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https://www.readbyqxmd.com/read/28697031/epidural-injections-contraindicated-for-lumbar-radiculopathy-in-may-thurner-syndrome-a-case-report
#1
Michael Sniderman
A 59-year-old patient presented to the chronic pain clinic with a 6-week history of worsening lumbar back pain, bilateral thigh pain, and unilateral radiculopathy. Magnetic resonance imaging revealed mild discogenic and facetogenic disease, but significant epidural venous plexus engorgement compressing the thecal sac. The patient reported previous treatment by a vascular surgeon for May-Thurner Syndrome, a type of inferior vena caval obstruction, yet had not experienced these specific complaints. A discussion with the radiologist confirmed worsening of the patient's May-Thurner Syndrome was the likely cause of the patient's symptoms...
July 10, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28670405/intradiscal-injection-of-autologous-platelet-rich-plasma-releasate-to-treat-discogenic-low-back-pain-a-preliminary-clinical-trial
#2
Koji Akeda, Kohshi Ohishi, Koichi Masuda, Won C Bae, Norihiko Takegami, Junichi Yamada, Tomoki Nakamura, Toshihiko Sakakibara, Yuichi Kasai, Akihiro Sudo
STUDY DESIGN: Preliminary clinical trial. PURPOSE: To determine the safety and initial efficacy of intradiscal injection of autologous platelet-rich plasma (PRP) releasate in patients with discogenic low back pain. OVERVIEW OF LITERATURE: PRP, which is comprised of autologous growth factors and cytokines, has been widely used in the clinical setting for tissue regeneration and repair. PRP has been shown in vitro and in vivo to potentially stimulate intervertebral disc matrix metabolism...
June 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/28666263/the-value-of-radiographic-indexes-in-the-diagnosis-of-discogenic-low-back-pain-a-retrospective-analysis-of-imaging-results
#3
Jian Song, Hong-Li Wang, Xiao-Sheng Ma, Xin-Lei Xia, Fei-Zhou Lu, Chao-Jun Zheng, Jian-Yuan Jiang
To explore value of different radiographic indexes in the diagnosis of discogenic low back pain (LBP). A total number of 120 cases (60 patients diagnosed with discogenic LBP and 60 healthy people) were retrospectively analysed to identify factors in the diagnosis of discogenic LBP by using univariate and multivariate analyses. A receiver operating characteristic (ROC) curve was drew to show the predictive accuracy of the finally enrolled factors. Among all the included patients, 60 were strictly admitted in the discogenic LBP group while the other 60 were enrolled in the control group...
June 27, 2017: Oncotarget
https://www.readbyqxmd.com/read/28655123/mechanical-low-back-pain-in-elite-track-and-field-athletes-an-observational-cohort-study
#4
Nikolaos Malliaropoulos, Georgios Bikos, Maria Meke, Ioannis Tsifountoudis, Dev Pyne, Vasileios Korakakis
OBJECTIVE: The aim of the study was to gain information about the incidence of mechanical Low Back Pain (MLBP) injuries etiology in elite track and field athletes and to assess the recurrence rate. BACKGROUND: The prevalence and the etiology of Low Back Pain (LBP) in athletic populations at the elite level of competition lack of longitudinal studies focused on certain sport fields. The present study evaluates MLBP incidents in elite track and field athletes visiting National Track and Field Centre in Thessaloniki, Greece and classifies MLBP according to etiology...
June 2, 2017: Journal of Back and Musculoskeletal Rehabilitation
https://www.readbyqxmd.com/read/28648909/clinical-efficacy-and-its-prognostic-factor-of-percutaneous-endoscopic-lumbar-annuloplasty-and-nucleoplasty-for-treatment-of-patients-with-discogenic-low-back-pain
#5
Jung Hwan Lee, Sang-Ho Lee
OBJECTIVE: The choice of appropriate treatment of discogenic low back pain (DLBP) was frequently difficult. This study was to identify the clinical efficacy of percutaneous endoscopic lumbar annuloplasty and nucleoplasty (PELAN) to treat the patients with DLBP and to investigate prognostic clinical or radiological variables. METHODS: Eighty-nine patients who underwent PELAN under diagnosis of DLBP were included. Numeric rating scale (NRS) for back pain, Oswestry disability index(%) (ODI%), and modified MacNab criteria were measured at short term(3-4 weeks) and long term follow up period(at least 12 months) to investigate clinical efficacy of PELAN...
June 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28645219/pullulan-microbeads-si-hpmc-hydrogel-injectable-system-for-the-sustained-delivery-of-gdf-5-and-tgf-%C3%AE-1-new-insight-into-intervertebral-disc-regenerative-medicine
#6
Nina Henry, Johann Clouet, Audrey Fragale, Louise Griveau, Claire Chédeville, Joëlle Véziers, Pierre Weiss, Jean Le Bideau, Jérôme Guicheux, Catherine Le Visage
Discogenic low back pain is considered a major health concern and no etiological treatments are today available to tackle this disease. To clinically address this issue at early stages, there is a rising interest in the stimulation of local cells by in situ injection of growth factors targeting intervertebral disc (IVD) degenerative process. Despite encouraging safety and tolerability results in clinic, growth factors efficacy may be further improved. To this end, the use of a delivery system allowing a sustained release, while protecting growth factors from degradation appears of particular interest...
November 2017: Drug Delivery
https://www.readbyqxmd.com/read/28617390/-pathopsychological-aspects-of-low-back-pain
#7
A I Krupatkin, A A Kuleshov, T V Sokolova, A O Gospod
Low back pain is one of the most common causes of disability in the world. Discogenic process is the leading component of the disease. A significant part of these pain syndromes become chronic that leads to disability and social maladjustment. Chronic low back pain is hard to treat due to the several types of pathogenesis. The paper analyzes the etiology, mechanisms of development, clinical features, specific characteristics, pathomorphology of the formation of psychogenic component of pain. A role of comorbid psychogenic states involved in the chronization of low back pain is considered...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
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/28550817/atypical-presentation-and-outcome-of-cervicogenic-headache-in-patients-with-cervical-degenerative-disease-a-single-center-experience
#9
Shyamal C Bir, Anil Nanda, Devi Prasad Patra, Tanmoy Kumar Maiti, Cesar Liendo, Alireza Minagar, Oleg Y Chernyshev
OBJECTIVE: Cervicogenic headache affects a significant portion of the entire population. This type of headache especially with atypical presentation is often hard to diagnose and manage since its etiopathophysiology is not been yet well understood. We have investigated the prevalence of cervicogenic headache with atypical presentation and discussed the etiology of it, and the outcome of surgical intervention on this type of headache in patients with cervical degenerative disease. PATIENTS AND METHODS: Radiological and clinical data of 160 patients (from 2001 through 2016) were retrospectively reviewed...
May 13, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28535552/stem-cell-therapy-for-chronic-pain-management-review-of-uses-advances-and-adverse-effects
#10
REVIEW
Krishnan Chakravarthy, Yian Chen, Cathy He, Paul J Christo
BACKGROUND: This review article outlines the recent advances, uses, and adverse effects of cell-based therapy for chronic pain management. Cell based therapies are gaining increasing ground as novel treatment modalities for a variety of pain pathologies that include, but are not limited to, neuropathic pain and degenerative disc disease. As these treatment modalities become more common practice, we have focused our review to provide pain practitioners and other practicing physicians an understanding of the technology and to summarize key clinical data and existing clinical trials that are being pursued by clinical investigators worldwide...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28535546/cost-utility-analysis-of-lumbar-interlaminar-epidural-injections-in-the-treatment-of-lumbar-disc-herniation-central-spinal-stenosis-and-axial-or-discogenic-low-back-pain
#11
Laxmaiah Manchikanti, Vidyasagar Pampati, Ramsin M Benyamin, Joshua A Hirsch
BACKGROUND: Cost utility or cost effective analysis continues to take center stage in the United States for defining and measuring the value of treatments in interventional pain management. Appropriate cost utility analysis has been performed for caudal epidural injections, percutaneous adhesiolysis, and spinal cord stimulation. However, the literature pertaining to lumbar interlaminar epidural injections is lacking, specifically in reference to cost utility analysis derived from randomized controlled trials (RCTs) with a pragmatic approach in a practical setting...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28491116/a-randomized-clinical-trial-comparing-the-effectiveness-of-electroacupuncture-versus-medium-frequency-electrotherapy-for-discogenic-sciatica
#12
Xue Zhang, Yang Wang, Zhao Wang, Chao Wang, Wentao Ding, Zhishun Liu
Objective. To investigate the short- and long-term effects of electroacupuncture (EA) compared with medium-frequency electrotherapy (MFE) on chronic discogenic sciatica. Methods. One hundred participants were randomized into two groups to receive EA (n = 50) or MFE (n = 50) for 4 weeks. A 28-week follow-up of the two groups was performed. The primary outcome measure was the average leg pain intensity. The secondary outcome measures were the low back pain intensity, Oswestry Disability Index (ODI), patient global impression (PGI), drug use frequency, and EA acceptance...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/28486758/stimulation-of-the-l2-l3-dorsal-root-ganglia-induces-effective-pain-relief-in-the-low-back
#13
Frank Huygen, Liong Liem, William Cusack, Jeffery Kramer
INTRODUCTION: Chronic low back pain affects millions of people worldwide and can arise through a variety of clinical origins. In the case of Failed Back Surgery Syndrome (FBSS), previous surgical procedures can contribute to low back pain that is often unresponsive to intervention. Although spinal cord stimulation can be an effective treatment modality, it does not provide sufficient pain relief for some intractable cases. Recently, alternative neuromodulation options have been developed, including dorsal root ganglion (DRG) stimulation...
May 9, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28486278/interventional-approaches-to-low-back-pain
#14
Ariana M Nelson, Geeta Nagpal
Chronic low back pain (LBP) places a tremendous economic burden on society due to both direct and indirect costs. Health care costs for adults with chronic LBP have steadily increased over the past 20 years, coinciding with a large increase in the utilization of spinal injections, surgical interventions, opioid medications, and physical therapy. The treatment of LBP is best approached by a multimodal and even multidisciplinary approach with a combination of physical rehabilitation, pharmacologic management, psychological intervention, spinal injections, and surgical intervention with a goal of improving the functional status of the patient...
May 8, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28430617/estrogen-receptors-involvement-in-intervertebral-discogenic-pain-of-the-elderly-women-colocalization-and-correlation-with-the-expression-of-substance-p-in-nucleus-pulposus
#15
Xiao-Xing Song, Sheng Shi, Zhen Guo, Xin-Feng Li, Bu-Wei Yu
Estrogenic modulation of pain is an exceedingly complex phenomenon. However, whether estrogen is involved in discogenic low back pain still remains unclear. Here, immunoreactivity staining technique was used to examine the expression level of the estrogen receptors (ERα and ERβ) and a pain related neuropeptide, Substance P in the lumbar intervertebral discs to analyze the relationship between the ERs and Substance P. Nucleus pulposus tissues of 23 elderly female patients were harvested during spinal surgeries and made to detect the immunoreactivity staining of ERα, ERβ and Substance P...
June 13, 2017: Oncotarget
https://www.readbyqxmd.com/read/28379575/no-transfer-of-pressure-to-adjacent-discs-during-human-low-pressure-controlled-discography-a-prospective-clinical-study
#16
Jan Willem Kallewaard, José W Geurts, Michel Terheggen, Chris Terwiel, Alfons Kessels, Maarten van Kleef, Paul C Willems
Background. : A substantial part of low back pain (LBP) originates from degeneration of the intervertebral disc. To confirm the diagnosis of discogenic pain, provocation discography seems the best available tool. However, provocation discography is also considered to be a controversial and subjective test because the patient's personal pain response is the most crucial for the result of the test. Recently, an in vivo porcine study and a study in nine human subjects showed passing of pressure to the adjacent discs during discography...
April 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28178999/the-correlation-between-the-high-intensity-zone-on-a-t2-weighted-mri-and-positive-outcomes-of-discography-a-meta-analysis
#17
Chunyang Fang, Wenbin Zhang, Liqiu Chen, Hongjie Li
BACKGROUND: This meta-analysis aimed to assess the correlation between the high-intensity zone (HIZ) of a lumbar MRI and discography. METHODS: We conducted an electronic search of the PubMed, MEDLINE, Embase, and ScienceDirect databases from their respective inceptions to October 2016 using the following search terms: "low back pain," "discogenic low back pain," "HIZ or high-intensity zone," and "discography". Relevant journals and conference proceedings were manually searched...
February 8, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28138783/issls-prize-in-basic-science-2017-intervertebral-disc-bone-marrow-cross-talk-with-modic-changes
#18
Stefan Dudli, David C Sing, Serena S Hu, Sigurd H Berven, Shane Burch, Vedat Deviren, Ivan Cheng, Bobby K B Tay, Todd F Alamin, Ma Agnes Martinez Ith, Eric M Pietras, Jeffrey C Lotz
STUDY DESIGN: Cross-sectional cohort analysis of patients with Modic Changes (MC). OBJECTIVE: Our goal was to characterize the molecular and cellular features of MC bone marrow and adjacent discs. We hypothesized that MC associate with biologic cross-talk between discs and bone marrow, the presence of which may have both diagnostic and therapeutic implications. BACKGROUND DATA: MC are vertebral bone marrow lesions that can be a diagnostic indicator for discogenic low back pain...
May 2017: European Spine Journal
https://www.readbyqxmd.com/read/28066745/deep-gluteal-space-problems-piriformis-syndrome-ischiofemoral-impingement-and-sciatic-nerve-release
#19
Luis Perez Carro, Moises Fernandez Hernando, Luis Cerezal, Ivan Saenz Navarro, Ana Alfonso Fernandez, Alexander Ortiz Castillo
BACKGROUND: Deep gluteal syndrome (DGS) is an underdiagnosed entity characterized by pain and/or dysesthesias in the buttock area, hip or posterior thigh and/or radicular pain due to a non-discogenic sciatic nerve entrapment in the subgluteal space. Multiple pathologies have been incorporated in this all-included "piriformis syndrome", a term that has nothing to do with the presence of fibrous bands, obturator internus/gemellus syndrome, quadratus femoris/ischiofemoral pathology, hamstring conditions, gluteal disorders and orthopedic causes...
July 2016: Muscles, Ligaments and Tendons Journal
https://www.readbyqxmd.com/read/27914651/individualised-functional-restoration-plus-guideline-based-advice-vs-advice-alone-for-non-reducible-discogenic-low-back-pain-a-randomised-controlled-trial
#20
Alexander Y P Chan, Jon J Ford, Luke D Surkitt, Matthew C Richards, Sarah L Slater, Megan Davidson, Andrew J Hahne
OBJECTIVES: To evaluate the effectiveness of individualised functional restoration plus guideline-based advice compared to advice alone in people with non-reducible discogenic pain (NRDP). DESIGN: Subgroup analysis within a multicentre, parallel group randomised controlled trial. SETTING: Fifteen primary care physiotherapy clinics. PARTICIPANTS: Ninety-six participants with clinical features indicative of NRDP (6 week to 6 month duration of injury)...
August 10, 2016: Physiotherapy
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