Pain physician
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Low back pain is a highly prevalent condition with substantial costs. Superior cluneal neuralgia is present in up to 14% of low back pain cases. This etiology of back pain is often overlooked because the symptoms of superior cluneal neuralgia manifest similarly to those of other conditions, such as radiculopathy and sacroiliac joint pain. Peripheral nerve stimulation (PNS) is an emerging pain management modality used to treat various chronic pain conditions. This retrospective study will examine the outcomes of patients who have back pain caused by neuralgia and are treated with the permanent Freedom® PNS System (Curonix LLC) at the superior cluneal nerve. ⋯ When used to target the superior cluneal nerve, the Curonix Freedom® PNS System is an effective and safe treatment for neuralgia-caused chronic lower back pain resistant to conservative therapy.
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Multicenter Study Clinical Trial
Composite Treatment Response from a Prospective, Multi-Center Study (US-nPower) Evaluating a Miniature Spinal Cord Stimulator for the Management of Chronic, Intractable Pain.
Measures of therapeutic efficacy in pain studies have historically focused on pain scores, such as the Visual Analog Scale (VAS) or the Numeric Rating Scale. However, pain scores capture a univariate measure of a multivariate condition present in patients with chronic pain, where the pain condition can affect activities of daily living, sleep, quality of life, and mood. Hence, examining composite endpoints, which incorporate outcomes from multiple facets of pain, may allow investigators to better assess improvements in chronic pain patients with various new treatments. ⋯ In the face of improving spinal cord stimulation pain outcomes, composite PROs are likely to become more common in evaluating therapeutic response. Responder rates, defined by the MCID, may help to establish composite endpoints. Since MCID was achieved across a variety of endpoints indicates that treatment with the Nalu Neurostimulation System provided a robust treatment response.
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Multicenter Study
Nucleus Pulposus Allograft Supplementation in Patients with Lumbar Discogenic Pain: Initial 6-month Outcomes from a Prospective Clinical Pilot Study.
Preventing disc degeneration remains a clinical challenge; patients experiencing chronic lumbar discogenic pain have limited treatment options. Minimally invasive intradiscal procedures such as allogeneic nucleus pulposus (NP) injection have the potential to fill the treatment gap between failed conservative care and spine surgery. ⋯ These pilot findings demonstrate the feasibility of treating patients with symptomatic lumbar disc degeneration with a single intradiscal injection of allogeneic NP to provide significant and durable improvements in back function and pain.
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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.