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Interventional spinal Injections

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https://www.readbyqxmd.com/read/29444239/therapeutic-efficacy-of-microtube-embedded-chondroitinase-abc-in-a-canine-clinical-model-of-spinal-cord-injury
#1
Hilary Z Hu, Nicolas Granger, S Balakrishna Pai, Ravi V Bellamkonda, Nick D Jeffery
Many hundreds of thousands of people around the world are living with the long-term consequences of spinal cord injury and they need effective new therapies. Laboratory research in experimental animals has identified a large number of potentially translatable interventions but transition to the clinic is not straightforward. Further evidence of efficacy in more clinically-relevant lesions is required to gain sufficient confidence to commence human clinical trials. Of the many therapeutic candidates currently available, intraspinally applied chondroitinase ABC has particularly well documented efficacy in experimental animals...
February 9, 2018: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/29412074/macroplastique-and-botox-are-superior-to-macroplastique-alone-in-the-management-of-neurogenic-vesicoureteric-reflux-in-spinal-cord-injury-population-with-presumed-healthy-bladders
#2
Vasileios I Sakalis, Rachel Oliver, Peter J Guy, Melissa C Davies
CONTEXT/OBJECTIVE: Vesico-ureteric reflux(VUR) is a known complication of neuropathic bladder in spinal cord injury(SCI) population. Bulking agents such as Macroplastique are new minimally-invasive treatment option for VUR with good results. The aim of this study is to assess the efficacy of Macroplastique alone or in combination with Botox(BTX-A), in managing VUR in SCI population with presumed healthy bladders and correlate the pre-and post-injection urodynamic findings with the outcome...
February 7, 2018: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/29408391/single-injection-ex-ovo-transplantation-method-for-broad-spinal-cord-engraftment-of-human-pluripotent-stem-cell-derived-motor-neurons
#3
Maria C Estevez-Silva, Akshitha Sreeram, Stephanie Cuskey, Nikolai Fedorchak, Nisha Iyer, Randolph S Ashton
BACKGROUND: Transplantation of human pluripotent stem cell (hPSC)-derived neurons into chick embryos is an established preliminary assay to evaluate engraftment potential. Yet, with recent advances in deriving diverse human neuronal subtypes, optimizing and standardizing such transplantation methodology for specific subtypes at their correlated anatomical sites is still required. NEW METHOD: We determined the optimal stage of hPSC-derived motor neuron (hMN) differentiation for ex ovo transplantation, and developed a single injection protocol that implants hMNs throughout the spinal cord enabling broad regional engraftment possibilities...
February 3, 2018: Journal of Neuroscience Methods
https://www.readbyqxmd.com/read/29386025/mirna-23a-cxcr4-regulates-neuropathic-pain-via-directly-targeting-txnip-nlrp3-inflammasome-axis
#4
Zhiqiang Pan, Qun Shan, Pan Gu, Xiao Min Wang, Lydia Wai Tai, Menglan Sun, Xin Luo, Liting Sun, Chi Wai Cheung
BACKGROUND: Chemokine CXC receptor 4 (CXCR4) in spinal glial cells has been implicated in neuropathic pain. However, the regulatory cascades of CXCR4 in neuropathic pain remain elusive. Here, we investigated the functional regulatory role of miRNAs in the pain process and its interplay with CXCR4 and its downstream signaling. METHODS: miRNAs and CXCR4 and its downstream signaling molecules were measured in the spinal cords of mice with sciatic nerve injury via partial sciatic nerve ligation (pSNL)...
January 31, 2018: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/29374352/image-guidance-technologies-for-interventional-pain-procedures-ultrasound-fluoroscopy-and-ct
#5
REVIEW
Dajie Wang
Chronic pain is a common medical condition. Patients who suffer uncontrolled chronic pain may require interventions including spinal injections and various nerve blocks. Interventional procedures have evolved and improved over time since epidural injection was first introduced for low back pain and sciatica in 1901. One of the major contributors in the improvement of these interventions is the advancement of imaging guidance technologies. The utilization of image guidance has dramatically improved the accuracy and safety of these interventions...
January 26, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29373140/-foot-drop-an-iatrogenic-complication-of-spinal-anesthesia
#6
Vipin Kumar Goyal, Vijay Mathur
BACKGROUND AND OBJECTIVES: Foot drop in postoperative period is very rare after spinal anesthesia. Early clinical assessment and diagnostic interventions is of prime importance to establish the etiology and to start appropriate management. Close follow-up is warranted in early postoperative period in cases when patient complain paresthesia or pain during needle insertion or drug injection. CASE REPORT: A 22-year-old male was undergone lower limb orthopedic surgery in spinal anesthesia...
January 16, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29372860/prospective-randomized-multicenter-study-with-2-year-follow-up-to-compare-the-performance-of-decompression-with-and-without-interlaminar-stabilization
#7
Sven Schmidt, Joerg Franke, Michael Rauschmann, Dieter Adelt, Matteo Mario Bonsanto, Steffen Sola
OBJECTIVE Surgical decompression is extremely effective in relieving pain and symptoms due to lumbar spinal stenosis (LSS). Decompression with interlaminar stabilization (D+ILS) is as effective as decompression with posterolateral fusion for stenosis, as shown in a major US FDA pivotal trial. This study reports a multicenter, randomized controlled trial in which D+ILS was compared with decompression alone (DA) for treatment of moderate to severe LSS. METHODS Under approved institutional ethics review, 230 patients (1:1 ratio) randomized to either DA or D+ILS (coflex, Paradigm Spine) were treated at 7 sites in Germany...
January 26, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29364174/molecular-understanding-of-the-activation-of-cb1-and-blockade-of-trpv1-receptors-implications-for-novel-treatment-strategies-in-osteoarthritis
#8
Jakub Mlost, Magdalena Kostrzewa, Natalia Malek, Katarzyna Starowicz
Osteoarthritis (OA) is a joint disease in which cartilage degenerates as a result of mechanical and biochemical changes. The main OA symptom is chronic pain involving both peripheral and central mechanisms of nociceptive processing. Our previous studies have implicated the benefits of dual- over single-acting compounds interacting with the endocannabinoid system (ECS) in OA treatment. In the present study, we focused on the specific molecular alterations associated with pharmacological treatment. OA was induced in Wistar rats by intra-articular injection of 3 mg of monoiodoacetate (MIA)...
January 24, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29354733/does-timing-of-transplantation-of-neural-stem-cells-following-spinal-cord-injury-affect-outcomes-in-an-animal-model
#9
Ivan Cheng, Don Y Park, Robert E Mayle, Michael Githens, Robert L Smith, Howard Y Park, Serena S Hu, Todd F Alamin, Kirkham B Wood, Alexander I Kharazi
Background: We previously reported that functional recovery of rats with spinal cord contusions can occur after acute transplantation of neural stem cells distal to the site of injury. To investigate the effects of timing of administration of human neural stem cell (hNSC) distal to the site of spinal cord injury on functional outcomes in an animal model. Methods: Thirty-six adult female Long-Evans hooded rats were randomized into three experimental and three control groups with six animals in each group...
December 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29338087/thrombospondin-4-acts-on-pre-synaptic-calcium-channel-alpha-2-delta-1-subunit-to-induce-synaptogenesis-between-sensory-and-spinal-cord-neurons-through-a-t-type-calcium-channel-dependent-pathway-that-is-blocked-by-early-low-dose-gabapentin-treatments
#10
Yanhui Peter Yu, Nian Gong, Tae Dong Kweon, Benjamin Vo, Z David Luo
BACKGROUND AND PURPOSE: Nerve injury induces concurrent upregulation of calcium channel alpha-2-delta-1 subunit (Cav α2 δ1 ) and extracellular matrix protein thrombospondin-4 (TSP4) in dorsal root ganglia and dorsal spinal cord, leading to neuropathic pain state development. Interactions of these proteins promote aberrant excitatory synaptogenesis that contributes to neuropathic pain state development through unknown mechanisms. We investigated the contributory role of Cav α2 δ1 /TSP4 to synaptogenesis, and pathway involved in vitro, and whether gabapentin could block this process and pain development in vivo...
January 16, 2018: British Journal of Pharmacology
https://www.readbyqxmd.com/read/29323045/does-vitamin-c-have-the-ability-to-augment-the-therapeutic-effect-of-bone-marrow-derived-mesenchymal-stem-cells-on-spinal-cord-injury
#11
Nesrine Salem, Mohamed Y Salem, Mohammed M Elmaghrabi, Moataz A Elawady, Mona A Elawady, Dina Sabry, Ashraf Shamaa, Abdel-Haleem H Elkasapy, Noha Ibrhim, Azza Elamir
Methylprednisolone (MP) is currently the only drug confirmed to exhibit a neuroprotective effect on acute spinal cord injury (SCI). Vitamin C (VC) is a natural water-soluble antioxidant that exerts neuroprotective effects through eliminating free radical damage to nerve cells. Bone marrow mesenchymal stem cells (BMMSCs), as multipotent stem cells, are promising candidates in SCI repair. To evaluate the therapeutic effects of MP, VC and BMMSCs on traumatic SCI, 80 adult male rats were randomly divided into seven groups: control, SCI (SCI induction by weight-drop method), MP (SCI induction, followed by administration of 30 mg/kg MP via the tail vein, once every other 6 hours, for five times), VC (SCI induction, followed by intraperitoneal administration of 100 mg/kg VC once a day, for 28 days), MP + VC (SCI induction, followed by administration of MP and VC as the former), BMMSCs (SCI induction, followed by injection of 3 × 106 BMMSCs at the injury site), and BMMSCs + VC (SCI induction, followed by BMMSCs injection and VC administration as the former)...
December 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/29322309/the-global-spine-care-initiative-a-summary-of-guidelines-on-invasive-interventions-for-the-management-of-persistent-and-disabling-spinal-pain-in-low-and-middle-income-communities
#12
REVIEW
Emre Acaroğlu, Margareta Nordin, Kristi Randhawa, Roger Chou, Pierre Côté, Tiro Mmopelwa, Scott Haldeman
PURPOSE: The purpose of this study was to synthesize recommendations on the use of common elective surgical and interventional procedures for individuals with persistent and disabling non-radicular/axial with or without myelopathy, radicular back pain, cervical myelopathy, symptomatic spinal stenosis, and fractures due to osteoporosis. This review was to inform a clinical care pathway on the patient presentations where surgical interventions could reasonably be considered. METHODS: We synthesized recommendations from six evidence-based clinical practice guidelines and one appropriate use criteria guidance for the surgical and interventional management of persistent and disabling spine pain...
January 10, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29318854/-effect-of-electroacupuncture-on-intracellular-calcium-ion-concentration-and-expression-of-calcium-calmodulin-dependent-protein-kinase-%C3%A2-in-lumbar-spinal-cord-in-rats-with-neuropathic-pain
#13
Xin-Tian Wu, Wei Liang, Li-Ping Yan, Ling-Ling Wang, Cheng Ma
OBJECTIVE: To observe the changes of intracellular calcium ([Ca2+]i) concentration and expression of calcium/calmodulin dependent protein kinaseⅡ (CaMKⅡ) in spinal dorsal horn neurons of spared nerve injury (SNI) rats, so as to explore its mechanisms underlying improvement of neuropathic pain. METHODS: One hundred and ten SD rats were randomly divided into 5 groups: sham control, model, EA, AP-5 and L-NAME groups. The sham group underwent only a simple separation of the sciatic nerve but without ligation and abscission...
December 25, 2017: Zhen Ci Yan Jiu, Acupuncture Research
https://www.readbyqxmd.com/read/29300251/do-preoperative-corticosteroid-injections-increase-the-risk-for-infections-or-wound-healing-problems-after-spine-surgery-a-swiss-prospective-multicenter-cohort-study
#14
Mazda Farshad, Jakob M Burgstaller, Ulrike Held, Johann Steurer, Cyrill Dennler
STUDY DESIGN: Prospective multi-center cohort study. OBJECTIVES: This study evaluates the risk for surgical site infections (SSI) or wound healing problems (WHP) in patients who underwent corticosteroid injection prior to lumbar decompression surgery. SUMMARY OF BACKGROUND DATA: Corticosteroid injections are often used for the treatment of the degenerated spine. However, their well-known immunosuppressive effects could increase the risk for local infections, particularly if a surgical intervention follows the injection rapidly...
January 3, 2018: Spine
https://www.readbyqxmd.com/read/29246324/polyethylenimine-nanoparticle-mediated-sirna-delivery-to-reduce-%C3%AE-synuclein-expression-in-a-model-of-parkinson-s-disease
#15
Christin Helmschrodt, Sabrina Höbel, Sandra Schöniger, Anne Bauer, Jana Bonicelli, Marieke Gringmuth, Simone A Fietz, Achim Aigner, Angelika Richter, Franziska Richter
RNA interference (RNAi)-based strategies that mediate the specific knockdown of target genes by administration of small interfering RNAs (siRNAs) could be applied for treatment of presently incurable neurodegenerative diseases such as Parkinson's disease. However, inefficient delivery of siRNA into neurons hampers in vivo application of RNAi. We have previously established the 4-12 kDa branched polyethylenimine (PEI) F25-LMW with superior transfection efficacy for delivery of siRNA in vivo. Here, we present that siRNA complexed with this PEI extensively distributes across the CNS down to the lumbar spinal cord after a single intracerebroventricular infusion...
December 15, 2017: Molecular Therapy. Nucleic Acids
https://www.readbyqxmd.com/read/29243586/symptomatic-lumbosacral-transitional-vertebra-a-review-of-the-current-literature-and-clinical-outcomes-following-steroid-injection-or-surgical-intervention
#16
Emil Kongsted Holm, Cody Bünger, Casper Bindzus Foldager
Bertolotti's syndrome (BS) refers to the possible association between the congenital malformation lumbosacral transitional vertebra (LSTV), and low back pain (LBP). Several treatments have been proposed including steroid injections, resections of the LSTV, laminectomy, and lumbar spinal fusion. The aim of this review was to compare the clinical outcomes in previous trials and case reports for these treatments in patients with LBP and LSTV. A PubMed search was conducted. We included English studies of patients diagnosed with LSTV treated with steroid injection, laminectomy, spinal fusion or resection of the transitional articulation...
2017: SICOT-J
https://www.readbyqxmd.com/read/29231159/facet-joint-injections-for-non-specific-low-back-pain-a-feasibility-rct
#17
Saowarat Snidvongs, Rod S Taylor, Alia Ahmad, Simon Thomson, Manohar Sharma, Angela Farr, Deborah Fitzsimmons, Stephanie Poulton, Vivek Mehta, Richard Langford
BACKGROUND: Pain of lumbar facet-joint origin is a common cause of low back pain in adults and may lead to chronic pain and disability, with associated health and socioeconomic implications. The socioeconomic burden includes an inability to return to work resulting in loss of productivity in addition to direct and indirect health-care utilisation costs. Lumbar facet-joints are paired synovial joints between the superior and inferior articular processes of consecutive lumbar vertebrae and between the fifth lumbar vertebra and the sacrum...
December 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29184268/impacts-of-bone-marrow-stem-cells-on-caspase-3-levels-after-spinal-cord-injury-in-mice
#18
Noushin Gashmardi, Seyed Ebrahim Hosseini, Davood Mehrabani, Mohammad Amin Edalatmanesh, Zahra Khodabandeh
Spinal cord injury (SCI) is a drastic disability that leads to spinal cord impairment. This study sought to determine the effects of bone marrow stem cells (BMSCs) on caspase-3 levels after acute SCI in mice. Forty-two mice were randomly divided into 3 groups: control (2 subcategories), subjected to no intervention; sham (3 subcategories), subjected to acute SCI; and experimental (2 subcategories), subjected to SCI and cell transplantation. In the experimental group, 2×105 BMSCs were injected intravenously 1 day after SCI...
November 2017: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/29173659/radiofrequency-denervation-of-the-cervical-and-lumbar-spine
#19
REVIEW
Jessica Arias Garau
Facet or zygapophysial joint pain is commonly seen in the aging population. Interventional procedures, such as facet joint nerve blocks, facet intraarticular injections, and radiofrequency denervation, are used for the diagnosis and treatment of axial spinal chronic neck and low back pain. The focus of this article is to understand how radiofrequency denervation works in the cervical and lumbar spine and to be able to properly select appropriate patients who might benefit from this safe and effective procedure...
February 2018: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/29149139/reversal-of-growth-of-utilization-of-interventional-techniques-in-managing-chronic-pain-in-medicare-population-post-affordable-care-act
#20
Laxmaiah Manchikanti, Amol Soin, Dharam P Mann, Sanjay Bakshi, Vidyasagar Pampati, Joshua A Hirsch
BACKGROUND: Over the past 2 decades, the increase in the utilization of interventional techniques has been a cause for concern. Despite multiple regulations to reduce utilization of interventional techniques, growth patterns continued through 2009. A declining trend was observed in a previous evaluation; however, a comparative analysis of utilization patterns of interventional techniques has not been performed showing utilization before and after the enactment of the Affordable Care Act (ACA)...
November 2017: Pain Physician
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