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Facet joint injections for management of low back pain: a clinically focused review
원형선,양미영,김연동 대한마취통증의학회 2020 Anesthesia and pain medicine Vol.15 No.1
Lumbar facet joints have been implicated in chronic low back pain in up to 45% of patients with low back pain (LBP). Facet joint pain diagnosis and management are always challenging for pain physicians. Facet joint pain is not diagnosed by specific demographic features, pain characteristics, or physical findings, even though electrodiagnostic studies and imaging modalities are available. Although comparative local anesthetics or placebo saline injections can be used, diagnostic blocks are the only reliable diagnostic measures according to the current literature. Treatment of chronic LBP arising due to facet joint includes intraarticular injections, medial branch blocks, and radiofrequency neurotomy. However, the evidence of their clinical efficacy is continuously under scrutiny. Pain physicians must have a detailed understanding of the spinal anatomy in order to perform safe and effective interventional procedures. This review outlines the important aspects of spinal anatomy as they relate to interventional pain management related to facet joint injections. Additionally, we provide a comprehensive review of the procedure and clinical evidence.
원형선,정인혁 대한체질인류학회 2002 대한체질인류학회지 Vol.15 No.2
Morphologic Variations of the Thyroid Gland in Korean AdultsHyung sun Won1, In hyuk Chung
원형선,Hyung-Jin Won,오창석,한승호,정인혁,Dong-Hoan Kim 대한해부학회 2013 Anatomy & Cell Biology Vol.45 No.4
We report a rare case of a left inferior epigastric artery arising from the internal iliac artery via a common trunk with the obturator artery in an 84-year-old female cadaver. A common trunk for the inferior epigastric and obturator arteries firstly originated from the left internal iliac artery, at 3.0 mm below the bifurcation of the left common iliac artery. This trunk ran straight between the left external iliac artery and left external iliac vein, and was finally divided into the left inferior epigastric and left obturator arteries just superior to the inguinal ligament.
원형선(Hyung-Sun Won),오창석(Chang-Seok Oh),한승호(Seung-Ho Han),정인혁(In-Hyuk Chung) 대한해부학회 2009 Anatomy & Cell Biology Vol.42 No.4
자신경 죄임증후군은 손목굴증후군 다음으로 흔한 팔의 신경죄임증후군으로 주로 팔꿈치굴에서 생긴다고 알려져 있으나, 신경이 달리는 길 주위에 있는 구조들의 변이에 의해 다른 부위에서도 생길 가능성이 있다. 이 연구는 위팔에서 자신경 죄임증후군을 일으킬 수 있는 인대와 근육 변이를 밝히기 위하여 시도하였다. 한국 성인 시신 50구의 팔 100쪽을 사용하였다, 스트러더활은 34%에서 관찰되었으며, 대부분 좁은 띠모양이었으나, 드물게 60mm로 넓어져 있는 경우도 있었다, 스트러더활은 안쪽위관절융기로부터 평균 78.1±1.9mm 몸쪽에 있었다. 속위팔인대는 17%, 도르래위팔꿈치근은 3%에서 관찰되었다. 위팔세갈래근 안쪽갈래가 자신경을 감싸거나 덮고 있는 경우가 5%였다. 이 연구는 위팔에서 자신경을 누를 수 있는 인대와 근육변이를 밝힘으로써, 자신경 죄임증후군에 대한 이해를 높이고, 이를 진단하고 치료하는데도 도움을 줄 것으로 기대된다. Compressive neuropathy of the ulnar nerve occurs commonly at the cubital tunnel, but it can also be occurred by the anatomic variations of the structures on the ulnar nerve passage. This study was thus performed to clarify the variations of the ligaments and muscles, which can cause the ulnar nerve entrapment syndrome in the upperarm. One hundred arms of 50 Korean adult cadavers were used. The arcade of Struthers, a musculo-tendinous band from the medial head of the triceps brachii to the medial intermuscular septum, was observed in 34% of the cases. This arcade was mostly in a narrow-band shape, but a broad-band shaped arcade was sometimes observed. The internal brachial ligament was observed in 17% of cases. The epitrochleoanconeus muscle between the medial epicondyle and the ole-cranon was observed in 3% of cases. The ulnar nerve was wrapped or covered by the medial head of triceps brachii in 5% of cases. This study is expected to further the current understanding of the anatomic variations of ligaments and muscles on the ulnar nerve passage, and to be helpful data for the diagnosis and treatment of the ulnar nerve entrap-ment syndrome in the upper arm.