Marshallmalmberg8258
ogical strategy in the treatment of both cervical and lumbar pain, evaluated according to PRO.
According to the results obtained in this study, and taking into account their limitations, PRGF infiltrations are an effective and minimally invasive biological strategy in the treatment of both cervical and lumbar pain, evaluated according to PRO.
There have been several recent reports of lumbar disc herniation (LDH) resorption; however, large sample studies are lacking, and the mechanism(s) underlying this phenomenon is unclear.
To explore the feasibility and clinical outcomes of conservative treatment for giant LDH and to analyze the factors affecting the resorption of giant LDH.
Observational study and original research.
This work was performed at a University Hospital of Traditional Chinese Medicine, Nanjing University of Traditional Chinese Medicine.
From January 2008 to December 2019, 409 patients with giant LDH who initially underwent nonsurgical treatment in our hospital were followed for 1-12 years to analyze the rate of surgical intervention, calculate the rate of resorption of protrusions, and the rate of excellent clinical outcomes.
Eighty-nine of the 409 patients (21.76%) underwent surgery, while the remaining 320 patients (78.24%) constituted the non-surgical treatment group. The Japanese Orthopaedic Association (JOA) score in no progressive nerve injury or cauda equina syndrome, conservative treatment is preferred for giant disc herniation. Resorption is more likely with greater disc protrusions in the spinal canal. A ring enhancement bull's eye sign) around a protruding disc on enhanced magnetic resonance imaging is an important indicator of straightforward resorption.
Patients with giant LDH are less likely to develop progressive nerve injury and cauda equina syndrome if their clinical symptoms improve after treatment. As long as there is no progressive nerve injury or cauda equina syndrome, conservative treatment is preferred for giant disc herniation. Resorption is more likely with greater disc protrusions in the spinal canal. A ring enhancement bull's eye sign) around a protruding disc on enhanced magnetic resonance imaging is an important indicator of straightforward resorption.
There are controversies about the optimal management of AO subtype A3 burst fractures. The most common surgical treatment consists of posterior fixation with pedicle screw and rod augmentation. Nevertheless, a loss of correction in height restoration and kyphotic reduction has been observed.
The aim of this study was to assess long-term outcomes of a minimally invasive technique using a percutaneous intravertebral expandable titanium implant (PIETI).
This prospective, single center, pilot study was carried out on a consecutive case series of 44 patients with acute (< 2 weeks) traumatic thoracolumbar fractures AO type A3. The average follow-up was 5.6 years.
A single center in Castilla y Leon, SpainMETHODS Clinical outcomes (pain intensity on visual analog scale [VAS], Oswestry Disability Index [ODI], analgesic consumption) and radiographic outcomes (anterior/mid/posterior vertebral body height, vertebral area, local kyphosis angle, traumatic regional angulation) were analyzed before surgery, at onal and functional improvement. The rate of cement leakage was lower than other reports.
This study showed that using a PIETI in the treatment of fractures type A3 is a safe and effective method that allows marked clinical improvement, as well as anatomical vertebral body restoration. Unlike with other treatments, results were maintained over time, allowing a better long-term clinical and functional improvement. The rate of cement leakage was lower than other reports.
Interventional radiofrequency (RF) ablation techniques are indicated when an adequate effect is not obtained with conservative measures.
The primary objective of this study was to evaluate pain relief after RF denervation of the sacroiliac joint. see more The secondary objective was to evaluate pain intensity and relief duration.
The study was retrospective.
The study was conducted at Vera Cruz Hospital, Campinas, Brazil.
Data were collected from the medical records of patients undergoing RF denervation for low back pain originating in the sacroiliac joint, from January 2015 to December 2017. There were 78 patients studied, between 18 and 65 years old, of both genders, ASA I or II, who underwent knee arthroscopic meniscectomy. The patients were submitted to denervation of sacroiliac joint by 3 types of RF (conventional, pulsed, and cooled). The following parameters were evaluated, number of patients who obtained ? 50% pain relief; pain intensity, measured using the visual analog scale (before the procedure amber of pulsed and cooled RF is low and in a retrospective study some data may be missing, especially from follow-up.
RF denervation of the sacroiliac joint is effective and promotes a long-lasting analgesic effect.
RF denervation of the sacroiliac joint is effective and promotes a long-lasting analgesic effect.
Transforaminal epidural steroid injection (TFESI) is an interventional technique used to relieve disc herniation related back and radicular pain. Although few studies have investigated the factors predicting positive outcomes after TFESI, there is no data concerning the possible relationship between pre-procedure serum 25-hydroxyvitamin D (25(OH)D) levels and the response to TFESI.
To investigate the effect of vitamin D deficiency to treatment success of fluoroscopy-guided transforaminal epidural steroid injection.
A retrospective assessment.
A university hospital interventional pain management center.
Nine hundred forty-eight patients received lumbosacral TFESI between January 2018 and December 2019 in a university hospital pain management center and were examined retrospectively for eligibility. Clinical and demographic data; magnetic resonance imaging (MRI); pre-procedure laboratory tests, including serum 25(OH)D; pain scores at baseline, third week, and third month follow-ups were collected.
A total of 83 patients were recruited and divided into 2 groups with respect to vitamin D status. The number of patients with serum 25(OH)D level below 20 ng/mL was 57 and the number of patients with serum 25(OH)D level above 20 ng/mL was 26. Treatment success rates were significantly lower in vitamin D deficient group at third week and third month (P 0.006, P 0.01).
Retrospective nature and the absence of functional outcomes.
Vitamin D deficiency is associated with a lower probability of meaningful pain relief following TFESI. It may worth assessing serum vitamin D level prior to this intervention, although prospective investigation is necessary.
Vitamin D deficiency is associated with a lower probability of meaningful pain relief following TFESI. It may worth assessing serum vitamin D level prior to this intervention, although prospective investigation is necessary.
We previously reported on a combined technique and initial data of hip denervation using an anterior approach and cooled radiofrequency.
A large retrospective study to evaluate the long-term effectiveness of cooled radiofrequency ablation (CRFA) in the general chronic hip pain population.
Retrospective electronic chart review.
A single specialty private practice.
Retrospective chart review of 235 consecutive (CRFA) in 136 patients with chronic hip pain.
Out of 235 CRFA, 178 (96 initial procedures and 82 repeats) were performed in 84 patients with 12 or more months follow-up. The average decrease in visual analog scale (VAS) pain scores was 7.3 ± 1.3 to 2.3 ± 1.5 and 2.48 ± 1.5 for the first and second diagnostic block, respectively, and was statistically significant (P < 0.001). Similarly, the average decrease in VAS pain scores at 6 and 12 months after CRFA denervation was 3.44 ± 2.5 and 4.23 ± 2.5, respectively; P < 0.001. Out of the 96 initial procedures in 84 patients, 66 procedures (69%omized prospective trials. Repeated CRFAs demonstrated consistency in pain relief and absolute safety of repeated denervation.
Despite previous reports on cerebral structures and functional connectivity in patients with myofascial pain (MFP), it is not clear whether alterations in neurovascular coupling occur in these patients.
We analyzed the coupling between resting-state cerebral blood flow (CBF) and functional connectivity strength (FCS) for observation of neurovascular coupling in patients with chronic MFP.
Observational study.
University hospital.
Resting-state functional magnetic resonance imaging and arterial spin labeling were performed in 23 patients with chronic MFP and 23 healthy controls (HC) for the calculation of FCS and CBF. The whole-brain gray matter CBF-FCS correlations and CBF/FCS ratios of the various voxels of the 2 groups were subsequently compared.
Compared with the HC, the patients with MFP experienced a decrease in whole-brain gray matter CBF-FCS coupling. In patients with MFP, a decrease in CBF/FCS was found in the bilateral superior temporal gyri, right parahippocampal gyrus, right hippocampus, caudate nucleus, right medial prefrontal cortex, and the periaqueductal gray matter (PAG), whereas an increase in CBF/FCS was found in the bilateral lingual gyri, posterior cingulate cortex, and bilateral inferior parietal lobules. In addition, the CBF/FCS of the PAG in patients with MFP was significantly negatively correlated with the pain visual analog scale score and pain duration.
Alterations in neurovascular coupling in patients with MFP were observed only before treatment. Therefore, there is a lack of data on the alterations that occurred after treatment.
This study demonstrated for the first time that impairment of neurovascular coupling in the brain may be a potential neuropathological mechanism of chronic MFP.
This study demonstrated for the first time that impairment of neurovascular coupling in the brain may be a potential neuropathological mechanism of chronic MFP.
In order to clarify the camera image and open the adhesions mechanically during epiduroscopy, saline is injected continuously in the epidural area. As a result, an increase in intracranial pressure is to be expected in theory. Increased intracranial pressure can be evaluated by measuring by optic nerve sheath diameter.
This study was designed to evaluate the relationship between optic nerve sheath diameter measurements and intracranial pressure, after injecting fluid to the epidural area during epiduroscopy procedures performed in our clinic.
Retrospective study.
Sakarya University Training and Research Hospital.
During the epiduroscopy procedure, pre and postoperative bilateral optic nerve sheath diameters were measured with an ultrasonography probe. With the patients' eyelids closed, the probe was placed on the orbita in the sagittal plane, measuring 3 mm posterior of the papilla.
While there was a statistically significant difference between pre- and post-operative optic nerve sheath diameter m fluid delivery, the total fluid amount, or the processing time.
Pancreatic cancer (PC) is one of the most lethal cancers and is the eleventh most common cancer worldwide. This disease is characterized by an often-fatal evolution and a high burden of symptoms, particularly pain. Several studies have demonstrated that pancreatic cancer patients have a high prevalence of pain, with up to 82% of patients reporting pain, often requiring systemic strong opioids as mainstay treatment. This comprehensive review of pancreatic cancer related pain (PCRP), focuses on current mechanisms that lead to pain including regional invasion processes, as well as the local secretion of factors that sensitize nociceptive nerves.
Our objective was to conduct a review of PCRP and provide updates on intrathecal drug delivery in PC therapeutic recommendations.
We used a narrative review design. We present a novel perspective in the field of pain research by converging data from intrathecal drug delivery trials with previous elements of molecular pain research in PCRP.
The literature review relating to PCRP pathophysiology and intrathecal drug delivery systems (IDDS) was done with searches of English, French, and Spanish abstracts, using PubMed, Dynamed, EMBASE, SciELO, Uptodate, Google Scholar, and manual searches of the bibliographies of known primary and review articles from IDDS inception until August 2020.