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Despite minimally invasive techniques for sacroiliac joint fixation, clinical challenges remain. The investigators hypothesized the studied technique will transfix the sacroiliac joint to a level comparable to the intact sacroiliac joint.

The study objective was to determine the dynamic stability of a square inter-joint implant using a triangular notch in opposing bone segments spanning the joint space.

Stability was assessed by measuring micromotion using contralaterally placed transducers spanning the sacroiliac joint of a specimen during cyclic loading.

A porcine in-vitro model was equipped with micromotion transducers on the intact and surgically implanted sacroiliac joint. Cyclic loading was applied on the L4 vertebra and the recorded micromotion data at each sacroiliac joint was analyzed.

Porcine specimens from L3 to the sacrum including the pelvic ring were used to biomechanically evaluate the implantation technique. A novel technique consisting of a square inter-joint implant was placed so aed to intact sacroiliac joint.

The use of porcine specimens resulted in uniform and good quality bone purchase. Further study may be required to evaluate the technique in older patients where bone quality is reduced.

Compared to the intact sacroiliac joint, the implant and procedure in this study demonstrated decreased motion under cyclic compression. Under rotation, the implanted sacroiliac joint displayed increased initial stability that subsequently normalized to intact sacroiliac joint values.

Compared to the intact sacroiliac joint, the implant and procedure in this study demonstrated decreased motion under cyclic compression. Under rotation, the implanted sacroiliac joint displayed increased initial stability that subsequently normalized to intact sacroiliac joint values.

Obesity had been previously considered to be a protective factor against osteoporosis or fractures; however, recent research indicates that obesity, especially abdominal obesity, may increase the risk of some types of fractures.

We explored the effects of abdominal obesity on subsequent vertebral fracture (SVF) after percutaneous vertebral augmentation (PVA).

A prospective observational cohort study.

Department of Spinal Surgery of a hospital affiliated with a medical university.

A total of 390 women and 237 men aged > 50 years suffering from osteoporotic vertebral fracture (OVF) were included. MEK phosphorylation Weight, height, bone mineral density (BMD), abdominal circumference, and other basic information were measured at baseline and 1-year follow-up visit.

During follow-up, 80 (33.7%) men and 143 (36.7%) women incurred SVF. Greater waist circumference (WC) and waist-to-hip ratio (WHR) increased the risk of SVF in men (WC HR 1.83, P = 0.016; WHR HR 1.63, P = 0.045) and women (WC HR 2.75, P = 0.001; WHR HR 2.63, P = 0.001) after adjustment for BMD and other potential confounders. Compared with normal BMI, being overweight was associated with lower SVF risk (women HR 0.55, P = 0.044; men HR 0.46, P = 0.046), and obesity was associated with greater SVF risk (women HR 4.53, P < 0.001; men HR 3.77, P < 0.001) in both genders. We observed a nonlinear relationship between BMI and SVF with a U-shaped curve; after adjusting BMD, this became a reverse J-curve.

There was no further statistical analysis of the relationship between abdominal obesity and other fracture sites. Asymptomatic SVF may underestimate the impact of abdominal obesity on the occurrence of SVF.

Abdominal obesity was significantly associated with a higher risk of SVF after PVA. Management of body type after PVA may be an effective prevention strategy against SVF.

Abdominal obesity was significantly associated with a higher risk of SVF after PVA. Management of body type after PVA may be an effective prevention strategy against SVF.

The treatment of post-laminectomy lumbar radiculopathy in the setting of a large posterolateral fusion mass presents an anatomic challenge to the spine interventionalist.

To describe outcomes of awake, transforaminal endoscopic surgical treatment for patients presenting with lumbar radiculopathy after instrumented posterolateral lumbar fusions.

Retrospective chart review.

This study took place in a single-center, academic hospital.

The records of 538 patients who underwent awake transforaminal lumbar endoscopic decompression surgery performed by a single surgeon at a single institution between 2014 and 2019 were retrospectively reviewed. Fifteen consecutive patients who required drilling through their posterolateral fusion masses to access the post-fusion foraminal stenosis were included in this study. All included patients were followed for at least one year after surgery.

Fifteen patients (7 male and 8 female) with an average age of 68.1 years (range 38-89, standard deviation 13.4 years) underwerior, bony fusion masses in transforaminal post-fusion foraminal decompression.

Transforaminal endoscopic spine surgery offers a unique approach to post-laminectomy and post-fusion foraminal compression because it avoids scar tissue resulting from previous posterior approaches. Large posterolateral fusion masses associated with some posterior fusions can be a sizeable bony barrier to transforaminal access. The authors share their techniques and success for navigating large posterior, bony fusion masses in transforaminal post-fusion foraminal decompression.

Whiplash injuries typically occur from a motor vehicle collision and lead to chronic whiplash-associated disorders (CWAD) in 20% to 50% of cases. Changes in neurotransmission, metabolism, and networks seem to play a role in the pathogenic mechanism of CWAD.

To further elucidate the functional brain alterations, a neurophysiological study was performed to investigate the somatosensory processing of CWAD patients by comparing the event-related potentials (ERPs) resulting from electrical nociceptive stimulation between patients suffering from CWAD and healthy controls (HC).

Case-control study.

University Hospital in Ghent.

In this case-control study (CWAD patients/HC 50/50), ankle and wrist electrical pain thresholds (EPT), and amplitude and latency of the event-related potentials (ERPs) resulting from 20 electrical stimuli were investigated. Correlations between the ERP characteristics, EPT, self-reported pain, disability, pain catastrophizing, and self-reported symptoms of central sensitization were he applied stimulus, self-reported symptoms of CS, and the worst pain reported during the past week.

The CWAD patients did not show signs of hypersensitivity, but their ERP characteristics were related to the intensity of the applied stimulus, self-reported symptoms of CS, and the worst pain reported during the past week.

Optimal analgesia following knee surgery is essential for early mobilization and rehabilitation and minimizing morbidity.

We compared the addition of the interspace between the popliteal artery and the posterior capsule of the knee (IPACK) block to the adductor canal block (ACB) versus ACB alone on postoperative analgesia and ambulation ability in patients undergoing total knee arthroplasty (TKA).

A prospective randomized study.

An academic medical center.

Eighty patients undergoing TKA were randomly allocated to receive either ACB or combined ACB-IPACK block at the end of surgery. ACB was performed using 20 mL bupivacaine 0.25% in both groups, while IPACK block using 30 mL bupivacaine 0.25% was added in the ACB-IPACK group only. Visual analog scale (VAS) was evaluated at rest and with 45° knee flexion at 4, 6, 12, and 24 hours postoperatively. The quadriceps muscle power and mobilization ability were assessed at 12 hours and 24 hours postoperative. Total 24 hour postoperative morphine consumption, K to the ACB significantly reduced the postoperative morphine consumption and postoperative pain scores compared to the ACB alone without significant difference in mobilization ability in patients undergoing TKA.

The addition of IPACK to the ACB significantly reduced the postoperative morphine consumption and postoperative pain scores compared to the ACB alone without significant difference in mobilization ability in patients undergoing TKA.

Intraarticular (IA) corticosteroid injection is commonly performed in patients with primary frozen shoulder (PFS). However, the best administration site remains controversial.

To compare the efficacy of rotator interval (RI) vs posterior capsule (PC) approach for ultrasound-guided corticosteroid injections into the glenohumeral joint of patients with PFS.

A randomized, exploratory, prospective study.

A single fellowship training institution in Daegu, Republic of Korea.

This study was approved by the Institutional Review Board (2019-04-047-001). Ninety patients with PFS were randomly assigned to either RI approach (RI group, n = 43) or PC approach (PC group, n = 45) for ultrasound-guided IA corticosteroid injection. Fluoroscopic images to assess the accuracy of the injection were obtained immediately after injection by a shoulder specialist. Visual Analog Scale for pain, the American Shoulder and Elbow Surgeons score, the subjective shoulder value, and range of motion (ROM) were used to assess clinicesults indicate that the RI and anterior structures are a major site in the pathogenesis and treatment target of PFS.

Both groups showed significant pain reduction and functional improvement until 12 weeks after injection. Although no significant differences were observed in pain and functional scores between the 2 groups, the RI group showed better improvement of ROM than the PC group. These results indicate that the RI and anterior structures are a major site in the pathogenesis and treatment target of PFS.

Inadvertent intravascular injection of local anesthetics can lead to false negative results following a lumbar medial branch block (MBB) performed to diagnose facet joint origin pain. A previous study demonstrated that the type of needle could affect the incidence of intravascular injection rates.

The primary endpoint of this study was to compare the incidence of intravascular injection during lumbar MBB between the Quincke and Touhy needles. The secondary endpoint of this study was to compare the injection time, radiation dose, and patient discomfort during lumbar MBB between the needle types.

Prospective randomized trial.

An interventional pain management practice in South Korea.

The incidence of intravascular uptake of contrast medium was compared using the Touhy and Quincke needles under real-time fluoroscopy during lumbar MBB. Injection time, radiation dose, and patient discomfort during lumbar MBB were also compared.

The incidence of intravascular injection was 21.8% (21/102) in the Touhy ne dose, and patient discomfort.

Pain due to inoperable upper abdominal malignancies is a challenging condition that needs a multimodal analgesic regimen to be managed properly. Celiac plexus alcohol neurolysis was proved to be effective in relieving such type of pain; however, there is no consistent data about the optimal volume to be used to maintain the balance between the neurolytic effect and the destructive effect of alcohol.

We aim to compare the analgesic effect of 2 different volumes of alcohol to improve the outcome of interventional management.

This was a randomized controlled double-blinded interventional clinical trial.

Single university hospital.

Thirty-two patients who suffered from abdominal pain due to unresectable abdominal malignancies were randomly allocated to receive in a single injection ultrasound-guided celiac plexus neurolysis (CPN) with injection of either 20 mL 70% alcohol (CPN20 group) or 40 mL 70% alcohol (CPN40 group). The primary outcome was the post-procedure pain score, while the secondary outcomes included the post-procedure total daily opioid consumption and quality of life (QOL).