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Interventional spinal Injections

Serbülent Gökhan Beyaz
STUDY DESIGN: A cross-sectional study. OBJECTIVE: we compared the 12 month outcomes of fluoroscopically guided transforaminal epidural steroid injections with interlaminar epidural steroid injections for the treatment of chronic lumbar spinal pain. Chronic lower back pain is a multifactorial disorder with many possible etiologies. The lifetime prevalence of spinal pain is reportedly 65-80% in the neck and lower back. Epidural injection of corticosteroids is a commonly used intervention for managing chronic spinal pain...
September 30, 2016: Revista Brasileira de Anestesiologia
Michael B Jirjis, Chris Valdez, Aditya Vedantam, Brian D Schmit, Shekar N Kurpad
OBJECTIVE The aims of this study were to determine if the morphological and functional changes induced by neural stem cell (NSC) grafts after transplantation into the rodent spinal cord can be detected using MR diffusion tensor imaging (DTI) and, furthermore, if the DTI-derived mean diffusivity (MD) metric could be a biomarker for cell transplantation in spinal cord injury (SCI). METHODS A spinal contusion was produced at the T-8 vertebral level in 40 Sprague Dawley rats that were separated into 4 groups, including a sham group (injury without NSC injection), NSC control group (injury with saline injection), co-injection control group (injury with Prograf), and the experimental group (injury with NSC and Prograf injection)...
September 30, 2016: Journal of Neurosurgery. Spine
Laxmaiah Manchikanti, Alan D Kaye, Joshua A Hirsch
The Centers for Medicare and Medicaid Services (CMS) released the proposed 2017 Medicare physician fee schedule on July 7, 2016, addressing Medicare payments for physicians providing services either in an office or facility setting, which also includes payments for office expenses and quality provisions for physicians. This proposed rule occurs in the context of numerous policy changes, most notably related to the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) and its Merit-Based Incentive Payment System (MIPS)...
September 2016: Pain Physician
JiHee Hong, Sung Won Jung
BACKGROUND: Thoracic epidural anesthesia (TEA) is frequently used to maintain intraoperative analgesia. After injecting the initial bolus dose of epidural local anesthetics (LA), intermittent injection of LA through an epidural catheter is required to maintain the intraoperative analgesia. For intermittent epidural administration, usually 2 - 5 mL of LA has been used. However, no studies have suggested an optimal volume of LA of TEA for intermittent epidural administration of TEA. OBJECTIVE: We focused on identifying an optimal volume of LA of TEA using epidurography of the thoracic level with 2 different volumes of contrast dye...
September 2016: Pain Physician
Laxmaiah Manchikanti, Joshua A Hirsch, Vidyasagar Pampati, Mark V Boswell
Increasing utilization of interventional techniques in managing chronic spinal pain, specifically facet joint interventions and sacroiliac joint injections, is a major concern of healthcare policy makers. We analyzed the patterns of utilization of facet and sacroiliac joint interventions in managing chronic spinal pain. The results showed significant increase of facet joint interventions and sacroiliac joint injections from 2000 to 2014 in Medicare FFS service beneficiaries. Overall, the Medicare population increased 35 %, whereas facet joint and sacroiliac joint interventions increased 313...
October 2016: Current Pain and Headache Reports
Henrik Hasseldam, Rune Skovgaard Rasmussen, Flemming Fryd Johansen
BACKGROUND: Multiple sclerosis is widely accepted as an inflammatory disease. However, studies indicate that degenerative processes in the CNS occur prior to inflammation. In the widely used animal model experimental autoimmune encephalomyelitis (EAE), we investigated the significance of degenerative processes from mitochondrial membrane potentials, reactive oxidative species, cell death markers, chemokines, and inflammatory cell types in brain, spinal cord, and optic nerve tissue during the effector phase of the disease, before clinical disease was evident...
2016: Journal of Neuroinflammation
Toru Funayama, Alessandro Gasbarrini, Riccardo Ghermandi, Marco Girolami, Stefano Boriani
PURPOSE: We describe a rare case of solitary bone cyst involving the vertebral body of L4. INTRODUCTION: To the best of the authors' knowledge, only 15 cases of solitary bone cysts involving the spine have been reported previously. All the reported cases were treated surgically, including resection and curettage with or without bone grafting. In the current case, treatment was with steroid injection alone. METHOD: A cystic lesion involving the vertebral body of L4 was identified in a 16-year-old girl with persistent low back pain of 2 years' duration...
August 23, 2016: European Spine Journal
Jianfeng Wang, Marco Zarbin, Ilene Sugino, Ian Whitehead, Ellen Townes-Anderson
PURPOSE: The RhoA pathway is activated after retinal injury. However, the time of onset and consequences of activation are unknown in vivo. Based on in vitro studies we focused on a period 2 hours after retinal detachment, in pig, an animal whose retina is holangiotic and contains cones. METHODS: Under anesthesia, retinal detachments were created by subretinal injection of a balanced salt solution. Two hours later, animals were sacrificed and enucleated for GTPase activity assays and quantitative Western blot and confocal microscopy analyses...
July 1, 2016: Investigative Ophthalmology & Visual Science
De Liang, Hui Ren, Ting Qiu, Gengyang Shen, Bo Xie, Qiushi Wei, Zhensong Yao, Jingjing Tang, Zhida Zhang, Xiaobing Jiang
Extracts from plastrum testudinis (PTE), an important traditional Chinese medicine, have been demonstrated promotion of osteoblastic function in vitro. This study aims to investigate the protective effect of PTE on glucocorticoid-induced osteoporosis(GIOP) in vivo and analyze therapeutic targets of PTE on GIOP. SD rats were randomly assigned to two experiments: preventive and therapeutic experiments, in which rats respectively received oral PTE at the same time of glucocorticoid injection or after glucocorticoid injection inducing osteoporosis...
August 2016: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Mark-Friedrich B Hurdle
As the population ages, more patients are developing degenerative changes of the spine and associated pain. Although interventional procedures for axial and radicular spine pain have been available for decades, common imaging modalities have relied on ionizing radiation for guidance. Over the past decade, ultrasound has become increasingly popular to image both peripheral musculoskeletal and axial structures. This article reviews the use of ultrasound in the guidance of spine procedures, including cervical and lumbar facet injections and medial branch blocks, third occipital nerve blocks, thoracic facet and costotransverse joint injections, sacroiliac joint injections, and caudal and interlaminar epidural injections...
August 2016: Physical Medicine and Rehabilitation Clinics of North America
JiHee Hong, Sungwon Jung
BACKGROUND: Interlaminar epidural steroid injection (ESI) is a well-established intervention to improve radicular leg pain. However, few studies have demonstrated the prognostic factors for interlaminar ESI. OBJECTIVE: To investigate the clinical effectiveness and prognostic indicators of parasagittal interlaminar ESI during a 2-week follow-up. STUDY DESIGN: Prospective evaluation. SETTING: An interventional pain management practice in South Korea...
July 2016: Pain Physician
William Stuart Reynolds, Elizabeth Timbrook Brown, Jill Danford, Melissa Kaufman, Alan Wein, Roger Dmochowski, Stephen Bruehl
INTRODUCTION: This study sought to provide a preliminary assessment of whether spinally mediated afferent hyperactivity (i.e., central sensitization) might contribute to manifestations of overactive bladder syndrome (OAB) in women as indexed by elevated temporal summation of evoked heat pain stimuli. METHODS: We recruited 20 adult women with OAB who were planning to undergo interventional therapy for OAB with either onabotulinumtoxinA injection or sacral neuromodulation and 23 healthy controls without OAB symptoms to undergo quantitative sensory testing with cutaneous thermal pain temporal summation...
July 19, 2016: Neurourology and Urodynamics
D E Miles, E A Mitchell, N Kapur, P A Beales, R K Wilcox
Degeneration of the spinal discs is a major cause of back pain. During the degeneration process, there is a loss of glycosaminoglycans (GAGs) from the proteoglycan-rich gel in the disc's nucleus, which adversely alters biomechanical performance. Current surgical treatments for back pain are highly invasive and have low success rates; there is an urgent need for minimally-invasive approaches that restore the physiological mechanics of the spine. Here we present an injectable peptide:GAG hydrogel that rapidly self-assembles in situ and restores the mechanics of denucleated intervertebral discs...
May 11, 2016: Journal of Materials Chemistry. B, Materials for Biology and Medicine
Alexander D Ramos, John D Rolston, Grant E Gauger, Paul S Larson
BACKGROUND Spinal subdural abscesses, also known as empyemas, are rare infectious lesions, the exact incidence of which is unknown. Presentation is typically dramatic, with back pain, fever, motor, and sensory deficits. Rapid identification and surgical intervention with laminectomy, durotomy, and washout provides the best outcomes. While hematogenous spread of an extra-spinal infection is the most common cause of this condition, a significant number of cases result from iatrogenic mechanisms, including lumbar punctures, epidural injections, and surgery...
2016: American Journal of Case Reports
Steven F DeFroda, Alan H Daniels, Matthew E Deren
Low back and lower extremity pain are among the most common complaints encountered by physicians. Distinguishing pain due to primary extremity pathology versus lumbar radiculopathy can be challenging. Careful physical examination and appropriate imaging with plain radiographs and advanced studies as needed are important in determining the cause of lower extremity complaints. Over-utilization of advanced imaging may reveal otherwise asymptomatic spinal pathology and can lead to an incorrect diagnosis. In patients in whom surgical intervention is being considered by a spine or arthroplasty surgeon, intra-articular or epidural steroid injections may help to reveal the underlying cause of pain via short-term symptomatic relief...
October 2016: American Journal of Medicine
Liang He, Jun-Mei Xu, Hui Li, Feng Zhong, Zhi Liu, Chang-Qi Li, Ru-Ping Dai
BACKGROUND: Hypothermia reduces immediate paralysis during surgical repair of aortic aneurysms. However, it is unknown what the impact of hypothermia is on delayed paralysis, a serious complication of this type of surgery. METHODS: Sprague-Dawley rats were subjected to occlusion of the descending aorta at different duration under normothermia (38.0±0.5) or hypothermia (33.0±0.5°). Neurologic function was assessed. Motor neuron number, glial activation, and cytokine expression in the spinal cord were examined...
October 1, 2016: International Journal of Cardiology
Ying-ying Tan, Ya-yun Wang, Qi Zhang
OBJECTIVE: To observe the effect of electroacupuncture (EA) stimulation of "Quchi" (LI 11) on arterial blood pressure (BP), sympathetic nerve activity, barorefiex sensitivity (BRS) and expression of brain derived neurotrophic factor (BDNF) and nicotinamide adenine dinucleotide phosphate (NADPH) enzyme subunit p 47 phox in the rostral ventrolateral medulla (RVML) in hypertension rats. METHODS: A total of 45 male SD rats were randomly divided into sham operation, artificial cerebro-spinal fluid (aCSF) , model, "Quchi"(LI 11), and Jianyu (LI 15) groups (n = 9 in each group)...
April 2016: Zhen Ci Yan Jiu, Acupuncture Research
J L Zheng, B S Li, X C Cao, W K Zhuo, G Zhang
Ginkgolide B has been known to inhibit cell apoptosis by modulating multiple cytokines and plays an important role in neuroprotection. Signal transducer and activator of transcription 1 (STAT1) has been studied in a spinal cord injury (SCI) model. However, the role of Ginkgolide B in SCI treatment remains unclear. This study investigated the potential mechanism of Ginkgolide B using an SCI rat model. SD rats were used to generate an SCI model followed by Ginkgolide B injection (4 mg/kg) for 14 days. Spinal cord tissue samples were examined using hematoxylin and eosin (H&E) staining...
2016: Genetics and Molecular Research: GMR
Guangning Wang, Xueyong Li, Xiaoli Xu, Pan Ren
OBJECTIVE: To study the changes in the expression of large-conductance calcium-activated potassium (BKCa) channels in dorsal root ganglion (DRG) neurons after electrical injury in rats' sciatic nerves and its influence on sensory conduction function. METHODS: One-hundred and thirty-six adult SD rats were divided into normal control group, sham electrical injury group, and 75, 100, 125 V electrical injury groups according to the random number table, with 8 rats in normal control group and 32 rats in each of the rest 4 groups...
June 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
Joseph A Sclafani, Alexandra Constantin, Pei-Shu Ho, Venu Akuthota, Leighton Chan
STUDY DESIGN: Retrospective, observational study. OBJECTIVE: To determine the utilization of various treatment modalities in the management of degenerative spondylolisthesis within Medicare beneficiaries. SUMMARY OF BACKGROUND DATA: Degenerative lumbar spondylolisthesis is a condition often identified in symptomatic low back pain. A variety of treatment algorithms including physical therapy and interventional techniques can be used to manage clinically significant degenerative spondylolisthesis...
May 31, 2016: Spine
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