Pain physician
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Controversy is not uncommon in the diagnosis of discogenic low back pain (DLBP) and in the identification of the location of the pain source for the symptomatic disc in patients with DLBP. Various techniques, from minimally invasive procedures to fusion surgery, are used to treat chronic DLBP, but the clinical outcomes are variable. Percutaneous endoscopic discectomy by transforaminal or interlaminar approach is considered to be an effective method to treat DLBP, but the evidence is limited; the lack of clear evidence may be associated with patient selection and surgical technique. ⋯ Transforaminal, interlaminar, outside-in technique, endoscopic discectomy, discogenic low back pain.
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The sacroiliac joint complex (SIJC) is considered a major sources of chronic low back pain. Interventional procedures for sacroiliac (SI) joint pain tend to be short-lived and surgical treatment usually involves a fusion procedure. ⋯ Endoscopic spine surgery, minimally invasive, low back pain, sacroiliac joint, radiofrequency treatment.
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Observational Study
Uncinate Process Area as a New Sensitive Morphological Parameter to Predict Cervical Neural Foraminal Stenosis.
Hypertrophy of the uncovertebral joint has been considered as a major cause of cervical neural foraminal stenosis (CNFS). The cross-sectional area of the uncinate process is a key morphologic parameter in the identification of uncovertebral joint hypertrophy. To evaluate the connection between CNFS and the uncinate process, we devised a new morphological parameter, the uncinate process area (UPA). ⋯ The newly devised UPA is a sensitive parameter for assessing CNFS. A hypertrophied UPA is associated with an increased risk of CNFS. We think that this result will be helpful for diagnostic radiology in evaluating patients with CNFS.Institutional Review Board (IRB) approval number: IS16RISI0002KEY WORDS: Uncinate process area, cervical neural foraminal stenosis, Uncovertebral joint hypertrophy, optimal cut-off point, cross- sectional area.
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Despite the existence of several screening tools for neuropathic pain, none of these are specific to surgery. We have developed a simple questionnaire tool, the Neuropathic Pain scale for Postsurgical patients (NeuPPS), to measure neuropathic pain in postsurgical patients. ⋯ Scale validation, Rasch analysis, item response model, persistent postoperative pain, intercostobrachial nerve, neuropathy, neuropathic pain, quantitative sensory testing, breast cancer.
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The facet joints contribute to chronic cervical spine pain in an estimated 55% of chronic neck pain cases and can be treated with percutaneous radiofrequency neurotomy (PRN). Damage to surrounding structures during treatment or successful treatment of the primary pain source leading to unmasking could lead to new onset of pain, including cervicogenic headache (CGH). In this study, we aimed to define the incidence of headache in patients who have been previously treated with PRN for lower cervical facet pain. ⋯ Cervical spine, facetogenic pain, percutaneous radiofrequency neurotomy, cervicogenic headache, chronic pain, zygapophysial joints, innervation convergence, retrospective chart review.