• Journal of Korean Neurosurgical Society
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• 제58권3호
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• pp.286-290
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• 2015

We report a case of neurilemmoma of deep peroneal nerve sensory branch that triggered sensory change with compression test on lower extremity. After resection of tumor, there are evoked thermal changes on pre- and post-operative infrared (IR) thermographic images. A 52-year-old female presented with low back pain, sciatica, and sensory change on the dorsal side of the right foot and big toe that has lasted for 9 months. She also presented with right tibial mass sized 1.2 cm by 1.4 cm. Ultrasonographic imaging revealed a peripheral nerve sheath tumor arising from the peroneal nerve. IR thermographic image showed hyperthermia when the neurilemoma induced sensory change with compression test on the fibular area, dorsum of foot, and big toe. After surgery, the symptoms and thermographic changes were relieved and disappeared. The clinical, surgical, radiographic, and thermographic perspectives regarding this case are discussed.

• Journal of Dental Anesthesia and Pain Medicine
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• 제24권4호
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• pp.227-243
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• 2024

This study aimed to evaluate pain assessment strategies and factors associated with outcomes after microvascular decompression for the treatment of primary trigeminal neuralgia in adults. We conducted a systematic review and meta-analysis of English, Spanish, and French literature. We searched three databases, PubMed, Ovid, and EBSCO, from 2010 to 2022 and selected studies including patients with primary trigeminal neuralgia, clear pain assessment, and pain outcomes. Population means and standard deviations were calculated. Studies that included factors associated with postoperative outcomes were included in the meta-analysis. A total of 995 studies involving 5673 patients with primary trigeminal neuralgia following microvascular decompression were included. Patients with arteries compressing the trigeminal nerve demonstrated optimal outcomes following microvascular decompression (odds ratio [OR]= 0.39; 95% confidence interval [CI] = 0.19-0.80; X² = 46.31; Dof = 15; I² = 68%; P = < 0.0001). Conversely, when comparing arterial vs venous compression of the trigeminal nerve (OR = 2.72; 95% CI = 1.16-6.38; X² = 23.23; Dof = 10; I² = 57%; P = 0.01), venous compression demonstrated poor outcomes after microvascular decompression. Additionally, when comparing single-vessel vs multiple-vessel compression (OR = 2.72; 95% CI = 1.18-6.25; X² = 21.17; Dof = 9; I² = 57%; P = 0.01), patients demonstrated unfavorable outcomes after microvascular decompression. This systematic review and meta-analysis evaluated factors associated with outcomes following microvascular decompression (MVD) for primary trigeminal neuralgia (PTN). Although MVD is an optimal treatment strategy for PTN, a gap exists in interpreting the results when considering the lack of evidence for most pain assessment strategies.

• Journal of Acupuncture Research
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• 제37권3호
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• pp.193-201
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• 2020

This case report describes a 60-year-old female patient diagnosed with intercostal neuropathy and vertebral compression fractures which occurred following an electric shock injury. The patient received acupuncture, pharmacopuncture, and herbal medicine administration between February 10^th, 2020 and April 25^th, 2020. The pain level in the thoracic and left intercostal areas was assessed using the Numerical Rating Scale. The Self-report of the Leeds Assessment of Neuropathic Symptoms and Signs Pain Scale were used to diagnose neuropathic pain. The Neuropathic-Pain -Scale was used to evaluate the degree of neuropathic symptoms. The Oswestry Disability Index and the European Quality of Life-5 Dimensions were used to assess quality of life scales and functional disorder. Following combined Korean medicine treatment, the patient exhibited reduced levels of pain and significant improvement in functional disorder symptoms and quality of life.

• Journal of Acupuncture Research
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• 제35권2호
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• pp.75-80
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• 2018

Background: The aim of this study was to assess the feasibility of conducting a clinical study of using acupuncture for chronic pain in patients with osteoporotic thoracolumbar vertebral compression fractures (VCFs) in the outpatient setting. Methods: A prospective case-series attempting to recruit 20 participants was performed from February 11, 2016, to December 31, 2016. We provided Manual and electrical acupuncture was provided one 1 to three 3 times a week, for 6 weeks, up to 18 sessions. The primary clinical outcome was the average pain intensity as measured by the visual analog scale (VAS) at 6 weeks. Secondary outcomes included back-specific dysfunction (Oswestry disability index), quality of life (quality of life questionnaire-26), patient-reported improvement, use of other healthcare resources, and adverse events at 6 weeks. Use of healthcare resources and adverse events were additionally followed-up at 12 weeks by telephone. Results: Of 33 patients screened, a total of 7 were enrolled in the study. Manual and electrical acupuncture was provided 1 to 3 times a week, for 6 weeks, up to 18 sessions. We observed reduced pain intensity at 6 weeks in all participants. The change in the quality of life and back-specific dysfunction was inconsistent among participants. Mild, temporary adverse events were observed in three patients. Conclusion: In our clinical setting, it was not feasible to recruit sufficient participants and to assess the efficacy of acupuncture for chronic pain after osteoporotic thoracolumbar VCFs under a year. Strategies to improve recruitment and to identify barriers to participation are required for future clinical trials.

• Journal of Korean Neurosurgical Society
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• 제29권3호
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• pp.365-371
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• 2000

Objectives : To describe a technique for percutaneous vertebroplasty of osteoporotic vertebral body compression fractures and to report preliminary results of its use. Methods : The technique was used over a 8-month period in 9 patients with 10 painful vertebral fractures. The technique involves percutaneous puncture of the involved vertebrae with a Jamshidi needle via a transpedicular approach followed by injection of polymethylmethacrylate(PMMA) into the vertebral body. Results : The procedure was technically successful in all patients, with an average injection amount of 5.9 cc per vertebral body. One patient complained of flank pain postoperatively in spite of improvement in back pain caused by the fractured vertebra. Remaining eight patients reported significant pain relief early after treatment. The patients were followed up for 3 to 15 months(average 7.2 months) and demonstrated no recurrence of pain or aggravation of deformity. Conclusion : Vertebroplasty appears to be a valuable tool in the treatment of painful osteoporotic vertebral fractures, providing acute pain relief and early mobilization in appropriate patients. However, it needs to have more extensive prospective clinical study to confirm its definitive role in the management of this condition.

• 한국산업보건학회지
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• 제7권2호
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• pp.289-297
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• 1997

Work-related low back pain(below LBP) is one of the major cause of morbidity, disability, limitation of activity and economic loss. Therefore the work-related LBP is one of the major issue in the field of industrial safety and health. This study was performed for detecting the risk factors and proposing the effective control programs of work-related LBP. The subjects were male workers employed at the welding and metal factory. The data was collected by self-reported questionnaire, interview and checking abdomen muscular and grasping power for two days on October, 1993. The contents of questionnaire were as follow: the experience of LBP, general characteristics, physical characteristics, employment status, type of work and working environment. The number of cases was 104 with a history of work-related LBP, so the prevalence of work-related LBP was 35.0%, and the number of controls was 140 without any history of LBP. As a result, marital status, educational level, abdomen muscular power, tenure, category of job, satisfaction of job, working posture, satisfaction for table and chair and lifting materials showed a statistical significance between the case and control groups. 284 Lifting jobs were quantified by NIOSH lifting equation method and ergonomic computer modelling methods. There were no significant differences in the action limit and disc compression force between group with LBP and without LBP. But in the lifting frequency and cumulative disc compression force there were significant differences. Therefore work-related LBP should be prevented by the ergonomic and environmental control.

• Journal of Korean Neurosurgical Society
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• 제47권3호
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• pp.199-202
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• 2010

Objective : Balloon kyphoplasty is a minimally invasive procedure that is mainly performed for refractory pain due to osteoporotic compression fractures. The purpose of this study was to evaluate the results of balloon kyphoplasty performed at different times after an injury. Methods : In this retrospective study, the records of 99 patients who underwent one level of balloon kyphoplasty between January 2005 and December 2007 were reviewed. The patients were divided into three groups : 21 patients treated within 3 weeks of an injury (the acute group), 49 treated within 3 weeks to 2 months of an injury (the subacute group), and 29 patients treated at more than 2 months after an injury (the chronic group). Clinical outcomes were assessed using a visual analogue scale (VAS). In addition, modified MacNab's grading criteria was used to assess the subjective patient outcome. The radiology findings, including vertebral height restoration and procedure related complications, were analyzed based on the different time intervals after the injury. Results : Patients in all three groups achieved marked pain relief in terms of the VAS within 7 days of the procedure. Good or excellent results were achieved by most patients in all three groups. However, the height restoration, the main advantage to performing a balloon kyphoplasty, was not achieved in the chronic group. Moreover, evidence of complications including cement leakage was observed significantly less frequently in the subacute group compared to the other two groups. Conclusion : Although balloon kyphoplasty is an effective treatment for osteoporotic compression fractures, with regard to pain relief, the subacute stage appears to be optimal for treating patients with a balloon kyphoplasty in terms of achieving the best outcomes with minimal complications.

• 대한정형외과학회지
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• 제56권3호
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• pp.266-271
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• 2021

임신 및 수유와 연관된 골다공증은 젊은 여성에서 골다공증성 척추 압박골절을 일으킬 수 있는 희귀한 질환이다. 환자들은 주로 요통을 호소하며, 이는 임신과 출산, 수유에 의한 통증으로 오인되기 쉬워 빠른 진단과 치료가 어렵다. 저자들은 요통을 주소로 내원한 29세 여자 환자와 31세 여자 환자에 대해 신체 진찰, 단순 방사선 검사, 전신 골주사 검사, 자기공명영상 검사, 골밀도 검사, 혈액 검사 등을 통하여 임신과 수유에 연관된 골다공증성 척추 압박골절을 진단하였으며, 테리파라타이드(teriparatide) 주사와 흉요천추 보조기 착용, 칼슘과 비타민 D 제제 복용을 통해 증상이 호전된 2예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• 대한방사선협회지
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• 제25권1호
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• pp.22-22
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• 1999

There is patient's complain, problem of mammography, with increasing mammography every year. We tried to find out how much the pain can be decreased through power of compression, number of compression and change of study style with having maintain existin

• The Korean Journal of Pain
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• 제9권1호
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• pp.256-259
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• 1996

Epidural adhesiolysis is a convenient and safe method for the management of back pain. However, we experienced a case where a patient developed sensory change to S2 area after epidural adhesiolysis. Male patient, 43 years old, was admitted to our pain clinic for epidural adhesiolysis for back pain. Patient was experiencing pain radiating to left thigh, and sensory change and motor disturbance to the S1 area. Patient's symptoms and signs were much improved on the first day of epidural adhesiolysis. Patient, however, complained of numbness of perineal and S2 areas after the next day of injections. We postulated the cause of this complication was due to: compression of nerve root by the large volume of injectate and hematoma, and the side effect of local anesthetic, hypertonic saline and steroid.