Annales de réadaptation et de médecine physique : revue scientifique de la Société française de rééducation fonctionnelle de réadaptation et de médecine physique
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Ann Readapt Med Phys · Jun 2006
Multicenter Study[Psychobehavioural assessment for chronic low back pain].
Psychobehavioural assessment may be a complementary approach to assess response to treatment for pain and disability in patients with low back pain. ⋯ All the correlation assessments with psychobehaviour factors are weak. So evaluating each of these parameters will be interesting. Duration of pain was not correlated with increasing pain or change in behavioural strategy. Psychobehavioural factors are more invalidating than pain. More study is needed to assess psychobehavioural therapies in patients with low back pain.
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Ann Readapt Med Phys · Jun 2006
Case Reports[Transforaminal epidural steroid injection and paraplegia: case report and bibliographic review].
We report a patient in whom paraplegia developed following transforaminal epidural injection of a corticosteroid and discuss the physiopathology of this complication, based on a literature survey. ⋯ The occurrence of paraplegia following epidural transforaminal injection of corticosteroids is a rare complication. To our knowledge, only 5 similar cases have been described. Most of the authors proposed that the mechanism of this complication is ischemia of the terminal cone due to accidental suppression of medullary blood supply. Direct lesion of a medullar artery, arterial spasm, or corticosteroid-induced occlusion due to undetected intra-arterial injection could lead to this medullar infarction. Anatomical variations of the path followed by the Adamkievicz artery strongly support this hypothesis.
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Ann Readapt Med Phys · Jun 2006
Case Reports[Radiculopathy following intrathecal baclofen pump implantation].
Intrathecally delivered baclofen has been used as a treatment for severe spasticity since 1984. After a successful intrathecal baclofen trial, a programmable drug delivery system was implanted. Few early complications such as infection or hematoma are observed after this surgery. ⋯ Intrathecal baclofen therapy with a subcutaneously implanted progammable pump can be complicated by radiculalgy secondary to a conflict between the catheter and symptomatic root. The diagnosis is made by CT lumbar scan. If medical treatment is not sufficient, surgery could be proposed to replace the catheter.