Percutaneous Sacroplasty for the Sacral Insufficiency Fracture Caused by Metastasis / 대한통증학회지

Insufficiency fractures of the sacrum are relatively common and cause severe low back and buttock pain. Percutaneous vertebroplasty is effective for treating vertebral compression fractures. We present a case of percutaneous sacroplasty for the treatment of low back and buttock pain in a sacral insufficiency fracture. A 79-year-old male with non-small lung cancer presented with severe low back and buttock pain after series of radiation treatments. Preoperative MRI showed both a sacral ala and S2 metastatic insufficiency fracture. An epidural port was inserted for continuous morphine infusion and sacral nerve root blocks were performed. However, his pain did not diminish and we attempted percutaneous sacroplasty. Both sides of the sacroplasty were done with a fluoroscopy-guided technique with 1.7 ml and 2.3 ml of bone cement injected into the right and left sacral ala. Pain relief was significant and the patient was able to sit down 1 day after the procedure.

A Comparison of Personality Characteristics in Trigeminal Neuralgia and Atypical Facial Pain Using Minnesota Multiphasic Personality Inventory (MMPI) / 대한마취과학회지

BACKGROUND: Trigeminal neuralgia and atypical facial pain are representative disease entities of chronic facial pain. Most patients of these disaeses could be accompanied with psychological, emotional problems as their pain become chronic. The purpose of this study is to investigate whether different types of chronic facial pain lead to alteration in personality disorder or they are associated with particular characteristics of personality disorders using Minnesota multiphasic personality inventory (MMPI). METHODS: 40 patients of trigeminal neuralgia and 21 patients of atypical facial pain who had responded MMPI were enrolled in this study. Two groups were compared for age, sex, pain intensity (Visual analogue scale, VAS), duration of pain, MMPI scores and psychological impression from MMPI results. RESULTS: Pain intensity and chronicity were more severe and longer in trigeminal neuralgia group than atypical facial pain. However, some MMPI profiles such as hypochondriasis and hysteria were significantly elevated in atypical facial pain. Pain intensity and duration did not correlate with MMPI profiles in each group. Meaningful psychological impression from MMPI results which were interpreted by one psychologist were shown in 13 patients of trigeminal neuralgia (32.5%) and 14 patients of atypical facial pain (66.7%). Especially, psychosomatic disorder was most frequently found in atypical facial pain patients (47.6%). CONCLUSIONS: Atypical facial pain have more psychologic and emotional problems than trigeminal neuralgia, regardless of pain intensity and chronicity. Therefore, psychologic evaluation and treatment should be considered in atypical facial pain.