• Title/Summary/Keyword: C5 root block

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The Effects of Nerve Blocks in the Management of Occipital Neuralgia (후두신경통과 신경차단)

  • Jeong, Eui-Taeg;Choi, Hong-Cheol;Lim, So-Young;Shin, Keun-Man;Hong, Soon-Yong;Choi, Young-Ryong;Jeong, Yong-Joong
    • The Korean Journal of Pain
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    • v.9 no.2
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    • pp.390-394
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    • 1996
  • Background: Occipital neuralgia is characterized by pain, usually deep and aching, in the distribution the second and/or third cervical dorsal root. Two broad groups of patients include primary occipital neuralgia with no apparent etiology and secondary neuralgia with structural pathology. Patients with occipital neuralgia can develop autonomic changes and hyperesthesia. In patients who have not improved with conservative treatment, we have carried out various nerve blocks and evaluated the effectiveness. Methods: In a series of 20 occipital neuralgia patients with no apparent etiolgy, we have carried out great occipital nerve blocks with needle TEAS. In patients who have not improved more than 75% on VAS with great occipital block, we have carried out C2 ganglion blocks and in patients who have not improved more than 75% with C2 ganglion block, C3 root blocks, C2/C3 facet joint blocks have been carried out in due order. Results: In 3 patients out of 10 patients who have not improved with great occipital nerve block, C2 ganglion block led to pain relief. A good response of C3 root block was achived in 2 of 7 patients without response to C2 ganglion block and C2/C3 facet joint block led to improvement in 1 of 5 patients without response to C3 root block. Conclusions: Nerve blocks like great occipital nerve block, C2 ganglion block, C3 root block, or C2/C3 facet joint block were effective in the patients who have not improved with conservative treatment.

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Comparison of the Clinical Outcomes of an Ultrasound-Guided and C-Arm Guided Cervical Nerve Root Block (초음파와 방사선 투시장치를 이용한 경추 신경근 차단술의 임상결과 비교)

  • Ha, Dae Ho;Shim, Dae Moo;Kim, Tae Kyun;Oh, Sung Kyun;Lee, Hyun Jun
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.78-84
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    • 2020
  • Purpose: This paper compares the clinical outcomes of patients who were treated with a cervical nerve block by ultrasound and C-arm and reports the complication. Materials and Methods: A total of 97 patients were treated with an ultrasound-guided nerve root block from May 1, 2015 to February 8, 2018. On the other hand, 94 patients were treated with a C-arm guided nerve root block. The consequences of the cervical pain and the radiating pain before and after the procedures were reviewed using the verbal numeric rating scale (VNRS). In addition, the complications related to the procedures from the daily notes from the chart were inspected. Results: Sixty-six cases out of 97 cases of ultrasound-guided nerve root block were enrolled in the study. The average age of the patients was 57 years, including 41 males and 25 females. Seventy seven out of 94 cases by a C-arm guided root block were included in the study. The average age of the patients was 55 years, including 40 males and 37 females. Before the nerve root block, the mean numeric rating pain scale (NRS) of the cervical pain in ultrasound-guided block decreased from 5.4 points to 2.7 points at three weeks and 1.4 points at six weeks (p=0.0023, p<0.001), and 3.1 points in the C-arm (p<0.001, p<0.001) at three weeks and 1.5 points at six weeks (p<0.001, p<0.001). In the case of radiating pain, the mean NRS in the ultrasound-guided nerve root block group improved from 6.3 points after the procedure to 2.8 points at three weeks and 1.5 points at six weeks (p<0.001, p<0.001). In the C-arm guided nerve root block group, the NRS improved from 7.4 points after the procedure to 3.3 points at three weeks and 1.9 points at six weeks. In the case of complications, Horner's syndrome and propriospinal myoclonus were observed in one case of C-arm guided block group. Conclusion: The clinical results of the patients who underwent ultrasound-guided cervical nerve root block were not significantly different from those who underwent a C-arm guided cervical nerve root block.

Rt $S_1$ Root Block during Rt $L_5$ Root Block in the Lumbar Radiculopathy (요부 신경질환에서 우측 $L_5$ 신경근 차단시 보여진 우측 $S_1$ 신경근 차단)

  • Kim, Jong-Lul;Yoon, Keon-Jung;Kang, Jun-Goo;Kim, Kyung-Hee;Lim, Chung-Hyuck;Lee, Myung-Woo;Park, Kyu-Ho;Choi, Hae-Sung
    • The Korean Journal of Pain
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    • v.11 no.2
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    • pp.307-310
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    • 1998
  • Selective lumbosacral radiculography and nerve root block techniques are very useful in determining the nerve root involved. We have done the lumbar root block to 61-year-old female who had suffered from low back pain radiating to right lower leg which was not relieved by epidural steroid injection two times. $L_5$ root block was performed under the fluoroscopic C-arm guide. When the needle was in correct position, we injected contrast medium (Isovist$^{(R)}$ - 300, Schering, Germany). After we injected 1.5 cc isovist, the S1 root was figured but L5 root was not figured. When we reinjected 1.5 cc isovist, $S_1$ root was enhanced and $L_5$ root was slightly visible due to severe disc bulging and lateral spinal stenosis.

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Perioperative Pain Management Using Regional Nerve Blockades in Shoulder Surgery: Ultrasound-Guided Intervention (견관절 수술 시 국소신경 차단술을 이용한 통증 관리 - 초음파 유도하 중재술 -)

  • Oh, Joo Han;Lee, Ye Hyun;Park, Hae Bong
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.7 no.1
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    • pp.67-75
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    • 2014
  • There are several kinds of regional nerve blockades, such as interscalene brachial plexus block, C5 root block, suprascapular nerve block, and axillary nerve block, which can be applied for anesthesia and postoperative pain control after shoulder surgeries. These regional nerve blockades have shown good results, but high failure rate and serious complications, such as phrenic nerve palsy, pneumothorax, and nerve injury, still remain. Ultrasound-guided intervention can increase the success rate of nerve blockades and reduce complications. We described the method of ultrasound-guided intervention for the regional nerve blockades around shoulder.

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Built-in self test for high density SRAMs using parallel test methodology (병렬 테스트 방법을 적용한 고집적 SRAM을 위한 내장된 자체 테스트 기법)

  • 강용석;이종철;강성호
    • Journal of the Korean Institute of Telematics and Electronics C
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    • v.35C no.8
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    • pp.10-22
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    • 1998
  • To handle the density increase of SRAMs, a new parallel testing methodology based on built-in self test (BIST) is developed, which allows to access multiple cells simultaneously. The main idea is that a march algorithm is dperformed concurently in each baisc marching block hwich makes up whole memory cell array. The new parallel access method is very efficient in speed and reuqires a very thny hardware overhead for BIST circuitry. Results show that the fault coverage of the applied march algorithm can be achieved with a lower complexity order. This new paralle testing algorithm tests an .root.n *.root.n SRAM which consists of .root.k * .root.k basic marching blocks in O(5*.root.k*(.root.k+.root.k)) test sequence.

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Computed Tomography Fluoroscopy-Guided Selective Nerve Root Block for Acute Cervical Disc Herniation

  • Eun, Sang-Soo;Chang, Won-Sok;Bae, Sang-Jin;Lee, Sang-Ho;Lee, Dong-Yeob
    • Journal of Korean Neurosurgical Society
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    • v.48 no.5
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    • pp.419-422
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    • 2010
  • Objective : To analyze the clinical outcomes of computed tomography (CT) fluoroscopy-guided selective neve root block (SNRB) for severe arm pain caused by acute cervical disc herniation. Methods : The authors analyzed the data obtained from 25 consecutive patients who underwent CT fluoroscopy-guided SNRB for severe arm pain, i.e., a visual analogue scale (VAS) score of 8 points or more, caused by acute soft cervical disc herniation. Patients with chronic arm pain, motor weakness, and/or hard disc herniation were excluded. Results : The series comprised 19 men and 6 women whose mean age was 48.1 years (range 35-72 years). The mean symptom duration was 17.5 days (range 4-56 days) and the treated level was at C5-6 in 13 patients, C6-7 in 9, and both C5-6 and C6-7 in 3. Twenty-three patients underwent SNRB in 1 session and 2 underwent the procedure in 2 sessions. No complications related to the procedures occurred. At a mean follow-up duration of 11.5 months (range 6-22 months), the mean VAS score and NDI significantly improved from 9 and 58.2 to 3.4 and 28.1, respectively. Eighteen out of 25 patients (72%) showed successful clinical results. Seven patients (28%) did not improve after the procedure, and 5 of these 7 underwent subsequent anterior cervical discectomy and fusion. Conclusion : CT fluoroscopy-guided SNRB may play a role as a primary conservative treatment for severe arm pain caused by acute cervical disc herniation.

An Analysis of location of Needle Entry Point and Palpated PSIS in S1 Nerve Root Block

  • Kim, Shin-Hyung;Yoon, Kyung-Bong;Yoon, Duck-Mi;Choi, Seong-Ah;Kim, Eun-Mi
    • The Korean Journal of Pain
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    • v.23 no.4
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    • pp.242-246
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    • 2010
  • Background: The first sacral nerve root block (S1NRB) is a common procedure in pain clinic for patients complaining of low back pain with radiating pain. It can be performed in the office based setting without C-arm. The previously suggested method of locating the needle entry point begins with identifying the posterior superior iliac spine (PSIS). Then a line is drawn between two points, one of which is 1.5 cm medical to the PSIS, and the other of which is 1.5 cm lateral and cephalad to the ipsilateral cornu. After that, one point on the line, which is 1.5 cm cephalad to the level of the PSIS, is considered as the needle entry point. The purpose of this study was to analyze the location of needle entry point and palpated PSIS in S1NRB. Methods: Fifty patients undergoing C-arm guided S1NRB in the prone position were examined. The surface anatomical relationships between the palpated PSIS and the needle entry point were assessed. Results: The analysis revealed that the transverse and vertical distance between the needle entry point and PSIS were $28.7{\pm}8.8mm$ medially and $3.5{\pm}14.0mm$ caudally, respectively. The transverse distance was $27.8{\pm}8.3mm$ medially for male and $29.5{\pm}9.3mm$ medially for female. The vertical distance was $1.0{\pm}14.1mm$ cranially for male and $8.1{\pm}12.7mm$ caudally for female. Conclusions: The needle entry point in S1NRB is located on the same line or in the caudal direction from the PSIS in a considerable number of cases. Therefore previous recommended methods cannot be applied to many cases.

A Prospective Study of Lumbar Spinal Root Block (요추부 신경근 차단술의 추적조사)

  • Yoo, Byung-Hoon;Kim, Kyung-Tae;Kim, Young-Jin;Song, Chan-Woo;Hong, Kee-Hyek
    • The Korean Journal of Pain
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    • v.10 no.1
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    • pp.77-81
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    • 1997
  • Background : We studied the effects of lumbar spinal root block (RB) prospectively in 21 patients who had suffered from low back pain with radiating pain even treated epidural steroid injection three times. Method : RB was performed under the fluoroscopic C-arm guide. When the needle was in correct position, we confirmed the needle placement and expected drug spreading by injection of contrast medium ($Isovist^{(R)}$-300, Sobering, Germany). Next 2% mepivacaine 1 ml mixed to 40 mg of Depomedrol was injected. Pain assessment was carried out 7 days after RB by numeric pain score regarding the pain just before RB was 10. Remained pain after RB was graded as excellent; 0-2, good; 3-5, bad; 6-8 and poor 9-10. Results : Mean age of the patients was 52.3 years. 38.1% and 47.6% of the patients showed excellent and goo dresults after RB, respectively. Conclusion : We concluded that RB is easy and safe procedure to perfirm and effective for the treatment of remnant pain following epidural steroid injection, especially in the patients who had spinal stenosis.

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The growth and productivity of native Indonesian rice progenies and its relationship with root development during dry-season

  • Zakaria, Sabaruddin;Fitrya, Farid;Kurniawan, Trisda;Hereri, Agam Ihsan;Maulana, Teuku
    • Proceedings of the Korean Society of Crop Science Conference
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    • 2017.06a
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    • pp.338-338
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    • 2017
  • One of the problems in increasing rice production is getting lines or varieties that have high adaptability so that able to produce maximum production in a variety of environmental conditions. One strategy that can be done to get adaptive varieties is through the improvement of native varieties. This research was conducted in rain fed paddy field, Aceh province, Indonesia from June to September 2014. The texture of the soil was clay-loam with the soil pH ranged from 6.5-6.7. Five potential progenies of rice from crossing between native Indonesian rice with introduced rice varieties consist of C3, C4, S3, S5, S6 were used in this study. Besides that, one national rice variety Ciherang also used as a comparison. The plants were growth in the plot with the size of $2m{\times}1.4m$ with plant distance was $20cm{\times}20cm$. The fertilizers used in this study were Urea, NPK, and KCl. Randomized block design with 6 rice progenies/variety and 3 replications were used in this study. There were 18 experimental units and each experimental unit had 10 samples for the sources of data. The variables that were observed in this study including plant height at harvesting time, number of productive tiller, the percentage of empty grains and filled grain per panicle, weight of filled grains per hill, weight of filled grain per plot and yield potential per hectare. Analyzed were also conducted for the depth of root penetration, dry-root weight, dry-shoot weight, shoot-root weight ratio and its correlation with the weight of filled grain per hill. The research results show that there was significant difference on plant height at harvesting time, number of productive tillers, the percentage of empty grains and filled grain per panicle, weight of filled grains per hill, weight of filled grain per plot and yield potential per ha (p>0.01) among the treatments. In addition, depth root penetration, dry-root weight, dry-shoot weight, shoot-root weight ratio also had significant difference (p>0.01) among the treatment. The highest plant at harvesting time was found in S6, reaching 129.8 cm and the shortest plants was found in C3 reaching 107.5 cm. The largest number of productive tillers and the highest percentage of filled grains per panicle were found in Ciherang reaching 10.5 tillers and 80.7% respectively. Ciherang also had the heaviest weight of filled grains per hill and per plot reaching 21.1 g and 2.18 kg respectively. Whereas, S6 had the lowest number of tillers and the lowest percentage of filled grain per panicle.. The highest yield potential per ha was found in Ciherang reaching 7.79 tons. Among the progenies, S5 had the highest yield potential reaching 5 tons/Ha. The result also showed significant relationship between shoot-root weight ratio with weight of filled grains per hill. The highest value of shoot-root weight ratio (1.57) in Ciherang is thought had closed relationship with its yield potential.

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Herpes Zoster Infection Involved in Cervical and Thoracic Spinal Segment Bilaterally (경부 및 흉부신경근에 동시에 발생한 대상포진 -증례 보고-)

  • Han, Kyung-Ream;Kwak, No-Kil;Kim, Soo-Mi;Min, Kyung-Shin;Kim, Chan;Kim, Seong-Mo
    • The Korean Journal of Pain
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    • v.12 no.1
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    • pp.144-147
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    • 1999
  • A 72-year-old female patient was presented complaining of unbearable abdominal pain in the upper left quadrant at our hospital. Two weeks earlier she had developed a vesicular eruption on the right C3 dermatome and 1 week earlier she had experienced a vesicular eruption on the left T11 dermatome. Her medical history was unremarkable. She had suffered from severe abdominal pain in the upper left quadrant for 10 days and the mild pain in the right shoulder region for 20 days. The pain in the upper left quadrant had increased and was unresponsive to drugs prescribed by the local clinic. And we performed T11 root block with 0.5% lidocaine 5 ml and dexametasone 5 mg, and thoracic epidural blockade on 1st hospital day under diagnosis of herpes zoster infection. Her VAS were improved from 10 to 2 on 2nd hospital day. We performed thoracic epidural blockade with 0.5% lidocaine 6 ml. Her VAS were changed from 2 to 7 and so then we performed the thoracic epidural blockade with 0.5% lidocaine 5 ml and triamcinolone 40 mg on 3rd hospital day. On 4th hospital day, her VAS were from 7 to 1. After 4 month of our managements she was tolerable without any medications.

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