Pain practice : the official journal of World Institute of Pain
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Transforaminal epidural steroid injection (TFESI) can be used to control radicular pain following lumber spinal stenosis (LSS). However, limited information is available on the long-term prognosis of TFESI in patients with LSS. ⋯ The prognosis after TFESI for controlling LSS-induced radicular pain is thought to be relatively poor. However, considering poor long-term outcome and complications after surgery, we believe that TFESI is worth considering as a safe modality for controlling radicular pain following LSS.
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The goal of the present study was to explore additional evidence of validity of the Serbian version of the Central Sensitization Inventory (CSI), a patient-reported outcome measure of symptoms that have been found to be associated with central sensitization (CS). The CSI has been found to be psychometrically sound, and has demonstrated evidence of convergent and discriminant validity in numerous published studies and in multiple languages. ⋯ The current study successfully demonstrated additional evidence of the convergent and discriminant validity of the Serbian version of the CSI.
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A method for modeling the acute pain trajectory using the simple linear fit of an individual's pain intensity scores after surgery was developed and affords more precise measurement than conventional pain assessment. However, the method has the disadvantage of using only the slope without considering the intercept. The purpose of this study was to verify our modification of the pain trajectory model including slope and intercept and to identify clusters. ⋯ Our results suggest that the pain trajectory using the slope and intercept is quite useful for predicting postoperative pain at 30 days after surgery. Additionally, patients were classified into 4 groups using the slope and intercept. By considering both the slope and intercept, clinicians may be able to detect the risk for prolonged pain earlier than other methods.
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Multicenter Study Clinical Trial Observational Study
Prospective, Multicenter Feasibility Study to Evaluate Differential Target Multiplexed SCS Programming in Subjects with Chronic Intractable Back Pain with or Without Leg Pain.
This prospective, open-label, multicenter study evaluated the feasibility of spinal cord stimulation (SCS) therapy programming for chronic low back pain that uses multiple electrical pulsed signals (Differential Target Multiplexed). ⋯ In this difficult-to-treat patient population, subjects reported significant reduction in chronic back pain when using multiplexed programming. A randomized clinical trial is needed to confirm the results from this feasibility study.
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Dorsal root ganglion stimulation (DRG-S) has emerged as a treatment for complex regional pain syndrome (CRPS) of the lower extremities, and recent small studies are demonstrating its potential efficacy in pain syndromes that are traditionally considered nociceptive in nature, such as axial low back pain. While improvements in neuromodulation technology have been substantial over the past decade, with DRG-S systems patients occasionally require additional interventional pain treatments for treatment of pain from other sources. Radiofrequency ablation (RFA) of medial branch nerves innervating the facet joints is an accepted therapy for pain arising from the facet joints. ⋯ RFA can interfere with implanted DRG-S systems, resulting in overstimulation with motor recruitment. Specific anatomical considerations and device settings that may prevent interference are discussed.