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management of neck pain

Nikolaos Spathas, Panagiota Economopoulou, Myrto Cheila, Ioannis Kotsantis, Antonis Fanouriakis, Dimitra Kassara, Amanda Psyrri
Introduction: T cell checkpoint inhibitors targeting Programmed cell Death protein-1 (PD-1) have emerged as novel immunotherapy agents showing remarkable efficacy in head and neck squamous cell carcinoma (HNSCC). Despite important clinical benefits, they are associated with side effects that occur as a consequence of general immunological stimulation due to loss of T cell inhibition. Herein, we report the unusual case of inflammatory arthritis induced by anti-PD-1 agent pembrolizumab. Case report: A 55-years old male was treated with pembrolizumab at a dose of 200 mg every 3 weeks for a metastatic hypopharyngeal carcinoma...
2018: Frontiers in Oncology
Farzaneh Amini Nezhad, Moloud Payab, Sara Nayebandi, Shirin Hasani-Ranjbar
BACKGROUND: Brown tumor may present as uni/multilocular osteolytic lesions with bone expansion, bone pain or pathologic fracture in primary, secondary and tertiary hyperparathyroidism. However, recently, such presentation is rare due to early detection using blood screening techniques before symptomatic bone lesions appear. CASE REPORT: A 65-year-old woman was admitted to our hospital with generalized bone pain and a progressive painless mass in her jaw appeared since 6 months ago...
October 4, 2018: International Journal of Surgery Case Reports
Puneet Malik, Pravin Salunke, Mandeep Kataria, Madhivanan Karthigeyan, Nirmalya Ray
BACKGROUND: An anomalous vertebral artery (VA) is not a deterrent for posterior C1-C2 joint manipulation and reduction of atlantoaxial dislocation (AAD). However, presence of an incidental aneurysm in the aberrant segment of artery with concurrent AAD adds to the surgical challenge. CASE DESCRIPTION: A 30-year-old woman presented with neck pain and spastic quadriparesis. Her imaging revealed atlantoaxial dislocation and bony segmentation defects. Three-dimensional computed tomography angiography showed bilateral anomalous vertebral arteries (V3 segment) and an incidental aneurysm on the arterial segment that crossed the right C1-C2 joint posteriorly...
October 9, 2018: World Neurosurgery
Laxmaiah Manchikanti, Yogesh Malla, Kimberly A Cash, Vidyasagar Pampati, Joshua A Hirsch
Background: Neck and back pain are leading sources of disability placing substantial burden on health care systems. Surgical interventions in managing chronic neck pain secondary to various disorders continue to increase. Even though surgical interventions are effective, a significant proportion of patients continue to have symptomatology and develop cervical post-surgery syndrome. This study was performed to know the effectiveness of cervical interlaminar epidural injections with or without steroids...
October 2018: Korean Journal of Pain
Gabriel Lopez, M Kay Garcia, Wenli Liu, Michael Spano, Susan Underwood, Seyedeh S Dibaj, Yisheng Li, Rocio Moguel, Janet Williams, Eduardo Bruera, Lorenzo Cohen
Background: Increased access to complementary therapies such as acupuncture at academic medical centers has created new opportunities for management of cancer and cancer treatment related symptoms. Methods: Patients presenting for acupuncture treatment during calendar year 2016 at an outpatient integrative medicine clinic in a comprehensive cancer center were asked to complete a modified Edmonton Symptom Assessment Scale (ESAS; 16 symptoms, score 0-10, 10 worst possible) before and after each visit. ESAS subscales analyzed included global (GDS; score 0-90), physical (PHS, 0-60) and psychological distress (PSS, 0-20)...
2018: Journal of Cancer
John H Y Moi, Uyen Phan, Adam de Gruchy, Danny Liew, Tanya I Yuen, John E Cunningham, Ian P Wicks
OBJECTIVES: To report on the design, implementation and evaluation of the safety and effectiveness of the Back pain Assessment Clinic (BAC) model. DESIGN: BAC is a new, community-based specialist service for assessing and managing neck and low back pain (LBP). The BAC pilot was supported by a Victorian Department of Health and Human Services grant and was evaluated using the Victorian Innovation Reform Impact Assessment Framework (VIRIAF). Data were obtained by auditing BAC activity (22 July 2014 to 30 June 2015) and conducting surveys and interviews of patients, stakeholders and referrers...
October 10, 2018: BMJ Open
Melissa Henry, Ali Alias, Saul Frenkiel, Keith Richardson, Michael Hier, Anthony Zeitouni, Karen Kost, Alex Mlynarek, Martin Black, Christina MacDonald, Gabrielle Chartier, Zeev Rosberger
PURPOSE: The purpose of this study was to determine, within the first-year post-head and neck cancer (HNC) diagnosis, the contribution of past and upon HNC psychiatric diagnoses (i.e., substance use disorder (SUD), major depressive disorder (MDD), and anxiety disorder (AD)) to the extent (i.e., cumulated dose) of opioid prescription. METHODS: Prospective longitudinal study of 223 consecutive adults (on 313 approached; 72% participation) newly diagnosed (<2 weeks) with a first occurrence of primary HNC, including Structured Clinical Interviews for DSM-IV disorders, validated psychometric measures, and medical chart reviews...
October 11, 2018: Psycho-oncology
Haiyi Wang, Guanhu Yang, Shaobai Wang, Xin Zheng, Wei Zhang, Yongming Li
Acupuncture has been a popular alternative medicine in the United States for several decades. Its therapeutic effects on pain have been validated by both basic and clinical researches, and it is currently emerging as a unique non-pharmaceutical choice for pain against opioid crisis. However, the full spectrum of acupuncture indications remains unexplored. In this study, we conducted a cross-sectional survey among 419 acupuncturists nation-wide to investigate the top 10 and top 99 acupuncture indications in private clinics in the United States...
October 9, 2018: American Journal of Chinese Medicine
Michael J Marmura
PURPOSE OF REVIEW: A wide variety of triggers prompt attacks in episodic migraine. Although experimental triggers such as glyceryl trinitrate reliably produce migraine, natural triggers are much less predictable and vary in importance between individuals. This review describes the most common triggers in episodic migraine and provides strategies for managing them in clinical practice. RECENT FINDINGS: Multiple migraine attack triggers have been established based on patient surveys, diary studies, and clinical trials...
October 5, 2018: Current Pain and Headache Reports
Lisa Doan, Hersh Patel, Yeseniya Aronova, Christopher Gharibo
BACKGROUND: Previous surveys have identified variations in practice patterns related to epidural steroid injections. Since then, the United States Food and Drug Administration (FDA) has required the addition of drug warning labels for injectable corticosteroids. Updated evidence, as well as scrutiny from regulatory agencies, may affect practice patterns. OBJECTIVE: To provide an update on interlaminar epidural steroid injection (ILESI) practice patterns, we surveyed interventional pain management (IPM) physicians in the United States...
September 2018: Pain Physician
Michael C Gerling, Kris Radcliff, Robert Isaacs, Kristina Bianco, Cyrus M Jalai, Nancy J Worley, Gregory W Poorman, Samantha R Horn, Olivia J Bono, John Moon, Paul M Arnold, Alexander R Vaccaro, Peter Passias
Background: Effects of nonoperative treatments on surgical outcomes for patients who failed conservative management for cervical spine pathologies remain unknown. The objective is to describe conservative modality use in patients indicated for surgery for degenerative cervical spine conditions and its impact on perioperative outcomes. Methods: The current study comprises a retrospective review of a prospective multicenter database. A total of 1522 patients with 1- to 2-level degenerative cervical pathology who were undergoing surgical intervention were included...
April 2018: International Journal of Spine Surgery
Stephen May, Nils Runge, Alessandro Aina
BACKGROUND: Centralization and directional preference are common management and prognostic factors in spinal symptoms. OBJECTIVE: To update the previous systematic review. DESIGN: Systematic review to synthesis multiple aspects of centralization and directional preference. METHOD: Contemporary search was made of multiple databases using relevant search terms. Abstracts and titles were filtered by two authors; relevant articles were independently reviewed by two authors for content, data extraction, and quality...
September 18, 2018: Musculoskeletal Science & Practice
Mauricio Daniel Sánchez-Calderón, Diego Ochoa-Cacique, Oscar Medina Carrillo, Ulises García González, Rosa María Vicuña González, Carlos Cesar Bravo Reyna, José Raúl Guerra-Mora
INTRODUCTION: Brown tumors are non-neoplastic, expansive bone lesions that occur only in the setting of hyperparathyroidism. The most usual localization of brown tumors is in mandible, ribs and large bones. In cervical spine, to date, there are only 11 cases reported. The aim of this work is to report the case of a patient with Wegener´s granulomatosis with secondary end stage renal failure who developed a brown tumor in C4 vertebra. PRESENTATION OF CASE: A 25-year-old woman with an history of 2 months of worsening cervicalgia without history of trauma...
September 18, 2018: International Journal of Surgery Case Reports
Stephen G Henry, Debora A Paterniti, Bo Feng, Ana-Maria Iosif, Richard L Kravitz, Gary Weinberg, Penney Cowan, Susan Verba
Clinical guidelines discourage prescribing opioids for chronic pain but give minimal advice about how to discuss opioid tapering with patients. We conducted focus groups and interviews involving 21 adults with chronic back or neck pain in different stages of opioid tapering. Transcripts were qualitatively analyzed to characterize patients' tapering experiences, build a conceptual model of these experiences, and identify strategies for promoting productive discussions of opioid tapering. Analyses revealed 3 major themes...
September 20, 2018: Journal of Pain: Official Journal of the American Pain Society
Arun Govindraj Ramaswamy, Vinay Kumaraswamy, Neelanagowda Patil, Veeresh Pattanshetti
Osteoid osteoma (OO) is a benign, solitary bone tumor of the long bones of the lower limbs and accounts for 10% to 12% of all benign bone. However, an OO of the femoral neck is extremely rare and difficult to treat. Arthroscopic excision of OO of the femoral neck has many advantages. We report a 15-year-old patient with OO of the femoral neck which was treated with arthroscopic excision. The clinical and radiographic findings along with the surgical management of the lesion are presented. The pain disappeared immediately after the operation...
September 2018: Indian Journal of Orthopaedics
Paxton V Dickson, Lawrence Kim, Tina W F Yen, Anthony Yang, Elizabeth G Grubbs, Dhavel Patel, Carmen C Solórzano
This is the first of a two-part review on adrenocortical carcinoma (ACC), a rare and aggressive malignancy that often presents at an advanced stage. Most patients present with symptoms related to cortisol and/or androgen excess. Appropriate biochemical evaluation and imaging is important in assessing the extent of disease, operative planning, and oncologic surveillance for patients with ACC. For patients with locoregional disease, potential cure requires margin-negative resection, and accumulating evidence suggests that regional lymphadenectomy should be performed...
September 18, 2018: Annals of Surgical Oncology
Tony Fordham, Helen Marie Sims, Terence Farrant
Pancreatitis, panniculitis and polyarthritis syndrome (PPP syndrome) is a rare and complex manifestation of pancreatitis that is currently reported in few cases. We present this case regarding a 77-year-old man who presented unusually with a 6-week history of bilateral lesions on his lower limbs. During this time, he experienced increasing fatigue, joint pain, and reported fevers and significant weight loss. An incidental serum amylase was found to be significantly elevated and remained elevated throughout his 2-month hospital stay...
September 15, 2018: BMJ Case Reports
Adiguno Suryo Wicaksono, Wiryawan Manusubroto
STUDY DESIGN: Observational, cross-sectional study. PURPOSE: The purpose of this study was to evaluate the clinical efficacy and safety profile of open-door laminoplasty (ODL) using titanium mesh. OVERVIEW OF LITERATURE: The most appropriate surgical management of degenerative spine disorders, particularly ossification of the posterior longitudinal ligament, remains controversial and continues unabated in the neurosurgical community. However, recently, ODL has become popular among surgeons...
October 2018: Asian Spine Journal
Rashad Jabarkheel, Yi-Ren Chen, Linda Xu, Carol H Yan, Zara M Patel, Atman M Desai
BACKGROUND: Anterior cervical osteophytes (ACOs) are a common radiological finding in the elderly; rarely, they can cause dysphagia, dysphonia, and dyspnea. Symptomatic ACOs are most commonly found between C4-C7 and much less commonly at higher cervical levels. Here, we present a case series, with an example case of a 57-year-old woman with high cervical osteophytes at C1-C2 causing globus sensation, dysphagia, and dysphonia. Additionally, we provide a literature review regarding the etiology, diagnosis, and treatment of ACOs with a focus on management of high ACOs...
September 4, 2018: World Neurosurgery
Ryan J Li, Myriam Loyo Li, Enrique Leon, Cherrie W K Ng, Maisie Shindo, Katie Manzione, Peter Andersen, Daniel Clayburgh, Mark Wax, Jason Y K Chan
Importance: The current opioid abuse epidemic in the United States requires evaluation of prescribing practices within all medical specialties. This examination includes a review of postoperative pain management for patients undergoing major head and neck procedures. Objective: To report differences in postoperative pain regimens between an international and domestic head and neck surgical program. Design, Setting, and Participants: Pain management patterns after head and neck surgery in the programs at Chinese University of Hong Kong (CUHK) and Oregon Health and Science University (OHSU) were compared with a focus on opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen or paracetamol, and anxiolytics...
September 6, 2018: JAMA Otolaryngology—Head & Neck Surgery
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