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Nikolai Bogduk
Among other important features of the functional anatomy of the spine, described in this chapter, is the remarkable difference between the design and function of the cervical spine and that of the lumbar spine. In the cervical spine, the atlas serves to transmit the load of the head to the typical cervical vertebrae. The axis adapts the suboccipital region to the typical cervical spine. In cervical intervertebrtal discs the anulus fibrosus is not circumferential but is crescentic, and serves as an interosseous ligament in the saddle joint between vertebral bodies...
2016: Handbook of Clinical Neurology
Stephen Endres, Allison Shufelt, Nikolai Bogduk
BACKGROUND: Guidelines have been published that recommend discontinuing anticoagulants in patients undergoing interventional pain procedures. The safety and effectiveness of these guidelines have not been tested. OBJECTIVES: The present study was performed to determine if continuing or discontinuing anticoagulants for pain procedures is associated with a detectable risk of complications. METHODS: An observational study was conducted in a private practice in which some partners continued anticoagulants while other partners routinely discontinued anticoagulants...
June 12, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Jorge F Ramirez Leon, Jose G Rugeles Ortiz, Enrique Osorio Fonseca, Carolina Ramirez Martinez, Gabriel Oswaldo Alonso Cuellar
BACKGROUND: Zygapophysial joint arthrosis is a pathology related with axial lumbar pain. The most accepted treatment, after failure of medical management, is the thermal denervation of the medial branch. Nonetheless, the placement of the heat probe remains a challenge to surgeons, even when using the fluoroscope. Using a variation of Shealy's and Bogduk's original techniques, which includes ablation of the medial branch and the nerves present in the joint capsule, we hypothesize that we can obtain similar outcomes to those found in the literature...
March 2016: Pain Physician
Andrew J Engel, Nikolai Bogduk
BACKGROUND: Diagnostic blocks are used in different ways for the diagnosis of spinal pain, but their validity has not been fully evaluated. METHODS: Four clinical protocols were analyzed mathematically to determine the probability of correct responses arising by chance. The complement of this probability was adopted as a measure of the credibility of correct responses. RESULTS: The credibility of responses varied from 50% to 95%, and was determined less by the agents used but more by what information was given to patients and if the agents were fully randomized for each block...
March 19, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Nikolai Bogduk
No abstract text is available yet for this article.
April 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
A Nakayama, G Major, E Holliday, J Attia, N Bogduk
SUMMARY: We assessed the ability of a fracture liaison service (FLS) to directly reduce re-fracture risk. Having a FLS is associated with a ∼40% reduction in the 3-year risk of major bone and ∼30% of any bone re-fracture. The number needed to treat to prevent a re-fracture is 20. INTRODUCTION: FLS have been promoted as the most effective interventions for secondary fracture prevention, and while there is evidence of increased rate of investigation and treatment at institutions with a FLS, only a few studies have considered fracture outcomes directly...
March 2016: Osteoporosis International
Nikolai Bogduk
No abstract text is available yet for this article.
July 2015: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
James P Rathmell, Honorio T Benzon, Paul Dreyfuss, Marc Huntoon, Mark Wallace, Ray Baker, K Daniel Riew, Richard W Rosenquist, Charles Aprill, Natalia S Rost, Asokumar Buvanendran, D Scott Kreiner, Nikolai Bogduk, Daryl R Fourney, Eduardo Fraifeld, Scott Horn, Jeffrey Stone, Kevin Vorenkamp, Gregory Lawler, Jeffrey Summers, David Kloth, David O'Brien, Sean Tutton
BACKGROUND: Epidural corticosteroid injections are a common treatment for radicular pain caused by intervertebral disc herniations, spinal stenosis, and other disorders. Although rare, catastrophic neurologic injuries, including stroke and spinal cord injury, have occurred with these injections. METHODS: A collaboration was undertaken between the U.S. Food and Drug Administration Safe Use Initiative, an expert multidisciplinary working group, and 13 specialty stakeholder societies...
May 2015: Anesthesiology
Nikolai Bogduk
No abstract text is available yet for this article.
February 2015: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Milan P Stojanovic, Diana M Higgins, Adrian Popescu, Nikolai Bogduk
No abstract text is available yet for this article.
March 2015: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
N Bogduk
The posterior elements of the vertebral column are innervated by branches of the dorsal rami of the spinal nerves, while the intervertebral discs and related ligaments are innervated by various branches of the ventral rami and sympathetic nervous system. A knowledge of this nerve supply forms the basis for a systematic classification of the possible sources of primary spinal pain, and the basis for several diagnostic techniques that use needles to provoke and anaesthetize putative sources of pain. In particular, the demonstration of a nerve supply to intervertebral discs vindicates the concept that these structures intrinsically may be sources of pain...
1985: Australian Journal of Physiotherapy
Andrew J Engel, David J Kennedy, John Macvicar, Nikolai Bogduk
No abstract text is available yet for this article.
May 2014: Anesthesiology
Andrew Engel, John MacVicar, Nikolai Bogduk
BACKGROUND: In the absence of a suitable reference standard, diagnostic local anesthetic blocks cannot be validated in the manner conventionally used for diagnostic tests. Consequently, diagnostic blocks are vulnerable to criticism for lacking validity, or being "not proven." STUDY DESIGN: Philosophical essay. METHODS: Inspired by the "viewpoints" proposed by Bradford Hill for testing cause and effect in epidemiology, a set of axiomatic criteria was developed with which the validity of diagnostic blocks could be assessed...
June 2014: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Nikolai Bogduk
Cervicogenic headache is pain referred to the head from a source in the cervical spine or mediated by cervical nerves. Clinical features allow for no more than a diagnosis of probable cervicogenic headache. Definitive diagnosis requires evidence of a cervical source of pain. For most treatments, the evidence is limited or poor. Many patients with probable cervicogenic headache can be managed with exercise therapy, with or without manual therapy. Intractable cervicogenic headache can be investigated with controlled diagnostic blocks of the upper cervical joints and treated with thermal radiofrequency neurotomy...
May 2014: Neurologic Clinics
I Khan, R Hargunani, A Saifuddin
The high intensity zone (HIZ) was first described by Aprill and Bogduk on lumbar spine magnetic resonance imaging (MRI) studies in 1992. Correlation with lumbar computed tomography (CT) discography showed that the HIZ represents a deep radial tear of the annulus fibrosus, which may be a cause of chronic low back pain. Initial studies comparing the finding of a HIZ on MRI with discography suggested that it may be a highly specific marker of a painful lumbar disc, but later investigators demonstrated that it is also present in asymptomatic individuals...
June 2014: Clinical Radiology
John Bui, Nikolai Bogduk
OBJECTIVE: To determine the effectiveness and safety of computerized tomography (CT) guided, lumbar transforaminal injection of steroids in the treatment of radicular pain. DESIGN: Systematic review of published literature. INTERVENTIONS: Two reviewers independently assessed 19 publications on the effectiveness and safety of CT-guided, lumbar transforaminal injection of steroids. OUTCOME MEASURES: For effectiveness, the primary outcome was the success rate for relief of pain...
December 2013: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Nikolai Bogduk
No abstract text is available yet for this article.
December 16, 2013: Medical Journal of Australia
Nicholas Lucas, Petra Macaskill, Les Irwig, Robert Moran, Luke Rickards, Robin Turner, Nikolai Bogduk
BACKGROUND: The aim of this project was to investigate the reliability of a new 11-item quality appraisal tool for studies of diagnostic reliability (QAREL). The tool was tested on studies reporting the reliability of any physical examination procedure. The reliability of physical examination is a challenging area to study given the complex testing procedures, the range of tests, and lack of procedural standardisation. METHODS: Three reviewers used QAREL to independently rate 29 articles, comprising 30 studies, published during 2007...
2013: BMC Medical Research Methodology
A Nowitzke, M Westaway, N Bogduk
The relationship was examined between the height and slope of the cervical zygapophyseal joints and the patterns of motion of the cervical vertebrae. The height and orientation of the C3C7 superior articular processes were measured in lateral radiographs of 40 normal subjects. The C4-C6 facets were oriented at approximately 40° to the vertical, while the C3 and C7 facets were more steeply oriented. The heights of the superior articular processes were found to increase at progressively lower vertebral levels...
November 1994: Clinical Biomechanics
B Amevo, D Worth, N Bogduk
The reliability of a modified protocol for plotting the instantaneous axes of sagittal rotation for the cervical spine was evaluated by measuring the observer differences when the process was performed separately by two observers, and by a single observer, on two separate occasions. Small observer differences were found both for individual steps in the process and for the process as a whole. These differences were substantially less than those found using the conventional technique for plotting the instantaneous axes of rotation...
February 1991: Clinical Biomechanics
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