Articles: back-pain.
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Clinical Trial
Intradiscal high-voltage, long-duration pulsed radiofrequency for discogenic pain: a preliminary report.
Intradiscal radiofrequency, with the electrode placed in the center of the nucleus pulposus, has been a controversial procedure in patients with discogenic pain. Possibly the effect has not been due to the production of heat, but to exposure to electric fields. ⋯ There was a very significant fall in the NRS scores over the first 3 months (P < 0.0001). On an individual basis, all patients had a fall of the NRS score of at least 4 points at the 3-month follow-up. A follow-up of 12.8 months (range 6-25, median 9) was available for five patients. All these patients are now pain free, except for one patient with an NRS score of 2. Conclusion. It is concluded that this method merits a controlled, prospective study.
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To report our data of cases of failed back surgery syndrome (FBSS) and surgical and nonsurgical etiologies. ⋯ The failure of back surgery remains a challenge for the surgeons. There is an incessant search for the causes and the action mechanisms of this syndrome and the best method of treatment.
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Failed back surgery syndrome is a common problem with enormous costs to patients, insurers, and society. The etiology of failed back surgery can be poor patient selection, incorrect diagnosis, suboptimal selection of surgery, poor technique, failure to achieve surgical goals, and/or recurrent pathology. ⋯ The diagnostic evaluation should endeavor to accurately identify symptoms, rule out extraspinal causes, identify a specific spinal etiology, and assess the psychological state of the patient. Only after these factors have been assessed can further treatment be planned.
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Equipments for epiduroscopy consist of an epidural endoscope, video camera system, video screen, recording system and C arm X-ray system. Epidural endoscope with a diameter of 0.9 mm is inserted from the hiatus sacralis, and has been used clinically for the observation of epidural space of a lumbar vertebrae level since 1996. There are still some problems to be solved in the epiduroscope development, but its dramatic pain reduction effect has been recognized and it has been held as an attractive diagnostic tool.
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Vertebral compression fractures (VCFs) result in severe and disabling pain, diminished quality of life, and substantial medical costs. There exists no standard instrument with which to measure pain and functional status before and after treatment of VCFs. ⋯ The Vertebral Compression Fracture Pain and Functional Disability Questionnaire appears to be a reliable and valid instrument for assessing back pain and functional ability in patients before and after treatment for VCFs.