Articles: back-pain.
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In current medical literature, most reported complications during spinal cord stimulation (SCS) concern technical problems, such as malfunction, migration or breakage of the lead, or internal pulse generator dysfunction, while reports about side-effects caused by SCS are rare. In this clinical report, we describe uncommon and unexplained gastrointestinal (GI) side-effects of constipation, abdominal pain, and distension during SCS in a patient suffering for chronic neuropathic pain caused by failed back surgery syndrome. These GI symptoms disappeared after suspension of SCS and were reduced if the stimulation settings were reduced below paresthesia threshold. The symptoms experienced by our patient could be related to a functional and reversible block of parasympathetic outflow in the GI system since SCS may involve not only dorsal horn structures but also somatic and visceral sensory afferents to these structures in an unpredictable way.
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The history of the use of electrical stimulation for pain is a cavalcade of research and innovation of many great scholars, scientists, and physicians over centuries that continues up to the present day. The legacy of this philosophy, research, and innovation is the field of neuromodulation for pain control. Today, patients with chronic pain from damage to the nervous system and chronic pain of the extremities, the axial low back, and neck, the face, and the viscera, all derive benefit from these early pioneers that have led to the expanding field of neuromodulation ... "on the shoulders of giants." We present here a history of the understandings of pain from the ancients to the present, which has led to our understandings of the use of electricity to cure disease and release patients from their suffering, generating the new, exciting, and expanding field of neuromodulation.
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Randomized Controlled Trial Comparative Study
[Desire for early retirement and therapy of chronic back pain: relevance of social medical variables for outpatient psychotherapeutic treatment].
This study investigated the influence of patients' desire for early retirement on the success of an outpatient cognitive behavioural treatment (CBT) in patients with chronic back pain. Previous studies have shown that the desire for early retirement and social compensation had a negative influence on therapy outcome, e.g. pain intensity and pain disability. This study was conducted to reassess whether these results can be replicated in an outpatient CBT setting. ⋯ CBT in an outpatient setting seems to be an effective treatment for patients with chronic back pain and even patients with a desire for early retirement benefit from treatment.
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Clinical Trial
Total disc replacement in the treatment of lumbar discogenic pain with disc herniation: a prospective clinical study.
Biomechanical benefits of Total Disc Replacement (TDR) including both the restoration of normal segmental range of motion and the prevention of physiological lumbar lordosis encourage spine surgeons to perform TDR for lumbar disc disease. ⋯ Results from this series are promising and indicate that placement of TDR for degenerative disc disease with lumbar disc herniation is a valuable alternative to conventional techniques. The main advantages of this application are preservation of spinal stability, early mobilization, restoration of normal segmental range of motion and elimination of problems related to intervertebral disc tissue such as discogenic pain and recurrence of disc herniation.