Corrigendum: The Usefulness of Selective Nerve Root Block for Failed Back Surgery Syndrome / 대한정형외과학회잡지

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The Usefulness of Selective Nerve Root Block for Failed Back Surgery Syndrome / 대한정형외과학회잡지

PURPOSE: To retrospectively evaluate the improvement of symptoms and diagnosis using selective nerve root block (SNRB) for radiating pain after spine surgery. MATERIALS AND METHODS: From October 2012 to October 2013, 112 patients with failed back surgery syndrome (41 male and 71 female, with the mean age of 62.4 years and range of 35 to 78 years), who were admitted and underwent SNRB, were included. All patients were followed-up for more than 12 months. Three groups were classified: Group 1 included patients with no improvement or aggravation of symptoms, group 2 included those with improvement of radiating pain, and group 3 included those with recurrence of radiating. RESULTS: Among the 112 patients, there were 15 patients in group 1, 59 patients in group 2, and 38 patients in group 3. Laminectomy was the highest surgical procedure, inducing failed back surgery syndrome. In group 2, the occurrence of failed back surgery syndrome was higher in case that radiating pain was complained more than 1 year before the first surgery. There is statistically significant symptom improvement in accordance with the visual analogue scale and Korean version of Oswestry disability index on every group after SNRB (p<0.05). CONCLUSION: It is considered that SNRB is expected to improve the symptoms and to find the cause of symptoms as a diagnostic value even after spine surgery.

The Usefulness of Selective Spinal Nerve Root Block in Neuropathic Pain Patients with Radiculopathy / 대한정형외과학회잡지

PURPOSE: This study was conducted in order to evaluate effect and efficiency of selective spinal nerve root block for neuropathic pain patients with lower leg radiating pain. MATERIALS AND METHODS: A total of 113 patients were evaluated and follow-up periods were a minimum of 12 months. They were divided into two groups: group A included 41 patients with neuropathic pain and group B included 72 patients with simple lower leg radiating pain. RESULTS: Fourteen (34.1%) patients in group A and 45 (62.5%) patients in group B had favorable results for selective spinal nerve block (p<0.05). Visual analog scale (VAS) was improved from 7.57 to 5.23 at 12 months in group A and from 7.11 to 3.49 at 12 months in group B. CONCLUSION: The initial treatment period for group A was significantly later than in group B. For patients with neuropathic pain and radiculopathy, early assessment was recommended and early selective spinal nerve block could be a good treatment option for neuropathic pain patients.

Comparison of Ultrasonography and MRI in Measuring of Cervical Soft Tissue Structure / 대한정형외과학회잡지

PURPOSE: We wanted to determine the usefullness of ultrasonography for exploring cervical anatomical structures and to compare its results with those of magnetic resonance imaging. MATERIALS AND METHODS: Between May, 2008 and January, 2009, 16 patient (8 male patients and 8 female patients, average age: 55.5 years old) with neck pain following in out patient clinic and who had cervical MRI performed were selected. By using ultrasonography, we measured the shortest distance of the internal carotid artery, internal jugular vein, sternocleidomastoid muscle and longus colli muscle based on the vertebral body of cricoid cartilage. We also measured the thickness of the longus colli muscle. We measured the average length of the shortest distance and thickness of C6 on MRI axial view. RESULTS: The length using ultrasonography showed that the average length was 2.12 cm for the internal carotid artery, 3.04 cm for the internal jugular vein, 4.34 cm for the sternocleidomastoid muscle and 0.68 cm for the longus colli muscle. Cervical MRI was used to measure the same structures. Its results were 2.23 cm for the internal carotid artery, 3.14 cm for the internal jugular vein, 4.39 cm for the sternocleidomastoid muscle and 0.70 cm for the longus colli muscle. We also measured the thickness of the longus colli muscle with ultrasonography and cervical MRI, and the results were 0.77 cm and 0.76 cm, respectively. There was no statistically significant difference between ultrasonography and MRI for the measurement of length, but there was a statistically significant difference for the measurement of thickness. CONCLUSION: There was a significant difference for the measurement of cervical anatomical stuctures using ultrasonography, and especially the longus coli thickness, as compared with that of MRI. Therefore, we suggest that ultrasonography can give more useful information for the diagnosis and treatment of problems in the cervical spinal field.

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.