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https://www.readbyqxmd.com/read/27910253/a-computed-tomography-guided-demonstration-of-the-unilateral-distribution-of-low-volume-epidural-injectate
#1
Semih Gungor, Rohit Aiyer
The epidural space is frequently used for placement of the epidural needle, catheter, and various pharmacological agents. The presence of structures in the epidural space such as epidural fat, venous plexus, or ligaments that may lead to uneven distribution of agents within the epidural space have been described.(1-3) Whether these structures are anatomical (such as connective tissue) or functional (due to distortions of actual anatomy secondary to injection of agents epidurally) has been disputed.(2-5) We describe our management of a patient who presented with bilateral radicular symptoms and severe low back pain...
December 2, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27908615/unilaterally-posterior-lumbar-interbody-fusion-with-double-expandable-peek-cages-without-pedicle-screw-support-for-lumbar-disc-herniation
#2
Aydemir Kale, Ibrahim Ilker Oz, Ayhan Onk, Murat Kalaycı, Çağatay Büyükuysal
OBJECTIVES: Posterior lumbar interbody fusion (PLIF) is usually bilateral procedure, and it is combined with posterior by bilateral pedicle screw support or with fixation. The purpose of this retrospective study was to compare the surgical outcomes of simple discectomy and PLIF without pedicle screw support in patients with lumbar disc herniation (LDH). PATIENTS AND METHODS: 60 patients with single segment LDH were operated between February 2010 and June 2013. 40 patients were treated with simple discectomy (Group 1) and 20 patients were treated with PLIF using double expandable polyetheretherketone (PEEK) cages without instrumentation (Group 2) unilaterally...
November 17, 2016: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/27906952/conus-medullaris-infarction-after-a-right-l4-transforaminal-epidural-steroid-injection-using-dexamethasone
#3
Christopher G Gharibo, Michael Fakhry, Sudhir Diwan, Alan D Kaye
BACKGROUND: For decades, epidural steroid injections have been an effective tool in the management of many pain related conditions, including lumbar radiculopathy. Transforaminal epidural steroid injections in particular have been reported to potentially result in central nervous system infarctions which have not been reported with interlaminar epidural steroid injections, while providing comparable efficacy. This rare, catastrophic complication has been attributed by some authors to be due to vascular injury secondary to vasospasm, thrombus formation, dissection, as well as concerns with placing the needle at the so-called "safe triangle...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27906950/clinical-evaluation-and-magnetic-resonance-imaging-assessment-of-intradiscal-methylene-blue-injection-for-the-treatment-of-discogenic-low-back-pain
#4
XiaoJun Zhang, Jie Hao, Zhenming Hu, HaiTao Yang
BACKGROUND: Low back pain is a common worldwide health problem and has a significant socioeconomic impact on public health. Internal disc disruption has been considered as the most common cause of low back pain. Various therapies, including interbody fusion, disc replacement, injection therapies, and thermal annular procedures have been utilized for the treatment of discogenic low back pain. Recently, a new method of intradiscal methylene blue injection has been introduced to treat discogenic low back pain, but the clinical outcomes are controversial...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27906739/posterior-vertebral-column-resection-with-intraoperative-manual-retraction-for-the-treatment-of-posttubercular-kyphosis-in-upper-thoracic-spine-or-cervicothoracic-junction
#5
Yuqiao Chen, Guohua Lü, Bing Wang, Lei Li, Lei Kuang
STUDY DESIGN: This is a case-series. OBJECTIVE: To evaluate the clinical and radiologic outcomes of posterior vertebral column resection (PVCR) for treatment of posttubercular kyphosis in upper thoracic spine and cervicothoracic junction (CTJ). SUMMARY OF BACKGROUND DATA: Surgical management of severe posttubercular kyphosis in upper thoracic spine or CTJ is challenging. A new technique that combines PVCR and intraoperative manual traction in a single procedure, was developed to maximize the correction rate and minimize the risk of dural buckling and spinal cord injury...
November 30, 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27904817/transitional-vertebra-and-spina-bifida-occulta-related-with-chronic-low-back-pain-in-a-young-patient
#6
Maryam Kundi, Maham Habib, Sumbal Babar, Asif K Kundi, Salman Assad, Amjad Sheikh
Bertolotti's syndrome (BS) must be considered as a differential diagnosis in a young patient presenting with low back pain (LBP). We present a case of a 26-year-old male complaining of mild chronic LBP for six years, radiating to his left thigh for the past six months. He has been taking non-steroidal anti-inflammatory drugs (NSAIDs) with skeletal muscle relaxants for pain relief. The X-ray and computed tomography (CT) imagings showed congenital enlargement of the left transverse process of the fifth lumbar (L5) vertebra forming pseudo-articulation with the sacrum and unilateral pars interarticularis defect at the L4 level on the left side, respectively...
October 19, 2016: Curēus
https://www.readbyqxmd.com/read/27904232/inter-professional-practices-of-private-sector-physiotherapists-for-low-back-pain-management-who-how-and-when
#7
Kadija Perreault, Clermont E Dionne, Michel Rossignol, Stéphane Poitras, Diane Morin
Purpose: Although there have been increasing demands for health care providers to take part in inter-professional practices in recent years, very little attention has been paid to the actualization of such practices in the private sector. This study describes private-sector physiotherapists' inter-professional practices regarding low back pain (LBP) management and identifies organizational and provider-level variables associated with the intensity of such practices. Method: A total of 327 randomly selected physiotherapists were surveyed in the province of Quebec...
2016: Physiotherapy Canada. Physiothérapie Canada
https://www.readbyqxmd.com/read/27900710/customized-tantalum-augmented-reverse-shoulder-arthroplasty-for-glenoid-bone-defect-and-excessive-medialization-description-of-the-technique
#8
Nicola Ivaldo, Tony Mangano, Giovanni Caione, Mario Rossoni, Angelo Ligas
BACKGROUND: Glenoid bone defect and excessive medialization could represent challenging issues during reverse shoulder arthroplasty, especially in the setting of revision surgery. Although a solution is offered by the Boileau's BIO-RSA technique in primary cases, only autologous iliac crest bone graft and homologous graft from bone banks are available for revision surgeries, with known disadvantages and risk of graft resorption and implant failure. MATERIALS AND METHODS: We describe in this work a new technique based on a customized porous tantalum device to be used in salvage situations, aimed at lateralization of the glenoid component of a reverse shoulder arthroplasty...
December 2016: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/27900552/giant-chordoma-in-the-thoracolumbar-spine-a-case-report-and-literature-review
#9
Feifei Pu, Baichuan Wang, Jianxiang Liu, Fengxia Chen, Zengwu Shao
STUDY DESIGN: Case report. PURPOSE: We present a rare case of a giant chordoma in the thoracolumbar spine and review the current literature. We describe its complicated clinical progression, hoping to shed light on the clinical management of this complex tumor. METHODS: We present a previously healthy 41-year-old man who experienced progressive low back pain at T10-L2 for the past 2 years. A giant tumor was detected on magnetic resonance imaging, and aspiration biopsy was used to obtain a definite pathological diagnosis...
November 29, 2016: European Spine Journal
https://www.readbyqxmd.com/read/27899069/gastric-dilatation-and-intestinal-obstruction-mimicking-acute-coronary-syndrome-with-dynamic-electrocardiographic-changes
#10
H M M T B Herath, Anne Thushara Matthias, B S D P Keragala, W A E Udeshika, Aruna Kulatunga
BACKGROUND: ST elevation myocardial infarction is a medical emergency and the electrocardiogram is a part of the mainstay in the initial diagnosis. A variety of non-cardiac conditions have been known to mimic the electrocardiographic changes seen in acute coronary syndrome. We present a patient presenting with acute partial intestinal obstruction causing gastric distension and intestinal dilatation who also had dynamic electrocardiographic changes, mimicking anterior ST elevation myocardial infarction...
November 29, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27898491/psychosocial-factors-predict-opioid-analgesia-via-endogenous-opioid-function
#11
John W Burns, Stephen Bruehl, Christopher R France, Erik Schuster, Daria Orlowska, Asokumar Buvanendran, Melissa Chont, Rajnish K Gupta
Use of opioid analgesics for management of chronic nonmalignant pain has become common, yet there are presently no well-validated predictors of optimal opioid analgesic efficacy. We examined whether psychosocial factors (e.g. depressive symptoms) predicted changes in spontaneous low back pain following administration of opioid analgesics, and whether endogenous opioid (EO) function mediated these relationships. Participants with chronic low back pain but who were not chronic opioid users (N = 89) underwent assessment of low back pain intensity pre- and post-drug in three (counterbalanced) conditions: 1) placebo, 2) intravenous naloxone, 3) intravenous morphine...
November 18, 2016: Pain
https://www.readbyqxmd.com/read/27898363/the-adverse-event-profile-of-brivaracetam-a-meta-analysis-of-randomized-controlled-trials
#12
Li-Na Zhu, Deng Chen, Tao Chen, Da Xu, Si-Han Chen, Ling Liu
PURPOSE: To comprehensively evaluate the adverse events (AEs) significantly associated with brivaracetam (BRV) treatment in a large selection of randomized control trials. METHODS: We conducted an online database search using Pubmed, Embase, Cochrane Online Library, and Clinicaltrial.gov for all available randomized control trials (RCTs) that investigated the therapeutic effects of brivaracetam. Serious AEs (SAEs), withdrawal, and treatment-emergent adverse effects were then assessed for their association with brivaracetam...
November 14, 2016: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/27893667/abdominal-compartment-syndrome-after-endovascular-repair-for-ruptured-abdominal-aortic-aneurysm-leads-to-acute-intestinal-necrosis-case-report
#13
Xiyang Chen, Jichun Zhao, Bin Huang, Ding Yuan, Yi Yang, Yukui Ma
INTRODUCTION: Abdominal compartment syndrome (ACS) after endovascular repair (EVAR) of rupture abdominal aortic aneurysm (rAAA) is a rare emergency situation, which has a high mortality. However, the progression of ACS is rapid and the diagnosis is usually been delayed, which increase the difficulties in treatment and affect the prognosis. We describe a case of a sever complication (acute intestinal necrosis) resulting from ACS after endovascular repair of rAAA. CLINICAL FINDING: An elderly man, 81 years old, complained a sudden lower abdominal and back pain without any predisposing cause...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27892441/a-prospective-study-of-commonly-prescribed-drugs-in-the-management-of-neuropathic-pain-and-its-medication-adherence-pattern
#14
R Shrestha, P Silwal, N Basnet, S Shakya Shrestha, R Shrestha, B R Pokharel
Background Neuropathic pain is one of the common complains of patients visiting neurology and orthopedic departments in hospitals. Management of neuropathic pain is difficult and is often symptomatic rather than being curative. Adherence to medication is necessary for pain management to be effective. However, there are various factors related to patient, physician, drug regimen and other socio-economic affecting adherence. Objective To study commonly prescribed drugs in neuropathic pain management and the medication adherence pattern including its associated factors...
January 2016: Kathmandu University Medical Journal (KUMJ)
https://www.readbyqxmd.com/read/27891040/inadvertent-injection-of-potassium-chloride-instead-of-sodium-chloride-during-treatment-of-chronic-low-back-ache-with-epidural-injection-leading-to-paraplegia
#15
Rahul Ranjan, Naiyer Asif, Sohail Ahmad, Syed Ifthekar
Epidural injection of steroid is given for back pain resistant to other conservative management. Normal saline (NS) is used as diluent in 80 mg methylprednisolone and a local anesthetic. Due to a similar looking ampoule of NS and potassium chloride (KCl), there is a probability of accidental use of KCl instead of NS. We present a case of a 50-year-old male patient having low back ache refractory to other conservative treatments. Epidural injection of steroid was given, but accidently KCl was mixed with methylprednisolone instead of NS...
October 2016: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/27891031/spinal-compression-fractures-due-to-pregnancy-associated-osteoporosis
#16
R Krishnakumar, Arun T Kumar, Mathew John Kuzhimattam
OBJECTIVES: To report on unique cases of spinal compression fractures due to pregnancy-associated osteoporosis (PAO) and to suggest a satisfactory treatment modality. MATERIALS AND METHODS: A single-center retrospective study. We reviewed the data of 535 patients with osteoporotic spinal compression fractures over a period of 5-year. Two patients who developed spinal compression fractures due to PAO were identified and treated. RESULTS: The clinical presentation and blood investigations ruled out other causes of osteoporosis...
October 2016: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/27890757/percutaneous-endoscopic-removal-of-a-lumbar-epidural-angiolipoma-via-interlaminar-approach-a-technical-report
#17
Guang-Yu Ying, Ying Yao, Fang Shen, Yu-Cheng Ren, Chien-Min Chen, Yong-Jian Zhu
BACKGROUND: Percutaneous endoscopic technique has been routinely used in the treatment of disk herniation while there are few reports on its application in the management of intraspinal tumors. We presented here the first case report of lumbar epidural angiolipoma that was totally removed by percutaneous endoscopy. CASE DESCRIPTION: A 63-year-old man presented with 4-month history of progressively worsening low back pain was admitted to our hospital. No abnormal neurological finding was noticed on physical examination and magnetic resonance imaging demonstrated a dorsally located L2-L3 epidural lesion, suggestive of a non-infiltrating angiolipoma...
November 24, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27889288/quiet-dissent-the-attitudes-beliefs-and-behaviours-of-uk-osteopaths-who-reject-low-back-pain-guidance-a-qualitative-study
#18
Joanna Figg-Latham, Dévan Rajendran
INTRODUCTION: Clinical guidelines are derived from best research evidence and aim to: improve quality of non-specific low back pain (nsLBP) management and identify patients at risk of suffering chronic pain. However, guideline discordant attitudes and beliefs have been identified in healthcare students and practitioners, including osteopaths. DESIGN: A qualitative approach with elements of grounded theory was used to explore underlying attitudes and beliefs of practitioners/students working in a British osteopathic education institution...
October 18, 2016: Manual Therapy
https://www.readbyqxmd.com/read/27886938/implementation-of-musculoskeletal-models-of-care-in-primary-care-settings-theory-practice-evaluation-and-outcomes-for-musculoskeletal-health-in-high-income-economies
#19
REVIEW
Krysia S Dziedzic, Simon French, Aileen M Davis, Elizabeth Geelhoed, Mark Porcheret
Musculoskeletal conditions represent one of the largest causes of years lived with disability in high-income economies. These conditions are predominantly managed in primary care settings, and yet, there is a paucity of evidence on which approaches work well in increasing the uptake of best practice and in closing the evidence-to-practice gap. Increasingly, musculoskeletal models of service delivery (as components of models of care) such as integrated care, stratified care and therapist-led care have been tested in primary health care pathways for joint pain in older adults, for low back pain and for arthritis...
June 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27882767/-traumatic-symphyseal-rupture-by-vaginal-delivery-report-of-a-rare-case
#20
J Hofierková
OBJECTIVE: This case report draw attention symphysis pubic dysfunction and injury pelvic girdle by vaginal delivary (in our case compliated by dystokia shoulders), mainly its diagnostic, prediction and treatment. DESIGN: Case report. SETTING: Department of Obstetrics and Gynecology. Hospital Česká Lípa. CASE REPORT: We report a case of a 31 years old woman, who gave birth for the second time with rupture of symphysis after delivery...
2016: Ceská Gynekologie
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