Pain physician
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Observational Study
Endogenous Pain Facilitation Rather Than Inhibition Differs Between People with Chronic Fatigue Syndrome, Multiple Sclerosis, and Controls: An Observational Study.
Commonalities in the core symptoms of fatigue and cognitive dysfunction experienced by chronic fatigue syndrome (CFS, also known as ME) and multiple sclerosis (MS) patients have been described. Many CFS and MS patients also experience chronic pain, which has been attributed to central sensitization in both groups of patients. However, the characteristics of pain in CFS and MS patients have not been compared. ⋯ We found differences in the characteristics of pain symptoms reported by patients with CFS and patients with MS, which suggest different underlying mechanisms. Specifically, overactive endogenous pain facilitation was characteristic of pain in patients with CFS but not in patients with MS, suggesting a greater role for central sensitization in CFS.
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Intradiscal cement leakage (ICL) is a common complication following percutaneous vertebroplasty (PVP). However, the risk factors for such a complication are under debate and there is no accurate predictive nomogram to predict ICL. ⋯ Greater fracture severity, cortical disruption of the endplate, absence of Kummell's disease, and higher CT values are the independent risk factors for ICL. The novel nomogram gives an accurate prediction of ICL.
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Although percutaneous endoscopic lumbar discectomy (PELD) is an effective treatment for herniated discs, its application in a disc with extensive migration is still challenging. As such, epiduroscopic laser neural decompression (ELND) provides a new view of the epidural space as well as an alternative treatment for a herniated disc and epidural fibrosis. In this paper the authors introduce the novel combination of PELD and ELND for high grade down-migrated disc herniation. ⋯ The patient reported significant reduction of pain after surgery. Postoperative magnetic resonance imaging (MRI) showed complete removal of the ruptured disc fragment. A combination of PELD and ELND may be an option of treatments for down-migrated disc herniation.
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Observational Study
Evaluation of Depression in Subacute Low Back Pain: A Case Control Study.
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Accurate puncture during percutaneous transforaminal endoscopic discectomy at the L5/S1 level in cases with high iliac crest and narrow foramen were difficult, even though the difficulties of foraminoplasty could be overcome by advanced instruments like reamers. ⋯ The novel isocentric navigation technique with a definite pathway is practical and effective in reducing puncture times among difficult puncture cases at the L5/S1 level, which may contribute to the capacity of PETD at the L5/S1 level.