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failed back surgery

Haruki Funao, Khaled M Kebaish, Norihiro Isogai, Takahiro Koyanagi, Morio Matsumoto, Ken Ishii
BACKGROUND: Spondylodiscitis still remains a serious problem especially in immunocompromised patients. Surgery is necessary when non-surgical treatment is unsuccessful. Although minimally invasive spine stabilization (MISt) with percutaneous pedicle screws is less invasive, percutaneous sacropelvic fixation techniques are not common practice. Here, we describe two cases in which spondylodiscitis in the lumbosacral spine was treated with a percutaneous stabilization using S2 alar-iliac (S2AI) screw technique...
October 15, 2016: World Neurosurgery
Jin-Gyu Choi, Sang-Woo Ha, Byung-Chul Son
OBJECTIVES: The authors investigated the difference in clinical outcome and the position of paddle lead spinal cord stimulation (SCS) between three-column and five-column paddle lead SCS in patients with FBSS. MATERIALS AND METHODS: In 21 patients who underwent paddle lead SCS at T9 (three-column, n = 9; five-column, n =12) for FBSS, a 12-month follow-up numerical rating scale, percent pain relief, and CT assessment of contact angle and percent reduction of T9 canal area were investigated...
October 12, 2016: World Neurosurgery
Ciara Clancy, Alison Quinn, Fiona Wilson
PURPOSE: Four to fifty percent of patients will develop Failed Back Surgery Syndrome (FBSS) following lumbar spine surgery. Repeated surgeries lead to escalating costs and subsequent decreases in success rate. Much of the research to date has focused on the psychosocial factors associated with FBSS. All factors including physical and pathological aetiologies should be examined. These factors may be independent, co-exist with or predispose patients to the psychological factors associated with FBSS...
September 23, 2016: Journal of Back and Musculoskeletal Rehabilitation
Michael M Kreusser, Lorenz H Lehmann, Nora Wolf, Stanislav Keranov, Andreas Jungmann, Hermann-Josef Gröne, Oliver J Müller, Hugo A Katus, Johannes Backs
CaM kinase II (CaMKII) has been suggested to drive pathological cardiac remodeling and heart failure. However, the evidence provided so far is based on inhibitory strategies using chemical compounds and peptides that also exert off-target effects and followed exclusively preventive strategies. Therefore, the aim of this study was to investigate whether specific CaMKII inhibition after the onset of cardiac stress delays or reverses maladaptive cardiac remodeling and dysfunction. Combined genetic deletion of the two redundant CaMKII genes δ and γ was induced after the onset of overt heart failure as the result of pathological pressure overload induced by transverse aortic constriction (TAC)...
November 2016: Basic Research in Cardiology
Jen-Chung Liao, Ping-Yeh Chiu, Wen-Jer Chen, Lih-Hui Chen, Chi-Chien Niu
BACKGROUND: In Taiwan, the life expectancy of an 80-year-old man is 88.4 years and the life expectancy of an 80-year-old woman is 89.8 years. Some of these people will develop symptomatic degenerative lumbar diseases that interfere with an active lifestyle. These older surgical candidates usually ask the surgeon whether it would be safe to undergo surgery. However, there is no literature assessing the outcomes of laminectomy, fusion and posterior fixation for degenerative lumbar diseases in patients older than 80 years...
2016: BMC Musculoskeletal Disorders
David Pang
INTRODUCTION: Chronic pain in children has been an under-recognized problem compared to adult pain. The aim of management is to help children and their families cope with the symptoms rather than a cure. Current medical treatments to reduce pain intensity are often short lived, poorly tolerated or ineffective. RESULTS: The use of electrical stimulation to treat pain is the current basis of modern Neuromodulation at the spinal cord and has been well established as spinal cord stimulation in adult practice...
August 9, 2016: European Journal of Paediatric Neurology: EJPN
Ashraf Eskandr, Sadik Abdel Maseeh
Purpose. Failed back surgery syndrome is a chronic pain condition requiring rapid, effective, and efficient management. This study evaluates the effect of adding dexmedetomidine to lumbar epidural steroids in patients with failed back surgery syndrome. Methods. Fifty patients suffering from failed back surgery syndrome were randomly assigned to one of two groups, receiving an epidural injection of 20 mL of either a mixture of betamethasone (14 mg) and bupivacaine 0.5 mg (group C) or a mixture of betamethasone (14 mg), bupivacaine 0...
2016: Anesthesiology Research and Practice
Sonja Siegel, Monika Milian, Bernadette Kleist, Tsambika Psaras, Maria Tsiogka, Dagmar Führer, Maria Koltowska-Häggström, Jürgen Honegger, Oliver Müller, Ulrich Sure, Christa Menzel, Michael Buchfelder, Ilonka Kreitschmann-Andermahr
PURPOSE: Quality of life (QoL) and psychosocial well-being are substantially impaired in patients with Cushing's disease (CD), not only at the acute illness stage but also after therapy; however, the reason for these impairments remains unclear. METHODS: In this cross-sectional, patient-reported outcome study, we conducted a postal survey on psychosocial impairment and coping strategies in patients after surgical treatment of CD in three large tertiary referral centers...
September 2, 2016: Pituitary
Stefano Negrini, Silvia Minozzi, Josette Bettany-Saltikov, Nachiappan Chockalingam, Theodoros B Grivas, Tomasz Kotwicki, Toru Maruyama, Michele Romano, Fabio Zaina
STUDY DESIGN: A Cochrane Systematic Review OBJECTIVE.: To evaluate the efficacy of bracing for adolescents with AIS versus no treatment or other treatments, on quality of life, disability, pulmonary disorders, progression of the curve, psychological and cosmetic issues. SUMMARY OF BACKGROUND DATA: Idiopathic scoliosis is a three-dimensional deformity of the spine. The most common form is diagnosed in adolescence. While adolescent idiopathic scoliosis (AIS) can progress during growth and cause a surface deformity, it is usually not symptomatic...
August 31, 2016: Spine
Aaron J Yang, Rogelio A Coronado, Lilian Hoffecker, Chan Gao, Kelly Saurwein, Danielle Shoreman, Adam S Hoffberg, Venu Akuthota
OBJECTIVE: To evaluate the degree to which conservative care and failure was specifically defined in studies comparing non-operative treatment versus surgery for low back pain (LBP) conditions in adults. DATA SOURCES: A comprehensive literature search was conducted by an experienced librarian using MEDLINE (PubMed), EMBASE, Google Scholar, and CENTRAL (the Cochrane Central Register of Controlled Trials) from January 2003 to June 2014. Endnote bibliographic management application was utilized to remove duplicates and organize the citations...
August 26, 2016: Archives of Physical Medicine and Rehabilitation
Samiul Muquit, Ahmad Abdelhai Moussa, Surajit Basu
Failure of spinal cord stimulation (SCS) may be due to hardware problems, migration of electrodes and, in the long-term, plasticity in the spinal cord with habituation to the stimulation current. We describe a series of seven patients who experienced acute therapeutic loss of SCS effects following an acute nociceptive event unrelated to primary pathology. There were no hardware problems. We called this 'Pseudofailure', as the effective stimulation returned in all patients following a period off stimulation or reprogramming...
May 2016: British Journal of Pain
S M Krieg, B Meyer
BACKGROUND: Post-nucleotomy syndrome includes all existing sequelae after surgical nucleotomy for the resection of a lumbar disc herniation, such as axial lumbar back pain and persisting radiculopathy. OBJECTIVES: To describe underlying pathologies and to determine operative treatment options. MATERIALS AND METHODS: Extensive literature research was carried out on Medline. RESULTS: Various devices and approaches have been developed in the last decades...
September 2016: Der Orthopäde
V Tronnier
Unfortunately, 10-40 % of patients still experience pain after spinal surgery. There are many reasons for the patients' complaints. If no identifiable cause, such as a recurrent disc herniation, is visible, this is referred to as failed back surgery syndrome. However, this definition includes a variety of possible underlying causes of the pain, which result in just as many different therapeutic approaches. In addition to pharmacological, behavioral and physical therapy, also neuromodulation techniques can be offered; the best known method is spinal cord stimulation (SCS)...
September 2016: Der Orthopäde
Elizabeth Stokoe, Rein O Sikveland, Jon Symonds
BACKGROUND: Good communication is central to the effectiveness of GP service provision, as well as to patient satisfaction with surgeries, but very little is known about the actual communication that occurs between patients and surgeries. AIM: This study was carried out to examine, for the first time, how receptionists interact with patients on the telephone, to identify features of communication associated with efficacy and patient satisfaction. DESIGN AND SETTING: A qualitative conversation analysis of incoming patient telephone calls, recorded 'for training purposes', in three English GP surgeries...
August 15, 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
Hans-Raimund Casser
Failed back surgery syndrome (FBSS) is a frequent complication (15-40 %) of lumbar disc surgery and is rarely successfully treated by surgery with the exception of a re-prolapse associated with radicular pain. Multimodal pain treatment, however, is indicated by a lack of pathoanatomical correlates, unclear cause and psychosocial risk factors.This review describes a standardized non-operative treatment starting with broad interdisciplinary clarification by medical, psychological and physiotherapeutic means (assessment)...
September 2016: Der Orthopäde
Reid Hoshide, Erica Feldman, Brandon C Gabel, Natalie Taylor, James Gharib, Yu-Po Lee, William Taylor
INTRODUCTION: Minimally invasive lateral lumbar interbody fusion (LLIF) approaches to the lumbar spine reduce patient morbidity compared to anterior or posterior alternatives. This approach, however, decreases direct anatomical visualization, creating the need for highly sensitive and specific neurophysiological monitoring. We seek to determine feasibility in 'transabdominal motor action potential (TaMAP)' monitoring as an assessment for the integrity of the neural elements during lateral-approach surgeries to the lumbar spine...
2016: Curēus
Joseph R Kardouni, Tracie L Shing, Daniel I Rhon
INTRODUCTION: Musculoskeletal low back pain (LBP) is commonly treated symptomatically, with practice guidelines advocating reserving surgery for cases that fail conservative care. This study examined medical comorbidities and demographic variables as risk factors for chronic/recurrent LBP, spinal surgery, and time to surgery. METHODS: A 2015 retrospective cohort study was conducted in U.S. Army soldiers (N=1,092,420) from 2002 to 2011. Soldiers with medical encounters for LBP were identified using ICD-9 codes...
November 2016: American Journal of Preventive Medicine
A S Nikitin
This review provides current data on the failed back surgery syndrome (FBSS) of lumbar degenerative disease. The full range of complications forming this term is described. The data on the frequency and risk factors of various forms of FBSS are presented. General symptoms and diagnosis of the main FBSS forms are described. The questions of prevention and treatment of FBSS are considered.
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Kliment Gatzinsky, Roald Baardsen, Hendrik P Buschman
OBJECTIVE: To evaluate the effectiveness and safety of percutaneous octapolar (8-contact) leads in spinal cord stimulation (SCS) treatment of failed back surgery syndrome (FBSS) patients who have not reached their therapy goals with other treatment interventions. METHODS: Our prospective, multicenter, open-label, nonrandomized study included 93 patients ≥ 18 years of age suffering from chronic (≥ 6 months), intractable pain predominantly in the legs. Patients implanted with octapolar lead(s) and a neurostimulator after a successful test trial were followed for 12 months...
July 20, 2016: Pain Practice: the Official Journal of World Institute of Pain
Ahmed Kashkoush, Nitin Agarwal, Erin Paschel, Ezequiel Goldschmidt, Peter C Gerszten
INTRODUCTION: The development of adjacent-segment disease is a recognized consequence of lumbar fusion surgery. Posterior dynamic stabilization, or motion preservation, techniques have been developed which theoretically decrease stress on adjacent segments following fusion. This study presents the experience of using a hybrid dynamic stabilization and fusion construct for degenerative lumbar spine pathology in place of rigid arthrodesis. METHODS: A clinical cohort investigation was conducted of 66 consecutive patients (31 female, 35 male; mean age: 53 years, range: 25 - 76 years) who underwent posterior lumbar instrumentation with the Dynesys Transition Optima (DTO) implant (Zimmer-Biomet Spine, Warsaw, IN) hybrid dynamic stabilization and fusion system over a 10-year period...
2016: Curēus
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