Pain physician
-
Percutaneous adhesiolysis (PA) is considered to be a reasonable nonoperative treatment for herniation of intervertebral disc (HIVD), spinal stenosis, and post-lumbar-surgery syndrome (PLSS). The success of PA depends on the removal of epidural fibrosis and drug delivery to the target region. However, prognostic predictors of the effects of PA are not well known. ⋯ Good prognostic predictors were identified as no previous lumbar surgery or root compression with HIVD or foraminal stenosis. These results are expected to contribute to the establishment of indications for PA.
-
Comparative Study
Evaluation of interaction between a spinal cord stimulator and implanted cardioverter-defibrillator in a swine model.
Spinal cord stimulators (SCS) have been used for many years to treat a myriad of chronic pain conditions using electrical signals to diminish the perception of a painful stimulus. Because of the electrical nature of the devices, there is a concern about the potential for electromagnetic interaction between the device and lifesaving cardiac implantable cardioverters-defibrillators (ICVD). ⋯ This study clearly demonstrated the feasibility of the 2 devices coexisting and functioning appropriately in an animal model using an ICVD and SCS donated by Boston Scientific. Further studies are needed to elucidate restrictions, optimal settings and parameters in a human setting.
-
Neuropathic pain induction by nerve injury has been shown by in vitro studies to be accompanied by synaptic strengthening in the anterior cingulate cortex (ACC) and has been shown by pharmacological studies in vivo to be prevented by blocking N-methyl-D-aspartate (NMDA) receptor-dependent ACC plasticity. These findings indicate that ACC neurons undergo nerve injury-induced synaptic modifications and further raise a new question about neuropathic pain-associated changes in neuronal activity in the ACC in vivo, particularly spontaneous neuronal oscillations - a process believed to be fundamental for many forms of brain function. ⋯ Neuropathic pain is accompanied by the increase in rates of spontaneous oscillations of ACC neurons. This change may be critical for neuropathic pain development, as well as pain hypersensitivity and spontaneous pain in neuropathic pain animals.
-
Letter Case Reports
Serotonin syndrome with perioperative oxycodone and pregabalin.