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https://www.readbyqxmd.com/read/28731977/interventions-for-neuropathic-pain-an-overview-of-systematic-reviews
#1
Svjetlana Dosenovic, Antonia Jelicic Kadic, Maja Miljanovic, Marina Biocic, Krste Boric, Marija Cavar, Nikolina Markovina, Katarina Vucic, Livia Puljak
Numerous interventions for neuropathic pain (NeuP) are available, but its treatment remains unsatisfactory. We systematically summarized evidence from systematic reviews (SRs) of randomized controlled trials on interventions for NeuP. Five electronic databases were searched up to March 2015. Study quality was analyzed using A Measurement Tool to Assess Systematic Reviews. The most common interventions in 97 included SRs were pharmacologic (59%) and surgical (15%). The majority of analyzed SRs were of medium quality...
August 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28698694/efficiency-of-medetomidine-for-epidural-analgesia-effects-on-isoflurane-requirement-and-mean-systemic-arterial-blood-pressure-in-dogs
#2
Ryota Watanabe, Yukihiro Fujita
Five healthy beagle dogs anesthetized with isoflurane were administered medetomidine (α-2 adrenoceptor agonist) by the epidural route. Mean arterial pressure (MAP) and end-tidal concentration of isoflurane (ISO) were measured 1, 2.5, and 4 h after administration. Epidural administration of medetomidine reduced the isoflurane dose required to prevent changes in vital parameters following mechanical stimulation and maintained the MAP at a higher level compared to the control.
July 2017: Canadian Veterinary Journal. la Revue Vétérinaire Canadienne
https://www.readbyqxmd.com/read/28696946/optimal-treatment-for-lumbar-spinal-stenosis-an-update
#3
Janus Patel, Ian Osburn, Anne Wanaselja, Ryan Nobles
PURPOSE OF REVIEW: Our review of current literature within the past 12-24 months for the treatment of lumbar spinals stenosis (LSS) serves to update providers on recent advances and comparisons regarding therapy spanning lifestyle modification, pharmacologic therapy, minimally invasive interventions, and surgical interventions. RECENT FINDINGS: Current literature supporting the inclusion of physical therapy and gabapentin/pregabalin within an initial treatment regimen have been positive...
July 10, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28681962/systematic-review-of-management-of-chronic-pain-after-surgery
#4
REVIEW
V Wylde, J Dennis, A D Beswick, J Bruce, C Eccleston, N Howells, T J Peters, R Gooberman-Hill
BACKGROUND: Pain present for at least 3 months after a surgical procedure is considered chronic postsurgical pain (CPSP) and affects 10-50 per cent of patients. Interventions for CPSP may focus on the underlying condition that indicated surgery, the aetiology of new-onset pain or be multifactorial in recognition of the diverse causes of this pain. The aim of this systematic review was to identify RCTs of interventions for the management of CPSP, and synthesize data across treatment type to estimate their effectiveness and safety...
July 6, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28674775/hypothalamo-pituitary-adrenal-axis-after-a-single-epidural-triamcinolone-injection
#5
Ali Iranmanesh, Dakshinamurty Gullapalli, Ravinder Singh, Johannes D Veldhuis
PURPOSE: To quantify adrenocorticotropin and cortisol secretion after epidural glucocorticoid injection. METHODS: Eight men (ages 25-63 year) were studied at baseline, 1, 4, and 12 weeks after triamcinolone (80 mg) injection epidurally. Adrenocorticotropin (pg/mL) and cortisol (µg/dL) were measured every 10 min for 4 h, and after Corticotropin-releasing hormone (CRH) (1 µg/kg) injection. RESULTS: Epidural triamcinolone markedly suppressed: (1) pre-CRH injection ACTH (from 18 ± 3...
August 2017: Endocrine
https://www.readbyqxmd.com/read/28673596/intra-spinal-microstimulation-may-alleviate-chronic-pain-after-spinal-cord-injury
#6
Bin Shu, Fei Yang, Yun Guan
Chronic pain after spinal cord injury (SCI) is a form of central neuropathic pain that is debilitating and often refractory to current pharmacological treatments. Neurostimulation pain therapies, such as epidural spinal cord stimulation, have only moderate success in reducing SCI pain. The pathogenesis of SCI pain may involve a state of central neuronal hyperexcitability, especially in the spinal cord dorsal horn, that develops after injury. We hypothesize that the neuronal structures near the spinal cord injury site may be an important pain generator, and intraspinal microstimulation (ISMS) may normalize dorsal horn neuronal hyperexcitability and hence alleviate SCI pain...
July 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28658132/emergency-1-stage-anterior-approach-for-cervical-spine-infection-complicated-by-epidural-abscess
#7
Haoxi Li, Zhaoxiong Chen, Zhiyao Yong, Xinhua Li, Yufeng Huang, Desheng Wu
It was a retrospective analysis.The aim of the study was to explore the safety and reliability of emergency 1-stage radical debridement and reconstruction using titanium mesh filled with autologous bone for patients with cervical spine infection complicated by epidural abscess.At present, cervical spine infection complicated by epidural abscess is known as a severe spine disease. Recently, case report of this disease is showing quite an increasing tendency, particularly in economically undeveloped areas and countries...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28628595/activity-based-therapy-from-basic-science-to-clinical-application-for-recovery-after-spinal-cord-injury
#8
Andrea L Behrman, Elizabeth M Ardolino, Susan J Harkema
BACKGROUND AND PURPOSE: Collaboration between scientists and clinicians effectively accelerated translation of scientific evidence for activity-based therapies (ABTs) into rehabilitation. This article addresses the basic scientific findings of activity-dependent plasticity that led to locomotor training, an ABT, and its principles to advance recovery in adult and pediatric populations with spinal cord injury (SCI). Expansion to new therapies based on these common principles is highlighted, for example, epidural stimulation...
July 2017: Journal of Neurologic Physical Therapy: JNPT
https://www.readbyqxmd.com/read/28615341/high-frequency-epidural-stimulation-across-the-respiratory-cycle-evokes-phrenic-short-term-potentiation-after-incomplete-cervical-spinal-cord-injury
#9
Elisa J Gonzalez-Rothi, Kristi A Streeter, Marie H Hanna, Anna C Stamas, Paul J Reier, David M Baekey, David D Fuller
C2 spinal hemilesion (C2Hx) paralyzes the ipsilateral diaphragm, but recovery is possible through activation of "crossed spinal" synaptic inputs to ipsilateral phrenic motoneurons. We tested the hypothesis that high frequency epidural stimulation (HF-ES) would potentiate ipsilateral phrenic output after subacute and chronic C2Hx. HF-ES (300 Hz) was applied to the ventrolateral C4 or T2 spinal cord ipsilateral to C2Hx in anesthetized and mechanically ventilated adult rats. Stimulus duration was 60-sec and currents ranged from 100-1000 µA...
June 14, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28583460/spinal-cord-compression-secondary-to-epidural-fibrosis-associated-with-percutaneously-placed-spinal-cord-stimulation-electrodes-case-report-and-review-of-the-literature
#10
Mazin Al Tamimi, Salah G Aoun, Wayne Gluf
Spinal cord stimulation is a safe method for treating chronic pain syndromes. Spinal cord stimulators can be placed either surgically by creating a laminectomy defect for paddle leads or percutaneously by inserting electrodes. They are usually not associated with major complications. There have been several reports of epidural fibrosis formation after paddle lead placement but only 1 case of excessive fibrosis following percutaneous lead placement. We describe the unique case of excessive cervical fibrosis formation with creation of tolerance phenomenon, clinically significant stenosis, cord compression, and myelopathy after percutaneous lead placement, which improved after surgical removal of the implant...
August 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28576833/spinal-cord-stimulation-reduces-ventricular-arrhythmias-during-acute-ischemia-by-attenuation-of-regional-myocardial-excitability
#11
Kimberly Howard-Quijano, Tatsuo Takamiya, Erica A Dale, Jasmine Kipke, Yukiko Kubo, Tristan Grogan, Andyshea Afyouni, Kalyanam Shivkumar, Aman Mahajan
BACKGROUND: Myocardial ischemia creates autonomic nervous system imbalance and can trigger cardiac arrhythmias. We hypothesize that neuromodulation by spinal cord stimulation (SCS) will attenuate local cardiac sympathoexcitation from ischemia-induced increases in afferent signaling, reduce ventricular arrhythmias, and improve myocardial function during acute ischemia. METHODS: Yorkshire pigs (n=20) were randomized to SCS (50 Hz at 200μsec duration, current 90% motor threshold) or Sham for 30 min prior to ischemia...
June 2, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28560030/thoracolumbar-epidural-anaesthesia-with-0-5-bupivacaine-with-or-without-methadone-in-goats
#12
Priscila Dos Santos Silva, Paulo Fantinato-Neto, André Nicolai Elias Silva, Eduardo Harry Birgel Junior, Adriano Bonfim Carregaro
BACKGROUND: Epidural anaesthesia is one of the most commonly used locoregional techniques in ruminants. The lumbosacral epidural technique is reasonably easy to perform and requires low volumes of local anaesthetic drug to allow procedures caudal to the umbilicus. However, surgical procedures in the flank of the animal would require an increased volume of drugs. The anaesthetized area provided by thoracic epidural technique is larger than the lumbosacral technique; however the former is rather challenging to perform...
2017: Irish Veterinary Journal
https://www.readbyqxmd.com/read/28535546/cost-utility-analysis-of-lumbar-interlaminar-epidural-injections-in-the-treatment-of-lumbar-disc-herniation-central-spinal-stenosis-and-axial-or-discogenic-low-back-pain
#13
Laxmaiah Manchikanti, Vidyasagar Pampati, Ramsin M Benyamin, Joshua A Hirsch
BACKGROUND: Cost utility or cost effective analysis continues to take center stage in the United States for defining and measuring the value of treatments in interventional pain management. Appropriate cost utility analysis has been performed for caudal epidural injections, percutaneous adhesiolysis, and spinal cord stimulation. However, the literature pertaining to lumbar interlaminar epidural injections is lacking, specifically in reference to cost utility analysis derived from randomized controlled trials (RCTs) with a pragmatic approach in a practical setting...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28515284/long-lasting-increase-in-axonal-excitability-following-epidurally-applied-dc
#14
Elzbieta Jankowska, Dominik Kaczmarek, Francesco Bolzoni, Ingela Hammar
Effects of direct current (DC) on nerve fibres have primarily been investigated during or just after DC application. However, locally applied cathodal DC was recently demonstrated to increase the excitability of intraspinal preterminal axonal branches for more than one hour. The aim of this study was, therefore, to investigate whether DC evokes a similarly long-lasting increase in the excitability of myelinated axons within the dorsal columns. The excitability of dorsal column fibres stimulated epidurally was monitored by recording compound action potentials in peripheral nerves in acute experiments in deeply anaesthetized rats...
May 17, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28489550/a-fully-integrated-wireless-soc-for-motor-function-recovery-after-spinal-cord-injury
#15
Yi-Kai Lo, Yen-Cheng Kuan, Stanislav Culaclii, Brian Kim, Po-Min Wang, Chih-Wei Chang, Jonathan A Massachi, Minji Zhu, Kuanfu Chen, Parag Gad, V Reggie Edgerton, Wentai Liu
This paper presents a wirelessly powered, fully integrated system-on-a-chip (SoC) supporting 160-channel stimulation, 16-channel recording, and 48-channel bio-impedance characterization to enable partial motor function recovery through epidural spinal cord electrical stimulation. A wireless transceiver is designed to support quasi full-duplex data telemetry at a data rate of 2 Mb/s. Furthermore, a unique in situ bio-impedance characterization scheme based on time-domain analysis is implemented to derive the Randles cell electrode model of the electrode-electrolyte interface...
June 2017: IEEE Transactions on Biomedical Circuits and Systems
https://www.readbyqxmd.com/read/28487834/effect-of-treadmill-training-protocols-on-locomotion-recovery-in-spinalized-rats
#16
Hamid R Kobravi, Ali Moghimi, Zahra Khodadadi
Both treadmill training and epidural stimulation can help to reactivate the central pattern generator (CPG) in the spinal cord after a spinal cord injury. However, designing an appropriate training approach and a stimulation profile is still a controversial issue. Since the spinal afferent signals are the input signals of CPG in the spinal cord, it can be concluded that the number of input afferent signals can affect the quality of movement recovery, such a phenomenon is in accordance with Hebbian theory. Therefore, at first in this paper, through some simulation studies on a model of CPGs, the effective influence of increasing the afferent input weight on activating CPG model was certified...
January 2017: Journal of Medical Signals and Sensors
https://www.readbyqxmd.com/read/28474539/induced-neural-activity-promotes-an-oligodendroglia-regenerative-response-in-the-injured-spinal-cord-and-improves-motor-function-after-spinal-cord-injury
#17
Qun Li, Thierry Houdayer, Su Liu, Visar Belegu
Myelination in central nervous system (CNS) is a dynamic process that includes birth of oligodendrocyte progenitor cells (OPCs), their differentiation into oligodendrocytes, and ensheathment of axons. Regulation of myelination by neuronal activity has emerged as a new mechanism of CNS plasticity. Indeed, activity-dependent myelination has been shown to regulate sensory, motor and cognitive functions. In this work, we aimed to employ this mechanism of CNS plasticity by utilizing induced neuronal activity to promote remyelination and functional recovery in a subchronic model of SCI...
May 5, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28425137/three-dimensional-printing-an-aid-to-epidural-access-for-neuromodulation
#18
Murray G Taverner, John P Monagle
OBJECTIVE: The case report details to use of three-dimensional (3D) printing as an aid to neuromodulation. METHODS: A patient is described in whom previous attempts at spinal neuromodulation had failed due to lack of epidural or intrathecal access, and the use of a 3D printed model allowed for improved planning and ultimately, success. RESULTS: Successful spinal cord stimulation was achieved with the plan developed by access to a 3D model of the patient's spine...
April 20, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28422349/effects-of-extrinsic-cardiac-nerve-stimulation-on-atrial-fibrillation-inducibility-the-regulatory-role-of-the-spinal-cord
#19
Zixuan Dai, Congxin Huang, Qingyan Zhao, Shujuan Zhang, Hongyi Zhao, Youjing Zhang, Yongsheng Qian, Yanhong Tang
OBJECTIVE: To investigate the effect of the mutual regulation of the extrinsic cardiac nerves on atrial electrophysiology and atrial fibrillation (AF) vulnerability. METHODS AND RESULTS: Fourteen dogs were randomly divided into two groups: spinal cord stimulation (SCS) group (n = 7) and spinal cord block (SCB) group (n = 7). SCS was performed with 90% of the threshold voltage stimulating the T1 -T2 spinal level, while SCB was performed by injecting 2% lidocaine into the epidural space at the T2-3 level...
April 19, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28403104/effect-of-bipolar-pulsed-radiofrequency-on-refractory-chronic-cervical-radicular-pain-a-report-of-two-cases
#20
Min Cheol Chang
RATIONALE: Despite undergoing transforaminal epidural steroid injection (TFESI), many patients complain of persisting cervical radicular pain. For the management of chronic cervical radicular pain, clinicians are widely applying pulsed radiofrequency (PRF) stimulation to dorsal root ganglions (DRGs). To enhance the effect of PRF stimulation, we conducted bipolar PRF stimulation in 2 patients with chronic cervical radicular pain that was refractory to monopolar PRF and repeated TFESIs...
April 2017: Medicine (Baltimore)
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