Pain physician
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Dorsal root ganglion stimulation (DRGS) is an established method for treating persistent and severe pain conditions. However, performing DRGS has significant challenges. Current DRGS systems are expensive, hindering accessibility for many patients and health care systems. Additionally, placing DRGS devices requires specialized training in epidural techniques and lead anchoring methods. Technical and financial requirements also limit the clinical applicability and availability of DRGS. ⋯ To our knowledge, this feasibility cadaver study is the first of its kind to examine the accuracy and efficiency of a fluoroscopy-guided transforaminal approach to place injectable electrodes near the DRG. These promising results suggest that this method could be a viable alternative to existing DRGS techniques, warranting further investigation into its clinical potential.
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Kümmell disease (KD)-a rare and relatively complex spinal condition-is a type of posttraumatic osteoporotic vertebral compression fracture manifesting as a delayed collapse of a vertebral body. Although most patients with KD present with pain in the fracture area, some present with pain in the rib region or distal lumbosacral region, without pain in the fracture area, which poses challenges for diagnosing and treating KD. ⋯ Patients with Stage I or Stage II KD may experience pain distal to the fracture area, which may effectively be alleviated by percutaneous kyphoplasty.
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Randomized Controlled Trial
A Randomized Double-blind Trial of 5% Dextrose Versus Corticosteroid Hydrodissection for Meralgia Paresthetica.
Ultrasound-guided 5% dextrose (D5W) hydrodissection provides favorable outcomes for treating peripheral entrapment neuropathies; its safety is well recognized. However, clinical evidence regarding the use of D5W hydrodissection for meralgia paresthetica (MP) is limited. Although corticosteroids are the most common injectates, the possible adverse effects are a big concern. ⋯ Ultrasound-guided perineural injection therapy of D5W is more beneficial than corticosteroid injection for MP at 4 to 6 months posttreatment. Additionally, D5W displays a better safety profile than corticosteroid. Thus, we suggest D5W as a more suitable injectate for patients with MP.