Pain medicine : the official journal of the American Academy of Pain Medicine
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For many medical professionals dealing with patients with persistent pain following spine surgery, the term Failed back surgery syndrome (FBSS) as a diagnostic label is inadequate, misleading, and potentially troublesome. It misrepresents causation. Alternative terms have been suggested, but none has replaced FBSS. The International Association for the Study of Pain (IASP) published a revised classification of chronic pain, as part of the new International Classification of Diseases (ICD-11), which has been accepted by the World Health Organization (WHO). This includes the term Chronic pain after spinal surgery (CPSS), which is suggested as a replacement for FBSS. ⋯ This project is important to those in the fields of pain management, spine surgery, and neuromodulation, as well as patients labeled with FBSS. Through a shift in perspective, it could facilitate the application of the new ICD-11 classification and allow clearer discussion among medical professionals, industry, funding organizations, academia, and the legal profession.
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To perform an effective and safe nerve block, the needle must be placed near the target nerve while avoiding nerve damage. Our objective was to conduct an animal study to determine whether changes in electrical impedance (EI) could be used to guide the needle and achieve a safe and accurate nerve block. ⋯ EI values differed between extra- and paraneural sites, and monitoring these values allowed prediction of the needle tip location with respect to the target nerve. Real-time EI measurement could improve the nerve block.