Articles: back-pain.
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Clinical Trial
Stimulation of the L2-L3 Dorsal Root Ganglia Induces Effective Pain Relief in the Low Back.
Chronic low back pain affects millions of people worldwide and can arise through a variety of clinical origins. In the case of failed back surgery syndrome (FBSS), previous surgical procedures can contribute to low back pain that is often unresponsive to intervention. Although spinal cord stimulation (SCS) can be an effective treatment modality, it does not provide sufficient pain relief for some intractable cases. Recently, alternative neuromodulation options have been developed, including dorsal root ganglion (DRG) stimulation. The objective of this report is to further investigate these clinical observations. ⋯ For the studied population, DRG stimulation at the L2-L3 levels was effective at relieving low back pain. These reductions in pain were associated with improvements in quality of life. Thus, DRG stimulation at these levels may be effective for low back pain by recruiting both segmental and nonsegmental neural pathways that are not otherwise accessible via traditional SCS.
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Worldviews Evid Based Nurs · Feb 2018
Randomized Controlled TrialA Comparison of the Incidence of Post-Dural Puncture Headache and Backache After Spinal Anesthesia: A Pragmatic Randomized Controlled Trial.
Although bed rest is recommended after spinal anesthesia to prevent the occurrence of post-dural puncture headache, current literature suggests that periods of bed rest did not prevent headache as well as increase the risk of other complications such as backache. However, information is scarce regarding an appropriate period of bed rest following a dural puncture. ⋯ Bed rest after spinal anesthesia did not prevent the occurrence of headache and increased the incidence of patients experiencing a backache and, therefore, is not recommended. The findings provide information for establishing evidence-based nursing practices for patients after a dural puncture.
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The study's aim was to address three fundamental questions related to pregnancy and adolescent idiopathic scoliosis (AIS), and provide clinically applicable answers to spine specialists and general practitioners alike. ⋯ Women with AIS experience slightly elevated rates of nulliparity, infertility treatment, prepartum back pain, and peripartum curve progression. However, most women are able to have children and are not at increased risk of pregnancy-related complications. Higher quality evidence is needed to better define these relationships and allow more guided counseling and treatment.
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The causes of chronic diskogenic back pain have not yet been clearly identified. Neural ingrowth around the annulus is widely considered to be one of the possible cause. However, neuropathy around the annulus has yet to be observed visually. We report a case of a hotspot that was observed in an epiduroscopic view, but not in imaging findings. ⋯ In this study, we observed annulus hotspots, which have not been observed in imaging studies such as computed tomography or magnetic resonance imaging in patients with chronic back pain and leg pain, and observed remarkable symptom improvement after transforaminal epiduroscopic laser ablation.
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Review Case Reports
Delayed traumatic aortic pseudoaneurysm formation causing vertebral body erosion and back pain: case report and literature review.
Aortic pseudoaneurysms are a rare cause of chronic back pain, usually resulting from compression of the adjacent neurovasculature. It is uncommon for patients with pseudoaneurysms of the abdominal aorta to present in a delayed fashion after initial traumatic injury. ⋯ In our patient, a combined surgical and endovascular (hybrid) approach led to the complete resolution of his back pain symptoms and to complete exclusion of the pseudoaneurysm on follow-up imaging. Endovascular management of aortic pseudoaneurysms may be a reasonable alternative to open surgery in high-risk patients; however, this approach may result in a higher recurrence of pseudoaneurysm and initial presenting symptoms. Further investigation is needed to elucidate the efficacy of endovascular treatment of these lesions.