Articles: chronic-pain.
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Background. Previous reports have indicated that ketamine anesthesia may produce significant improvement if not complete recovery of patients with complex regional pain syndrome (CRPS). Aims. ⋯ The observed changes in brain response to evoked stimuli provide a readout for the subjective response. Conclusion. Future studies of brain function in these patients may provide novel insight into brain plasticity in response to this treatment for chronic pain.
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Orthopaedic surgery · Feb 2009
Comparative StudyAnalysis of the relationship between morphology of intervertebral disc and some correlated factors following discography in patients with chronic low back pain.
To evaluate the diagnostic effectiveness of discography in discogenic low back pain (LBP). ⋯ (i) Compared with the younger patients, older LBP patients have a lower positive rate of discography despite the presence of more serious degenerative disc changes; (ii) outer layer disruption of the annulus fibrous correlates with positive discography; (iii) MRI intensity changes are not specific in diagnosing discogenic pain. Additional discography is needed to identify the painful disc; and (iv) the contrast volume injected into discs can be affected by a variety of factors which restrict its diagnostic value.
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Objective. This study aims to evaluate the usefulness of peripheral nerve stimulation as a treatment option for patients with chronic low back pain. Materials and Methods. More than 12 months, we collected data on consecutive patients who had successful trials and were subsequently implanted with octrode percutaneous leads placed subcutaneously within the major area of pain. Eleven patients met diagnostic criteria for failed back surgery syndrome. ⋯ Pain relief was highly correlated with reduced analgesia and patient satisfaction. No complications were reported. Conclusion. This study demonstrates a treatment option that is safe, nonpharmacologic, reversible, and effective for patients with chronic low back pain that have exhausted other treatment options.
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Objective. This study aims to assess peripheral nerve field stimulation as a treatment option for chronic pain and test for indicators of outcome. Materials and Methods. We reviewed all patients permanently implanted with peripheral nerve field stimulators over the past 24 months. A questionnaire was used to assess outcomes. ⋯ Most patients reported decreases in analgesic use after treatment. Pain relief was significantly and highly correlated with reduced analgesic intake and patient satisfaction. Conclusion. Peripheral nerve field stimulation is a safe, reversible, and effective treatment option for patients with chronic pain, particularly those under 60 years.