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radicular pain

Deed E Harrison, Paul A Oakley, Joseph W Betz
[Purpose] To present the case of the dramatic reduction in pain, disability, and neurologic symptoms following the reduction of forward head translation and increased cervical curvature in a patient suffering from post-surgical radiculopathy. [Subject and Methods] A 52-year-old male mechanic presented with chronic neck pain, unilateral paresthesia along the C5 and C6 dermatome distributions and diminished unilateral grip strength for 12 years following a C5-C6 cervical discectomy and fusion. Outcome measures included the neck disability index, the numerical pain rating scale, and the Zebris cervical range of motion system...
February 2018: Journal of Physical Therapy Science
Pini Koplovitch, Marshall Devor
Ectopic impulse discharge (ectopia) generated in the soma of afferent neurons in dorsal root ganglia (DRGs) following nerve injury is thought to be a major contributor to neuropathic pain. The DRG is thus a prime interventional target. The process of electrogenesis (impulse generation) in the DRG is far more sensitive to systemically administered Na channel blockers than the process of impulse propagation along sensory axons. It should therefore be possible to selectively suppress DRG ectopia with local application of membrane stabilizing agents without blocking normal impulse traffic...
March 12, 2018: Pain
Víctor Rodrigo, Marta Claramonte, Mónica Martín, Juan B Calatayud
BACKGROUND: Intradural disc herniation is a rare phenomenon in spine surgery. Diagnosis is difficult despite current neuroradiologic imaging techniques. METHOD: We present a case of a 59-year-old man with lumbar and radicular pain and a recurrent lumbar herniation. A laminectomy was performed after no clear disc herniation in the epidural space was found and an intradural mass was palpable. A durotomy showed an intradural disc fragment that was removed, followed by an arthrodesis...
March 12, 2018: Acta Neurochirurgica
Saeid Abrishamkar, Sohrab Salimi, Habib Pirmoradi
Background: The standard treatment for cervical disc herniation is open discectomy surgery but some of techniques, such as nucleoplasty were applied by neurosurgeons in recent decade. The aim of this study was to compare the postoperation results of open discectomy and nucleoplasty methods in people suffering from single cervical disc herniation. Materials and Methods: In a clinical trial study that performed during 2012-2013, 70 patients who candidate for neck surgery were selected and randomly divided into two groups...
2018: Advanced Biomedical Research
Behnaz Ansari, Majid Ghasemi, Mana Ahmadian, Fariborz Khorvash
Background: Radicular pain is one of the most common forms of chronic pain in the world, which has challenges about effective medical therapy. The aim of this study was to evaluate the effect of pregabalin (PGB) and metformin (Met) on subacute and chronic radiculopathy. Materials and Methods: This double-blind prospective clinical trial was performed on 71 patients with subacute and chronic cervical and lumbosacral radiculopathy. Group A was treated with PGB 75 mg daily while Group B was treated with PGB 75 mg daily and Met 500 mg daily for 3 months...
2018: Advanced Biomedical Research
Salah G Aoun, Nicole Bedros, Tarek Y El Ahmadieh, Jake Kreck, Nikhil Mehta, Mazin Al Tamimi
BACKGROUND: Venous thromboembolism can be a significant cause of morbidity in the trauma population. Medical and surgical specialties have been pushing the indication for prophylactic filter placement. CASE DESCRIPTION: A 36-year-old man presented with axial lower back pain with a radicular right L2 component after lifting a heavy object. He had a history of penetrating brain trauma 3 years prior, with placement of a prophylactic inferior vena cava filter. His x-ray, computed tomography, and magnetic resonance imaging of the lumbar spine showed fracture of his filter, with migration of the fractured fragment through the inferior vena cava and into the L2-L3 disc space, and surrounding bony lysis and severe osteodiscitis...
March 7, 2018: World Neurosurgery
Brian Wetherington, Talal W Khan
BACKGROUND: Spinal cord stimulation (SCS) can be beneficial for low back and radicular pain. A short trial of SCS evaluates the potential effectiveness of this therapy for a specific patient, while also decreasing the likelihood of a failed permanent implant. While rare, an epidural abscess is difficult to diagnose based on its nonspecific and unreliable clinical presentation. CASE: We present a case of an acute onset methicillin-sensitive Staphylococcus aureus epidural abscess 72-96 hours into a trial of a percutaneous spinal cord stimulator...
March 8, 2018: Pain Practice: the Official Journal of World Institute of Pain
Charlotte Pauwels, Alexandra Roren, Adrien Gautier, Jonathan Linières, François Rannou, Serge Poiraudeau, Christelle Nguyen
BACKGROUND: Lumbar-flexion-based endurance training, namely cycling, could be effective in reducing pain and improving function and health-related quality of life in older people with chronic low back pain. OBJECTIVES: To assess barriers and facilitators to home-based cycling in older patients with lumbar spinal stenosis (LSS). METHODS: We conducted a retrospective mixed-method study. Patients ≥ 50 years old followed up for LSS from November 2015 to June 2016 in a French tertiary care center were screened...
February 27, 2018: Annals of Physical and Rehabilitation Medicine
Mahdi Safdarian, Farshid Farzaneh, Vafa Rahimi-Movaghar
Lumbar disc herniation is the most common cause of radiculopathy. In most cases, the chief complaint is associated with radicular pain due to nerve compression on the herniated side. However, a radicular pain contralateral to the herniation side is an unusual finding rarely reported in the literature. Here, a case of right lower limb radicular pain in the presence of left extruded L4-L5 disc herniation is reported. Management of the patient is discussed in addition to a review of the literature regarding hypotheses on the mechanism of this unusual situation...
January 2018: Asian Journal of Neurosurgery
K Farah, T Graillon, P Rakotozanany, S Pesenti, B Blondel, S Fuentes
INTRODUCTION: Circumferential fusion for lumbar low-grade isthmic spondylolisthesis (LGIS) provides the best spinal stability and highest fusion rates. The aim of this study is to investigate results of minimal invasive management of LGIS and correlations between Intervertebral Foramen Surface (IFS) and other parameters. METHODS: We retrospectively reviewed cases of 43 patients who underwent a minimally invasive circumferential fusion (Anterior lumbar interbody fusion followed by percutaneous posterior pedicle screw fixation) for LGIS between January 2010 and December 2014 in our institution...
February 23, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Jae-Sung Ahn, Ho-Jin Lee, Dae-Jung Choi, Ki-Young Lee, Sung-Jin Hwang
This study was performed to describe the extraforaminal approach of biportal endoscopic spinal surgery (BESS) as a new endoscopic technique for transforaminal decompression and discectomy and to demonstrate the clinical outcomes of this new procedure for the first time. Twenty-one patients (27 segments) who underwent the extraforaminal approach of BESS between March 2015 and April 2016 were enrolled according to the inclusion and exclusion criteria. The operative time (minutes/level) and complications after the procedure were recorded...
February 23, 2018: Journal of Neurosurgery. Spine
Mary-Anne Jess, Ryan Cormac, Sharon Hamilton, Shaun Wellburn, Greg Atkinson, Charles Greenough, Andrew Coxon, Diarmaid Ferguson, Francis Fatoye, John Dickson, Andrea Jones, Denis Martin
Supplemental Digital Content is available in the text STUDY DESIGN.: Longitudinal observational study. OBJECTIVE: To investigate the association between the duration of pain at baseline and the clinical outcomes of patients with low back pain (LBP) enrolled on the North East of England Regional Back Pain and Radicular Pain Pathway (NERBPP). SUMMARY OF BACKGROUND DATA: The NERBPP is a clinical pathway based upon NICE guidelines (2009) for LBP of <1-year duration...
February 21, 2018: Spine
Stanley Sau Ching Wong, Qiu Qiu, Chi Wai Cheung
OBJECTIVE: Lumbar transforaminal epidural steroid injection is commonly used for treating lumbar radicular pain. We report a case of segmental spinal myoclonus that developed during lumbar transforaminal epidural injection with local anesthetic and steroid. CASE REPORT: A 58-year-old woman with failed back surgery syndrome presented with low back and right L3 and L4 radicular pain. As she had responded well previously to diagnostic selective nerve root injection with local anesthetic at the right L3 and L4 levels, lumbar transforaminal epidural steroid injection at the same levels was scheduled...
February 16, 2018: Regional Anesthesia and Pain Medicine
Roger Chou, Pierre Côté, Kristi Randhawa, Paola Torres, Hainan Yu, Margareta Nordin, Eric L Hurwitz, Scott Haldeman, Christine Cedraschi
PURPOSE: The purpose of this review was to develop recommendations for the management of spinal disorders in low-income communities, with a focus on non-invasive pharmacological and non-pharmacological therapies for non-specific low back and neck pain. METHODS: We synthesized two evidence-based clinical practice guidelines for the management of low back and neck pain. Our recommendations considered benefits, harms, quality of evidence, and costs, with attention to feasibility in medically underserved areas and low- and middle-income countries...
February 19, 2018: European Spine Journal
Basabjit Das, Melissa Conroy, David Moore, Joanne Lysaght, Connail McCrory
Radicular pain is a common cause of disability. Traditionally treatment has been either epidural steroid injection providing short-term relief or surgery with associated complications. Pulsed radiofrequency (PRF) applied to the Dorsal Root Ganglion (DRG) is a minimally invasive day-care treatment, which is gaining significant clinical acceptance in a selective group of patients with pure radicular pain. Greater insights into the immunomodulatory effects of this procedure may help to further optimise its application and find alternative treatment options...
February 16, 2018: Brain, Behavior, and Immunity
He Zhao, Xing Yu, Xian-Sheng Tang, Feng He, Yong-Dong Yang, Yang Xiong, Zhen-Guo Hu, Lin Xu
The inflammatory cytokines of IL-1β and TNF-α participate in the process of intervertebral disc degeneration is focused by the spine surgeons. Inflammatory cytokines represented by IL-1β and TNF-α act as the key factors in the process of intervertebral disc degeneration resulting in low back pain and radicular symptoms. Annulus fibrosus and nucleus pulposus can secrete TNF-α and IL-1β under the stimulation of mechanical injury, overstressed, genetic susceptibility and infection. The mechanism of inflammatory cytokines in intervertebral disc degeneration needs further investigation...
September 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Charles D Rosen, P Douglas Kiester, Thay Q Lee
We conducted a study to determine the common characteristics of patients who developed radiculopathy symptoms and corresponding heterotopic ossification (HO) from transforaminal lumbar interbody fusions (TLIF) using recombinant human bone morphogenetic protein 2 (rhBMP-2). HO can arise from a disk space with rhBMP-2 use in TLIF. Formation of bone around nerve roots or the thecal sac can cause a radiculopathy with a consistent pattern of symptoms. We identified 38 patients (26 males, 12 females) with a mean (SD) age of 50...
January 2018: American Journal of Orthopedics
Shin-Yi Chiou, Ermis Koutsos, Pantelis Georgiou, Paul H Strutton
OBJECTIVES: Characteristics of muscle activity, represented by surface electromyography (EMG), have revealed differences between patients with low back pain (LBP) and healthy adults; how they relate to functional and clinical parameters remains unclear. The purpose of the current study was to examine the correlation between frequency characteristics of EMG (analysed using continuous wavelet transform (CWT) analysis) and patients' self-rated score of disability. DESIGN AND SETTING: This is a case-control study with 15 patients with mechanical LBP without radicular symptoms...
February 14, 2018: BMJ Open
Lauren M Boden, Stephanie A Boden, Ajay Premkumar, Michael B Gottschalk, Scott D Boden
STUDY DESIGN: Retrospective analysis of prospectively collected data. OBJECTIVE: To create a data-driven triage system stratifying patients by likelihood of undergoing spinal surgery within one year of presentation. SUMMARY OF BACKGROUND DATA: Low back pain (LBP) and radicular lower extremity (LE) symptoms are common musculoskeletal problems. There is currently no standard data-derived triage process based on information that can be obtained prior to the initial physician-patient encounter to direct patients to the optimal physician type...
February 9, 2018: Spine
R Figa, C Morera-Dominguez
OBJECTIVE: To evaluate the predictive value of Modic typeII changes on nuclear magnetic resonance (NMR) prior to intervention by discectomy for lumbar disc herniation in patients with radicular symptoms. MATERIAL AND METHOD: Retrospective descriptive study of 190 patients (58.2% men and 41.8% women) with a mean age of 43.5 years, treated between December 2005 and January 2013. They were divided into group 1, single disc herniation (n=85), and group 2, with disc herniation and changes Modic typeII (n=80)...
February 6, 2018: Revista Española de Cirugía Ortopédica y Traumatología
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