Pain physician
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Chronic low back and lower limb pain occurs in 13% of Americans, and is the leading cause of disability. Patients with this condition have a reduced quality of life, have mental health disorders, and cognitive disfunction. While back pain alone is difficult to manage, back pain with associated leg pain results in further reduced outcomes. Spinal cord stimulation (SCS) is a minimally invasive therapy that has been used for a variety of chronic pain disorders when conservative management strategies have failed. The therapy is appealing because of its ability to provide long-term relief at a reduced cost and it has low rates of serious adverse events. ⋯ The Freedom SCS System is an effective and safe therapy for treating patients with chronic back and leg pain that is resistant to conservative therapy due to nerve compression and CRPS Type I and/or II. These types of patients often report aggravation of symptoms with surgery. Minimal invasive surgery should decrease the chance of extra symptoms.
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Randomized Controlled Trial
Fluoroscopy-guided Intradiscal Radiopaque Gelified Ethanol Injection Using an Anteroposterior View Compared to an Oblique View: A Randomized Controlled Trial.
This study introduces a new fluoroscopy-guided intradiscal radiopaque gelified ethanol injection technique using the antero-posterior view and compare it to conventional oblique view. Intradiscal procedures, are minimally invasive techniques that aim to reduce pain associated with lumbar disc herniation by modifying the disc material and decreasing pressure on surrounding nerves. ⋯ An anteroposterior view radiopaque gelified ethanol injection is a promising alternative to the conventional oblique view technique for radicular leg pain management. This novel approach offers a safer and more efficient treatment option, reducing radiation exposure and procedure time without compromising clinical outcomes. Its potential to minimize patient discomfort and enhance overall management of radicular leg pain warrants further investigation and widespread adoption.
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Observational Study
Prophylactic Perioperative Fluid Infusion Strategy During Splanchnic Nerve Neurolysis to Prevent Systemic Hypotension: A Case Series of 70 Patients With Cancer.
When performing splanchnic nerve neurolysis (SNN), systemic hypotension may occur due to upper abdominal sympathetic blockade; therefore, appropriate periprocedural fluid resuscitation is crucial. ⋯ Our prophylactic perioperative fluid resuscitation for treating systemic hypotension post-SNN is sufficient and safe.