Pain physician
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Randomized Controlled Trial
Management of pain of post lumbar surgery syndrome: one-year results of a randomized, double-blind, active controlled trial of fluoroscopic caudal epidural injections.
Post lumbar surgery syndrome represents a cluster of nomenclature and syndromes following spine surgery wherein the expectations of the patient and spine surgeon are not met, with persistent pain following lumbar surgery. Multiple causes have been speculated to cause pain after lumbar surgery. Epidural steroid injections are most commonly used in managing post surgical pain in the lumbar spine. However, there is a paucity of evidence of epidural injections in managing chronic low back pain with or without lower extremity pain in post surgery syndrome. ⋯ NCT00370799.
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Case Reports
Osteoid osteoma and osteoblastoma of the cervical spine: the cause of unusual persistent neck pain.
The most important symptom in patients with osteoid osteoma and osteoblastoma is a resistant localized neck pain and stiffness in the spine. ⋯ Surgical treatment of osteoid osteoma and osteoblastoma of the spine has been standardized. The most common symptom of osteoid osteoma and osteoblastoma of the cervical spine is local persistent neck pain in the region of the tumor. This symptom can be significant in the diagnosis of these tumors.
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Many studies have reported lead migration and breakage as complications of epidural spinal cord stimulation. In cases where rapid changes in physique such as those caused by pregnancy are expected, it is unclear whether extra consideration regarding possible adjustments and care to avoid complications such as lead breakage are required. ⋯ Pregnancy following implantation of a spinal cord stimulator might result in lead breakage as abdominal girth increases. The present case exemplifies how pregnancy following implantation of a spinal cord stimulator might cause lead breakage as abdominal girth increases. Extra care is required to prevent lead breakage when anchors are fixed.
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Persistent neck pain is a common problem after surgery of the cervical spine. No therapy recommendation exists for these patients. ⋯ For persistent postsurgical neck pain only limited therapy recommendations exist. This study suggests treating these patients in a first instance with therapeutic medial branch blocks. The success rate is 52.9 %.
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Comment Letter Case Reports
Paraparesis following spinal cord stimulator trial, implantation and revision.