• Journal of Korean Society of Spine Surgery
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• v.25 no.4
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• pp.175-179
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• 2018

Study Design: Case report. Objectives: We report 3 cases of loss of disc height after spontaneous regression of a herniated lumbar disc. Summary of Literature Review: Reports of spontaneous regression of a herniated lumbar disc were identified. Materials and Methods: We conservatively treated 3 patients who were diagnosed with a herniated lumbar disc. During outpatient follow-up, radiating pain improved in all patients, but they complained of chronic lower back pain. Magnetic resonance imaging (MRI) was performed for diagnostic purposes. Results: On MRI, spontaneous regression of the herniated lumbar discs was observed, but loss of disc height was also found. Conclusions: A herniated lumbar disc may be a risk factor for loss of disc height. It is important to recognize that a patient with a herniated lumbar disc can struggle with chronic lower back pain even if spontaneous regression of the herniated lumbar disc occurs.

• Journal of Korean Neurosurgical Society
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• v.54 no.1
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• pp.68-70
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• 2013

A 39-year old female presented with chronic spinal subdural hematoma manifesting as low back pain and radiating pain from both legs. Magnetic resonance imaging (MRI) showed spinal subdural hematoma (SDH) extending from L4 to S2 leading to severe central spinal canal stenosis. One day after admission, she complained of nausea and severe headache. Computed tomography of the brain revealed chronic SDH associated with midline shift. Intracranial chronic SDH was evacuated through two burr holes. Back pain and radiating leg pain derived from the spinal SDH diminished about 2 weeks after admission and spinal SDH was completely resolved on MRI obtained 3 months after onset. Physicians should be aware of such a condition and check the possibility of concurrent cranial SDH in patients with spinal SDH, especially with non-traumatic origin.

• The Journal of Korean Physical Therapy
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• v.20 no.3
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• pp.69-74
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• 2008

Purpose: The majority of patients with radiculopathy caused by a herniated nucleus pulposus (HNP) heal spontaneously without surgery. The aim of this report is to describe the spontaneous regression of lumbar disc herniation and the results of clinical follow-up. Methods: Three patients with radiating low back pain presented with an extruded intervertebral disc on magnetic resonance imaging (MRI). We performed follow-up with conservative treatment (epidural injection, medication, physical therapy, exercise) and clinical assessments on the 6th, 10th and 22nd months. Results: The extruded intervertebral disc almost complete regressed, and correlated with clinical improvement and follow-up MRI. Conclusion: Conservative treatment can be an effective approach for a herniated lumbar discs if no neurological deficits are present.

• The Korean Journal of Pain
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• v.10 no.1
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• pp.109-112
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• 1997

Spontaneous intracranial hypotension(SIH) is a rare syndrome of spontaneously occurring postural headache associated with low CSF pressure. It usually occur without evidence of any preceeding events such as lumbar puncture, back trauma, operative procedure, or medical illness. This syndrome usually resolves spontaneously or with strict bed rest. When the headache persists or is incapacitating, more aggressive treatment may be necessary. Autologous epidural blood patch is highly effective in the management of SIH. We experienced a case of SIH with downward displacement of brain in MRI and successfully treated with epidural blood patch.

• Journal of Chest Surgery
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• v.25 no.10
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• pp.1020-1024
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• 1992

Thirty-four patients underwent 39 subaxillary minithoracotomies for the treatment of primary spontaneous pneumothorax from June 1987 to April 1992. The age of patients ranged from 17 to 32 years. The ratio of male to female was 8.8: 1 with male predominance. The associated pulmonary lesions and pleural adhesion were not seen on the chest X-rays in all cases. Average operative time was 83 minutes[30~130 min]. Postoperative average duration of air leakage was 2.4 days, the chest tube indwelling was 5.1 days, and postoperative hospital stay was 8 days, Analgegics were not given for pain control postoperatively In conclusion, the subaxillary minithoracotomy has the following advantages: reducing the operative time, postoperative pain, morbidity, hospital stay, shoulder problems, and excellent cosmetic result.

• The Journal of Korean Medicine
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• v.23 no.1
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• pp.183-188
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• 2002

Adverse reactions associated with acupuncture are common even in standard practice. The incidence of recorded reactions are various from mild symptoms: tiredness, itching, dizziness or nausea to serious symptoms: pneumothorax, cardiac injury or infection. Recently we experienced one patient, a 36-year-old woman, admitted to the emergency department with chest pain, dyspnea and back pain one hour after acupuncture treatment. The diagnosis was a left-sided pneumothorax by chest PA X-ray and chest HR CT. In this study, we differentiate spontaneous pneumothorax from misunderstood iatrogenic. Further evaluation between adverse effects and similar symptoms is needed.

• Journal of Korean Neurosurgical Society
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• v.56 no.3
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• pp.269-271
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• 2014

Spinal subdural hematoma is a rarely reported disease and spontaneous spinal subdural hematomas (SSDH) without underlying pathological changes are even rarer. The patients usually show typical symtoms such as back pain, quadriplegia, paraplegia or sensory change. But rarely, patients may show atypical symptoms such as hemiparesis and misdiagnosed to cerebrovascular accident. We recently experienced a case of SSDH, where the patient initially showed vague symptoms, such as the sudden onset of headache which we initially misdiagnosed as subarachnoid hemorrhage. In this case, the headache of patient improved but the neck pain persisted until hospital day 5. Therefre, we conducted the MRI of cervical spine and finally confirmed SSDH. The patient was managed conservatively and improved without recurrence. In this case report, we discuss the clinical features of SSDH with emphasis on the importance of an early diagnosis.

• The Korean Journal of Pain
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• v.27 no.1
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• pp.54-62
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• 2014

Background: The recently known analgesic action mechanisms of nefopam (NFP) are similar to those of anticonvulsants and antidepressants in neuropathic pain treatment. It is difficult to prescribe high doses of oral neuropathic drugs without titration due to adverse effects. Unfortunately, there are few available intravenous analgesics for the immediate management of acute flare-ups of the chronic neuropathic pain. The aim of this study was to determine the additional analgesic effects for neuropathic pain of NFP and its adverse effects during the titration of oral medications for neuropathic pain among inpatients with postherpetic neuralgia (PHN). Methods: Eighty inpatients with PHN were randomly divided into either the NFP or normal saline (NS) groups. Each patient received a 3-day intravenous continuous infusion of either NFP with a consecutive dose reduction of 60, 40, and 20 mg/d, or NS simultaneously while dose titrations of oral medications for neuropathic pain gradually increased every 3 days. The efficacy of additional NFP was evaluated by using the neuropathic pain symptom inventory (NPSI) score for 12 days. Adverse effects were also recorded. Results: The median NPSI score was significantly lower in the NFP group from days 1 to 6 of hospitalization. The representative alleviating symptoms of pain after using NFP were both spontaneous and evoked neuropathic pain. Reported common adverse effects were nausea, dizziness, and somnolence, in order of frequency. Conclusions: An intravenous continuous infusion of NFP reduces spontaneous and evoked neuropathic pain with tolerable adverse effects during the titration of oral medications in inpatients with PHN.

• The Journal of Pediatrics of Korean Medicine
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• v.10 no.1
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• pp.245-263
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• 1996

In order to investigate the effects of Yangsymtang on the activities of central nervous system, we observed the effects on convulsions induced by pentylenetetrazole, strychnine and picrotoxin. The sedative those on spontaneous motor activity and by rota rod method, the those on sleeping time induced by barbiturate and the alleviative those on pain induced by acetic acid and hind limb pressure also were analyzed. The results were as follows: 1. The solid extracts of Yangsymtang showed no anticonvulsive effects on convulsions induced by pentylenetetrazole, strychnine and picrotoxin. 2. As to the sedative effects by rota rod method, th solid extracts of Yangsymtang were recognized as significance(P<0.01). 3. The sleeping time induced by thiopental sodium was not prolonged by the oral administration of the solid extracts of Yangsymtang. 4. The oral administration of Yangsymtang did not influenced the sleeping induced by pentobarbital sodium significantly. 5. As to the effects on spontaneous motor activity, the oral administration of Yangsymtang made spontaneous motor activity decrease significantly(P<0.05). 6. The oral administration of Yangsymtang was significant on pain induced by acetic acid(P<0.001). 7. As to alleviative effects on pain induced by hind limb pressure. The solid extracts of Yangsymtang were not significant.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.152-156
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• 1999

Spontaneous intracranial hypotension (SIH) is a rare syndrome which causes postural headache associated with low cerebrospinal fluid (CSF) pressure, without preceding events such as lumbar puncture, back trauma, operative procedure or illness. The headche is usually accompanied by nausea, vomiting, tinnitus, neck stiffness, vertigo, photophobia and in rare cases diplopia, transient visual obscuration. Brain MRI may show subdural effusion, downward displacement of brain and diffuse and continuous meningeal enhancement when enhanced by gadolinium. Low opening pressure was shown through lumbar puncture. The value of protein and cell count of CSF may be slightly elevated. This syndrome usually resolves itself spontaneously or with strict bed rest. When the headache is persistent or incapacitating, more aggressive treatment may be necessary. We treated two cases of SIH in which epidural blood patch produced immediate and complete relief of the symptoms.