Pain physician
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Observational Study
Cost-effectiveness of Radiofrequency Denervation for Zygapophyseal Joint Pain.
Chronic pain is a leading cause of disability. Radiofrequency denervation (RFD) is effective when performed according to guidelines for patients with correctly diagnosed zygapophyseal joint pain (ZJP). However, the cost-effectiveness of this method has not been fully explored. ⋯ Patients referred for RFD in Sweden report extremely low HRQoL. HRQoL significantly increased following RFD in patients with ZJP. Medications and health care consumption decreased after RFD. RFD was cost-effective, and the sensitivity analysis yielded stable results in different scenarios. Therefore, RFD is a cost-effective treatment that meets the Swedish National Board of Health and Welfare criteria for a high priority treatment.
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There is a debate on the long-term outcomes of surgical decompression for lumbar spinal stenosis (LSS) as compared to conservative treatment, with even more limited outcomes in repeat surgeries. Hence, other less invasive treatment modalities, such as neuromodulation with a modern spinal cord stimulator (SCS), could be considered in the spectrum of management options for symptoms of neurogenic claudication (NC) related to LSS as an alternative to surgery. ⋯ With modern SCS techniques, the majority of patients can achieve sustained improvement of symptoms of NC of at least a 2-year duration regardless of previous history of lumbar decompressive surgery. SCS can be considered as part of the conservative treatment options before committing to surgical decompression.
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The supraorbital foramen or notch is located at the superior orbital rim. Previous studies have reported anatomical variations in these structures. However, the results varied depending on races and the measurement method used. ⋯ Supraorbital notch was more frequently found than the supraorbital foramen. The supraorbital notch had a wider diameter and was more centrally located than the supraorbital foramen.
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The traditional treatment for an instrumented vertebral fracture involves removing the loosened pedicle screws and extending the posterior instrumentation cephaladly or caudally. There has been a recent trend of performing minimally invasive fluoroscopy-guided percutaneous vertebroplasty as a salvage procedure. ⋯ Minimally invasive fluoroscopy-guided percutaneous vertebroplasty can be used as an alternative to extension of posterior instrumentation for instrumented vertebral fracture. It has several advantages, including a shorter operating time, earlier postoperative ambulation, less blood loss, and a shorter hospital stay. The clinical outcomes of these 2 treatment approaches were similar.