Articles: back-pain.
-
Pain of spinal origin contributes significantly to cervical, thoracic, and lower back pain presentations. Such pain originates in the nerve fibers supplying the joints or the surrounding ligaments and intervertebral discs. Although there has been little detailed discussion of spinal bony innervation patterns in the literature, the clinical implications of these patterns are anatomically and medically significant. ⋯ The clinical implications of these various studies lie in the importance of the innervation patterns for the mechanism of spinal pain. Immunohistochemical studies have provided further evidence regarding the nature of the innervation of the spine.
-
A cross-sectional survey. ⋯ 2.
-
Since the percutaneous posterolateral approach in treating lumbar disc herniation was introduced in 1973, percutaneous endoscopic lumbar discectomy (PELD) has become a routine minimally invasive spinal procedure. However, as clinical evidence accumulated, several complications of PELD have raised our concerns, including the intraoperative injury to neural, vascular structures and failure of surgery. Herein, we present 2 patients who experienced guidewire breakage during PELD procedure to demonstrate the details. ⋯ In conclusion, the guidewire breakage in PELD procedures is a rare but severe complication, which requires immediate removal. An appropriate manner and fluoroscopic control are recommended to forestall such problems. It is.
-
Pain can be modulated by contextual stimuli, such as emotions, social factors, or specific bodily perceptions. We presented painful laser stimuli together with body-related masochistic visual stimuli to persons with and without preferred masochistic sexual behavior and used neutral, positive, and negative pictures with and without painful stimuli as control. Masochists reported substantially reduced pain intensity and unpleasantness in the masochistic context compared with controls but had unaltered pain perception in the other conditions. ⋯ Masochists additionally showed negative correlations between the duration of interest in masochistic activities and activation of areas involved in motor activity and affective processing. We propose that the parietal operculum serves as an important relay station that attenuates the affective-motivational aspects of pain in masochists. This novel mechanism of pain modulation might be related to multisensory integration and has important implications for the assessment and treatment of pain.
-
Observational Study
Prevalence of spinal pathology in patients presenting for lumbar MRI as referred from general practice.
The use of magnetic resonance imaging (MRI) as initial imaging for back pain has increased in general practice. However, few data are available on the characteristics of these referred patients. The objective of this study was to describe the baseline characteristics and MRI findings of patients presenting for a lumbar MRI examination as referred by their GP. ⋯ Almost all patients presenting for a lumbar MRI examination as referred by their GP had abnormal MRI findings. In total, 55% of the patients reported persistent sciatica in which imaging is recommended according to international guidelines.