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https://www.readbyqxmd.com/read/29149139/reversal-of-growth-of-utilization-of-interventional-techniques-in-managing-chronic-pain-in-medicare-population-post-affordable-care-act
#1
Laxmaiah Manchikanti, Amol Soin, Dharam P Mann, Sanjay Bakshi, Vidyasagar Pampati, Joshua A Hirsch
BACKGROUND: Over the past 2 decades, the increase in the utilization of interventional techniques has been a cause for concern. Despite multiple regulations to reduce utilization of interventional techniques, growth patterns continued through 2009. A declining trend was observed in a previous evaluation; however, a comparative analysis of utilization patterns of interventional techniques has not been performed showing utilization before and after the enactment of the Affordable Care Act (ACA)...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29119066/bipolar-radiofrequency-facet-ablation-of-the-lumbar-facet-capsule-an-adjunct-to-conventional-radiofrequency-ablation-for-pain-management
#2
Robert E Jacobson, Ovidiu Palea, Michelle Granville
Radiofrequency facet ablation (RFA) has been performed using the same technique for over 50 years. Except for variations in electrode size, tip shape, and change in radiofrequency (RF) stimulation parameters, using standard, pulsed, and cooled RF wavelengths, the target points have remained absolutely unchanged from the original work describing RFA for lumbar pain control. Degenerative changes in the facet joint and capsule are the primary location for the majority of lumbar segmental pathology and pain. Multiple studies show that the degenerated facet joint is richly innervated as a result of the inflammatory overgrowth of the synovium...
September 1, 2017: Curēus
https://www.readbyqxmd.com/read/29016999/the-space-of-okada-with-bilateral-facet-joint-arthrograms-during-a-lumbar-interlaminar-epidural-injection
#3
David S Stolzenberg, Ari C Greis
No abstract text is available yet for this article.
July 13, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28955005/accurate-diagnosis-of-chronic-low-back-pain-in-a-high-level-college-athlete-a-case-report
#4
Kenji Yokoyama, Kazuta Yamashita, Masatoshi Morimoto, Fumitake Tezuka, Fumio Hayashi, Yoichiro Takata, Toshinori Sakai, Kosaku Higashino, Takashi Chikawa, Hiroshi Yonezu, Akihiro Nagamachi, Koichi Sairyo
A 21-year-old woman who was high-level college softball player presented with a 6-month history of low back pain that had been treated unsuccessfully by medication at local clinics. There was tenderness in the left paravertebral muscle at the lower lumbar level. X-ray and computed tomography revealed congenital scoliosis and an L6 hemivertebra. Short tau inversion recovery magnetic resonance imaging showed a fluid collection at the left L6-S1 facet joint. We performed a diagnostic facet injection, consisting of 1% lidocaine and steroids, that was infiltrated into the left facet joint at L6-S1...
2017: Journal of Medical Investigation: JMI
https://www.readbyqxmd.com/read/28934800/comparison-of-intraarticular-pulsed-radiofrequency-and-intraarticular-corticosteroid-injection-for-management-of-cervical-facet-joint-pain
#5
Ji Woon Lim, Yun-Woo Cho, Dong Gyu Lee, Min Cheol Chang
BACKGROUND: Disorders of the facet joints are some of the most common sources of chronic spinal pain. Facet joint pain is responsible for approximately 50% of patients with chronic neck pain. Pulsed radiofrequency (PRF) stimulation, after placing needle electrodes into the joint space, has been recently reported for the management of joint pain. OBJECTIVE: The aim of this study was to evaluate the effect of intraarticular (IA) PRF for the management of cervical facet joint (CFJ) pain...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28797833/percutaneous-rupture-of-zygapophyseal-joint-synovial-cysts-a-prospective-assessment-of-nonsurgical-management
#6
Gregory E Lutz, Michael R Nicoletti, George E Cyril, Julian R Harrison, Christopher Lutz, Jennifer L Solomon, Paul M Cooke, James F Wyss, Richard J Herzog, Peter J Moley
BACKGROUND: Although lumbar zygapophyseal joint synovial cysts are fairly well recognized, they are an uncommon cause of lumbosacral radicular pain. Nonoperative treatments include percutaneous aspiration of the cysts under computed tomography or fluoroscopic guidance with a subsequent corticosteroid injection. However, there are mixed results in terms of long-term outcomes and cyst reoccurrence. This study prospectively evaluates percutaneous ruptures of zygapophyseal joint (Z-joint) synovial cysts for the treatment of lumbosacral radicular pain...
August 7, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28690952/targeted-radiofrequency-ablation-as-an-adjunct-in-treatment-of-lumbar-facet-cysts
#7
Jesse Hatgis, Michelle Granville, Aldo Berti, Robert E Jacobson
Lumbar facet cysts are frequently found in patients with facet degeneration and segmental instability. When the facet cyst is localized in the neural foramina and lateral recess or becomes large, it can cause radiculopathy or neurogenic claudication. These symptomatic cysts are typically treated interventionally with drainage and a corticosteroid injection or attempts via overinflation to rupture the cyst; however, these procedures have a significant recurrence rate (up to 50%) and often need to be repeated or lead to lumbar surgery if unsuccessful...
June 6, 2017: Curēus
https://www.readbyqxmd.com/read/28689926/ablation-of-ib4-non-peptidergic-afferents-in-the-rat-facet-joint-prevents-injury-induced-pain-and-thalamic-hyperexcitability-via-supraspinal-glutamate-transporters
#8
Christine L Weisshaar, Jeffrey V Kras, Parul S Pall, Sonia Kartha, Beth A Winkelstein
The facet joint is a common source of neck pain, particularly after excessive stretch of its capsular ligament. Peptidergic afferents have been shown to have an important role in the development and maintenance of mechanical hyperalgesia, dysregulated nociceptive signaling, and spinal hyperexcitability that develop after mechanical injury to the facet joint. However, the role of non-peptidergic isolectin-B4 (IB4) cells in mediating joint pain is unknown. Isolectin-B4 saporin (IB4-SAP) was injected into the facet joint to ablate non-peptidergic cells, and the facet joint later underwent a ligament stretch known to induce pain...
August 10, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28670027/learning-curve-of-radiology-residents-during-training-in-fluoroscopy-guided-facet-joint-injections
#9
Tiago Rocha Dias, João de Deus da Costa Alves Junior, Nitamar Abdala
OBJECTIVE: To develop a simulator for training in fluoroscopy-guided facet joint injections and to evaluate the learning curve for this procedure among radiology residents. MATERIALS AND METHODS: Using a human lumbar spine as a model, we manufactured five lumbar vertebrae made of methacrylate and plaster. These vertebrae were assembled in order to create an anatomical model of the lumbar spine. We used a silicon casing to simulate the paravertebral muscles. The model was placed into the trunk of a plastic mannequin...
May 2017: Radiologia Brasileira
https://www.readbyqxmd.com/read/28663652/clonidine-as-an-adjuvant-in-fluoroscopic-guided-transforaminal-epidural-steroid-injection-in-a-patient-of-chronic-lumbosacral-radiculopathy
#10
Nandita Mehta, Misbah Salaria, A Q Salaria
Transforaminal epidural steroid injection (TFESI) is a minimally invasive modality used to treat patients with lumbosacral radiculopathy secondary to prolapsed intervertebral disc or spinal canal stenosis. In this case report, we describe the management of a patient with chronic lumbosacral radiculopathy secondary to intervertebral disc herniation which was seen as a right paracentral disc protrusion at levels L4-L5, L5-S1 causing thecal sac indentation, effacement of the right lateral recess and right exiting nerve root impingement as was seen on the magnetic resonance image...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28639551/facet-joint-injections-for-people-with-persistent-non-specific-low-back-pain-facet-injection-study-a-feasibility-study-for-a-randomised-controlled-trial
#11
David R Ellard, Martin Underwood, Felix Achana, James Hl Antrobus, Shyam Balasubramanian, Sally Brown, Melinda Cairns, James Griffin, Frances Griffiths, Kirstie Haywood, Charles Hutchinson, Ranjit Lall, Stavros Petrou, Nigel Stallard, Colin Tysall, David A Walsh, Harbinder Sandhu
BACKGROUND: The National Institute for Health and Care Excellence (NICE) 2009 guidelines for persistent low back pain (LBP) do not recommend the injection of therapeutic substances into the back as a treatment for LBP because of the absence of evidence for their effectiveness. This feasibility study aimed to provide a stable platform that could be used to evaluate a randomised controlled trial (RCT) on the clinical effectiveness and cost-effectiveness of intra-articular facet joint injections (FJIs) when added to normal care...
May 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28591071/comparison-of-intra-articular-thoracic-facet-joint-steroid-injection-and-thoracic-medial-branch-block-for-the-management-of-thoracic-facet-joint-pain
#12
Dong Gyu Lee, Sang Ho Ahn, Yun Woo Cho, Kyung Hee Do, Sang Gyu Kwak, Min Cheol Chang
STUDY DESIGN: A prospective observational study OBJECTIVE.: The aim of this study was to show the effect of intraarticular (IA) thoracic facet joint (TFJ) steroid injection for the management of TFJ pain, and to compare it with the effect of therapeutic thoracic medial branch block (MBB) with a local anesthetic and steroid. SUMMARY OF BACKGROUND DATA: Several studies have shown the effects of thoracic MBB with local anesthetics with or without steroids and radiofrequency neurotomy in managing TFJ pain, but thus far, the effectiveness of IA TFJ steroid injection has not been studied...
June 6, 2017: Spine
https://www.readbyqxmd.com/read/28580253/arthroscopic-patellar-lateral-facetectomy
#13
Marcio B Ferrari, George Sanchez, Jorge Chahla, Gilbert Moatshe, Robert F LaPrade
Isolated patellofemoral osteoarthritis is relatively prevalent, with the lateral facet of the patella being the most commonly affected portion. This pathology can be a result of a patellar maltracking syndrome, patella instability, or idiopathic degenerative changes. A thorough diagnostic work-up with a physical examination and imaging studies are mandatory for a proper diagnosis and to rule out other causes of patellofemoral knee pain. These patients are often treated nonoperatively with exercises for patella mobility, intra-articular injections, braces, patellar tracking, quadriceps balance and strength, and activity modification...
April 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28571789/virtual-reality-based-simulators-for-spine-surgery-a-systematic-review
#14
REVIEW
Michael Pfandler, Marc Lazarovici, Philipp Stefan, Patrick Wucherer, Matthias Weigl
BACKGROUND CONTEXT: Virtual reality (VR)-based simulators offer numerous benefits and are very useful in assessing and training surgical skills. Virtual reality-based simulators are standard in some surgical subspecialties, but their actual use in spinal surgery remains unclear. Currently, only technical reviews of VR-based simulators are available for spinal surgery. PURPOSE: Thus, we performed a systematic review that examined the existing research on VR-based simulators in spinal procedures...
May 29, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28557395/-analysis-of-the-clinical-efficacy-of-fasetoplasty-method-for-the-treatment-of-facet-syndrome-at-lumbar-spine-in-patients-with-middle-and-old-age-group
#15
V A Byvaltsev, A A Kalinin, A K Okoneshnikova
The aim of the study was to analyze results of using of fasetoplasty method in the treatment of facet-syndrome at lumbar spine in patients with middle and old age groups. The study included 227 patients older than 65 years with degenerative-dystrophic diseases of the lumbosacral spine and the clinical manifestations in the form of a facet syndrome, which in the period from 2010 to 2013 years made fasetoplasty prosthesis of synovial fluid. To assess the clinical effectiveness of using a visual analogue scale of pain (VAS) and a questionnaire for patients with back problems in Oswestry...
2017: Advances in Gerontology, Uspekhi Gerontologii
https://www.readbyqxmd.com/read/28508761/posterior-branches-of-lumbar-spinal-nerves-part-ii-lumbar-facet-syndrome-pathomechanism-symptomatology-and-diagnostic-work-up
#16
Katarzyna Kozera, Bogdan Ciszek, Paweł Szaro
Posterior branches of the lumbar spinal nerves are the anatomic substrate of pain in the lower back, sacrum and the gluteal area. Such pain may be associated with various pathologies which cause pain in the posterior branches of the lumbar spinal nerves due to entrapment, mechanical irritation or inflammatory reaction and/or degeneration. The posterior branches are of significant functional importance, which is related to the function of the structures they supply, including facet joints, which are the basic biomechanical units of the spine...
April 12, 2017: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28422871/ultrasound-versus-fluoroscopy-guided-medial-branch-block-for-the-treatment-of-lower-lumbar-facet-joint-pain-a-retrospective-comparative-study
#17
COMPARATIVE STUDY
Seung Hoon Han, Ki Deok Park, Kyoung Rai Cho, Yongbum Park
The aim of this study was to compare the mid-term effects and benefits of ultrasound (US)-guided and fluoroscopy (FL)-guided medial branch blocks (MBBs) for chronic lower lumbar facet joint pain through pain relief, functional improvement, and injection efficiency evaluation.Patients with chronic lumbar facet joint pain who received US (n = 68) or FL-guided MBBs (n = 78) were included in this retrospective study. All procedures were performed under FL or US guidance. Complication frequency, therapeutic effects, functional improvement, and the injection efficiency of MBBs were compared at 1, 3, and 6 months after the last injection...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28413117/structure-specific-movement-patterns-in-patients-with-chronic-low-back-dysfunction-using-lumbar-combined-movement-examination
#18
Aubrey P Monie, Roger I Price, Christopher R P Lind, Kevin P Singer
OBJECTIVE: A test-retest cohort study was conducted to assess the use of a novel computer-aided, combined movement examination (CME) to measure change in low back movement after pain management intervention in 17 cases of lumbar spondylosis. Additionally we desired to use a CME normal reference range (NRR) to compare and contrast movement patterns identified from 3 specific structural pathologic conditions: intervertebral disc, facet joint, and nerve root compression. METHODS: Computer-aided CME was used before and after intervention, in a cohort study design, to record lumbar range of movement along with pain, disability, and health self-report questionnaires in 17 participants who received image-guided facet, epidural, and/or rhizotomy intervention...
June 2017: Journal of Manipulative and Physiological Therapeutics
https://www.readbyqxmd.com/read/28395102/percutaneous-translaminar-facet-cyst-rupture-and-epidural-access-description-of-a-novel-technique
#19
David Spinner, Moris Aner, Geet Paul, Thomas Simopoulos, Jatinder Gill
Synovial cysts of the lumbar zygapophysial joints can be treated by percutaneous injection of corticosteroids, with distension and rupture of the cyst. Some cysts can be difficult to access, particularly when they lie deep in relation to the lamina. This technical report describes a fluoroscopy-guided technique for accessing sublaminar pathology. Crucial to the safety of the technique is visualization of the ventral margin of the lamina using a contralateral oblique view, and controlling and limiting the insertion of the needle such that only its tip passes the lamina...
March 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28382238/evaluation-and-interventional-management-of-pain-after-vertebral-augmentation-procedures
#20
Jesse Hatgis, Michelle Granville, Robert E Jacobson
INTRODUCTION: A small subset of patients who underwent successful vertebral compression fracture (VCF) augmentation procedures may develop subsequent pain requiring spinal injections. In a retrospective analysis, we determined whether the pain was related to the original fracture site or to another area within the lumbar or thoracic spine. The pain occurred either at the same/adjacent level and/or non-adjacent level as the VCF. Interventional treatments primarily targeted the facet joints, specifically in the form of facet joint blocks and/or radiofrequency ablation to the medial branches...
February 28, 2017: Curēus
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