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paraspinal block

Maria Alejandra Hernandez, Lucio Palazzi, Julio Lapalma, Mauricio Forero, Ki Jinn Chin
OBJECTIVE: Historically, regional anesthesia for surgery on the posterior thoracic wall has been limited to neuraxial and paravertebral nerve blocks. The erector spinae plane (ESP) block is a novel technique that anesthetizes the dorsal rami of the spinal nerves innervating the posterior thoracic wall. We report the use of the ESP block for this clinical application in a pediatric patient. CASE REPORT: A healthy 3-year-old girl was scheduled for resection of a giant paraspinal lipoma extending over the T4-T7 dermatomes...
December 22, 2017: Regional Anesthesia and Pain Medicine
Chang Il Ju, Seok Won Kim, Jong Gyue Kim, Seung Myung Lee, Ho Shin, Hyeun Young Lee
BACKGROUND: Bertolotti's syndrome is a spinal disorder characterized by abnormal enlargement of the transverse process of the most caudal lumbar vertebra. The L5 transverse process may be enlarged either unilaterally or bilaterally and may articulate or fuse with the sacrum or ilium. Pseudoarticulation between the transverse process of the L5 and the alar of the sacrum can cause buttock pain and leg pain. In addition, the L4 exiting nerve root could be compressed by an enlarged L5 transverse process...
September 2017: Pain Physician
Mauricio Forero, Manikandan Rajarathinam, Sanjib Adhikary, Ki Jinn Chin
BACKGROUND AND AIMS: Post thoracotomy pain syndrome (PTPS) remains a common complication of thoracic surgery with significant impact on patients' quality of life. Management usually involves a multidisciplinary approach that includes oral and topical analgesics, performing appropriate interventional techniques, and coordinating additional care such as physiotherapy, psychotherapy and rehabilitation. A variety of interventional procedures have been described to treat PTPS that is inadequately managed with systemic or topical analgesics...
October 2017: Scandinavian Journal of Pain
Carlos Eduardo Restrepo-Garces, Ki Jinn Chin, Patricia Suarez, Alejandro Diaz
The erector spinae plane (ESP) block is a regional anesthetic technique involving local anesthetic injection in a paraspinal plane deep to the erector spinae muscle. Originally described for thoracic analgesia when performed at the T5 transverse process, the ESP block can provide abdominal analgesia if performed at lower thoracic levels because the erector spinae muscles extend to the lumbar spine. A catheter inserted into this plane can extend analgesic duration and can be an alternative to epidural analgesia...
December 1, 2017: A & A Case Reports
Adam P Harrison, Ziyue Xu, Amir Pourmorteza, David A Bluemke, Daniel J Mollura
PURPOSE: We present a denoising algorithm designed for a whole-body prototype photon-counting computed tomography (PCCT) scanner with up to 4 energy thresholds and associated energy-binned images. METHODS: Spectral PCCT images can exhibit low signal to noise ratios (SNRs) due to the limited photon counts in each simultaneously-acquired energy bin. To help address this, our denoising method exploits the correlation and exact alignment between energy bins, adapting the highly-effective block-matching 3D (BM3D) denoising algorithm for PCCT...
June 2017: Medical Physics
Kyung-Chul Choi, Jin-Sung Kim, Dong Chan Lee, Choon-Keun Park
STUDY DESIGN: Retrospective analysis. OBJECTIVE OF THE STUDY: The objective of the study was to present the surgical outcome and analyze the prognostic factors for postoperative leg pain after posterior decompression alone for foraminal/extraforaminal L5 entrapment at L5-S1 segment (LSS). SUMMARY OF BACKGROUND DATA: Disk extrusion, hypertrophy of facet joint, osteophyte of vertebral body, thickened lumbosacral ligament, and collapsed disk lead to form the lumbosacral tunnel which compresses the L5 exiting nerve root...
November 2017: Clinical Spine Surgery
Robert B Bryskin, Daniel K Robie, Frederick M Mansfield, Eugene B Freid, Siam Sukumvanich
BACKGROUND: A safe and effective method of multilevel thoracic pain control remains an elusive goal in patients undergoing the Nuss procedure. The aim of our study was to develop a nonopioid centered approach using a novel regional technique as part of a quality improvement initiative. METHODS: The proposed ultrasound-guided technique positions multi-perforated soaker catheter deep to the paraspinal muscles from T2 to T11. The project was conducted in two phases...
March 2017: Journal of Pediatric Surgery
Honorio T Benzon, Yogen G Asher, Craig T Hartrick
The incidence of back pain after neuraxial anesthesia in the adult population is not different from that after general anesthesia. The pain is usually mild, localized in the low back, rarely radiates to the lower extremities, and has a duration of only a few days. The risk factors for development of back pain include the lithotomy position, multiple attempts at block placement, duration of surgery longer than 2.5 hours, body mass index ≥32 kg/m, and a history of back pain. However, there is no permanent worsening of preexisting back pain after neuraxial anesthesia...
June 2016: Anesthesia and Analgesia
Donald A Ross, Miner N Ross
STUDY DESIGN: Clinical case series. OBJECTIVE: This study sought to clarify symptoms, diagnostic criteria, and treatment of C4 radiculopathy, and the role of diagnostic C4 root block in this entity. SUMMARY OF BACKGROUND DATA: Although well understood cervical dermatomal/myotomal syndromes have been described for symptoms originating from impingement on the C2, C3, C5, C6, C7, and C8 roots, less has been written about the syndrome(s) associated with the C4 root...
December 1, 2016: Spine
Brenda J Weigel, Elizabeth Lyden, James R Anderson, William H Meyer, David M Parham, David A Rodeberg, Jeff M Michalski, Douglas S Hawkins, Carola A S Arndt
PURPOSE: Patients with metastatic rhabdomyosarcoma (RMS), except those younger than 10 years with embryonal RMS, have an estimated long-term event-free survival (EFS) of less than 20%. The main goal of this study was to improve outcome of patients with metastatic RMS by dose intensification with interval compression, use of the most active agents determined in phase II window studies, and use of irinotecan as a radiation sensitizer. PATIENTS AND METHODS: Patients with metastatic RMS received 54 weeks of therapy: blocks of therapy with vincristine/irinotecan (weeks 1 to 6, 20 to 25, and 47 to 52), interval compression with vincristine/doxorubicin/cyclophosphamide alternating with etoposide/ifosfamide (weeks 7 to 19 and 26 to 34), and vincristine/dactinomycin/cyclophosphamide (weeks 38 to 46)...
January 10, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Lei Qi, Mu Li, Haipeng Si, Shuai Zhang, Yunpeng Jiang, Jingsong Xue
OBJECTIVE: To evaluate the clinical and radiological efficacy of paraspinal muscle approach with winglike working channel in the treatment of thoracic and lumbar spine fracture. METHODS: From October 2010 to August 2012, a total of 51 patients with thoracic and lumbar spine fractures without neurological symptoms were enrolled in the study, including 32 males and 19 females. All patients were divided into two groups: 26 patients were treated through posterior paraspinal muscle approach with winglike working channel, and 25 patients were treated through traditional posterior approach...
April 2015: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Karen Felix da Rosa, Vinícius Atrib Amantéa, Antônio Cardoso dos Santos, Ricardo Francalacci Savaris
PURPOSE: To determine whether paraspinal block reduces pain scores compared to placebo in women with chronic pelvic pain refractory to drug therapy. METHODS: Subjects with chronic pelvic pain due to benign conditions and refractory to drug therapy were invited to participate in a randomized, double blind, superiority trial at a tertiary reference center. Subjects were randomly allocated to receive paraspinal anesthetic block with 1% lidocaine without epinephrine or placebo (control)...
March 2015: Revista Brasileira de Ginecologia e Obstetrícia
Jingwei Zhang, Davide Barbieri, Hetty ten Hoopen, Joost D de Bruijn, Clemens A van Blitterswijk, Huipin Yuan
The presence of micropores in calcium phosphate (CaP) ceramics has shown its important role in initiating inductive bone formation in ectopic sites. To investigate how microporous CaP ceramics trigger osteoinduction, we optimized two biphasic CaP ceramics (i.e., BCP-R and BCP-S) to have the same chemical composition, equivalent surface area per volume, comparable protein adsorption, similar ion (i.e., calcium and phosphate) exchange and the same surface mineralization potential, but different surface architecture...
March 2015: Journal of Biomedical Materials Research. Part A
Jennifer D Hastings, Julie Dickson, Linsey Tracy, Christine Baniewich, Cedar Levine
We report successful correction of new onset neuromuscular scoliosis without spinal surgery in a man who is 30-years post-American Spinal Injury Association Impairment Scale grade A C6 injury with new onset of left neuromuscular scoliosis (Cobb angle 45°) after a motor vehicle collision. Interventions included nightly low-load prolonged stretching (LLPS) (4h left side lying over bolster), a series of 6 botulinum toxin injections (BTIs) at 3-month intervals, and progressive seating adjustments to counteract the spinal curvature...
December 2014: Archives of Physical Medicine and Rehabilitation
M R Bookhout
Plain x-rays of the lumbar spine are not helpful in diagnosing most known causes of low back pain but can reveal structural changes such as disc space narrowing, scoliosis, lumbarization or sacralization, spondylolysis, and spondylolisthesis. Spondylolisthesis is defined as the forward displacement of one vertebrae upon another, usually at the L5-S1 level, but also occurring at L4-5. For spondylolisthesis to occur there must be an anatomical change in the structures which normally resist the anterior displacement of one vertebrae upon the other...
January 1, 1993: Journal of Back and Musculoskeletal Rehabilitation
S T Howard, D R Woerner, D J Vote, J A Scanga, P L Chapman, T C Bryant, R J Acheson, J D Tatum, K E Belk
The effect of ractopamine hydrochloride (RH) and zilpaterol hydrochloride (ZH) on slice shear force (SSF) and sensory characteristics of beef from calf-fed Holstein steers was evaluated. All steers were implanted with a progesterone (100 mg) plus estradiol benzoate (10 mg) implant followed by a terminal trenbolone acetate (200 mg) plus estradiol (40 mg) implant. Steers were blocked by weight into pens (n = 32) randomly assigned to 1 of 4 treatments: control, RH fed at 300 mg·steer(-1)·d(-1) (RH 300) or RH fed at 400 mg·steer(-1)·d(-1)(RH 400) for the final 31 d of finishing, or ZH fed at 6...
January 2014: Journal of Animal Science
Elizabeth L Stegemöller, Jaimie Roper, Chris J Hass, David J Kennedy
BACKGROUND CONTEXT: Using diagnostic anesthetic blocks, the lumbar zygapophysial (facet) joint has been shown to be the primary cause of pain in approximately 15% of patients with chronic low back pain. Radiofrequency neurotomy (RFN) of the lumbar medial branch innervating the zygapophysial joint has been shown to provide a significant decrease in pain in patients selected by dual comparative anesthetic blocks, but quantitative improvements in mobility have not been fully elucidated. A theoretical concern with RFN is that the multifidus muscle, a stabilizing paraspinal muscle, is also denervated during this procedure, which may have adverse effects on mobility and spine stability...
June 1, 2015: Spine Journal: Official Journal of the North American Spine Society
K T Korn, R P Lemenager, M C Claeys, J N Waddell, M Engstrom, J P Schoonmaker
Two hundred and ten Angus × Simmental steers (initial BW 314 ± 11 kg) were separated into heavy and light BW blocks and allotted evenly by BW to 6 treatments (3 heavy and 2 light pens per treatment) to determine the effect of supplemental vitamin D3: 0 IU (no D), 250,000 IU for 165 d (long-term D), or 5 × 10(6) IU for 10 d (short-term D) on plasma and muscle calcium concentrations and gene expression in steers fed either 0 (NZ) or 8.38 mg/kg (ZH) zilpaterol hydrochloride (ZH) daily for 21 d. Placebo or ZH was added to the diet 24 d, and short-term D was added 13 d before slaughter...
July 2013: Journal of Animal Science
Marie-Pierre Harvey, Martin Descarreaux
BACKGROUND: Low back pain (LBP) is one of the most frequent musculoskeletal conditions in industrialized countries and its economic impact is important. Spinal manipulation therapy (SMT) is believed to be a valid approach in the treatment of both acute and chronic LBP. It has also been shown that SMT can modulate the electromyographic (EMG) activity of the paraspinal muscle. The purpose of this study was to investigate, in a group of patients with low back pain, the persistence of changes observed in trunk neuromuscular responses after a spinal manipulation (SMT)...
2013: BMC Musculoskeletal Disorders
Geoff M Schneider, Gwendolen Jull, Kenneth Thomas, Ashley Smith, Carolyn Emery, Peter Faris, Kathryn Schneider, Paul Salo
OBJECTIVE: To measure the intra- and interrater reliability of select standardized clinical tests used for the assessment of patients with axial neck pain referred for diagnostic facet joint blocks. DESIGN: Single-group, repeated-measures study. SETTING: Tertiary interventional pain management center. PARTICIPANTS: Consecutive patients with persistent neck pain, referred to a tertiary interventional pain management center, were approached to participate...
August 2013: Archives of Physical Medicine and Rehabilitation
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