Pain medicine : the official journal of the American Academy of Pain Medicine
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Lumber punctures are a common procedure in patients with cancer. However, a potential complication of a lumbar puncture is a postdural puncture headache. The risk of neoplastic seeding to the central nervous system has led to concern over performing epidural blood patches (EBPs) for the treatment of postdural puncture headaches in patients with cancer. The goal of this retrospective study was to evaluate cancer seeding in the central nervous system in patients diagnosed with leukemia or lymphoma. ⋯ Though the risks of EBP in the cancer patient population have been hypothesized, no previous studies have assessed the risk of seeding cancer to the central nervous system. Based on our results, an epidural blood patch bears low risk of cancer seeding when used to treat postdural puncture headache that is unresponsive to conservative treatments.
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The hypotheses of this systematic review were the following: 1) Prevalence of post-traumatic stress disorder (PTSD) will differ between various types of chronic pain (CP), and 2) there will be consistent evidence that CP is associated with PTSD. ⋯ The results of this systematic review confirmed the hypotheses of this review.
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Review Meta Analysis
Sham Surgery in Orthopedics: A Systematic Review of the Literature.
To evaluate the evidence for the effectiveness of sham surgery in orthopedics by conducting a systematic review of literature. ⋯ This review suggests that sham surgery has shown to be just as effective as actual surgery in reducing pain and disability; however, care should be taken to generalize findings because of the limited number of studies.
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Randomized Controlled Trial Multicenter Study Comparative Study
Twelve-Month Follow-up of a Randomized Clinical Trial Comparing Intradiscal Biacuplasty to Conventional Medical Management for Discogenic Lumbar Back Pain.
This report conveys 12-month outcomes of subjects treated with intradiscal biacuplasty (IDB) and conservative medical management (CMM) for chronic low back pain of discogenic origin, and results for subjects who elected to receive IDB + CMM 6 months after CMM-alone. ⋯ The study demonstrated long-term clinical effectiveness of IDB + CMM for treating chronic lumbar discogenic pain. Furthermore, the cross-over study subjects experienced similar improvements in pain, function, disability, and satisfaction.
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Clinical Trial
Role of Magnetic Resonance Imaging in Ascertaining the Success of Transforaminal Epidural Steroid Injection for Lumbar Radicular Pain.
To explore the outcome differences of lumbar transforaminal epidural steroid injection (TFESI) according to magnetic resonance imaging (MRI) findings in patients with lumbar radicular pain. ⋯ TFESI was an effective treatment method in patients with radicular pain, irrespective of the type or location of disc herniation. However, greater improvement in pain may be expected at the second week in patients with HIZ and at the third month in patients with NRI.