• Journal of Korean Neurosurgical Society
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• 제51권4호
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• pp.203-207
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• 2012

Objective: The purpose of this prospective study was to evaluate the efficacy and safety of screw fixation without bone fusion for unstable thoracolumbar and lumbar burst fracture. Methods: Nine patients younger than 40 years underwent screw fixation without bone fusion, following postural reduction using a soft roll at the involved vertebra, in cases of burst fracture. Their motor power was intact in spite of severe canal compromise. The surgical procedure included postural reduction for 3 days and screw fixations at one level above, one level below and at the fractured level itself. The patients underwent removal of implants 12 months after the initial operation, due to possibility of implant failure. Imaging and clinical findings, including canal encroachment, vertebral height, clinical outcome, and complications were analyzed. Results: Prior to surgery, the mean pain score (visual analogue scale) was 8.2, which decreased to 2.2 at 12 months after screw fixation. None of the patients complained of worsening of pain during 6 months after implant removal. All patients were graded as having excellent or good outcomes at 6 months after implant removal. The proportion of canal compromise at the fractured level improved from 55% to 35% at 12 months after surgery. The mean preoperative vertebral height loss was 45.3%, which improved to 20.6% at 6 months after implant removal. There were no neurological deficits related to neural injury. The improved vertebral height and canal compromise were maintained at 6 months after implant removal. Conclusion: Short segment pedicle screw fixation, including fractured level itself, without bone fusion following postural reduction can be an effective and safe operative technique in the management of selected young patients suffering from unstable burst fracture.

• Journal of Korean Neurosurgical Society
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• 제44권1호
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• pp.8-14
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• 2008

Objective : The purpose of this study was to determine the efficacy of short segment fixation following postural reduction for the re-expansion and stabilization of unstable burst fractures in patients with osteoporosis. Methods : Twenty patients underwent short segment fixation following postural reduction using a soft roll at the involved vertebra in cases of severely collapsed vertebrae of more than half their original height. All patients had unstable burst fracture with canal compromise, but their motor power was intact. The surgical procedure included postural reduction for 2 days and bone cement-augmented pedicle screw fixations at one level above, one level below and the fractured level itself. Imaging and clinical findings, including the level of the vertebra involved, vertebral height restoration, injected cement volume, local kyphosis, clinical outcome and complications were analyzed. Results : The mean follow-up period was 15 months. The mean pain score (visual analogue scale) prior to surgery was 8.1, which decreased to 2.8 at 7 days after surgery. The kyphotic angle improved significantly from $21.6{\pm}5.8^{\circ}$ before surgery to $5.2{\pm}3.7^{\circ}$ after surgery. The fraction of the height of the vertebra increased from 35% and 40% to 70% in the anterior and middle portion. There were no signs of hardware pull-out, cement leakage into the spinal canal or aggravation of kyphotic deformities. Conclusion : In the management of unstable burst fracture in patients with severe osteoporosis, short segment pedicle screw fixation with bone cement augmentation following postural reduction can be used to reduce the total levels of pedicle screw fixation and to correct kyphotic deformities.

• Journal of Korean Neurosurgical Society
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• 제54권5호
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• pp.379-383
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• 2013

Objective : There are differences in the clinical characteristics and surgical results between upper (L1-2 and L2-3) and lower (L3-4, L4-5, and L5-S1) lumbar disc herniations. We conducted this study to compare the clinical features and surgical outcomes between the two types of lumbar disc herniations. Methods : We retrospectively reviewed the clinical features of patients who underwent microdiscectomies from 2008 to 2012. We evaluated the clinical characteristics such as age, preoperative autonomic dysfunction, the presence or absence of previous lumbar surgery and fusion required during surgery. Visual Analogue Scale (VAS) scores about back pain and leg pain were evaluated preoperatively and at the final follow-up. Results : Upper lumbar group (n=15) was significantly older than lower lumbar group (n=148). The incidence of autonomic dysfunction was significantly higher in upper lumbar group. The number of patients with a previous lumbar surgery was significantly greater in upper lumbar group. There was no statistical significance for fusion required during surgery between two groups. Both groups showed a significant decrease in the VAS scores of leg pain. VAS scores of back pain were significantly decreased in lower lumbar group. But this was not seen in upper lumbar group. Both groups showed significant improvement of Oswestry Disability Index score. Conclusion : Upper lumbar group had different clinical characteristics from those of lower lumbar group and these include older age, a higher incidence of autonomic dysfunctions and a higher incidence of patients with previous lumbar surgery. There were no significant differences in surgical outcomes, except for back pain, between two groups.

• 성인간호학회지
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• 제14권2호
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• pp.222-232
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• 2002

Background and Purpose: After the coronary angiography procedure, patients are required to remain on bed rest to reduce the risk of bleeding and hematoma formation at the puncture site. This prolonged bed rest in the supine position is difficult for many patients, who frequently complain of low back pain. The purpose of the study was to determine whether a specially designed exercise therapy and transcutaneous electrical nerve stimulation (TENS) had an effect on the alleviation of low back pain. Method: Sixty-two patients were assigned to one of three groups : specially designed exercise therapy plus TENS plus general nursing care (exercise group N=21), general nursing care plus TENS (TENS group, N=23) or general nursing care (control group, N=18). The exercise therapy consisted of five movements including stretching, pelvic tilting, knee to chest, modified situps and trunk rotation with minimizing the motion of the puncture site. The severity of low back pain was assessed by a visual analogue scale(VAS) every two hours. The use of analgesic and any development of bleeding or other complications were monitored as well. The level of serum ${\beta}$-endorphin was determined before and after the three interventions. Result: The pain score of the exercise group was significantly lowered compared to that of the other groups. There was no difference in the serum ${\beta}$-endorphin level among three groups. Analgesic were less frequently taken by the exercise group. However the incidence of bleeding complications was not significantly different among the three groups. Conclusion: Exercise therapy is more effective than general care or TENS in alleviating low back pain of the patients with coronary angiography.

• Journal of Acupuncture Research
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• 제33권3호
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• pp.161-168
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• 2016

Objectives : This study was done to show the clinical effect of miniscalpel acupuncture treatment on osteoarthritis of the knee which is refractory to acupuncture treatment. Methods : A patient was treated with acupuncture for three weeks, non-treated(wash out period) for two weeks, and treated with miniscalpel acupuncture for three weeks. The effect of treatments were measured with Visual Analogue Scale(VAS), Range of Motion(ROM), Short form McGill pain questionnaire(SF-MPQ), Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC). Results : During the three weeks of acupuncture treatment, VAS, SF-MPQ and WOMAC improved, but after two weeks of the wash out period each score worsened. During the three weeks of miniscalpel acupuncture VAS, SF-MPQ, and WOMAC improved while ROM improved remarkably. Conclusion : These results suggest that miniscalpel acupuncture might be a therapeutic option for knee degenerative osteoarthritis patients who does not responded to acupuncture treatment.

• Journal of Acupuncture Research
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• 제34권1호
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• pp.67-79
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• 2017

Objectives : The aim of this study was to report the effect of Korean medical therapy on pain and dysfunction after anterior cruciate ligament (ACL) reconstruction. Methods : A 25-year-old man experienced severe pain after right ACL reconstruction surgery. He received Korean medical treatments such as acupuncture, herbal medicine, and physiotherapy from July 10, 2014 to August 2, 2014. Results : After the treatments, his visual analogue scale scores generally decreased and the range of motion of the right knee improved from $0^{\circ}$ to $90^{\circ}$. Furthermore, the Knee Infury and Osteoarthritis Outcome Score increased from 99 to 142. Conclusion : The findings suggest that Korean medical treatments might be effectively used to treat pain and dysfunction after soft-tissue surgeries such as ACL reconstruction. Nevertheless, further research is warranted because of the limited sample size of this study.

• Journal of Korean Neurosurgical Society
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• 제56권4호
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• pp.310-314
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• 2014

Objective : To analyze the clinical courses and outcomes after anterior lumbar interbody fusion (ALIF) for the treatment of postoperative spondylodiscitis. Methods : A total of 13 consecutive patients with postoperative spondylodiscitis treated with ALIF at our institute from January, 1994 to August, 2013 were included (92.3% male, mean age 54.5 years old). The outcome data including inflammatory markers (leukocyte count, C-reactive protein, erythrocyte sedimentation rate), the Oswestry Disability Index (ODI), the modified Visual Analogue Scale (VAS), and bony fusion rate using spine X-ray were obtained before and 6 months after ALIF. Results : All of the cases were effectively treated with combination of systemic antibiotics and ALIF with normalization of the inflammatory markers. The mean VAS for back and leg pain before ALIF was $6.8{\pm}1.1$, which improved to $3.2{\pm}2.2$ at 6 months after ALIF. The mean ODI score before ALIF was $70.0{\pm}14.8$, which improved to $34.2{\pm}27.0$ at 6 months after ALIF. Successful bony fusion rate was 84.6% (11/13) and the remaining two patients were also asymptomatic. Conclusion : Our results suggest that ALIF is an effective treatment option for postoperative spondylodiscitis.

• 대한한의학방제학회지
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• 제13권2호
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• pp.193-206
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• 2005

Objective: This study is designed to compare the effects of Sulguanjul-Bang No.1 on osteoarthritis in knee joint according to formulation. Methods: 47 patients with symptomatic osteoarthritis of the knee joint were enrolled in a open clinical trial. The 47 patients were devided into two groups at random and taken Sulguanjul-bang No.1 with decoction type, suspension type respectively for8 weeks. After 8-week treatment period, the following parameters were analyzed ; Visual analogue Scale(VAS), Lysholm index score, patients' global assessment. Results: Sulguanjul-bang No.1 treatment led to significant improvement in the pain and symptoms of osteoarthritis as determined by all efficacy measures. After 8 weeks of therapy, there was significant improvement in VAS, Lysholm index and patients' global assessment. But there is no significant difference between two groups. Conclusions: Sulguanjul-bang No.1 was very beneficial pain relief effect and functional improvement irrespect of formulation, decoction type or suspension type.

• The Korean Journal of Pain
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• 제22권1호
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• pp.74-77
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• 2009

Implantable intrathecal pump is one of the therapeutic options for intractable pain. A 24-year-old male with complex regional pain syndrome was suffering from right lower extremity pain. He had all modalities of treatment including spinal cord stimulator. However, his pain had been worse in the past 6 months. His visual analogue pain scale (VAS) was 8-10 and he could not sit or walk. Only opioid was thought to be effective. Then, intrathecal pump was considered. We estimated the minimal effective dose of spinal morphine before implantation. 0.3 mg of morphine was injected intrathecally as a starting dose. Dosage had been increased up to 0.8 mg in 10 days. His VAS score decreased from 8 to 5. He could sleep without pain and walk with crutch. Therefore, intrathecal pump was inserted. He could tolerate to pain. This case suggests that intrathecal morphine delivery can provide effective treatment for intractable non-malignant pain.

• 척추신경추나의학회지
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• 제6권2호
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• pp.23-32
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• 2011

본 논문은 3차례의 양방적 수술 치료를 받은 후에도 지속적으로 요통과 함께 하지 방사통을 호소하며 일상생활 수행에 장애가 따르던 70세 여환에 대한 증례로 침구치료, 약물치료, 추나치료, 봉약침치료 등의 한의학적 보존적 치료방법으로 통증의 감소와 함께 일상생활 능력 개선에 유의한 효과를 보였다. 향후 요추 추간판 탈출증 환자의 한방적 보존적 치료에 대한 보다 다양한 연구와 임상적 고찰이 이루어져야 한다고 사료된다.