Objective : There were few reports about statistically significant factor which contribute to low back pain[LBP] after microscopic discectomy. We analyzed the result of percutaneous radiofrequency neurotomy[PRN] for low back pain after microscopic discectomy in lumbar disc herniation. Methods : Forty four patients with LBP after microscopic discectomy who were treated by one level microscopic discectomy from January 2003 to March 2004 were included in this study. They were divided into two groups by the presence of preoperative LBP into preoperative back pain group [group I] and postoperative back pain group [group II]. Radiofrequency procedures were performed in the usual manner, targetting the medial branch of L4, L5 and Sl. Pain relief was estimated at 1 week, 1 month and 6 months following the procedure, using the visual analogue scale. Above 50% pain relief was defined as the positive response. Results : Positive responders were 16 patients [73%] at 1 week, 12 patients [55%] at 1 month, and 7 patients [32%] at 6 months after PRN in group I. In Group II, 18 patients, 15 patients and 13 patients responded positively after 1 week, 1 month and 6 months after PRN, respectively. Conclusion : PRN is an effective treatment for newly developed low back pain after microscopic discectomy. There was no morbidity in our series, but long-term follow up is necessary.
Kim, Inah;Lee, Jong In;Jang, Yongjun;Park, Hae-Yeon
Clinical Pain
/
v.20
no.1
/
pp.49-52
/
2021
Bertolotti's syndrome (BS) refers to chronic low back pain (LBP) associated with lumbosacral transitional vertebrae (LSTV). Many studies suggest that the anomalous articulation alters biomechanics, resulting in discomfort on the ipsilateral side. Herein, we present an unusual case of BS presenting pain on the non-articulated side. A 46-year-old man visited our clinic with history of chronic LBP, refractory to treatment of analgesics, modalities and manual therapies. Electrodiagnostic studies showed no evidence of lumbosacral radiculopathy. Radiographies noted unilateral pseudoarticulation of L5~S1 vertebrae, on the contralateral side of his pain. The pain improved dramatically after sacroiliac joint block and facet joint block with iliolumbar ligament infiltration on the non-articulated side. Clinicians should be cautious that the unaffected joint in BS may serve an important role in altered lumbopelvic biomechanism, since it might eventually lead to intractable chronic LBP when overlooked.
Journal of the Korean Society of Physical Medicine
/
v.3
no.3
/
pp.185-192
/
2008
Purpose : The purpose of this study is to examine the effect of the electro-acupuncture stimulation into the multifidus for the lumbar flexibility improvement and pain reduction. The subjects were consisted of 20 women patients with chronic low back pain. Methods : 20 women patients with chronic low back pain voluntary participated for the research. 15 minute electro-acupuncture stimulation(frequency: 4Hz, Intensity: below threshold of pain) with Infra-red therapy, 3 times a week during 6 weeks period. Acupuncture application given to the patients' trigger point of the multifidus. The Application of multifidus was L3, L4, L5 spinal vertebra levels Short form McGill pain questionnaire (SFMPQ) was used to measure patient's pain level. Lumbar flexibility measurement was trunk flexion and trunk extension. Global Perceived Effect Scale(GPES) was used to measure recovery or worse of patient's condition. Results : SFMPQ was after treatment showed significantly decreased more than before stimulation treatment (P<.05). Lumbar flexibility was after treatment showed significantly increase more than before treatment(P<.05). GPES was after treatment showed significantly increased more than before treatment(p<.05). Conclusion : This study will be used as treatment method of patient with chronic LBP. The multifidus muscle in chronic LBP patients clinical significance. Most of chronic LBP patients have multifidus contraction pattern. So chronic LBP patients necessary multifidus muscle release treatment.
Background: The International Classification of Functioning, Disability and Health (ICF) model, created by the World Health Organization, provides a theoretical framework that can be applied in the diagnosis and treatment of various disorders. Objects: Our research purposed to ascertain the relationship between structure/function, activity, and participation domain variables of the ICF and pain, pain-associated disability, activities of daily living (ADL), and quality of life in patients with chronic low back pain (LBP). Methods: Two-hundred patients with chronic LBP (mean age: 35.5 ± 8.8 years, females, n = 40) were recruited from hospital and community settings. We evaluated the body structure/function domain variable using the Numeric Pain Rating Scale (NPRS) and Roland-Morris disability (RMD) questionnaire. To evaluate the activity domain variable, we used the Oswestry Disability Index (ODI) and Quebec Back Pain Disability Scale (QBDS). For clinical outcome measures, we used Short-form 12 (SF-12). Pearson's correlation coefficient was used to ascertain the relationships among the variables (p < 0.05). All the participants with LBP received 30 minutes of conventional physical therapy 3 days/week for 4 weeks. Results: There were significant correlations between the body structure/function domain (NPRS and RMD questionnaire), activity domain (ODI and QBDS), and participation domain variables (SF-12), rending from pre-intervention (r = -0.723 to 0.783) and postintervention (r = -0.742 to 0.757, p < 0.05). Conclusion: The identification of a significant difference between these domain variables point to important relationships between pain, disability, performance of ADL, and quality in participants with LBP.
Kim, Ha-Neul;Kim, Kyoung-Hun;Kim, Joo-Won;Jin, Eun-Seok;Ha, In-Hyuk;Koh, Dong-Hyun;Hong, Soon-Sung;Kwon, Hyeok-Joon
Journal of Korean Medicine Rehabilitation
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v.19
no.1
/
pp.135-143
/
2009
Objectives : Low back pain(LBP) is a common disabling disease in clinical practice and loss of working hours due to this condition is huge. The aim of this study was to determine if there was an association between fat deposit of paraspinal muscles as observed on MRI scans in patients presenting with unilateral LBP. Methods : 24 patients who visiting our hospital with a clinical presentation of unilateral LBP were recruited to the study. Patients were between 20 and 30 years and had a history of unilateral LBP within 12 months. After MRI scaning, the images were saved in DICOM file format for Picture Archiving and Communication System(PACS). The percentage of fat infiltrated area was measured using a pseudocoloring technique. Data were analyzed comparing the fat deposits of the muscles on the symptomatic and asymptomatic sides. Paired t-test was used to find the difference between the measurements of fat tissue in individual patients. Results : The amount of fat in the symptomatic side was $7.6{\pm}4.51%$, asymptomatic side was $6.7{\pm}4.29%$. There were increases, statistically significant, in the fat changes of the paraspinal muscles at the L4-5 disc level(P <0.05). Also, men were likely than women to have more fat deposit in symptomatic side(men $8.5{\pm}5.1%$, women $6.5{\pm}3.6%$). Conclusions : The amount of fat in the symptomatic side shows significantly increased than asymptomatic side in the paraspinal muscles at the L4-5 disc level. It suggested that fat infiltration in the muscles associated with LBP. Further studies will be needed to confirm the relationship between the muscle fatty changes and LBP in the large sample size. In addition, the correlation of pain severity with fat infiltration needs to be addressed.
Fukui, Sei;Nitta, Kazuhito;Iwashita, Narihito;Tomie, Hisashi;Nosaka, Shuichi;Rohof, Olav
The Korean Journal of Pain
/
v.25
no.3
/
pp.155-160
/
2012
Background: We have developed an intradiscal pulsed radiofrequency (Disc PRF) technique, using Diskit $II^{(R)}$ needles (NeuroTherm, Wilmington, MA, USA), as a minimally invasive treatment option for chronic discogenic low back pain (LBP). The purpose of this study was to compare the representative outcomes of Disc PRF and Intradiscal Electrothermal Therapy (IDET) in terms of pain relief and reduction of disability. Methods: Thirty-one patients with chronic discogenic LBP who underwent either Disc PRF (n = 15) or IDET (n = 16) were enrolled in the study. A Diskit $II^{(R)}$ needle (15-cm length, 20-gauge needle with a 20-mm active tip) was placed centrally in the disc. PRF was applied for 15 min at a setting of $5{\times}50$ ms/s and 60 V. The pain intensity score on a 0-10 numeric rating scale (NRS) and the Roland-Morris Disability Questionnaire (RMDQ) were assessed pretreatment and at 1, 3, and 6 months post-treatment. Results: The mean NRS was significantly improved from $7.2{\pm}0.6$ pretreatment to$2.5{\pm}0.9$ in the Disc PRF group, and from $7.5{\pm}1.0$ to $1.7{\pm}1.5$ in the IDET group, at the 6-month follow-up. The mean RMDQ also showed significant improvement in both the Disc PRF group and the IDET group at the 6-month follow-up. There were no significant differences in the pretreatment NRS and RMDQ scores between the groups. Conclusions: Disc PRF appears to be an alternative to IDET as a safe, minimally invasive treatment option for patients with chronic discogenic LBP.
The prevalence rate of low back pain in nurses is higher than that of other jobs, because there are many more risk factors(for example, standing postures, lifting and carrying heavy loads, transfering patients, changing a patient's position etc.). This investigation is to provide basic data for prevention of low back pain by analyzing the prevalence rate and related factors of low back pain in nurses(esp. operating room staff) in general hospitals. A self-reported questionaire survey was carried out on three hundred and five nurses of three general hospitals in Seoul from June, 1996 to August, 1996. Subjects of the survey were divided into a low back pain group(LBP) and a cotrol group to investigate the association between low back pain and the general characteristics and work related factors of each group. The results were as follows: 1. In the subjects of the survey, the prevalence rate of low back pain was 60.0% for the last year. 2. 73.6% of operating room(OR) staff complained of low back pain. 3. Standing for a long time and working in twisting postures were associated with low back pain, and so were the shift, the type of work, and the frequency of transfering patients. 4. The weight loads which nurses frequently carried were, under 5kg, 5-10kg, 15-20kg, 15-20kg, over 20kg, and all, except for 10-15kg, were associated with LBP. 5. 76.9% of the LBP experienced low back pain within 3 years after starting nursing jobs. 6. Concerning the degrees of low back pain: 75.8% was limited to waist; 18.8% reached the knees; 4.2% reached ankles. In conclusion, the prevalence rate of low back pain in general hospital nurses was associated with the works in operating room and other work related factors, therefore it is necessary to develop on educational program for the prevention of low back pain as well as and to improve working environments.
Ha, Jin-Woong;Myung, Ji-Ho;Suk, Jhin-Ik;Lee, An-Sung;Kim, Young-Cheol
Proceedings of the Korean Society for Noise and Vibration Engineering Conference
/
2011.04a
/
pp.425-432
/
2011
In tilting pad bearing design process, the selection of the proper configuration type of either a Load-Between-Pad (LBP) or Load-On-Pad (LOP) as well as preload and pivot offset conditions is to be carefully considered. Also the bearing needs to be designed in order to be suited for the rotor-bearing system and operating condition. In this paper, it is observed that the dynamic characteristics in a 5 pad tilting pad bearing for the LBP and the LOP configurations are influenced by the variation of preload and pivot offset. In this context, rotor dynamic analysis of the 5MW industrial gas turbine supported by the tilting pad bearing at the front and roller bearing at the rear is carried out based on the dynamic coefficients of the tilting pad bearing investigated. The result shows that two rigid body critical modes experience various changes according to the influence of the tilting pad bearing uniquely applied to one side of this machine. Mainly, the second critical speed, the rigid body mode of conical shape with high whirling in the tilting pad bearing, is significantly changed by preload and pivot offset regardless of the LBP and LOP configurations. And, the first critical mode, the rigid body mode of conical shape with high whirling in the roller bearing, is sensitively affected by preload applied to the LOP configuration and by the its asymmetric dynamic properties.
Jang, Kun-Soo;Kim, Heyun-Sung;Ju, Chang-Il;Kim, Seok-Won;Lee, Sung-Myung;Shin, Ho
Journal of Korean Neurosurgical Society
/
v.49
no.3
/
pp.163-166
/
2011
Objective : Both the paraspinal muscle sparing approach and percutaneous screw fixation are less traumatic procedures in comparison with the conventional midline approach. These techniques have been used with the goal of reducing muscle injury. The purpose of this study was to evaluate and to compare the safety and efficacy of the paraspinal muscle sparing technique and percutaneous screw fixation for the treatment of L5-S1 spondylolisthesis. Methods : Twenty patients who had undergone posterior lumbar interbody fusion (PLIF) at the L5-S1 segment for spondylolisthesis were prospectively studied. They were divided into two groups by screw fixation technique (Group I : paraspinal muscle sparing approach and Group II: percutaneous screw fixation). Clinical outcomes were assessed by Low Back Outcome Score (LBOS) and Visual Analogue Scale (VAS) for back and leg pain at different times after surgery. In addition, modified MacNab's grading criteria were used to assess subjective patients' outcomes 6 months after surgery. Postoperative midline surgical scarring, intraoperative blood loss, mean operation time, and procedure-related complications were analyzed. Results : Excellent or good results were observed in all patients in both groups 6 months after surgery. Patients in both groups showed marked improvement in terms of LBOSs all over time intervals. Postoperative midline surgical scarring and intraoperative blood loss were lower in Group II compared to Group I although these differences were not statistically significant. Low back pain (LBP) and leg pain in both groups also showed significant improvement when compared to preoperative scores. However, at 7 days and 1 month after surgery, patients in Group II had significantly better LBP scores compared to Group I. Conclusion : In terms of LBP during the early postoperative period, patients who underwent percutaneous screw fixation showed better results compared to ones who underwent screw fixation via the paraspinal muscle sparing approach. Our results indicate that the percutaneous screw fixation procedure is the preferable minimally invasive technique for reducing LBP associated with L5-S1 spondylolisthesis.
Ha, Jin-Woong;Myung, Ji-Ho;Suk, Jhin-Ik;Lee, An-Sung;Kim, Young-Cheol
Transactions of the Korean Society for Noise and Vibration Engineering
/
v.21
no.8
/
pp.752-760
/
2011
In tilting pad bearing design process, the selection of the proper configuration type of either a load-between-pad(LBP) or load-on-pad(LOP) as well as preload and pivot offset conditions is to be carefully considered. Also the bearing needs to be designed in order to be suited for the rotor-bearing system and operating condition. In this paper, it is observed that the dynamic characteristics in a five pad tilting pad bearing for the LBP and the LOP configurations are influenced by the variation of preload and pivot offset. In this context, rotor dynamic analysis of the 5 MW industrial gas turbine supported by the tilting pad bearing at the front and roller bearing at the rear is carried out based on the dynamic coefficients of the tilting pad bearing investigated. The result shows that two rigid body critical modes experience various changes according to the influence of the tilting pad bearing uniquely applied to one side of this machine. Mainly, the second critical speed, the rigid body mode of conical shape with high whirling in the tilting pad bearing, is significantly changed by preload and pivot offset regardless of the LBP and LOP configurations. And, the first critical mode, the rigid body mode of conical shape with high whirling in the roller bearing, is sensitively affected by preload applied to the LOP configuration and by its asymmetric dynamic properties.
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