Pain physician
-
Observational Study
Sacroplasty: A Ten-Year Analysis of Prospective Patients Treated with Percutaneous Sacroplasty: Literature Review and Technical Considerations.
The treatment of sacral fractures has evolved since its first description in 1982. Several techniques for sacral augmentation have been developed since 2001, and the rate of improvement is rapid with over 50% reduction in pain achieved prior to post-procedure discharge of the patient. Pain reduction occurs primarily within the first 3 months and is sustained at 12 months; however, the long-term outcomes have not previously been studied. ⋯ Sacroplasty, sacral fracture, fracture, osteoporosis, insufficiency, radiology.
-
Urine drug testing is used by health care providers to determine a patient's compliance to their prescribed regimen and to detect non-prescribed medications and illicit drugs. However, the cutoff levels used by clinical labs are often arbitrarily set and may not reflect the urine drug concentrations of compliant patients. ⋯ Urine drug testing, patient adherence, clinical toxicology, immunoassay, LC-MS, definitive drug testing, REMS, negative test results, false negative.
-
Electrical stimulation of the greater occipital nerves is performed to treat pain secondary to chronic daily headaches and occipital neuralgia. The use of fluoroscopy alone to guide the surgical placement of electrodes near the greater occipital nerves disregards the impact of tissue planes on lead stability and stimulation efficacy. ⋯ Neuromodulation, peripheral nerve stimulation, occipital nerve stimulation, occipital neuralgia, chronic daily headaches, ultrasonography.
-
Meta Analysis Comparative Study
Comparison of 7 Surgical Interventions for Lumbar Disc Herniation: A Network Meta-analysis.
The number of interventions on intervertebral discs rapidly increased and the treatment options for lumbar disc surgery quickly evolved. It is important that the safety and efficacy of all new innovative procedures be compared with currently accepted forms of treatment; however, the previous pairwise meta-analyses could not develop the hierarchy of these treatments. ⋯ This meta-analysis provides evidence that PELD might be the best choice to increase the success rate and decrease the complication rate, moreover SOMD might be the best option to drop the reoperation rate. APLD might lead to the lowest success rate and the highest complication and reoperation rate. Higher quality RCTs and direct head to head trials are needed to confirm these results.Key words: Lumbar disc herniation, discectomy, minimally invasive surgery, network meta-analysis.