Articles: back-pain.
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La Tunisie médicale · Nov 2004
Case Reports Comparative Study[Chronic-contained ruptured aortic aneurysm: un unusual cause of back pain].
Chronic contained rupture of abdominal aortic aneurysm is a rare event which can cause diagnostic difficulties. It can present as a chronic back pain and the delayed diagnosis and delayed surgical repair may compromise the final results. ⋯ We report a case of contained rupture of a small abdominal aortic aneurysm with delayed diagnosis, evaluated by computed tomography showing a beginning erosion of the lumbar vertebral body. The patient was operated on within 24 hours on admission with uneventful surgical outcome.
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Comparative Study Clinical Trial
Factors predicting pain reduction in chronic back and neck pain after multimodal treatment.
To determine whether treatment related pain reduction on the short- and long-term is predicted by different baseline variables, and with different accuracy, in patients with chronic low back pain as compared with those with chronic neck pain. ⋯ Patients who reported unchanged or increased pain after multimodal treatment could be predicted with good accuracy, whereas those who reported decreased pain were more difficult to identify. Treatment-related pain alteration in chronic low back pain seems to be predicted by partly different variables than in chronic neck pain.
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In the last 2 years, we have examined 9640 patients experiencing back pain or sciatica, using MRI. There were 13 (0.13%) patients who had radicular symptoms that clinically mimicked lumbar disc herniation or spinal stenosis. All of these patients had inferior vena caval obstruction or occlusion that caused engorgement in the epidural and paravertebral venous system, causing nerve root compression. ⋯ The authors believe that epidural venous engorgement should be considered when the symptoms of patients with deep venous and inferior vena cava thrombosis are accompanied by radicular and/or back pain, because pathologic processes compressing a nerve root can cause pain.
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The aim of this study is to give a short overview about the innervation of the intervertebral disc and the nerve connections between the somatosensible and autonomous nervous systems in the paravertebral region. ⋯ The neuroanatomical basis of discogenic pain can be summarised as follows: 1. The intervertebral disc receives an extensive innervation, especially the annulus fibrosus. 2. Nerve extension was found into the nucleus pulposus of the degenerated disc. 3. The sinuvertebral nerve plexuses facilitate a polysegmental signal and pain spreading. 4. The innervation of the intervertebral disc is very high connected with the paravertebral muscles. 5. A local denervation of the paravertebral muscles was found in post-discotomy syndrome.
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Lumbar facet (zygapophysial) joints have been implicated as the source of chronic pain in 15% to 45% of patients with chronic low back pain. Diagnosis may be confounded by false-positive results with a single diagnostic block and administration of anxiolytics and narcotics prior to or during the diagnostic facet joint blocks. ⋯ The administration of sedation with midazolam or fentanyl is a confounding factor in the diagnosis of lumbar facet joint pain in patients with chronic low back pain. However, this study suggests that if strict criteria including pain relief and ability to perform prior painful movements is used as the standard for evaluating the effect of controlled local anesthetic blocks, the diagnostic validity of lumbar facet joint nerve blocks may be preserved.