Journal of pain research
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Journal of pain research · Jan 2019
Targeted Epidural Blood Patches Under Fluoroscopic Guidance For Incidental Durotomies Related To Spine Surgeries: A Case Series.
Incidental durotomies are usually managed conservatively. However, 1.8% of patients require surgical dural repair for CSF leak. There are limited data available regarding the use of epidural blood patches (EBP) for persistent CSF leaks secondary to incidental durotomies. This case series aims to evaluate the efficacy of targeted EBPs under fluoroscopic guidance in the treatment of incidental durotomies. ⋯ This case series demonstrated that targeted EBP can be an effective treatment for CSF leak from incidental durotomies. However, dural tears in the cervical region may be more difficult to treat. Larger scale studies are required to evaluate efficacy of EBP in the treatment of symptomatic incidental durotomies.
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Journal of pain research · Jan 2019
C7 slope and its association with serum lipid levels and Modic changes in patients with cervical spondylotic myelopathy.
Background: Several studies have substituted the T1 slope (T1S) with the C7 slope (C7S) because the C7 endplate is clearer on radiographs. Further, abnormal serum lipid levels have been proven to be related with the development of disc degeneration. The aim of this study was to explore the relationship between C7S, serum lipid levels, cervical parameters related to cervical sagittal balance and Modic changes (MCs) in patients with multisegment cervical spondylotic myelopathy (CSM). ⋯ The correlation between HDL-C, LDL-C, ALB, GLB, Ca2+, C7S, T1S, MCs, NT, TIA, and C2-C7 SVA was statistically significant. Conclusion: Significant correlations were observed between MCs and TG (as well as other preoperative sagittal parameters), which may accelerate the development of degeneration of the cervical spine. Therefore, alcohol consumption, TG, and sagittal parameters, such as C7S, and T1S could be a promising candidate for the assessment of cervical sagittal balance and predicting neck pain.
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Journal of pain research · Jan 2019
The effectiveness of ultrasound-guided cervical transforaminal epidural steroid injections in cervical radiculopathy: a prospective pilot study.
Cervical transforaminal epidural steroid injection (CTFESI) is used to provide pain relief and restore function in patients with cervical radiculopathy. Traditionally, it is performed under the guidance of fluoroscopy or computed tomography. Here, we introduce a novel technique - ultrasound-guided CTFESI - with which operators can easily distinguish the close soft tissue (nerve, vessels) around the cervical foramina to avoid intravascular injection during the procedure. ⋯ We suggest that ultrasound-guided CTFESI is an effective, safe, and simple procedure free of radiation or magnetization and provides sustained pain relief in patients with cervical radiculopathy who have failed previous conservation therapies.
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Journal of pain research · Jan 2019
The World Health Organization Disability Assessment Schedule-2.0 (WHODAS 2.0) in a chronic pain population being considered for chronic opioid therapy.
To examine the validity of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) for the assessment of function in a community-based sample of patients with chronic pain conditions undergoing evaluation for chronic opioid therapy. ⋯ The WHODAS 2.0 was significantly positively correlated with other measures, including measures of disability, risk of opioid misuse, and depression among patients being evaluated for chronic opioid therapy. The WHODAS 2.0 may be a useful measure of disability across a number of important domains when discussing expectations of both patients and providers at initiation of opioid therapy for chronic pain management. This assessment and discussion is crucial, particularly given the focus on function, rather than analgesia alone, when evaluating the effectiveness of opioid treatment.
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Journal of pain research · Jan 2019
Local ozone (O2-O3) versus corticosteroid injection efficacy in plantar fasciitis treatment: a double-blinded RCT.
To compare the efficacy of local ozone injection versus corticosteroid in plantar fasciopathy treatment. ⋯ The present results showed no remarkable superiority between the two groups. In other words, although ozone injection showed a slower efficacy than methylprednisolone, it could be used in plantar fasciitis management as an appropriate alternative.