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Interventional spinal Injections

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https://www.readbyqxmd.com/read/29019641/spine-conditions-lumbar-spinal-stenosis
#1
Steven D Trigg, Zachary Devilbiss
Lumbar spinal stenosis (LSS) is a frequent cause of chronic low back and lower extremity pain in older patients. Symptomatic LSS typically is described as neurogenic claudication consisting of pain, weakness, numbness, and/or fatigue arising in the back and radiating into the buttock, thigh, or lower leg. The diagnosis is complicated by lack of reliable clinical or x-ray criteria. North American Spine Society guidelines recommend magnetic resonance imaging study without contrast to confirm anatomic narrowing of the spinal canal or nerve root impingement...
October 2017: FP Essentials
https://www.readbyqxmd.com/read/29016914/spinal-cord-injury-during-attempted-cervical-interlaminar-epidural-injection-of-steroids
#2
Milton H Landers
Background: Interlaminar cervical epidural injections are commonly performed in the practice of interventional pain medicine. Injury to the spinal cord following injection into the substance of the cord is a known complication of this procedure, but it has rarely been reported and illustrated in the literature. Objective: To describe and analyze a case where an inadvertent injection of contrast medium into the cervical spinal cord occurred. Highlighted is the dissonance between how the procedure was performed and published guidelines for its performance...
July 11, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28987657/feasibility-of-percutaneous-cryoablation-of-vertebral-metastases-under-local-anaesthesia-in-asaiii-patients
#3
Alessandro Motta, Giuseppe Caltabiano, Stefano Palmucci, Giovanni Failla, Antonio Basile
PURPOSE: spine metastases are common concern from several primary neoplasms, modern management include percutaneous techniques such as ablation and cementoplasty. This research aims to evaluate the treatment under local anaesthesia in high-risk patients (ASA III). METHODS AND MATERIAL: from January 2013 up to September 2016 we treated via percutaneous cryoablation 11 advanced oncological patients classified as ASA III, then retrospectively a review of their clinical history has been performed...
October 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28984753/cervical-epidural-analgesia-complicated-by-epidural-abscess-a-case-report-and-literature-review
#4
REVIEW
Jun-Hui Zhang, Zhi-Li Wang, Li Wan
RATIONALE: Spinal epidural abscess is an uncommon complication in clinical practice. If the abscess is large enough, the patient will rapidly develop neurologic signs of spinal injury, and urgent neurosurgical intervention may be required. PATIENT CONCERNS: Rapid and correct diagnosis and treatment is important for spinal epidural abscess complication. DIAGNOSES: This report describes a cervical epidural abscess (CEA) caused by epidural analgesia, wherein the patient was punctured twice...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28980210/photobiomodulation-therapy-improves-acute-inflammatory-response-in-mice-the-role-of-cannabinoid-receptors-atp-sensitive-k-channel-p38-mapk-signalling-pathway
#5
Laís M S Neves, Elaine C D Gonçalves, Juliana Cavalli, Graziela Vieira, Larissa R Laurindo, Róli R Simões, Igor S Coelho, Adair R S Santos, Alexandre M Marcolino, Maíra Cola, Rafael C Dutra
Although photobiomodulation therapy (PBM) has been applied clinically for the treatment of pain and inflammation, wound healing, sports and soft tissue injuries, as well as to repair injured spinal cords and peripheral nerves, it remains unclear which molecular substrates (receptor) are implicated in the cellular mechanisms of PBM. Here, we reported that PBM (660 nm, 30 mW, 0.06 cm(2), 50 J/cm(2), plantar irradiation) significantly inhibited carrageenan-induced paw oedema, but not noxious thermal response, through positive modulation to both CB1 and CB2 cannabinoid receptors...
October 4, 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/28945854/reduced-acute-care-costs-with-the-eras%C3%A2-minimally-invasive-transforaminal-lumbar-interbody-fusion-compared-with-conventional-minimally-invasive-transforaminal-lumbar-interbody-fusion
#6
Michael Y Wang, Hsuan Kan Chang, Jay Grossman
BACKGROUND: Enhancing Recovery After Surgery (ERAS®) programs have been widely adopted throughout the world, but not in spinal surgery. In this report, we review the implementation of a "fast track" surgery for lumbar fusion and its effect on acute care hospitalization costs. OBJECTIVE: To determine if a "fast track" surgery methodology results in acute care cost savings. METHODS: Thirty-eight consecutive ERAS patients were compared with patients undergoing conventional minimally invasive transforaminal lumbar interbody fusion...
July 28, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28927210/navigation-and-image-injection-for-control-of-bone-removal-and-osteotomy-planes-in-spine-surgery
#7
Michael Kosterhon, Angelika Gutenberg, Sven Rainer Kantelhardt, Elefterios Archavlis, Alf Giese
BACKGROUND AND IMPORTANCE: In contrast to cranial interventions, neuronavigation in spinal surgery is used in few applications, not tapping into its full technological potential. We have developed a method to preoperatively create virtual resection planes and volumes for spinal osteotomies and export 3-D operation plans to a navigation system controlling intraoperative visualization using a surgical microscope's head-up display. The method was developed using a Sawbone ® model of the lumbar spine, demonstrating feasibility with high precision...
April 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28895486/iatrogenic-adrenal-insufficiency-secondary-to-combination-therapy-with-elvitegravir-cobicistat-tenofovir-disoproxil-fumarate-emtricitabine-and-interlaminar-triamcinolone-injection-in-an-aids-patient
#8
Chanie Wassner, Sutapa Maiti, Kurt Kodroff, Henry Cohen
We report the first identified case of suspected iatrogenic adrenal insufficiency after an interlaminar injection of triamcinolone acetonide while on concomitant Stribild (elvitegravir 150 mg/cobicistat 150 mg/tenofovir disoproxil fumarate 300 mg/emtricitabine 200 mg [EVG/c/TDF/FTC]). A 49-year-old female with HIV on EVG/c/TDF/FTC therapy presented to our endocrinology clinic to be evaluated for suspected Cushing syndrome. Prior to presentation, the patient had been given 2 interlaminar spinal injections of triamcinolone...
January 1, 2017: Journal of the International Association of Providers of AIDS Care
https://www.readbyqxmd.com/read/28870058/technologically-advanced-assessment-of-upper-limb-spasticity-a-pilot-study
#9
Federico Posteraro, Simona Crea, Stefano Mazzoleni, Mihai Berteanu, Ileana Ciobanu, Nicola Vitiello, Marco Cempini, Sabata Gervasio, Natalie Mrachacz-Kersting
BACKGROUND: Spasticity is a muscle disorder associated with upper motor neuron syndrome occurring in neurological disorders, such as stroke, multiple sclerosis, spinal cord injury and others. It influences the patient's rehabilitation, interfering with function, limiting independence, causing pain and producing secondary impairments, such as contractures or other complications. Due to the heterogeneity of clinical signs of spasticity, there is no agreement on the most appropriate assessment and measurement modality for the evaluation of treatment outcomes...
September 4, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28867325/neuroprotective-effects-of-valproic-acid-in-a-rat-model-of-cauda-equina-injury
#10
Qing-Jie Kong, Yuan Wang, Yang Liu, Jing-Chuan Sun, Xi-Ming Xu, Xiao-Fei Sun, Jian-Gang Shi
BACKGROUND: Histone deacetylase inhibitors (HDACi), including valproic acid (VPA), are promising therapeutic interventions in neurological disorders and play an important role in synaptic activity and neuronal function. MATERIAL AND METHODS: A total of 30 rats were randomly allocated to three groups: sham, control, and VPA. The rats in the VPA and control groups received laminectomy at the L4 level of the vertebrae and silicone gel implantation into the epdidural spaces L5 and L6...
August 31, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28842370/the-effect-of-preoperative-intra-articular-methylprednisolone-on-pain-after-tka-a-randomized-double-blinded-placebo-controlled-trial-in-patients-with-high-pain-knee-osteoarthritis-and-sensitization
#11
Iben E Luna, Henrik Kehlet, Claus M Jensen, Thorbjørn G Christiansen, Thomas Lind, Snorre L Stephensen, Eske K Aasvang
In a randomized, double-blind, placebo controlled trial, we investigated the postoperative analgesic effect of a single intra-articular injection of 40 mg methylprednisolone acetate (MP) administered 1 week before total knee arthroplasty (TKA). Forty-eight patients with high pain osteoarthritis (≥5 on a numeric rating scale during walk) and sensitization (pressure pain threshold <250 kPa), aged 50 to 80 years and scheduled for primary unilateral TKA under spinal anaesthesia were included. The primary outcome was the proportion of patients with moderate/severe pain during a 5-m walk test 24 hours postoperatively...
August 24, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28827823/comparison-of-efficacy-of-continuous-epidural-block-and-pulsed-radiofrequency-to-the-dorsal-root-ganglion-for-management-of-pain-persisting-beyond-the-acute-phase-of-herpes-zoster
#12
COMPARATIVE STUDY
Eung Don Kim, Young In Lee, Hue Jung Park
BACKGROUND: There is little evidence regarding the effectiveness of intervention methods in the treatment of zoster-related pain (ZAP) after the acute phase of zoster. Generally, if ZAP remains after more than 180 days from its onset, the likelihood of pain reduction is very low; this condition is considered as a "well established" post-herpetic neuralgia (PHN). Although the clinical efficacy of intrathecal steroid injection and spinal cord stimulation (SCS) for ZAP management has been reported, these interventions are not widely used due to inherent disadvantages...
2017: PloS One
https://www.readbyqxmd.com/read/28792585/centrally-mediated-late-motor-recovery-after-botulinum-toxin-injection-case-reports-and-a-review-of-current-evidence
#13
Manuel F Mas, Sheng Li, Gerard E Francisco
OBJECTIVE: Botulinum neurotoxin is commonly utilized in neurorehabilitation as a treatment for focal spasticity. Clinical experience has yielded observations of late motor recovery after intramuscular injection of botulinum neurotoxin, that are not readily explained by the classical mechanism of action of the neurotoxin in controlling spasticity. These findings have triggered speculation regarding a botulinum neurotoxin mediated effect at the central level after peripheral intervention...
August 31, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28760628/laparoscopic-minimally-invasive-approach-to-sentinel-lymph-node-mapping-of-the-ovary-using-the-near-infrared-fluorescent-s1-hd-pinpoint-system-with-indocyanine-green-dye
#14
Alessandro Buda, Paolo Passoni, Claudio Reato, Giampaolo Di Martino
STUDY OBJECTIVE: To show a novel minimally invasive approach to sentinel lymph node (SLN) detection of the ovary with the near-infrared guided-surgery using indocyanine green (ICG). DESIGN: step by step description of the technique with video and figures (educational video). SETTING: The standard surgical staging of early stage I-II ovarian cancer include systematic pelvic and aortic lymphadenectomy, even in the absence of clear evidence regarding the survival benefits associated with comprehensive retroperitoneal staging...
July 28, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28760030/cervical-vertebroplasty-for-osteolytic-metastases-as-a-minimally-invasive-therapeutic-option-in-oncological-surgery-outcome-in-14-cases
#15
Martin Stangenberg, Lennart Viezens, Sven O Eicker, Malte Mohme, Klaus C Mende, Marc Dreimann
OBJECTIVE The treatment of cervical spinal metastases represents a controversial issue regarding the type, extent, and invasiveness of interventions. In the lumbar and thoracic spine, kypho- and vertebroplasties have been established as minimally invasive procedures for patients with metastases to the vertebral bodies and without neurological deficit. These procedures show good results with respect to pain reduction and low complication rates. However, limited data are available for kypho- and vertebroplasties for cervical spinal metastases...
August 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28751464/effects-of-electroacupuncture-stimulation-at-different-spinal-segmental-levels-in-a-rat-model-of-diabetes-mellitus
#16
Huan-Huan Tian, Bing-Yan Cao, Rui Li, Yan-Jia Ma, Xiao-Gang Hu, Ning Jia, Yue-Ying Wang
BACKGROUND: Diabetes mellitus (DM) is associated with high morbidity, mortality and economic cost. Studies have shown that acupuncture can improve many symptoms of DM. OBJECTIVES: To examine for differences in effects of electroacupuncture (EA) stimulation at Weiwanxiashu, BL15 and BL23 in the streptozotocin (STZ)-induced DM rat model, to help guide clinical selection of acupuncture points. METHODS: 90 male rats weighing 160±5 g were used...
July 27, 2017: Acupuncture in Medicine: Journal of the British Medical Acupuncture Society
https://www.readbyqxmd.com/read/28727707/continuing-anti-thrombotic-medication-during-low-to-intermediate-risk-spinal-procedures-a-retrospective-evaluation
#17
Noud van Helmond, Wesley Day, Kenneth B Chapman
BACKGROUND: The current American Society of Regional Anesthesia (ASRA) guidelines recommend discontinuing anti-thrombotic therapy prior to any interventional spine procedures to decrease the incidence of bleeding complications. However, discontinuing anti-thrombotics may pose considerable danger in terms of cerebrovascular and cardiovascular events. Recent evidence suggests that some spinal interventions may still be performed safely with anti-thrombotics on board and some practitioners thus elect to continue certain anti-thrombotics for these procedures...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28696946/optimal-treatment-for-lumbar-spinal-stenosis-an-update
#18
Janus Patel, Ian Osburn, Anne Wanaselja, Ryan Nobles
PURPOSE OF REVIEW: Our review of current literature within the past 12-24 months for the treatment of lumbar spinals stenosis (LSS) serves to update providers on recent advances and comparisons regarding therapy spanning lifestyle modification, pharmacologic therapy, minimally invasive interventions, and surgical interventions. RECENT FINDINGS: Current literature supporting the inclusion of physical therapy and gabapentin/pregabalin within an initial treatment regimen have been positive...
October 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28681962/systematic-review-of-management-of-chronic-pain-after-surgery
#19
REVIEW
V Wylde, J Dennis, A D Beswick, J Bruce, C Eccleston, N Howells, T J Peters, R Gooberman-Hill
BACKGROUND: Pain present for at least 3 months after a surgical procedure is considered chronic postsurgical pain (CPSP) and affects 10-50 per cent of patients. Interventions for CPSP may focus on the underlying condition that indicated surgery, the aetiology of new-onset pain or be multifactorial in recognition of the diverse causes of this pain. The aim of this systematic review was to identify RCTs of interventions for the management of CPSP, and synthesize data across treatment type to estimate their effectiveness and safety...
September 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28668379/design-and-optimization-of-plga-microparticles-for-controlled-and-local-delivery-of-neuregulin-1-in-traumatic-spinal-cord-injury
#20
Kallivalappil T Santhosh, Arsalan Alizadeh, Soheila Karimi-Abdolrezaee
Spinal cord injury (SCI) results in significant tissue damage that underlies functional impairments. Pharmacological interventions to confer neuroprotection and promote cell replacement are essential for SCI repair. We previously reported that Neuregulin-1 (Nrg-1) is acutely and permanently downregulated after SCI. Nrg-1 is a critical growth factor for differentiation of neural precursor cells (NPCs) into myelinating oligodendrocytes. We showed that intrathecal delivery of Nrg-1 enhances oligodendrocyte replacement following SCI...
September 10, 2017: Journal of Controlled Release: Official Journal of the Controlled Release Society
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