Pain physician
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There are controversies about the optimal management of AO subtype A3 burst fractures. The most common surgical treatment consists of posterior fixation with pedicle screw and rod augmentation. Nevertheless, a loss of correction in height restoration and kyphotic reduction has been observed. ⋯ This study showed that using a PIETI in the treatment of fractures type A3 is a safe and effective method that allows marked clinical improvement, as well as anatomical vertebral body restoration. Unlike with other treatments, results were maintained over time, allowing a better long-term clinical and functional improvement. The rate of cement leakage was lower than other reports.
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In order to clarify the camera image and open the adhesions mechanically during epiduroscopy, saline is injected continuously in the epidural area. As a result, an increase in intracranial pressure is to be expected in theory. Increased intracranial pressure can be evaluated by measuring by optic nerve sheath diameter. ⋯ We think more prospective randomized controlled studies are required to examine the increase in the diameter of the optic nerve sheath, which is an indirect indicator of increased intracranial pressure after epiduroscopy applications, in order to determine whether the pressure increase is associated with the rate of fluid delivery, the total fluid amount, or the processing time.
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Interventional radiofrequency (RF) ablation techniques are indicated when an adequate effect is not obtained with conservative measures. ⋯ RF denervation of the sacroiliac joint is effective and promotes a long-lasting analgesic effect.
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Spinal cord stimulation has been utilized with increasing frequency in managing chronic intractable spinal pain and complex regional pain syndrome (CRPS) in addition to other neuropathic pain states. The literature has shown the effectiveness of spinal cord stimulation in managing chronic pain with improvement in quality of life and cost utility. There have not been any reviews performed in the fee-for-service (FFS) Medicare population in reference to utilization and expenditure patterns of spinal cord stimulators. ⋯ The analysis of spinal cord stimulators in the FFS Medicare population from 2009 to 2018 showed explosive increases of trials, implants and overall costs.
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The COVID-19 infection poses a serious threat to global health for millions of people. In addition to therapeutic treatment methods, preventive measures are also important in controlling the pandemic. As a result, billions of people are quarantined in their homes to prevent the spread of coronavirus. However, social isolation may result in immobility, which can lead to musculoskeletal problems and an increased level of pain, depending on the weakness of the muscles. ⋯ Social isolation has had an increasing effect on low back pain during the COVID-19 pandemic. The results of our study showed a significant relationship between activity level and pain intensity. We also found that patients who have benefited from spinal injections administered in the prepandemic period experience less severe low back pain during the pandemic.