Pain physician
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Observational Study
Microendoscopic Discectomy Combined with Annular Suture Versus Percutaneous Transforaminal Endoscopic Discectomy for Lumbar Disc Herniation: A Prospective Observational Study.
Microendoscopic discectomy (MED) and percutaneous transforaminal endoscopic discectomy (PTED) are 2 of the most popular minimally invasive spinal surgery techniques. We are investigating whether minimally invasive early annular closure can achieve a better clinical effect in the treatment of lumbar disc herniation (LDH). ⋯ PTED has the advantages of shorter length of incision, shorter operation time, and shorter length of stay. MED + annular suture is associated with greater preservation of disc height, and showed certain advantages of lower recurrence rate, although there was no statistical difference.
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Chronic pain syndromes are poorly understood and challenging to treat. However, intrathecal drug delivery systems (IDDS) have been shown to have good efficacy in treating various pain subtypes and patient populations. The success of IDDS interventions is largely dependent on consideration of and adherence to varying practice patterns. ⋯ Incorporation of the principles found in this evidence-based narrative, which is comprised of the highest level of evidence supportive of various facets of IDDS practice management, is essential to optimize outcomes, treatment efficacy, and safety profiles.
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Gene polymorphism is an important factor affecting the efficacy and dosage of opioids. A recent study showed RETN rs3745367 was associated with postoperative pain intensity. OPRM1 gene was confirmed to affect the postoperative analgesic consumption of morphine and other opioids. ⋯ RETN rs3745367 was associated with postoperative average pain intensity, OPRM1 rs2075572 and rs9322447 may influence postoperative maximal pain intensity.