Pain physician
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Percutaneous endoscopic cervical discectomy has evolved as an efficient, minimally invasive spine surgery for radiculopathy caused by soft and/or osseous foraminal stenosis. Although interlaminar access can be used to resect lateral herniated lesions or osteophytes located in the foramina, with limited operative space, nerve retraction may be unavoidable. This procedure may injure the nerve root and cause postoperative arm pain, numbness, and muscle weakness, especially when the herniation is located in the ventral nerve root or when there is a massive osteophyte in the foramina. However, posterior partial cervical pediculectomy under endoscopy provides a new approach to effectively reduce or even avoid nerve retraction and reduce the potential risk of nerve injury. ⋯ Cervical disc herniation, foraminal stenosis, percutaneous endoscopic cervical discectomy, PECD, P-PECD, partial pediculectomy.
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Cooled radiofrequency ablation (CRFA) in a randomized, prospective study demonstrated significantly greater improvements in pain, functional, and global outcome measures. ⋯ Radiofrequency ablation, chronic knee pain, knee osteoarthritis.
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Interlaminar and transforaminal epidural steroid injections (ILESI and TFESI) are commonly performed procedures. However, the United States Food and Drug Administration has required the addition of drug warning labels for injectable corticosteroids. Updated evidence and scrutiny from regulatory agencies may affect practice patterns. ⋯ Epidrual steroid injections, transforaminal epidural steroid injection, steroids, local anesthetic, survey, interventional pain.
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Scoliosis secondary to lumbar disc herniation (LDH) may occur in both adolescents and adults. As the spine is more flexible in adolescents than in adults, the curve features and curve evolution could be different between these 2 cohorts, which were unclear. ⋯ Sciatic scoliosis, lumbar disc herniation, adolescent, adult, resolution, lumbar discectomy.
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The current opioid epidemic is perhaps the greatest public health crisis in the United States. Although multiple factors led to the rise of this epidemic, it is without question associated with the rise in opioid prescribing. ⋯ Opioid, opioid epidemic, opioid utilization.