• The Korean Journal of Pain
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• v.25 no.1
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• pp.33-37
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• 2012

Thoracic paravertebral block is performed for the treatment of patients with chronic pain, such as complex regional pain syndrome (CRPS) and post-herpetic neuralgia. Thoracic paravertebral block can result in iatrogenic pneumothorax. Because pneumothorax can develop into medical emergencies and needle aspiration or chest tube placement may be needed, early diagnosis is very important. Recently, thoracic ultrasonography has begun to be used to diagnose pneumothorax. In addition, ultrasound-guided aspiration can be an accurate and safe technique for treatment of pneumothorax, as the needle position can be followed in real time. We report a case of iatrogenic pneumothorax following thoracic paravertebral block for the treatment of chronic pain due to CRPS, treated successfully by ultrasound-guided aspiration.

• The Korean Journal of Pain
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• v.30 no.4
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• pp.296-303
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• 2017

Background: To achieve a prolonged therapeutic effect in patients with lumbar facet joint syndrome, radiofrequency medial branch neurotomy (RF-MB) is commonly performed. The purpose of this study was to evaluate the prognostic value of paravertebral muscle twitching when performing RF-MB in patients with lumbar facet joint syndrome. Methods: We collected and analyzed data from 68 patients with confirmed facet joint syndrome. Sensory stimulation was performed at 50 Hz with a 0.5 V cut-off value. Patients were divided into 3 groups according to the twitching of the paravertebral muscle during 2 Hz motor stimulation: 'Complete', when twitching was observed at all needles; 'Partial', when twitching was present at 1 or 2 needles; and 'None', when no twitching was observed. The relationship between the long-term effects of RF-MB and paravertebral muscle twitching was analyzed. Results: The mean effect duration of RF-MB was 4.6, 5.8, and 7.0 months in the None, Partial, and Complete groups, respectively (P = 0.47). Although the mean effect duration of RF-MB did not increase significantly in proportion to the paravertebral muscle twitching, the Complete group had prolonged effect duration (> 6 months) than the None group in subgroup analysis. (P = 0.03). Conclusions: Paravertebral muscle twitching while performing lumbar RF-MB may be a reliable predictor of long-term efficacy when sensory provocation under 0.5 V is achieved. However, further investigation may be necessary for clarifying its clinical significance.

• Journal of International Academy of Physical Therapy Research
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• v.12 no.1
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• pp.2302-2307
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• 2021

Background: Patients with lumbar spinal stenosis show abnormal changes in muscle activity due to pain and limited range of motion of the lumbar spine. Excessive increased muscle tone and decreased muscle activity patterns threaten the patients' quality of life. However, there have been a few studies showing how to improve muscle performance in patients with lumbar spinal stenosis. Among these, joint mobilization is one way of improving muscle performance through pain relief and increasing the range of motion. Objectives: To investigate the effect of lumbar mobilization by orthopedic manual physical therapy on paravertebral muscle activity and tone in patients with lumbar spinal stenosis. Design: A randomized controlled trial. Methods: In this study, 24 patients with lumbar spinal stenosis were randomized (1:1 ratio) into two groups. The experimental group underwent lumbar posteroanterior mobilization, and the control group underwent conventional physical therapy (conventional transcutaneous electrical nerve stimulation) for 15 minutes each. For outcome measures, Myoton^®PRO was used to evaluate muscle tone when resting of the paravertebral muscle in the pain area. For muscle activity evaluation, the reference voluntary contraction of the paravertebral muscle was evaluated using surface electromyography. Results: Muscle tone and activity were significantly improved after intervention in both the experimental and control groups. In addition, the experimental group showed more significant decrease in muscle tone and activity than the control group. Conclusion: These results suggest that lumbar mobilization improving muscle performance in patients with lumbar spinal stenosis.

• The Journal of Korean Physical Therapy
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• v.25 no.1
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• pp.16-22
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• 2013

Purpose: This study evaluated the validity of measuring paravertebral muscle function with 3D-NEWTON (Hanmed, Korea) by assessing the correlation between Biodex (Biodex, USA) and surface electromyography (EMG). Methods: Nineteen healthy adults participated. The function of their paravertebral muscle was measured in three ways. Maximum endurance time was measured in seconds when 3D-NEWTON was inclined forward for assessing extensor function, and inclined backward for assessing flexor function. Using surface EMG, maximum muscle activity was obtained from the eractor spinae and rectus abdominis during the 3D-NEWTON measurement. Maximum muscle activity was the mean activity from 10 seconds when the root mean squared firing data was highest. Through Biodex the peak torques of the extensor and flexor were measured during isometric exercises. The Spearman correlation coefficiencts from 3D-NEWTON, surface EMG, and Biodex were calculated. Results: The data from surface EMG and Biodex were statistically correlated when measured for flexor function, but less so for extensor function. In the case of 3D-NEWTON, the correlation coefficient with Biodex was 0.50 (p=0.05), while the coefficient with surface EMG was 0.53 (p=0.02) when measured for extensor function. Similarly, the correlation coefficienct with Biodex was 0.60 (p=0.01), while the surface EMG was 0.51 (p=0.03) for flexor function. Conclusion: 3D-NEWTON was a useful method for measuring paravertebral muscle function and can give helpful information for treating people with diseases associated with the lumbar spine.

• Journal of Yeungnam Medical Science
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• v.3 no.1
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• pp.95-102
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• 1986

Among the skeletal tuberculosis, tuberculous spondylitis is high incidence and curable disease, if early diagnosis and treatment are possible. We reviewed clinical manifestations and radiologic analysis of 30 cases tuberculous spondylitis from May 1983 to Sept. 1986, at Yeungnam medical center, Yeungnam University. The results were follows : 1. The frequent involve sites were thoracolumbar vertebra. 2. The continuous lesion is 86.7% of the all cases. 3. The most common type was intervertebral type, and lytic and sclerotic lesion were same incidence. 4. Paravertebral abscess, kyphosis and disc space narrowing were demonstrated more than 80.0% of the cases. 5. Computed tomography was more accurate diagnostic method rather than conventional plain study to evaluation of extent of lesion, involvement of spinal canal and cord, and size and location of paravertebral abscess. And CT guided abscess drainage procedure was helpful to diagnosis and treatment. 6. Ultrasonography was helpful to differential diagnosis between paravertebral abscess and other solid mass, and useful to follow up study of paravertebral abscess after treatment.

• Clinical Pain
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• v.20 no.2
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• pp.141-144
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• 2021

There are some cases of myofascial pain syndrome (MPS) with chronic upper back pain that does not respond to dry needling or trigger point injection, well-known treatments for MPS. A 67-year-old female developed a stabbing upper back pain with trigger point at left T7~8 levels 10 years ago. She complained of the pain with Numeral Rating Scale (NRS) 8 points. Myofascial release technique and trigger point injection had no effect. Under ultrasound guidance 20 ml of 1% lidocaine was injected into thoracic paravertebral space. Immediately, the pain was reduced to NRS 4 points. One week later, the second block was performed in the same way as the first, and the pain was reduced to NRS 2 points. The stabbing pain disappeared, and oral opioids were discontinued. Ultrasound guided thoracic paravertebral space block is an effective and safe treatment for refractory MPS with chronic upper back pain.

• Journal of Korean Neurosurgical Society
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• v.53 no.5
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• pp.305-308
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• 2013

Myositis ossificans (MO) is a benign condition of non-neoplastic heterotopic bone formation in the muscle or soft tissue. Trauma plays a role in the development of MO, thus, non-traumatic MO is very rare. Although MO may occur anywhere in the body, it is rarely seen in the lumbosacral paravertebral muscle (PVM). Herein, we report a case of non-traumatic MO in the lumbosacral PVM. A 42-year-old man with no history of trauma was referred to our hospital for pain in the low back, left buttock, and left thigh. On physical examination, a slightly tender, hard, and fixed mass was palpated in the left lumbosacral PVM. Computed tomography showed a calcified mass within the left lumbosacral PVM. Magnetic resonance imaging (MRI) showed heterogeneous high signal intensity in T1- and T2-weighted image, and no enhancement of the mass was found in the postcontrast T1-weighted MRI. The lack of typical imaging features required an open biopsy, and MO was confirmed. MO should be considered in the differential diagnosis when the imaging findings show a mass involving PVM. When it is difficult to distinguish MO from soft tissue or bone malignancy by radiology, it is necessary to perform a biopsy to confirm the diagnosis.

• The Korean Journal of Legal Medicine
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• v.42 no.4
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• pp.153-158
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• 2018

Staphylococcus aureus is an important cause of human infections, and it is also a commensal that colonizes the nose, axillae, vagina, throat, or skin surfaces. S. aureus has increasingly been recognized as a cause of severe invasive illness, and individuals colonized with this pathogen are subsequently at increased risk of its infections. S. aureus infection is a major cause of skin, soft tissue, respiratory, bone, joint, and endovascular disorders, and staphylococcal bacteremia may cause abscess, endocarditis, pneumonia, metastatic infection, foreign body infection, or sepsis. The authors describe a case of a fisherman who died of sepsis on a fishing boat during sailing out for fish. The autopsy shows paravertebral abscess, pus in the pericardial sac, infective endocarditis with vegetation on the aortic valve cusp, myocarditis, pneumonia and nephritis with bacterial colonization, and also liver cirrhosis and multiple gastric ulcerations.

• Journal of Korean Neurosurgical Society
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• v.48 no.5
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• pp.461-464
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• 2010

The authors report a 58-year-old woman with low-grade fibromyxoid sarcoma primarily located in the right paravertebral area with extension to L4 neural foramen. The patient complained lower back pain with radiating pain along the posterolateral aspect of the right lower leg. She underwent subtotal surgical removal and Cyber Knife therapy. Diagnosis was made by strikingly characteristic microscopic appearance of a bland spindle cell sarcoma which contained numerous giant collagen rosettes and was also supported by immunohistological findings. The diagnostic image findings and literatures are reviewed and discussed.

• The Korean Journal of Pain
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• v.6 no.1
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• pp.122-128
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• 1993

Two cases are described transient unilateral paraplegia following a splanchnic nerve block (SNB) among 683 procedures in 708 patients from 1968 to 1992. The first case, 64 year-old male, had bilteral splanchnic nerve block twice with pure alcohol 4 months and 2month ago. The paraparesis of right leg was developed 4 minutes after the pure alcohol injection during the third SNB and was completely recovered after 37 minutes. The second case, 60 year-old male, had also a first SNB with temporary relief of pain for a week. The Second SNB with 95% alcohol was followed by paraplegia of left leg. He showed almost complete improvement but expired 18 days later. The probable cause was the spread of alcohol onto the lumbar plexus or paravertebral space unilaterally, because of adhesion or paravertebral space due to previous alcohol injections.