Journal of Yeungnam Medical Science

Original article

Neurosurgery
Quantitative evaluation of upper extremity strength recovery after cervical epidural block: a retrospective study: Dong Hyuck Kim, Do Yun Kwon, Kwang-Ryeol Kim; J Yeungnam Med Sci. 2025;42:73. Published online November 13, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.73

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Abstract PDF: Background
We aimed to evaluate the clinical efficacy of cervical epidural block (CEB) in enhancing upper extremity (UE) muscle strength in patients with cervical disc herniation (CDH).
Methods
Ten patients with CDH underwent a single CEB session. Follow-up assessments were conducted weekly for 2 weeks through outpatient visits. Handgrip strength on the affected side (AHGS) and the interlateral difference in handgrip strength (DHGS) between the affected and unaffected sides were measured using a dynamometer before, immediately after, 1 and 2 weeks after CEB. Neck pain and radiating UE pain were assessed using a visual analog scale (VAS) at baseline and 2 weeks posttreatment.
Results
The median patient age was 46.4 years (range, 35–78 years). The affected disc levels were C5–6 in five patients, C6–7 in three, and C5–6–7 in two. The left side was affected in six patients and the right in four. The mean VAS score for neck pain decreased from 7.2 to 2.9, whereas that for radiating UE pain decreased from 6.3 to 2.8 after treatment. Both the AHGS and DHGS improved significantly compared to the baseline values at all posttreatment times. However, no significant differences were observed among the posttreatment time points. These findings remained consistent even after adjusting for age and sex.
Conclusion
CEB may offer therapeutic benefits by alleviating pain and improving UE muscle weakness in patients with CDH. However, further large-scale prospective studies are required to validate these preliminary results and determine the long-term efficacy of CEB in managing CDH.

Case report

Musculoskeletal Disorders
Focal hand dystonia due to hemorrhage of the cervical spinal mass: a case report: Pelin Analay, Hazal Sevinç, Hilmi Berkan Abacıoğlu, Rahşan Göçmen, Bayram Kaymak, Levent Özçakar; J Yeungnam Med Sci. 2025;42:10. Published online November 26, 2024; DOI: https://doi.org/10.12701/jyms.2024.01123

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Abstract PDF Supplementary Material: Dystonia is a movement disorder characterized by intermittent or sustained muscle contractions that lead to abnormal postures and/or repetitive movements. Although dystonia is traditionally considered a disorder of the basal ganglia, it has been observed in association with lesions at various sites of the motor and sensory pathways, including spinal cord pathologies such as syringomyelia, tumors, and demyelinating lesions. However, there has been an increasing number of focal dystonia cases due to peripheral injuries, such as soft tissue trauma, mononeuropathy, plexopathy, and radiculopathy. In this report, to the best of our knowledge, we present the first case of a patient who developed focal hand dystonia due to cervical mass hemorrhage. We review the literature and discuss possible mechanisms.

Original article

Anesthesiology and Pain Medicine
Digital subtraction angiography vs. real-time fluoroscopy for detection of intravascular injection during transforaminal epidural block: Kibeom Park, Saeyoung Kim; Yeungnam Univ J Med. 2019;36(2):109-114. Published online January 24, 2019; DOI: https://doi.org/10.12701/yujm.2019.00122

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7 Crossref

Abstract PDF

Background
Transforaminal epidural block (TFEB) is an effective treatment option for radicular pain. To reduce complications from intravascular injection during TFEB, use of imaging modalities such as real-time fluoroscopy (RTF) or digital subtraction angiography (DSA) has been recommended. In this study, we investigated whether DSA improved the detection of intravascular injection during TFEB at the whole spine level compared to RTF.
Methods
We prospectively examined 316 patients who underwent TFEB. After confirmation of final needle position using biplanar fluoroscopy, 2 mL of nonionic contrast medium was injected at a rate of 0.5 mL/s under RTF; 30 s later, 2 mL of nonionic contrast medium was injected at a rate of 0.5 mL/s under DSA.
Results
Thirty-six intravascular injections were detected for an overall rate of 11.4% using RTF, with 45 detected for a rate of 14.2% using DSA. The detection rate using DSA was statistically different from that using RTF (p=0.004). DSA detected a significantly higher proportion of intravascular injections at the cervical level than at the thoracic (p=0.009) and lumbar (p=0.011) levels.
Conclusion
During TFEB at the whole spine level, DSA was better than RTF for the detection of intravascular injection. Special attention is advised for cervical TFEB, because of a significantly higher intravascular injection rate at this level than at other levels.

Citations

Citations to this article as recorded by

Feasibility of Ultrasound-Guided Lumbar Transforaminal Epidural Steroid Injections for Management of Lumbar Radicular Back Pain
Amaresh Vydyanathan, Priya Agrawal, Khaled Donia, Sayed Wahezi, Sarang Koushik, Kateryna Slinchenkova, Karina Gritsenko, Naum Shaparin
Journal of Pain Research.2025; Volume 18: 759. CrossRef
The Importance of Image Guidance in Common Spine Interventional Procedures for Pain Management: A Comprehensive Narrative Review
Martina Rekatsina, Philip W. H. Peng
Pain and Therapy.2025; 14(3): 841. CrossRef
1. Lumbosacral radicular pain
Laurens Peene, Steven P. Cohen, Jan Willem Kallewaard, Andre Wolff, Frank Huygen, Antal van de Gaag, Steegers Monique, Kris Vissers, Chris Gilligan, Jan Van Zundert, Koen Van Boxem
Pain Practice.2024; 24(3): 525. CrossRef
Safety of local anesthetics in cervical nerve root injections: a narrative review
Zachary E. Stewart
Skeletal Radiology.2023; 52(10): 1893. CrossRef
An update on technical and safety practice patterns in transforaminal epidural steroid injections
Ashley E. Gureck, Berkenesh Gebrekristos, Razvan Turcu, Dana Kotler, Alec L. Meleger
Interventional Pain Medicine.2023; 2(4): 100286. CrossRef
Thoracic transforaminal epidural steroid injection for management of thoracic spine pain: A multicenter cross-sectional study of short-term outcomes
Josh Levin, John Chan, Lisa Huynh, Matt Smuck, Jayme Koltsov, Bilge Kesikburun, Graham E. Wagner, Marc Caragea, Keith Kuo, Zachary L. McCormick, Byron Schneider, Evan Berlin, D.J. Kennedy, Serdar Kesikburun
Interventional Pain Medicine.2022; 1(1): 100004. CrossRef
The American Society of Pain and Neuroscience (ASPN) Best Practices and Guidelines for the Interventional Management of Cancer-Associated Pain
Mansoor M Aman, Ammar Mahmoud, Timothy Deer, Dawood Sayed, Jonathan M Hagedorn, Shane E Brogan, Vinita Singh, Amitabh Gulati, Natalie Strand, Jacqueline Weisbein, Johnathan H Goree, Fangfang Xing, Ali Valimahomed, Daniel J Pak, Antonios El Helou, Priyanka
Journal of Pain Research.2021; Volume 14: 2139. CrossRef

Original Article

Anesthesiology and Pain Medicine
A comparison of 0.075% and 0.15% of ropivacaine with fentanyl for postoperative patient controlled epidural analgesia after laparoscopic gynecologic surgery: Hyun Chul Jung, Hyo Jung Seo, Deok Hee Lee, Sang Jin Park; Yeungnam Univ J Med. 2017;34(1):37-42. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.37

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Abstract PDF: BACKGROUND
A motor blockade of lower limbs interferes with early ambulation and limits the usefulness of patient-controlled epidural analgesia (PCEA). The concentration of local anesthetic solution is a major determinant for motor block with PCEA. We compared the effects of epidural infusion of 0.075% ropivacaine with 0.15% epidural ropivacaine on postoperative analgesia, motor block of lower limbs, and other side effects. METHODS: A total of 70 patients undergoing laparoscopic gynecologic surgery received epidural infusions (group R1, 0.15% ropivacaine with fentanyl; group R2, 0.075% ropivacaine with fentanyl). Pain score, motor block, and side effects (hypotension, nausea, vomiting, pruritus, urinary retention, dizziness, and numbness) were measured. RESULTS: There were no significant differences in the demographic profiles between the groups. Pain scores of the group R1 and the group R2 were not significantly different. Motor block was more frequent in the group R1 (0.15% ropivacaine with fentanyl) than in the group R2 (0.075% ropivacaine with fentanyl). CONCLUSION: Lower concentration of ropivacaine (0.075%), when compared with higher concentration of ropivacaine (0.15%), seemed to provide similar analgesia with less motor blockade of the lower limbs for the purpose of PCEA.

Case Reports

Nephrology
Two Cases of Spinal Epidural Abscess in Hemodialysis Patients.: Young Hwan Kim, Jin Taek Yoo, Soon Myung Jung, Sang Chang Kwon, Seung Min Ryu, Mun Jang, Jung Choi; Yeungnam Univ J Med. 2013;30(1):36-38. Published online June 30, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.1.36

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Abstract PDF: While epidural abscesses are rare in hemodialysis patients, they can cause severe neurological complications that can be fatal because only nonspecific symptoms appear in the early stages of the infection. Their incidence increased recently due to intravenous drug abuse, invasive spinal surgery, percutaneous vertebral procedures, and the development of diagnostic modalities. The increased number of cases is related to the use of dialysis catheters in hemodialysis patients. If a patient has fever and back pain, doctors should eliminate the possibility of other common diseases and consider spinal epidural infection. Early diagnosis and proper treatment are important to prevent neurological complications. In this paper, the symptoms, blood work, magnetic resonanceimaging (MRI) findings, and clinical course of two hemodialysis patients who developed spinal epidural abscesses are described.

Neurosurgery
Nonsurgical Management of Parasagittal Epidural Hematoma Report of 4 Cases.: Dong Soo Nam, Seong Ho Kim, Bum Dae Kim, Jang Ho Bae, Eun Sig Doh, Oh Lyong Kim, Yong Chul Chi, Byung Yearn Choi, Soo Ho Cho, Jow Hyuk Ihm; Yeungnam Univ J Med. 1990;7(2):173-179. Published online December 31, 1990; DOI: https://doi.org/10.12701/yujm.1990.7.2.173

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Abstract PDF: Nonsurgical management of four cases of the parasagittal epidural hematoma were experienced. Patients were mildly symptomatic or minimal neurological disturbances on admission. Patients were treated conservatively because of stable neurologic sign. All patients had who diastatic fracture and / or suture have become a complete neurological recovery with satisfactory absorption of EDH over a period of 5 to 12 weeks.

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