Articles: back-pain.
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Ugeskrift for laeger · Jan 2014
[Implementation of the Danish national database Danespine for spinal surgery].
The purpose of this study was to evaluate the response rate at one year follow-up in Danespine (DS) and the outcome after spine surgery. Medical charts were compared to the number of patients in DS. Outcome was measured in pain reduction for legs/back and the improvement in EuroQol (EQ-5D) score. 99.5% of the patients were registered in DS at the time of surgery, 83.7% at one year follow-up. ⋯ The patients' EQ-5D score improved from 0.33 to 0.62. The complication rate was 12.7%. We have implemented DS in order to evaluate the patient satisfaction after surgery, and the patients' benefit from spine surgery.
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Reg Anesth Pain Med · Jan 2014
Comparative StudyMagnetic Positioning System and Ultrasound Guidance for Lumbar Zygapophysial Radiofrequency Neurotomy: A Cadaver Study.
Chronic low back pain related to degenerative spondylosis is commonly managed by the radiofrequency ablation of sensory nerves. Fluoroscopic guidance has been considered mandatory to ensure placement of the active tip of the cannula parallel to the nerve to provide adequate neurolysis. Conversely, analgesic (or diagnostic) blockade is usually accomplished by placing the needle perpendicular to the nerve using either fluoroscopy or ultrasound (US) guidance. The recently introduced disposable equipment of internally cooled radiofrequency allows the denervation procedure to be performed similarly to the routine diagnostic block. Consequently, US may now potentially be used for image-guided radiofrequency neurotomy. We sought to compare the accuracy using a novel US-based technique with the traditional fluoroscopy-guided placement. ⋯ A magnetic positioning system allows accurate and quick US-guided placement of radiofrequency cannula to the desired anatomical targets, sparing patients and personnel from exposure to ionized radiation.
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Anesthesia and analgesia · Jan 2014
Multicenter StudyEpidural lysis of adhesions for failed back surgery and spinal stenosis: factors associated with treatment outcome.
Failed back surgery syndrome (FBSS) is a challenging problem. One treatment advocated to treat FBSS is epidural lysis of adhesions (LOA). The results of studies examining LOA for FBSS have been mixed, but are limited because no study has ever sought to identify factors associated with outcomes. ⋯ Considering our modest success rate, selecting patients for epidural LOA based on demographic and clinical factors may help better select treatment candidates. Procedural factors such as the use of hyaluronidase that increase risks and costs did not improve outcomes, so further research is needed before these become standard practice.
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The Ochsner journal · Jan 2014
Midline minimally invasive placement of spinal cord stimulators: a technical note.
Spinal cord stimulators (SCSs) have conventionally been implanted through open approaches requiring extensive muscle dissection to perform laminectomies and permanently place the paddle lead. This approach could contribute to worsening the pain syndrome in patients who experience chronic pain. In an attempt to reduce operative times, minimize blood loss and postoperative pain, and ease the technical challenges of placing the paddle lead in the midline via a paramedian and off-midline incision, we designed a new minimally invasive surgery (MIS) technique to place the paddle lead using a tubular retractor system through a true midline approach. ⋯ Our technique is safe and effective and carries minimal surgical morbidity compared to standard open techniques for placement of SCSs.