• The Korean Journal of Pain
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• 제10권2호
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• pp.270-273
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• 1997

Caudal epiduroscopy has been introduced as an alternative technique for direct injection of epidural steroid and lysis of adhesion. Futher, it gives a better understanding of the role of epidural adhesion in recurrence of sciatica and low back disorder after surgery. We experienced a clinical application of flexible fiberoptic epiduroscope inserted through the sacral canal. A 37-year-old woman was suffering from right lumbar radiculopathy after an operation for a herniated disc. A series of volumetric caudal steroid injections and physical therapy had little effect on her symptoms. Patient was thought to be a good candidate for epiduroscopy. Flexible flberoptic epiduroscopy was as follows: 60 ml of normal saline irrigation and epidurogram, 40 mg of triamcinolone in 10m1 of normal saline was directed around right L5 nerve root. The following morning, patient reported reduced pain in her leg.

• The Korean Journal of Pain
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• 제8권2호
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• pp.371-373
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• 1995

Percutaneous retrogasserian gangliolysis is suitable for treatment of trigeminal neuralgia because it is simple and effective. Further, it can avoid severe complications such as anesthesia dolorosa or dysesthesia that may develop after surgical procedure. However we have experienced an anesthesia dolorosa(pain in an area or region that is anesthetic) after percutaneous retrogasserian glycerol injection. This deafferentation pain is characterized by scratching, burning or itching sensation; and has shown to be of higher incidence in older and inemotionally unstable patients. Anesthesia dolorosa is relatively rare but difficult to treat. Consideration should be made for the complication which may develop during the procedure.

• The Korean Journal of Pain
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• 제5권2호
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• pp.199-205
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• 1992

• The Korean Journal of Pain
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• 제21권3호
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• pp.229-232
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• 2008

Insufficiency fractures of the sacrum are relatively common and cause severe low back and buttock pain. Percutaneous vertebroplasty is effective for treating vertebral compression fractures. We present a case of percutaneous sacroplasty for the treatment of low back and buttock pain in a sacral insufficiency fracture. A 79-year-old male with non-small lung cancer presented with severe low back and buttock pain after series of radiation treatments. Preoperative MRI showed both a sacral ala and S2 metastatic insufficiency fracture. An epidural port was inserted for continuous morphine infusion and sacral nerve root blocks were performed. However, his pain did not diminish and we attempted percutaneous sacroplasty. Both sides of the sacroplasty were done with a fluoroscopy-guided technique with 1.7 ml and 2.3 ml of bone cement injected into the right and left sacral ala. Pain relief was significant and the patient was able to sit down 1 day after the procedure.

• The Korean Journal of Pain
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• 제11권2호
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• pp.273-282
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• 1998

Background: Twelve years have passed since the Korean Pain Society was organized. Nowadays, there are so many problems to be solved in pain clinics including health insurance, pain education and public information etc. in Korea. The present study was designed to evaluate the current status of pain clinics in Korea. Methods: Eight hundred twenty regular members of Korean Pain Society were surveyed by questionnaire in October 1997. We compared the general characteristics, contents of diseases in pain clinic, treatment Methods, patients satisfaction, pain educations, problems in pain treatments, requests to Korean Pain Society among the 138 respondents. Results: Thirty seven percents of the respondents worked at university hospitals, 39% at non-university hospitals and 24% at private pain clinics. The most common diseases treated in pain clinics was low back pain(32% in university and non-university hospital and 28% in private pain clinic respectively). However, cancer pain was 10% in university and non-university hospital and 0.7% in private pain clinic. Epidural block was the most frequently used procedure in chronic pain treatments. And 74.6% of the respondents were studied and learned in Korea and Japan. And then, current problems in pain management and requests to Korean Pain Society were medical insurance problems, pain education and public information of pain clinics. Conclusions: These results suggest that the Korean Pain Society should make an effort to solve these current problems in order to activate pain medicine and increase the quality of life for those suffering from pain.

• The Korean Journal of Pain
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• 제20권2호
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• pp.174-180
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• 2007

Background: The diagnosis of trigeminal neuralgia (TN) is based on only clinical criteria. The purpose of this study was to estimate the clinical manifestations of TN patients treated at our pain clinic. Methods: A total of 341 patients with TN from Jan. 2004 to Dec. 2006 was evaluated the intensity, site, and onset of pain, facial sensation, duration of pain attack, pain free interval, triggering factors, and effects of the previous treatments with TN specific questionnaire and interview at the first visit of our pain clinic. Results: About 80% of the patients were over 50 years of age and 256 (75%) patients were women. Average durations from first attack of their pain and from current pain attack were 7 years and 16 weeks, respectively. The two most frequently involved trigeminal nerve branches were maxillary (40%) and mandibular (39%) branches. Three quarters of the total patients experienced only paroxysmal pain that lasted less than one minute. About 90% of patients had pain free period at least one time. Most common triggering factors were chewing (88%), brushing teeth (82%), washing face (79%), and talking (70%). Only 16 patients (5%) had no previous treatment and the others had more than one treatment, such as medication (68%) and interventional procedures (35%). The most common reasons for early discontinuation of carbamazepine were dizziness, ataxia, and vomiting. Conclusions: TN has specific clinical features of pain, which should be considered at diagnosis.

• The Korean Journal of Pain
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• 제12권2호
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• pp.191-194
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• 1999

Background: Millions of patients with chronic sciatica are still treated with epidural corticosteroids. The efficacy of epidural corticosteroids remains questionable, especially in the failed back surgery syndrome (FBSS). We studied to evaluate outcome for 10 patients with failed back surgery syndrome treated with spinal nerve root block using corticosteroids, hyaluronidase, and local anesthetics. Methods: The affected nerve roots are localized with the help of fluoroscopy and contrast dye. Local anesthetic diluted in 1,500 U hyaluronidase and 40 mg methylprednisolone is injected. A small retrospective pilot group of 10 patients with FBSS was treated. The success rate is evaluated using a visual analogue scale at 1 week and 3 month interval after the last injection. Results: Initially, 7 patients experienced good pain relief; 5 patients suspained pain relief for 3 months. No complications were observed. Conclusions: This technique is worthwhile for patients with FBSS and where epidural fibrosis is suspected to be the pain origin.

• The Korean Journal of Pain
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• 제8권2호
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• pp.225-234
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• 1995

Low back pain(LBP) is one of the most common ailment. There were two type of LBP in the clinic. One of them is low back pain with leg pain, the other one is low back pain without leg pain. Author explain the reasons, characters. mechanism, diagnosis, and reported 156 cases of LBP. There are various method to treatment of low back pain in recent. The first selection for treatment of LBP were intervertebral block added "+" type block(IVP "+" TB). according to author's experience, the rate of Excellent and good were account for 96.2%. Other method of LBPO therapy were also used in Pain clinic, such as psoas compartment block, caudal block, epidural steroid block, zygapophysial joint block, nerve root block, subarachnoid neural block, Lumbar sympathetic block, etc. Finally, author introduced Pain clinic in China. divided to three titles: (1) history, (2) CASP and scientific activity, (3) pain therapy in China.

• The Korean Journal of Pain
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• 제3권2호
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• pp.160-164
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• 1990

Herpes Zoster Ophthalmicus comprises 7% of all herpes zoster infection, 50% of those involving eyeballs, and is one disease entitiy with a very grave prognosis. We have experienced a 68-year-old man who visited the emergency room complaining of severe pain in his eye and headache with loss of vision. He was seen by neurosurgeons, dermatologists and ophthalmologists, and finally sent to the pain clinic for control of pain under the diagnosis of herpes zoster ophthalmicus. In spite of zealous treatment efforts, loss of vision, pain and infectious condition did not recover; and furthermore, due to severe infection, he had his eyeball extracted 100 days after the onset of diseases. 140 days after onset, contralateral hemiplegia accompanied the disease process. We present an unusual case of herpes zoster ophthalmicus with no treatment effect.

• The Korean Journal of Pain
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• 제8권1호
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• pp.110-116
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• 1995

The pain clinic at the Chonbuk National University Hospital opened in 1983. We analyzed 3,212 patients who visited the clinic during the 10 years from 1983 to 1993. The patients visited total of 11,628 times. The most frequent age group was in the fifties. About an half of the patients complained of low back pain, and the epidural block was most frequently given as a treatment. We need more personnels involving in pain management and more equipments in diagnosing and treating the patients with chronic pain. Understanding and cooperation among departments under the basis of closer interdepartmental relationship would be essential for the further development of the pain clinc.