Pain physician
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In the aging population, osteoporosis and related complications have become a global public health problem. Osteoporotic vertebral compression fractures are among the most common type of osteoporotic fractures and patients are at risk of secondary vertebral compression fracture. ⋯ Patients with low Hounsfield units value of L1 or non-spinal fracture history are an important population to target for secondary fracture prevention.
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Observational Study
Lumbar Disc Herniation is a Nonnegligible Factor for the Degeneration of Sacroiliac Joints.
Sacroiliac joint (SIJ) abnormality is a potential source of low back pain (LBP), therefore numerous patients receive various treatments because of the degenerative changes of SIJ. However, the outcome is unfavorable for patients because these morphologic alterations are common but not the origins of LBP. Previous studies revealed lumbar fusion and transitional vertebra increased the prevalence of degeneration of SIJ. Lumbar disc herniation (LDH) is one of the most common lumbar diseases, but there is no study regarding the relationship between LDH and SIJ degradation. ⋯ The SIJ degeneration in patients with LDH was more serious than in individuals without LDH. SIJ degeneration was more significant in patients with LDH with more pathological alterations, symptoms, and complications. Age and LDH relate to SIJ degeneration. Therefore the diagnosis and selection of treatment for SIJ changes should comprehensively consider the coexistence of LDH.
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In clinical practice, we have found that the pain caused by thoracolumbar osteoporotic vertebral compression fracture (OVCF) is sometimes not limited to the level of the fractured vertebrae but instead occurs in areas far away from the injured vertebrae, such as the lower back, area surrounding the iliac crest, or buttocks, and this type of pain is known as distant lumbosacral pain. The pathogenesis of pain in distant regions caused by thoracolumbar OVCF remains unclear. ⋯ Both PVP and PKP can effectively alleviate pain in the distant lumbosacral region caused by thoracolumbar OVCF, and distant lumbosacral pain associated with thoracolumbar OVCF may be considered vertebrogenic referred pain.
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Radiofrequency thermal rhizotomy demonstrates an excellent treatment outcome with a high success rate among patients of intractable trigeminal neuralgia. The triangular plexus which is an immediate retrogasserian portion of the trigeminal root is suggested as the best place of lesioning during radiofrequency thermal rhizotomy. However, the anatomy of the triangular plexus has been relatively unrecognized, while the anatomical study related to therapeutic procedure is scarce. ⋯ When an electrode tip was placed on the petroclival junction, 53% of radiofrequency thermal rhizotomy could reach the triangular plexus.