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Chronic back pain post surgery

Daniel Gaudin, Brianna M Krafcik, Tarek R Mansour, Ahmed Alnemari
OBJECTIVE: This literature review was conducted to better understand the factors associated with optimal post-operative results following lumbar spinal fusion for chronic back pain, and the current tools used for evaluation. BACKGROUND: Despite widespread use of lumbar spinal fusion as a treatment for back pain, outcomes remain variable. Optimizing patient selection can help to reduce adverse outcomes. METHODS: The PubMed database was searched for clinical trials related to psychosocial determinants of outcome following lumbar spinal fusion surgery, evaluation of commonly used patient subjective outcome measures, and perioperative cognitive, behavioral, and educational therapies...
October 31, 2016: World Neurosurgery
Mohammad Zarei, Arvin Najafi, Pejman Mansouri, Sadaf Sadeghi-Yazdankhah, Houshang Saberi, Mehran Moradi, Mahmoud Farzan
OBJECTIVES: Despite the progress in understanding acute pain physiology during recent decade, eighty percent of patients still suffer from post-operative discomfort. Pregabalin is an anticonvulsant agent that is approved for painful neuropathies in diabetic patients and post herpetic neuralgia. The main objective of the present study was to compare the improvement in post-operative pain management and patient lifestyle in 3 groups, as first group received placebo, second who received Pregabalin for one day and the last group those who received it for 14 days...
October 17, 2016: Clinical Neurology and Neurosurgery
Mario G Zotti, Oscar P Brumby-Rendell, Ben McDonald, Tom Fisher, Christovalantis Tsimiklis, Wai Weng Yoon, Orso L Osti
BACKGROUND: Our aim was to determine whether patients derived benefit from removal of pedicle screw instrumentation for axial pain without other cause using our surgical technique and patient selection. A secondary aim was to investigate factors that were associated with poorer outcomes for this procedure as well as complication rate in this cohort. METHODS: Theater records from a single spinal surgeon's practice were reviewed to identify patients that had undergone lumbar fusion for discogenic back pain with subsequent pedicle screw instrumentation removal (Expedium, DePuy Synthes) in the preceding 3 years with a minimum of 18 months follow-up...
December 2015: Journal of Spine Surgery (Hong Kong)
Mert Akbaş, Mehmet Arif Yeğin, İrem Özdemir, Ethem Göksu, Mahmut Akyüz
Spinal cord stimulation as treatment of chronic low back pain via neuromodulation has been frequently performed in recent years. The dorsal column is stimulated by an electrode placed at the epidural region. In the case presently described, subcutaneous lead was implanted in a patient with failed back syndrome after spinal cord stimulation was inadequate to treat back and gluteal pain. A 65-year-old male had undergone surgery to treat lumbar disc herniation, after which he received physical therapy and multiple steroid injections due to unrelieved pain...
January 2016: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
B Shrauner, A Blikslager, J Davis, N Campbell, M Law, M Lustgarten, T Prange
REASONS FOR PERFORMING STUDY: The large size of the adult horse prevents the use of advanced imaging modalities in most areas of the axial skeleton, including the lumbosacral vertebral column. Traditional imaging techniques are frequently unable to pinpoint the underlying pathology in horses with caudal back pain. In man, lumbosacral epiduroscopy is used to diagnose and treat subjects with chronic back and leg pain. This technique may close the diagnostic gap in horses with similar clinical signs...
May 14, 2016: Equine Veterinary Journal
Erik Van de Kelft
STUDY DESIGN: This is a feasibility study to confirm the design, the patient population and the surgical technique for FENIX™ implants. OBJECTIVE: This study evaluated the safety, the clinical and radiological performance of bilaterally implanted FENIX™ facet resurfacing device. INTRODUCTION: Facet joint osteoarthritis is responsible for up to 30% of chronic low back pain. Arthroplasty is a surgical treatment option that aims to relieve pain while maintaining or restoring motion...
May 3, 2016: Clinical Spine Surgery
Maria C S Inacio, Craig Hansen, Nicole L Pratt, Stephen E Graves, Elizabeth E Roughead
OBJECTIVES: To determine chronic opioid use pre-THA (total hip arthroplasty) and post-THA, and risk factors for persistent or new chronic opioid use post-THA. DESIGN: Retrospective cohort study. SETTING: Australian Government Department of Veterans' Affairs health claims database. PARTICIPANTS: 9525 patients who had an elective unilateral THA between 1/01/2001 and 12/31/2012. PRIMARY OUTCOME MEASURE: Chronic opioid use...
2016: BMJ Open
Mengqiao Alan Xi, Henry C Tong, Daniel K Fahim, Mick Perez-Cruet
Background Context Controversy remains over the use of provocative discography in conjunction with computed tomography (CT) to locate symptomatic intervertebral discs in patients with chronic, low back pain (LBP). The current study explores the relationship between discogenic pain and disc morphology using discography and CT, respectively, and investigates the efficacy of this combined method in identifying surgical candidates for lumbar fusion by evaluating outcomes. Methods 43 consecutive patients between 2006 and 2013 who presented with refractory low back pain and underwent discography and CT were enrolled in the study...
2016: Curēus
Jing L Han, Daniel B Loriaux, Caroline Tybout, Merritt D Kinon, Shervin Rahimpour, Scott L Runyon, Thomas J Hopkins, Richard L Boortz-Marx, Shivanand P Lad
BACKGROUND: Intrathecal catheter placement has long-term therapeutic benefits in the management of chronic, intractable pain. Despite the diverse clinical applicability and rising prevalence of implantable drug delivery systems in pain medicine, the spectrum of complications associated with intrathecal catheterization remains largely understudied and underreported in the literature. OBJECTIVE: To report a case of thoracic nerve root entrapment resulting from intrathecal catheter migration...
March 2016: Pain Physician
Ali Zamir Khan, Geethakrishnan Gopalakrishna Pillai
BACKGROUND: Among the traditional systems of medicine practiced all over the world, Ayurveda and Yoga has a documented history dating back to beyond 200 BC. Robotic and video assisted thoracic surgery (VATS) is an invention of the 21(st) century. We aim to quantify the effects of integration of Ayurveda and Yoga on patients undergoing minimally invasive robotic and VATS. METHODS: Four hundred and fifty-four patients undergoing VATS and robotic thoracic surgery were introduced to a pre and postoperative protocol of Yoga therapy, mediation and oil massages...
February 2016: Journal of Thoracic Disease
Standiford Helm, Gabor B Racz, Ludger Gerdesmeyer, Rafael Justiz, Salim M Hayek, Eugene D Kaplan, Mohamed Ahamed El Terany, Nebojsa Nick Knezevic
BACKGROUND: Chronic refractory low back and lower extremity pain is frustrating to treat. Percutaneous adhesiolysis and spinal endoscopy are techniques which can treat chronic refractory low back and lower extremity pain.Percutaneous adhesiolysis is performed by placing the catheter into the tissue plane at the ventrolateral aspect of the foramen so that medications can be injected. Adhesiolysis is used both for pain caused by scarring which is not resistant to catheter placement and other sources of pain, including inflammation in the absence of scarring...
February 2016: Pain Physician
Salim M Hayek, Elias Veizi, Michael Hanes
BACKGROUND: Intrathecal (IT) pumps have become a valuable tool in managing intractable non-cancer pain. The purpose of this study was to evaluate the efficacy of using a rigorous treatment algorithm for trialing and implanting IT pumps with hydromorphone and bupivacaine in managing a more homogeneous population of post-laminectomy syndrome or failed back surgery syndrome (FBSS) patients. METHODS:  This is a retrospective analysis of FBSS patients with chronic intractable back pain implanted with IT pumps delivering hydromorphone and bupivacaine...
March 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Tara Renton, Nadine Kahwaja
Neuropathic pain is a significant social and economic burden. Back pain, joint pain and headaches affect over 30% of the population. Chronic orofacial pain is a common condition and is difficult to diagnose and manage. This two-part paper aims to provide an overview of novel understanding of neuropathic pain, and furnish clinical teams with an update on the less common and less well-recognized chronic orofacial conditions. Headaches and temporomandibular disorders are the most common conditions and are covered in separate papers (6 and 10)...
October 2015: Dental Update
Alan D Kaye, Laxmaiah Manchikanti, Salahadin Abdi, Sairam Atluri, Sanjay Bakshi, Ramsin Benyamin, Mark V Boswell, Ricardo Buenaventura, Kenneth D Candido, Harold J Cordner, Sukdeb Datta, Gulshan Doulatram, Christopher G Gharibo, Vahid Grami, Sanjeeva Gupta, Sachin Jha, Eugene D Kaplan, Yogesh Malla, Dharam P Mann, Devi E Nampiaparampil, Gabor Racz, Prithvi Raj, Maunak V Rana, Manohar Lal Sharma, Vijay Singh, Amol Soin, Peter S Staats, Ricardo Vallejo, Bradley W Wargo, Joshua A Hirsch
BACKGROUND: Epidural injections have been used since 1901 in managing low back pain and sciatica. Spinal pain, disability, health, and economic impact continue to increase, despite numerous modalities of interventions available in managing chronic spinal pain. Thus far, systematic reviews performed to assess the efficacy of epidural injections in managing chronic spinal pain have yielded conflicting results. OBJECTIVE: To evaluate and update the clinical utility of the efficacy of epidural injections in managing chronic spinal pain...
November 2015: Pain Physician
Robyn Capobianco, Daniel Cher
Postpartum posterior pelvic girdle pain (PPGP) affects nearly 20 % of women who experience back pain in the peripartum period. The sacroiliac joint is a source of this pain in 75 % of women with persistent PPGP. A subset of women will fail to obtain acceptable pain relief from the current array of non-surgical treatment options. The purpose of this study is to assess the safety and effectiveness of minimally invasive sacroiliac (SI) joint fusion in women with chronic SI joint dysfunction whose pain began in the peri-partum period whose symptoms were recalcitrant to non-surgical management...
2015: SpringerPlus
Adriaan Louw, Emilio J Puentedura, Ina Diener, Randal R Peoples
Therapeutic neuroscience education (TNE) has been shown to be effective in the treatment of mainly chronic musculoskeletal pain conditions. This case study aims to describe the changes in brain activation on functional magnetic resonance imaging (fMRI) scanning, before and after the application of a newly-designed preoperative TNE program. A 30-year-old female with a current acute episode of low back pain (LBP) and radiculopathy participated in a single preoperative TNE session. She completed pre- and post-education measures including visual analog scale (VAS) for LBP and leg pain; Oswestry Disability Index (ODI); Fear Avoidance Beliefs Questionnaire (FABQ); Pain Catastrophizing Scale (PCS) and a series of Likert-scale questions regarding beliefs and attitudes to lumbar surgery (LS)...
2015: Physiotherapy Theory and Practice
Erik Van de Kelft, Johan Van Goethem
PURPOSE: This prospective randomized comparative trial compared radiological and clinical outcome of Trabecular Metal™ (TM) spacers in PLIF, used as standalone (SA) devices, to TM spacers in PLIF with pedicle screw fixation (PF), in patients with single-level degenerative disc disease (DDD). METHODS: Patients (n = 80) with chronic low back pain and single-level degenerative disc were randomly assigned to the SA PLIF (n = 40) or PLIF with PF (n = 40). The primary radiological outcome was the evaluation of a long-term (±6 years; range 6...
November 2015: European Spine Journal
Tracy Jackson, Sarah Thomas, Victoria Stabile, Xue Han, Matthew Shotwell, Kelly McQueen
BACKGROUND: The global burden of chronic pain and disability could be related to unmet surgical needs. This systematic review and meta-analysis aims to characterise existing data regarding the prevalence and associations of chronic pain in low-income and middle-income countries; this is essential to allow better assessment of its relationship to pre-operative and post-operative pain as emergency and essential surgical services are expanded. METHODS: According to PRISMA guidelines, we searched PubMed, PsycInfo, and Cochrane registries for articles published before Dec 31, 2013, using the search terms "pain AND (chronic OR persistent) AND (low income countries OR middle income countries OR LMIC OR Africa OR Asia OR Central America OR South America) AND (incidence OR prevalence)...
April 27, 2015: Lancet
Mahmoud R Khalatbari, Mehrdokht Hamidi, Yashar Moharamzad, Elham Shobeiri
BACKGROUND: Myxopapillary ependymoma (MPE) is a rare variant of ependymoma usually occurring in the conus medullaris or the filum terminale. It is usually a single encapsulated lesion. The aim of this study was to describe patients with primary multifocal MPE of the filum terminale. METHODS: In this retrospective study, medical records of 22 patients with spinal MPE who underwent surgical treatment in our hospital between January 2003 and January 2010 were enrolled...
December 2016: Journal of Neurosurgical Sciences
Martin T N Knight, Ingrid Jago, Christopher Norris, Lynne Midwinter, Christopher Boynes
BACKGROUND: Conventional diagnosis between axial and foraminal stenosis is suboptimal and long-term outcomes limited to posterior decompression. Aware state Transforaminal Endoscopic Lumbar Decompression and Foraminoplasty (TELDF) offers a direct aware state means of localizing and treating neuro-claudicant back pain, referred pain and weakness associated with stenosis failing to respond to conventional rehabilitation, pain management or surgery. This prospective survivability study examines the outcomes 10 years after TELDF in patients with foraminal stenosis arising from degeneration or failed back surgery...
2014: International Journal of Spine Surgery
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