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https://www.readbyqxmd.com/read/27906939/a-new-radiofrequency-ablation-procedure-to-treat-sacroiliac-joint-pain
#1
Jianguo Cheng, See Loong Chen, Nicole Zimmerman, Jarrod E Dalton, Garret LaSalle, Richard Rosenquist
BACKGROUND: Low back pain may arise from disorders of the sacroiliac joint in up to 30% of patients. Radiofrequency ablation (RFA) of the nerves innervating the sacroiliac joint has been shown to be a safe and efficacious strategy. OBJECTIVES: We aimed to develop a new RFA technique to relieve low back pain secondary to sacroiliac joint disorders. STUDY DESIGN: Methodology development with validation through prospective observational non-randomized trial (PONRT)...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27903340/-the-clinical-application-of-lumbar-plexus-the-first-posterior-sacral-foramina-block-for-hip-arthroplasty-in-elderly-patients
#2
J Li, X J Ke, Y Liu, K Chen, M B Chen, W Mei
Objective: To evaluate the clinical efficacy of lumbar plexus-the first posterior sacral foramina block as an anesthesia technique for hip arthroplasty in elderly patients. Methods: Forty-four patients, aged 60-91 years, weighing 37-100 kg, American Society of Anesthesiologists (ASA) Ⅰ-Ⅲ, underwent elective hip arthroplasty in Tongji Hospital from February 2015 to January 2016.All patients received lumbar plexus and the first posterior sacral foramina block.The first posterior sacral foramina puncture point of 23 cases were located by traditional positioning method, the others were orientated via ultrasonic method...
November 22, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27865134/polychromatic-light-480-3400nm-similar-to-the-terrestrial-solar-spectrum-without-its-uv-component-in-post-surgical-immunorehabilitation-of-breast-cancer-patients
#3
Natalia A Zhevago, Alexander A Zimin, Tatyana V Glazanova, Natalia I Davydova, Natalia V Bychkova, Zhanna V Chubukina, Anna I Buinyakova, Marina F Ballyuzek, Kira A Samoilova
To this day, two methods of phototherapy (PT) have been successfully used in post-surgical immunorehabilitation of patients with breast cancer (BC): intravenous laser irradiation of the patients' blood and reinfusion of lympholeukosuspension of BC patients after single irradiation with HeNe laser. The objective of this pilot experimental study was to verify the effectiveness of the percutaneous use of polychromatic visible light combined with polychromatic infrared (pVIS+pIR) radiation similar to the major components of natural solar spectrum in post-surgical management of BC patients...
November 5, 2016: Journal of Photochemistry and Photobiology. B, Biology
https://www.readbyqxmd.com/read/27852382/-effect-comparison-of-ultrasound-guided-lower-extremity-nerve-block-and-spinal-anesthesia-in-ankle-surgery
#4
L L Yang, J S Ji, Z W Zhao, W Wang, S Luo, Y C Mo, J L Wang
Objective: To compare the anesthesia effect between ultrasound-guided lower extremity nerve block and spinal anesthesia in ankle surgery. Methods: Upon the approval of institutional Ethics Committee and informed consent, 80 patients American Society of Anesthesiology (ASA)Ⅰ-Ⅱaged 18-70 yr, undergoing ankle surgery from December 2014 to May 2015 in the Fifth Affiliated Hospital of Wen Zhou Medical College, were randomly divided by random numbers into two groups (n=40): nerve block group (group N) and spinal anesthesia (group S)...
November 8, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27811527/a-cadaveric-study-evaluating-the-feasibility-of-an-ultrasound-guided-diagnostic-block-and-radiofrequency-ablation-technique-for-sacroiliac-joint-pain
#5
Shannon L Roberts, Robert S Burnham, Anne M Agur, Eldon Y Loh
BACKGROUND AND OBJECTIVES: Ultrasound (US)-guided diagnostic block/radiofrequency ablation (RFA) along the lateral sacral crest (LSC) has been proposed for managing sacroiliac joint (SIJ) pain. We sought to investigate (1) ease of visualization of bony landmarks using US; (2) consistency of US-guided needle placement along the LSC; and (3) percentage of the posterior sacral network (PSN) innervating the SIJ complex that would be captured if an RFA strip lesion were created between the needles...
November 2, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27747222/sacro-iliac-joint-sensory-block-and-radiofrequency-ablation-assessment-of-bony-landmarks-relevant-for-image-guided-procedures
#6
Trevor J G Robinson, Shannon L Roberts, Robert S Burnham, Eldon Loh, Anne M Agur
Image-guided sensory block and radiofrequency ablation of the nerves innervating the sacro-iliac joint require readily identifiable bony landmarks for accurate needle/electrode placement. Understanding the relative locations of the transverse sacral tubercles along the lateral sacral crest is important for ultrasound guidance, as they demarcate the position of the posterior sacral network (S1-S3 ± L5/S4) innervating the posterior sacro-iliac joint. No studies were found that investigated the spatial relationships of these bony landmarks...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27729478/contribution-of-gabaa-glycine-and-opioid-receptors-to-sacral-neuromodulation-of-bladder-overactivity-in-cats
#7
Xuewen Jiang, Thomas W Fuller, Jathin Bandari, Utsav Bansal, Zhaocun Zhang, Bing Shen, Jicheng Wang, James R Roppolo, William C de Groat, Changfeng Tai
In α-chloralose anesthetized cats, we examined the role GABAA, glycine, and opioid receptors in sacral neuromodulation-induced inhibition of bladder overactivity elicited by intravesical infusion of 0.5% acetic acid (AA). AA irritation significantly (p<0.01) reduced bladder capacity to 59.5±4.8% of saline control. S1 or S2 dorsal root stimulation at threshold intensity for inducing reflex twitching of the anal sphincter or toe significantly (p<0.01) increased bladder capacity to 105.3±9.0% and 134...
October 11, 2016: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/27684866/transsacrococcygeal-approach-to-ganglion-impar-block-for-treatment-of-chronic-coccygodynia-after-spinal-arachnoid-cyst-removal-a-case-report
#8
Young Deog Cha, Chun Woo Yang, Jung Uk Han, Jang Ho Song, WonJu Na, Sora Oh, Byung-Gun Kim
BACKGROUND: Coccygodynia is a pain in the region of the coccyx that radiates to the sacral, perineal area. The cause of the pain is often unknown. Coccygodynia is diagnosed through the patient's past history, a physical examination, and dynamic radiographic study, but the injection of local anesthetics or a diagnostic nerve blockade are needed to distinguish between somatic, neuropathic, and combined pain. Ganglion impar is a single retroperitoneal structure made of both paravertebral sympathetic ganglions...
September 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27676716/dystonia-of-the-lower-limb-after-sacral-neuromodulation-implanted-to-a-16-year-old-boy-with-non-obstructive-chronic-urinary-retention
#9
Teng Maëlys, Gilberte Robain, Samy Bendaya
OBJECTIVE: Sacral neuromodulation is usually used to treat non-obstructive urinary retention when other forms of treatment have failed. An improvement greater than 50% in urinary symptoms after 40months of follow-up has been shown: - moreover, it also has few complications: infections, technical failures, discomfort; - we report a case of dystonia of the lower limb, appeared after sacral neuromodulation implantation. OBSERVATIONS: MMP is a 16-year-old boy with early puberty as noteworthy medical history...
September 2016: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27637163/induced-wedge-technique-to-improve-liquid-embolic-agent-penetration-into-spinal-dural-arteriovenous-fistula
#10
Dae Chul Suh, Ji Eun Park, Hairi Liu, Sung Chul Jung
OBJECTIVE: To promote embolization of spinal dural arteriovenous fistula (SDAVF) with a small long tortuous feeder that may impede successful application of an embolic agent. METHODS: An induced-wedge technique was developed in which blood flow was blocked by coiling at the proximal part of the microcatheter for secure injection of N-butyl cyanoacrylate. We used this techniques in 11 SDAVF patients (M:F = 8:3): 7 thoracic, 2 lumbar, 1 sacral, and 1 cervical. Clinical outcome was evaluated by the Aminoff-Logue Disability Scale...
September 13, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27546959/lower-limb-orthopedic-surgery-in-geriatric-patients-under-paravertebral-blocks-a-prospective-feasibility-study
#11
Rajesh Kumar Singh, J P Chaturvedi, H S Agrawal, Nitesh Agrawal
BACKGROUND: Aging causes progressive deterioration of all the organ systems. Physiological changes of aging and co-morbidities make regional anesthesia a preferred technique for this age group. Regional anesthesia with risk of hypotension and its consequences is fraught with dangers. Peripheral nerve blocks (PNBs) are much safer and give much superior post-op analgesia. The present study was undertaken to perform major lower limb orthopedic surgeries PNBs in geriatric settings. METHODS: A feasibility study was undertaken in patients above age of 60 years admitted for lower limb surgeries to undertake these surgeries under para-vertebral blocks for a period of one year from Mar 2011 to Feb 2012...
July 2016: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/27376481/a-novel-supine-isocentric-approach-for-craniospinal-irradiation-and-its-clinical-outcome
#12
Yi-Kan Cheng, Lei Zeng, Shu-Biao Ye, Jian Zheng, Lin Zhang, Peng Sun, Xiao-Bo Jiang, Wen-Zhao Sun, Tao Xu, Lei Chen
OBJECTIVE: To report a novel approach for craniospinal irradiation (CSI) using a supine isocentric technique. METHODS: Patients were treated in the supine position using CT simulation. Half-beam-blocked lateral cranial fields and superior spinal fields have the same isocentre, and their beam divergences match. Tangential irradiation provides a non-divergent junction for the other two full-beam spinal fields. Shielding for cranial fields was generated, and dose distribution was calculated using a three-dimensional planning system...
September 2016: British Journal of Radiology
https://www.readbyqxmd.com/read/27349628/liposomal-bupivacaine-incisional-injection-in-single-level-lumbar-spine-surgery
#13
Ross C Puffer, Kevin Tou, Rose E Winkel, Mohamad Bydon, Bradford Currier, Brett A Freedman
BACKGROUND CONTEXT: Postsurgical pain control is important in spine surgery as it can lead to earlier mobilization, decreased length of stay, decreased side effects from narcotic medications, and improved patient satisfaction. Liposomal bupivacaine (LB) is an injectable formulation of bupivacaine, providing prolonged local anesthesia, up to 72 hours postinjection. Although, LB has been used with increasing frequency following other musculoskeletal procedures, specifically total joint replacements, its pre-emptive analgesic effect following lumbar microdiskectomy has hitherto not been reported...
June 24, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27340538/sacral-insufficiency-fractures-mimicking-lumbar-spine-pathology
#14
G Sudhir, Kalra K L, Shankar Acharya, Rupinder Chahal
Sacral insufficiency fractures (SIFs) are a common cause of back pain in the elderly. SIFs mimic the symptoms of lumbar spine pathology and so are commonly missed or underdiagnosed. Here we present four cases of missed SIFs that were subsequently identified and treated. One patient was treated as mechanical lower back ache, another patient underwent root block and two patients underwent surgery for lumbar canal stenosis. None experienced relief of their symptoms after these procedures. Retrospective analysis of X-ray and magnetic resonance imaging data revealed SIFs that were confirmed by computed tomography scans...
June 2016: Asian Spine Journal
https://www.readbyqxmd.com/read/27172818/hypotensive-epidural-anesthesia-reduces-blood-loss-in-pelvic-and-sacral-bone-tumor-resections
#15
Alex K Freeman, Chris J Thorne, C Louie Gaston, Richard Shellard, Tom Neal, Michael C Parry, Robert J Grimer, Lee Jeys
BACKGROUND: Resection of pelvic and sacral tumors can cause severe blood loss, complications, and even postoperative death. Hypotensive epidural anesthesia has been used to mitigate blood loss after elective arthroplasty, but to our knowledge, it has not been studied as an approach that might make resection of pelvic and sacral tumors safer. QUESTIONS/PURPOSES: The purposes of this study were (1) to compare the blood loss and blood product use for patients undergoing pelvic and sacral tumor surgery under standard anesthesia or hypotensive epidural anesthesia; (2) to assess the frequency of end-organ damage with the two techniques; and (3) to compare 90-day mortality between the two techniques...
May 12, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27126092/osler-weber-rendu-syndrome-an-anaesthetic-challenge
#16
Diana Chieira, Luis Conceição, Edgar Semedo, Valentina Almeida
Osler-Weber-Rendu syndrome, or hereditary haemorrhagic telangiectasia (HHT), is an autosomal dominant vascular dysplasia characterised by mucocutaneous telangiectases and arteriovenous malformations (AVMs). Diagnosis is clinical and treatment is supportive. The authors demonstrate a safe anaesthetic approach for a patient with HHT. A 53-year-old woman with a left trochanteric fracture was scheduled for urgent orthopaedic surgery. She was diagnosed as having HHT and presented with recurrent epistaxis, telangiectases and gastrointestinal AVMs...
April 28, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27066206/the-use-of-emla-cream-reduces-the-pain-of-skin-puncture-associated-with-caudal-block-in-children
#17
Eun Kyung Choi, YoungHo Ro, Sung-Sik Park, Ki-Bum Park
BACKGROUND: Caudal block is a popular regional anesthesia in children undergoing infraumbilical surgeries including inguinal hernia repair and orchiopexy. We evaluated the efficacy of eutectic mixture of local anesthetic (EMLA) cream for reducing needle insertion pain during caudal block in pediatric patients. METHODS: Forty-one children between the ages of 13 months and 5 years undergoing infraumbilical surgery were randomized to receive either topical EMLA or placebo cream over the sacral hiatus one hour before caudal block...
April 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/26999074/stimulation-of-dopamine-d2-like-receptors-in-the-lumbosacral-defaecation-centre-causes-propulsive-colorectal-contractions-in-rats
#18
Kiyotada Naitou, Hiroyuki Nakamori, Takahiko Shiina, Azusa Ikeda, Yuuta Nozue, Yuuki Sano, Takuya Yokoyama, Yoshio Yamamoto, Akihiro Yamada, Nozomi Akimoto, Hidemasa Furue, Yasutake Shimizu
KEY POINTS: The pathophysiological roles of the CNS in bowel dysfunction in patients with irritable bowel syndrome and Parkinson's disease remain obscure. In the present study, we demonstrate that dopamine in the lumbosacral defaecation centre causes strong propulsive motility of the colorectum. The effect of dopamine is a result of activation of sacral parasympathetic preganglionic neurons via D2-like dopamine receptors. Considering that dopamine is a neurotransmitter of descending pain inhibitory pathways, our results highlight the novel concept that descending pain inhibitory pathways control not only pain, but also the defaecation reflex...
August 1, 2016: Journal of Physiology
https://www.readbyqxmd.com/read/26953816/electrical-stimulation-of-the-spinal-dorsal-root-inhibits-reflex-bladder-contraction-and-external-urethra-sphincter-activity-is-this-how-sacral-neuromodulation-works
#19
Jian Ren, Daniel J Chew, Nikesh Thiruchelvam
INTRODUCTION: Using a rat model, we aimed to confirm the inhibitory effect of dorsal spinal root (afferent) stimulation and test if bilateral stimulation is more effective than unilateral stimulation. External urethral sphincter (EUS) electromyography (EMG) is also assessed in conjunction with cystometrogram. MATERIALS AND METHODS: Eighteen female Sprague-Dawley rats were tested following urethane anesthesia. Via urethral catheterization, the bladder was infused with normal saline to evoke rhythmic bladder reflex contractions (BRC)...
2016: Urologia Internationalis
https://www.readbyqxmd.com/read/26837396/the-role-of-ultrasound-guidance-in-pediatric-caudal-block
#20
Koray Erbüyün, Barış Açıkgöz, Gülay Ok, Ömer Yılmaz, Gökhan Temeltaş, İdil Tekin, Demet Tok
OBJECTIVES: To compare the time interval of the procedure, possible complications, post-operative pain levels, additional analgesics, and nurse satisfaction in ultrasonography-guided and standard caudal block applications.  METHODS: This retrospective study was conducted in Celal Bayar University Hospital, Manisa, Turkey, between January and December 2014, included 78 pediatric patients. Caudal block was applied to 2 different groups; one with ultrasound guide, and the other using the standard method...
February 2016: Saudi Medical Journal
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