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Interventional spinal Injections

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https://www.readbyqxmd.com/read/28792585/centrally-mediated-late-motor-recovery-after-botulinum-toxin-injection-case-reports-and-a-review-of-current-evidence
#1
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 9, 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
#2
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
#3
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
#4
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
#5
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
#6
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...
July 10, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28681962/systematic-review-of-management-of-chronic-pain-after-surgery
#7
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
#8
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
https://www.readbyqxmd.com/read/28648004/-effects-of-botulinum-toxin-type-a-injection-for-pathological-characteristic-of-calf-in-rats-with-spinal-cord-injure
#9
X M Wei, Z L Dou, Y W Zhang, M Dai, F Yu, Q Y Wang, L Jiang
Objective: To explore the effect of BoTN-A on pathological characteristics of calf (GM) and motor function of ankle dorsiflexors in SCI model rats. Methods: Thirty-six SD male rats (weight 260-280 g) were randomly allocated into normal control group and 12w-control group, NS-injection group and BT-injection group in this study.NS/BT-injection groups were divided into two subgroups separately (2w-NS, 2w-BT, 8w-NS, 8w-BT). No injection was applied in normal control group or 12w-control group.Saline/BoTN-A was injected in right GM in NS/BT-injection group at two different time points(2w, 8w)...
June 20, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28612061/management-of-vesicoureteral-reflux-in-neurogenic-bladder
#10
REVIEW
Charlotte Q Wu, Israel Franco
Vesicoureteral reflux (VUR) is a significant risk factor for pyelonephritis and renal scarring. VUR can occur through a defective ureterovesical junction (UVJ) or an overwhelmed normal UVJ mechanism such as in bladder dysfunction of congenital, acquired, or behavioral etiology. There are numerous causes for the development of a neurogenic bladder from spinal dysraphisms to spinal cord trauma and even centrally based abnormalities in children with apparently normal motor function (inappropriately termed nonneurogenic neurogenic bladder)...
June 2017: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/28593744/thermosensitive-heparin-poloxamer-hydrogels-enhance-the-effects-of-gdnf-on-neuronal-circuit-remodeling-and-neuroprotection-after-spinal-cord-injury
#11
Ying-Zheng Zhao, Xi Jiang, Qian Lin, He-Lin Xu, Ya-Dong Huang, Cui-Tao Lu, Jun Cai
Traumatic spinal cord injury (SCI) results in paraplegia or quadriplegia, and currently, therapeutic interventions for axonal regeneration after SCI are not clinically available. Animal studies have revealed that glial cell-derived neurotrophic factor (GDNF) plays multiple beneficial roles in neuroprotection, glial scarring remodeling, axon regeneration and remyelination in SCI. However, the poor physicochemical stability of GDNF, as well as its limited ability to cross the blood-spinal cord barrier, hampers the development of GDNF as an effective therapeutic intervention in clinical practice...
June 7, 2017: Journal of Biomedical Materials Research. Part A
https://www.readbyqxmd.com/read/28586588/outcome-analysis-of-two-different-injection-solutions-for-epidural-injection-in-radicular-lumbar-backache-syndromes
#12
Muhammad Saqib, Sajid Nazir Bhatti, Muhammad Ayaz Khan, Khalid Samad, Muhammad Mukhtar Khan, Ehtisham Mukhtar Khan Afridi, Rubaiqa Khan, Muhammad Imran Khan
BACKGROUND: Backache is a significant source of disability and suffering in our society. The treatment modalities need continued enhancement in order to achieve the desired goals of lowering morbidity and financial losses while improving the response of the patient. METHODS: This prospective comparative study was conducted at the department of Orthopaedics and Spine Surgery, Khyber Teaching Hospital Peshawar from July 2013 to June 2015. Two interventional groups were designated; Group 1 was comprised of 54 patients who were injected with epidural bupivacaine plus methylprednisolone while Group 2 included 55 patients who were injected with bupivacaine only...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28586445/relative-conspicuity-of-gadolinium-based-contrast-agents-in-interventional-pain-procedures
#13
Timothy P Maus, Beth A Schueler, Dixon J Magnuson, Dayne Magnuson
Objective: To assess the relative radiographic conspicuity of gadolinium-based contrast agents (GBCAs) that may be used in spinal injection procedures when iodine-based contrast agents are contraindicated. Methods: Eight GBCAs and three iodinated agents of varying iodine concentrations were radiographed under conditions representative of lumbar spinal injections at four kilovoltage peak (kVp) values. Radiographic contrast of each agent was measured as the percent pixel value difference with respect to background...
April 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28570482/targeting-the-s1p-s1pr1-axis-mitigates-cancer-induced-bone-pain-and-neuroinflammation
#14
Shaness A Grenald, Timothy M Doyle, Hong Zhang, Lauren M Slosky, Zhoumou Chen, Tally M Largent-Milnes, Sarah Spiegel, Todd W Vanderah, Daniela Salvemini
Metastatic bone pain is the single most common form of cancer pain and persists as a result of peripheral and central inflammatory, as well as neuropathic mechanisms. Here, we provide the first characterization of sphingolipid metabolism alterations in the spinal cord occurring during cancer-induced bone pain (CIBP). Following femoral arthrotomy and syngenic tumor implantation in mice, ceramides decreased with corresponding increases in sphingosine and the bioactive sphingolipid metabolite, sphingosine 1-phosphate (S1P)...
September 2017: Pain
https://www.readbyqxmd.com/read/28546769/treatment-of-chronic-low-back-pain-new-approaches-on-the-horizon
#15
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/28535546/cost-utility-analysis-of-lumbar-interlaminar-epidural-injections-in-the-treatment-of-lumbar-disc-herniation-central-spinal-stenosis-and-axial-or-discogenic-low-back-pain
#16
Laxmaiah Manchikanti, Vidyasagar Pampati, Ramsin M Benyamin, Joshua A Hirsch
BACKGROUND: Cost utility or cost effective analysis continues to take center stage in the United States for defining and measuring the value of treatments in interventional pain management. Appropriate cost utility analysis has been performed for caudal epidural injections, percutaneous adhesiolysis, and spinal cord stimulation. However, the literature pertaining to lumbar interlaminar epidural injections is lacking, specifically in reference to cost utility analysis derived from randomized controlled trials (RCTs) with a pragmatic approach in a practical setting...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28530017/mechanical-stress-by-spasticity-accelerates-fracture-healing-after-spinal-cord-injury
#17
Naoyoshi Sakitani, Hiroyuki Iwasawa, Masato Nomura, Yasushi Miura, Hiroshi Kuroki, Junya Ozawa, Hideki Moriyama
Accelerated fracture healing in patients with spinal cord injuries (SCI) is often encountered in clinical practice. However, there is no distinct evidence in the accelerated fracture healing, and the mechanisms of accelerated fracture healing in SCI are poorly understood. We aimed to determine whether SCI accelerated fracture healing in morphology and strength, to characterize the healing process with SCI, and to clarify the factors responsible for accelerated fracture healing. In total, 39 male Wistar rats were randomly divided into healthy control without intervention, SCI only, fracture with SCI, botulinum toxin (BTX) A-treated fracture with SCI, and propranolol-treated fracture with SCI groups...
May 22, 2017: Calcified Tissue International
https://www.readbyqxmd.com/read/28514309/a-randomized-controlled-trial-of-botulinum-toxin-a-for-treating-neuropathic-pain-in-patients-with-spinal-cord-injury
#18
RANDOMIZED CONTROLLED TRIAL
Gang Li, Chang-An Lv, Li Tian, Lian-Jin Jin, Ping Sun, Wei Zhao
BACKGROUND: To assess the effect of botulinum toxin A (BTA) for treating neuropathic pain in patients with spinal cord injury (SCI). METHODS: A total of 44 patients with SCI with neuropathic pain were randomly divided into the intervention group and the placebo group, each group 21 patients. The subjects in the intervention group received BTA (200 U subcutaneous injection, once daily) at the painful area, whereas those in the placebo group were administered a saline placebo...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28492440/diskitis-osteomyelitis-spinal-epidural-abscess-meningitis-and-endocarditis-following-sacroiliac-joint-injection-for-the-treatment-of-low-back-pain-in-a-patient-on-therapy-for-hepatitis-c-virus
#19
Geeta Nagpal, John P Flaherty, Honorio T Benzon
OBJECTIVE: Sacroiliac joint injections are frequently performed procedures in the management of acute and chronic low-back pain, including patients with various immunocompromised states. Infectious complications following these procedures along with other spinal injections are rarely reported, but the true incidence is unknown. The purpose of this report is to highlight the devastating neurologic sequela that can occur, and to discuss potential future management strategies. CASE REPORT: We present a patient who developed diskitis, osteomyelitis, spinal epidural abscess, meningitis, and endocarditis from Staphylococcus aureus, all of which developed shortly after a sacroiliac joint injection...
July 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28486278/interventional-approaches-to-low-back-pain
#20
Ariana M Nelson, Geeta Nagpal
Chronic low back pain (LBP) places a tremendous economic burden on society due to both direct and indirect costs. Health care costs for adults with chronic LBP have steadily increased over the past 20 years, coinciding with a large increase in the utilization of spinal injections, surgical interventions, opioid medications, and physical therapy. The treatment of LBP is best approached by a multimodal and even multidisciplinary approach with a combination of physical rehabilitation, pharmacologic management, psychological intervention, spinal injections, and surgical intervention with a goal of improving the functional status of the patient...
May 8, 2017: Clinical Spine Surgery
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