Pain physician
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Case Reports
Vertebroplasty for the compression of the dorsal root ganglion due to spinal metastasis.
Radicular pain has been considered to be a relative contraindication to vertebroplasty. It was reported by some authors in the literature that percutaneous vertebroplasty (PV) in these conditions were performed without complications. ⋯ We suggest that carefully performed PV is an option for terminally ill patients with epidural and dorsal root ganglion involvement who do not respond to conservative treatment or cannot undergo radiation therapy and surgery. PV is minimally invasive compared to open surgery and may merit serious consideration in patients with limited physiologic reserves.
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Comparative Study
The use of advanced imaging and representation of workers compensation in vertebral augmentation: a single-center comparison with the INVEST Trial.
Vertebral augmentation (VA) techniques have changed the paradigm of treatment during the past decade and involve injection of polymethylmethacrylate (PMMA) cement directly into a compressed vertebral body. During the summer of 2009, the INVEST trial was one of 2 randomized controlled studies that reported equivalence between vertebroplasty and a control procedure. ⋯ We reviewed our time-matched database in terms of 2 variables we thought curious in the INVEST trial. In comparison to our practice, where advanced imaging is essentially required and Workers compensation largely not seen, these aspects of the INVEST trial's population stood out.
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Comparative Study
Comparative assessment of different percutaneous endoscopic interlaminar lumbar discectomy (PEID) techniques.
Percutaneous endoscopic lumbar discectomy is a common surgical treatment for lumbar disc herniation, and percutaneous endoscopic interlaminar lumbar discectomy (PEID) is commonly used for direct decompression of L5-S1. Like microdiscectomy, recurrence of herniation after endoscopic discectomy is an important problem. In this study, we aimed to decrease the recurrence after PEID using a new surgical technique. ⋯ Though a learning curve is needed in order to become familiar with PEID, recurrence after PEID was associated with advanced age, and PEID with annular sealing resulted in lower early recurrence rates than without annular sealing. Thus, PEID with annular sealing may be a useful technique for reducing early recurrence.
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Vertebroplasty (VP) and kyphoplasty (KP) are emerging procedures for almost immediate pain relief when treating osteoporotic or osteolytic fractures. The main reported complication is polymethylmethacrylate (PMMA) leakage, which may lead to compression of neural structures or embolism. Different authors have proposed that intravertebral pressure (IP) is an important factor determining the risk for leakage, although so far only limited information has been gathered from clinical and experimental studies. There is also a lack of understanding of the IP during conventional interventions in VP and KP in the clinic. ⋯ This study showed that the IP of compressed vertebrae was significantly higher than that of adjacent normal vertebrae. There was a significant increase in IP during the PMMA filling in VP and KP; the IP of compressed vertebrae was not significantly reduced by the balloon inflation in KP, and no statistically significant differences in IP were found during all common stages of PMMA filling in VP and KP.