Pain physician
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Comparative Study Observational Study
A Novel Inextensible Endoscopic Tube Versus Traditional Extensible Retractor System in Single-Level Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Prospective Observation Study.
Currently, various retractor systems are widely used for access to the lumbar spine in minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). Nevertheless, studies concerning the comparison of extensible retractor and inextensible tube systems are quite rare. ⋯ Minimally invasive, endoscopic, lumbar interbody fusion, tubular, multifidus muscle.
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The surgical selection for patients with lumbar disc herniation (LDH) with Modic changes (MCs) is still contentious. Percutaneous endoscopic lumbar discectomy via a transforaminal approach (TF-PELD) as a representative minimally invasive spine surgery technique for LDH has been standardized. However, its efficacy has not been thoroughly described in the patients with LDH with MCs. ⋯ Modic changes, Modic type 1, Modic type 2, transforaminal percutaneous endoscopic lumbar discectomy, lumbar disc herniation, back pain, recurrence, complication.
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Opioid medications are frequently used effectively for analgesia in acute settings, however, they are associated with dependence and addiction, and were implicated in 47,600 American fatalities in 2017. Evidence suggests that despite guidelines and professional body recommendations, acute prescribing remains highly variable. Educational interventions targeting prescribers have potential to optimize prescribing in-line with evidence-based best practice. ⋯ Opioids, education, physician education, prescriber education, opioid education, opioid prescribing, systematic review, prescriptions, prevention.
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Dry needling (DN) is a commonly used technique by clinicians for the treatment of mechanical neck pain (MNP) by targeting trigger points and nontrigger point structures. It is a skilled intervention that uses a thin ?liform needle to penetrate the skin and stimulate underlying trigger points, muscular and connective tissues without the use of injectate. Another popular treatment technique used in the management of musculoskeletal pathologies is kinesiotaping (KT). Although its popular, there is minimal scientific evidence supporting KT for neck pain. Although there are a few studies regarding KT for neck pain in literature, there is a lack of randomized, controlled studies evaluating KT for neck pain. ⋯ Dry needling, kinesiotaping, mechanical neck pain, quality of life.
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General anesthesia (GA), which is routinely applied in patients who undergo percutaneous endoscopic interlaminar lumbar discectomy (PEILD) of L5-S1 disc herniation, is closely associated with postoperative cognitive dysfunction (POCD) in the elderly. Local anesthesia (LA) is an alternative pain control protocol that has not yet been fully evaluated. ⋯ L5-S1 disc herniation, older patients, percutaneous endoscopic interlaminar lumbar discectomy, local anesthesia, general anesthesia, postoperative cognitive dysfunction, American Society of Anesthesiologists grade, Oswestry Disability Index, MacNab Criteria, Mini-Mental State Examination.