• The Korean Journal of Pain
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• v.31 no.2
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• pp.87-92
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• 2018

Background: An epidural steroid injection (ESI) is a commonly administered procedure in pain clinics. An unintentional lumbar facet joint injection during interlaminar ESI was reported in a previous study, but there has not been much research on the characteristics of an unintentional lumbar facet joint injection. This study illustrated the imaging features of an unintentional lumbar facet joint injection during an interlaminar ESI and analyzed characteristics of patients who underwent this injection. Methods: From December 2015 to May 2017, we performed 662 lumbar ESIs and we identified 24 cases (21 patients) that underwent a lumbar facet joint injection. We gathered data contrast pattern, needle approach levels and directions, injected facet joint levels and directions, presence of lumbar spine disease as seen on magnetic resonance images (MRI), and histories of lumbar spine surgeries. Results: The contrast pattern in the facet joint has a sigmoid or ovoid contrast pattern confined to the vicinity of the facet joint. The incidence of unintentional lumbar facet joint injection was 3.6%. The mean age was 68.47 years. Among these 21 patients, 14 (66.7%) were injected in the facet joint ipsilaterally to the needle approach. Among the 20 patients who received MRI, all (100%) had central stenosis and 15 patients (75%) had severe stenosis. Conclusions: When the operator performs an interlaminar ESI on patients with central spinal stenosis, the contrast pattern on the fluoroscopy during interlaminar ESI should be carefully examined to distinguish between the epidural space and facet joint.

• The Korean Journal of Pain
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• v.5 no.1
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• pp.108-112
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• 1992

Pain from pelvic cancer is very difficult to manage because it's vague ness and bilateral nature. Furthermore, nerve blocks in this area are dangerous because sensory afferent nerves from pelvic viscera are adjacent to nerves that regulate bowel and bladder control, and motor nerve of lower extremities'. Bilateral lumbar sympathectomy has been used for malignant pelvic pain with little risk of neurologic complication. However it is not a specific block for pelvic visceral pain, because the lumbar sympathetic chain does not innervate pelvic viscera in a direct manner. Therefore the potentials of lumbar sympathectomy for pelvic visceral pain are attributed to caudad diffusion of neurolytic agents to the smperior hypogastric plexus. I have experienced 3 cases of superior hypogastric plexus neurolysis per se without any significant complications.

• The Korean Journal of Pain
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• v.19 no.2
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• pp.237-240
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• 2006

This report describes a case of spinal cord infarction after acupuncture. The patient was treated with lumbar sympathetic block with using C-arm fluoroscopy. A 66-year-old patient with chronic low back pain and radiating pain in the lower limb was treated with acupuncture and he suddenly had a loss of motor and sensory of both lower extremities. His clinical presentaion and neuroimaging studies were consistent with spinal cord infarction. He was treated with steroid megatherapy and he showed improved in motor function, but there was no pain relief despite the phamacological treatments that were combined with caudal blockade. He visited to our hospital and had lumbar sympathetic blockade performed. The pain was relieved without any related complication after 1 month (VAS $9/10{\rightarrow}2/10$), and he has been content with the results of treatment.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.4
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• pp.79-84
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• 2016

PURPOSE: The purpose of this study was to investigate effects of Horse riding simulator exercise on pain, dysfunction and dynamic balance in adults with nonspecific chronic low back pain. METHODS: In this study, total 19 college students usually complain of low back pain who were randomly divided into the horse riding simulator exercise group (n=10), lumbar strengthening exercise group (n=9) were recruited. Each group carried out for 30 minutes exercise three times a week for 4 weeks. Horse riding simulator exercise group carried out 15 minutes horse riding simulator exercise and 15 minutes lumbar strengthening exercise. Lumbar strengthening exercise group carried out 30 minutes lumbar strengthening exercise. Visual analogue scale (VAS) were measured for evaluation back pain. Korean oswestry disability index (KODI) were measured for dysfunction. Limits of stability (LOS) were measured for dynamic balance. RESULTS: VAS, KODI, LOS results showed a significant change within both horse riding simulator exercise group, lumbar strengthening exercise group. CONCLUSION: Present study suggested that the horse riding simulator exercise can improve back pain, dysfunction, dynamic balance. Horse riding simulator exercise provides more convenience, interest and motivation than conversional therapy and it could be a possible approach to adults with nonspecific chronic low back pain.

• The Korean Journal of Pain
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• v.18 no.1
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• pp.23-28
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• 2005

Background: An epidural steroid injection (ESI) is usually used for the treatment of low back pain with radiculopathy. An ESI can be performed by two procedures: I) a lumbar or caudal epidural steroid injection and II) a transforaminal epidural steroid injection. Methods: Ninety-three patients, who had undergone transforaminal epidural steroid injection (Group II), and either a lumbar or caudal epidural steroid injection (Group I), were retrospectively studied. The authors assessed the pain, walking, standing improvement and side effects after each procedure, which were evaluated as being very good, good, fair or poor. Data were collected from the patients medical records and analyzed using the chi-squared test. P < 0.05 was considered significant. Results: There were no statistically significant differences in the pain, walking, standing improvement and side effects between the two groups. However, there was a statistically significant difference in the pain improvement following transforaminal epidural steroid injection in those not effectively responding to an initial lumbar or caudal epidural block in Group II. Conclusions: A transforaminal epidural steroid injection is a useful alternative to a lumbar or caudal epidural steroid injection for low back pain with radiculopathy.

• Physical Therapy Korea
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• v.25 no.4
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• pp.27-36
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• 2018

Background: We developed a novel integrative lumbar stabilization technique that combines lumbar extension (LE) exercise with abdominal drawing-in maneuver (ADIM) to ameliorate low back pain (LBP) associated with neuromuscular imbalance and instability, based on the collective evidence of contemporary spinal rehabilitation. Objects: The specific aim of the present study was to investigate the effects of LE exercise with and without ADIM on core muscle strength, lumbar spinal instability, and pain, as well as functional characteristics in individuals with LBP using advanced radiographic imaging techniques. Methods: patients with mechanical LBP (N = 40, 6 males; $35.1{\pm}7.6years$) were recruited and randomly assigned either to the combined LE and ADIM (experimental group) or the LE alone (control group). Outcome measures included the visual analog scale, the modified Oswestry Disability Index, muscle strength imbalance (MSI), and radiographic imaging. The lumbar intervertebral displacement (LID), intervertebral (IV) and total lumbar extension (TLE) angles were calculated to evaluate the lumbar segmental instability. Results: The experimental group showed significant differences in the L3-L4, L5-S1 LIDs, L4-L5 and L5-S1 IV angles, and TLE angle as compared to the controls (p<.05). Immediate pain reduction and muscle strength imbalance ratio were significantly different between the groups (p<.05). Conclusion: These results suggest that the addition of ADIM significantly increased lumbar spinal stabilization in individuals with LBP, thereby reducing pain associated with functional lumbar flexion during daily activities.

• The Journal of Korean Physical Therapy
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• v.13 no.3
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• pp.495-507
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• 2001

The purpose of this study was to find the effects of the dynamic lumbar stabilization exercise on functional recovery of low back pain patients. The subjects were consisted of sixty patients who had nonspecific subacute low back pain. All subjects randomly assigned to dynamic lumbar stabilization exercise group. Williams exercise group and modalities treatment group. The dynamic lumbar stabilization exercise group received modalities treatment with dynamic lumbar stabilization exercise. Williams exercise group received modalities treatment with Williams flexion exercise and modalities treatment group received modalities treatment without exercise. The Oswestry low back pain disability questionnaire was used to measure disability of low back pain. Assessment was carried out before treatment fur obtain baseline measurement of low back pain and reassessment were carried out at after 20 and 40 treatment sessions. The results of this study were as following: 1. The Oswestry low back pain disability questionnaire scores were significantly decreased after 20th and 40th treatment in dynamic lumber stabilization exercise group(p<.05). 2. The Oswestry low back pain disability questionnaire scores were significantly decreased after 20th and 40th treatment in Williams exercise group(p<.05). 3. The Oswestry low back pain disability questionnaire scores were significantly decreased after 20th and 40th treatment in modalities treatment group(<.05). 4. There were no statistical difference between the 3 groups at pre-treatment with Oswestry low back pain disability questionnaire scores(p>.05). 5. There were no statistical difference between the 3 groups after 20th treatment with Oswestry low back pain disability questionnaire scores(p>.05). 6. There were statistical difference between the 3 groups after 40th treatment with Oswestry low back pain disability questionnaire scores(p<.05). 7. The Oswestry low back pain disability questionnaire scores were significantly decreased after 40th treatment in all 3 groups and the decrement were greater in order of dynamic lumbar stabilization exercise group. Williams exercise group and modalities treatment group.

• The Korean Journal of Pain
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• v.18 no.1
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• pp.92-95
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• 2005

Primary hyperhidrosis, a disorder of unknown etiology, is characterized by excessive uncontrollable sweating, most often of the palm surface of the hands, armpits, groin and feet. To decrease the symptoms of hyperhidrosis, drug therapy, iontophoresis, excision of axillary sweat glands and thoracoscopic sympathectomy have been attempted. A lumbar sympathectomy is one of the available choices for the treatment hyperhidrosis of the lower extremities. A 28-year old female patient presented with excessive sweating of her hands and feet. For the treatment of her foot hyperhidrosis, a bipolar radiofrequency ablation system was used to ablate the lumbar sympathetic ganglion, with a successful result. This modality will receive greater attention as an available alternative to lumbar sympathetic neurolysis.

• Physical Therapy Korea
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• v.10 no.3
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• pp.109-126
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• 2003

This study was designed 10 investigate the effects of therapeutic gymnastic ball exercise on pain, flexibility, lumbar disability level and daily activity levels in male patients of the armed forces medical hospital who complain of chronic low back pain. Twenty-three males were placed in the experimental group and twenty-nine males were placed in the control group. All of the subjects were chosen on the basis of availability among in-patients who were diagnosed with low back pain. The control patients were matched to the experimental group and they were selected considering gender, pain duration and age. Gymnastic ball exercise therapy was developed by the author with the assistance of a rehabilitation specialist. Gymnastic ball exercise therapy includes muscle relaxation, flexibility, muscle strength and posture development exercises. The gymnastic ball exercise therapy was carried out by the experimental group three times a week for eight weeks. Before and after the experiments, the intensity of pain, the lumbar joint mobility (flexibility), the lumbar disability levels, and the daily activity levels of the subjects were measured, respectively. The intensity of pain and the lumbar disability levels were measured by the Visual Analogue Scale, the level of flexibility by a measurement ruler, and the level of disability by the Oswestry Low Back Pain Disability Scale. Data were analysed using a t-test, a paired t-test and an unpaired t-test. The results were as follows: 1. The intensity of pain in the lumbar spine in the experimental group was significantly decreased compared with that of the control group during the 4th week and 8th week. 2. The flexibility of the lumbar spine in the experimental group was significantly increased compared with that of the control group during the 4th week and 8 week. 3. The level of pain caused by anterior, posterior, left lateral and right lateral bending and by rotation in experimental group was significantly decreased compared with that of the control group. 4. The Oswestry Disability score of the experimental group was significantly increased compared with that of control group. These findings indicate that gymnastic ball exercise therapy could be effective in decreasing pain and lumbar disability, and increasing the daily activity levels and lumbar flexibility in patients with chronic low back pain. The study also suggests that gymnastic ball exercise therapy could be an essential factor for effective nursing intervention for patients suffering from chronic low back pain.

• Journal of Korean Physical Therapy Science
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• v.13 no.1
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• pp.39-52
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• 2006

The purpose of this study was to investigate the effects of lumbar stabilization exercise therapy on low back pain patients' lumbar spinal function. Identify the effect of stabilization exercise therapy, this study attempted to determine lumbar spinal functions, using spinoscopy, for 20 patients with low back pain This study applied lumbar stabilization exercise to 20 low back pain patients without a control group for 8 weeks and 4 times a week, and examined their spinal functions before and after the application. Data collected from the test were analyzed using Wilcoxon signed ranked test, a nonparametric test. Absolute index, functionality and performance increased significantly compared to them before treatment. FE loads and velocity control while conducting exercise tasks increased significantly compared to them before treatment. Test item ROL and ROM, which indicate the change of angle, both showed significant differences. Of stiff spine, stiff pelvic score and sprain score, which indicate the effects of the conduct of exercise tasks on the movement of the spine, stiff spine score and sprain score showed significant differences. According to the results as presented above, lumbar stabilization exercise may be greatly helpful in improving low back pain patients' lumbar spinal functions.