Articles: back-pain.
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Case Reports
SynchroMed II intrathecal pump memory errors due to repeated magnetic resonance imaging.
Cancer patients with severe refractory pain are often managed with implantable drug delivery systems (IDDS). The only drugs with US Food and Drug Administration approval for intrathecal use are morphine, ziconotide, and baclofen. Other drugs used and mixed include, hydromorphone, bupivacaine, sufentanil, and fentanyl. ⋯ The second time, 29 months later, the patient was admitted to the hospital to manage withdrawal symptoms and the pump had to be exchanged with a new device. Post-MRI pump interrogation should be performed on all patients with IDDS to ensure proper functioning of the pump. Special attention should be paid to patients receiving baclofen, as acute withdrawal can be very serious, even deadly.
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[Immediate analgesic effect of electroacupuncture and its regulation mechanism via spinal p-ERK1/2].
To observe influence of electroacupuncture (EA) on phosphorylation of extracellular signal-regulated kinases 1/2 (ERK1/2) in spinal cord dorsal horn (SCDH) in rats with acute inflammatory pain induced by complete Freund's adjuvant (CFA), further elucidate the immediate analgesic mechanism of EA via cellular signal transduction. ⋯ Inhibiting ERK1/2 activation of SCDH may be one of the pivotal mechanism of cellular signal transduction of the immediate analgesic effect educed by EA.
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J Spinal Disord Tech · Oct 2012
Cost effectiveness analysis of graft options in spinal fusion surgery using a Markov model.
Statistical decision model. ⋯ RhBMP is the most cost-effective graft option for L4-L5 fusion for degenerative spondylolisthesis largely due to the reduced rate of revision spine surgery. The increased upfront cost and list of complications associated with RhBMP is offset by the reduced rate of revision surgery.
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Int J Obstet Anesth · Oct 2012
Case ReportsEpidural lipomatosis causing new debilitating back pain in a patient with human immunodeficiency virus on highly active antiretroviral therapy.
Spinal epidural lipomatosis is a rare condition of adipose tissue hypertrophy in the epidural space. Through nerve root and spinal canal compression, it may lead to both sensory and motor compromise. Chronic steroid use, obesity and other metabolic derangements are known causes of spinal epidural lipomatosis. ⋯ Epidural lipomatosis was diagnosed by magnetic resonance imaging. Given her evolving symptoms, neuraxial anesthesia was considered to be contraindicated. We present her management and labor course.