Pain practice : the official journal of World Institute of Pain
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A CSF leak that persists despite conservative therapy may significantly increase the morbidity associated with implantable intrathecal drug delivery systems. This report presents 2 cases where the application of a subdural blood patch led to the satisfactory resolution of a persistent CSF leak after previous epidural blood patches had failed.
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Evaluation of the age related prevalence of persistent low back pain has been estimated to be consistently higher in the elderly compared to the younger population. Facet joints have been shown to be the cause of chronic low back pain in 15% to 45% of the patients in controlled studies. Prevalence of facet joint mediated pain has not been studied in the elderly. ⋯ Facet joints were investigated with diagnostic blocks initially using lidocaine 1% followed by bupivacaine 0.25%, usually 2 weeks apart. The prevalence of facet joint mediated pain was determined to be 30% in the adults and 52% in the elderly, which was significantly higher with a false positive rate of 26% in adults and 33% in the elderly. In conclusion, the results of this study show that facet joint mediated pain is a significant problem in all patients suffering with chronic low back pain with the prevalence of 52% in the elderly and 30% in adults.