greenman's 4 Point Test within negative Orthopedic Test, and was 0.523 within positive Orthopedic Test(p>0.05) Conclusions : The results suggested that the Thompson's Sacrum Test was not statistically correlation with Greenman's 4 Point Test within negative Orthopedic Test, and was not correlated within positive Orthopedic Test.

Effect of epidural corticosteroid injection on magnetic resonance imaging findings

  • Kim, Min Soo;Jeong, Tae Yoon;Cheong, Yu Seon;Jeon, Young Wook;Lim, So Young;Kang, Seong Sik;Kim, In Nam;Chang, Tsong Bin;Seong, Hyun Ho;Hwang, Byeong Mun
    • The Korean Journal of Pain
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    • v.30 no.4
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    • pp.281-286
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    • 2017
  • Background: Magnetic resonance imaging (MRI) of the spine is the preferred diagnostic tool for pathologic conditions affecting the spine. However, in patients receiving epidural corticosteroid injection (ESI) for treatment of spinal diseases, there is a possibility of misreading of MR images because of air or fluid in the epidural space after the injection. Therefore, we defined the characteristics of abnormal changes in MRI findings following an ESI in patients with low back pain. Methods: We reviewed the medical records of 133 patients who underwent MRI of the lumbar spine within 7 days after ESI between 2006 and 2015. All patients were administered an ESI using a 22-gauge Tuohy needle at the lumbar spine through the interlaminar approach. The epidural space was identified by the loss of resistance technique with air. Results: The incidences of abnormal changes in MRI findings because of ESI were 54%, 31%, and 25% in patients who underwent MRI at approximately 24 h, and 2 and 3 days after ESI, respectively. Abnormal MRI findings included epidural air or fluid, needle tracks, and soft tissue changes. Epidural air, the most frequent abnormal finding (82%), was observed in 41% of patients who underwent MRI within 3 days after injection. Abnormal findings due to an ESI were not observed in MR images acquired 4 days after ESI or later. Conclusions: Pain physicians should consider the possibility of abnormal findings in MR images acquired after epidural injection using the interlaminar approach and the loss of resistance technique with air at the lumbar spine.

Effect of Intravenous Lidocaine on the Neuropathic Pain of Failed Back Surgery Syndrome

  • Park, Chan-Hong;Jung, Sug-Hyun;Han, Chang-Gyu
    • The Korean Journal of Pain
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    • v.25 no.2
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    • pp.94-98
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    • 2012
  • Background: An intravenous infusion of lidocaine has been used on numerous occasions to produce analgesia in neuropathic pain. In the cases of failed back surgery syndrom, the pain generated as result of abnormal impulse from the dorsal root ganglion and spinal cord, for instance as a result of nerve injury may be particularly sensitive to lidocaine. The aim of the present study was to identify the effects of IV lidocaine on neuropathic pain items of FBSS. Methods: The study was a randomized, prospective, double-blinded, crossover study involving eighteen patients with failed back surgery syndrome. The treatments were: 0.9% normal saline, lidocaine 1 mg/kg in 500 ml normal saline, and lidocaine 5 mg/kg in 500 ml normal saline over 60 minutes. The patients underwent infusions on three different appointments, at least two weeks apart. Thus all patients received all 3 treatments. Pain measurement was taken by visual analogue scale (VAS), and neuropathic pain questionnaire. Results: Both lidocaine (1 mg/kg, 5 mg/kg) and placebo significantly reduced the intense, sharp, hot, dull, cold, sensitivity, itchy, unpleasant, deep and superficial of pain. The amount of change was not significantly different among either of the lidocaine and placebo, or among the lidocaine treatments themselves, for any of the pain responses, except sharp, dull, cold, unpleasant, and deep pain. And VAS was decreased during infusion in all 3 group and there were no difference among groups. Conclusions: This study shows that 1 mg/kg, or 5 mg/kg of IV lidocaine, and palcebo was effective in patients with neuropathic pain attributable to FBSS, but effect of licoaine did not differ from placebo saline.

Extreme Multi-Level Percutaneous Vertebroplasty for Newly Developed Multiple Adjacent Compression Fractures

  • Kim, Han-Woong;Song, Jae-Wook;Kwon, Austin;Kim, In-Hwan
    • Journal of Korean Neurosurgical Society
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    • v.45 no.6
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    • pp.378-380
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    • 2009
  • Osteoporotic patients who undergo percutaneous vertebroplasty (PVP) have the risk of a repeated collapse of their adjacent vertebral body due to alteration of load transfer into the adjacent vertebral body. The authors have experienced a rare case of repeated osteoporotic vertebral compression fractures (VCF) resulting in extreme multi-level PVP. A 74-year-old female developed severe back pain after slipping down one month ago. Her X-ray and MR images indicated a T11 VCF. She underwent successful PVP with polymethylmethacrylate (PMMA). Two weeks later, she returned to our hospital due to a similar back pain. Repeated X-ray and MR images showed an adjacent VCF on T12. A retrial of PVP was performed on T12, which provided immediate pain relief. Since then, repeated collapses of the vertebral body occurred 12 times in 13 levels within a 24-month period. Each time the woman was admitted to our hospital, she was diagnosed of newly developed VCFs and underwent repeated PVPs with PMMA, which finally eased back pain. Based on our experience with this patient, repeated multiple PVP is not dangerous because its few and minor complications. Therefore, repeated PVP can serve as an effective treatment modality for extreme-multi level VCFs.

Therapeutic Exercise of Low Back Pain (요통(腰痛)의 운동요법(運動療法)에 관한 고찰(考察))

  • Song, Young-Sang;Lim, Hyung-Ho
    • The Journal of Korea CHUNA Manual Medicine
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    • v.2 no.1
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    • pp.51-84
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    • 2001
  • Objective : The therapeutic exercise on low back found In the literatures mostly have adopted methods that are applied to only certain muscles. The purpose of this paper to classify various low pains and to Investigate an active physical treatment can be applied to certain low back pain. Methods : By exploring the journals and medical publications. Results and Conclusions 1. A goal of low back exercise is reinforcement and extension of muscles in order to control pains. 2 Low back exercise which causes the movement of the spinal joint and disk can control pains. 3. Flexion exercise of lumbar spine can be generally applied to any low back pains except kyposis. 4. Extension exercise of lumbar spine can be applied to any low back pains except facet joint syndrome or hyperlordosis. 5. Rotation exercise of lumbar spine can be applied to any low back pains except facet joint syndrome. 6. Lateral bending exercise of lumbar spine can be applied to HNP. facet Joint syndrome, scoliosis.

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Efficacy of transforaminal laser annuloplasty versus intradiscal radiofrequency annuloplasty for discogenic low back pain

  • Park, Chan Hong;Lee, Kyoung Kyu;Lee, Sang Ho
    • The Korean Journal of Pain
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    • v.32 no.2
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    • pp.113-119
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    • 2019
  • Background: Discogenic pain is a common cause of disability and is assumed to be a major cause of non-specific low back pain. Various treatment methods have been used for the treatment of discogenic pain. This study was conducted to compare the therapeutic success of radiofrequency (an intradiscal procedure) and laser annuloplasty (both an intradiscal and extradiscal procedure). Methods: This single-center study included 80 patients and followed them for 6 months. Transforaminal laser annuloplasty (TFLA, 37 patients) or intradiscal radiofrequency annuloplasty (IDRA, 43 patients) was performed. The main outcomes included pain scores, determined by the numeric rating scale (NRS), and Oswestry disability index (ODI), at pre-treatment and at post-treatment months 1 and 6. Results: The patients were grouped according to procedure. In all procedures, NRS and ODI scores were significantly decreased over time. Mean post-treatment pain scores at months 1 and 6 were significantly lower (P < 0.01) in both groups, and between-group differences were not significant. The ODI score was also significantly decreased compared with baseline. Among patients undergoing TFLA, 70.3% (n = 26) reported pain relief (NRS scores < 50% of baseline) at post-treatment 6 months, vs. 58.1% (n = 25) of those undergoing IDRA. There were no statistically significant differences between the groups in ODI reduction of > 40%. Conclusions: Our results indicate that annuloplasty is a reasonable treatment option for carefully selected patients with lower back and radicular pain of discogenic origin, and TFLA might be superior to IDRA in patients with discogenic low back pain.

Herniated Lumbar Disc Combined with Spinal Intradural Extramedullary Cysticercosis

  • Choi, Kyeong-Bo;Hwang, Byeong-Wook;Choi, Won-Gyu;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • v.48 no.6
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    • pp.547-550
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    • 2010
  • Spinal cysticercosis is a very uncommon manifestation of neurocysticercosis which is caused by the larvae of Taenia solium. However, it can develop as a primary infection through blood stream or direct larval migration. It can result in high recurrence and severe neurologic morbidity if not treated appropriately. We report the case of a 43-year-old woman who presented with severe lower back pain and left leg radiating pain in recent 2 weeks. Magnetic resonance image (MRI) of lumbar spine demonstrated extruded disc at the L5-S1 level combined with intradural extramedullary cystic lesion. We performed the open lumbar microdiscectomy (OLM) at L5-S1 on the left with total excision of cystic mass. After surgery, the patient showed an improvement of previous symptoms. Diagnosis was confirmed by histopathological examination as intradural extramedullary cysticercosis. We discuss clinical features, diagnostic screening, and treatment options of spinal cysticercosis.

Neurogenic muscle hypertrophy: a case report

  • Shin, Hyun Ho;Jeon, Young Hoon;Jang, Seung Won;Kim, Sae Young
    • The Korean Journal of Pain
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    • v.29 no.4
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    • pp.270-273
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    • 2016
  • Muscular hypertrophy is caused mainly due to myopathic disorder. But, it is also rarely produced by neurogenic disorder. A 74-year-old woman complained of right calf pain with hypertrophy for several years. Recent lumbar spine magnetic resonance imaging (MRI) showed central and lateral canal narrowing at the L4-L5 intervertebral space. Lower extremity MRI revealed fatty change of right medial head of the gastrocnemius and soleus, causing right calf hypertrophy. Electrodiagnostic examinations including electromyography and nerve conduction velocity testing demonstrated $5^{th}$ lumbar and $1^{st}$ sacral polyradiculopathy. Integrating all the results, the diagnosis was neurogenic muscle hypertrophy. Neurogenic muscle hypertrophy is very rare, but we recommend that clinicians consider this problem when a patient complains of lower limb hypertrophy and pain.

Analysis of Women with Low Back Pain and Bone mineral density (일부 여성에 대한 요통의 관련인자 분석)

  • Kang, Jeom-Deok;Kim, Jong-Bong
    • Journal of Korean Physical Therapy Science
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    • v.8 no.1
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    • pp.851-857
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    • 2001
  • Objectives: The objective of this study was to investigate the associated factors of low back pain in measurement of women. Methods: The data were collected from women who visited Physical Examination Center of hospital located in Daegu from July 20, 2000 to September 29, 2000. Data from 36 normal in the women. Results: The experience rate for low back pain was 58.3%. The mean age is 56 years. The the lumbar spine of healthy women in age($50\sim59$) was 73.4%, the lumbar spine of women low back pain in age($50\sim59$) was 66.7%, Variables significantly associated with low back pain were weight, education, Exercise time, menopause existence, occupation(p<0.05). The experience for LBP increased as weight increased(Odds ratio = 999.000). The experience for LBP increased as Exercise time decreased(Odds ratio = 1.090), The experience for LBP increased as menopause existence increased(Odds ratio = 0.7111), However all three variables had significant relationship. Conclusions: Results from this study indicated that a statistically significant association between LBP and weight, education. Exercise time, menopause existence, occupation, smoking in $x^2$-test. In logistic regression test. there were related variables.

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