Articles: chronic-pain.
-
The sacroiliac joint is an accepted source of low back pain with or without associated lower extremity symptoms. The diagnosis and management of sacroiliac joint pain and the role of interventional techniques have been controversial. ⋯ The evidence for the specificity and validity of diagnostic sacroiliac joint injections was moderate.The evidence for therapeutic intraarticular sacroiliac joint injections was limited to moderate. The evidence for radiofrequency neurotomy in managing chronic sacroiliac joint pain was limited.
-
We present here a descriptive article on the development of a national quality system for neuromodulatory techniques in the Netherlands. In 1994, due to reimbursement difficulties in the Netherlands, a Neuromodulation Working Group (WGN) undertook an initiative to develop a national quality system for neuromodulation. It was believed that with official recognition of neuromodulation as a therapy by the health authorities in the Netherlands, a quality system for monitoring would then follow. ⋯ We therefore conclude that developed quality systems can provide a basis for medical specialists to cooperate around groups of patients or diseases. These quality systems can facilitate implementation and innovation within the health care system. The role of medical specialists and their will to cooperate is essential.
-
Introduction. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) and of the pars interna of Globus Pallidus (GPi) is used to improve parkinsonian symptoms and attenuate levodopa-induced motor complications in Parkinson's disease (PD) (DBS for PD study group, 2001). It is still not clear what the best anatomic structures to stimulate are or what the physiologic effects of DBS are. ⋯ Most patients remained were chronically treated with bilateral stimulation of both targets. Conclusion. We conclude that DBS of STN and GPi was effective, with most patients treated chronically with both targets stimulated.
-
The objective of this study was to objectively assess the physical activity of daily living in chronic pain patients treated with spinal cord stimulation (SCS). Changes in pain and spontaneous physical activity following SCS were evaluated under real life conditions. Five series of measurements were performed before the implant (baseline) and at one, three, six, and 12 months after the implantation of an SCS system. ⋯ The average total walking distance increased up to 389% at 12 months, reaching statistical significance (p < 0.05) after three months. The stride length and the speed increased (p < 0.01) at all times. We conclude that the reduction in pain intensity due to SCS is associated with a progressive and sustained improvement in physical activity. j.
-
Percutaneous epidural adhesiolysis and spinal endoscopic adhesiolysis are interventional pain management techniques that play an active role in managing chronic intractable low back pain. There have not been any systematic reviews performed on this subject. ⋯ The evidence of effectiveness of percutaneous adhesiolysis with administration of hypertonic sodium chloride administration, and spinal endoscopic adhesiolysis with epidural steroid administration in managing chronic, refractory low back and lower extremity pain of post lumbar laminectomy syndrome or epidural fibrosis was moderate to strong.