이평복 교수

BACKGROUND: The presence of a transitional vertebra can create difficulty in identifying the lumbar level corresponding to an exiting nerve root at the time of a spinal nerve block. We investigated the possibility that the muscle innervation pattern and sensory dermatomes of the lumbar nerve roots are altered when a lumbosacral transitional vertebra is present using electrical stimulation. METHODS: We determined the existence of transitional vertebrae using Castellvi's criteria. Patients having

OBJECTIVE: This study investigated psychological characteristics of patients with chronic complex regional pain syndrome (CRPS) and examined relationships between psychosocial factors and pain severity. METHODS: In total, 76 patients with CRPS, 95 patients with other types of chronic pain, 171 healthy controls, and 66 patients with major depressive disorder (MDD) were included. Minnesota Multiphasic Personality Inventory (MMPI-2) profiles and scores on the Beck Depression Inventory and State-Tra

BACKGROUND: Percutaneous adhesiolysis (PA) is considered to be a reasonable nonoperative treatment for herniation of intervertebral disc (HIVD), spinal stenosis, and post-lumbar-surgery syndrome (PLSS). The success of PA depends on the removal of epidural fibrosis and drug delivery to the target region. However, prognostic predictors of the effects of PA are not well known. OBJECTIVE: The aim of this study was to evaluate prognostic predictors of PA using a Racz catheter for patients with PLSS o

Non-particulate steroids can form crystals upon combination with local anesthetics. Crystal formation may be caused by alkalinization of steroids. The mixing of ropivacaine or levobupivacaine and betamethasone sodium phosphate may require caution during an epidural steroid injection. Lidocaine or bupivacaine is recommended as a local anesthetic. Dexamethasone palmitate is a candidate for a mixture, but additional studies on its safety and effectiveness are needed.

BACKGROUND: Topical capsaicin therapy may be of benefit in providing pain relief in patients with peripheral neuropathy. OBJECTIVES: To investigate the efficacy and safety of 0.625% (50 µg/cm2) and 1.25% (100 µg/cm2) capsaicin patches (CPs) compared to conventional 0.075% capsaicin cream or placebo patches in patients suffering from peripheral neuropathy. STUDY DESIGN: Early Phase II, multi-center, randomized, semi-double-blind, and placebo-controlled clinical trial. SETTING: Two medical college

Gabapentin acts primarily on the central nervous system. Therefore, we hypothesized that the direct epidural administration of gabapentin could have various advantages over its oral administration with respect to required dose, side effects, and efficacy. However, before administering gabapentin into the epidural space in a clinical setting, its neurotoxicity must be examined in animals. Thus, we evaluated neurotoxicity of epidural gabapentin by observing behavioral and sensory-motor changes, an

BACKGROUND: Percutaneous epidural adhesiolysis (PEA) is a minimally invasive procedure that is performed to relieve low back and/or lower limb pain secondary to adhesions or scarring in the epidural space that is refractory to conservative treatment. The optimal concentration of hypertonic saline might be an important factor in the safety and efficacy of PEA. We evaluated differences in the efficacy and safety of 2 concentrations of hypertonic saline (5% and 10%) used in lumbar PEA at our instit

BACKGROUND: Breast cancer-related lymphedema (BCRL) not only has physical implications, but also affects the quality of life in breast cancer survivors. Despite numerous studies of various therapies, the optimal treatment for BCRL is unknown. OBJECTIVE: In this study, we investigated the efficacy of sympathetic blockade (thoracic sympathetic ganglion block, [TSGB]) in treating BCRL. STUDY DESIGN: Retrospective study. SETTING: Tertiary referral center/teaching hospital. METHODS: TSGB was performe

Spinal stenosis is a common condition in elderly individuals. Many patients are unresponsive to the conventional treatment. If the transforaminal epidural block does not exert a sufficient treatment effect, percutaneous transforaminal epidural adhesiolysis (PTFA) through the safe-triangle approach using an inflatable balloon catheter can reduce the patients' pain and improve their functional capacity. We aimed to evaluate the safety and efficacy of the Kambin's-triangle approach for PTFA using a

OBJECTIVE: The positive effects of percutaneous epidural neuroplasty (PEN) likely result from elimination of fibrous tissue. However, a direct link between epidural adhesions and pain symptoms is debatable. We tested the hypothesis that epidurographic improvements correspond to improved patient outcome. METHODS: In this prospective study, patients with a filling defect on initial epidurography underwent PEN. Two weeks later, contrast agent distribution around the target area was assessed with re

BACKGROUND: Complex regional pain syndrome (CRPS) is a rare but debilitating pain disorder. Although the exact pathophysiology of CRPS is not fully understood, central and peripheral mechanisms might be involved in the development of this disorder. To reveal the central mechanism of CRPS, we conducted a proteomic analysis of rat cerebrum using the chronic postischemia pain (CPIP) model, a novel experimental model of CRPS. MATERIALS AND METHODS: After generating the CPIP animal model, we performe

Objective . Nonsurgical spinal decompression therapy (NSDT) is a conservative treatment for the lumbosacral herniated intervertebral disc (L‐HIVD). This study aimed to evaluate the clinical effectiveness of the NSDT and change in disc volume through magnetic resonance imaging (MRI) in subacute L‐HIVD. Methods . Sixty patients with subacute L‐HIVD were randomized into either the decompression group (group D, n = 30) or the nondecompression group (group N, n = 30). In group D, NSDT was performed t

BACKGROUND: Acute postoperative pain is a common complication of inguinal hernia repair. Pain management using local application of anesthetic agents over the skin surrounding the surgical incision may reduce the requirement for other pain medications. Targeted topical analgesics such as 5% lidocaine patches have been known to improve acute and chronic pain. However, the clinical effect of lidocaine patches on postoperative pain after inguinal hernia repair has not been studied, especially in pa