• 혜화의학회지
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• 제14권1호
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• pp.95-100
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• 2005

Objective: The purpose of this study is to report chronic sciatica paitient with HIVD of L-spine who improveded by orthotics Methods: once we treated the patient with acupuncture, nagatives, chu-na after that added with orthotics, We compared each effect. The effect was evaluated by progress of symtoms and Visual Anlogue Scale Results & Conclusion :After treatment of orthotics sciatica was reduced in the score of VAS from 7to3.

• The Korean Journal of Pain
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• 제33권4호
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• pp.359-377
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• 2020

Background: This study investigated whether current smoking and a higher nicotine dependency were associated with chronic low back pain (LBP), lumbar related leg pain (sciatica) and/or radicular neuropathic pain. Methods: A cross-sectional study was conducted on 150 patients (mean age, 60.1 ± 13.1 yr). Demographic data, the International Association for the Study of Pain (IASP) neuropathic pain grade, STarT Back tool, and the Fagerström test were completed. A control group (n = 50) was recruited. Results: There was a significant difference between current smokers and nonsmokers in the chronic LBP group in the mean pain score (P = 0.025), total STarT Back score (P = 0.015), worst pain location (P = 0.020), most distal pain radiation (P = 0.042), and in the IASP neuropathic pain grade (P = 0.026). There was a significant difference in the mean Fagerström score between the four IASP neuropathic pain grades (P = 0.005). Current smoking yielded an odds ratio (OR) of 3.071 (P = 0.011) for developing chronic LBP and sciatica, and an OR of 4.028 (P = 0.002) for obtaining an IASP "definite/probable" neuropathic pain grade, for both cohorts. The likelihood for chronic LBP and sciatica increased by 40.9% (P = 0.007), while the likelihood for an IASP neuropathic grade of "definite/probable" increased by 50.8% (P = 0.002), for both cohorts, for every one unit increase in the Fagerström score. Conclusions: A current smoking status and higher nicotine dependence increase the odds for chronic LBP, sciatica and radicular neuropathic pain.

• The Korean Journal of Pain
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• 제33권4호
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• pp.305-317
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• 2020

Not all sciatica-like manifestations are of lumbar spine origin. Some of them are caused at points along the extra-spinal course of the sciatic nerve, making diagnosis difficult for the treating physician and delaying adequate treatment. While evaluating a patient with sciatica, straightforward diagnostic conclusions are impossible without first excluding sciatica mimics. Examples of benign extra-spinal sciatica are: piriformis syndrome, walletosis, quadratus lumborum myofascial pain syndrome, cluneal nerve disorder, and osteitis condensans ilii. In some cases, extra-spinal sciatica may have a catastrophic course when the sciatic nerve is involved in cyclical sciatica, or the piriformis muscle in piriformis pyomyositis. In addition to cases of sciatica with clear spinal or extra-spinal origin, some cases can be a product of both origins; the same could be true for pseudo-sciatica or sciatica mimics, we simply don't know how prevalent extra-spinal sciatica is among total sciatica cases. As treatment regimens differ for spinal, extra-spinal sciatica, and sciatica-mimics, their precise diagnosis will help physicians to make a targeted treatment plan. As published works regarding extra-spinal sciatica and sciatica mimics include only a few case reports and case series, and systematic reviews addressing them are hardly feasible at this stage, a scoping review in the field can be an eye-opener for the scientific community to do larger-scale prospective research.

• Journal of Korean Neurosurgical Society
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• 제29권3호
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• pp.420-425
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• 2000

Epidural steroid injection(ESI) has been a commonly applied conservative therapy for the management of chronic low back pain and sciatica. However, there are many reports concerning various local, systemic and neurological complications related to ESI. We report two cases with fatal complications after ESI for low back pain and sciatica. In both patients, ventriculitis and meningitis were causative factors to be fatal. Aseptic procedures and careful post-procedure assessment are essential to avoid serious complications following ESI.

• Journal of Korean Neurosurgical Society
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• 제67권2호
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• pp.217-226
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• 2024

Objective : The efficacy of sciatic nerve decompression via transgluteal approach for entrapment of the sciatic nerve at the greater sciatic notch, called piriformis syndrome, and factors affecting the surgical outcome were analyzed. Methods : The outcome of pain reduction was analyzed in 81 patients with sciatic nerve entrapment who underwent decompression through a transgluteal approach. The patients were followed up for at least 6 months. The degree of pain reduction was analyzed using a numerical rating scale-11 (NRS-11) score and percent pain relief before and after last follow-up following surgery. Success was defined by at least 50% reduction in pain measured via NRS-11. To assess the degree of subjective satisfaction, a 10-point Likert scale was used. In addition, demographic characteristics, anatomical variations, and variations in surgical technique involving sacrotuberous ligamentectomy were analyzed as factors that affect the surgical outcome. Results : At a follow-up of 17.5±12.5 months, sciatic nerve decompression was successful in 50 of 81 patients (61.7%), and the pain relief rate was 43.9±34.17. Subjective improvement based on a 10-point Likert scale was 4.90±3.43. Among the factors that affect the surgical outcome, only additional division of the sacrotuberous ligament during piriformis muscle resection played a significant role. The success rate was higher in the scarotuberous ligementectomy group (79.4%) than in the non-resection group (42.6%), resulting in statistically significant difference based on average NRS-11 score, percent pain relief, and subjective improvement (p<0.05, independent t-test). Conclusion : Sciatic nerve decompression is effective in pain relief in chronic sciatica due to sciatic nerve entrapment at the greater sciatic notch. Its effect was further enhanced by circumferential dissection of the sciatic nerve based on the compartment formed by the piriformis muscle and the sacrotuberous ligament in the greater sciatic notch.

• The Korean Journal of Pain
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• 제4권2호
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• pp.162-167
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• 1991

Epidural steroid therapy has been well-established for the treatment of sciatica and low back pain. Disappointing results following surgical decompression or discectomy pain owing for to nerve root compression have led to trials of corticosteroids injected either systemically or into the intrathecal or epidural space to treat intervertebral disc. Epidural steroid is less effective in the patients with low back pain who have a history of surgical operation, so that the use of epidural morphine and methylprednisolone has been advocated for the amelioration of chronic low back pain in the post-laminectomy pain("failed back") syndrome over the past several years. We treated 47 patients with low back pain who had a history of one or two surgical procedures. We concluded that epidural steroid therapy is less effective in the patients with "failed back" syndrome than in the virgin back furthermore, there is a greater risk of complication such as inadvertent dural puncture and corresponding motor paralysis and headache.

• The Korean Journal of Pain
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• 제12권2호
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• pp.191-194
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• 1999

Background: Millions of patients with chronic sciatica are still treated with epidural corticosteroids. The efficacy of epidural corticosteroids remains questionable, especially in the failed back surgery syndrome (FBSS). We studied to evaluate outcome for 10 patients with failed back surgery syndrome treated with spinal nerve root block using corticosteroids, hyaluronidase, and local anesthetics. Methods: The affected nerve roots are localized with the help of fluoroscopy and contrast dye. Local anesthetic diluted in 1,500 U hyaluronidase and 40 mg methylprednisolone is injected. A small retrospective pilot group of 10 patients with FBSS was treated. The success rate is evaluated using a visual analogue scale at 1 week and 3 month interval after the last injection. Results: Initially, 7 patients experienced good pain relief; 5 patients suspained pain relief for 3 months. No complications were observed. Conclusions: This technique is worthwhile for patients with FBSS and where epidural fibrosis is suspected to be the pain origin.

• The Korean Journal of Pain
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• 제9권1호
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• pp.98-101
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• 1996

Background: Lumbar epidural steroid injection for relief of low back pain and sciatica has become a popular procedure. further, cervical epidural steroid injection with nerve block (CESNB) is known to be effective for the management of acute and chronic pain of neck, shoulder and arm. However, many anesthesiologists are not familiar with CESNB. Methods: Charts of 34 patients who had undergone 60 cervical epidural steroid injections over a three year period, 1993 to 1995, were reviewed. We studied the followings: initial visit and department, injected interspaces, personal characteristics, indications for injection and complications. Results: Patients' first visits were mainly to orthopaedics (11 patients) and neurosurgery (10 patients). Epidural injection sites were: C7-T1 interspace (29 patients) and C6-C7 interspace (6 patients). Mean age of patients were 50.1 years. range 21~73 years. There were twenty male and fourteen female patients. Complications varied from dizziness after CESNB (1 patient). loss of consciousness with transient apnea (2 patients), and local infection with suspicious meningitis (1 patient). Conclusion: We conclude from the above data that CESNB is a good, safe and conservative form of therapeutic procedure in the management of patients suffering from cervical radiculopathy, and neck and shoulder pain.

• The Korean Journal of Pain
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• 제34권3호
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• pp.346-368
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• 2021

Background: Recalcitrant disc herniation may result in chronic lumbar radiculopathy or sciatica. Fluoroscopically directed epidural injections and other conservative modalities may provide inadequate improvement in some patients. In these cases, percutaneous neurolysis with targeted delivery of medications is often the next step in pain management. Methods: An evidence-based system of methodologic assessment, namely, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used. Multiple databases were searched from 1966 to January 2021. Principles of the best evidence synthesis were incorporated into qualitative evidence synthesis. The primary outcome measure was the proportion of patients with significant pain relief and functional improvement (≥ 50%). Duration of relief was categorized as short-term (< 6 months) and long-term (≥ 6 months). Results: This assessment identified one high-quality randomized controlled trial (RCT) and 5 moderate-quality non-randomized studies with an application of percutaneous neurolysis in disc herniation. Overall, the results were positive, with level II evidence. Conclusions: Based on the present systematic review, with one RCT and 5 non-randomized studies, the evidence level is II for percutaneous neurolysis in managing lumbar disc herniation.

• Journal of Acupuncture Research
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• 제27권6호
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• pp.115-122
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• 2010

Objectives : The purpose of this study was to propose the utilization plan of Ryodoraku in the U-health care systems. Methods : Computerized literature searches were performed for Ryodoraku related articles using the following databases: KISS, RISS, DBPIA, NDSL from 1990 to Oct 2010. Search terms were '양도락' or 'Ryodoraku' or 'U-health'. Due to Ryodoraku coming from Japan, additional literature review(articles published by 2008) on Japanese journal of Ryodoraku medicine was done for compensation. Results : 1. Introduction of U-health : As rapid progress of population aging and strong interest in health, the demand for the traditional Korean medical service is increasing. Until now healthcare service has provided post treatment by face-to-face manner. But according to related researches, proactive treatment is resulted to be more effective for preventing diseases. Particularly, the existing healthcare services have limitations in preventing and managing chronic geriatric degenrative diseases such as metabolic syndrome, CVA, coronary heart diseases, parkinson's diseases, degenerative joint disease, spondylosis, etc., because the cause of the above is complex and even related to life habit. As the advent of ubiquitous technology, patients with the chronic geriatric degenrative diseases can improve life habit such as poor eating habits and physical inactivity without the constraints of time and space through u-healthcare service. Therefor, lots of researches for u-healthcare service focus on providing the personalized healthcare service for preventing and managing that. To cope with this situations, The concept of u-healthcare service should be adopted in the traditional korean medicine and diagnostic devices suitable for it should be also devised and developed based on traditonal korean medine. 2. Review of existing Ryodoraku related articles for applying to U-health : articles investigating feasibility applying Ryodoraku to meridian diagnosis and raising problems of it, articles providing recent research trends of Ryodoraku, Ryodoraku related articles considering usefulness for U-health, and articles confirming the repeatability and reproducity of Ryodoraku were included. Based on the review of the above Ryodoraku related articles, several application of Ryodoraku in the U-health care system. Conclusions : To make preparations for the increasing need of traditional Korean medicine due to rising morbidity rate of chronic geriatric degenerative diseases, it is necessary to appropriately apply Ryodoraku to the U-health care system. The application of Ryodoraku is as follows. 1. To use Ryodoraku additionally to the established diagnostic device of metabolic syndrome, CVA, coronary heart diseases, parkinson's diseases, degenerative joint disease, spondylosis. 2. To apply Ryodoraku to the symptoms or diseases having a tendency to be diagnosed by correlation between the affected meridian and the lesion such as headache, nuchal pain, shoulder pain, low back pain, sciatica, HNP, etc. 3. To secure the repeatability and reproducity of Ryodoraku. 4. To devise and develop Ryodoraku appliance in order to overcome the known drawbacks and to improve error of measurement.