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Back pain and neuraxial

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https://www.readbyqxmd.com/read/27317550/a-randomized-controlled-trial-comparing-ametop%C3%A2-with-placebo-for-reducing-pain-associated-with-local-anesthetic-skin-infiltration-before-neuraxial-anesthesia-in-parturients
#1
T Kavanagh, A Dube, A Albert, V Gunka
BACKGROUND: Between 10-22% of the general population experience needle phobia. Needle phobic parturients are at increased risk of adverse outcomes. We assessed the efficacy of topical Ametop™ (tetracaine 4%) gel in reducing the pain associated with local anesthetic skin infiltration before neuraxial block in non-laboring women. METHODS: This was a prospective, randomized, double-blind, placebo-controlled study. Ametop™ or placebo was applied to the skin of the lower back at least 20min before neuraxial block using a standardized technique with 1% lidocaine skin infiltration...
August 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27195644/back-pain-and-neuraxial-anesthesia
#2
Honorio T Benzon, Yogen G Asher, Craig T Hartrick
The incidence of back pain after neuraxial anesthesia in the adult population is not different from that after general anesthesia. The pain is usually mild, localized in the low back, rarely radiates to the lower extremities, and has a duration of only a few days. The risk factors for development of back pain include the lithotomy position, multiple attempts at block placement, duration of surgery longer than 2.5 hours, body mass index ≥32 kg/m, and a history of back pain. However, there is no permanent worsening of preexisting back pain after neuraxial anesthesia...
June 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27100449/risk-of-chronic-low-back-pain-among-parturients-who-undergo-cesarean-delivery-with-neuraxial-anesthesia-a-nationwide-population-based-retrospective-cohort-study
#3
MULTICENTER STUDY
Yuan-Yi Chia, Yuan Lo, Yan-Bo Chen, Chun-Peng Liu, Wei-Chun Huang, Chun-Hsien Wen
To investigate the risk of chronic low back pain (LBP) in parturients undergoing cesarean delivery (CD) with neuraxial anesthesia (NA). LBP is common during pregnancy and also after delivery, but its etiology is poorly understood. Previous studies that investigated the correlation between epidural labor analgesia and chronic low back pain were inconclusive. These studies lacked objective diagnostic criteria for LBP and did not exclude possible confounders. We performed this nationwide population-based retrospective cohort study to explore the relationship between CD with NA and subsequent LBP...
April 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/26921671/calcifying-pseudoneoplasms-of-the-neuraxis-report-on-four-cases-and-review-of-the-literature
#4
Sara García Duque, Diego Medina Lopez, Ana Ortiz de Méndivil, Jorge Diamantopoulos Fernández
OBJECTIVES: Calcifying pseudoneoplasms of the neuraxis (CAPNON) are rare lesions occurring anywhere in the central nervous system (CNS). Since their description, only 55 cases have been reported. We present the largest series reviewing their imaging features, histology and potential origins. PATIENTS AND METHODS: four patients with histopathologically verified CAPNON are presented. Subsequently, we review all reports published with respect to study type, number of patients, clinical presentation, anatomical area (intracranial, spinal, or both), radiological features, therapy, histopathologic features, duration of follow-up, complications, and outcome...
April 2016: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/26634280/interscapular-pain-associated-with-neuraxial-labour-analgesia-a-case-series
#5
Thomas T Klumpner, Paloma Toledo, Cynthia A Wong, Jason R Farrer
PURPOSE: Some labouring women with neuraxial labour analgesia experience severe upper back pain, typically between the scapulae. This pain may complicate management of neuraxial analgesia/anesthesia, and it may also have important implications for the mode of delivery. This case series describes the clinical course and management of three patients who developed interscapular pain associated with neuraxial labour analgesia. PRINCIPAL FINDINGS: Neuraxial labour analgesia was initiated in all patients with a combined spinal-epidural technique and maintained via patient-controlled epidural analgesia...
April 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/26218956/peripheral-and-neuraxial-chemical-neurolysis-for-the-management-of-intractable-lower-extremity-pain-in-a-patient-with-terminal-cancer
#6
Mario De Pinto, Ramana K Naidu
We present the case of a 74-year-old man with Stage IV metastatic, multifocal, malignant fibrous histiocytoma (T2b, N1, M1, G4) invading the proximal area of the left lower extremity and resulting in intractable neuropathic pain along the distribution of the femoral nerve. He described the pain as being so severe to cause inability to ambulate without assistance or to sleep in a supine or prone position. After a spinal cord stimulation trial and a trial of intrathecal (IT) hydromorphone, both performed at an outside institution, had failed to achieve adequate pain relief, we decided to perform a femoral nerve chemical neurolysis with phenol under ultrasound (US) guidance...
July 2015: Pain Physician
https://www.readbyqxmd.com/read/25974276/worsening-of-neurologic-symptoms-after-spinal-anesthesia-in-two-patients-with-spinal-stenosis
#7
Sandra L Kopp, Shannon M Peters, Peter S Rose, James R Hebl, Terese T Horlocker
OBJECTIVE: Spinal stenosis has been proposed as a previously unrecognized risk factor for neurologic complications after neuraxial techniques. CASE REPORT: We report progression of neurologic symptoms after spinal anesthesia in 2 patients with preexisting spinal stenosis, characterized preoperatively solely by nonradicular back pain. One patient had complete resolution of his proximal lower-extremity weakness/numbness within 48 hours. In the second patient, the pain became severe and disabling, requiring surgical decompression...
September 2015: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/25949855/intradural-extramedullary-capillary-hemangioma-of-the-cauda-equina-case-report-and-literature-review
#8
Jonathan J Liu, Darrin J Lee, Lee-Way Jin, Kee D Kim
BACKGROUND: Capillary hemangiomas are benign vascular tumors that rarely occur in the neuraxis. When encountered in the spine, prompt diagnosis and complete resection is crucial. On rare instances, these lesions can acutely hemorrhage, leading to sudden neurological decline. To date, there are only 16 reported cases of intradural capillary hemangiomas in the cauda equina. CASE DESCRIPTION: We report a case of an intradural extramedullary cauda equina capillary hemangioma that resulted in back pain and lower extremity motor deficit...
2015: Surgical Neurology International
https://www.readbyqxmd.com/read/25901483/intractable-pruritus-during-outpatient-epidural-hydromorphone-infusion-a-case-report-and-a-focused-review-of-the-literature
#9
REVIEW
Xiulu Ruan, Li Ma, J Patrick Couch, Tao Chen, Gary W Bumgarner
BACKGROUND: Intraspinal drug delivery therapy has been increasingly used in patients with intractable, nonmalignant pain who have failed to respond to conventional treatment or cannot tolerate systemic opioid(s) due to adverse events. By infusing a small dose of an opioid analgesic directly into the cerebrospinal fluid, near opioid receptors, profound spinal analgesia can be obtained. Before the implantation of permanent intraspinal pump, a neuraxial opioid infusion trial is usually conducted to demonstrate the effectiveness of neuraxial opioid for analgesia...
March 2015: Journal of Opioid Management
https://www.readbyqxmd.com/read/25883840/should-routine-mri-of-the-lumbar-spine-be-required-prior-to-lumbar-epidural-steroid-injection-for-sciatica-pain
#10
Ramis F Ghaly, Alexei Lissounov, Kenneth D Candido, Nebojsa Nick Knezevic
BACKGROUND: We describe three patients who received lumbar epidural steroid injections (LESI) for lumbosacral radicular pain that resulted in worsening of their symptoms. The procedures were performed following a review of remote diagnostic imaging studies. These cases demonstrate the lack of consensus in pain management domains for how to approach the workup and treatment of persistent/chronic low back pain, with a noted fragmentation in pain management strategies and applied therapies...
2015: Surgical Neurology International
https://www.readbyqxmd.com/read/25794113/labor-analgesia-consumption-and-time-to-neuraxial-catheter-placement-in-women-with-a-history-of-surgical-correction-for-scoliosis-a-case-matched-study
#11
Jeanette R Bauchat, Robert J McCarthy, Tyler R Koski, Cynthia A Wong
BACKGROUND: Neuraxial analgesic techniques are the most effective form of labor analgesia. Small studies (9-21 patients), conducted 10 to 20 years ago, demonstrated successful neuraxial labor analgesia in only 50% to 66% of patients with surgical correction for scoliosis. Newer surgical techniques for scoliosis correction make the epidural space more accessible, but postsurgical changes may still alter the efficacy of neuraxial labor analgesia. The purpose of this prospective case-matched study was to compare hourly bupivacaine consumption and time to placement of neuraxial technique in laboring women with spinal instrumentation compared with women without previous back surgery...
October 2015: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/24986157/malignant-peripheral-nerve-sheath-tumor-of-the-cauda-equina-with-craniospinal-metastasis
#12
Jonathan G Thomas, Christie Lincoln, J Clay Goodman, Shankar P Gopinath
Intradural spinal malignant peripheral nerve sheath tumors (MPNST) are extremely rare, with only 20 adult patients reported to our knowledge, and only four primary tumors arising from the cauda equina. A 49-year-old man presented with back pain, constipation, and lower extremity weakness and was found to have a large intradural lesion involving the cauda equina. Imaging of the rest of his neuraxis revealed additional small left temporal lobe, cervical, and thoracic lesions. The patient underwent laminectomy for tumor debulking and biopsy, as gross total resection was not possible due to envelopment of the cauda equina...
December 2014: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/24943307/real-time-ultrasound-guided-spinal-anesthesia-using-the-sonixgps-ultrasound-guidance-system-a-feasibility-study
#13
A U Niazi, K J Chin, R Jin, V W Chan
BACKGROUND: Real-time ultrasound-guided neuraxial blockade remains a largely experimental technique. SonixGPS® is a new needle tracking system that displays needle tip position on the ultrasound screen. We investigated if this novel technology might aid performance of real-time ultrasound-guided spinal anesthesia. METHODS: Twenty patients with body mass index < 35 kg/m(2) undergoing elective total joint arthroplasty under spinal anesthesia were recruited...
August 2014: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/24688346/urgent-cesarean-section-in-a-patient-with-a-spinal-cord-stimulator-implications-for-surgery-and-anesthesia
#14
Suhas Patel, Samita Das, Robin B Stedman
BACKGROUND: Spinal cord stimulation used in the treatment of chronic pain is offered to women of child-bearing age. This practice warrants special consideration on the part of the obstetricians and anesthesiologists charged with their care. CASE REPORT: We report the instance of a parturient with a spinal cord stimulator who presented for urgent cesarean section. In spite of the patient's daunting back examination, the suitability of neuraxial anesthesia for cesarean delivery was rapidly determined by accessing images in our centerwide electronic medical record system...
2014: Ochsner Journal
https://www.readbyqxmd.com/read/24674671/epithelioid-sarcoma-of-the-spine-case-report-and-literature-review
#15
REVIEW
Clara Chamadoira, Paulo Pereira, Pedro S Silva, Ligia Castro, Rui Vaz
Epithelioid sarcomas are rare mesenchymal neoplasms mainly arising in the limbs of young adults. We report the case of a 24-year-old male presenting low back pain radiating to both lower limbs, constipation and urinary retention. The MRI scan showed an intraspinal lesion extending from L4 to S2. Surgery resulted in gross total removal of the extradural lesion and partial removal of the intradural component. The immunohistological study of the lesion was consistent with an epithelioid sarcoma. The patient was submitted to radiotherapy and chemotherapy, but a local recurrence of the lesion and dissemination along the neuraxis were observed 3 months after surgery...
July 2014: Neurocirugía
https://www.readbyqxmd.com/read/24085642/paracervical-local-anaesthesia-for-cervical-dilatation-and-uterine-intervention
#16
REVIEW
Thumwadee Tangsiriwatthana, Ussanee S Sangkomkamhang, Pisake Lumbiganon, Malinee Laopaiboon
BACKGROUND: Cervical dilatation and uterine intervention can be performed under sedation, local or general anaesthesia for obstetrics and gynaecological conditions. Many gynaecologists use paracervical local anaesthesia but its effectiveness is unclear. This review was originally published in 2009 and was updated in 2013. OBJECTIVES: The objectives of this review were to determine the effectiveness and safety of paracervical local anaesthesia for cervical dilatation and uterine intervention, versus no treatment, placebo, other methods of regional anaesthesia, sedation and systemic analgesia, and general anaesthesia...
2013: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/23809016/spinal-anaesthesia-for-caesarean-section-in-the-presence-of-respiratory-failure-and-spinal-metastases-from-a-soft-tissue-clear-cell-sarcoma
#17
A M Miskovic, D P Dob
Spinal metastases occur in up to 70% of all patients with cancer. However, only 10% are symptomatic. Before considering central neuraxial blockade in patients with malignancy, a history of back pain should be excluded. Anaesthetists should be aware that intrathecal and epidural injections could cause paraplegia if metastases are impinging on the spinal cord. Failure to achieve adequate sensory anaesthesia after central neuraxial blockade or presentation with postoperative paraplegia may indicate the presence of asymptomatic vertebral canal metastases...
July 2013: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/23692059/a-preliminary-study-to-determine-if-a-muscle-pain-protocol-can-produce-long-term-relief-in-chronic-back-pain-patients
#18
Norman J Marcus, Allyson Augusta Shrikhande, Bill McCarberg, Edward Gracely
OBJECTIVE: To assess the effectiveness of a muscle protocol to treat patients diagnosed with neuraxial low back pain (LBP) before and after invasive treatments. DESIGN: Patients with chronic (>6 months) LBP-postinvasive treatment and pre-spine surgery-were assessed and treated. An electrical device rather than palpation was used to determine muscle(s) as possible sources of pain. Patients testing positive for muscle pain were treated with a comprehensive protocol and were followed for >3 months to determine the effect of treatment on pain severity and interference in function...
August 2013: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/23554950/somatosensory-abnormalities-for-painful-and-innocuous-stimuli-at-the-back-and-at-a-site-distinct-from-the-region-of-pain-in-chronic-back-pain-patients
#19
Christian Puta, Birgit Schulz, Saskia Schoeler, Walter Magerl, Brunhild Gabriel, Holger H W Gabriel, Wolfgang H R Miltner, Thomas Weiss
Chronic low back pain (CLBP) was shown to be associated with pathophysiological changes at several levels of the sensorimotor system. Changes in sensory thresholds have been reported but complete profiles of Quantitative Sensory Testing (QST) were only rarely obtained in CLBP patients. The aim of the present study was to investigate comprehensive QST profiles in CLBP at the painful site (back) and at a site distinct from their painful region (hand) and to compare these data with similar data in healthy controls...
2013: PloS One
https://www.readbyqxmd.com/read/23406771/dual-gliomas-with-syringomyelia-in-a-child-case-report-and-literature-review
#20
REVIEW
Mohana Rao Patibandla, Ashish Kumar, Suchanda Bhattacharjee, Barada Prasad Sahu, Megha Uppin, Sundaram Challa
BACKGROUND AND IMPORTANCE: The occurrence of multiple tumors of different histopathologies in the central nervous -system is rare. Here, we report a case of a child with dual neuroepithelial tumors of different histological cell types and -review the available literature for analyzing the causal hypo-thesis. CASE REPORT: A 7-year-old girl presented with history of headaches associated with multiple episodes of early morning projectile vomiting and visual blurring...
2012: Pediatric Neurosurgery
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