• The Korean Journal of Pain
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• v.19 no.2
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• pp.249-252
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• 2006

Postlaminectomy syndrome is characterized by persistent low back pain and radiculopathy of the legs after surgery of the spine. Pseudomeningocele is an uncommon cause of postlaminectomy syndrome; it is characterized by an extradural collection of cerebrospinal fluid (CSF) without dural covering, resulting from unrecognized dural tears at the time of lumbar surgery. In most cases, surgery to repair a pseudomeningocele is recommended. However if surgical treatment does not yield symptomatic relief, then conservative treatment should be considered. We treated a patient with a pseudomeningocele after spine surgery in which selective transforaminal epidural block produced long-term relief of symptoms. Here we describe the management of this patient.

• Journal of Korean Neurosurgical Society
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• v.38 no.6
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• pp.442-444
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• 2005

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.

• Clinical and Experimental Pediatrics
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• v.63 no.12
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• pp.485-490
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• 2020

Background: Recurrent abdominal pain (RAP) is one of the frequent complaints in general practice, particularly in pediatrics and is among the common cause of referral to gastroenterology clinics. Purpose: This study is designed to investigate the effects of probiotics for the treatment of RAP and desired therapeutic outcomes. Methods: One hundred twenty-five children with the diagnosis of RAP according to Rome III criteria for irritable bowel syndrome (IBS), functional abdominal pain (FAP), functional dyspepsia (FD), and abdominal migraine (AM), were enrolled in this double-blind randomized controlled trial. Results: Sixty-five subjects received probiotics, and others received placebo treatment for 4 weeks. Lactobacillus reuteri was therapeutically effective in 32 patients compared to 8 patients, responding to the placebo treatment. Compared to baseline, all pain-related variables showed a significant reduction for the IBS and FD at the end of the 4th week. However, it did not respond well in FAP and AM groups. Pain-related outcomes such as, frequency of the pain, severity, and duration of the pain were decreased following the probiotic treatment. No therapeutic response was seen in AM group after the administration of probiotics. L. reuteri significantly led to pain relief in the overall population, and also in FAP, FD, and IBS subgroups. Conclusion: L. reuteri probiotics are likely to lead to RAP relief and can be recommended for the treatment of functional gastrointestinal disorders.

• Journal of International Academy of Physical Therapy Research
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• v.10 no.1
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• pp.1746-1749
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• 2019

Background: Surgery has been known as an inefficient approach to reduce back pain in patients with lumbar spinal stenosis; therefore, non-surgical treatments are necessary. However, there has been little research to analyze the effect of non-surgical treatments on lumbar spinal stenosis pain. Objective: To identify the effectiveness of 2 physiotherapeutic treatment approaches to relieve pain due to lumbar spinal stenosis. Design: Randomized controlled trial Methods: The participants were 36 lumbar spinal stenosis patients who were randomized in the joint mobilization group (JMG) and transcutaneous electrical nerve stimulation group (TENSG). Joint mobilization (JM) was conducted at the posteroanterior joint in the spinous process of the lumbar spine with stenosis. Transcutaneous electrical nerve stimulation (TENS) was applied on the lumbar spine with stenosis at a high frequency and intensity. Results: Visual analog scale (VAS) pain score significantly decreased in both groups, and the VAS value decreased more after JMG than that after TENSG. The pain thresholds of both groups also significantly increased, and that of JMG increased more compared to TENSG. In both the groups, significant improvements in VAS and pain thresholds were found, and JMG showed better results than TENSG. Conclusions: JM and TENS showed significant relief in both pain threshold and painpain, and JM showed more advanced relief compared to TENS.

• Biomedical Science Letters
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• v.26 no.4
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• pp.310-318
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• 2020

The sciatic nerve is the largest nerve among the peripheral nerves, and the damage to the sciatic nerve is caused by mechanical and physical pressure. This is an important disease that consumes a lot of time and money in the treatment process. Among them, research on relieving nerve pain caused by damage to the peripheral sciatic nerve has been made efforts to prevent and treat this disease through various methods such as drugs, natural products, electrical stimulation, exercise therapy, and massage. Existing treatments are not very effective in neurological pain, and countermeasures are needed. Forsythia Fructus, used in this study, has been used as a therapeutic agent for infectious diseases and a pain reliever for cancer from the past, and in past studies, it has been known to properly control the inflammatory response. In this study, rengyolone, a physiologically active substance of Forsythiae Fructus, was administered to rats that caused chronic left nerve pain to verify the pain relief effect. As a result of the experiment, it was found that mechanical pain and cold stimulation pain were significantly reduced in the rengyolone-treated group compared to the non-administered group. In addition, it was found that nerve growth factor (NGF) mRNA expression was significantly reduced and Cyclin-dependent kinase 2 (Cdc2) expression was increased in the rengyolone administration group. This increase in NGF expression is thought to be related to rengyolone's anti-inflammatory regulatory mechanism. It is expected that the reduced NGF was directly involved in pain relief.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 1999.03a
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• pp.38-40
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• 1999

$\cdot$ Arthroscopic management is the effective method with acceptable results for coronoid impingement of stiff elbow contributing to the functional improvement and pain relief. $\cdot$ The functional improvement and pain relief seem to be affected by the severity of a degenerative change of the elbow joint. $\cdot$ Excision of coronoid process is required in a marked limitation of further flexion in addition to deeping of the coronoid fossa and anterior capsular release. $\cdot$ Excision of olecranon tip or posterior capsular release are effective method in severe flexion contracture.

• Journal of Korean Neurosurgical Society
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• v.38 no.5
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• pp.338-343
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• 2005

Objective : The sacroiliac joint complex is often related with functionally incapacitating pain in old aged people. The purpose of this study is to delineate the investigation strategies and to determine the long-term effect of radiofrequency [RF] neurotomies for pain arising from sacroiliac Joint dysfunction[SIJD]. Methods : Sixteen patients were diagnosed as having chronic pain from SIJD by comparative controlled blocks on L5 dorsal rami, sacroiliac Joints and deep interosseous ligaments. After confirming the positive response [more than 50% of pain relief], sensory stimulation was applied to detect the 'pathological' branches. Subsequently, RF neurotomies were performed on the selected nerve branches. Surgical outcome was graded as successful, moderate improvement, and failure after a 6month follow-up period. Results : Stimulation intensity was 0.45V to elicit pain response in the L5 dorsal rami and lateral sacral branches. The number of RF-lesioned nerve branches was 6per patient. The average number of lesions for each branch was 1.3. Most commonly selected branches were L5 dorsal ramus [88%] and S2-upper division [88%]. Ten patients [63%] reported a successful outcome according to the outcome criteria after 6months of follow-up, and five patients [31%] reported complete relief [100%]. Five patients [31%] showed moderate improvements. One patient reported failure. Conclusion : RF neurotomy of lateral sacral branches is an excellent treatment modality for the pain due to SIJD, provided that comparative controlled block shows a positive response.

• The Korean Journal of Pain
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• v.24 no.1
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• pp.48-52
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• 2011

Occipital neuralgia is usually defined as paroxysmal stabbing pain in the greater or lesser occipital nerve (GON or LON) distribution. In occipital neuralgia patients, surgical considerations are carefully taken into account if medical management is ineffective. However, identification of the occipital artery by palpation in patients with thick necks or small occipital arteries can be technically difficult. Therefore, we established a new technique using transcranial Doppler (TCD) sonography for more accurate and rapid identification. The patient was a 64-year-old man who had undergone C1-C3 screw fixation and presented with intractable stabbing pain in the bilateral GON and LON distributions. In cases in which pain management was performed using medication, physical therapy, nerve block, or radiofrequency thermocoagulation, substantial pain relief was not consistently achieved, and recurrence of pain was reported. Therefore, we performed occipital neurectomy of the bilateral GON and LON by using TCD sonography, which helped detect the greater occipital artery easily. After the operation, the patient’s headache disappeared gradually, although he had discontinued all medication except antidepressants. We believe that this new technique of occipital neurectomy via a small skin incision performed using TCD sonography is easy and reliable, has a short operative time, and provides rapid pain relief.

• The Korean Journal of Pain
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• v.34 no.4
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• pp.375-393
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• 2021

Percutaneous osteoplasty (POP) is defined as the injection of bone cement into various painful bony lesions, refractory to conventional therapy, as an extended technique of percutaneous vertebroplasty (PVP). POP can be applied to benign osteochondral lesions and malignant metastatic lesions throughout the whole skeleton, whereas PVP is restricted to the vertebral body. Common spinal metastases occur in the thoracic (70%), lumbosacral (20%), and cervical (10%) vertebrae, in order of frequency. Extraspinal metastases into the ribs, scapulae, sternum, and humeral head commonly originate from lung and breast cancers; extraspinal metastases into the pelvis and femoral head come from prostate, urinary bladder, colon, and uterine cervical cancers. Pain is aggravated in the dependent (or weight bearing) position, or during movement (or respiration). The tenderness and imaging diagnosis should match. The supposed mechanism of pain relief in POP is the augmentation of damaged bones, thermal and chemical ablation of the nociceptive nerves, and local inhibition of tumor invasion. Adjacent (facet) joint injections may be needed prior to POP (PVP). The length and thickness of the applied needle should be chosen according to the targeted bone. Bone cement is also selected by its osteoconduction, osteoinduction, and osteogenesis. Needle route should be chosen as a shortcut to reach the target bony lesions, without damage to the nerves and vessels. POP is a promising minimally invasive procedure for immediate pain relief. This review provides a technical survey for POPs in painful bony lesions.

• The Korean Journal of Pain
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• v.8 no.2
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• pp.235-243
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• 1995

A retrospective study was performed to evaluate the effects, and side effects, of epidural analgesia for postoperative pain relief of 2,381 surgical patients who received general-epidural, or epidural anesthesia only. Anesthesia records, patients charts, and pain control records were reviewed and classified according to: age, sex, body weight, department, operation site, epidural puncture site, degree of pain relief by injection mode & epidural injectate, and side effects(including nausea, vomiting, pruritus, urinary retention and respiratory depression). The results were as follows: 1) From the total of 2,381 patients, there were 1,563(66%) female patients; 1.032(43%) patients were from Obstetrics and Gynecology. 2) Lower abdomen, thorax, lower extremity and upper abdomen in the operation site; and lumbar, upper, lower thoracic in puncture site were order of decreasing frequency. Length of epidural injection for pain relief averaged $1.72{\pm}1.02$ days. 3) Ninety three percent of the patients experienced mild or no pain in the postoperative course. Analgesic quality was not affected by the kind of epidural injectate. 4) Nausea occurred in 3.2% of all patients, vomiting in 1.1%, pruritus 0.9%, urinary retention 0.6%, respiratory depression 0.08%. 5) Frequency of nausea was higher with female patients compared to male patients(p<0.05). 6) Pruritus frequency was higher with male patients than female patients(p<0.05); and more frequent with patients who received epidural injection with morphine than patients who received epidural injection without morphine(p<0.01). 7) Urinary retention was higher in female patients, and more frequent with patients who had received epidural injection with morphine than epidural injection without morphine(p<0.05). 8) There were two cases of respiratory depression. The course of treatment consisted of: cessation of epidural infusion, then administration of oxygen and intravenous naloxone. We conclude that postoperative epidural analgesia with a combination of local anesthetics and opiate is and effective method for postoperative pain relief with low incidence of side effects. However, patients should be carefully evaluated as rare but severe complications of respiratory depression may ensue.