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요하지통 환자에서 선택적 경추간공 경막외강 블록의 예후 인자

Other Titles
 The Prognostic Factors of Selective Transforaminal Epidural Block in Patients with Low Back Pain 
Authors
 최병인  ;  한정미  ;  이윤우  ;  권태동 
Citation
 Korean Journal of Pain (대한통증학회지), Vol.20(1) : 54-59, 2007 
Journal Title
 Korean Journal of Pain  (대한통증학회지) 
ISSN
 1226-2579 
Issue Date
2007
Abstract
Background Selective transforaminal epidural block (STEB) has showen effectiveness as a diagnostic and therapeutic option for the management of patients with low back pain or sciatica. This study was carried out in order to determine the short-term effects and prognostic factors associated with STEB in patients with low back pain or sciatica. Methods Ninety-seven patients were selectedfor participation in this study. Their diagnosis were based werewason the clinical symptoms and MRI findings. We performed STEB under fluoroscopic guidance and injected 3 ml of radio opaque dye in order to confirm the technical success of the procedure. We then injected 20 mg of triamcinolone mixed into 3 ml of 0.5% mepivacaine. One month later, we classified the patient outcomes as excellent, good, moderate or poor, according to the degree of reduction in VAS score from baseline. The independent variables assessed included symptom duration, block level, number of blocks, primary diagnosis, prior caudal block, anterior epidural space filling of dye, medication history, demographic data, radiating pain, back surgery and spondylolisthesis. Results At a mean follow-up period of 1 month after STEB, excellent results were noted in the patients diagnosed with herniated lumbar disc (70%), non-specific spondylosis (54%), spinal stenosis (44%), and failed back syndrome (28%). The patients with epidural adhesion and combined spondylolisthesis were associated with poorer outcomes. Combined caudal block, symptom duration and the extent of epidural spread of the drug were not related to the effectiveness of the treatment. Conclusions Selective transforaminal epidural block is effective in treating patients with radiculopathy, such as herniated lumbar disc, but it isrelatively ineffective in treating patients with structural deformities, such as failed back syndrome and spondylolisthesis.
Files in This Item:
T200700355.pdf Download
DOI
10.3344/kjp.2007.20.1.54
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
권태동(Kweon, Tae Dong) ORCID logo https://orcid.org/0000-0002-5451-1856
이윤우(Lee, Youn Woo)
최병인(Choi, Byung In)
한정미(Han, Jeong Mi)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/96435
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