Neurosurgery
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Significant controversy exists regarding when an athlete may return to contact sports after anterior cervical discectomy and fusion (ACDF). Return-to-play (RTP) recommendations are complicated due to a mix of medical factors, social pressures, and limited outcome data. ⋯ After a single-level ACDF, an athlete may return to contact sports if there are normal findings on a neurological examination, full range of neck movement, and solid arthrodesis. There may be an increased risk of the development of adjacent segment disease above or below the level of fusion. Cord hyperintensity may not necessarily preclude RTP.
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Resiniferatoxin (RTX), an excitotoxic agonist for vanilloid receptor 1, is a promising candidate for intractable pain treatment. ⋯ The pathway of NGF-TrkA expressed in the small-size neurons, associated with neuropathic pain, was shifted to the NGF-p75 pathway expressed in the large-size neurons after RTX treatment, in association with neuropathic pain inhibition. These findings may play an important role in clinical trial designs.
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Controlled Clinical Trial
Cognitive functioning, emotional processing, mood, and personality variables before and after stereotactic surgery: a study of 8 cases with chronic neuropathic pain.
Stereotactic central lateral thalamotomy (CLT) has been applied as a treatment for chronic intractable neuropathic pain. However, it is not clear whether this intervention influences the emotional and cognitive impairments observed in patients who have chronic neuropathic pain. ⋯ For our patients with chronic neuropathic pain, CLT provided pain relief and reduction of their depression scores without causing postsurgical cognitive impairments.