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Lumbar epidural

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https://www.readbyqxmd.com/read/28072802/efficacy-of-adjuvant-10-hypertonic-saline-in-transforaminal-epidural-steroid-injection-a-retrospective-analysis
#1
Eun Young Joo, Won Uk Koh, Seong-Soo Choi, Jae-Hyung Choi, Ho-Soo Ahn, Hye Joo Yun, Jin-Woo Shin
BACKGROUND: Chronic lower back pain with or without radiculopathy represents an important medical, social, and economic problem. Many treatment modalities and techniques, including surgery and epidural administration of steroids, have been used to manage this pain. Hypertonic saline, which has been used as an adjunct to percutaneous epidural adhesiolysis, can also be injected via a transforaminal approach in expectation of longer-lasting effects. OBJECTIVES: This study aimed to determine the effect of adding hypertonic saline to conventional transforaminal epidural steroid injections (TFEI) to provide pain relief for chronic radiculopathy patients...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28072795/treatment-outcomes-for-patients-with-failed-back-surgery
#2
Jae Hwan Cho, Jae Hyup Lee, Kwang Sup Song, Jae-Young Hong, Yoon-Suk Joo, Dong-Ho Lee, Chang Ju Hwang, Choon Sung Lee
BACKGROUND: Failed back surgery syndrome (FBSS) is a frequently encountered disease entity following lumbar spinal surgery. Although many plausible reasons have been investigated, the exact pathophysiology remains unknown. Various medications, reoperations, interventions such as spinal cord stimulation, epidural adhesiolysis or epidural injection, exercise therapy, and psychotherapy have been suggested treatment options. However, the evidence of the clinical outcome for each treatment has not been clearly determined...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28068278/cervical-spondylitis-and-epidural-abscess-caused-by-brucellosis-a-case-report-and-literature-review
#3
Hatice Reşorlu, Suzan Saçar, Beşir Şahin Inceer, Ayla Akbal, Ferhat Gökmen, Coskun Zateri, Yilmaz Savaş
Brucellosis is a zoonotic disease widely seen in endemic regions and that can lead to systemic involvement. The musculoskeletal system is frequently affected, and the disease can exhibit clinical involvements such as arthritis, spondylitis, spondylodiscitis, osteomyelitis, tenosynovitis and bursitis. Spondylitis and spondylodiscitis, common complications of brucellosis, predominantly affect the lumbar and thoracic vertebrae. Epidural abscess may occur as a rare complication of spondylitis. Spinal brucellosis and development of epidural abscess in the cervical region are rare...
December 1, 2016: Folia Medica
https://www.readbyqxmd.com/read/28061487/thermal-induced-osteonecrosis-of-adjacent-vertebra-after-intradiscal-electrothermal-therapy
#4
Soonjoon Kim, Sun-Ho Lee, Eun-Sang Kim, Whan Eoh
A 42-year-old man was admitted to our hospital with complaints of low back pain and intermittent right thigh pain. Twelve weeks before admission, the patient received intradiscal electrothermal therapy (IDET) at a local hospital. The patient still reported low back pain after the procedure that was managed with narcotic analgesics. Follow-up magnetic resonance imaging (MRI) was performed, and his referring physician thought the likely diagnosis was spondylodiscitis at the L4-5 spinal segment with a small epidural abscess...
January 1, 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28059710/inadvertent-intrafacet-injection-during-lumbar-interlaminar-epidural-steroid-injection-a-comparison-of-ct-fluoroscopic-and-conventional-fluoroscopic-guidance
#5
P G Kranz, A B Joshi, L A Roy, K R Choudhury, T J Amrhein
BACKGROUND AND PURPOSE: Inadvertent intrafacet injection can occur during interlaminar epidural steroid injection, resulting in a false-positive loss of resistance and nontarget injection of medication. The purpose of this investigation was to compare the observed rates of this phenomenon during lumbar interlaminar epidural steroid injection performed by using conventional fluoroscopic and CT fluoroscopic guidance. MATERIALS AND METHODS: We retrospectively reviewed 349 lumbar interlaminar epidural steroid injections performed by using conventional fluoroscopy or CT fluoroscopic guidance to determine the observed rates of inadvertent intrafacet injection with each technique...
November 10, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28045758/a-virtual-reality-simulation-model-of-spinal-ultrasound-role-in-teaching-spinal-sonoanatomy
#6
Reva Ramlogan, Ahtsham U Niazi, Rongyu Jin, James Johnson, Vincent W Chan, Anahi Perlas
BACKGROUND AND OBJECTIVES: Ultrasound assessment of the lumbar spine improves the success of spinal and epidural anesthesia, especially for patients with underlying difficult anatomy. To assist with the teaching and learning of ultrasound-guided neuraxial anesthesia, we have created an online interactive educational model (http://www.usra.ca/vspine.php and http://pie.med.utoronto.ca/vspine). The aim of the current study was to determine whether the virtual spine model improved the knowledge of neuraxial anatomy and sonoanatomy...
December 29, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28042042/posterior-epidural-migration-of-herniated-lumbar-disc-fragment
#7
Lauriane Chambard, Jean Wach, Pierre-Charles Andonian, Jacques-Guy Tebib, Fabienne Coury
No abstract text is available yet for this article.
December 29, 2016: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/28028447/spinal-epidural-abscess-in-a-patient-with-piriformis-pyomyositis
#8
Gerald S Oh, Hussam Abou-Al-Shaar, Gregory D Arnone, Ashley L Barks, Ziad A Hage, Sergey Neckrysh
BACKGROUND: Spinal epidural abscess resulting from piriformis pyomyositis is extremely rare. Such condition can result in serious morbidity and mortality if not addressed in a timely manner. CASE DESCRIPTION: The authors describe the case of a 19-year-old male presenting with a 2-week history of fever, low back pain, and nuchal rigidity. When found to have radiographic evidence of a right piriformis pyomyositis, he was transferred to our institution for further evaluation...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/28028446/a-purely-extradural-lumbar-nerve-root-cavernoma-mimicking-acute-myeloid-leukemia-recurrence-case-report-and-literature-review
#9
Edson Oliveira, José Pedro Lavrador, Joaquim Teixeira, Alexandra Pignatelli, Sérgio Livraghi
BACKGROUND: Myeloid sarcoma (MS) is a malignant tumor that usually occurs concomitantly with or following acute myeloid leukemia (AML). Cavernomas are benign congenital malformations that are unusual in the spine and exceedingly rare in pure extradural locations. CASE DESCRIPTION: We report a 73-year-old female with a previous medical history of AML in remission for 3 years who presented with symptoms of low back pain and right lower extremity radiculopathy. A magnetic resonance scan showed an extradural, foraminal lesion centered at the L2 level involving the right L2 nerve root...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/28025354/the-effectiveness-and-risks-of-non-image-guided-lumbar-interlaminar-epidural-steroid-injections-a-systematic-review-with-comprehensive-analysis-of-the-published-data
#10
REVIEW
Yakov Vorobeychik, Anil Sharma, Clark C Smith, David C Miller, Milan P Stojanovic, Steve M Lobel, Marc A Valley, Belinda Duszynski, David J Kennedy
OBJECTIVE: To determine the effectiveness and risks of non-image-guided lumbar interlaminar epidural steroid injections. DESIGN: Systematic review. INTERVENTIONS: Three reviewers with formal training and certification in evidence-based medicine searched the literature on non-image-guided lumbar interlaminar epidural steroid injections. A larger team of seven reviewers independently assessed the methodology of studies found and appraised the quality of the evidence presented...
December 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28025353/imaging-determinants-of-clinical-effectiveness-of-lumbar-transforaminal-epidural-steroid-injections
#11
Timothy P Maus, Christine A El-Yahchouchi, Jennifer R Geske, Rickey E Carter, Timothy J Kaufmann, John T Wald, Felix E Diehn
OBJECTIVE: To examine associations between imaging characteristics of compressive lesions and patient outcomes after lumbar transforaminal epidural steroid injections (TFESIs) stratified by steroid formulation (solution versus suspension). DESIGN/SUBJECTS: Retrospective observational study, academic radiology practice. A 516-patient sample was selected from 2,634 consecutive patients receiving lumbar TFESI for radicular pain. METHODS: The advanced imaging study(s) preceding sampled TFESI were reviewed...
December 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28017166/comparison-of-transforaminal-and-interlaminar-epidural-steroid-injections-for-the-treatment-of-chronic-lumbar-pain
#12
Serbülent Gökhan Beyaz
STUDY DESIGN: A cross-sectional study. OBJECTIVE: We compared the 12 month outcomes of fluoroscopically guided transforaminal epidural steroid injections with interlaminar epidural steroid injections for the treatment of chronic lumbar spinal pain. Chronic lower back pain is a multifactorial disorder with many possible etiologies. The lifetime prevalence of spinal pain is reportedly 65-80% in the neck and lower back. Epidural injection of corticosteroids is a commonly used intervention for managing chronic spinal pain...
January 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28012973/methotrexate-prevents-epidural-fibrosis-through-endoplasmic-reticulum-stress-signalling-pathway
#13
Hui Chen, Lianqi Yan, Jingcheng Wang, Yu Sun, Xiaolei Li, Shuai Zhao, Daxin Wang, Gengyao Zhu, Yuan Liang
Lumbar laminectomy is one of the most common treatments for lumbar disc herniation and other lumbar disorders with serious complications, such as failed back surgery syndrome, mainly caused by epidural fibrosis (EF). The developing fibrosis causes radicular pain after the laminectomy or discectomy. Methotrexate (MTX) is a folic acid antagonist that has shown anti-proliferative effects in previous studies. The aim of our experiment is to study whether MTX has positive effects on the outcome of the laminectomy in rats...
December 21, 2016: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28005161/-epidural-anesthesia-for-fetoscopy-retrospective-analysis-of-a%C3%A2-one-year-cohort
#14
N Kiefer, S F Suter, C Berg, U Gembruch, S U Weber
BACKGROUND: The introduction of routine prenatal screening using ultrasound has led to a substantial increase in diagnoses of fetal disorders that are amenable to intrauterine treatment. While an ultrasound guided insertion of small bore cannulas can be performed under local anesthesia, insertion of a fetoscope usually requires anesthetic management for the mother and the fetus. Additionally, the fetus' intrauterine position may have to be manipulated in order to enable access. Such manoeuvres depend on relaxation of the mother's abdominal wall...
December 22, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27994783/closed-drainage-versus-non-drainage-for-single-level-lumbar-disc-surgery-relationship-between-epidural-hematoma-and-fibrosis
#15
Kadir Kotil
STUDY DESIGN: A prospective clinical series with prospectively collected data. PURPOSE: The efficacy of using closed suction drains (CSD) after single-level lumbar disc surgery was evaluated. Postoperative CSD are regularly fitted to prevent postoperative epidural hematomas (EH) after multilevel lumbar decompression, although it remains unclear whether CSD also reduces postoperative EH following single-level lumbar disc surgery. OVERVIEW OF LITERATURE: Few articles have addressed the clinical outcome in patients with single-level lumbar disc disease who were treated by two different operative methods (with and without drainage)...
December 2016: Asian Spine Journal
https://www.readbyqxmd.com/read/27979742/neurological-deficit-secondary-to-a-pre-sacral-abscess-with-epidural-extension-up-to-l3-a-case-report-and-literature-review
#16
M Khalifé, D Lebeaux, J-L Mainardi, P Guigui, B Bouyer
Isolated epidural abscesses are uncommon lesions. Surgical treatment may be difficult due to the extension of these lesions. We present a case of a pelvic abscess spreading along the path of the sciatic nerve to the gluteus muscles and the lumbar canal, causing neurological compression; requiring surgical treatment with three simultaneous approaches.
December 12, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27965310/rare-cause-of-back-pain-staphylococcus-aureus-vertebral-osteomyelitis-complicated-by-recurrent-epidural-abscess-and-severe-sepsis
#17
Louise Dunphy, Shabnam Iyer, Christopher Brown
An epidural abscess represents a rare acute medical emergency, with a reported incidence of 2.5/10 000 hospital admissions annually. The clinical features include fever, spinal pain, radiating nerve root pain and leg weakness. When sepsis is present, prompt recognition is required to initiate appropriate antimicrobial therapy and surgical decompression. We present the case of a man aged 68 years presenting to the emergency department with a 3-day history of fever, low back, right hip and leg pain. He was hypoxic, tachycardic and hypotensive...
December 13, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27965254/retrospective-cohort-study-of-usage-patterns-of-epidural-injections-for-spinal-pain-in-the-us-fee-for-service-medicare-population-from-2000-to-2014
#18
Laxmaiah Manchikanti, Vidyasagar Pampati, Joshua A Hirsch
OBJECTIVE: To assess the usage patterns of epidural injections for chronic spinal pain in the fee-for-service (FFS) Medicare population from 2000 to 2014 in the USA. DESIGN: A retrospective cohort. METHODS: The descriptive analysis of the administrative database from Centers for Medicare and Medicaid Services (CMS) Physician/Supplier Procedure Summary (PSPS) master data from 2000 to 2014 was performed. The guidance from Strengthening the Reporting of Observational studies in Epidemiology (STROBE) was applied...
December 13, 2016: BMJ Open
https://www.readbyqxmd.com/read/27955704/first-report-on-treating-spontaneous-infectious-spondylodiscitis-of-lumbar-spine-with-posterior-debridement-posterior-instrumentation-and-an-injectable-calcium-sulfate-hydroxyapatite-composite-eluting-gentamicin-a-case-report
#19
Richard Bostelmann, Hans Jakob Steiger, Armin O Scholz
BACKGROUND: Spontaneous infectious spondylodiscitis is a rare, but serious disease with the risk of progressive neurological impairment. The surgical approach to spontaneous infectious spondylodiscitis is in most cases an anterior debridement and fusion, often in staged surgeries. Here we report a case of single-stage posterior debridement and posterior instrumented fusion in combination with an injectable calcium sulfate/hydroxyapatite composite eluting gentamicin. CASE PRESENTATION: A 59-year-old Caucasian man presented with a 6-week history of lumbar pain without sensory or motor disorders of his lower extremities...
December 12, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27935769/fluoroscopically-guided-epidural-injections-of-the-cervical-and-lumbar-spine
#20
Euddeum Shim, Joon Woo Lee, Eugene Lee, Joong Mo Ahn, Yusuhn Kang, Heung Sik Kang
Advances in imaging and the development of injection techniques have enabled spinal intervention to become an important tool in managing chronic spinal pain. Epidural steroid injection (ESI) is one of the most widely used spinal interventions; it directly delivers drugs into the epidural space to relieve pain originating from degenerative spine disorders-central canal stenoses and neural foraminal stenoses-or disk herniations. Knowledge of the normal anatomy of the epidural space is essential to perform an effective and safe ESI and to recognize possible complications...
December 9, 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
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