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Spine injections

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https://www.readbyqxmd.com/read/28535567/radiation-dose-and-procedure-time-for-994-ct-guided-spine-pain-control-procedures
#1
Matthew S Lazarus, Rebecca B Forman, Alan L Brook, Todd S Miller
BACKGROUND: Image guidance for spine pain control procedures, including epidural steroid injection, nerve root block, and facet block, can be performed with either computed tomography (CT) or conventional fluoroscopy. CT has the advantage of improved anatomic localization and use of air for contrast; however, there are concerns that CT leads to higher radiation dose and longer procedure time. OBJECTIVE: To evaluate procedure time and radiation dose for multiple types of spine pain control procedures performed under CT guidance...
May 2017: Pain Physician
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
#2
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/28508761/posterior-branches-of-lumbar-spinal-nerves-part-ii-lumbar-facet-syndrome-pathomechanism-symptomatology-and-diagnostic-work-up
#3
Katarzyna Kozera, Bogdan Ciszek, Paweł Szaro
Posterior branches of the lumbar spinal nerves are the anatomic substrate of pain in the lower back, sacrum and the gluteal area. Such pain may be associated with various pathologies which cause pain in the posterior branches of the lumbar spinal nerves due to entrapment, mechanical irritation or inflammatory reaction and/or degeneration. The posterior branches are of significant functional importance, which is related to the function of the structures they supply, including facet joints, which are the basic biomechanical units of the spine...
April 12, 2017: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28508556/impact-of-co-morbidities-on-resource-use-and-adherence-to-guidelines-among-commercially-insured-adults-with-new-visits-for-back-pain
#4
Sean D Rundell, Laura S Gold, Ryan N Hansen, Brian W Bresnahan
RATIONALE, AIMS AND OBJECTIVES: To assess if co-morbidity is associated with higher use of back-related care and adherence to back pain guidelines. METHODS: We conducted a retrospective cohort study using administrative claims data from 2007-2011. We included individuals ≥18 years with an index visit for back pain. Co-morbidities were measured 12 months prior to index. Co-morbidity burden was measured using Quan's Co-morbidity Index. Co-morbidities categories were measured using chronic condition indicators from the Agency for Healthcare Research and Quality...
May 16, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28502041/glucose-can-epigenetically-alter-the-gene-expression-of-neurotrophic-factors-in-the-murine-brain-cells
#5
Md Shamim Hossain, Yutaka Oomura, Toshihiko Katafuchi
Glucose is believed to improve the memory in both human and mice, but the detailed insights were mostly elusive. In this study, we focused on two major neurotrophic factors, brain-derived neurotrophic factor (BDNF) and fibroblast growth factor 1 (FGF1), which are believed to be associated with the memory enhancement and assessed their expressional regulation among the murine neuronal and glial cells. Our findings showed that the glucose administration increased phosphorylated Akt, phosphorylated CREB, exon 1- and exon 4-specific BDNF transcripts, and FGF1 transcripts that are associated with the epigenetic changes expected to open the chromatin and a reduction in histone deacetylase 2 (HDAC2) in neurons and astrocytes of the murine hippocampus...
May 13, 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/28501759/resource-utilization-for-non-operative-cervical-radiculopathy-management-by-surgeons-versus-non-surgeons
#6
Sophie H Chung, Daniel D Bohl, Jonathan T Paul, Jeffrey A Rihn, James S Harrop, Zoher Ghogawala, Alan S Hilibrand, Jonathan N Grauer
OBJECTIVES: To compare the estimated resource utilization for non-operative treatment of cervical radiculopathy if managed by surgeons versus non-surgeons. PATIENTS AND METHODS: A Cervical Spine Research Society-sponsored survey was administered at a national spine surgery conference to surgeons and non-surgeons, as classified above. The survey asked questions regarding resource utilization and perceived costs for the "average patient" with cervical radiculopathy managed non-operatively...
May 6, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28501720/characterization-and-restoration-of-degenerated-ivd-function-with-an-injectable-in-situ-gelling-alginate-hydrogel-an-in-vitro-and-ex-vivo-study
#7
Emily A Growney Kalaf, Meghana Pendyala, J Gary Bledsoe, Scott A Sell
Intervertebral disc (IVD) degeneration is a naturally, irreparable process that causes loss in IVD hydration, cellularity, and, mechanical stability. Invasive surgical attempts to ease back pain and, radiculopathy have shown to cause increased degeneration along the rest, of the spine. Due to its highly tunable mechanical and degradation, properties, alginate is a viable option for a less-invasive injectable, repair for IVD degeneration. This study centers on the characterization, of in situ gelling alginate and subsequent injection into enzymatically, degraded motion segments...
May 7, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28494130/visualization-of-stereoscopic-anatomic-models-of-the-paranasal-sinuses-and-cervical-vertebrae-from-the-surgical-and-procedural-perspective
#8
Jian Chen, Andrew D Smith, Majid A Khan, Allan R Sinning, Marianne L Conway, Dongmei Cui
Recent improvements in three-dimensional (3D) virtual modeling software allows anatomists to generate high-resolution, visually appealing, colored, anatomical 3D models from computed tomography (CT) images. In this study, high-resolution CT images of a cadaver were used to develop clinically relevant anatomic models including facial skull, nasal cavity, septum, turbinates, paranasal sinuses, optic nerve, pituitary gland, carotid artery, cervical vertebrae, atlanto-axial joint, cervical spinal cord, cervical nerve root, and vertebral artery that can be used to teach clinical trainees (students, residents, and fellows) approaches for trans-sphenoidal pituitary surgery and cervical spine injection procedure...
May 11, 2017: Anatomical Sciences Education
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
#9
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...
May 10, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28489775/effects-of-nimodipine-on-postoperative-delirium-in-elderly-under-general-anesthesia-a-prospective-randomized-controlled-clinical-trial
#10
Ya-Nan Li, Qi Zhang, Chun-Ping Yin, Yang-Yang Guo, Shu-Ping Huo, Liang Wang, Qiu-Jun Wang
Nimodipine is a clinical commonly used calcium antagonistscan lowering the apoptosis rate of hippocampal neuron to reduce the incidence of postoperative cognitive dysfunction (POCD). This study was designed to evaluate the effects of nimodipine on postoperative delirium in elderly under general anesthesia.Sixty patients shceduced spine surgery under general anesthesia were randomly assigned into 2 groups using a random number table: control group (Group C) and nimodipine group (Group N). In Group N, nimodipine 7...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28487495/naoling-decoction-restores-cognitive-function-by-inhibiting-the-neuroinflammatory-network-in-a-rat-model-of-alzheimer-s-disease
#11
Zian Xia, Weijun Peng, Shunhua Cheng, Bingwu Zhong, Chenxia Sheng, Chunhu Zhang, Wei Gong, Shuai Cheng, Jun Li, Zhe Wang
Neuroinflammation is central to the pathogenesis of Alzheimer's disease (AD). We previously showed that Naoling decoction (NLD), a traditional Chinese medicine, was effective against AD, acting by inhibiting expression of IL-1β and IL-6. In the present study, we generated the rat model of AD by injecting Aβ1-42 peptide intracerebroventricularly and evaluated the dose-dependent effects of NLD treatment. The NLD-treated rats exhibited significant improvements in cognitive function as evaluated by the Morris water maze test...
April 21, 2017: Oncotarget
https://www.readbyqxmd.com/read/28485657/mri-findings-in-lumbar-spine-following-o2-o3-chemiodiscolysis-a-long-term-follow-up
#12
Federico Bruno, Fernando Smaldone, Marco Varrassi, Francesco Arrigoni, Antonio Barile, Ernesto Di Cesare, Carlo Masciocchi, Alessandra Splendiani
Intradiscal O2-O3 injections are conventionally used as a minimally invasive treatment for lumbar disc herniation in patients not responding to conservative treatments. The aim of the present study is to report data of long-term imaging follow-up (3 years) of patients treated with intradiscal O2-O3 lumbar chemiodiscolysis. We evaluated the changes of disc volume and the modifications in disc appearance (in terms of disc degeneration) and endplate changes (according to Modic), comparing the results with a control group of patients...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28479397/locomotor-sensitization-to-intermittent-ketamine-administration-is-associated-with-nucleus-accumbens-plasticity-in-male-and-female-rats
#13
C E Strong, K J Schoepfer, A M Dossat, S K Saland, K N Wright, M Kabbaj
Clinical evidence suggests superior antidepressant response over time with a repeated, intermittent ketamine treatment regimen as compared to a single infusion. However, the club drug ketamine is commonly abused. Therefore, the abuse potential of repeated ketamine injections at low doses needs to be investigated. In this study, we investigated the abuse potential of repeated exposure to either 0, 2.5, or 5 mg/kg ketamine administered once weekly for seven weeks. Locomotor activity and conditioned place preference (CPP) were assayed to evaluate behavioral sensitization to the locomotor activating effects of ketamine and its rewarding properties, respectively...
May 4, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/28478791/oblique-intrathecal-injection-in-lumbar-spine-surgery-a-technical-note
#14
Gordon A E Jewett, Daniel Yavin, Perry Dhaliwal, Tara Whittaker, JoyAnne Krupa, Stephan Du Plessis
OBJECTIVES: Intrathecal morphine (ITM) is an efficacious method of providing postoperative analgesia and reducing pain associated complications. Despite adoption in many surgical fields, ITM has yet to become a standard of care in lumbar spine surgery. Spine surgeons' reticence to make use of the technique may in part be attributed to concerns of precipitating a cerebrospinal fluid (CSF) leak. METHODS: Herein we describe a method for oblique intrathecal injection during lumbar spine surgery to minimize risk of CSF leak...
May 8, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28465226/repeated-propofol-anesthesia-induced-downregulation-of-hippocampal-mir-132-and-learning-and-memory-impairment-of-rats
#15
Shuo Zhang, Zuodi Liang, Wenchong Sun, Ling Pei
Several studies have reported that neonatal exposure to propofol may cause neurotoxicity in the hippocampus, involving long-term neurodevelopmental impairments. We aimed to detect real-time changes of miR-132 of neonatal rats exposed to propofol anesthesia and to characterize subsequent changes in learning and memory. Seven-day-old Sprague-Dawley rats were injected intraperitoneally with 40 mg/kg propofol at 0, 120, and 240 minutes or with isotonic fat emulsion as controls. Expression levels of miR-132 were assessed, and the mRNA and protein expression levels of p250GAP, a prominent target for miR-132, were evaluated at different time points during development...
April 29, 2017: Brain Research
https://www.readbyqxmd.com/read/28460690/pain-catastrophizing-moderates-changes-in-spinal-control-in-response-to-noxiously-induced-low-back-pain
#16
Gwyneth B Ross, Peter J Sheahan, Brian Mahoney, Brendon J Gurd, Paul W Hodges, Ryan B Graham
It is generally accepted that spine control and stability are relevant for the prevention and rehabilitation of low back pain (LBP). However, there are conflicting results in the literature in regards to how these variables are modified in the presence of LBP. The aims of the present work were twofold: (1) to use noxious stimulation to induce LBP in healthy individuals to assess the direct effects of pain on control (quantified by the time-dependent behavior of kinematic variance), and (2) to assess whether the relationship between pain and control is moderated by psychological features (i...
April 19, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28451492/recurrent-laryngeal-nerve-palsy-after-cervical-spine-surgery-a-multicenter-aospine-clinical-research-network-study
#17
Ziya L Gokaslan, Mohamad Bydon, Rafael De la Garza-Ramos, Zachary A Smith, Wellington K Hsu, Sheeraz A Qureshi, Samuel K Cho, Evan O Baird, Thomas E Mroz, Michael Fehlings, Paul M Arnold, K Daniel Riew
STUDY DESIGN: Multicenter retrospective study. OBJECTIVES: To investigate the risk of symptomatic recurrent laryngeal nerve palsy (RLNP) following cervical spine surgery, to examine risk factors for its development, and to report its treatment and outcomes. METHODS: A multicenter study from 21 high-volume surgical centers from the AOSpine North America Clinical Research Network was performed. Each center screened for rare complications following cervical spine surgery, including RLNP...
April 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28435744/diagnosis-of-spinal-epidural-abscess-a-case-report-and-literature-review
#18
Chidinma Chima-Melton, Michelle Pearl, Marni Scheiner
INTRODUCTION: Spinal epidural abscess (SEA) is a rare but serious cause of back pain in the critical care setting. It occurs most commonly in adults in their fifth and sixth decades of life. Risk factors include diabetes mellitus, alcoholism, AIDS or other immunocompromised states, cancer, intravenous drug use, trauma and spinal surgery. The clinical presentation can be non-specific but the classical triad includes back pain, fever and neurological deficits. Magnetic resonance imaging (MRI) with gadolinium is the diagnostic imaging modality of choice...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28431428/computational-and-in-vitro-experimental-investigation-of-intrathecal-drug-distribution-parametric-study-of-the-effect-of-injection-volume-cerebrospinal-fluid-pulsatility-and-drug-uptake
#19
Kevin M Tangen, Roxanne Leval, Ankit I Mehta, Andreas A Linninger
BACKGROUND: Intrathecal drug delivery is an attractive option to circumvent the blood-brain barrier for pain management through its increased efficacy of pain relief, reduction in adverse side effects, and cost-effectiveness. Unfortunately, there are limited guidelines for physicians to choose infusion or drug pump settings to administer therapeutic doses to specific regions of the spine or the brain. Although empiric trialing of intrathecal drugs is critical to determine the sustained side effects, currently there is no inexpensive in vitro method to guide the selection of spinal drug delivery parameters...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28430741/utility-of-8%C3%A2-h-and-time-decay-corrected-acquisition-scintigraphy-with-in-vitro-labeled-white-blood-cells-for-the-diagnosis-of-osteoarticular-infection
#20
Edel Noriega-Álvarez, Guillermo A Martínez Pimienta, Ana M Benítez Segura, María T Bajén Lázaro, Alba Rodríguez-Gasén, Julio Rodríguez-Rubio Corona, Jaime Mora-Salvadó
INTRODUCTION: Except in the spine, labeled white-blood cell scintigraphy (WBCS) with image acquisition up to 24 h is the nuclear medicine test of choice for diagnosing osteoarticular infection. However, distinguishing between inflammation and infection is a challenge. OBJECTIVES: The first aim of this study was to verify earlier research studies that used 4 and 24 h time decay-corrected acquisition (TDCA) to differentiate infection from inflammation. The second aim was to analyze whether 8 h acquisition (1-day protocol) yielded similar results as 20-24 h acquisition...
June 2017: Nuclear Medicine Communications
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