• Title/Summary/Keyword: Lumbar spine fusion

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Pain Control with Continuous Infusion of Epidural Morphine and Bupivacaine after Lumbar Spinal Surgery : A Prospective Study (요추부 수술후 경막외 Morphine Sulfate와 Bupivacaine의 지속적 주입에 의한 통증 조절의 효과)

  • Shin, Moon Soo;Lee, Byung Hee;Choi, Hun Kyu;Noh, Jae Sub;Ahn, Jung Young;Sheen, Seung Hun;Lee, Byung Hee;Chung, Bong Sub
    • Journal of Korean Neurosurgical Society
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    • v.29 no.5
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    • pp.604-608
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    • 2000
  • Objective : The purpose of this non randomized prospective study was to verify the effect of pain control in small doses of epidural morphine and bupivacaine through continuous infusion for 48 hours. Patients and Methods : Thirty-five patients who underwent spine surgery including laminectomy, fusion with fixation were assigned into two groups ; pain control group(n=20) and control group(n=15). Pain score was measured on a visual analogue scale(VAS). A continuous infusor was used to give morphine and bupivacaine continuously via indwelling epidural catheter which was placed before closure of muscles in pain control group. Results : Mean scores(VAS) of pain control group were between 1.3 and 2.1 from the 30 min to the 72 hour, but the lowest mean score in the control group was about 2.6 at the 72 hour. Although a number of extra-analgesics were used in control group, differences of mean scores were statistically significant till 24 hour in pain control group. The patients in pain control group was less painful than the patients in control group from 24 hour till 72 hour, but it was statistically insignificant. There were some side effects such as nausea/vomiting, pruritus, urinary retention which existed transiently, but there was no respiratory depression. Conclusion : It was concluded that the early postoperative pain can be easily and safely controlled with continuous infusion of epidural morphine and bupivacaine in small doses.

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Efficacy of Unilateral Biportal Endoscopic Decompression in Lumbar Foraminal Stenosis (요추 추간공 협착증에서 일측성 양방향 내시경적 측부 추간공 감압술의 효과)

  • Lee, Ji-Min;Woo, Young-Ha;Yoo, Seong-Ho;Kim, Young-Jun;Seo, Jin-Hyuk;Bae, Hyuk
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.5
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    • pp.411-417
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    • 2020
  • Purpose: This paper reports the short-term clinical and radiological results of unilateral biportal endoscopic decompression (UBE) to prove its efficacy. Materials and Methods: Twenty patients who received unilateral biportal endoscopic far-lateral decompression (UBEFLD) were analyzed statistically using the visual analogue scale (VAS), modified Macnab criteria and Oswestry Disability Index (ODI) clinically. Radiologically, their intervertebral angle (IVA), percentage slip, disc height index (DHI) and foraminal height index (FHI) were analyzed pre- and postoperatively. Results: The VAS scores were 6.20 preoperatively, which improved to 2.05, 1.75 and 1.45 at postoperative one month, three months and one year, respectively (p<0.001). The modified macnab criteria in both the good or excellent category was 70.0%, 80.0% and 85.0% at postoperative one month, three months and one year, respectively (p=0.034). The ODI improved from 59.8% preoperatively to 35.8%, 33.2%, and 17.1% at postoperative one month, three months, and one year, respectively (p<0.001). The IVA was increased 0.40±0.88 after a surgery (p=0.057). Percentage slip was increased 0.19% after surgery (p=0.134). The DHI changed from 0.49 preoperatively to 0.62 postoperatively (p=0.359), and the FHI changed from 0.71 preoperatively to 0.79 postoperatively (p<0.001). Conclusion: UBEFLD displayed satisfactory results. Such a result highlights the potential of UBEFLD as an excellent alternative to spinal fusion or microscopic surgery.