Pain medicine : the official journal of the American Academy of Pain Medicine
-
Available percutaneous procedures for lumbar disk herniation are not sufficiently effective for large herniations. Percutaneous intradiscal high-pressure injection of saline (IDHP) is designed to tear the thinned posterior longitudinal ligament (PLL), leading to significant reduction in mechanical compression of nerves by the herniation. We evaluated the effectiveness of this new therapy for patients with refractory lumbar herniation. ⋯ IDHP leads to prompt relief of pain, with good outcome in patients with lumbar disk large herniation resistant to medical treatment.
-
To ascertain the self-reported reasons for participation in the clinical research of chronic low back pain and to evaluate those reasons in the context of informed consent and the concept of therapeutic misconception. This is the belief that research participation is equivalent to clinical care. ⋯ Assessing the adequacy of informed consent requires a thorough understanding of how subjects viewed a study and their reasons for participation. Quantitative-based surveys may not capture the complexities of reasons for study participation. Reasons of personal benefit, seemingly contradictory reasons for participation, or overriding desire for relief may all affect the quality of informed consent. Yet, these issues may not automatically signal the presence of TM.
-
To evaluate the psychometric properties of two commonly used low back pain (LBP) disability questionnaires in a sample solely comprising community-dwelling older adults. ⋯ It appears that both questionnaires have excellent test-retest reliability and good construct validity when used to evaluate LBP-related disability for older adults with varying degrees of LBP. Neither questionnaire appears to have superior psychometric properties; therefore, both the Oswestry and Quebec can be recommended for use among geriatric patients with LBP.
-
This case report outlines a significant type of morbidity due to continued use of gabapentin during an episode of acute renal failure. Setting. University teaching hospital. ⋯ All doctors need to be aware of the need to review the indications for gabapentin use during periods of acute illness, especially with regard to renal impairment. Off-label use should be discouraged.