Pain physician
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Observational Study
Clinical Observation of CT-Guided Intervertebral Foramen Puncture and Radiofrequency Thermocoagulation for the Treatment of Refractory PHN in the Superior Thoracic Segment.
Post-herpetic neuralgia (PHN) is a typical neuropathic pain. Conventional oral analgesics and nerve block therapy can only obtain temporary analgesia in many cases. This study summarized the clinical effect of CT-Guided intervertebral foramen puncture and radiofrequency thermocoagulation through the superior margin of costotransverse joint for the treatment of refractory PHN in the superior thoracic segment. ⋯ CT-Guided intervertebral foramen puncture and RFT through the superior margin of the costotransverse joint can effectively improve refractory PHN in the superior thoracic segment with good safety.
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Observational Study
Correlation Between Electromyography and Severity and Prognosis of Upper Limb Herpes Zoster.
There are differences in the clinical treatment schemes for patients with different severities of herpes zoster (HZ). Therefore, effective and accurate evaluation of disease severity is of great significance for the formulation of treatment plans. Postherpetic neuralgia (PHN) with long-term chronic pain leads to anxiety, depression, and even suicidal thoughts, which place a heavy burden on society and the family. Therefore, identifying risk factors and taking early intervention to reduce the occurrence of PHN is meaningful. Electromyography (EMG) can provide technical support for the early diagnosis of peripheral neuropathy. However, the application of EMG in HZ and PHN has rarely been reported. The purpose of this study was to compare the detection indices of EMG in patients with different severities and prognoses of HZ and to analyze the application of EMG in severity and prognosis of HZ. ⋯ The CMAP and SNAP amplitudes of the median nerve on the affected limb were related to the degree of pain in patients with upper limb HZ. The CMAP and SNAP amplitudes of the median nerve on the affected limb can be used as prognostic factors for patients with upper limb HZ, and CMAP amplitude combined with SNAP amplitude is more valuable in predicting prognosis.
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Observational Study
Comparison of the Effects of Lumbar Spine Flexion on the Acoustic Windows Between Young and Elderly Patients.
The effects of lumbar flexion on posterior longitudinal ligament (PLL) length as an acoustic window for neuraxial block in older patients have not been fully elucidated. ⋯ Lumbar spine flexion can increase PLL length in young and old patients. However, lumbar spine flexion is less effective in increasing the PLL length in old patients than in young patients.
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Symptomatic herniated intervertebral discs are debilitating. However, surgical management poses a significant challenge for endoscopic spine surgeons, especially in high-grade migrated lesions. ⋯ Computed tomography-navigated percutaneous endoscopic surgery is safe and effective for lumbar disc herniation with high-grade migration, and enhance early functional recovery even compared with conventional fluoroscopic guidance.
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Randomized Controlled Trial
The Effect of Erector Spinae Plane Block With and Without Addition of Magnesium on Relief of Pain from Post-herpetic Neuralgia.
The best tool for management of postherpetic neuralgia (PHN) is a matter of debate. The use of ultrasound-guided erector spinae plane block (ESPB) in patients with PHN may decrease pain severity and the need for analgesics. ⋯ ESPB with or without adding magnesium sulphate is an effective pain management tool for cases of PHN. It leads to a significant decrease in pain score and analgesic requirements.