• The Korean Journal of Pain
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• v.13 no.2
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• pp.247-250
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• 2000

Recently, some authors reported that discogenic low back pain should be regarded as a referred pain in respect of neural pathway. The afferent pathways of discogenic low back pain is transmitted mainly by sympathetic afferent fibres from the sinuvertebral nerves in the second lumbar nerve root. This pain arises from the lumbar intervertebral discs, and it had been transmitted mainly through the sympathetic afferent fibres contained in the second lumbar spinal nerve root. Second lumbar dermatome corresponds to the low back area. We experienced a case of low back pain which could not be controlled by conventional therapy and progressed wax and wane. The CT finding showed bulging disc between $L_4$ and $L_5$ and spinal stenosis in $L_4$ area. And epiduroscopic feature showed severe adhesion in $L_4$, $L_5$ and $S_1$. After we blocked $L_2$ root, pain score decreased 10 to 2. Therefore, the $L_2$ root block may be a useful diagnostic procedure as well as provide therapeutic value.

• The Korean Journal of Pain
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• v.23 no.4
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• pp.266-269
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• 2010

Spinal cord stimulation (SCS) is used to manage chronic pain syndromes and it is accepted a cost-effective therapy. Child-bearing women who had SCS become or choose to become pregnant despite these policies pregnancy is a relative contraindication. A 32-year-old woman had SCS as a treatment for the CRPS I of the left lower extremity, During various check up tests, we happen to find out that her serum beta-hCG was positive and confirmed pregnancy. SCS is not recommended in pregnancy because the effects of SCS on pregnancy and nursing mothers had not been confirmed. However, many female patients suffering from chronic pain may expect future pregnancy and we think that they must be informed about the possibility of pregnancy and the effects of SCS device implantation in the course of pregnancy. First of all, a good outcome requires a multidisciplinary team approach, including obstetrics, neonatology, pain medicine and anesthesia, as was used from an early pregnancy. Unfortunately, she had a misabortrion after 6 weeks.

• Journal of Korean Biological Nursing Science
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• v.13 no.2
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• pp.156-163
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• 2011

Purpose: The purpose of this study was to examine the effects of a bergamot essential oil-inhalation on chronic pain after surgery for lumbar spinal stenosis. Methods: Fifty-two subjects were randomly assigned to the experimental (bergamot essential oil-inhalation) and control (almond oil-inhalation) group. All patients understood the purpose of this study and a written informed consent for the study was obtained. Results: Bergamot essential oil-inhalation was conducted during twenty minutes. Visual analog scale, blood pressure, heart rate, and respiratory rate were measured before and after treatment in the two groups. The visual analog scale score, heart rate, and respiratory rate in bergamot essential oil-inhalation group were significantly lower than those in almond oil-inhalation group. However, there was no significant difference in systolic and diastolic blood pressure between the two groups. Conclusion: Therefore, bergamot essential oil-inhalation is effective in alleviating pain, heart rate, and respiratory rate. These results suggest that bergamot essential oil-inhalation can be a useful method for the relief of chronic pain during the treatment after spinal surgery.

• Journal of muscle and joint health
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• v.19 no.3
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• pp.294-307
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• 2012

Purpose: The purpose of this study is to identify main factors affecting patients' uncertainty following lumbar spinal surgery. Methods: A survey was conducted of a sample 155 post -operative patients in April to June 2010. Uncertainty and knowledge about self-care after spinal surgery and the back pain evaluation were measured. Data were analyzed with t-test, ANOVA, Pearson correlation, and multiple regressions. Results: The mean score of uncertainty level was $27.66{\pm}6.32$. Levels of uncertainty were different by age, gender, educational level, pain duration, and number of types of pain. Uncertainty was positively correlated with knowledge of post-op self-care, back pain, and mental health. The results of multiple regression indicated that knowledge of post-op self-care and mental health were significant predictors with 35.1% of the variance in uncertainty. Conclusion: A program including post-operative self-care education and mental health promotion is required to reduce uncertainty of patients with lumbar spinal surgery.

• Journal of Korean Clinical Nursing Research
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• v.15 no.3
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• pp.39-48
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• 2009

Purpose: The purpose of this study was to examine the effects of a video exercise program on pain, daily living function and educational satisfaction for patients with spinal surgery. Methods: The data were collected from September 2008 to May 2009. The participants were 20 people in the experimental group and 20 in the control group. The video exercise therapy, which was 15 minutes in length, was shown twice a day for 8 weeks using a CD. Results: In the experimental group, pain decreased significantly, and daily living function and educational satisfaction increased significantly compared to the control group. Conclusion: In has been confirmed that video exercise therapy has positive effects on pain, daily living function and educational satisfaction for patients following spinal surgery.

• Korean Journal of Psychosomatic Medicine
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• v.3 no.1
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• pp.91-97
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• 1995

Pain is a complex symptom consisting of a sensation underlying potenial disease and associated emotional state. Acute pain is a reflex biological response to injury, in contrast, chronic pain consists of pain of a mininum of 6 months duration and associates with physical, emotional past experience, economic resources of the patient, family and society. Moreover, chronic pain is characterized by physiological affective and behavioral responses that are quite different than those of acute pain. The different type of stimuli exciting pain receptor are mechanical, thermal and chemical stimli and chronic pain are concerned with three of all stimli. The major three components of pain central(Analgesia) system in the brain and spinal cord are 'periaqueductal gray area of the mesencephalon', 'the raphe magnus nucleus' and 'pain inhibitory complex located in the dorsal horns of the spinal cord'. But unfortunately, the central biochemical mechanisms of chronic pain are not clearly defined. To proper management of chronic pain, comprehensive urderstanding as a psychosomatic aspect and multidisciplinary therapeuti-team approach must be emphasized.

• The Korean Journal of Pain
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• v.19 no.1
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• pp.17-21
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• 2006

Background: Cyclic guanosine monophosphate (cGMP) plays an important role in the modulation of nociception. Although local sildenafil produces antinociception, by increasing cGMP through the inhibition of phosphodiesterase 5, the effect of spinal sildenafil has not been determined. The authors evaluated the effects of intrathecal sildenafil on the nociceptive behavior evoked by formalin injection and thermal stimulation. Methods: Lumbar intrathecal catheters were implanted into rats, with formalin and Hot-Box tests used as nociceptive models. The formalin-induced nociceptive behavior (flinching response) and withdrawal latency to radiant heat were measured, and the general behaviors also observed. Results: The intrathecal administration of sildenafil produced dose-dependent suppression of the flinches in both phases in the formalin test, and increased the withdrawal latency in the Hot-Box test. No abnormal behaviors were noted. Conclusions: Sildenafil, an inhibitor of phosphodiesterase 5, is active against the nociceptive state evoked in the spinal cord by formalin and thermal stimulations. Accordingly, spinal sildenafil may be useful in the management of pain.

• Journal of Korean Physical Therapy Science
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• v.29 no.2
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• pp.38-47
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• 2022

Background: The purpose of this study was to investigate the effect of the combined application of manipulation and stabilization exercises on pain and spinal curvature in patients with chronic back pain. Design: Randomized controlled trial Methods: The research subjects included 24 women in their 40s and 50s who have chronic back pain. The sample was evenly divided into an experimental group, which received the combined application of manipulation and stabilization exercises, and a control group, which received stabilization exercises only. The 30-minute intervention was applied five times a week for eight weeks. A bivariate repeated measures analysis of variances was conducted to identify the differences between the two groups before the experiment, after the fourth week, and at the end of the eight-week experiment. The level of statistical significance was set at.05. This analysis examined the within-group changes and the between-group changes using a paired t-test and an independent t-test, respectively. Results: Changes in pain differed significantly depending on the time of the measurement, the interaction between the time of the measurement and each group, and between the two groups (p<.05). Changes in the curvature of the bones of the neck, the bones of the back, and the lumbar vertebrae differed significantly depending on the time of the measurement and the interaction between the time of the measurement and each group (p<.05). Conclusion: The combined application of manipulation and stabilization exercises demonstrated a positive effect on changes in pain and spinal curvature, and the method is expected to be a useful intervention for reducing pain and improving spinal curvature in patients with back pain.

• The Korean Journal of Pain
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• v.36 no.4
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• pp.441-449
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• 2023

Background: Hypertonic saline is used for treating chronic pain; however, clinical studies that aid in optimizing therapeutic protocols are lacking. We aimed to determine the concentration of intrathecally injected hypertonic saline at which the effect reaches its peak as well as the underlying γ-aminobutyric acid (GABA) receptor-related antinociceptive mechanism. Methods: Spinal nerve ligation (SNL; left L5 and L6) was performed to induce neuropathic pain in rats weighing 250-300 g. Experiment 1: one week after implanting the intrathecal catheter, 60 rats were assigned randomly to intrathecal injection with 0.45%, 0.9%, 2.5%, 5%, 10%, and 20% NaCl, followed by behavioral testing at baseline and after 30 minutes, 2 hours, 1 day, and 1 week to determine the minimal concentration which produced maximal analgesia. Experiment 2: after determining the optimal intrathecal hypertonic saline concentration, 60 rats were randomly divided into four groups: Sham, hypertonic saline without pretreatment, and hypertonic saline after pretreatment with one of two GABA receptor antagonists (GABA_A [bicuculline], or GABA_B [phaclofen]). Behavioral tests were performed at weeks 1 and 3 following each treatment. Results: Hypertonic saline at concentrations greater than 5% alleviated SNL-induced mechanical allodynia and had a significant therapeutic effect, while showing a partial time- and dose-dependent antinociceptive effect on thermal and cold hyperalgesia. However, pretreatment with GABA receptor antagonists inhibited the antinociceptive effect of 5% NaCl. Conclusions: This study indicates that the optimal concentration of hypertonic saline for controlling mechanical allodynia in neuropathic pain is 5%, and that its analgesic effect is related to GABA_A and GABA_B receptors.

• Journal of Korean Neurosurgical Society
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• v.37 no.3
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• pp.187-192
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• 2005

Objective: Spinal myeloma has been treated with radiation therapy and chemotherapy. However, the role of surgery was not fully evaluated. This study is performed to evaluate the efficacy of surgery in the treatment of spinal myeloma. Methods: 22 patients who were treated with surgery for spinal myeloma from August 1999 to April 2003 were analyzed. Radiological finding, surgical methods and result were reviewed in retrospective study. For compression fracture due to myeloma infiltration, percutaneous vertebroplasy(PVP) was done. Decompression surgery with or without fixation was performed for patients with neurologic deficit. The modalities of surgery consist of PVP (14 cases), corpectomy and fixation (7 cases), and laminectomy and epidural mass removal (3 cases). To evaluate clinical outcome, visual analogue pain score and Frankel neurological scale were used. Results: In 14 cases of PVP, total 57 vertebral segments were treated including 21 thoracic vertebral bodies and 36 lumbar vertebral bodies. Pain relief was achieved in all cases. The pain score changed from 7.7 (preoperatively) to 2.5 (postoperatively). And pain relief effect was maintained over than one year. Frankel grade improved in decompression cases. Conclusion: Surgical treatment can alleviate pain and improve neurologic deficit immediately in spinal myeloma patients.