The Effect of Nerve Root Block on the Patients Who Are Considered as Surgical Candidates with Cervical Radicular Pain / 대한정형외과학회잡지

PURPOSE: This study was conducted to evaluate the effect and usefulness of cervical selective nerve root block in advance for the patients who was scheduled for operation. MATERIALS AND METHODS: Between January 2001 to December 2008, 28 cases were selected from the patients, who underwent selective nerve root block before operation. The mean follow-up period was 30.4 months and the mean age was 59.2 years. The patients were divided into the operation group and the only cervical nerve root block group. The groups were compared for age, gender, the contraction period and the, solidity of the disc. The groups were radiologically evaluated for the existence of cervical spondylosis and the neural compression rate. The clinical results were analyzed using the neck disability index (NDI) and the visual analogue scale (VAS) score. RESULTS: Among the 28 cases that were scheduled for operation, 18 cases did not proceed to operation and 10 cases among them were treated with additional conservative treatment. The average VAS score for the operation group and the cervical nerve root block group was 8.3 and 7.7 at the preoperative state and the preinjection state, respectively. After surgical treatment and cervical nerve root block, the scores were 3.2 and 3.6, respectively. The NDI for the operation group was 40.6 at the preoperative state and this decreased to 11.2 at the last follow up. The NDI for the cervical nerve root block group was 38.4 at the preinjection state and this decreased to 13.6 at the last follow up. The mean contraction period was 3.2 months and the mean age was 51.9 years for the operative group. The mean contraction period was 14.82 months and the mean age was 55.9 years for the root block group. There was no difference of clinical outcomes between the operative group and the cervical nerve root block group. The operation group's mean age was younger and the duration of symptom was shorter than those of the cervical nerve root block group. CONCLUSION: Cervical nerve root block is considered to be an effective treatment for patients with cervical disc herniation with radiating pain and who are scheduled for an operation.

The Results of the P.F.C(R) Sigma(TM) RP-F Knee System in High Flex Rotating Platform Total Knee Arthroplasty -Comparison of Preoperative Range of Motion less than 90degrees Versus more than 90degrees-

PURPOSE: The purpose of this study was to evaluate the clinical and radiological results of using the P.F.C(R) Sigma(TM) RP-F Knee System for high flex rotating platform-flexion total knee arthroplasty in 2 groups of patients with a preoperative range of motion (ROM) less than 90 degrees or more than 90 degrees, respectively. MATERIALS AND METHODS: From January 2005 to November 2006, eighty-two patients received the P.F.C(R) Sigma(TM) RP-F Knee System for high flex rotating platform total knee arthroplasty, and they were evaluated for a minimum of 3 years. We subdivided the patients into two groups: the preoperative ROM less than 90degrees group and the more than 90degrees group. The clinical results were assessed using the ROM, the Hospital for Special Surgery (HSS) score, the Knee Society Score (KSS) and the Western Ontario and MacMaster Universities Osteoarthritis (WOMAC) score. The radiological results were evaluated using the tibio-femoral angle and the presence of loosening or osteolysis of the components. RESULTS: The ROM increased in the two groups at the last follow-up. The mean ROM range at the last follow up was significantly increased more in the less than 90degrees group compared to that in the more than 90o group. The HSS score, KSS, and WOMAC score significantly increased in the two groups, but there was no statistical difference between the two groups. The tibio-femoral angle improved in the two groups. There was no aseptic loosening or osteolysis. CONCLUSION: The postoperative clinical and radiological measures were significantly improved using the P.F.C(R) Sigma(TM) RP-F Knee System on the short term follow-up, and especially for the patients whose preoperative ROM was poor.

Acute Spinal Cord Injury after Cervical Nerve Root Block / 대한정형외과학회잡지

Selective cervical nerve root block is a widely utilized nonsurgical strategy for the management of cervical radicular and axial pain. The technique has been shown to be efficacious in relieving the patient's symptoms. Although effective, there are a range of possible complications associated with this procedure. In particular, acute spinal cord injury after cervical nerve root block is very rare, but it lead to serious functional impairment. The literature on acute spinal cord injury is very small and there have been no reports from Korea. We experienced a case of a patient with an acute injury of the cervical spinal cord after cervical nerve root block who was followed 28 months.