Pain physician
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Laser ablation under an epiduroscopic view allows for the vaporization of a small amount of the nucleus pulposus, causing a reduction in intradiscal pressure and relief of radicular pain. Currently, Ho:YAG and Nd:YAG lasers are commonly used for spinal diseases. However, the use of the Nd:YAG laser for intra-spinal procedures can be limited because of thermal injury and low efficacy. ⋯ The 1414 nm Nd:YAG laser can be used effectively and safely under the guidance of a spinal epiduroscope in an in vivo porcine model and in a human cadaveric model. STUDY APPROVAL: Approval for the current study was granted by the Institutional Review Board of our institute (approval number: 1-2014-0049).
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Review Meta Analysis
Manual Therapy for Hip Osteoarthritis: A Systematic Review and Meta-analysis.
Hip osteoarthritis (HOA) is one of the major causes of disability in seniors and is costly to society. Manual therapy is one therapeutic approach to treating HOA. ⋯ This review did not suggest there was enough evidence for manual therapy for the management of HOA. However, we are not confident in making such a conclusion due to the limitations listed above.
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Review Meta Analysis
Invasive Management for Pediatric Complex Regional Pain Syndrome: Literature Review of Evidence.
Complex regional pain syndrome (CRPS) is a multifactorial condition with complex pathogenesis characterized by spontaneous or stimulus-induced pain that is disproportionate to the inciting event. It is also commonly accompanied by a myriad of autonomic and motor disturbances in highly variable combinations. This condition has been underreported in children until recently. Consequently, the management of CRPS in the pediatric population presents an even greater challenge than in adults, partly because there is a lack of clinical data concerning the efficacy of the diverse treatment methods available, and partly because successful treatment of CRPS involves a multidisciplinary approach. There is a variety of invasive methods to the treatment of CRPS, but scarce pediatric-focused trials have been published to date. ⋯ Invasive techniques have been used to treat CRPS over the last few decades; however, the evidence for their use is still very weak. Invasive management should be contemplated only when high-standard conservative management has failed to work.
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Review Meta Analysis
Coxib's Safety in Patients with Inflammatory Bowel Diseases: A Meta-analysis.
Patients with inflammatory bowel diseases (IBD) frequently have extraintestinal manifestations including arthritis, sacroiliitis, and ankylosing spondylitis. While the treatment of these rheumatological conditions with traditional non-steroidal anti-inflammatory drugs (NSAIDs) has been reported to lead to frequent IBD exacerbation, the safety of cyclooxygenase-2 (COX-2) inhibitors (Coxibs) remains unclear. ⋯ This meta-analysis showed that Coxibs are safe in most patients with IBD. Controlled trials of Coxibs compared with NSAIDs would be useful, at least in patients suffering from rheumatic pain refractory to standard treatment.