Pain physician
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Randomized Controlled Trial
The Potential Impact of Venobasillar System Morphology and Applied Technique on Epidural Cement Leakage with Percutaneous Vertebroplasty.
Bone cement leakage during vertebroplasty is a frequently reported complication with the potential for neural injury. ⋯ The type of venobasillar system should be taken into account when planning a vertebroplasty procedure as a magistral type of venobasillar system is associated with the increased rate of epidural cement leakage. It is important to try and achieve a large distance between the needle tip and the midline, especially when a magistral type of venobasillar system is present, to reduce the risk of epidural cement leakage.
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Multicenter Study
A Multicenter Clinical Study on Treating Post-Dural Puncture Headache with an Intravenous Injection of Aminophylline.
Post-dural puncture headache (PDPH) is the most common complication of lumbar puncture. Aminophylline has been reported to be effective in the prevention of PDPH in some clinical studies, but its efficacy for the treatment of PDPH has been unproven. ⋯ An IV injection of aminophylline may be an effective and safe early-stage treatment for PDPH.
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Comparative Study
Percutaneous Vertebroplasty versus Conservative Treatment for One Level Thoracolumbar Osteoporotic Compression Fracture: Results of an Over 2-Year Follow-up.
We retrospectively compared the clinical and radiological results of percutaneous vertebroplasty with those of conservative treatment in the management of thoracolumbar osteoporotic compression fractures. Sixty-five patients who could be followed up for more than 2 years with thoracic and lumbar spine osteoporotic compression fractures, between January 2005 and October 2010, were reviewed. The patients were divided into 2 groups according to the type of management: group 1, non-operated group treated conservatively; group 2, operated group that underwent percutaneous vertebroplasty. ⋯ The overall VAS score and the VAS score until 6 months post-injury were statistically more improved in group 2 than in group 1 (P < 0.05 and P < 0.005, respectively). Overall, the compression ratio was statistically more improved in group 2 than in group 1 (P < 0.05). Early pain control and restoration of the compressed vertebral body are the beneficial and real effects of percutaneous vertebroplasty in patients with thoracolumbar osteoporotic compression fractures.
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Case Reports
Functional Reorganization of the Primary Somatosensory Cortex of a Phantom Limb Pain Patient.
Functional reorganization of the somatosensory system was widely observed in phantom limb pain patients. Whereas some studies demonstrated that the primary somatosensory cortex (S1) of the amputated limb was engaged with the regions around it, others showed that phantom limb pain was associated with preserved structure and functional organization in the former brain region. However, according to the law of use and disuse, the sensitivity of S1 of the amputated limb to pain-related context should be enhanced due to the adaptation to the long-lasting phantom limb pain experience. ⋯ This observation suggested the increased sensitivity of S1 of the amputated limb to the pain-related context. In addition, such increase of sensitivity was significantly larger if the context was associated with the amputated limb of the patient. In summary, our findings provided novel evidence for a possible neuroplasticity of S1 of the amputated limb: in an amputee with long-lasting phantom limb pain, the sensitivity of S1 to pain-related and amputated-limb-related context was greatly enhanced.
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Clinical Trial
Stimulation of the Spinal Cord and Dorsal Nerve Roots for Chronic Groin, Pelvic, and Abdominal Pain.
Chronic neuropathic groin pain is a common problem. It can arise following surgery or trauma, or spontaneously as part of various pelvic pain syndromes. A number of different stimulation techniques have been reported in the literature to treat this area, but due to the complex anatomy of the region, it can be difficult to target effectively with paresthesias. ⋯ Dorsal nerve root stimulation is an effective long-term treatment for neuropathic groin pain.