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Failed back syndrome

Elias Veizi
No abstract text is available yet for this article.
April 1, 2018: Spine
Dilip K Sengupta
No abstract text is available yet for this article.
April 1, 2018: Spine
Andrei D Sdrulla, Yun Guan, Srinivasa N Raja
The field of spinal cord stimulation (SCS) owes its inception to the concept of gate control theory (GCT), put forth by Wall and Melzack in their landmark 1965 paper, which proposed that "control of pain may be achieved by selectively activating the large, rapidly conducting fibers". The first reported clinical application of dorsal column stimulation came 2 years later, and the field has gradually expanded ever since. Today, an estimated 50,000 spinal cord neurostimulators are implanted annually...
March 11, 2018: Pain Practice: the Official Journal of World Institute of Pain
Nagy Mekhail, Ogi Visnjevac, Gerges Azer, Diana Sue Mehanny, Priya Agrawal, Victor Foorsov
To assess the efficacy of spinal cord stimulation (SCS) for each indication, one must critically assess each specific clinical outcome to identify outcomes that benefit from SCS therapy. To date, a comprehensive review of clinically relevant outcome-specific evidence regarding SCS has not been published. We aimed to assess all randomized controlled trials from the world literature for the purpose of evaluating the clinical outcome-specific efficacy of SCS for the following outcomes: perceived pain relief or change pain score, quality of life, functional status, psychological impact, analgesic medication utilization, patient satisfaction, and health care cost and utilization...
February 23, 2018: Regional Anesthesia and Pain Medicine
Stanley Sau Ching Wong, Qiu Qiu, Chi Wai Cheung
OBJECTIVE: Lumbar transforaminal epidural steroid injection is commonly used for treating lumbar radicular pain. We report a case of segmental spinal myoclonus that developed during lumbar transforaminal epidural injection with local anesthetic and steroid. CASE REPORT: A 58-year-old woman with failed back surgery syndrome presented with low back and right L3 and L4 radicular pain. As she had responded well previously to diagnostic selective nerve root injection with local anesthetic at the right L3 and L4 levels, lumbar transforaminal epidural steroid injection at the same levels was scheduled...
February 16, 2018: Regional Anesthesia and Pain Medicine
Mats De Jaeger, Robbert-Jan van Hooff, Lisa Goudman, Alexis Valenzuela Espinoza, Raf Brouns, Martine Puylaert, Wim Duyvendak, Maarten Moens
Background: Spinal cord stimulation (SCS) is a proven and effective treatment for neuropathic pain conditions such as failed back surgery syndrome (FBSS). The hypothesis that different settings for SCS parameters activate unique, pain-relieving mechanisms has boosted the development of various SCS paradigms. High density spinal cord stimulation (HD-SCS) is one of those promising, novel stimulation forms characterized by subthreshold stimulation, delivering more pulses per second and a higher pulse density to the spinal cord than conventional SCS...
June 2017: Anesthesiology and Pain Medicine
Krishnan Chakravarthy, Alexander R Kent, Adil Raza, Fang Xing, Thomas M Kinfe
BACKGROUND: Burst spinal cord stimulation (SCS) technology uses a novel waveform that consists of closely packed high-frequency electrical impulses followed by a quiescent period. Within the growing field of neuromodulation, burst stimulation is unique in that it mimics the natural burst firing of the nervous system, in particular the thalamo-cingulate rhythmicity, resulting in modulation of the affective and attentional components of pain processing (e.g., medial thalamic pathways). STUDY DESIGN: A review of preclinical and clinical studies regarding burst SCS for various chronic pain states...
February 12, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Juntaro Matsumoto, Toyohiko Isu, Kyongsong Kim, Naotaka Iwamoto, Kazuyoshi Yamazaki, Daijiro Morimoto, Masanori Isobe
INTRODUCTION: Some patients suffer failed back surgery syndrome (FBSS) after lumbar spine surgery. We report the effect of additional treatments for para-lumbar- and peripheral nerve diseases addressing residual symptoms after lumbar spine surgery. MATERIALS AND METHODS: We enrolled 74 patients (59 men and 15 women, mean age 62.9 years) who had undergone lumbar posterior decompression surgery in our department. Mean follow-up after initial lumbar surgery was 26...
January 31, 2018: World Neurosurgery
Xiaonan Liang, Gang Yu, Ruibin Su
Neuropathic pain is among the most common and difficult-to-treat types of chronic pain and is associated with sodium channel malfunction. The sodium channel blocker ralfinamide has exhibited potent analgesic effects in several preclinical pain models and in patients with mixed neuropathic pain syndromes (Phase II trials), but it failed to ameliorate neuropathic low back pain in Phase III trials. It is unclear whether ralfinamide is effective against neuropathic pain induced by specified etiologies. In the present study, the antinociceptive effects of ralfinamide in neuropathic pain models induced by spared nerve injury and chemotherapy were compared in a gabapentin-controlled manner...
January 30, 2018: European Journal of Pharmacology
Michelle Granville, Aldo F Berti, Robert E Jacobson
Spinal cord stimulation (SCS) is an effective treatment for chronic back and limb pain. The criteria for use of SCS for specific problems such as failed back surgery syndrome (FBSS), peripheral neuropathic pain and residual pain after joint replacement is well established. With an aging population, there are more patients presenting with a combination of various multi-factorial chronic pain problems rather than from a single clear cause. It is not uncommon to see patients with chronic back pain years after spine surgery with new additional pain in the area of joint replacement or due to peripheral neuropathy...
November 17, 2017: Curēus
S J Tuijp, J Van Zundert, P De Vooght, M Puylaert, R Mestrum, R Heylen, P Vanelderen
BACKGROUND AND AIMS: Persistent low back pain after initially successful surgery that is not attributed to structural deficits, is called failed back surgery syndrome (FBSS). When conservative and minimal invasive therapy fail, the recommended treatment is spinal cord stimulation (SCS). Because epidural fibrosis can be a contributing factor in the majority of FBSS patients, lumbosacral epiduroscopic lysis of adhesions may be considered as a less invasive alternative treatment option. We hypothesized that the use of epiduroscopic lysis of adhesions could reduce the need for SCS...
January 18, 2018: Pain Practice: the Official Journal of World Institute of Pain
Yasar Ozturk, Ismail Bozkurt, Mesut Emre Yaman, Yahya Guvenc, Tolga Tolunay, Deniz Billur, Fatma Kubra Erbay, Salim Senturk, Gokhan Bozkurt
BACKGROUND: Epidural fibrosis is a challenging topic in spinal surgery. This phenomenon constitutes one of the the main reasons behind "post-laminectomy syndrome" or "failed-back surgery syndrome", which leads to persistent back and leg pain in association with compression and/or stretching the nerve root or the dura. The exact mechanism of action in epidural fibrosis is complex and remains uncertain. Excessive deposition of collagen, fibronectin, and dermatan sulfate known as "extracellular matrix", and decrease of tissue cellularity results in epidural fibrosis...
January 8, 2018: World Neurosurgery
Ryan J Galica, Salim M Hayek, Elias Veizi, Matthew T McEwan, Sivakanth Katta, Omar Ali, Nida Aziz, Nidhi Sondhi
OBJECTIVES: Intrathecal (IT) trial is a prognostic interventional pain management procedure employed to determine the potential success of treating intractable pain with an implantable infusion device system. There is a dearth of data regarding trials with continuous infusion of combination therapy (e.g. opioid combined with local anesthetic). The objective of the this study was to determine the overall outcomes of continuous infusion IT trials and factors influencing long-term success of IT therapy in patients with chronic intractable pain post-laminectomy...
December 5, 2017: Neuromodulation: Journal of the International Neuromodulation Society
L Brugliera, A De Luca, S Corna, M Bertolotto, G A Checchia, M Cioni, P Capodaglio, C Lentino
We studied 8 patients with spinal cord stimulation (SCS) devices which had been previously implanted to treat neuropathic chronic pain secondary to Failed Back Surgery Syndrome. The aim of our study was to investigate the effects of SCS on posture and gait by means of clinical scales (Short Form Health Survey-36, Visual Analogue Scale for pain, and Hamilton Depression Rating Scale) and instrumented evaluation with 3D Gait Analysis using a stereophotogrammetric system. The latter was performed with the SCS device turned both OFF and ON...
2017: Pain Research & Management: the Journal of the Canadian Pain Society
Benjamin L Rambo-Martin, Jennifer G Mulle, David J Cutler, Lora J H Bean, Tracie C Rosser, Kenneth J Dooley, Clifford Cua, George Capone, Cheryl L Maslen, Roger H Reeves, Stephanie L Sherman, Michael E Zwick
One in five people with Down syndrome (DS) are born with an atrioventricular septal defect (AVSD), an incidence 2,000 times higher than in the euploid population. The genetic loci that contribute to this risk are poorly understood. In this study, we tested two hypotheses: 1) individuals with DS carrying chromosome 21 copy number variants (CNVs) that interrupt exons may be protected from AVSD, because these CNVs return AVSD susceptibility loci back to disomy, and 2) individuals with DS carrying chromosome 21 genes spanned by microduplications are at greater risk for AVSD because these microduplications boost the dosage of AVSD susceptibility loci beyond a tolerable threshold...
November 15, 2017: G3: Genes—Genomes—Genetics
Jose De Andres, Vicente Monsalve-Dolz, Gustavo Fabregat-Cid, Vicente Villanueva-Perez, Anushik Harutyunyan, Juan Marcos Asensio-Samper, Nerea Sanchis-Lopez
Objectives: Spinal cord stimulation (SCS) for patients with failed back surgery syndrome (FBSS) show variable results and limited to moderate evidence. In the last years the stimulation of high frequency (HF) has been considered as a better alternative in this pathology for its supposed benefits compared to the stimulation with conventional frequency (CF). To compare in one year follow-up, the efficacy of high-frequency SCS (HF) versus conventional frequency SCS (CF) on the patients with FBSS...
November 4, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Krishnan Chakravarthy, Hira Richter, Paul J Christo, Kayode Williams, Yun Guan
BACKGROUND: Traditional spinal cord stimulation (SCS) requires that paresthesia overlaps chronic painful areas. However, the new paradigm high-frequency SCS (HF-SCS) does not rely on paresthesia. STUDY DESIGN: A review of preclinical and clinical studies regarding the use of paresthesia-free HF-SCS for various chronic pain states. METHODS: We reviewed available literatures on HF-SCS, including Nevro's paresthesia-free ultra high-frequency 10 kHz therapy (HF10-SCS)...
November 3, 2017: Neuromodulation: Journal of the International Neuromodulation Society
Lisa Goudman, Iris Smet, Peter Mariën, Mats De Jaeger, Sander De Groote, Eva Huysmans, Koen Putman, Jean-Pierre Van Buyten, Ronald Buyl, Maarten Moens
OBJECTIVES: To understand the subjective pain experience of patients, healthcare providers rely heavily on self-reporting. However, to quantify this unique pain experience, objective parameters are not yet available in daily clinical practice. With regard to patients with failed back surgery syndrome (FBSS) treated with spinal cord stimulation (SCS), pain therapists may recover the individual functional information about the patient's posture from the implantable pulse generator (IPG) of the stimulator...
January 2018: Neuromodulation: Journal of the International Neuromodulation Society
M Carassiti, A Di Martino, A Centonze, C C Quattrocchi, A Caldaria, F Agrò, V Denaro
PURPOSE: Evaluate the efficacy and safety of MESNA (sodium 2-mercaptoethanesulfonate) injection into the epidural space in the FBSS. METHODS: We designed a prospective phase II longitudinal study. Six consecutive patients were enrolled. Patients underwent one peridural injection per week for 3 weeks. NRS and ODI were investigated before and 48 h after injections, and at 1 week, 1 month and 2 months after the last procedures. Opioids intake is investigated before procedures and 1 week, 1 month and 3 months after the last procedures...
November 2, 2017: Musculoskeletal Surgery
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