Pain physician
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Observational Study
Predictive Factors of Chronic Post-Surgical Pain at 6 Months Following Knee Replacement: Influence of Postoperative Pain Trajectory and Genetics.
The frequency of chronic postsurgical pain (CPSP) after knee replacement remains high, but might be decreased by improvements to prevention. ⋯ Our findings suggest that several preoperative and postoperative characteristics could be used to facilitate the identification of patients at high risk of CPSP after knee surgery. All therapeutic strategies decreasing APOP, such as anxiety management or performing knee replacement before the pain has a serious effect on ability to walk, may help to decrease the risk of CPSP. Further prospective studies testing specific management practices, including a training program before surgery, are required.
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No studies to date have compared bone mineral density (BMD) changes after epidural steroid injection (ESI) between postmenopausal patients taking antiosteoporotic medication and those who are not. ⋯ Our data provide new evidence indicating that ESI causes BMD changes in postmenopausal women who do not take antiosteoporotic medication. Thus, we recommend that prophylactic antiosteoporotic treatment be considered for postmenopausal women who require ESI treatment.
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Painful vertebral compression fractures (VCF) caused by osteoporosis are a common health problem in the elderly population. If conservative treatments are unsuccessful, surgical treatments like vertebroplasty or kyphoplasty are recommended. But the use of Polymethylmethacrylat (PMMA) bone cement for augmentation surgery is associated with risks. ⋯ The study results demonstrate that the clinical outcome of VAS and ODI of using the silicon polymer VK100 is comparable or slightly better than using PMMA. VK 100 shows a trend to minor additional fractures during the follow-up. However, height restoration is not satisfactory in comparison to PMMA, although vertebral height stayed more or less constant in the VK group. To address the augmentation success further, it would be necessary to study a larger patient group over a longer study period and to assess additional parameters such as bone density and injected amount of filling material.
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Observational Study
High-Resolution Three-Dimensional Computed Tomography for Assessing Complications Related to Intrathecal Drug Delivery.
The assessment of the functionality of intrathecal drug delivery (IDD) systems remains difficult and time-consuming. Catheter-related problems are still very common, and sometimes difficult to diagnose. ⋯ High-resolution 3D CT VRT is a non- invasive method that can identify IDD-related complications with more precision than axial CT and fluoroscopy.
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It is important to understand the anatomical relationship between the medial and lateral branches of superficial radial nerve (SRN) and the first dorsal compartment to prevent and minimize possible injury to these nerves during various procedures around the tip of radial styloid process (RSP). ⋯ Due to the anatomical proximity of the branches of the SRN and the first dorsal compartment around the RSP, physicians must be cautious during procedures near this location. It is important to approach from above the EPB, rather than from above the APL, when performing blind procedures, although ultrasound guidance is preferable.