Articles: back-pain.
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Epidural steroid injections have been used for decades as part of a rehabilitation program to relieve back or neck pain and the associated radicular nerve component that often accompanies these problems. These injections are minimally invasive and offer many patients substantial relief without the need for more invasive procedures. Although effective and generally simple, they must be performed accurately and properly for maximum benefit and complication avoidance. This article discusses the various technical aspects of the procedure that must be observed by the operator to accomplish these ends.
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Retrospective study. ⋯ Hemilaminectomy or laminectomy remains one of the mainstay surgical treatments for symptomatic intraspinal synovial cysts. Our experience shows that the majority of patients undergoing decompression/excision of synovial cysts will have immediate improvement in back and leg pain. However, within 2 years, patients receiving hemilaminectomy or laminectomy alone have an increased incidence of back pain and cyst recurrence. Decompression with instrumented fusion appears to be associated with the lowest incidences of cyst recurrence or back pain.
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Pain that develops in the cervical, thoracic, lumbar, and sacral spine is typically initiated from a clinical condition called spondylosis. Radiofrequency ablation is a key element in the treatment protocol of patients with spondylosis of the cervical, thoracic, lumbar, and sacroiliac joint pain. ⋯ Radiofrequency neurolysis is a common technique used in the treatment of chronic pain, particularly facet (zygapophyseal joint) arthralgia. The technique involves an insulated needlelike cannula; x-rays passing through the patient show the projected relative radioopaque bony landmarks and the metallic cannula.
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Case Reports
[Necrotizing fasciitis after "banal" back pain. An unusual course of a retrocoecal appendicitis and its sequellae].
Necrotizing fasciitis is a life-threatening disease which can only be successfully treated by an interdisciplinary team. An immediate and radical debridement with opening of all compartments and debridement of the affected fascia is the basis for a successful therapy. We report about the treatment of a 21-year-old man who was taken to hospital due to "banal" back pain which was caused by a perforated appendicitis. In only 2 days necrotizing fasciitis developed which spread out over the complete right leg.