Pain physician
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Bone cement distribution patterns in percutaneous kyphoplasty (PKP) is the key factor in keeping the vertebral stabilization and curative effect. However, the same cement volume can result in different bone cement distribution patterns and can thereby lead to different clinical outcomes. Therefore we investigated associations between cement distribution patterns and the occurrence rates of recompression in cemented vertebrae after PKP for patients with osteoporotic vertebral compression fractures (OVCFs). ⋯ Percutaneous kyphoplasty, osteoporotic vertebral compression fracture, bone cement distribution patterns.
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Observational Study
Pressure-Induced Referred Pain as a Biomarker of Pain Sensitivity in Fibromyalgia.
Fibromyalgia (FM) syndrome is characterized by widespread pain, fatigue, and generalized increased pain sensitivity. Appropriate and simple pain models are methods employed to assess pain mechanisms that can potentially lead to improved treatments. Pressure pain thresholds (PPTs) or mapping the referred pain area produced by pressure stimulation at suprathreshold intensities are used to assess pain mechanisms. The optimal suprathreshold stimulation intensity to elicit referred pain with minimal discomfort for patients with FM has yet to be determined. ⋯ Referred pain, pain sensitivity, fibromyalgia, central sensitization, suprathreshold, pressure pain threshold, biomarker, facilitated pain mechanisms.
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Epidural steroid injection (ESI) is a common practice for pain treatment since 1953. In 2014, the FDA issued a warning about ESI. Studies have focused on the effect of the particle size and their ability to generate harmful aggregates. Although steroid aggregates provide longer times for reabsorption, therefore a longer anti-inflammatory effect, they are potentially harmful to the central nervous system via embolic mechanisms.Previous studies have established that steroidal aggregates with asizes over 100 mu m are potentially able to occlude blood vessels. Studies by Tiso et al and Benzon et al addressed the role of steroids on CNS adverse events, with similar outcomes. The main difference was on the role of aggregates with a size over 100 mu m, which Benzon et al. attributed to the ability of certain steroid preparations to rapidly precipitate and form large aggregates. ⋯ Epidural steroid injection, triamcinolone, betamethasone, dexamethasone, steroid aggregates.
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More patients with cardiac implantable electrical devices (CIEDs) are presenting to spine and pain practices for radiofrequency ablation (RFA) procedures for chronic pain. Although the potential for electromagnetic interference (EMI) affecting CIED function is known with RFA procedures, available guidelines do not specifically address CIED management for percutaneous RFA for zygapophyseal (z-joint) joint pain, and thus physician practice may vary. ⋯ Radiofrequency ablation, neurotomy, cardiac implantable electrical device, zygapophyseal joint, spondylosis, neck pain, low back pain, chronic pain.