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Interventional spinal Injections

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https://www.readbyqxmd.com/read/29618074/letter-epidural-steroid-injection-induced-menorrhagia-an-under-recognized-complication-associated-with-a-common-spinal-intervention
#1
Ketan Yerneni, John F Burke, Lee A Tan
No abstract text is available yet for this article.
March 30, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29573872/prevention-and-treatment-of-low-back-pain-evidence-challenges-and-promising-directions
#2
REVIEW
Nadine E Foster, Johannes R Anema, Dan Cherkin, Roger Chou, Steven P Cohen, Douglas P Gross, Paulo H Ferreira, Julie M Fritz, Bart W Koes, Wilco Peul, Judith A Turner, Chris G Maher
Many clinical practice guidelines recommend similar approaches for the assessment and management of low back pain. Recommendations include use of a biopsychosocial framework to guide management with initial non-pharmacological treatment, including education that supports self-management and resumption of normal activities and exercise, and psychological programmes for those with persistent symptoms. Guidelines recommend prudent use of medication, imaging, and surgery. The recommendations are based on trials almost exclusively from high-income countries, focused mainly on treatments rather than on prevention, with limited data for cost-effectiveness...
March 20, 2018: Lancet
https://www.readbyqxmd.com/read/29565952/the-effect-of-bipolar-pulsed-radiofrequency-treatment-on-chronic-lumbosacral-radicular-pain-refractory-to-monopolar-pulsed-radiofrequency-treatment
#3
Dong Gyu Lee, Yun Woo Cho, Sang Ho Ahn, Min Cheol Chang
BACKGROUND: Patients with lumbosacral radicular pain may complain of persisting pain after monopolar pulsed radiofrequency (PRF) treatment. OBJECTIVE: We evaluated the effect of bipolar PRF stimulation of the dorsal root ganglion (DRG) in patients with chronic lumbosacral radicular pain who were unresponsive to both monopolar PRF stimulation of the DRG and transforaminal epidural steroid injection (TFESI). STUDY DESIGN: This is a prospective observational study...
March 2018: Pain Physician
https://www.readbyqxmd.com/read/29565946/anatomy-pathophysiology-and-interventional-therapies-for-chronic-pelvic-pain-a-review
#4
Corey W Hunter, Brad Stovall, Grant Chen, Jonathan Carlson, Robert Levy
BACKGROUND: Chronic pelvic pain (CPP) represents a group of poorly understood disorders that are often refractory to conventional treatment. Referral to pain management typically occurs later in the continuum of care; as such, many of the injections and nerve blocks commonly prescribed for such patients are potentially limited in efficacy. While neuromodulation is conventionally considered the next algorithmic step in the treatment of chronic pain after injections fail, there is a common perception that neuromodulation is largely ineffective for CPP conditions...
March 2018: Pain Physician
https://www.readbyqxmd.com/read/29550454/microrna-146a-5p-attenuates-visceral-hypersensitivity-through-targeting-chemokine-ccl8-in-the-spinal-cord-in-a-mouse-model-of-colitis
#5
Ying Lu, De-Li Cao, Lin-Xia Zhao, Yu Han, You-Li Zhang
Visceral pain, observed in inflammatory bowel disease (IBD) patients, is a challenging medical problem and remains poorly understood because the mechanisms underlying it are unclear. Emerging evidence indicates that microRNAs (miRNAs) play a crucial role in the pathogenesis of acute and chronic pain. In this study, we aimed to explore the potential role of miR-146a-5p (the mature form of miR-146a) in a mouse model of colitis induced by intracolonic injection of trinitrobenzene sulfonic acid (TNBS). We found that induction of colitis resulted in visceral hyperalgesia manifested by a decreased pain threshold to colorectal distension and upregulation of miR-146a-5p expression in the lumbosacral spinal cord...
March 14, 2018: Brain Research Bulletin
https://www.readbyqxmd.com/read/29533040/-effects-of-decompression-combined-with-electro-acupuncture-on-rat-with-acute-severe-upper-cervical-spinal-cord-compression-injury
#6
Ming-Sheng Tan, Yan-Lei Wang, Ying-Na Qi, Chun-Ke Dong, Wei Wang, Ping Yi, Feng Yang, Xiang-Sheng Tang, Qing-Ying Hao
OBJECTIVE: To explore the effect and underlying mechanism of decompression(DE)combined with Governor Vessel(GV)electro-acupuncture(EA) on rats with acute severe upper cervical spinal cord compression injury. METHODS: Thirty SPF rats were randomly divided into 5 groups(control group A, B and experiment group C, D, E), 6 rats in each group. The model of acute severe upper cervical spinal cord compression injury were made by forcing a balloon catheter put in atlas pillow clearance...
January 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29496640/opposing-roles-of-estradiol-and-testosterone-on-stress-induced-visceral-hypersensitivity-in-rats
#7
Yaping Ji, Bo Hu, Jiyun Li, Richard J Traub
Chronic stress produces maladaptive pain responses, manifested as alterations in pain processing and exacerbation of chronic pain conditions including irritable bowel syndrome. Female predominance, especially during reproductive years, strongly suggests a role of gonadal hormones. However, gonadal hormone modulation of stress-induced pain hypersensitivity is not well understood. In the present study, we tested the hypothesis that estradiol is pronociceptive and testosterone is antinociceptive in a model of stress-induced visceral hypersensitivity (SIVH) in rats by recording the visceromotor response to colorectal distention following a 3 day forced swim stress (FS) paradigm...
February 26, 2018: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29483004/dual-lumen-balloon-catheter-an-effective-substitute-for-two-single-lumen-catheters-in-treatment-of-vascular-targets-with-challenging-anatomy
#8
Ljubisa Borota, Ehab Mahmoud, Christoffer Nyberg, Anders Lewén, Per Enblad, Elisabeth Ronne-Engström
The aim of this study was to describe our experience in the treatment of various pathological conditions of the cranial and spinal blood vessels and hypervascularized lesions using dual lumen balloon catheters. Twenty-five patients were treated with endovascular techniques: two with vasospasm of cerebral blood vessels caused by subarachnoid hemorrhage, one with a hypervascularized metastasis in the vertebral body, two with spinal dural fistula, four with cerebral dural fistula, three with cerebral arteriovenous malformations, and 13 with aneurysms...
February 23, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29460009/the-global-spine-care-initiative-applying-evidence-based-guidelines-on-the-non-invasive-management-of-back-and-neck-pain-to-low-and-middle-income-communities
#9
REVIEW
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
https://www.readbyqxmd.com/read/29444239/therapeutic-efficacy-of-microtube-embedded-chondroitinase-abc-in-a-canine-clinical-model-of-spinal-cord-injury
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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/gabapentin-prevents-synaptogenesis-between-sensory-and-spinal-cord-neurons-induced-by-thrombospondin-4-acting-on-pre-synaptic-ca-v-%C3%AE-2-%C3%AE-1-subunits-and-involving-t-type-ca-2-channels
#19
Yanhui Peter Yu, Nian Gong, Tae Dong Kweon, Benjamin Vo, Z David Luo
BACKGROUND AND PURPOSE: Nerve injury induces concurrent up-regulation of the voltage-gated calcium channel subunit Cav α2 δ1 and the extracellular matrix protein thrombospondin-4 (TSP4) in dorsal root ganglia and dorsal spinal cord, leading to the development of a neuropathic pain state. Interactions of these proteins promote aberrant excitatory synaptogenesis that contributes to neuropathic pain state development through unknown mechanisms. We investigated the contributions of Cav α2 δ1 subunits and TSP4 to synaptogenesis, and the pathways involved in vitro, and whether treatment with 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
#20
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
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