| A Rapid Pain Management and Possible Mechanism of Severe Acute Low Back Pain after Traumatic Event : A Comparative Analysis of Spinal Injection Therapy with Segmental 3-Column Theory |
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Hyeun Sung Kim1, Kun Soo Jang2 |
1Department of Neurosurgery, Nanoori Hospital, Suwon, Korea
2Department of Neurosurgery, 365 Yeollin Hospital, Taean, Korea |
Correspondence:
Kun Soo Jang, Tel: 82-41-671-1365, Fax: 82-41-675-9708,
Email: deme2000@naver.com
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| Abstract |
Objective
In case of severe acute low back pain (LBP) after traumatic event, early effective management is unknown because mechanism of acute LBP has yet to be established. The purposes of this study were to evaluate the outcome of spinal injection therapy according to segmental 3-column theory and to discuss the possible mechanism of acute LBP.
Methods
This prospective study included 235 patients. All the patients had experienced a critical traumatic event such as lifting or snapping and had visual analogue scale (VAS) of 7 or greater. On the basis of the segmental 3-column concept, the patients were divided into 4 groups : group A, no segmental injection group; group B, 1-column injection group; group C, 2-column injection group; and group D, 3-column therapy group. Clinical outcomes were assessed by using the VAS. Total follow-up period was two weeks. Magnetic resonance imaging (MRI) scans were also evaluated before the treatment.
Results
All the treatments of each group were shown to be statistically effective for control of acute LBP. But, compared to that in other groups, the decrease in the VAS score of group D (3-column therapy group) was statistically significant. And, derangement patterns of the intervertebral disc were observed on MRI in all groups.
Conclusion
Severe acute LBP after the traumatic event is likely to occur from the segmental 3-column distress. Therefore, it would be better for patient to have the 3-column therapy. Additionally, internal disc derangement could be the measure to allow us to know the status of 3-column distress. |
| Key Words:
Acute pain; Low back pain; Spinal injections; Spinal column; Intervertebral disc. |
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