• The Korean Journal of Pain
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• 제5권1호
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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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• 제1권2호
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• pp.171-176
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• 1988

It is well known that the celiac plexus block is specially useful for relieve intractable upper abdominal pain caused by upper abdominal visceral malignancy or upper abdominal metastasis from distant organs. But in cases of lower abdominal or pelvic metastasis from upper abdominal malignancy, the lower abdominal intractable pain is remained after the successful celiac plexus block. We have reported 7 cases of celiac plexus block combined with lumbar sympathetic ganglion block, among the 305 cases of the celiac plexus block from 1968 to Nov. 1987, performed in patients with lower abdominal or back pain due to carcinomatosis of lower abdominal metastatic malignancy, that their results were excellent for pain relief.

• The Korean Journal of Pain
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• 제25권1호
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• pp.43-46
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• 2012

The superior hypogastric plexus block (SHPB) is used for treating pelvic pain, especially in patients with gynecological malignancies. Various approaches to this procedure have been reported due to the anatomic obstacles of a high iliac crest or large transverse process of the $5^{th}$ lumbar vertebra. Here, we report a new technique of superior hypogastric plexus block using a unilateral single-needle approach to block the bilateral superior hypogastric plexus with a Tuohy needle and epidural catheter. We have confidence that this new technique can be another option in performing the SHPB when the conventional bilateral approach is difficult to perform.

• Journal of Korean Neurosurgical Society
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• 제29권5호
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• pp.623-627
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• 2000

Objective : Spontaneous lumbar epidural hematoma is a rare entity, although the precipitating factors such as anticoagulation therapy frequently precede it. The authors report four cases of surgically confirmed spontaneous epidural hematoma mimicking lumbar disc herniation. Methods : Between 1995 and 1998, four patients with spontaneous lumbar epidural hematoma were diagnosed. The clinical findings which are identical to that of acute disc herniation are included in this study. The operative findings and radiological characteristics are also included. Results : The magnetic resonance(MR) image findings demonstrated epidural lesions of intermediate to low signal intensity equivalent to those of normal discs on $T_1$-weighted images, and epidural lesions of high signal intensity higher than these normal discs on a $T_2$-weighted image. The image findings also showed rim enhanced pattern of the gadolinium-enhanced $T_1$-weighted MR images. All of the hematomas was associated with a small concomitant disc herniation or underlying annular tear. Conclusion : The authors speculate that spontaneous lumbar epidural hematoma results from tearing of the fragile penetrating vein caused by underlying disc or annulus disruption between Batson' plexus and vertebral body.

• Journal of Korean Neurosurgical Society
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• 제43권1호
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• pp.31-33
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• 2008

We present a rare case of fracture-dislocation at the level of the first sacral (S1) and second sacral (S2) vertebrae. The S1 was displaced forward into the pelvic cavity and was located just in front of the S2. Because the patient also had extensive neurological injury to the lumbar plexus and instability of the pelvic ring, surgery to stabilize the pelvis and to decompress the lumbar plexus was performed. The surgery was successful and the patient experienced marked improvement in neurological function.

• Journal of Korean Neurosurgical Society
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• 제59권4호
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• pp.410-413
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• 2016

Lumbar radiculopathy is generally caused by such well-recognized entity as lumbar disc herniation in neurosurgical practice; however rare pathologies such as thrombosed epidural varix may mimic them by causing radicular symptoms. In this case report, we present a 26-year-old man with the complaint of back and right leg pain who was operated for right L4-5 disc herniation. The lesion interpreted as an extruded disc herniation preoperatively was found to be a thrombosed epidural varix compressing the nerve root preoperatively. The nerve root was decompressed by shrinking the lesion with bipolar thermocoagulation and excision. The patient's complaints disappeared in the postoperative period. Thrombosed lumbar epidural varices may mimic lumbar disc herniations both radiologically and clinically. Therefore, must be kept in mind in the differential diagnosis of lumbar disc herniations. Microsurgical techniques are mandatory for the treatment of these pathologies and decompression with thermocoagulation and excision is an efficient method.

• Annals of Clinical Neurophysiology
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• 제8권2호
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• pp.174-178
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• 2006

The diagnosis of peripheral neuropathy had been performed by electrophysiologic studies and neurologic examination. However, Magnetic Resonance Imaging (MRI) has recently been proposed as a supplementary tool for its diagnosis. A 55-year-old woman presented with back pain and painful proximal weakness of the right leg. Neurologic examination and electrophysiologic studies suggested an upper lumbar plexopathy. MRI disclosed the signal change in lumbar plexus with the atrophy of the innervating muscles. We report a patient with idiopathic lumbar plexopathy confirmed by MRI.

• Journal of Trauma and Injury
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• 제36권3호
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• pp.290-294
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• 2023

Generally, patients with severe burst fractures, instability, or neurological deficits require surgical treatment. In most cases, circumferential reconstruction is performed. Surgical methods for three-column reconstruction include anterior, lateral, and posterior approaches. In cases involving an anterior or lateral approach, collaboration with general or thoracic surgeons may be necessary because the adjacent anatomical structures are unfamiliar to spinal surgeons. Risks include vascular or lumbar plexus injuries and cage displacement, and in most cases, additional posterior fusion surgery is required. However, the posterior approach is the most common and anatomically familiar approach for surgeons performing spinal surgery. We present a case in which three-column reconstruction was performed using only the posterior approach to treat a patient with a severe lumbar burst fracture.

• The Korean Journal of Pain
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• 제31권1호
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• pp.54-57
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• 2018

Burner or stinger syndrome is a rare sports injury caused by direct or indirect trauma during high-speed or contact sports mainly in young athletes. It affects peripheral nerves, plexus trunks or spinal nerve roots, causing paralysis, paresthesia and pain. We report the case of a 57-year-old male athlete suffering from burner syndrome related to a lumbar nerve root. He presented with prolonged pain and partial paralysis of the right leg after a skewed landing during the long jump. He was initially misdiagnosed since the first magnet resonance imaging was normal whereas electromyography showed denervation. The insurance company refused to pay damage claims. Partial recovery was achieved by pain medication and physiotherapy. Burner syndrome is an injury of physically active individuals of any age and may appear in the cervical and lumbar area. MRI may be normal due to the lack of complete nerve transection, but electromyography typically shows pathologic results.

• The Korean Journal of Pain
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• 제24권4호
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• pp.226-230
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• 2011

Surgical excision was performed on a 30-years old woman with a painful mass on her left thigh. The pathologic findings on the mass indicated fibromatosis. After the operation, she complained of allodynia and spontaneous pain at the operation site and ipsilateral lower leg. We treated her based on postoperative femoral neuropathy, but symptom was aggravated. We found a large liposarcoma in her left iliopsoas muscle which compressed the lumbar plexus. In conclusion, the cause of pain was lumbar plexopathy related to a mass in the left iliopsoas muscle. Prompt diagnosis of acute neuropathic pain after an operation is important and management must be based on exact causes.