Pain physician
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Case Reports Multicenter Study
Four Complications Associated with Lateral and Oblique Fusion Treatable with Endoscopic Spine Surgery: Technical Note and Case Series.
The lateral fusion procedure is a newer minimally invasive approach to indirectly decompressing and fusing a lumbar motion segment. As with many new procedures, new thoughtful approaches to recognizing and treating the complications of these procedures need to be developed. ⋯ Transforaminal endoscopic surgery is a useful minimally invasive surgical technique to treat several complications associated with lateral and oblique lumbar interbody fusion procedures.
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Thoracolumbar or caudal epidural anesthesia affects intracranial pressure (ICP) in both animals and humans. Epidural injection increases ICP at least transiently. Measurement of the optic nerve sheath diameter (ONSD) using ultrasonography is one of the noninvasive methods for ICP assessment. ⋯ Thoracic epidural injection of 10 mL of normal saline resulted in a significant increase of ONSD compared with the baseline. However, the different posture did not affect the increase of ONSD.
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Research into cervical spinal pain syndromes has indicated that the cervical facet joints can be a potent source of neck pain, headache, and referred pain into the upper extremities. There have been multiple diagnostic accuracy studies, most commonly utilizing diagnostic facet joint nerve blocks and an acute pain model, as Bogduk has proposed. Subsequently, Manchikanti has focused on the importance of the chronic pain model and longer lasting relief with diagnostic blocks. ⋯ Based on this investigation, utilizing a chronic pain model, there was significant difference in the relief patterns. This assessment showed prevalence and false-positive rates of 49.3% and 25.6% in chronic neck pain. Duration of relief >= 80% pain relief was 6 days with lidocaine and 12 days with bupivacaine, with total relief of >= 50% of 31 days with 55 days respectively.