Assessment of Clinical Outcome of Lumbar Transforaminal Foraminoplasty in Patients with Lumbar Spinal Stenosis.

Background: Lumbar spinal stenosis (LSS), a common spinal disorder that negatively affects quality of life, is a disabling condition accompanied by back pain, leg pain, and claudication. Lumbar foraminal stenosis (LFS) is often accompanied by lumbar central stenosis (LCS) and conservative treatment is often ineffective. A surgical approach, including a minimally invasive technique, is usually recommended for the conservative treatment of refractory conditions.

Contrast Runoff Correlates with the Clinical Outcome of Cervical Epidural Neuroplasty Using a Racz Catheter.

Background: Epidural neuroplasty using a Racz catheter has a therapeutic effect. Studies have found no correlation between foraminal stenosis and the outcome of epidural neuroplasty, which is thought to depend on contrast runoff.

Objective: To examine the correlation between the contrast spread pattern and pain reduction in cervical epidural neuroplasty using a Racz catheter.

Radiologic Analysis and Clinical Study of the Upper One-third Joint Technique for Fluoroscopically Guided Sacroiliac Joint Injection.

Background: Sacroiliac intraarticular injection by the traditional technique can be challenging to perform when the joint is covered with osteophytes or is extremely narrow.

Objective: To examine whether there is enough space for the needle to be advanced from the L5-S1 interspinous space to the upper one-third sacroiliac joint (SIJ) by magnetic resonance image (MRI) analysis as an alternative to fluoroscopically guided SIJ injection with the lower one-third joint technique, and to determine the feasibility of this novel technique in clinical practice.

Study Design: MRI analysis and observational study.

Assessment of clinical outcomes of cervical epidural neuroplasty using a Racz-catheter and predictive factors of efficacy in patients with cervical spinal pain.

Background: Epidural neuroplasty using the Racz catheter has a therapeutic effect in patients with cervical disc herniation and central stenosis who do not respond to fluoroscopically guided epidural injections.

Objective: To evaluate the clinical outcomes of cervical epidural neuroplasty in patients with posterior neck and upper extremity pain and to demonstrate correlations between predictive factors and unsuccessful results of cervical epidural neuroplasty.

Study Design: Observational study.

Ultrasound-guided Pararadicular Injection in the Lumbar Spine: A Comparative Study of the Paramedian Sagittal and Paramedian Sagittal Oblique Approaches.

Background: Ultrasound-guided nerve root blocks and transforaminal injections are well established, and several procedural feasibility studies have been reported. However, the contrast dispersion pattern during ultrasound-guided pararadicular injection has not been reported. We hypothesized that the paramedian sagittal oblique approach provides a superior intraforaminal contrast-spread pattern compared to the paramedian sagittal approach during ultrasound-guided pararadicular injections in the lumbar spine.

Assessment of factors affecting the difficulty of caudal epidural injections in adults using ultrasound.

Background: In unaided caudal epidural block (CEB), incorrect needle insertion has been reported to occur in 15% to 38% of attempts.

Objective: To statistically analyze the anatomical variables affecting difficult CEB using ultrasonographic measurement.

Methods: Preprocedural ultrasonography was performed and the following measurements were obtained in 146 patients: the distance from the skin to the apex of the sacral hiatus; the depth of the sacral canal at the apex of the sacral hiatus; the length of the sacrococcygeal ligament between the apex of the sacral hiatus and sacral base; the distance from the skin to the apex of the sacral cornu; and the distance between the apexes of bilateral cornua.

Genome-wide expression profiling of complex regional pain syndrome.

Complex regional pain syndrome (CRPS) is a chronic, progressive, and devastating pain syndrome characterized by spontaneous pain, hyperalgesia, allodynia, altered skin temperature, and motor dysfunction. Although previous gene expression profiling studies have been conducted in animal pain models, there genome-wide expression profiling in the whole blood of CRPS patients has not been reported yet. Here, we successfully identified certain pain-related genes through genome-wide expression profiling in the blood from CRPS patients.

Ultrasound-guided Pulsed Radiofrequency of the Third Occipital Nerve.

A C2-3 zygapophygeal joint is a major source of cervicogenic headache. Radiofrequency (RF) neurotomy is preformed widely for zygapophygeal joint pain. Conventional RF denervation technique is generally performed under fluoroscopic control.

Anti-allodynic effects of levodopa in neuropathic rats.

Purpose: Levodopa is the most effective anti-Parkinsonian agent. It has also been known to exhibit analgesic properties in laboratory and clinical settings. However, studies evaluating its effects on neuropathic pain are limited.

Stevens-johnson syndrome induced by carbamazepine treatment in a patient who previously had carbamazepine induced pruritus - a case report -.

Stevens-Johnson syndrome (SJS) is a rare but life-threatening skin reaction disease and carbamazepine is one of its most common causes. We report a case of SJS secondary to carbamazepine in a patient with previous pruritus due to carbamazepine which was given for treatment of trigeminal neuralgia. We would like to caution all providers that carbamazepine readministration should be avoided in the patient with a previous history of SJS or adverse skin reaction.

Analgesic effects of dexmedetomidine in vincristine-evoked painful neuropathic rats.

Dexmedetomidine, which is a selective α2-adrenoceptor agonist, was recently introduced into clinical practice for its analgesic properties. The purpose of this study was to evaluate the effects of dexmedetomidine in a vincristine-evoked neuropathic rat models. Sprague-Dawley rats were injected intraperitoneally with vincristine or saline (0.

Ginkgo biloba extract attenuates hyperalgesia in a rat model of vincristine-induced peripheral neuropathy.

Background: Chemotherapy-induced peripheral neuropathy is a common, dose-limiting side effect of cancer chemotherapeutic drugs. Hyperalgesia is a common component of neuropathic pain. Ginkgo biloba extract (GBE) is an oriental herbal medicine that has various pharmacological actions.

Pain acceptance-based coping in complex regional pain syndrome Type I: daily relations with pain intensity, activity, and mood.

This study aimed to examine the temporal patterning of pain acceptance-based coping, activity, and mood in patients with complex regional pain syndrome Type I (CRPS-I), by using a daily diary method. A total of 30 patients with CRPS-I seeking treatment in a tertiary pain management center located in Seoul, Korea participated in the study. Multilevel random effects analyses indicated that (a) engagement in pain acceptance-based coping was significantly associated with lower same-day pain and negative mood and greater same-day activity and positive mood; (b) pain acceptance-based coping predicted increases in activity on the following day; (c) greater pain intensity was significantly associated with lower same-day pain acceptance-based coping and activity and greater same-day negative mood; and (d) pain intensity did not predict pain acceptance-based coping, activity, or mood on the following day.

The antinociceptive effect of acetaminophen in a rat model of neuropathic pain.

Acetaminophen is one of the most popular and widely used analgesics for the treatment of pain and fever but few studies have evaluated its effects on neuropathic pain. This study examined the effect of acetaminophen on thermal hyperalgesia, mechanical and cold allodynia in a rat model of neuropathic pain. Male Sprague-Dawley rats were prepared by tightly ligating the left L5 and L6 spinal nerves to produce a model of neuropathic pain.

A new technique for inferior hypogastric plexus block: a coccygeal transverse approach -a case report-.

Chronic pelvic pain is a common problem with variable etiology. The sympathetic nervous system plays an important role in the transmission of visceral pain regardless of its etiology. Sympathetic nerve block is effective and safe for treatment of pelvic visceral pain.

Ultrasound-guided Aspiration of the Iatrogenic Pneumothorax Caused by Paravertebral Block -A Case Report-.

Thoracic paravertebral block is performed for the treatment of patients with chronic pain, such as complex regional pain syndrome (CRPS) and post-herpetic neuralgia. Thoracic paravertebral block can result in iatrogenic pneumothorax. Because pneumothorax can develop into medical emergencies and needle aspiration or chest tube placement may be needed, early diagnosis is very important.

Sacral nerve stimulation for the treatment of sacroiliac joint dysfunction: A case report.

Introduction: Sacroiliac joint (SIJ) dysfunction is a significant contributing factor in 10-30% of individuals with lower back pain. However, definitive diagnostic methods and treatments are still controversial.

Methods: We present a case of a 41-year-old woman with left buttock pain, referred pain to the left leg, and dyspareunia.

Psychometric properties of a Korean version of the Chronic Pain Acceptance Questionnaire in chronic pain patients.

Purpose: Accepting pain rather than trying to control it has been the focus of recent pain management research. Pain acceptance often has been assessed using the chronic pain acceptance questionnaire (CPAQ). This study aimed to evaluate the factor structure and other psychometric properties of a Korean language version of the CPAQ (KCPAQ).

Daily functioning in chronic pain: study of structural relations with posttraumatic stress disorder symptoms, pain intensity, and pain avoidance.

Background: This study aimed to evaluate processes from the mutual maintenance model in relation to daily functioning in patients with both chronic pain and a history of a traumatic experience. The mechanism illustrated the structural relations for daily functioning among pain intensity, hyperarousal, re-experiencing, trauma avoidance, and pain avoidance.

Methods: Archival data (N = 214) was used for this study and data were analyzed for 142 chronic pain patients reporting a traumatic experience and seeking treatment at a tertiary pain clinic in Korea.

Reversible posterior leukoencephalopathy syndrome after cervical transforaminal epidural steroid injection presenting as transient blindness.

Transforaminal epidural steroid injections have been introduced as a nonsurgical treatment for cervical pain syndromes; however, they have also raised safety concerns. We present a patient who developed a headache and bilateral visual disturbance after cervical transforaminal epidural steroid injections. Brain magnetic resonance imaging showed a high signal intensity in the posterior region on T2-weighted and fluid-attenuated inversion recovery images, and the findings of diffusion-weighted imaging and the apparent diffusion coefficient map suggested vasogenic edema.

Efficacy and tolerability of pregabalin using a flexible, optimized dose schedule in Korean patients with peripheral neuropathic pain: a 10-week, randomized, double-blind, placebo-controlled, multicenter study.

Background: Clinical trials from various countries have reported the efficacy of pregabalin for reducing peripheral neuropathic pain.

Objective: This study assessed the efficacy and tolerability of pregabalin in Korean patients with neuropathic pain.

Methods: This was a Phase III, 10-week, randomized, double-blind, placebo-controlled, multicenter study.

The effects of preoperative intravenous acetaminophen in patients undergoing abdominal hysterectomy.

Purpose: Although intravenous acetaminophen is commonly used for the management of postoperative pain, very limited evidence supports the usefulness of preoperative administration. The aim of this study was to determine the analgesic effect of preoperative acetaminophen on opioid consumption, pain scores, and side effects in patients receiving an elective abdominal hysterectomy.

Methods: A randomized, double-blinded, placebo-controlled clinical trial was performed in 76 women undergoing abdominal hysterectomy.

Pharmacologic management of chronic pain.

Chronic pain is a multifactorial condition with both physical and psychological symptoms, and it affects around 20% of the population in the developed world. In spite of outstanding advances in pain management over the past decades, chronic pain remains a significant problem. This article provides a mechanism- and evidence-based approach to improve the outcome for pharmacologic management of chronic pain.

Ganglion impar block with botulinum toxin type a for chronic perineal pain -a case report-.

Chronic perineal pain is an often encountered problem, which produces a great degree of functional impairment and frustration to the patient and a challenge to the treating physician. The reason for this problem is that the region contains diverse anatomic structures with mixed somatic, visceral and autonomic innervations affecting bladder and bowel control and sexual function. A blockade of nociceptive and sympathetic supply to the perineal region, supplied through the ganglion impar has been shown to benefit patients with chronic perineal pain.