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https://www.readbyqxmd.com/read/28637309/anterior-cervical-pseudarthrosis-treated-with-bilateral-posterior-cervical-cages
#1
William Smith, Mark Gillespy, Jason Huffman, Veasna Vong, Bruce M McCormack
BACKGROUND: Pseudarthrosis after anterior cervical discectomy and fusion (ACDF) causes persistent pain and related disability. Posterior revision surgery results in higher healing rates, but is more extensive compared to anterior surgery. OBJECTIVE: To evaluate minimally disruptive, tissue sparing posterior fusion via bilateral placement of posterior cages between the facet joints as an alternative treatment option. METHODS: A retrospective, multicenter, medical chart review was performed and included 25 patients with symptomatic pseudarthrosis after ACDF treated with posterior cervical cages, and in select cases, anterior revision...
June 14, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28634634/pain-and-fracture-related-limitations-persist-6%C3%A2-months-after-a-fragility-fracture
#2
Joanna E M Sale, Lucy Frankel, Stephen Thielke, Larry Funnell
Our objective was to examine the experience of pain after a fracture beyond the conventional healing duration of 6 months. We conducted a phenomenological study in participants who were deemed high risk for future fracture and recruited through an urban fracture clinic in Toronto, Canada. In-depth interviews were conducted with questions addressing the experience of pain, the status of recovery from the fracture, ways in which the fracture affected one's daily activities, and interactions with health care providers...
June 20, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28634015/three-dimensional-3d-printed-model-for-deep-infiltrating-endometriosis-die-a-case-report
#3
Mobolaji O Ajao, Nisse V Clark, Tatiana Kelil, Sarah L Cohen, Jon I Einarsson
The combination of a thorough physical exam and imaging with either MRI or pelvic ultrasound are important in pre-operative planning for deep infiltrating endometriosis. Nevertheless, the 2-dimensional rendering of the pathology by imaging does not always accurately represent intra-operative findings. An in-depth topographical relationship and extent of surrounding tissue invasion can be better appreciated from 3-dimensional modeling. A 49 year old patient with history of endometriosis and persistent pain underwent pre-operative imaging with MRI that was consistent with infiltrating endometriosis...
June 17, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28629009/surgical-suture-braided-with-a-diclofenac-loaded-strand-of-poly-lactic-co-glycolic-acid-for-local-sustained-pain-mitigation
#4
Beom Kang Huh, Byung Hwi Kim, Se-Na Kim, Chun Gwon Park, Seung Ho Lee, Ka Ryeong Kim, Chan Yeong Heo, Young Bin Choy
In this work, we propose a surgical suture that can sustainably release diclofenac (DF) for the local pain relief of surgical wounds. We separately fabricated a DF-loaded strand composed of a biodegradable polymer, poly(lactic-co-glycolic acid) (PLGA), which was then braided with a surgical suture already in clinical use, i.e., VICRYL™. In this way, the drug-delivery suture presented herein could release DF in a sustained manner for 10days while maintaining the mechanical strength needed for wound closure...
October 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28625307/postcesarean-delivery-analgesia
#5
REVIEW
Brendan Carvalho, Alexander J Butwick
Effective pain management should be a key priority in women undergoing cesarean delivery. Suboptimal perioperative pain management is associated with chronic pain, greater opioid use, delayed functional recovery, impaired maternal-fetal bonding, and increased postpartum depression. Severe acute postoperative pain is also strongly associated with persistent pain after cesarean delivery. Multimodal analgesia is the core principle for cesarean delivery pain management. The use of neuraxial morphine and opioid-sparing adjuncts such as scheduled nonsteroidal anti-inflammatory medications and acetaminophen is recommended for all women undergoing cesarean delivery with neuraxial anesthesia unless contraindicated...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28622486/the-physiological-basis-of-cervical-facet-mediated-persistent-pain-basic-science-and-clinical-challenges
#6
Meagan E Ita, Sijia Zhang, Timothy P Holsgrove, Sonia Kartha, Beth A Winkelstein
Synopsis Chronic neck pain is common and a primary clinical symptom of whiplash and other spinal injuries. Loading-induced neck injuries produce abnormal kinematics between the vertebrae, with the potential to injure facet joints and the afferent fibers that innervate the specific joint tissues, including the capsular ligament. Mechanoreceptive and nociceptive afferents that innervate the facet have their peripheral terminals in the capsule, cell bodies in the dorsal root ganglia, and terminal processes in the spinal cord...
June 16, 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/28622274/a-role-for-neurokinin-1-receptor-neurons-in-the-rostral-ventromedial-medulla-in-the-development-of-chronic-postthoracotomy-pain
#7
Sergey G Khasabov, Jeffrey Chi-Fei Wang, Donald A Simone, Gary R Strichartz
Thoracotomy results in chronic postoperative pain (CPTP) in half of the cases. Earlier findings in rat models of persistent post-surgical pain suggest that spinal pathways are critical for pain onset but not its maintenance. Descending systems from the brain stem modulate nociceptive transmission in the spinal cord and contribute to persistent pain, but their role in chronic postoperative pain has not been studied. Here, we ablated pronociceptive neurokinin-1 receptor (NK-1R)-expressing neurons in the rat rostral ventromedial medulla (RVM) to identify their role in CPTP...
July 2017: Pain
https://www.readbyqxmd.com/read/28615337/accumulation-of-methylglyoxal-increases-the-advanced-glycation-end-products-levels-in-drg-and-contributes-to-lumbar-disc-herniation-induced-persistent-pain
#8
Cui-Cui Liu, Xin-Sheng Zhang, Yu-Ting Ruan, Zhu-Xi Huang, Su-Bo Zhang, Meng Liu, Hai-Jie Luo, Shao-Ling Wu, Chao Ma
Lumbar disc herniation (LDH) with discogenic low back pain and sciatica is a common and complicated musculoskeletal disorder. The underlying mechanisms are poorly understood and there are no effective therapies for LDH-induced pain. In the present study, we found that the patients who suffered from LDH-induced pain had elevated plasma methylglyoxal (MG) levels. In rats, implantation of autologous nucleus pulposus (NP) to the left lumbar 5 spinal nerve root, which mimicked LDH, induced mechanical allodynia and increased MG level in plasma and dorsal root ganglion (DRG) and enhanced the excitability of small DRG neurons (< 30μm in diameter)...
June 14, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28613245/population-characteristics-in-a-tertiary-pain-service-cohort-experiencing-chronic-non-cancer-pain-weight-status-comorbidities-and-patient-goals
#9
Katherine Brain, Tracy Burrows, Megan E Rollo, Chris Hayes, Fiona J Hodson, Clare E Collins
We describe the characteristics of patients attending an Australian tertiary multidisciplinary pain service and identify areas for nutrition interventions. This cross-sectional study targets patients experiencing chronic pain who attended the service between June-December 2014. Self-reported data was captured from: (1) an Electronic Persistent Pain Outcomes Collaboration (ePPOC) referral questionnaire, incorporating demographics, pain status, and mental health; (2) a Pain Assessment and Recovery Plan (PARP), which documents patients' perceived problems associated with pain and personal treatment goals...
June 14, 2017: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/28611169/morel-lavall%C3%A3-e-lesion-of-the-proximal-tibia-in-an-obese-patient-after-low-energy-trauma
#10
Dirk Pieter Hogerzeil, Joris Jansen
Morel-Lavallée lesions (MLL) are usually localised in the hip or gluteal region, but have rarely been reported at the proximal tibia. We present a case of an overweight patient, aged 59, with a MLLof the left proximal tibia after a low-energy fall in his backyard. MLL pathogenesis, history, radiographic imaging, applied treatment and relevant literature to this specific case and MLL in general are discussed. Initially the patient's MLL was managed conservatively until he presented with persisting pain and swelling...
June 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28609318/biochemical-and-pharmacological-characterization-of-a-mice-model-of-complex-regional-pain-syndrome
#11
Vaskar Das, Jeffrey S Kroin, Mario Moric, Asokumar Buvanendran
BACKGROUND AND OBJECTIVES: Complex regional pain syndrome is a challenging disease to treat. Recently, a mouse fracture model of complex regional pain syndrome has been developed that has many signs of the clinical syndrome. However, many aspects of the sensory neuron biochemistry and behavioral and pharmacological characterization of this model remain to be clarified. METHODS: Mice were randomly assigned to fracture/cast or control (naive) groups. Fracture/cast mice underwent a closed distal tibia facture, with hindlimb wrapped in casting tape for 3 weeks...
July 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28607342/continuous-regional-anesthesia-a-review-of-perioperative-outcome-benefits
#12
Dario Bugada, Daniela Ghisi, Edward R Mariano
Routine use of regional anesthesia for patients having surgery is supported by general safety and proven effectiveness as a targeted modality in the prevention and treatment of acute pain. Recently, perioperative physicians have become much more interested in improving long-term outcomes after surgery rather than focusing on the well-established short-term benefits of regional anesthesia. This interest has raised important questions regarding the potential influence of regional anesthesia on morbidity and mortality, persistent pain and cancer prognosis...
June 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28606383/a-case-series-of-removal-of-nickel-titanium-sterilization-microinserts-from-the-uterine-cornua-using-laparoscopic-electrocautery-for-salpingectomy
#13
Aaron Lazorwitz, Kristina Tocce
Nickel-titanium sterilization microinserts are surgically removed for various indications, including persistent pain. Previously described removal techniques include salpingostomy and cornuectomy with judicious use of electrocautery to avoid potential injury to adjacent structures or fracturing the micoinsert. This case series presents our technique of laparoscopic salpingectomy, utilizing electrocautery on the microinsert.
June 9, 2017: Contraception
https://www.readbyqxmd.com/read/28605000/hip-arthroscopy-in-patients-less-than-25-years-of-age-in-the-treatment-of-labral-tears-aetiology-and-clinical-outcomes
#14
Gillian Bayley, Stephane Poitras, Gillian Parker, Paul E Beaulé
BACKGROUND: Hip arthroscopy has evolved into a well-established and rapidly growing field of orthopedic surgery for the management of labral tears. The purpose of this study was to review clinical outcomes of patients less than 25 years of age undergoing hip arthroscopy for treatment of a labral tear. METHODS: From 2005 to 2013, 82 hips in 76 patients with mean age of 20.4 (16-25 range) underwent hip arthroscopy for treatment of labral-chondral damage. The Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) and hip disability and osteoarthritis outcome score (HOOS) were recorded at latest follow-up...
June 7, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28604789/the-association-between-baseline-persistent-pain-and-weight-change-in-patients-attending-a-specialist-weight-management-service
#15
Cormac G Ryan, Arutchelvam Vijayaraman, Victoria Denny, Alison Ogier, Louisa Ells, Shaun Wellburn, Lesley Cooper, Denis J Martin, Greg Atkinson
OBJECTIVE: To quantify the influence of baseline pain levels on weight change at one-year follow-up in patients attending a National Health Service specialist weight management programme. METHODS: We compared one-year follow-up weight (body mass) change between patient sub-groups of none-to-mild, moderate, and severe pain at baseline. A mean sub-group difference in weight change of ≥5kg was considered clinically relevant. RESULTS: Of the 141 complete cases, n = 43 (30...
2017: PloS One
https://www.readbyqxmd.com/read/28604219/potentiation-of-nmda-receptor-mediated-synaptic-transmission-at-the-parabrachial-central-amygdala-synapses-by-cgrp-in-mice
#16
Yuya Okutsu, Yukari Takahashi, Masashi Nagase, Kei Shinohara, Ryo Ikeda, Fusao Kato
The capsular part of the central amygdala (CeC) is called the "nociceptive amygdala," as it receives nociceptive information from various pathways, including monosynaptic input from the lateral part of the parabrachial nucleus (LPB), a major target of ascending neurons in the spinal and medullary dorsal horn. LPB-CeC synaptic transmission is mediated by glutamate but the fibers from the LPB also contain calcitonin gene-related peptide (CGRP) and the CeC is rich in CGRP-binding sites. CGRP might be released in response to strong nociception and activate these CGRP receptors...
January 2017: Molecular Pain
https://www.readbyqxmd.com/read/28594509/differentiating-hip-pathology-from-lumbar-spine-pathology-key-points-of-evaluation-and-management
#17
Aaron J Buckland, Ryan Miyamoto, Rakesh D Patel, James Slover, Afshin E Razi
The diagnosis and treatment of patients who have both hip and lumbar spine pathologies may be a challenge because overlapping symptoms may delay a correct diagnosis and appropriate treatment. Common complaints of patients who have both hip and lumbar spine pathologies include low back pain with associated buttock, groin, thigh, and, possibly, knee pain. A thorough patient history should be obtained and a complete physical examination should be performed to identify the primary source of pain. Plain and advanced imaging studies and diagnostic injections can be used to further delineate the primary pathology and guide the appropriate sequence of treatment...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28590818/work-ability-is-influenced-by-kinesiophobia-among-patients-with-persistent-pain
#18
Mona-Lisa Åkerström, Anna Grimby-Ekman, Mari Lundberg
The purpose of this study was to investigate how kinesiophobia fluctuates in patients over a four weeks multimodal rehabilitation program and to study the relationship between work ability and kinesiophobia. The study included 112 patients (94 women, 18 men). Measurements were made before, directly after, 2 months after, and 12 months after the program. The level of work ability was rated by the patients on a scale from 0% to 100%, and kinesiophobia was measured by the Swedish version of the Tampa Scale for Kinesiophobia (TSK-SV)...
June 7, 2017: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/28590258/opioid-induced-hyperalgesia-in-clinical-anesthesia-practice-what-has-remained-from-theoretical-concepts-and-experimental-studies
#19
Lena Weber, David C Yeomans, Alexander Tzabazis
PURPOSE OF REVIEW: This article reviews the phenomenon of opioid-induced hyperalgesia (OIH) and its implications for clinical anesthesia. The goal of this review is to give an update on perioperative prevention and treatment strategies, based on findings in preclinical and clinical research. RECENT FINDINGS: Several systems have been suggested to be involved in the pathophysiology of OIH with a focus on the glutaminergic system. Very recently preclinical data revealed that peripheral μ-opioid receptors (MORs) are key players in the development of OIH and acute opioid tolerance (AOT)...
June 5, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28587657/modified-pedicle-screw-rod-fixation-as-a-minimally-invasive-treatment-for-anterior-pelvic-ring-injuries-an-initial-case-series
#20
Xiaotian Wu, Zuoqing Liu, Wenqin Fu, Shan Zhao, Juntao Feng
BACKGROUND: Unstable pelvic ring injuries often involve high mortality and morbidity. This study was aimed to evaluate the modified minimally invasive pedicle screw-rod fixation for anterior pelvic ring injuries, in the respects of its feasibility, merits, and limitations. METHODS: Twenty-three patients with unstable pelvic ring injuries underwent the modified anterior pedicle screw-rod fixation, with or without posterior fixation. The clinical outcomes were assessed using Majeed scores, and the quality of reduction was evaluated according to the criteria of Matta...
June 6, 2017: Journal of Orthopaedic Surgery and Research
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