Articles: back-pain.
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Rhizolysis has been regarded as a controversial, but safe, procedure for the treatment of back pain. A case of a neuralgia-like pain syndrome resulting from transection of the lateral branches of the lumbar dorsal rami during rhizolysis is reported. The anatomy of the lumbar lateral branches is described, and their vulnerability is discussed. Attention is drawn to the likelihood of this complication with the use of rhizolysis in the vicinity of cutaneous branches of the dorsal rami
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A series of 40 young patients with lumbar spondylolisthesis is presented. The patients were treated surgically using osteoperiosteal transplants as the fusion material. In 29 patients, the fusion was posterior and in 11 patients posterolateral. ⋯ The best results were obtained using posterior fusion, while the rate of nonunion was higher in the posterolateral group. The periosteum was taken from the anteromedial aspect of the tibia using a sharp chisel. The method gives clinical and radiological results comparable with those obtained using bone transplants.
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Fluoroscopically controlled intra-articular facet joint block is a reliable method of diagnosing low back pain and sciatica caused by lumbar facet arthropathy. Of 20 patients studied, 13 had complete and immediate relief of pain, confirming the diagnosis, Six patients have been free of pain for more than six months following a single facet joint block with injection of a local anesthetic and corticosteroid suspension. Preliminary findings suggest that computed tomography has an important role in diagnosing symptomatic facet arthropathy.
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Lumbar facet arthropathy is an important cause of low back pain and sciatica. Intra-articular facet block can confirm symptomatic facet joint disease. Good understanding of the anatomy of the joint and fluoroscopic control are essential for intra-articular placement of anesthetics and steroids.