Pain medicine : the official journal of the American Academy of Pain Medicine
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To introduce a minimally invasive, percutaneous fluoroscopic technique for treating symptomatic zygapophysial joint (z-joint) synovial cysts. ⋯ This technical case report illustrates that puncture of an intraspinal z-joint synovial cyst using an interlaminar approach with fluoroscopic guidance may be safely performed with effective relief of radicular symptoms.
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Randomized Controlled Trial Clinical Trial
A randomized, double-blind, placebo-controlled, cross-over pilot study to assess the effects of long-term opioid drug consumption and subsequent abstinence in chronic noncancer pain patients receiving controlled-release morphine.
The long-term use of strong opioid analgesics among chronic noncancer pain (CNCP) patients remains controversial because of concerns over problematic drug use. However, previous surveys suggest that this is not necessarily the case. Therefore, we designed a controlled study to generate evidence in support of these findings. ⋯ The results suggest the existence of a group of CNCP patients whose long-term opioid consumption can be beneficial and remain moderate without them suffering from the consequences of problematic opioid drug use.
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This review was undertaken to outline the procedural limitations of the randomized controlled trials (RCTs) of radiofrequency (RF) neurotomy for low back pain. Second, the literature related to patient selection, diagnostic testing, and the technique of performing lumbar spine RF neurotomy will be critically reviewed and analyzed. Based on these analyses, diagnostic and procedural guidelines will be proposed. ⋯ The evidence-based procedural guidelines provide consistent criteria for multisite studies that could enroll a sufficiently large homogenous study cohort.