Pain physician
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Multicenter Study
Single Level Percutaneous Vertebroplasty for Vertebral Hemangiomata - A Review of Outcomes.
Percutaneous vertebroplasty is a minimally invasive technique to treat patients with symptomatic vertebral hermangiomata. ⋯ Percutaneous vertebroplasty is associated with good post-procedural outcomes in patients with vertebral hermangiomata. Complications such as neurological injury and cement leakages are rare.
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Loss of efficacy (LOE) is a well-known phenomenon associated with spinal cord stimulation (SCS) and is the leading cause of explant. Although recent advances in neuromodulation have resulted in a decreased incidence of LOE, it still occurs. Intuition suggests that when LOE ensues, switching to a different SCS therapy/platform could potentially be a viable clinical option; however, there are no data presently available to validate this theory. ⋯ LOE is an unfortunate occurrence with few evidence-based solutions presently available to reverse it. Our findings suggest that implementing D-Burst stimulation may be an effective option for treating LOE, as well as potentially reducing opioid consumption, regardless of the prior SCS system.
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Case Reports Multicenter Study
Four Complications Associated with Lateral and Oblique Fusion Treatable with Endoscopic Spine Surgery: Technical Note and Case Series.
The lateral fusion procedure is a newer minimally invasive approach to indirectly decompressing and fusing a lumbar motion segment. As with many new procedures, new thoughtful approaches to recognizing and treating the complications of these procedures need to be developed. ⋯ Transforaminal endoscopic surgery is a useful minimally invasive surgical technique to treat several complications associated with lateral and oblique lumbar interbody fusion procedures.
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Randomized Controlled Trial Multicenter Study Clinical Trial
The Effect of Percutaneous Nucleoplasty vs Anterior Discectomy in Patients with Cervical Radicular Pain due to a Single-Level Contained Soft-Disc Herniation: A Randomized Controlled Trial.
Cervical radicular pain (CRP) is a common problem in the adult population. When conservative treatment fails and the severe pain persist, surgical treatment is considered. However, surgery is associated with some serious risks. To reduce these risks, new minimally invasive techniques have been developed, such as percutaneous nucleoplasty. Several studies have shown that percutaneous nucleoplasty is a safe and effective technique for the treatment of CRP, but until now no randomized controlled trials have been conducted that compare percutaneous cervical nucleoplasty (PCN) to anterior cervical discectomy (ACD) in patients with a single-level contained soft-disc herniation. ⋯ At 3 months, the ACD group performed significantly better on arm pain reduction than the PCN group in patients with CRP as a result of a single-level contained soft-disc hernia. However, the clinical relevancy of this treatment effect can be debated. For all parameters, after one year, no significant differences between the groups were found. When it comes to the longer-term effectiveness, we conclude that PCN can be a good alternative for ACD.
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Multicenter Study
10 kHz High-Frequency Spinal Cord Stimulation for Chronic Thoracic Pain: A Multicenter Case Series and a Guide for Optimal Anatomic Lead Placement.
Surgical options for thoracic pain are limited and carry significant risk and morbidity. Spinal cord stimulation has the potential to be used for treatment of thoracic pain, as it has been useful for treating multiple types of chronic pain. Conventional tonic stimulation is limited in the treatment of thoracic pain, as it can produce paresthesia that is difficult to localize. Conversely, high-frequency spinal cord stimulation (HF-SCS) does not activate dorsal column A Beta fibers and does not produce paresthesia, and thus may be more beneficial in treating thoracic back pain not manageable with tonic stimulation. ⋯ Thoracic pain, back pain, spinal cord stimulation, high frequency, 10 kHz.