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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
Daniel B Rodrigues, Paulo S F Campos, Larry M Wolford, Jaqueline Ignácio, João R Gonçalves
PURPOSE: Maxillary segmentation involving interdental osteotomies can have an adverse effect on the interdental crestal bone and adjacent teeth. The purpose of the present study was to evaluate the effect of interdental osteotomies on surrounding osseous and dental structures, including adjacent teeth, using cone beam computed tomography (CBCT), in patients who underwent segmental maxillary osteotomies. PATIENTS AND METHODS: The present retrospective cohort study evaluated interdental osteotomy (IDO) sites between the lateral incisors and canines in patients treated with 3-piece Le Fort I osteotomies...
February 19, 2018: Journal of Oral and Maxillofacial Surgery
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
Lívia Natália Sales Brito, Maria Manuela Rodrigues de Lemos Almeida, Lélia Batista de Souza, Pollianna Muniz Alves, Cassiano Francisco Weege Nonaka, Gustavo Pina Godoy
INTRODUCTION: Galectins play important roles in immunoinflammatory responses, but their participation in the development of periapical lesions remains unclear. This study aimed to evaluate the expressions of galectins-1, -3, and -7 in periapical lesions, correlating them with the intensity of the inflammatory infiltrate and the pattern of the cystic epithelium. METHODS: Twenty periapical granulomas (PGs), 20 radicular cysts (RCs), and 20 residual radicular cysts (RRCs) were submitted to immunohistochemistry using anti-galectin-1, -3, and -7 antibodies...
March 3, 2018: Journal of Endodontics
Nilukshana Yogendranathan, H M M T B Herath, W D Jayamali, Anne Thushara Matthias, Aruna Pallewatte, Aruna Kulatunga
BACKGROUND: Spinal cord infarction is an uncommon condition. Anterior cord syndrome present with paraparesis or quadriparesis with sparing of vibration and proprioceptive senses. The common causes of anterior cord syndrome are aortic dissection and aortic surgical interventions. Spontaneous unruptured nondissected aortic aneurysms with intramural thrombus can rarely cause anterior cord infarctions. CASE PRESENTATION: We report a case of anterior spinal cord syndrome due to aneurysm of the thoracic aorta with a mural thrombus...
March 5, 2018: BMC Cardiovascular Disorders
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
Nghia Huynh, Fang-Chi Li, Shimon Friedman, Anil Kishen
INTRODUCTION: Pericervical dentin (PCD) loss may increase root fracture propensity in root-filled teeth. This study evaluated the impacts of bonding PCD with composite resin (CR) on radicular microstrain distribution and load at failure of root-filled maxillary premolars. METHODS: Ten single-canal maxillary premolars decoronated 2 mm coronal to the cementoenamel junction (CEJ) had canals enlarged with ProTaper Universal instruments (Dentsply Tulsa Dental Specialties, Tulsa, OK) to F3...
February 16, 2018: Journal of Endodontics
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
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