• Title/Summary/Keyword: Decompression Therapy

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Diagnosis and Arthroscopic Decompression of Impingement Syndrome of the Shoulder (견관절 충돌 증후군의 진단 및 관절경적 견봉 감압술)

  • Byun Ki-Yong;Kwon Soon-Tae;Lee Jang-Ik;Rhee, Kwang-Jin
    • Clinics in Shoulder and Elbow
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    • v.1 no.1
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    • pp.19-25
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    • 1998
  • Appropriate clinical examination and imaging may lead to early diagnosis and treatment of the shoulder impingement syndrome, thus preventing progressing to a complete tear of rotator cuff. The impingement syndrome was caused by repeated entrapment and compression of supraspinatus tendon between the proximal end of humerus inferiorly, particullary its greater tuberosity. and one or m <)re component of coracoacromial arch superiorly. The purpose of this study is to critically, evaluate the result of twenty-five consecutive subacromial decompression with impingement syndrome and to assess the diagnostic accuracy of MR imaging by using oblique coronal and oblique sagittal plan. These patients were treated by arthroscopic subacromial decompression after their pains failed to improve with conservative therapy over three month. The average follow up was 25 month(range, 12 to 50). The mean age was 43 year old. The results were rated based on subjective response and the UCLA shoulder rating scale of the result. Ten patients(40%) were rated as excellent, 11patients(44%) were good. while four patients(16%) were fair. Radiologic evaluation suggested that the oblique sagittal plan of MRI can be helpful in evaluation of bony and soft-tissue structure of the coracoacromial arch and determining depth of bony resection. There were no infection or neurovascular injury. In reviewing our result, it appears that the arthroscopic subacromial decompression can be successful sugery for shoulder impingement syndrome and diagnostic accuracy of supplimentary oblique sagittal view of MRI was relatively higher than oblique coronal view alone for apprqpriate surgical plan.

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Case of Abdominal Compartment Syndrome Treated by using a Bedside Open Linea Alba Fasciotomy (외상에 의한 후복막 출혈환자에서 발생한 복부구획증후군을 침상 옆 백선 근막 절개술로 치료한 증례)

  • Kim, Ji-Hoon T.;Han, Myung-Sik;Choi, Gun-Moo;Jang, Hyuck-Jae;Kwak, Jin-Ho;Kim, Ji-Hoon S.
    • Journal of Trauma and Injury
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    • v.24 no.1
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    • pp.56-59
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    • 2011
  • Abdominal compartment syndrome (ACS) is a life-threatening disorder caused by rapidly increasing intra-abdominal pressure. ACS can result in multiorgan failure and carries a mortality of 60~70%. The treatment of choice in ACS is surgical decompression. There are very few reports of ACS and experience in Korea. We report 12-year-old male patient who developed an abdominal compartment syndrome due to traffic-accident-induced retroperitoneal hematomas, Which was successfully treated by performing a bedside emergency surgical decompression with open linea alba fasciotomy with intact peritoneum. When patients do not respond to medical therapy, a decompressive laparotomy is the last surgical resort. In patients with severe abdominal compartment syndrome, the use of a linea alba fasciotomy is an effective intervention to lower intra-abdominal hypertension (IAH) without the morbidity of a laparotomy. Use of a linea alba fasciotomy as a first-line intervention before committing to full abdominal decompression in patients with abdominal compartment syndrome improves physiological variables without mortality. Consideration for a linea alba fasciotomy as a bridge before full abdominal decompression needs further evaluation in patients with polytrauma abdominal compartment syndrome.

Review of Shoulder Joint Impingement Syndrome (견관절 충돌증후군의 고찰)

  • Kim, In-Sup
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.2 no.1
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    • pp.93-100
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    • 2004
  • Shoulder impingement syndrome is cause by the collision of acromion, acrominoclaviclar joint, coracoacromino ligament, coracoid process and synovial sac, biceps brachiialis tendon, rotator cuff muscle. Treatment for Shoulder impingement syndrome is genetally classified into two different methods; preservative method and operational method. Operational method includes rotator cuff sutura, anterior acromioplasty, arthroscope decompression. Preservative method includes rest, medicinal therapy, physical therapy. Physical therapy concentrates on pain control, functional recovery and prevention of disease progress. It is also important for physical therapy to maintain the strength of rotator cuff. Strengthening rotator cuff decreases the collision and helps the stability of shoulder joint. In conclusion, it must be aware that shoulder impingement syndrome and some other shoulder problem demand different treatment, which results in a better outcome.

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Radiofrequency Thermocoagulation for Trigeminal Neuralgia Sustained Following Microvascular Decompression -A case report- (미세혈관감압술에도 지속된 삼차신경통의 고주파 열응고술을 이용한 치험 -증례 보고-)

  • Kim, Hae-Kyu;Kang, Dong-Hee;Kim, Ki-Yeob;Baik, Seong-Wan;Kim, In-Se
    • The Korean Journal of Pain
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    • v.11 no.2
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    • pp.302-306
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    • 1998
  • The authors report the result achieved in the treatment of trigeminal neuralgia patient, especially V2 involved patient, using radiofrequency (RF) thermocoagulation of Gasserian ganglion. A 62-year old female patient had severe burning pain on right cheek usually initiating from upper molar teeth area for 10 years. She was treated with microvascular decompression operation 10 years ago. However, there was no pain relief by operation. She wanted non-surgical treatment. Therefore, we recommended RF thermocoagulation therapy. After 2 times of RF thermocoagulation, there was excellent pain relief without complications. And, for 6months follow-up, there were no pain, and no evidences of complication and recurrence.

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The Effect of Flexion-distraction Technique and Drop Technique on Pain and Sacral Angle of Patients with Lumbar Spine Herniated Intervertebral Disc (굴곡-신연기법과 낙차 교정법이 허리 척추사이원반 탈출증 환자의 시각적 상사 척도 및 엉치뼈 각에 미치는 영향)

  • Oh, Hyun-Ju;Choi, Seok-Joo;Lee, Kwan-Sub;Choi, Ji-Oun
    • Journal of Korean Physical Therapy Science
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    • v.25 no.3
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    • pp.9-16
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    • 2018
  • Background: In order to find out the effect of therapy methods through Flexion-distraction technique and drop technique on pain, sacral angle of patients with lumbar herniated intervertebral disc targeting patients with lumbar herniated intervertebral disc due to L5-S1. Method: This study was to present the directivity of the therapy method for lumbar herniated intervertebral disc by comparing and analyzing the spinal decompression therapy and provide an effective treatment method to patients with lumbar herniated intervertebral disc by identifying the therapeutic effect of Flexion-distraction technique and drop technique. The research period is March 1, 2018 to June 30, 2018 and subjects are the patients diagnosed as lumbar herniated intervertebral disc due to L5-S1 by their doctor through clinical findings and medical equipment such as X-ray, CT, MRI etc. Among patients who visited and hospitalized in S Orthopaedics located in Daegu and 30 female patients with sacral angle of more than $30^{\circ}$ were randomly classified into 15 people and we carried out treatment three times a week for 8 weeks for 15 people in the experimental group applying Flexion-distraction technique and drop technique and 15 people in the control group applying spinal decompression therapy to compare and analyze the changes in pain, sacral angle of patients with lumbar herniated intervertebral disc. Result: According to the results of this study, changes in the Visual Analogue Scale showed statistically significant differences in both the experimental group and control group(p<.05), while there was statistically significant difference in the comparison between groups before and after measurement of experimental group (p<.05). In the comparison within two groups of sacral angle, both groups showed statistically significant difference(p<.05) but there was no statistically significant difference in the comparison of scores between groups before and after measurement of each group(p>.05). Discussion: All those results the above proved that we need to confirm various benefits of the therapy with the flexion-distraction technique and drop technique, and the findings of the concerned study will possibly become useful information when doctors actually work on a therapy to treat patients with the lumbar herniated intervertebral disc.

Treatment of Painful Rotator Interval Widening After Subcoracoid Decompression in Elite Archer - Case Report - (양궁 선수의 오구 충돌 증후군의 치료 후 발생한 회전근 간격의 손상에 대한 치료 - 증례 보고 -)

  • Park, Jin-Young;Lee, Seung-Jun
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.280-285
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    • 2010
  • Purpose: Coracoid impingement syndrome refers to subscapularis impingement between the coracoid process and lesser tuberosity of the humerus, and pain may occur when the arm is positioned in forward flexion, internal rotation and adduction. This position is common for archers. Material and methods: A female archer with coracoid impingement syndrome that was uncontrolled by conservative therapy underwent arthroscopic subcoracoid decompression. At the 20th postoperative month of follow up, she complained of painful rotator interval widening and so she underwent arthroscopic rotator interval plication. Results: At the postoperative 6th month of follow up after the second operation, she showed no pain and good functional results, and she returned to competing as an archer. Conclusion: We have reported here on a case of successful treatment of painful rotator widening after subcoracoid decompression in an elite archer.

Randomized Controlled Trials of Miniscalpel Acupuncture for Lumbar Spinal Stenosis Cited in the China National Knowledge Infrastructure Database

  • Yoon, Sang Hoon;Kim, Yoon Sik;Kwon, Min Goo;Kwon, Chan Young
    • Journal of Acupuncture Research
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    • v.34 no.3
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    • pp.59-69
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    • 2017
  • Objectives : This study analyzed the current status of randomized controlled trials (RCTs) of miniscalpel acupuncture for lumbar spinal stenosis (LSS) in China. Methods : A literature search was performed using the China National Knowledge Infrastructure (CNKI) database. All studies up to June 7th, 2017 were searched. The quality of included RCTs was assessed with the Jadad scale. Results : Five RCTs were finally included in this review. The overall quality of the RCTs was assessed as low. All articles evaluated miniscalpel acupuncture as monotherapy or in combination with filiform needle therapy, drug injection therapy, Tuina treatment, thermal coagulation therapy, or spinal decompression. Miniscalpel acupuncture as monotherapy or adjunctive therapy showed greater therapeutic effect and fewer adverse effects. Conclusion : Miniscalpel acupuncture is a safe and effective nonpharmacological treatment for LSS. However, high-quality studies with consistent treatment protocols are needed to confirm these findings.

Presumption of low hack pain and symptoms for surgical treatment (요통의 예후와 수술적응증 판단)

  • Lee, Geon-mok
    • Journal of Acupuncture Research
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    • v.18 no.2
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    • pp.237-244
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    • 2001
  • Back pain has plagued humans for many thousands of years. The treatment of back pain is divided into operative treatment and conservative treatment. It is reported that cure rate of conservative treatment is 80~90 percent. Generally, the treatment of oriental medicine is mostly conservative treatment. But, surgery should not be used as a last resort in treatment; it is just one of many treatment options for various spinal conditions. In some instance, it can be to preferred choice; in other situations, alternative therapies may be superior. Selections of the operation in HIVD 1. Acute disc herniations with a protracted significant component af back pain. 2. Chronic disc degeneration with significant back pain and degeneration limited to one or two disc levels. 3. Sugical instability created during decompression. 4. The presence of neural arch defects coincident with disc disease. 5. Symptamatic and radiographically demonstrable segmental instability. Selections of the operation in stenosis 1. If it does not slowly progress in physical therapy and other nonoperative measures, many of these patients may ultimately need surgical decompression. 2. Absolute stenosis in an impression of CT, MRI.(under 10mm) 3. In patients with established symptoms of .neurogenic claudication. 4. In patients with bad influence of neurogenic derangement.(strength, sensory) Selections of the operation in spondylolisthesis 1. Persistence or recurrence of major symptoms for at least one year despite activity modification and physical therapy. 2. Tight hamstrings, persistently abnormal gait, or postural deformities unrelieved by physical therapy. 3. Sciatic scoliosis. 4. Progressive neurologic deficit. 5. Progressive slipping beyond 25 or 50 percent, even when asymptomatic. 6. A high slip angle (40 to 50 degrees) in a growing child, since it is likely to be associated with further progression and deformity. 7. Psychologic problems attributed to shortness of trunk, abnormal gait, and postural deformities characteristic of more severe slips.

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Epidural Steroid Therapy as a Treatment of Post-laminectomy Low Back Pain (추궁 절제술 후의 요하지통에 대한 경막외 Steroid 주입요법)

  • Choe, Huhn;Han, Young-Jin
    • The Korean Journal of Pain
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    • v.4 no.2
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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.

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Femoral Neuropathy due to Iliacus Muscle Hematoma in a Patient on Warfarin Therapy

  • Kong, Woo-Keun;Cho, Keun-Tae;Lee, Ho-Jun;Choi, Jae-Sung
    • Journal of Korean Neurosurgical Society
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    • v.51 no.1
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    • pp.51-53
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    • 2012
  • Spontaneous hematomas of the iliacus muscle are rare lesions and these are seen in individuals receiving anticoagulation therapy or patients with blood dyscrasias such as hemophilia. It can cause femoral neuropathy and resultant pain and paralysis. Although there is no clear consensus for the treatment of femoral neuropathy from iliacus muscle hematomas, delays in the surgical evacuation of hematoma for decompression of the femoral nerve can lead to a prolonged or permanent disability. We report here on a rare case of a spontaneous iliacus muscle hematoma that caused femoral neuropathy in a patient who was taking warfarin for occlusive vascular disease and we discuss the treatment.