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연구 계획: Level III, 후향적 연구목적: 만성 요통을 주소로 내원한 환자에 대하여 외래에서 초음파 후관절 차단술군과 투시기하 후관절 차단술군, 보존적 치료군으로 나누어 그 결과를비교하였다. 선행 문헌의 요약: 초음파를 이용한 척추 후관절 주사요법에 대한 문헌 보고나 치료 효과에 대한 논문은 찾을 수 없었다. 대상 및 방법: 2009년 10월부터 2011년 3월까지 3달 이상의 요통을 호소하여 본원 외래 내원한 환자를 대상으로 하였다. 이중 수술 받은 과거력이 없고 신경근 증상을 호소하지 않는 환자에서 최소 3회 이상의 외래 진료, 1년의 추시가 가능하였던 98명의 환자를 조사하였다. 초음파 후관절 차단술을 시행한 군은 27명이였으며, 투시기하 후관절 차단술을 시행한 군은 39명, 약물 투여를 이용한 보존적 치료를 시행한 군은 32명이였다. 이에 대하여 일상생활 수행 능력 및 통증의 호전 정도에 대하여 조사하였다. 통증의 호전 정도는 시행전, 시행 후 1주 후, 4주 후, 3개월 후 외래 방문시 조사 하였다. VAS score, Kim’s criteria를 이용하였으며, 일상생활 수행 능력에 대하여 ODI score, Physician’s global assessment(subjective), Patient’s global assessment(Objective)를 이용하여 평가하였다. 통계 방법으로는 시술전과 시술후의 임상적인 각 항목의 평균 점수 차이를 알아 보기 위해 대응표본(paired-sample) t-test 를 시행하였고, 집단 간 분석에서는 분산분석(ANOVA)을 이용하여 각 통계 결과의 P value이 0.05 미만인 것을 유의한 것으로 하였다. 결과: VAS score는 초음파 후관절 차단술군에서 치료전 7.75, 투시기하 후관절 차단술군에서 7.81, 보존적 치료군에서 7.87이었으며, 1년 추시상에서각각 3.75, 4.39, 5.88로 호전되었다. 초음파 후관절 차단술과 투시기하 후관절 차단술을 시행한 군에서 보존적 치료군보다 VAS 및 Kim Score의 호전이 유의하게 나타났으며(P<0.05), ODI score, Physician’s global assessment(subjective), Patient’s global assessment(Objective)도 유의하게 호전이 있었다. 결론: 만성적 요통을 호소하는 외래 환자군에서 초음파를 이용한 후관절 차단술은 약물을 이용한 보존적 치료군과 비교하였을 때 임상적 호전 정도의차이에서 더 좋은 결과를 얻었다.


Study Design: Level III, retrospective studies. Objectives: This study is conducted to evaluate the effect and usefulness of ultrasound guided facet block for the outpatients who complained of chronic lower back pain. Summary of Literature Review: Facet joint syndrome was introduced in 1976, by Mooney V. It was considered to be one of the major causes of low back pain. Materials and Methods: Between October 2009 to March 2011, 98 cases were selected from the outpatients who complained of chronic lower back pain for more than 3 months. The patients had no surgery history and did not complain of neuromuscular symptoms, and they had more than three times outpatient care at least and could be followed up for 1 year. The patients were divided into three groups; first was the ultrasound guided facet block group (27 cases), second was the Fluoroscopy guided facet block group (39cases) and third was the conservative group (32 cases).The clinical results were analyzed using Kim’s criteria and the Visual Analog Scale score, ODI score, Physician’s global assessment (subjective), Patient’s global assessment (Objective). Results: The VAS score was improved from an average of 7.75±1.5 to 4.47±2.4 in the ultrasound guided facet block group, and from 7.81±1.4 to 4.39 ±2.6 in the Fluoroscopy guided facet block group, and from 7.87±1.3 to 6.24±2.1 in the conservative group. The VAS score, Kim’s criteria, ODI score, Physician’s global assessment (subjective), and Patient’s global assessment (Objective) showed statistically significant improvement in the ultrasound guided facet block group and Fluoroscopy guided facet block group. Conclusion: In the outpatient clinics, comparing with the group that underwent conservative treatment with medication, the group treated with ultrasound for block could have better results in clinical improvement.


Study Design: Level III, retrospective studies. Objectives: This study is conducted to evaluate the effect and usefulness of ultrasound guided facet block for the outpatients who complained of chronic lower back pain. Summary of Literature Review: Facet joint syndrome was introduced in 1976, by Mooney V. It was considered to be one of the major causes of low back pain. Materials and Methods: Between October 2009 to March 2011, 98 cases were selected from the outpatients who complained of chronic lower back pain for more than 3 months. The patients had no surgery history and did not complain of neuromuscular symptoms, and they had more than three times outpatient care at least and could be followed up for 1 year. The patients were divided into three groups; first was the ultrasound guided facet block group (27 cases), second was the Fluoroscopy guided facet block group (39cases) and third was the conservative group (32 cases).The clinical results were analyzed using Kim’s criteria and the Visual Analog Scale score, ODI score, Physician’s global assessment (subjective), Patient’s global assessment (Objective). Results: The VAS score was improved from an average of 7.75±1.5 to 4.47±2.4 in the ultrasound guided facet block group, and from 7.81±1.4 to 4.39 ±2.6 in the Fluoroscopy guided facet block group, and from 7.87±1.3 to 6.24±2.1 in the conservative group. The VAS score, Kim’s criteria, ODI score, Physician’s global assessment (subjective), and Patient’s global assessment (Objective) showed statistically significant improvement in the ultrasound guided facet block group and Fluoroscopy guided facet block group. Conclusion: In the outpatient clinics, comparing with the group that underwent conservative treatment with medication, the group treated with ultrasound for block could have better results in clinical improvement.