Articles: radiculopathy.
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To determine the efficacy and safety of administering low-dose analgesic infusions through cervical epidural catheters. ⋯ Patients with chronic persistent cervical radiculopathy pain were effectively treated with infusion of analgesics through epidural catheters for 2 to 17 days while they were at home.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1994
[Epidural infiltrations in the treatment of lumbar radiculopathy. Apropos of 200 cases].
The authors report a prospective study on the treatment of radicular compression using epidural infiltrations. ⋯ Avoiding surgical treatment is not the only parameter which should be studied in evaluating the effectiveness of treatment. Lassale's pre and postoperative evaluation with a minimum 1 year follow up showed improvement in all non surgical cases. When compared to the literature, this study shows favorable long term results.
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J Bone Joint Surg Br · Nov 1993
Repeat decompression of lumbar nerve roots. A prospective two-year evaluation.
In a prospective, consecutive study 93 patients who had had previous lumbar spinal surgery underwent repeat decompression for persistent or recurrent back and leg pain. The previous operations had been discectomies in 65 patients and decompression for spinal stenosis in 28; two of the latter group had also had posterolateral fusion. At the repeat operation, disc herniation was found in 19 patients, lateral spinal stenosis in 19, central spinal stenosis in 20 and periradicular fibrosis in 35. ⋯ Nerve-root compression due to recurrent disc herniation or to bony compression responded well to repeat decompression. In patients with a single nerve-root compression the results were similar to those obtained in primary operations. Sciatica due to nerve-root scarring was seldom improved by the repeat operation.
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Based on the experimental and clinical results in the literatures and the author's experience, a working hypothesis for the pathomechanism of radicular pain is proposed. When the nerve root is involved, mechanical and circulatory changes are produced. ⋯ Disturbed or enhanced synthesis and transport of neuropeptides can also be elicited. These multifactorial changes may finally result in sensitization of both the central and peripheral nervous systems, causing radicular pain.
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A retrospective analysis was done on 100 patients who had received cervical epidural steroid injections for neck pain and cervical radiculopathy to identify the predictors of outcome after such treatment. Potential predictors of outcome were assessed individually and then simultaneously with a multiple-regression model. Patients with radicular symptoms and signs had the best pain relief in contradistinction to those with axial (neck) pain. A clinical classification model predicting the outcome and an algorithm for the use of such injections in the treatment of cervical radiculopathy were developed.