• The Korean Journal of Pain
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• 제25권3호
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• pp.155-160
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• 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.

• The Korean Journal of Pain
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• 제9권1호
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• pp.200-205
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• 1996

Radiofrequency thermocoagulation(RF) techniques are safe and effective methods as compared to neurodestructive procedure. Other advantages are: ability to perform RF lesions under local or sedative anesthesia, rapid recovery period, low incidence of morbidity and mortality, ability to repeat RF lesions, and leaves no significant scarring. We performed C2 ganglionotomy by RF lesion generator on a patient, suffering post-traumatic occipital neuralgia, as the patient did not respond to conservative therapies such as: trigger point injection, TENS, cryotherapy and stretch, occipital nerve block, C2 ganglion block. Prognostic nerve block was performed usng local anesthetics. Excellent effect was conformed before C2 ganglionotomy. This procedure was performed under fluoroscopy. Type RCK-2A Rosomoff Cordotomy kit was used to stabilize the head and neck. Postoperatively, the patient was free of occipital pain and head motions no longer triggered pain. To date, the patient remains symptom free except for some cervical discomfort.

• The Korean Journal of Pain
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• 제8권2호
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• pp.341-346
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• 1995

Piriformis Syndrome is characterized by pain of the low back, groin, perineum, buttock, hip, posterior thigh, leg and foot. Symptoms are aggravated by sitting, prolonged combination of hip flexion, adduction, the medial rotation, or by activity. In addition, patient may complain of painful swelling of the limb and sexual dysfunction-dyspareunia in female, and impotence in male. It currently appears that three specific conditions may contribute to the piriformis syndrome: (a) myofascial pain; (b) nerve and vascular entrapment; (c) dysfunction of the sacroiliac joint. The important keys of diagnosis are history and physical examination. There is no known objective diagnostic method. We described the clinical features of four cases of piriformis syndrome and reviewed foreign literature.

• The Korean Journal of Pain
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• 제4권1호
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• pp.51-55
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• 1991

There is a variety of therapeutic modality for herniated nucleus pulposus. Recently the low level laser has come into use for treatment for it. We treated two patients suffered from herniated nucleus pulposus of the central type of $L_{3,4}$ level, with He-Ne, $CO_2$ and Ga Al As laser simultaneously daily under hospitalization. In order to determine the efficacy of treatment, we used the "visual analogue scale" and its improvement rate. The results were as follows; Case I complained of gait disturbance, and hypoesthesia on the lateral side of the left lower leg, as and as low back pain. At the 15th day after treatment, VAS improvement rate was 40%, and the gait disturbance and hypoesthesia were markedly improved. 35th days after tratement, VAS improvement rate was 80%. Case II complained only of low back pain. At the 15th day after treatment, the VAS improvement rate was 68%, and at 20 days after treatment it was 84%. We sugsest that, using the low level laser for treatment of herniated nucleus pulposus increased the cartilage entrophism, and inhibitory effects of the inflammatory materials such as acid glycosaminoglycan by its anti-inflammatory and analgesic effects.

• The Korean Journal of Pain
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• 제2권2호
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• pp.129-134
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• 1989

• The Korean Journal of Pain
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• 제7권1호
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• pp.100-105
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• 1994

좌측 대퇴 절단부에서의 통증을 주소로 하고 다양한 증상을 강하제 호소하던 환자에서 통증의 원인 검색 중 신경종을 발견하여 그것을 적출한 후에 절단부의 통증 뿐아니라 미증호소도 함께 경감된 증례를 경험했다. 이러한 미증호소는 지속되는 통증 및 정확하지 않은 치료방법에 의해 증가 할 수도 있다고 생각된다. 본 증례에서와 같은 경우 정신적 배려를 충분히 해가면서 통증의 원인 검색 및 치료를 하는 것이 합리적일 것으로 사료된다.

• The Korean Journal of Pain
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• 제20권2호
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• pp.174-180
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• 2007

Background: The diagnosis of trigeminal neuralgia (TN) is based on only clinical criteria. The purpose of this study was to estimate the clinical manifestations of TN patients treated at our pain clinic. Methods: A total of 341 patients with TN from Jan. 2004 to Dec. 2006 was evaluated the intensity, site, and onset of pain, facial sensation, duration of pain attack, pain free interval, triggering factors, and effects of the previous treatments with TN specific questionnaire and interview at the first visit of our pain clinic. Results: About 80% of the patients were over 50 years of age and 256 (75%) patients were women. Average durations from first attack of their pain and from current pain attack were 7 years and 16 weeks, respectively. The two most frequently involved trigeminal nerve branches were maxillary (40%) and mandibular (39%) branches. Three quarters of the total patients experienced only paroxysmal pain that lasted less than one minute. About 90% of patients had pain free period at least one time. Most common triggering factors were chewing (88%), brushing teeth (82%), washing face (79%), and talking (70%). Only 16 patients (5%) had no previous treatment and the others had more than one treatment, such as medication (68%) and interventional procedures (35%). The most common reasons for early discontinuation of carbamazepine were dizziness, ataxia, and vomiting. Conclusions: TN has specific clinical features of pain, which should be considered at diagnosis.

• The Korean Journal of Pain
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• 제8권1호
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• pp.82-85
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• 1995

Hemifacial spasm is a distressing condition characterized clinically by paroxysmal and an involuntary movement in muscles innervated by the facial nerve on one side of the face. Blockade of the facial nerve can be performed percutaneously, without any serious complications. There are certain clinical problems associated with the conventional procedure, such as severe pain and technical difficulties to find facial nerve. This report describes a fluoroscope guided facial nerve block. This new technique reduced the difficulties in identifying the facial nerve and decreased the suffering associated with the conventional way of facial nerve block.

• The Korean Journal of Pain
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• 제8권2호
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• pp.367-370
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• 1995

We experienced two case of persistent Horner's syndrome which might be side effect of stellate ganglin block(SGB). Case one, a 35 year old male patient with severe pain and hyperesthesia of the right thumb. We performed repeated SGB with 1% mepivacaine 5 ml on the right side daily. After 9 times of SGB, he had continued ptosis, photophobia for one month and miosis for 6 months. Second case, the patients was a 21 year old male. He visited at our pain clinic to be cured of both sudden deafness which had begun two week ago. We performed SGB on both sides alternatively twice a day. About a week later, hearing ability of the left ear was recovered. After then we performed SGB only the right side. 34 SGB was performed in two months after that he got persistent Horner's syndrome.

• The Korean Journal of Pain
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• 제5권1호
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• pp.1-8
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• 1992

A total of 578,886 nerve blocks were performed during a period of 28 years. Based on our experience, we introduced the concept of compartment block, and then improved our technique of nerve blocking. If the location of a compartment was defined by injecting a contrast medium under fluoroscopic monitoring, the effect of nerve block could be estimated. As a result, we can safely perform nerve blocks with alcohol within a short period of time.