Pain physician
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COVID-19 quarantine measures have created new challenges in the delivery of medical care, especially in the realm of medical and interventional chronic pain management. This study evaluated the effect of COVID-19 social distancing and quarantine measures on symptoms of pain and anxiety, as well as substance abuse and health care engagement in patients with chronic pain and the role of the clinic's virtual assessment initiatives in managing these patients. ⋯ The survey conducted among high-utilizers demonstrated that patients who remained engaged with their health care team reported minimal concerns regarding chronic pain and associated symptoms during the COVID-19 quarantine period. In addition, the early implementation of virtual consults in the pain clinic may have contributed to mitigating patient concerns. Finally, the study also identified the importance of outreach and patient education on the availability and utilization of telemedicine services. Consequently, it is reasonable to implement virtual assessments and visits alongside other education outreach methods to engage patients with chronic pain who frequently utilize chronic pain health care resources.
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Numerous animal models of intervertebral disc (IVD) degeneration have been proposed in the literature. The rat caudal disc has been used in disc degeneration studies because of its low cost and simplicity. However, no consensus on the size of the needle to be used during this process has been reached, yet. ⋯ We conclude that the size of the needle affects the onset and the progression of disc degeneration; a larger needle size leads to a more extended histological and radiographic degeneration within the IVD and in a relatively short time. Therefore, a 21G needle is an optimal choice to induce rapid degeneration in rats' caudal discs. However, the use of a 29G needle failed to establish a degenerative IVD model, which makes it ideal for IVD injection of drugs, plasmids, and growth factors. A 25G needle may be used to induce gradual degeneration.
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Comment Letter Randomized Controlled Trial Multicenter Study
Comment on "Safety and Efficacy of Platelet Rich Plasma for Treatment of Lumbar Discogenic Pain: A Prospective, Multicenter, Randomized, Double-blind Study".
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Controlled Clinical Trial
Comparison of Unilateral and Bilateral Percutaneous Kyphoplasty for Bone Cement Distribution and Clinical Efficacy: An Analysis Using Three-Dimensional Computed Tomography Images.
Percutaneous kyphoplasty (PKP) is an effective treatment for osteoporotic vertebral compression fractures (OVCF). Comparisons of different approaches have previously focused primarily on x-rays. Three-dimensional (3D) computed tomography (CT) enables better imaging evaluation of bone cement distribution. ⋯ While unilateral PKP was as effective as bilateral PKP, it had a shorter operation time. However, the bilateral PKP approach might be followed when bone cement is distributed in only one side following the unilateral PKP procedure.
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Postherpetic neuralgia (PHN) is a common complication after herpes zoster infection. While conventional dorsal column temporary spinal cord stimulation (tSCS) has been shown as an effective treatment option for this pain condition, recent data suggests ipsilateral temporary spinal nerve root stimulation (tSNRS) as a safe alternative for treating PHN. However, there is no direct clinical comparison between the newer tSNRS and the traditional tSCS. ⋯ While tSNRS provides similar therapeutic efficacy compared to tSCS for patients with unilateral PHN; it offers several technical advantages. These advantages include shorter procedure time, less radiation exposure, fewer implanted electrodes, more effective stimulation, and lower overall cost.