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https://www.readbyqxmd.com/read/28546769/treatment-of-chronic-low-back-pain-new-approaches-on-the-horizon
#1
REVIEW
Nebojsa Nick Knezevic, Shane Mandalia, Jennifer Raasch, Ivana Knezevic, Kenneth D Candido
Back pain is the second leading cause of disability among American adults and is currently treated either with conservative therapy or interventional pain procedures. However, the question that remains is whether we, as physicians, have adequate therapeutic options to offer to the patients who suffer from chronic low back pain but fail both conservative therapy and interventional pain procedures before they consider surgical options such as discectomy, disc arthroplasty, or spinal fusion. The purpose of this article is to review the potential novel therapies that are on the horizon for the treatment of chronic low back pain...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28544182/burst-or-high-frequency-10-khz-spinal-cord-stimulation-in-failed-back-surgery-syndrome-patients-with-predominant-back-pain-one-year-comparative-data
#2
Sajjad Muhammad, Sandra Roeske, Shafqat Rasul Chaudhry, Thomas Mehari Kinfe
OBJECTIVES: Burst and 10 kHz spinal cord stimulation (SCS) demonstrated improvement for failed back surgery syndrome (FBSS) with predominant, refractory back pain. Here, we report the long-term follow-up of a previously published study comparing the safety and efficacy of burst vs. 10 kHz SCS for predominant back pain (70% of global pain) of FBSS patients. METHODS: This comparative, observational study extended the follow-up period up to 20 months evaluating both SCS modalities...
May 24, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28507834/clinical-and-radiological-improvement-following-ozone-disc-nucleolysis-a-case-report
#3
Sharad Ghatge, Pranav D Modi, Dhaval B Modi
The results of traditional open surgery for herniated intervertebral disc are often limited by complications and failed back surgery syndrome (FBSS). Over the past few decades, a considerable amount of research has been done in the field of minimally invasive procedures as a treatment option for herniated intervertebral disc disease. Ozone disc nucleolysis is one such procedure which has results equal to or better than traditional surgery with virtually no complications. A 27-year-old post-partum female presented to the clinic with acute onset of severe lower back pain radiating to the left lower limb for one month...
April 13, 2017: Curēus
https://www.readbyqxmd.com/read/28505029/treatment-options-for-failed-back-surgery-syndrome-fbss-patients-with-refractory-chronic-pain-an-evidence-based-approach
#4
Kasra Amirdelfan, Lynn Webster, Lawrence Poree, Vishad Sukul, Porter McRoberts
STUDY DESIGN: A significant number of lumbar post-surgical patients continue to suffer persistent pain and limited function and are termed to have "Failed back surgery syndrome" (FBSS). This review evaluates clinical trial data for the treatment of FBSS patients. OBJECTIVE: Using an evidence-based approach to evaluate FBSS treatments will assist clinicians in choosing the most effective options for FBSS patients. Furthermore, reducing the utilization of less effective therapies may result in substantial financial savings for this patient population...
April 12, 2017: Spine
https://www.readbyqxmd.com/read/28486758/stimulation-of-the-l2-l3-dorsal-root-ganglia-induces-effective-pain-relief-in-the-low-back
#5
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/28464357/effect-of-multicolumn-lead-spinal-cord-stimulation-on-low-back-pain-in-failed-back-surgery-patients-a-three-year-follow-up
#6
Thibault Yves Remacle, Vincent Luce Bonhomme, Henri-Jean Paul Renwart, Jean Michel Remacle
OBJECTIVES: Spinal cord stimulation (SCS) remains poorly efficient at reducing back pain in failed back surgery syndrome (FBSS) patients. We aimed at determining whether a new multicolumn lead SCS technique was efficient at durably reducing their leg (LP) and back (BP) pain. MATERIALS AND METHODS: Sixty-two consecutive refractory FBSS patients received multicolumn SCS. Visual analogue scale (VAS) self-evaluation of BP, LP, and limitation of daily activity (LAD) were recorded preoperatively and at 2, 6, 12, 24, and 36 months after surgery...
May 2, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28448860/a-unique-presentation-of-renal-cell-transformation-into-renal-cell-carcinoma-in-subcutaneous-fatty-tissue-post-twenty-year-old-healing-gun-shot-wound-a-case-report
#7
Awadh R Alqahtani, Mohammed A Alqahtani
INTRODUCTION: Renal cell carcinoma (RCC) is the most common malignancy in the genitourinary tract, and is among the 10 most common cancers in both males and females. PRESENTATION OF CASE: We report a case of a 61-year-old male who presented with a cutaneous lesion on his left back side at a site where he had undergone several surgeries - including Left nephrectomy - twenty years ago for a gun-shot wound he sustained which penetrated his abdomen. DISCUSSION: At that time pathology reports turned out to be normal, specially left kidney pathology report which was negative for any malignancy...
March 21, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28441313/clinical-evidence-for-spinal-cord-stimulation-for-failed-back-surgery-syndrome-fbss-systematic-review
#8
Leonardo Kapural, Erika Peterson, David A Provenzano, Peter Staats
STUDY DESIGN: A systematic review OBJECTIVE.: A systematic literature review of the clinical data from prospective studies was undertaken to assess the efficacy of spinal cord stimulation (SCS) in the treatment of FBSS in adults. SUMMARY OF BACKGROUND DATA: For patients with unrelenting back pain due to mechanical instability of the spine, degenerative disc disease, spinal injury, or deformity, spinal surgery is a well-accepted treatment option; however, even after surgical intervention, many patients continue to experience chronic back pain that can be notoriously difficult to treat...
April 24, 2017: Spine
https://www.readbyqxmd.com/read/28438284/intradiscal-o2o3-rationale-injection-technique-short-and-long-term-outcomes-for-the-treatment-of-low-back-pain-due-to-disc-herniation
#9
REVIEW
Francesco Giurazza, Gianluigi Guarnieri, Kieran J Murphy, Mario Muto
The management of low back pain should always start with a conservative approach; however, when it fails, intervention is required and at that moment the most appropriate choice remains unclear. Before invasive surgery, minimally invasive techniques can be adopted. In European trials and in a trans-Canadian clinical trial 03 ozone has been used successfully. In total over 50,000 patients have been treated safely. Ozone is a gas normally present in the atmosphere with potent oxidizing power; it has been used for percutaneous intradiscal injection combined with oxygen (O2O3) at very low concentrations for 15 years in Europe...
May 2017: Canadian Association of Radiologists Journal, Journal L'Association Canadienne des Radiologistes
https://www.readbyqxmd.com/read/28435912/one-and-two-level-posterior-lumbar-interbody-fusion-plif-using-an-expandable-stand-alone-interbody-fusion-device-a-varilift-%C3%A2-case-series
#10
Rebecca Barrett-Tuck, Diana Del Monaco, Jon E Block
BACKGROUND: Surgical interventions such as posterior lumbar interbody fusion (PLIF) with and without posterior instrumentation are often employed in patients with degenerative spinal conditions that fail to respond to conservative medical management. The VariLift(®) Interbody Fusion System was developed as a stand-alone solution to provide the benefits of an intervertebral fusion device without the requirement of supplemental pedicle screw fixation. METHODS: In this retrospective case series, 25 patients underwent PLIF with a stand-alone VariLift(®) expandable interbody fusion device without adjunctive pedicle screw fixation...
March 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28435318/prevalence-characteristics-and-burden-of-failed-back-surgery-syndrome-the-influence-of-various-residual-symptoms-on-patient-satisfaction-and-quality-of-life-as-assessed-by-a-nationwide-internet-survey-in-japan
#11
Shinsuke Inoue, Mitsuhiro Kamiya, Makoto Nishihara, Young-Chang P Arai, Tatsunori Ikemoto, Takahiro Ushida
We conducted a cross-sectional, Internet-based survey with a nationally representative sample of Japanese adults to assess the prevalence and characteristics of failed back surgery syndrome (FBSS). Data regarding the residual symptoms and patient satisfaction from an online survey of 1842 lumbar surgery patients revealed the prevalence of FBSS to be 20.6% (95% confidence interval [CI], 18.8-22.6). The prevalence of low back pain, dull ache, numbness, cold sensations, and paresthesia after surgery was 94.0%, 71...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28434048/clinical-and-radiological-outcomes-of-endoscopic-partial-facetectomy-for-degenerative-lumbar-foraminal-stenosis
#12
Myung Soo Youn, Jong Ki Shin, Tae Sik Goh, Jung Sub Lee
BACKGROUND: Several different techniques exist to treat degenerative lumbar foraminal stenosis. Failure to adequately decompress the lumbar foramen may lead to failed back surgery syndrome. However, wide decompression often causes spinal instabilities or may require an additional fusion surgery. The aim of this study was to report the outcomes of endoscopic partial facetectomy (EPF) performed on patients with degenerative lumbar foraminal stenosis. METHODS: Between 2012 and 2014, 25 consecutive patients (12 women and 13 men) who underwent EPF were included in the study...
June 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28400696/seprafilm%C3%A2-application-method-in-laparoscopic-surgery
#13
Mun-Kun Hong, Dah-Ching Ding
BACKGROUND AND OBJECTIVES: Postoperative adhesions occur less often in laparoscopies than in laparotomies, but the incidence can be reduced further. Seprafilm, a sodium hyaluronate/carboxymethylcellulose absorbable barrier, was developed to prevent adhesions after abdominal surgery, and is approved for postoperative adhesion prevention. However, Seprafilm is seldom used in laparoscopic surgery because of its tendency to break apart when it is inserted into the abdominal cavity through a trocar, resulting in a high placement failure rate...
January 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28384950/familial-schwannomatosis-a-diagnostic-challenge
#14
Sameer Ajit Mansukhani, Rajendra Prasad R Butala, Sunil H Shetty, Ravindra G Khedekar
Schwannomatosis is a disease characterized by the development of multiple benign tumours originating from Schwann cells. Schwannomatosis is a member of the family of diseases known as Neurofibromatosis (NF). Patients with Schwannomatosis develop multiple Schwannomas on cranial, spinal and peripheral nerves. We report a rare case of a 60-year-old female who presented with a painful swelling on the ulnar aspect of her distal forearm. She underwent an excisional biopsy for it; which was suggestive of a Schwannoma...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28379464/filum-terminale-needle-placement-during-caudal-epidural-steroid-injection
#15
Ryan R Ramsook, David Spinner, Rajiv R Doshi
Objective. : Caudal epidural steroid injections (ESIs) are commonly used to treat lumbar radicular pain. Touhy needles are placed under live fluoroscopic guidance to ensure epidural administration of medication. This is a case report of direct needle and catheter placements into and through the filum terminale during a caudal approach to the epidural space. Design. : Single case report. Setting. : Beth Israel Deaconess Medical Center...
March 30, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28377862/arthrodesis-rate-and-patient-reported-outcomes-after-anterior-lumbar-interbody-fusion-utilizing-a-plasma-sprayed-titanium-coated-peek-interbody-implant-a-retrospective-observational-analysis
#16
Joseph A Sclafani, Sophea R Bergen, Miranda Staples, Kevin Liang, Ramin Raiszadeh
BACKGROUND: Anterior lumbar interbody fusion (ALIF) is utilized in symptomatic spinal disc destabilization due to degenerative lumbar disc disease, isthmic and degenerative spondylolisthesis, internal disc disruption, or pseudarthrosis after non-operative treatments fail. The addition of a plasma-sprayed titanium coating (PTC) to polyether ether ketone spacers (PEEK) may reduce the rate of implant subsidence or non-union secondary to poor osseous-integration of non-coated PEEK or metal interbody systems...
2017: International Journal of Spine Surgery
https://www.readbyqxmd.com/read/28350948/bending-the-cost-curve-establishing-value-in-spine-surgery
#17
Scott L Parker, Silky Chotai, Clinton J Devin, Lindsay Tetreault, Thomas E Mroz, Darrel S Brodke, Michael G Fehlings, Matthew J McGirt
BACKGROUND: As publically promoted by all stakeholders in health care reform, prospective outcomes registry platforms lie at the center of all current evidence-driven value-based models. OBJECTIVE: To demonstrate the variability in outcomes and cost at population level and individual patient level for patients undergoing spine surgery for degenerative diseases. METHODS: Retrospective analysis of prospective longitudinal spine registry data was conducted...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28347691/workers-perspectives-on-return-to-work-after-total-knee-arthroplasty
#18
Pascale Maillette, Marie-France Coutu, Nathaly Gaudreault
OBJECTIVES: Total knee arthroplasty is an effective intervention for people with osteoarthritis. However, 15 to 30% of patients do not return to work, and studies frequently fail to provide an explanation of what may lead to work disability from workers' perspectives of the biopsychosocial factors. This study aimed to document workers' representations or understanding of work disability after total knee arthroplasty. METHOD: We adopted a qualitative approach with a narrative inquiry method...
March 24, 2017: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28328589/cervical-retrograde-spinal-cord-stimulation-lead-placement-to-treat-failed-back-surgery-syndrome-a-case-report
#19
Noud van Helmond, Caroline N Kardaszewski, Kenneth B Chapman
Spinal cord stimulation is an effective treatment modality for refractory neuropathic pain conditions, but the placement of leads can be challenging due to unforeseen anatomical variations. We used a retrograde C7-T1 approach to place a lead at the bottom of T8 in a patient suffering from failed back surgery syndrome. We were able to achieve adequate stimulation in her lower back and legs, which resulted in significant reduction in pain intensity during the spinal cord stimulation trial. Cervical retrograde placement of leads may represent an alternative method for successful placement of percutaneous leads in patients with abnormal anatomy due to thoracic postsurgical changes...
March 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28322477/impact-of-insurance-provider-on-overall-costs-in-failed-back-surgery-syndrome-a-cost-study-of-122-827-patients
#20
Aladine A Elsamadicy, Samuel Harrison Farber, Siyun Yang, Syed Mohammed Qasim Hussaini, Kelly R Murphy, Amanda Sergesketter, Carter M Suryadevara, Promila Pagadala, Beth Parente, Jichun Xie, Shivanand P Lad
OBJECTIVES: Failed back surgery syndrome (FBSS) affects 40% of patients following spine surgery with estimated costs of $20 billion to the US health care system. The aim of this study was to assess the cost differences across the different insurance providers for FBSS patients. METHODS: A retrospective longitudinal study was performed using the Truven MarketScan(®) database to identify FBSS patients from 2001 to 2012. Patients were grouped into Commercial, Medicaid, or Medicare cohorts...
March 21, 2017: Neuromodulation: Journal of the International Neuromodulation Society
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