• The Korean Journal of Pain
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• 제32권1호
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• pp.47-50
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• 2019

Background: It is uncommon for patients who have received a permanent implant to remove the spinal cord stimulator (SCS) after discontinuation of medication in complex regional pain syndrome (CRPS) due to their completely painless state. This study evaluated CRPS patients who successfully removed their SCSs. Methods: This 10-year retrospective study was performed on patients who had received the permanent implantation of an SCS and had removed it 6 months after discontinuation of stimulation, while halting all medications for neuropathic pain. Age, sex, duration of implantation, site and type of CRPS, and their return to work were compared between the removal and non-removal groups. Results: Five (12.5%, M/F = 4/1) of 40 patients (M/F = 33/7) successfully removed the permanent implant. The mean age was younger in the removal group ($27.2{\pm}6.4$ vs. $43.5{\pm}10.7$ years, P < 0.01). The mean duration of implantation in the removal group was $34.4{\pm}18.2$ months. Two of 15 patients (13.3%) and 3 of 25 patients (12%) who had upper and lower extremity pain, respectively, had removed the implant. The implants could be removed in 5 of 27 patients (18.5%) with CRPS type 1 (P < 0.01). All 5 patients (100%) who removed their SCS returned to work, while only 5 of 35 (14.3%) in the non-removal group did (P < 0.01). Conclusions: Even though this study had limited data, younger patients with CRPS type 1 could remove their SCSs within a 5-year period and return to work with complete pain relief.

• The Journal of Korean Physical Therapy
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• 제18권1호
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• pp.65-73
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• 2006

Purpose: The purpose of this study was to identify the effect of electroacupuncture(EA) and transcutaneous electric nerve stimulation(TENS) after sciatic nerve crush injury in rats. Methods: The EA for experimental group I (Exp I, n=15) and TENS for experimental group II (Exp II, n=15) was applied from post-injury day(PD) 1 to PD 14 after sciatic nerve injury using low frequency stimulator that gave electrical stimulation(15min/60Hz). In order observe the effect of EA and TENS, this study examined GAP-43 expression in rat lumbar spinal cord at the PD 1, PD 7 and PD 14. In addition, the stride length(SL) and toe out angle(TOA) were measured at the PD 7 and PD 4. Results; Exp I and Exp II had higher GAP-43 immunoreactivity than control group(PD 1, 7, 14). The SL of Exp I and Exp II were significantly higher than control group(PD 7, 14). The TOA of Exp I and Exp II were significantly lower than control group(PD 7, 14). Conclusion: EA and TENS application increased motor nerve recovery and expression of GAP-43 immunoreactivity after sciatic nerve crush injury. Therefore effect of TENS and EA had similar effect on nerve regeneration and functional recovery.

• 대한한의학회지
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• 제23권2호
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• pp.97-107
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• 2002

Objective : Acupuncture is a method used to treat many kinds of pain in oriental cultural medicine. Especially when hetero-segmental area acu-points are stimulated, the therapeutic effects of pain control have more critical properties than other methods of acupuncture. However, the mechanism of pain control by acupuncture is contradictory so far. The present study examined the effects of electroacupuncture (EA) applied to the acu-point of the hetero-segmental area on modulation of formalin-induced pain in Sprague-Dawley rats. Methods : In order to apply EA to acu-points in the plantar area of right forepaws, a pair of Teflon-coated stainless steel wires were implanted in HT 7 (Shin-Moon) and PC 7 (Dae-Reung) 7 days before the behavioral test. A behavioral test was performed by means of video camera after injection of 5% formalin ($50{\;}\mu\textrm{l}$) into the lateral plantar region of the left hind paw. EA was delivered by a constant DC current stimulator at 4~5 mA, 2 ms, and 10 Hz for 30 min. c-Fos protein expression was measured in the lumbar spinal cord at 2 hr and 4 hr after formalin injection. Results : Behavioral responses including favoring, flinching and biting occurred in the biphasic pattern, such as the 1st phase (0~5 min) and the 2nd phase (20~45 min) after formalin injection. However, EA (4~5 mA, 2 ms, 10 Hz) significantly inhibited the behavioral responses. Injection of formalin expressed c-Fos protein on the ipsilateral dorsal horn neurons in L3 - L5 and the expression was sustained more than 4 hrs after formalin injection. However, EA decreased c-Fos protein expression at dorsal horn neurons in the lumbar spinal cord till 4hrs after formalin injection. Conclusions : These results suggest that EA modulates formalin-induced pain and this inhibitory action may be elicited by the descending inhibitory system.

• The Korean Journal of Pain
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• 제22권1호
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• pp.74-77
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• 2009

Implantable intrathecal pump is one of the therapeutic options for intractable pain. A 24-year-old male with complex regional pain syndrome was suffering from right lower extremity pain. He had all modalities of treatment including spinal cord stimulator. However, his pain had been worse in the past 6 months. His visual analogue pain scale (VAS) was 8-10 and he could not sit or walk. Only opioid was thought to be effective. Then, intrathecal pump was considered. We estimated the minimal effective dose of spinal morphine before implantation. 0.3 mg of morphine was injected intrathecally as a starting dose. Dosage had been increased up to 0.8 mg in 10 days. His VAS score decreased from 8 to 5. He could sleep without pain and walk with crutch. Therefore, intrathecal pump was inserted. He could tolerate to pain. This case suggests that intrathecal morphine delivery can provide effective treatment for intractable non-malignant pain.