• Journal of Korean Medicine Rehabilitation
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• v.24 no.4
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• pp.41-48
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• 2014

Objectives The present study examines the domestic trend of Failed Back Surgery Syndrome (FBSS) in Korea. Methods The studies on FBSS were investigated via searching Korean web databases. As a result, 41 research papers were found and they were analyzed according to the year of publishment, the titles of journals which have the papers, the types of study, the definition of FBSS, employed treatment trials, and the instruments for assessment. Results The number of the research papers on FBSS published was increased since 2005. The studies on FBSS were mainly published in the Korean Journal of Pain. The most popular type of the studies were the case report and the most studies defined FBSS as persistent or recurring low back pain with or without sciatica after receiving spine surgeries. Various surgical and conservative treatments were employed in the studies and Visual Analogue Scale (VAS), Numeric Rating Scale (NRS), Oswestry Disability Index (ODI) were used as primary means of assessments. Conclusions Reviewing the domestic trends of studies on FBSS and examining the definition of FBSS is essential for the future studies because there is no clear criteria for making diagnosis of FBSS. Therefore, the further studies on FBSS need to be more elaborate with the definition of FBSS, and it is also necessary to apply more assessment tools for the better understanding of FBSS from various aspects. Ultimately, this review is anticipated to benefit the future in-depth study on FBSS.

• Journal of Communications and Networks
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• v.16 no.6
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• pp.627-638
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• 2014

In this paper, we study the joint price and power allocation in spectrum sharing macro-femtocell networks. The proposed game theoretic framework is based on bi-level Stackelberg game where macro base station (MBS) works as a leader and underlaid femto base stations (FBSs) work as followers. MBS has fixed data rate and imposes interference price on FBSs for maintaining its data rate and earns revenue while FBSs jointly adjust their power for maximizing their data rates and utility functions. Since the interference from FBSs to macro user equipment is kept under a given threshold and FBSs compete against each other for power allocation, there is a need to determine a power allocation strategy which converges to Stackelberg equilibrium. We consider two cases for MBS power allocation, i.e., fixed and dynamic power. MBS can adjust its power in case of dynamic power allocation according to its minimum data rate requirement and number of FBSs willing to share the spectrum. For both cases we consider uniform and non-uniform pricing where MBS charges same price to all FBSs for uniform pricing and different price to each FBS for non-uniform pricing according to its induced interference. We obtain unique closed form solution for each case if the co-interference at FBSs is assumed fixed. And an iterative algorithm which converges rapidly is also proposed to take into account the effect of co-tier interference on interference price and power allocation strategy. The results are explained with numerical simulation examples which validate the effectiveness of our proposed solutions.

• The Korean Journal of Pain
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• v.12 no.2
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• pp.191-194
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• 1999

Background: Millions of patients with chronic sciatica are still treated with epidural corticosteroids. The efficacy of epidural corticosteroids remains questionable, especially in the failed back surgery syndrome (FBSS). We studied to evaluate outcome for 10 patients with failed back surgery syndrome treated with spinal nerve root block using corticosteroids, hyaluronidase, and local anesthetics. Methods: The affected nerve roots are localized with the help of fluoroscopy and contrast dye. Local anesthetic diluted in 1,500 U hyaluronidase and 40 mg methylprednisolone is injected. A small retrospective pilot group of 10 patients with FBSS was treated. The success rate is evaluated using a visual analogue scale at 1 week and 3 month interval after the last injection. Results: Initially, 7 patients experienced good pain relief; 5 patients suspained pain relief for 3 months. No complications were observed. Conclusions: This technique is worthwhile for patients with FBSS and where epidural fibrosis is suspected to be the pain origin.

• Journal of Acupuncture Research
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• v.23 no.3
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• pp.67-75
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• 2006

Objectives : The purpose of this study is to evaluate the clinical effect of moxibustion treatment for FBSS patients by VAS. Methods : This clinical study was carried out for 51 cases with FBSS, who had been treated from January, 2003 to October, 2005, in oriental medical clinic. The patients were treated by the moxibustion during 8 weeks on the pain region of lower back or legs. We measured the effects of treatment by VAS. SPSS( Statistical Program for Social Science) for Windows was used for statistical analysis and repeated measures ANOVA was performed to gauge the improvement of VAS. Results : 1. We investigated 25 female and 26 male patients. The age distribution was from early 20's to 70's, among which 50's were most common. 2. The worsening factors are usually overwork and heavy lifting, but the main reason is unknown. 3. According to VAS, The patients with FBSS were improved by moxibustion treatment. Conclusion : Through this research, moxibustion therapy is considered to be effective and safe method for FBSS(Failed Back Surgery Syndrome). Moxibustion treatment had some problems that should be overcome such as severe pain and burning. Therefore we should pay more attention.

• The Korean Journal of Pain
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• v.37 no.1
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• pp.73-83
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• 2024

Background: Failed back surgery syndrome (FBSS) is a chronic condition that is characterized by persistent back pain following one or more spinal surgeries. Pharmacological interventions, such as the use of opioids and gabapentinoids, are frequently used in the treatment of FBSS. However, prolonged and excessive use of these medications can lead to dependence and adverse effects. This study investigates trends in opioid and gabapentinoid prescriptions among patients with FBSS in Korea from 2016 to 2020. Methods: Data from the Health Insurance and Review Agency were analyzed, and claims listing FBSS were selected for the study. Prescription patterns of opioids and gabapentinoids were classified based on the number of days prescribed per year. Results: Of the 390,095 patients diagnosed with FBSS, 41.6% of the patients were prescribed gabapentinoids, and 42.0% of them were prescribed opioids, while 10.6% of the patients were classified as long-term gabapentinoid users, 11.4% as long-term opioid users, and 7.4% of the patients were found to have long-term prescriptions for both drugs. The proportion of patients who received both gabapentinoid and opioid prescriptions increased annually. The doses of opioids prescribed have also increased along with the increase in the number of patients receiving opioid prescriptions. Conclusions: The prescription rates of opioids and gabapentinoids among patients with FBSS in Korea continue to increase steadily, posing potential risks of addiction and adverse effects. Further research is needed to better understand the actual status of addiction in patients with FBSS.

• Korean Journal of Acupuncture
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• v.28 no.3
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• pp.233-244
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• 2011

Objectives : To evaluate the effectiveness of direct moxibustion in patients with failed back surgery syndrome (FBSS). Methods : 5 patients (3 females and 2 males) with FBSS underwent direct moxibustion on ouch points (阿是穴) for 10 to 15 weeks (once a week). The effectiveness of the treatment was evaluated with NRS (numerical rating scale), ODI (Oswestry disability index), BDI (Beck depression inventory) score, SF-36 (short form 36 health survey) score and PSQI (Pittsburgh sleep quality index) before and after the treatment. Results : Within observation period, average value changed from 10.0 to 4.2 in NRS of pain, from 37.0 to 20.6 in ODI, from 20.6 to 12.0 in BDI score, 42.2 to 62.6 in SF-36 score, and from 8.6 to 5.2 in PSQI. Conclusions : Direct moxibustion on FBSS patients showed more or equivalent effectiveness when compared to conventional FBSS treatment modalities.

• The Korean Journal of Pain
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• v.19 no.1
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• pp.123-126
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• 2006

Spinal cord stimulation (SCS) has been used since 1967 for refractory chronic pain. SCS has recently undergone a variety of technical modifications and advances, and it has been applied in a variety of pain conditions. SCS has been most commonly applied for those patients with chronic back and leg pain and failed back surgery syndrome (FBSS). The clinical hallmark of FBSS is chronic postoperative pain. The pain pattern varies and the pain may show an axial or radicular distribution. Chronic intractable pain after FBSS is difficult to treat. This report describes our experience with treating chronic pain in two patients who suffered from FBSS with a spinal cord stimulator. A permanent spinal cord stimulator was implanted after a successful trial of stimulation with temporarily implanted electrodes. After 5 months of follow-up, the two patients had satisfactory improvement of their pain.

• The Journal of Internal Korean Medicine
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• v.40 no.1
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• pp.126-135
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• 2019

Background: Because of fear of reoperation and low efficiency, some patients with failed back surgery syndrome (FBSS) opt for Korean medicine treatment. Gold standard treatment is not present for FBSS, therefore both surgical and non-surgical treatment are possible. Studies of Korean conservative medicine for FBSS had a short duration of treatment and mainly pre- and post-treatment comparisons. And case of female patients who have worsened after childbirth is rare. The purpose of this study was to report long-term follow-up and rare cases of FBSS. Case summary: A 33-year-old female patient diagnosed with lumbar disc herniation complained with low back pain and radicular pain in the left leg after surgery in 2011. Acupuncture and decoction (Cheongpa-jeon, GCSB-5) were administered to her twice a day for about 6 years and 6 months. The patient's complaints improved with each hospitalization, and Magnetic Resonance Imaging (MRI) showed a slight decrease in the size of the recurrent disc (L4/5) and a newly developed disc (L5/S1) that had deteriorated after delivery. Conclusion: Korean medicine could be used to manage the pain of lumbar spine FBSS patients for 6-7 years and to alleviate lumbago after delivery.

• Journal of Korean Neurosurgical Society
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• v.30 no.6
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• pp.734-742
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• 2001

Objective : To evaluate the role of anterior lumbar interbody fusion in treatment of failed back surgery syndrome, the authors retrospectively analyzed the result of anterior lumbar interbody fusion performed in our institute. Methods : Fifteen FBSS patients due to variable causes have been treated with anterior lumbar interbody fusion in our institute from April 1994 to June 1999. We analyzed clinical changes in 15 patients who were followed up for an average of 23 months. Results : The etiologies of FBSS were post operative discitis(6 cases), post operative instability(3 cases), post operative adhesion(5 cases), and recurrence(1 case). These fifteen FBSS patients were treated with anterior lumbar interbody fusion. The overall treatment outcome was satisfactory(excellent and good) in 11 cases. Three patients were slightly improved, but post operative low back pain was remained. One patient who had underwent nerve root injury due to pedicle screw insertion showed no improvement. Conclusion : We conclude that the anterior lumbar interbody fusion for FBSS seems to be safe and favorable treatment in selective patients, because low incidence of nerve injury risk and post-operative infection.

• Journal of Acupuncture Research
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• v.39 no.3
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• pp.159-169
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• 2022

Failed back surgery syndrome (FBSS) is a term that applies to symptoms such as persistent or recurring low back pain, paresthesia, sciatica, or numbness after spine surgery. Electroacupuncture (EA) has been reported to have excellent analgesic effects although there have been no systematic reviews on the effects of EA on FBSS. Therefore, a systematic review and meta-analysis of the effectiveness of EA on FBSS was conducted. Eight databases were searched for studies that used EA for FBSS and 7 randomized controlled trials (RCTs) were included. RCTs of EA as combination therapy for FBSS compared with conventional treatment demonstrated improvement in the level of pain, lumbar functional scale scores, and quality of life. However, meta-analysis showed that reduction in pain was not statistically significant, while evaluation of lumbar function significantly improved, although the quality of evidence in the RCTs was generally low. RCTs comparing EA alone with conventional treatment demonstrated an improved level of pain, lumbar function, and effective rate of treatment. Meta-analysis showed that pain was significantly decreased in the EA alone group compared with the control group, although the quality of evidence was low. To improve the quality of evidence, high-quality RCTs are required in the future.