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Facet pain

Seba Ramhmdani, Marc Comair, Camilo A Molina, Daniel M Sciubba, Ali Bydon
Interspinous process devices (IPDs) have been developed as less-invasive alternatives to spinal fusion with the goal of decompressing the spinal canal and preserving segmental motion. IPD implantation is proposed to treat symptoms of lumbar spinal stenosis that improve during flexion. Recent indications of IPD include lumbar facet joint syndrome, which is seen in patients with mainly low-back pain. Long-term outcomes in this subset of patients are largely unknown. The authors present a previously unreported complication of coflex (IPD) placement: the development of a large compressive lumbar synovial cyst...
June 15, 2018: Journal of Neurosurgery. Spine
Stella Samoborec, Rasa Ruseckaite, Darshini Ayton, Sue Evans
BACKGROUND: Globally, road transport accidents contribute significantly to mortality and burden of disability. Up to 50 million people suffer a transport-related non-fatal injury each year, which often leads to long-term disability. A substantial number of people with minor injuries struggle to recover and little is known about the factors leading to poor or non-recovery. The aim of this paper is to present a systematic review of biopsychosocial factors related to poor or non-recovery after a minor transport-related injury...
2018: PloS One
Arvind G Kulkarni, Shashidhar Bangalore Kantharajanna, Abhilash N Dhruv
Background: The conventional interlaminar approach is adequate for access to most disc herniations in lumbar spine surgery. The access to cranially and caudally migrated disc fragments, by conventional interlaminar fenestration, requires an extension of the fenestration with the potential destruction of the facet joint complex and consequent postsurgical instability. To describe the technique and results of the translaminar technique of targeted discectomy using tubular retractors for the surgical treatment of cranially and caudally extruded discs...
May 2018: Indian Journal of Orthopaedics
Cheng-Li Lin, Po-Hsin Chou, Jing-Jing Fang, Kuo-Yuan Huang, Ruey-Mo Lin
Objective We assessed our results of short-segment decompression and fixation for osteoporotic thoracolumbar fractures with neurological deficits. Methods We evaluated 20 elderly patients (age, 60-89 years; mean, 73.2 years) with osteoporotic thoracolumbar fractures and neurological deficits. They underwent short-segment decompression and fixation and followed up for 40.6 (range, 24-68) months. A visual analog scale (VAS) and the Oswestry Disability Index (ODI) were used to measure back pain and disability...
January 1, 2018: Journal of International Medical Research
Ju-Eun Kim, Dae-Jung Choi
Background context: Open laminectomy has been regarded as the standard surgical method up to date in degenerative spinal stenosis or herniation of intervertebral disc. The conventional method may lead to instability and provoke chronic lower back pain by scarifying facet joint, posterior ligamentous complex as well as paraspinal muscle. For this reason, the new technique using an endoscope, which could protect soft tissue and facet joint, recently got spotlight. Purpose: The aim of this study is to introduce a new spinal surgical technique using a 30-degreed endoscopy through bi- or tri- portals and to report the preliminary result of this technique...
June 2018: Journal of Orthopaedics
Giorgio Cacciola, Alessandro Pisani, Pietro Cavaliere, Bruno Pitrone, Domenico Rizzo, Giuseppina Rizzo, Filippo Cascio, Federico De Meo, Andrea Barbanera
In humans the acquisition of the bipedalism caused different structural changes to achieve the new functional demands. In particular, several changes have occurred in the spine and pelvis. In recent years the sagittal morphology of the spine and pelvis has become one of the most focused topics in spine research. The sample consists of 348 volunteers, with no history of low back pain, without any previous major trauma at the spine or at the pelvis. Aged between 20 and 29 years. The presence and severity of zygoapophyseal facet arthrosis were investigated in accordance with Pathria's classification (it considered four parameters: width of interarticular space, the presence of osteophytes, the presence of facet hypertrophy and presence of areas of bone erosion)...
June 2018: Journal of Orthopaedics
Min-Woo Kim, Kyu Yeol Lee, Seunghyun Lee
STUDY DESIGN: A retrospective cohort study. PURPOSE: To investigate the factors affecting symptoms in young adults with L5 spondylolysis. OVERVIEW OF LITERATURE: L5 spondylolysis is a common disease. However, not all patients diagnosed with L5 spondylolysis exhibit symptoms. This study examined the factors associated with the symptoms of young adults with L5 spondylolysis. METHODS: The medical records of 70 young adults (mean age, 31...
June 2018: Asian Spine Journal
Balachandar Gopalan, Janardhan Srinivas Yerramshetty
STUDY DESIGN: Case control study. PURPOSE: The association of lumbosacral transitional vertebra (LSTV) with low back pain (LBP) is controversial, as is the role of occupational physical activity and radiological spinal abnormalities suggestive of other spinal disorders (OSDs) such as spinal degeneration and instability. This study aimed to determine if any association of LSTV with LBP exists. If so, the association of the level of physical activity and presence of OSD with LSTV-related LBP was determined...
June 2018: Asian Spine Journal
David S Stolzenberg, Ryan Pheifer, Joshua Armstrong, George Young, Jeffrey Gehret, Jeremy Simon, George C Chang-Chien
BACKGROUND: Neural blockade of the cervical medial branches is a validated procedure in the diagnosis and treatment of cervical zygapophyseal joint pain. Fluoroscopic visualization of the lower cervical medial branch target zones (CMBTZs) in lateral view is sometimes challenging or not possible due to the patient's shoulders obscuring the target. Large shoulders and short necks often exacerbate the problem. Clear visualization is critical to accuracy and safety. OBJECTIVE: We aim to describe a method for optimal fluoroscopic visualization of the lower CMBTZs using a modified swimmer's view...
May 2018: Pain Physician
Tim Hahn, Marc-Eric Halatsch, Christian Wirtz, Stephan Klessinger
BACKGROUND: Among the various causes of vertigo, the so-called cervicogenic vertigo (CV) has been the most controversial. However, perturbations of proprioceptive signals and abnormal activity of the cervical afferents can induce vertigo. Medial branch blocks (MBBs) are a diagnostic tool designed to test whether a patient's neck pain is mediated by one or more of the medial branches of the dorsal rami of the spinal nerve. It is unknown whether MBBs are also suitable for testing symptoms other than pain...
May 2018: Pain Physician
Seung-Kook Kim, Byoung-Hoi Lee, Moon-Bok Song, Su-Chan Lee
BACKGROUND: Benign spinal cysts are relatively common, but can cause significant pain. However, consensus regarding the best method for treating these cysts has not been established. We aimed to examine the usefulness of epiduroscopic neural laser decompression (ENLD), a novel percutaneous treatment, for treating lumbo-sacral cysts. METHODS: Ten patients (6 men, 4 women; mean age 45.5 years) with benign lumbo-sacral cysts underwent ENLD. The lumbo-sacral cysts were caused by multiple pathophysiologies and displayed different characteristics...
June 4, 2018: Journal of Orthopaedic Surgery and Research
Ning Qu, René Lindstrøm, Rogerio Pessoto Hirata, Thomas Graven-Nielsen
Aims Evaluate pressure pain threshold (PPT) over cervical facet joints before and after injection of experimental pain in the trapezius and multifidus muscles. Methods Fourteen healthy subjects (6 women) received randomized ultrasound-guided injections of hypertonic saline (5.8%), in the right multifidus muscle medial to C4/C5 facet joint and in the right trapezius muscle at the midpoint between C7 spinous process and acromion. The saline-induced pain intensity was assessed on a VAS scale. Before and during saline-induced pain PPTs were assessed by pressure algometry bilaterally over C2/C3 and C5/C6 facet joints...
December 29, 2017: Scandinavian Journal of Pain
Steven P Cohen, Tina L Doshi, Octav C Constantinescu, Zirong Zhao, Connie Kurihara, Thomas M Larkin, Scott R Griffith, Michael B Jacobs, William J Kroski, Timothy C Dawson, Ian M Fowler, Ronald L White, Aubrey J Verdun, David E Jamison, Mirinda Anderson-White, Stephanie E Shank, Paul F Pasquina
BACKGROUND: With facet interventions under scrutiny, the authors' objectives were to determine the effectiveness of different lumbar facet blocks and their ability to predict radiofrequency ablation outcomes. METHODS: A total of 229 participants were randomized in a 2:2:1 ratio to receive intraarticular facet injections with bupivacaine and steroid, medial branch blocks, or saline. Those with a positive 1-month outcome (a 2-point or more reduction in average pain score) and score higher than 3 (positive satisfaction) on a 5-point satisfaction scale were followed up to 6 months...
May 30, 2018: Anesthesiology
Andrew Nataraj, Andrew S Jack, Ihsan Ihsanullah, Shawn Nomani, Frank Kortbeek, Richard Fox
STUDY DESIGN: This is a single-center, retrospective, observational cohort study. OBJECTIVE: To determine whether surgery or nonoperative treatment has better clinical outcomes in neurologically intact patients with an intermediate severity thoracolumbar burst fracture. SUMMARY OF BACKGROUND DATA: Optimal management, whether initial operative or nonoperative treatment, for thoracolumbar injury classification score (TLICS) 4 burst fractures remains controversial...
May 25, 2018: Clinical Spine Surgery
Haring J Nauta, Sabrina L McIlwrath, Karin N Westlund
Punctate midline myelotomy (PMM) has been successfully applied clinically in humans for the relief of intractable visceral pain. The operation is thought to work by interrupting the postsynaptic dorsal column pathway (PSDC) of the spinal cord. In fact, PMM was developed specifically for that purpose after it was demonstrated in rats that the PSDC conveyed about 90% of the visceral pain information to the thalamus. The application of PMM also to the problem of severe intractable back or spine pain was never tested, and it has never been established whether the PSDC pathway relates only to visceral pain or whether there may be a broader involvement with pain affecting structures of embryological midline origin, perhaps including the spine...
March 26, 2018: Curēus
Sergio M Borghi, Victor Fattori, Miriam S N Hohmann, Waldiceu A Verri
BACKGROUND: Neuroinflammatory diseases that affect spinal cord or associated spinal nerves represent challenging conditions for management in current medicine because of their complex pathology, poor prognosis, and high morbidity, which strikingly reduces the quality of life of patients. In this sense, a better understanding of the cellular and molecular mechanisms of spinal cord neuroinflammation might contribute to the development of novel therapies. Oligodendrocytes have unique and vital biological properties in central nervous system (CNS) homeostasis and physiology...
May 21, 2018: Current Medicinal Chemistry
Adrian Kastler, Hannes Gruber, Elke Gizewski, Alexander Loizides
BACKGROUND AND OBJECTIVES: Real-time ice-ball formation during cryoneurolysis has sparsely been assessed with ultrasound (US). Cryoneurolysis in lower back pain syndrome represents a validated management option in cases of facet joint syndrome. Ultrasound may be a useful tool to perform facet joint cryodenervation. The objective of this study was to assess, ex vivo, the ability of US to assess the ice-ball formation of a cryoneurolysis device. METHODS: Ultrasound assessment of the ice-ball depiction was done using chicken muscle at 22°C in which several freezing cycles were performed with both 2...
May 17, 2018: Regional Anesthesia and Pain Medicine
Michelle P Grover, Mark P Jensen, David R Patterson, Kevin J Gertz, Melissa A Day
Mindfulness-based interventions and hypnosis are efficacious treatments for addressing a large number of psychological and physical conditions, including chronic pain. However, there continues to be debate surrounding the relative uniqueness of the theorized mechanisms of these treatments-reflected by measures of mindfulness facets and hypnotizability-with some concern that there may be so much overlap as to make the mechanism constructs (and, therefore, the respective interventions) redundant. Given these considerations, the primary aim of the current study was to examine the degree of unique versus shared variance between two common measures of mindfulness facets and hypnotizability: the Five Facet Mindfulness Questionnaire and the Stanford Hypnotic Clinical Scale...
July 2018: American Journal of Clinical Hypnosis
Kerry Peek, Mariko Carey, Lisa Mackenzie, Robert Sanson-Fisher
The effectiveness of exercise programs for chronic low back pain (CLBP) is dependent upon patient adherence which is problematic to measure accurately. This cross-sectional observational study aimed to compare patient-reported levels of adherence with physiotherapists' perceptions of patient adherence; and to explore the proportion of patients who could accurately recall and demonstrate the exercises contained within their prescribed exercise program for CLBP. Participating patients (n = 61) included those attending for a follow-up consultation with a physiotherapist (n = 15) at a consenting practice (n = 6) who had been prescribed an exercise program for CLBP...
May 17, 2018: Physiotherapy Theory and Practice
Ovidiu Palea, Haroon M Andar, Ramon Lugo, Michelle Granville, Robert E Jacobson
Radiofrequency cervical rhizotomy has been shown to be effective for the relief of chronic neck pain, whether it be due to soft tissue injury, cervical spondylosis, or post-cervical spine surgery. The target and technique have traditionally been taught using an oblique approach to the anterior lateral capsule of the cervical facet joint. The goal is to position the electrode at the proximal location of the recurrent branch after it leaves the exiting nerve root and loops back to the cervical facet joint. The standard oblique approach to the recurrent nerve requires the testing of both motor and sensory components to verify the correct position and ensure safety so as to not damage the slightly more anterior nerve root...
March 14, 2018: Curēus
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