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Sciatica pain

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https://www.readbyqxmd.com/read/28545491/treatment-of-acute-sciatica-with-transforaminal-epidural-corticosteroids-and-local-anesthetic-design-of-a-randomized-controlled-trial
#1
Bastiaan C Ter Meulen, Esther T Maas, Amrita Vyas, Marinus van der Vegt, Koo de Priester, Michiel R de Boer, Maurits W van Tulder, Henry C Weinstein, Raymond W J G Ostelo
BACKGROUND: Transforaminal epidural injections with steroids (TESI) are used increasingly for patients with sciatica. However there is much debate about their safety and effectiveness. It is important to identify patients that benefit most from TESI and only few trials have yet evaluated the effects in patients with acute sciatica. METHODS: We describe a prospective, randomized controlled trial (RCT), with the aim to evaluate the hypothesis that TESI plus Levobupivacaine (TESI-plus) added to oral pain medication is more effective compared to pain medication alone or compared to transforaminal injection with a local anesthetic of short duration among patients with acute sciatica...
May 25, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28533868/-rare-medico-surgical-emergency-spinal-epidural-abscess-about-3-cases
#2
Abderrazzak El Saqui, Mohamed Aggouri, Mohamed Benzagmout, Khalid Chakour, Mohamed El Faiz Chaoui
The awareness about infections in the epidural space is increasing thanks to the development of neurosurgery, including MRI. Spinal epidural abscess is a rare pathology but extremely serious from a functional point of view and potentially life threatening. We report three cases of male patients (the first one aged 52 years, the second 57 years and the third 63 years) with diagnosed spinal epidural abscess. Two patients were admitted to the Neurosurgical Emergencies with slow progressive spinal cord compression evolving in the context of infection...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28512052/cystic-dilation-of-the-ventriculus-terminalis-cdvt-report-of-six-surgical-cases-treated-with-cyst-subarachnoid-shunting-using-t-catheter
#3
Liang Zhang, Zhifeng Zhang, Wuyang Yang, Wenqing Jia, Yulun Xu, Jun Yang
OBJECT: Cystic dilation of the ventriculus terminalis (CDVT) is a rare anatomical variation and may become symptomatic. Existing literature regarding CDVT is limited, and as a result, the clinical characteristics and management strategy of CDVT is unclear. We report in this study six cases of CDVT in our institution, and provide a review of current literature. METHODS: We included six patients with CDVT in Beijing Tiantan Hospital between September 2010 and June 2015...
May 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28491116/a-randomized-clinical-trial-comparing-the-effectiveness-of-electroacupuncture-versus-medium-frequency-electrotherapy-for-discogenic-sciatica
#4
Xue Zhang, Yang Wang, Zhao Wang, Chao Wang, Wentao Ding, Zhishun Liu
Objective. To investigate the short- and long-term effects of electroacupuncture (EA) compared with medium-frequency electrotherapy (MFE) on chronic discogenic sciatica. Methods. One hundred participants were randomized into two groups to receive EA (n = 50) or MFE (n = 50) for 4 weeks. A 28-week follow-up of the two groups was performed. The primary outcome measure was the average leg pain intensity. The secondary outcome measures were the low back pain intensity, Oswestry Disability Index (ODI), patient global impression (PGI), drug use frequency, and EA acceptance...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/28454511/percutaneous-laser-disc-decompression-versus-conventional-microdiscectomy-for-patients-with-sciatica-two-year-results-of-a-randomised-controlled-trial
#5
Patrick A Brouwer, Ronald Brand, M Elske van den Akker-van Marle, Wilco Ch Jacobs, Barry Schenk, Annette A van den Berg-Huijsmans, Bart W Koes, Mark A Arts, M A van Buchem, Wilco C Peul
Background Percutaneous laser disc decompression is a minimally invasive treatment, for lumbar disc herniation and might serve as an alternative to surgical management of sciatica. In a randomised trial with two-year follow-up we assessed the clinical effectiveness of percutaneous laser disc decompression compared to conventional surgery. Materials and methods This multicentre randomised prospective trial with a non-inferiority design, was carried out according to an intent-to-treat protocol with full institutional review board approval...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28441971/the-clinical-and-cost-effectiveness-of-stratified-care-for-patients-with-sciatica-the-scopic-randomised-controlled-trial-protocol-isrctn75449581
#6
Nadine E Foster, Kika Konstantinou, Martyn Lewis, Reuben Ogollah, Kate M Dunn, Danielle van der Windt, Ruth Beardmore, Majid Artus, Bernadette Bartlam, Jonathan C Hill, Sue Jowett, Jesse Kigozi, Christian Mallen, Benjamin Saunders, Elaine M Hay
BACKGROUND: Sciatica has a substantial impact on patients, and is associated with high healthcare and societal costs. Although there is variation in the clinical management of sciatica, the current model of care usually involves an initial period of 'wait and see' for most patients, with simple measures of advice and analgesia, followed by conservative and/or more invasive interventions if symptoms fail to resolve. A model of care is needed that does not over-treat those with a good prognosis yet identifies patients who do need more intensive treatment to help with symptoms, and return to everyday function including work...
April 26, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28438457/-tophaceous-gout-of-the-lumbar-spine-in-a-patient-without-systemic-gout-or-normouricaemia
#7
Alejandro Lorente, Rafael Lorente, Jorge Romero
Gout is a common metabolic disorder typically diagnosed in peripheral joints. Tophaceous deposits in the lumbar spine is a very rare condition with very few cases reported in the literature. We present a case of tophaceous gout that originated in the lumbar spine in a patient with normal uric acid blood levels. The following case report concerns a 52-year-old patient with low back pain, left sciatica and numbness in the left leg. Serum uric acid levels were within normal range. MRI and bone scan images suggested an inflammatory-infectious process focussed at L4...
April 21, 2017: Neurocirugía
https://www.readbyqxmd.com/read/28429339/observational-multicentric-study-on-chronic-sciatic-pain-clinical-data-from-44-italian-centers
#8
G A Checchia, G Letizia Mauro, G Morico, A Oriente, C Lisi, V Polimeni, M Lucia, M Ranieri
OBJECTIVE: To provide information on the clinical presentation of sciatic neuropathy and its management in a real-world setting, and to analyze the effects of a multimodal approach based on the association of physical and pharmacological therapy. PATIENTS AND METHODS: A multicentric observational prospective study was conducted in 44 Italian tertiary centers specialized in Physical Medicine and Rehabilitation, Orthopedics, Neurology, Neurosurgery, and Rheumatology...
April 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28414677/a-rare-case-of-tropical-pyomysitis-acquired-on-vacation-in-a-healthy-male
#9
K Poole, T Tran
INTRODUCTION: Pyomyositis has traditionally been considered a tropical disease. Increasing prevalence has been observed in more northern climates, especially with HIV, immunosuppression, and IV drug abuse as predisposing factors. Pyomyositis has the tendency to mimic other conditions, such as muscle contusion, necrotizing fasciitis, or septic arthritis. The rarity of this disease and non-specificity of its symptoms often lead to delay in appropriate diagnosis and treatment. CASE: 24-year-old man, seen 2 days prior in orthopedics clinic and the Emergency Department for persistent gluteal pain thought to be due to right-sided sciatica, was admitted following worsening pain, diffuse generalized weakness with polyarthralgias and myalgias These symptoms were associated with night sweats, shaking chills, and difficulty walking...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28412162/incidence-and-clinical-features-of-sacral-insufficiency-fracture-in-the-emergency-department
#10
Yasuaki Tamaki, Akihiro Nagamachi, Kazumasa Inoue, Makoto Takeuchi, Kosuke Sugiura, Yasuyuki Omichi, Shunsuke Tamaki, Takashi Chikawa, Koichi Sairyo, Keisuke Adachi
INTRODUCTION: A sacral insufficiency fracture (SIF) often manifests as low back pain or sciatica in the absence of any antecedent trauma. These fractures may be missed because of lack of appropriate imaging. The purpose of this study was to clarify the incidence and clinical features of SIF as well as the characteristic findings on magnetic resonance imaging (MRI) of the lumbar spine. MATERIALS AND METHODS: The study participants comprised 250 patients (132 male, 118 female; mean age 58...
March 18, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28401158/histological-identification-of-propionibacterium-acnes-in-nonpyogenic-degenerated-intervertebral-discs
#11
Ye Yuan, Zezhu Zhou, Yucheng Jiao, Changwei Li, Yuehuan Zheng, Yazhou Lin, Jiaqi Xiao, Zhe Chen, Peng Cao
Purpose. Low-virulence anaerobic bacteria, especially the Propionibacterium acnes (P. acnes), have been thought to be a new pathogeny for a series of disc diseases. However, until now, there has been no histological evidence to confirm this link. The purpose of this study was to confirm the presence of P. acnes in nonpyogenic intervertebral discs via histological observation. Method. Degenerated intervertebral discs were harvested from 76 patients with low back pain and/or sciatica but without any symptoms of discitis or spondylodiscitis...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28399072/nonsteroidal-anti-inflammatory-drugs-for-sciatica-an-updated-cochrane-review
#12
Eva Rasmussen-Barr, Ulrike Held, Wilhelmus J A Grooten, Pepijn D D M Roelofs, Bart W Koes, Maurits W van Tulder, Maria M Wertli
STUDY DESIGN: Systematic review and meta-analysis. OBJECTIVE: To determine the efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) on pain reduction, overall improvement, and reported adverse effects in people with sciatica. SUMMARY OF BACKGROUND DATA: NSAIDs are one of the most frequently prescribed drugs for sciatica. METHODS: We updated a 2008 Cochrane Review through June 2015. Randomized controlled trials that compared NSAIDs with placebo, with other NSAIDs, or with other medication were included...
April 15, 2017: Spine
https://www.readbyqxmd.com/read/28384946/a-randomized-controlled-clinical-trial-to-determine-the-effectiveness-of-caudal-epidural-steroid-injection-in-lumbosacral-sciatica
#13
Jaydeep Nandi, Abhishek Chowdhery
INTRODUCTION: Caudal epidural steroid injection have been a part of nonsurgical management of lumbosacral sciatica since last half a century but various randomized controlled trials fail to provide convincing evidence in favour of its effectiveness. AIM: To assess the efficacy of caudal epidural steroid injection in patients of lumbosacral sciatica in comparison to placebo. MATERIALS AND METHODS: The study consisted of patients of sciatica caused by lumbosacral disc prolapse (observed on Magnetic Resonance Imaging (MRI) scan)...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28377548/solitary-osteochondroma-of-the-proximal-femur-causing-sciatic-nerve-compression
#14
Fahad Aldashash, Muhamed Elraie
Osteochondromas (OC) are the most common benign tumors of the bones. They are most frequently found near the knee joint and are typically asymptomatic. The presence of OC near the hip joint is rare. In addition, OC is an extremely uncommon cause of sciatica. We present a rare case of OC of the proximal femur. The patient presented with left hip pain and manifestations of sciatic nerve compression. Surgical excision was performed. The diagnosis was confirmed postoperatively by histopathology. SIMILAR CASES PUBLISHED: 1...
March 2017: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/28352340/clinical-efficacy-of-lumbar-interbody-fusion-using-a-channel-system-combined-with-ozone-therapy-for-the-treatment-of-central-type-l3-l4-lumbar-disc-herniation
#15
Yu Wang, Hong Sun, Shuzhen Qin
The clinical efficacy of minimally invasive lumbar interbody fusion via the intervertebral foramen combined with ozone (O3) therapy for the treatment of L3-L4 central-type lumbar disc herniation was explored. We recruited patients with sciatica who attended our hospital between July 2013 and October 2015 and underwent lumbar X-ray (anteroposterior and lateral view), lumbar flexion-extension radiographs, computed tomography, and magnetic resonance imaging after admission. Seventy-four patients with central-type lumbar disc herniation but no other complications were randomly selected and divided into the observation and control groups...
February 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28339334/a-movement-system-impairment-approach-to-evaluation-and-treatment-of-a-person-with-lumbar-radiculopathy-a-case-report
#16
Eileen Miller, Shirley A Sahrmann, Dale Avers
BACKGROUND AND PURPOSE: There are several systems of classification and treatment of patients with low back pain (LBP) based on assessment of the effect of lumbar postures and movements on symptoms. The efficacy of one of these systems, The Movement System Impairment (MSI) method, has not yet been demonstrated in the literature. The purpose of this case report is to describe the approach of the MSI method for an individual with lumbar radiculopathy. CASE DESCRIPTION: A 79-year-old woman with a history of chronic LBP was referred to PT with a physician's diagnosis of sciatica...
March 2017: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/28328324/trial-of-pregabalin-for-acute-and-chronic-sciatica
#17
RANDOMIZED CONTROLLED TRIAL
Stephanie Mathieson, Christopher G Maher, Andrew J McLachlan, Jane Latimer, Bart W Koes, Mark J Hancock, Ian Harris, Richard O Day, Laurent Billot, Justin Pik, Stephen Jan, C-W Christine Lin
BACKGROUND: Sciatica can be disabling, and evidence regarding medical treatments is limited. Pregabalin is effective in the treatment of some types of neuropathic pain. This study examined whether pregabalin may reduce the intensity of sciatica. METHODS: We conducted a randomized, double-blind, placebo-controlled trial of pregabalin in patients with sciatica. Patients were randomly assigned to receive either pregabalin at a dose of 150 mg per day that was adjusted to a maximum dose of 600 mg per day or matching placebo for up to 8 weeks...
March 23, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28325480/low-back-pain-and-sciatica-in-over-16s-assessment-and-management-nice-guideline-ng59
#18
Tarcisio Folly de Campos
No abstract text is available yet for this article.
April 2017: Journal of Physiotherapy
https://www.readbyqxmd.com/read/28294069/wallet-neuritis-an-example-of-peripheral-sensitization
#19
Md Abu Bakar Siddiq, Israt Jahan, Sam Masihuzzaman
BACKGROUND: Wallet neuritis is an example of extra-spinal tunnel neuropathy concerning sciatic nerve. Its clinical appearance often gets confused with sciatica of lumbar spine origin. Wallet-induced chronic sciatic nerve constriction produces gluteal and ipsilateral lower extremity pain, tingling, and burning sensation. It was Lutz, first describing credit-card wallet sciatica in an Attorney, surfaced on Journal of American Medical Association (JAMA), 1978; however, the condition has not been well-studied in various other occupations...
March 9, 2017: Current Rheumatology Reviews
https://www.readbyqxmd.com/read/28244968/prognostic-factors-for-persistent-leg-pain-in-patients-hospitalized-with-acute-sciatica
#20
Olaf Fjeld, Margreth Grotle, Vibeke Siewers, Linda M Pedersen, Kristian Bernhard Nilsen, John-Anker Zwart
STUDY DESIGN: Prospective cohort study. OBJECTIVE: To identify potential prognostic factors for persistent leg-pain at 12 months among patients hospitalized with acute severe sciatica. SUMMARY OF BACKGROUND DATA: The long-term outcome for patients admitted to hospital with sciatica is generally unfavorable. Results concerning prognostic factors for persistent sciatica are limited and conflicting. METHODS: A total of 210 patients acutely admitted to hospital for either surgical or nonsurgical treatment of sciatica were consecutively recruited and received a thorough clinical and radiographic examination in addition to responding to a comprehensive questionnaire...
March 2017: Spine
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