Pain physician
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Observational Study
Comparison of Radiation Doses of Contralateral Oblique and Lateral View for Fluoroscopy-Guided Lumbar Interlaminar Epidural Steroid Injection.
Despite newly developing technologies and techniques, the use of fluoroscopic guidance in spinal interventional treatments remains popular. Therefore, it is essential to set reference standards and techniques for reducing radiation exposure in fluoroscopy-guided procedures. ⋯ Although there was no difference in terms of radiation dose and duration of procedure between lumbar ILESI conducting using the CLO or lateral view fluoroscopy imaging, there was a significant difference in terms of complications. Therefore, conducting lumbar ILESI using a CLO view minimizes the complication rate.
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Chronic low back pain is widely prevalent, and there are a range of conditions that may result in the low back pain. In general, treatment of low back pain starts with conservative management such as medications, physical therapy, and home exercise regimens. If conservative measures fail, a range of interventional techniques can be employed to manage back pain. An uncommonly recognized cause of back pain is Bertolotti's syndrome which is a result of back pain due to lumbosacral transitional vertebrae (LSTV). LSTV is a congenital abnormality either characterized by the lumbarization of the sacrum where the first sacral bone fails to fuse with the rest of the sacrum or the sacralization of the lumbar spine where the L5 vertebra fuses with the sacrum creating a longer sacrum. In many cases, the condition can be recognized by imaging techniques such as an x-ray, computed tomography, or magnetic resonance imaging. ⋯ Our stepwise approach to diagnosing and managing the pain resulting from Bertolotti's syndrome is an effective method of treatment for the condition.
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Randomized Controlled Trial
Stellate Ganglion Destruction With Alcohol Versus Thermal Ablation for Chronic Post-Mastectomy Pain: A Randomized Trial.
Post-mastectomy pain syndrome (PMPS) is a persistent post-surgical neuropathic pain. Stellate ganglion (SG) block is used for diagnosis, prognosis, and treatment of pain syndrome. ⋯ US-guided SG destruction with alcohol was more effective than thermal radiofrequency for managing acute postoperative pain by decreasing pain score, oxycodone, and pregabalin consumption, which were consumed before the block.
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Spinal cord stimulator (SCS) surgeries, whether performed using the open or percutaneous approach, are becoming increasingly common for a range of neuropathic pain conditions, including post-laminectomy syndrome and complex regional pain syndrome. However, there is limited knowledge regarding the factors linked to same-day discharge patterns following SCS. ⋯ These results can be used to help determine hospital bed needs post-SCS surgery. Future research should focus on identifying the specific reasons certain demographic and geographic factors might influence same-day discharge rates. Our study provides important insights into the factors associated with same-day discharge rates post open and percutaneous SCS implant and highlights the need for patient-centered, evidence-based approaches to health care delivery.
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Since electronic cigarettes (E-Cigs) were introduced to the United States (US) in 2007 its use has increased. Like other tobacco products, E-Cigs too pose health risks. Studies have shown a correlation between pain and tobacco use, with the association being bidirectional. However, there is limited data on the effect of E-Cig use on chronic pain, as well as its association with opioid use. ⋯ In this study of chronic pain patients, cigarette smoking and E-Cig use was similar to the reported use in the general adult population in the US. The study showed a strong correlation between tobacco use, especially cigarettes and E-Cigs, and opioid use. As the use of E-Cigs becomes more mainstream, the association between E-Cig use, chronic pain, and opioid use should be monitored.