Pain physician
-
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.
-
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.
-
Multicenter Study
Short-Term Trigeminal Ganglion Stimulation in Patients with Multi-Branch Trigeminal Herpetic Neuralgia: A Pilot Study.
Trigeminal herpetic neuralgia (THN) presents with severe pain hyperalgesia and is a high-risk factor for postherpetic neuralgia (PHN). The current clinical treatments for THN are unsatisfactory, and new treatments are desperately required. ⋯ Short-term trigeminal ganglion stimulation can be used safely and effectively to treat patients with multi-branch THN and significantly reduce the occurrence of PHN.
-
Multicenter Study Observational Study
A Novel Sequential Percutaneous Radiofrequency Treatment Strategy for Drug-refractory Trigeminal Neuralgia: A Propensity Score-matched Study.
Gasserian ganglion-targeted conventional and pulsed radiofrequency treatments are percutaneous procedures performed for drug-refractory trigeminal neuralgia. However, ideal outcomes are not always achieved with these procedures; frequent postprocedural complications and therapeutic ineffectiveness are also of major concern. ⋯ Sequential radiofrequency treatment has the potential to provide effective, uncomplicated, pain-free outcomes.
-
Multicenter Study Observational Study
The Effect of Sedation on Diagnostic Lumbar Medial Branch Blocks for Facetogenic Low Back Pain: An Observational Study.
Lumbar medial branch blocks (MBB) are some of the most commonly performed pain procedures in the United States. Diagnostic MBBs are performed to confirm if the generator of low back pain is the facet joint. However, with diagnostic injections, false positive blocks may occur. ⋯ This study showed that midazolam did not change patients' perceived intensity of pain following MBB, as well as false positive rates after RFA. Larger studies are required to draw definitive conclusions.