Jin Seok Seo has completed his MD at the age of 26 years from Kyunghee University School of Medicine. He is a physical medicine and rehabilitation doctor of Veterans Health Service Medical Center, Seoul, Korea.

Background: Many treatment techniques have been used for refractory lumbar facet joint pain; however, their efficacy has been controversial. In this study, we investigated the clinical efficacy and safety of intraarticular pulsed radiofrequency for the treatment of refractory lumbar facet joint pain in patients with low back pain. Methods: Twenty patients with refractory lumbar facet joint pain were recruited and each patient was treated using intraarticular pulsed radiofrequency. The treatment effects were measured using a numerical rating scale, and the technical accuracy of intraarticular pulsed radiofrequency treatment was evaluated independently by two radiologists. Any adverse events or complications were also checked. Results: We performed intraarticular pulsed radiofrequency treatment at 48 levels of the lumbar facet joints in 20 patients (5 men and 15 women; mean age, 64.50 ± 10.65 years) with refractory lumbar facet joint pain. Pain scores were significantly reduced at 1 month, 3 months, and 6 months after treatment (p < 0.05). The face validity revealed good intraarticular pulsed radiofrequency results in all 20 patients, without any serious adverse effects. Conclusions: The treatment using intraarticular pulsed radiofrequency is an alternative to other techniques in patients with refractory lumbar facet joint pain. Acknowledgment: This study was supported by a VHS Medical Center Research Grant, Republic of Korea (grant number: VHSMC17021).

Vivian Y Lee has completed her Master’s degree from Massey University in New Zealand. She is currently conducting her PhD studies at The University of Sydney.

Introduction: Human papillomavirus (HPV) has been identified as a necessary cause of cervical cancer, but is uniquely vaccine preventable. HPV vaccine programs face several challenges such as high rates of local adverse events (AE) and psychogenic responses which may reduce vaccine acceptance and contribute to low coverage rates. Exercise at the time of vaccination has been investigated for its potential to adjuvant the immune response, which would be a valuable effect in multi-dose vaccines such as HPV. Notably, exercise may also provide analgesic effects to reduce pain and alter the occurrence of AE. Method: 116 students (11-13yrs) receiving HPV vaccinations through the school vaccination program were randomized to control (Con) or exercise groups (Ex). Control-group received the vaccination according to usual-care procedure; exercise-group completed a 15-min moderate exercise task prior to the normal vaccination procedure. Participants completed a seven day AE diary with parental supervision. Results: On average 90% of participants reported an AE per dose. Reported number of days with pain in Ex decreased from dose 1 (2.00±0.23) to dose 2 (1.54±0.23) while it increased for Con (Dose 1: 1.91±0.24; Dose 2: 2.00±0.25; p=0.140). Reported number of days with tenderness decreased in both Ex and Con (p=0.01), with a steeper decrease in Ex (Dose 1: 2.14±0.25; Dose 2: 1.29±0.25) than Con (Dose1: 2.12±0.26; Dose 2: 1.75±0.27). Reported pain and fear of the injection was not different between groups. Conclusion: Preliminary analysis shows a trend for a benefit in using exercise as an intervention to improve the vaccination process for children. Furthermore, the practicality of this intervention within a school vaccination program seems to be reasonable with all parties involved being satisfied with the logistics.

Jae-Hyung Kim has completed his PhD from Kyung-Hee University in Korea (South) and he has studied from Stanford University School of Medicine in USA as visiting scholar in 2015. He has been working as a Professor, Kwan-dong University School of Medicine. He has published more than 30 papers in reputed journals.

The occurrence of symptomatic epidural hematoma following percutaneous epidural neuroplasty (PEN) is a very rare but serious complication. This report is to inform a case of patient who developed a severe bleeding complication associated with PEN in elderly person. An 80-year-old man with a history of congestive heart failure and atrial fibrillation, on warfarin treatment, presented with posterior neck pain at C6-7 level was admitted. Ten days have passed since we stopped oral warfarin. He received PEN for pain control. He was damaged the thoracic spinal cord due to epidural hematoma by epidural catheter. Neurological examination revealed T5 (sensory level) incomplete paraplegia (AISA-B). At that time, whole spine MRI demonstrated posterior epidural hematoma (T1-T12) with mild compression of thecal sac and inhomogeneous signal and contrast enhancement in all pulse sequences. After 3 days later, he underwent posterior decompression surgery at T3-6 level for hematoma evacuation. He suffered from both lower limb weakness and neurogenic bladder symptoms. After spinal cord injury rehabilitation for 6 months, motor weakness and bladder function were partially recovered to ASIA-C. The modified Bathel Index score was increased from 39 to 75. We think, in elderly person, it needs much longer discontinuation period of oral warfarin for invasive procedure like PEN.

Michael Poulsen graduated from Valparaiso University achieving a Baccalaureate degree in the science of nursing in 2014. He is currently enrolled in Valparaiso University to earn a DNP in 2017. He currently works as a night charge nurse on a medical and surgical unit at Unity Hospital. He also has been instructing undergraduate clinical experiences at Valparaiso University for the last two years. Michael is also a member of Sigma Theta Tau International (STTI). He is interested in using alternative therapies to help reduce pain and psychological distress following his experience working in a multidisciplinary pain clinic. His interest in alternative therapies led to his DNP project writing a protocol for using therapeutic music to help reduce postoperative pain on an inpatient hospital unit. In December 2016, Michael published his first nursing article entitled “Alleviating Stress with Music” in the ISNA featured magazine Nursing Focus Magazine.

Statement of the Problem: Pain is one of the most common experienced symptoms reported by more than 80% of postoperative patients. Approximately 77-98% of post-operative patients report pain following their procedure with 40-80% having moderate to severe pain. Pain is shown to elevate stress levels manifesting in increased heart rates, blood pressures, and oxygen demand. Inadequate pain control can develop into surgical complications causing surgical failure, blood clots, pneumonia, and chronic pain. Complementary and alternative medicine such as music can be used in combination with opioid medication to help improve pain control leading to successful surgical outcomes. The purpose of this evidence-based practice project was to determine if implementing therapeutic music into the post-operative recovery process improves reported pain scores in adult spinal patients. Methodology & Theoretical Orientation: A one-group pretest-posttest comparison design was performed to help streamline an evidence-base protocol on an inpatient postoperative surgical unit. The evidence-based medicine and transpersonal caring models were used to create and implement a therapeutic music protocol by critically analyzing current literature. Findings: Data was collected using weekly chart audits retrieved from the paragon electronic medical record (EMR) system. Conclusion & Significance: The data will be analyzed using an independent t-test to determine the effectiveness of this therapeutic music protocol. Implications for practice will be discussed.